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Biomedical subjects

D Nutbeam

Publications and source records attributed to D Nutbeam.

At least 19 recordsLinked to original sources
PubMed1996

Asthma, health behaviors, social adjustment, and psychosomatic symptoms in adolescence.

The association of health behaviour, indicators of social adjustment, and psychosomatic symptoms with diagnosed asthma was assessed in a community-based sample of 4550 adolescents in South Western Sydney, Australia. The results of this survey found an asthma prevalence among 11-15-year-olds of 17.5%, being consistent with previous studies. Tobacco use and alcohol consumption were higher among asthmatic compared with nonasthmatic adolescents. Asthmatics reported feeling lonely more often, having a number of negative social perceptions and feelings, and having more frequent psychosomatic symptoms. The findings of the study suggest that adolescents with asthma represent an important vulnerable group of school children. Asthma education may need a greater life-style change focus, besides asthma self-management training.

Adolescent↗
PubMed1994

Current changes in smoking attitudes and behaviours among adolescents in Wales, 1986-1992.

This paper presents data on recent trends in adolescent smoking in Wales. The data are drawn from four large-scale surveys conducted across the Principality in 1986, 1988, 1990 and 1992. The results show that there has been some success in delaying early experimentation with smoking, as well as some improvement in the attitudes of smokers towards their habit. Against this, there has been little change in smoking prevalence amongst both boys and girls, and cigarettes remained widely available for purchase by the under-16s. The implications of these findings for further action on smoking and the young are discussed.

Adolescent↗
PubMed1993

Evaluation of two school smoking education programmes under normal classroom conditions.

OBJECTIVES: To assess the effectiveness of two school based smoking education projects in delaying onset of smoking behaviour and in improving health knowledge, beliefs, and values. DESIGN: Cluster randomised controlled trial of two projects taught under normal classroom conditions. Schools were allocated to one of four groups to receive the family smoking education project (FSE); the smoking and me project (SAM); both projects in sequence (FSE/SAM); or no intervention at all. SETTING: 39 schools in Wales and England matched for size and catchment profile. SUBJECTS: All first year pupils in the schools were included and were assessed on three occasions (4538 before teaching (1988), 3930 immediately after teaching (1989), 3786 at one year follow up (1990)). MAIN OUTCOME MEASURES: Self reported smoking behaviour (backed by saliva sample) and change in relevant health knowledge, beliefs, and values. RESULTS: No consistent significant differences in smoking behaviour, health knowledge, beliefs, or values were found between the four groups. For never smokers at baseline the rate of remaining never smokers in 1990 was 74% (594/804) in the control group, 65% (455/704) in the FSE group, 70% (440/625) in the SAM group, and 69% (549/791) in the FSE/SAM group (chi 2adj = 6.1, df = 3, p = 0.1). Knowledge about effects of smoking rose in all groups from a mean score of 5.4 in 1988 to 6.4 in 1989 and 6.5 in 1990. CONCLUSIONS: More comprehensive interventions than school health education alone will be needed to reduce teenage smoking. Other measures including further restrictions on access to cigarettes and on the promotion of tobacco products need to be considered. Further research will be needed to develop effective school based health education projects, which should be formally field tested under normal conditions before widespread dissemination.

Child↗
PubMed1993

Warning! Schools can damage your health: alienation from school and its impact on health behaviour.

An international study of health behaviour among school-age children was co-ordinated by the World Health Organization (WHO). The data were obtained from a self-completion questionnaire examining key health behaviours and associated psycho-social variables obtained from representative samples of young people in school aged 11.5, 13.5, and 15.5 years. The analysis focuses on the relationship between older (15.5 years) students' attitudes towards school and health behaviours such as regular smoking, alcohol use, physical activity and food choices. The data show a strong and progressive relationship between indicators of 'alienation' from school, and health compromising behaviours among school students from Australia and Wales. This relationship is most obvious with the 'abusive' behaviours of smoking and alcohol misuse. Summary data for nine other countries in the WHO study indicate that this relationship is found consistently across all countries in the study. This substantial minority of students (approximately 30% varying between countries) represents an important target population for efforts to promote healthy lifestyles. Traditional school health education is seen as insufficient to tackle this task and recommendations are made concerning change to the school environment and ethos, and the need to reach young people in their home and community settings.

Adolescent↗
PubMed1993

Maintaining evaluation designs in long term community based health promotion programmes: Heartbeat Wales case study.

STUDY OBJECTIVE: To examine the difficulties of developing and maintaining outcome evaluation designs in long term, community based health promotion programmes. DESIGN: Semistructured interviews of health promotion managers. SETTING: Wales and two reference health regions in England. PARTICIPANTS: Nine health promotion managers in Wales and 18 in England. MEASUREMENTS AND MAIN RESULTS: Information on selected heart health promotion activity undertaken or coordinated by health authorities from 1985-90 was collected. The Heartbeat Wales coronary heart disease prevention programme was set up in 1985, and a research and evaluation strategy was established to complement the intervention. A substantial increase in the budget occurred over the period. In the reference health regions in England this initiative was noted and rapidly taken up, thus compromising their use as control areas. CONCLUSION: Information on large scale, community based health promotion programmes can disseminate quickly and interfere with classic intervention/evaluation control designs through contamination. Alternative experimental designs for assessing the effectiveness of long term intervention programmes need to be considered. These should not rely solely on the use of reference populations, but should balance the measurement of outcome with an assessment of the process of change in communities. The development and use of intervention exposure measures together with well structured and comprehensive process evaluation in both the intervention and reference areas is recommended.

Cardiovascular Diseases↗
PubMed1992

Adolescent drug use in Wales.

As part of a larger survey of health-related behaviours, 2239 15-16-year-olds in Wales provided information on their use of eight different types of drugs. Key findings indicate that just over a fifth of this age group report to having tried drugs at some time, while a tenth say they have done so within the past month. The most frequently reported substances were marijuana, solvents and glue, and psilocybin. Few of the young people reported multiple or regular drug use. The prevalence of drug use was higher for pupils from single parent families, and more boys than girls reported using psilocybin. The reliability and validity of self-report data are discussed, and the implications of the findings for health education programmes considered.

Adolescent↗
PubMed1992

Demographic characteristics and health behaviours of consenters to medical examination. Results from the Welsh Heart Health Survey.

STUDY OBJECTIVE: The aim was to compare the demographic characteristics and health related behaviours of people who consented to a medical examination as part of a population survey with those who did not. STUDY DESIGN: The study formed part of the (1985) Welsh Heart Health Survey, which comprised a three stage design involving household interview, self completion questionnaire, and medical examination. Subjects for medical examination were selected from responders to the questionnaire survey (67%). Sixty six per cent of this group consented to medical examination (n = 11,637). Odds ratio analysis techniques were used to compare consenters and non-consenters. MEASUREMENTS AND MAIN RESULTS: The analysis was based on self reported information available from previously completed questionnaires, and from personal interviews. The study supported the findings of previous research indicating that consenters to medical examination are more likely to be from non-manual social groups, to be aged 25-44 years, to be educated beyond school age, and to be married. Individuals with healthy lifestyle characteristics (diet, physical activity) were overrepresented among consenters. The only exception to this finding was in relation to excessive alcohol consumption. CONCLUSIONS: These findings emphasise the importance of maximising response rates in all forms of social research including surveys with a clinical component. They also have methodological and analytical implications for the Welsh Heart Health Survey.

Adolescent↗
PubMed1991

The prevention of HIV infection from injecting drug use--a review of health promotion approaches.

This review examines the prevention of HIV infection among injecting drug users through the framework provided by the Ottawa Charter on Health Promotion. Among the key issues considered are the problems of achieving the changes in policy and service direction needed to prevent HIV infection. The role of the media in influencing public opinion is examined, together with the potential for traditional educational approaches to achieve safer practices among injecting drug users. The authors conclude that a better integrated and more comprehensive approach to HIV prevention may be needed for substantial progress to occur. A proactive response utilising outreach work is recommended for drug services, and health workers together with drug service professionals are encouraged to act as advocates in gaining public and political support for change.

HIV Infections↗
PubMed1991

Introducing healthy catering practice into hospitals: a case study from Wales.

This paper describes results from a study examining the introduction of policies to promote healthy catering in 102 hospitals in Wales. Policy development and implementation followed the publication of two major reports in the UK highlighting the relationship between poor nutrition and subsequent high levels of cardiovascular disease and cancer. Changes in hospital catering services were advocated in response to these reports. The study examines the translation of policy intentions into practical action in hospitals. It identifies achievements in implementing changes in catering practice, and promotion of healthier meals for staff, patients and visitors to hospitals. Important organisational problems and external constraints, including cost, are also highlighted. The authors recommend that greater effort is put into the implementation process following policy decisions, including consideration of training needs, the development of effective communication, and establishment of mechanisms for feedback and review.

Food Service, Hospital↗
PubMed1991

The lifestyle concept and health education with young people. Results from a WHO international survey.

This article draws upon data from a unique, 11-country study of young people's health behaviour, facilitated by the WHO Regional Office for Europe. Analyses of the data available on individual health behaviours cluster into two groups: (i) health enhancing behaviours; and (ii) health-compromising behaviours. The results were analysed to identify the strength and consistency of these lifestyles across countries. A relatively modest proportion of the variance of the original variables was explained by these two lifestyle factors, but a consistent pattern emerged between countries. This consistency indicates that the health-related lifestyles of young people may not vary greatly between the countries in the study, a finding which might be used as an encouragement for greater international cooperation in the development and use of health education materials for young people, which may be easily transferable between countries. The data also support a more integrated approach to health education based on the promotion of healthy lifestyles, rather than a focus on individual health behaviours.

Adolescent↗
PubMed1990

Modifiable risks for cardiovascular disease among general practitioners in Wales.

A random cluster sample of 520 general practitioners in Wales was invited to complete a postal questionnaire providing information on personal health status, and practice organisation and activities relating to the prevention of cardiovascular disease. Survey participants were also asked to provide a blood sample together with details of independently measured height, weight and blood pressure. 310 (60%) provided usable information and 280 (54%) provided blood samples. General practitioners in the study generally had better lifestyles and fewer coronary risk factors than the general population in Wales. Only 17% (43/251) of males were regular smokers, and 56% (134/239) of males and 32% (18/68) of females regularly take exercise. Few and uncontrolled elevated blood pressure. However, 39% (97/248) of males and 29% (15/52) of female GPs were overweight, and more than 40% (19/42) of male GPs aged 40-64 had cholesterol levels above 6.5 mmol. Six per cent (6/99) of male GPs aged 40-54 consumed greater than 35 units of alcohol each week. It is suggested that GPs have responded well to the challenges of reducing smoking among themselves and their patients, but that they have yet to recognise fully the risks to personal health associated with elevated cholesterol levels and high alcohol consumption.

Adult↗