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Biomedical subjects

B L Wright

Publications and source records attributed to B L Wright.

13 recordsLinked to original sources
PubMed1995

Identifying depressive symptoms among elderly Medicare HMO enrollees.

Increasing attention has been devoted to the urgent need for identifying depressive symptomatology at the primary care point of contact for older individuals to prevent more serious disease and potential negative behavioral outcomes. Delivering medical care services in a system that is sensitive to the symptoms of depression may lead to greater cost-effectiveness and improved quality of life. This paper examines the correlates of depression in a random sample of 1800 Medicare beneficiaries enrolled in a risk-sharing HMO. Ten percent of the total sample reported a high degree of depressive symptoms, as measured by the CES-D score. The prevalence of depressive symptoms was significantly higher for those who were not married, reported less well-developed social support networks, had low perceived ability to control future health, or had poorer health status. Depressive symptoms were also associated with a greater number of physician office visits and higher ambulatory charges, although no significant relationship was found for inpatient use or total charges. Practical approaches to monitoring depressive symptomatology at the primary care level in an HMO are suggested.

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PubMed1994

Changes in health behaviors of older adults: the San Diego Medicare Preventive Health Project.

BACKGROUND: This study presents behavioral outcomes at 1-year follow-up from a preventive services intervention trial with Medicare beneficiaries. METHODS: The health promotion package consisted of goal setting and counseling based on a health risk appraisal and a series of eight educational sessions. All subjects completed a health risk appraisal questionnaire immediately prior to the intervention and 1 year later; this served as the dependent measure. RESULTS: Results indicated that there were significant, positive changes in intervention subjects in activity level and selected nutrition behaviors relative to control subjects. The strengths and weaknesses of a broad-based approach to intervention are discussed.

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PubMed1994

Item non-response to lifestyle assessment in an elderly cohort.

BACKGROUND: Greater attention is being paid to data quality in surveys of older age groups. In this paper patterns of item non-response are examined in a health risk appraisal instrument administered to an elderly cohort participating in a randomized preventive intervention study. METHODS: The association between demographic and health status factors with the number of non-responses out of 174 items was examined at baseline and at the 12-month follow-up on 1791 subjects. RESULTS: Overall, non-response decreased from baseline to 12 months. The pattern was consistent across the seven major components of the questionnaire. Univariate analyses at baseline found that item non-response increased significantly (P < 0.05) with age, being female, being unmarried, lower annual income, less education, and poorer personal health ranking. Polychotomous logistic regression identified age and personal health ranking as statistically significant at both baseline and 12-month follow-up assessments after controlling for all other factors. In addition, education was significant at baseline. CONCLUSIONS: These results help to identify subgroups of elderly participants who contribute to non-random patterns of missing data.

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PubMed1992

Breast and cervical cancer screening in older women: the San Diego Medicare Preventive Health Project.

BACKGROUND. This study presents rates and correlates of cancer screening, including mammography, clinical breast exam, breast self-examination, and Pap tests, in older women. Age was the predictor of main interest. RESULTS. Among a sample of female Medicare beneficiaries ages 65 and older, who were members of a health maintenance organization, there was a significant, inverse relationship between age and mammography adherence, while controlling for health status, physician utilization, education, and income. The proportions of subjects ages 65-74 and 75+ never having had a mammogram were 17 and 32%, respectively, and the proportions having had annual mammograms were 40 and 28%, respectively. Pap test frequency showed a trend toward an inverse relationship with age, controlling for demographic and health-related variables. In the youngest age group (65-69), 52% had annual Pap tests, whereas in the oldest group (80+), only 36% had annual Pap tests. Age did not predict frequency of clinical breast exam, and the relationship of age to breast self-examination was inconclusive. The role of the physician in promoting cancer screening is discussed.

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PubMed1992

Compliance with a 12-month assessment in an elderly cohort participating in a preventive intervention study: the San Diego Medicare Preventive Health Project.

Non-compliance in long-term cohort studies contributes to bias in the estimation of study parameters and loss of power in hypothesis testing. This paper identifies baseline factors associated with non-compliance in a 12-month health assessment among elderly participants in the San Diego Medicare Preventive Health Project, a randomized preventive intervention study. A non-complier was defined as a study subject contacted by telephone by study personnel to schedule an appointment for the 12-month health assessment but who would not or could not attend. Of the almost 1600 contacted subjects, 14.1% did not participate in the evaluation. Using logistic regression, non-compliance was found to be associated with older age, intervention group assignment, nonsingle family residence, no alcohol use, and, to a lesser extent, depression. No interactions between group assignment and other baseline factors were detected. These results may be useful in designing cohort maintenance strategies where greater resources may be devoted to participants at higher risk of non-compliance and attrition.

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PubMedDate not supplied

HealthLine--marketing and public education wrapped up in one.

A service which can promote both marketing and public education is especially useful in these highly competitive times, writes Bridget Larsen Wright, M.P.H., et al. HealthLine, an information service for the general public, was developed to promote these areas, and Wright explains how a Southern California clinic implemented the service, and provides some preliminary results.

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PubMedDate not supplied

Longitudinal effects of preventive services on health behaviors among an elderly cohort.

This study examines the longitudinal (48 months) effects of a preventive services intervention trial with Medicare beneficiaries. The health promotion intervention incorporated a series of workshops and targeted individualized counseling dealing primarily with nutrition and exercise. All subjects completed a health risk appraisal (HRA) questionnaire, which served as a dependent measure. Results show significant, positive changes in intervention subjects in two activity outcomes, aerobic activity and stretching exercises. Although previous research on this cohort found significant positive changes in nutrition behaviors at 12-month follow-up, these differences were not sustained over the three-year follow-up period. The results offer encouragement that continued research on health promotion will eventually produce protocols for select activities that will improve the status of seniors' health.

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