The family physician's role in adolescent idiopathic scoliosis.
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Adolescent↗
Biomedical subjects
C G DiGuiseppi
Publications and source records attributed to C G DiGuiseppi.
Developing evidence-based clinical practice guidelines: lessons learned by the US Preventive Services Task Force.
The US Preventive Services Task Force is an expert panel established by the federal government in 1984 to develop evidence-based practice guidelines on screening tests and other preventive services. Its recommendations are published elsewhere. This article explores the lessons learned in the process of developing and disseminating the recommendations. Topics include project organization (analytic philosophy, project sponsorship, panel composition, topic selection); the review of evidence (selecting outcome measures for judging effectiveness, constructing "causal pathways," searching the literature, rating the evidence, synthesizing the results); crafting recommendations (extrapolation, assessing magnitude, balancing risks and benefits, addressing costs, dealing with insufficient data, separating science from policy); peer review; collaboration with other groups; evaluating impact on clinicians' knowledge, attitudes, and behavior; updating recommendations; and defining a research agenda. The lessons learned suggest potential refinements in the future work of the task force and other groups engaged in guideline development.
Diffusion of Innovation↗
Attitudes toward bicycle helmet ownership and use by school-age children.
To identify attitudes toward bicycle helmet ownership and use, questionnaires were sent to parents of 2178 third-graders; 1057 (48.5%) returned valid responses. Of 931 children who had bicycles, 24% owned helmets, but only 56% of children who owned helmets wore them. Helmet ownership, but not use, was associated with higher parental education. Fifty-one percent of 704 parents of bicycle owners who had not purchased helmets said they had never thought of it, 29% thought helmets were too costly, and 20% felt their children would not wear them. Of 792 children who did not wear helmets, 25% said they did not wear them because their friends did not; 22% never thought about wearing helmets; and 16% found them uncomfortable. Efforts to increase the wearing of helmets should address helmet design, awareness, peer pressure, and cost.
Attitude to Health↗
Bicycle helmet use by children. Evaluation of a community-wide helmet campaign.
To assess the effect of a community-wide bicycle helmet campaign on helmet use, we observed 9827 children riding bicycles at sites in high-, middle-, and low-income census tracts in Seattle, Wash (intervention city), and Portland, Ore (control city); observations were made during 2-week intervals before and 4, 12, and 16 months after the campaign's start. Helmet use increased from 5.5% before the campaign to 15.7% afterward in Seattle and from 1.0% to 2.9% in Portland. Strong associations were found between helmet use and white compared with black or other race; riding geared vs nongeared bicycles; riding at playgrounds, in parks, or on bicycle paths vs on city streets; and riding with adults or other children compared with riding alone. The proportions of helmet wearers, adjusted for these variables, increased from 4.6% to 14.0% in Seattle and from 1.0% to 3.6% in Portland, a significantly greater increase in use in Seattle compared with Portland. We conclude that a community-wide bicycle helmet campaign can increase helmet use among children.
Adolescent↗