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Biomedical subjects

E G Eakin

Publications and source records attributed to E G Eakin.

16 recordsLinked to original sources
PubMed2004

Program sustainability of a community-based intervention to prevent falls among older Australians.

Multi-strategy interventions have been demonstrated to prevent falls among older people, but studies have not explored their sustainability. This paper investigates program sustainability of Stay on Your Feet (SOYF), an Australian multi-strategy falls prevention program (1992-1996) that achieved a significant reduction in falls-related hospital admissions. A series of surveys assessed recall, involvement and current falls prevention activities, 5 years post-SOYF, in multiple original SOYF stakeholder groups within the study area [general practitioners (GPs), pharmacists, community health (CH) staff, shire councils (SCs) and access committees (ACs)]. Focus groups explored possible behavioural changes in the target group. Surveys were mailed, except to CH staff and ACs, who participated in guided group sessions and were contacted via the telephone, respectively. Response rates were: GPs, 67% (139/209); pharmacists, 79% (53/67); CH staff, 63% (129/204); SCs, 90% (9/10); ACs, 80% (8/10). There were 73 older people in eight focus groups. Of 117 GPs who were practising during SOYF, 80% recalled SOYF and 74% of these reported an influence on their practice. Of 46 pharmacists operating a business during SOYF, 45% had heard of SOYF and 79% of these reported being 'somewhat' influenced. Of 76 community health staff (59%) in the area at that time, 99% had heard of SOYF and 82% reported involvement. Four SCs retained a SOYF resource, but none thought current activities were related. Seven ACs reported involvement, but no activities were sustained. Thirty-five focus group participants (48%) remembered SOYF and reported a variety of SOYF-initiated behaviour changes. Program sustainability was clearly demonstrated among health practitioners. Further research is required to assess long-term effect sustainability.

Accidental Falls↗
PubMed2001

Physician advice and support for physical activity: results from a national survey.

BACKGROUND: It is increasingly well documented that physical activity (PA) is a key preventive behavior and that visits to a physician provide an important opportunity for advice and counseling. This paper reports on physician counseling behaviors regarding PA and other chronic disease risk factors from a national survey. METHODS: A diverse sample of U.S. adults (N=1818), with oversampling of lower-income households, was surveyed about their PA level as well as a host of social, environmental, and physician counseling issues. RESULTS: Overall, 28% of respondents reported receiving physician advice to increase their PA level. Of those who received advice, only 38% received help formulating a specific activity plan and 42% received follow-up support. Patients who received advice and support were more likely to be older, nonwhite, and to have more chronic illnesses and more contact with their doctor. CONCLUSIONS: Physician advice, counseling, and follow-up are important components of the social-environmental supports needed to increase population PA levels. Health system changes, including teaching communication skills, prompts to use those skills, and system changes to support attention to PA, are needed to extend promotion of PA to more patients.

Adolescent↗
PubMed2001

The diabetes network internet-based physical activity intervention: a randomized pilot study.

OBJECTIVE: Because of other competing priorities, physical activity (PA) is seldom addressed in a consistent way in either primary care or diabetes education. This 8-week pilot study evaluated the short-term benefits of an Internet-based supplement to usual care that focused on providing support for sedentary patients with type 2 diabetes to increase their PA levels. RESEARCH DESIGN AND METHODS: A total of 78 type 2 diabetic patients (53% female, average age 52.3 years) were randomized to the Diabetes Network (D-Net) Active Lives PA Intervention or an Internet information-only condition. The intervention condition received goal-setting and personalized feedback, identified and developed strategies to overcome barriers, received and could post messages to an on-line "personal coach," and were invited to participate in peer group support areas. Key outcomes included minutes of PA per week and depressive symptomatology. RESULTS: There was an overall moderate improvement in PA levels within both intervention and control conditions, but there was no significant improvement in regard to condition effects. There was substantial variability in both site use and outcomes within the intervention and control conditions. Internal analyses revealed that among intervention participants, those who used the site more regularly derived significantly greater benefits, whereas those in the control condition derived no similar benefits with increased program use. CONCLUSIONS: Internet-based self-management interventions for PA and other regimen areas have great potential to enhance the care of diabetes and other chronic conditions. We conclude that greater attention should be focused on methods to sustain involvement with Internet-based intervention health promotion programs over time.

Computer Communication Networks↗
PubMed2000

A brief smoking cessation intervention for women in low-income planned parenthood clinics.

OBJECTIVES: The purpose of this study was to evaluate a brief smoking cessation intervention for women 15 to 35 years of age attending Planned Parenthood clinics. METHODS: Female smokers (n = 1154) were randomly assigned either to advice only or to a brief intervention that involved a 9-minute video, 12 to 15 minutes of behavioral counseling, clinician advice to quit, and follow-up telephone calls. RESULTS: Seventy-six percent of those eligible participated. Results revealed a clear, short-term intervention effect at the 6-week follow-up (7-day self-reported abstinence: 10.2% vs 6.9% for advice only, P < .05) and a more ambiguous effect at 6 months (30-day biochemically validated abstinence: 6.4% vs 3.8%, NS). CONCLUSIONS: This brief, clinic-based intervention appears to be effective in reaching and enhancing cessation among female smokers, a traditionally underserved population.

Adolescent↗
PubMed2000

Review of primary care-based physical activity intervention studies: effectiveness and implications for practice and future research.

OBJECTIVE: To summarize the literature on primary care-based interventions for increasing physical activity and make recommendations for future research and for integrating successful strategies into practice. SEARCH STRATEGIES: We searched MEDLINE (1980 to 1998), psychological abstracts, ERIC and HealthStar databases, the WeB site for The Journal of Family Practice, bibliographies of selected studies, and previous reviews for relevant articles. The search was limited to the English language. Three experts in the field of physical activity were contacted for leads on unpublished trials. SELECTION CRITERIA: Inclusion criteria were: randomized controlled trial or quasiexperimental study using a comparison group, intervention delivered or initiated in a primary care setting, and reported results on at least 1 measure of physical activity. Studies that focused solely on patients with cardiovascular disease were excluded. MAIN RESULTS: Primary care-based physical activity counseling is moderately effective in the short term, although there is considerable variability across studies. Studies in which the interventions were tailored to participant characteristics and which offered written materials to patients produced stronger results. Unlike many types of health promotion, the reach of primary care-based physical activity interventions is high. Questions remain about the consistency of implementation and long-term maintenance of outcomes. CONCLUSIONS: Despite the need for further research, enough is known to recommend integration of key strategies of physical activity counseling into routine practice. We recommend incorporating these strategies into primary care and prioritizing them for further research.

Adolescent↗
PubMed1999

Concern about weight gain associated with quitting smoking: prevalence and association with outcome in a sample of young female smokers.

This study investigated the relationship between weight gain concern and outcomes of a large-scale smoking cessation study among 506 young female smokers attending Planned Parenthood clinics. Results of this prospective study did not support the clinical importance of weight gain concerns. Using an index of weight concern that was predictive in previous research, baseline weight concern was unrelated to smoking cessation efforts, whether participants made a quit attempt, reduced the number of cigarettes they smoked, or reported a change in self-efficacy for stopping smoking. Both the overall level of concern expressed in this sample of predominantly White young women and the lack of relationship between weight gain concern and smoking cessation outcomes suggest that weight gain concern may not be a critical factor for cessation programs targeting similar female smokers.

Adult↗
PubMed1998

Reaching those most in need: participation in a Planned Parenthood smoking cessation program.

We evaluated the representativeness of women approached and enrolled in a brief smoking cessation intervention conducted in Planned Parenthood clinics. In this effectiveness study, regular clinic staff were trained to identify, offer participation, and counsel willing smoking clients as part of their clinic visit. Chart audits were conducted to determine the percent of clients who had smoking status identified, as well as the percent and characteristics of potentially eligible clients who were not approached. Baseline and non-participant questionnaires were analyzed to determine participation rate and characteristics of those participating versus those not participating. Smoking status was documented in 99% of charts. Seventy percent of eligible smokers were approached about study participation and 74% of those approached participated. There were no significant differences between those approached and those not approached or between those who participated versus those who did not on a host of sociodemographic variables. This project was able to approach and attract a representative sample of young, lower income women to participate in a brief, clinic-based smoking cessation program.

Adolescent↗
PubMed1998

Validation of a new dyspnea measure: the UCSD Shortness of Breath Questionnaire. University of California, San Diego.

OBJECTIVE: Evaluate the reliability and validity of a new version of the University of California, San Diego Shortness of Breath Questionnaire (SOBQ), a 24-item measure that assesses self-reported shortness of breath while performing a variety of activities of daily living. DESIGN: PATIENTS enrolled in a pulmonary rehabilitation program were asked to complete the SOBQ, the Quality of Well-Being Scale, the Center for Epidemiologic Studies Depression Scale, and a 6-min walk with modified Borg scale ratings of perceived breathlessness following the walk. SETTING: University medical center pulmonary rehabilitation program. PATIENTS: Thirty-two male subjects and 22 female subjects with a variety of pulmonary diagnoses: COPD (n=28), cystic fibrosis (n=9), and postlung transplant (n=17). MEASUREMENTS AND RESULTS: The current version of the SOBQ was compared with the previous version, the format of which often resulted in a significant number of "not applicable" answers. The results demonstrated that the SOBQ had excellent internal consistency (alpha=0.96). The SOBQ was also significantly correlated with all validity criteria. CONCLUSIONS: The SOBQ is a valuable assessment tool in both clinical practice and research in patients with moderate-to-severe lung disease.

Activities of Daily Living↗
PubMed1997

Quality of life and associated characteristics in a large national sample of adults with diabetes.

OBJECTIVE: This study investigated the quality of life and the demographic, medical-history, and self-management characteristics associated with it. RESEARCH DESIGN AND METHODS: A diabetes self-management survey was sent to 2,800 adults with diabetes throughout the U.S. who were part of a marketing company national sample. The response rate was 73%. The final sample of 2,056 persons was heterogeneous: the average age was 59 years (range, 18-92 years); 53% had high school education or less; 86% had type II diabetes; 62% were female; and 31% reported being on an intensive management plan, such as the one used in the Diabetes Control and Complications Trial. Quality-of-life items included the social, physical, and mental health dimensions of the Short Form (SF-20) of the General Health Survey. RESULTS: Overall, respondents reported a moderate to low quality of life, relative to previous studies. Factors related to lower quality of life included: less education, lower income, older age, being female, type of health insurance (no medical insurance or Medicare/Medicaid recipients reported lower quality of life than those with either a health maintenance organization or private insurance), number of diabetes complications, number of comorbid illnesses, and lower levels of physical activity. Multiple regression analyses revealed that the level of self-reported exercise was the only significant self-management behavior to predict the quality of life, after controlling for demographic and medical variables. CONCLUSIONS: If the findings regarding physical activity are replicated, it may be that moderate-intensity physical activity programs could be initiated with diabetic individuals at risk of low quality of life. Quality of life is an important and understudied topic in diabetes that appears to be related to demographic, medical-history, and self-management factors.

Adult↗
PubMed1995

Treatment of dyspnea in COPD. A controlled clinical trial of dyspnea management strategies.

We conducted a randomized clinical trial to evaluate a limited pulmonary rehabilitation program focused on coping strategies for shortness of breath but without exercise training. Eighty-nine patients with COPD were randomly assigned to either 6-week treatment or general health education control groups. Treatment consisted of instruction and practice in techniques of progressive muscle relaxation, breathing retraining, pacing, self-talk, and panic control. Tests of 6-min walk distance, quality of well-being, and psychological function as well as six dyspnea measures were administered at baseline, posttreatment, and 6 months after the intervention. Baseline pulmonary function tests also were obtained. At the end of the 6-week treatment, there were no significant differences between the treatment and control groups on any outcome measure. At the 6-month follow-up, a significant group difference was seen on only one variable, Mahler's transition dyspnea index. The results of this evaluation suggest that a treatment program of dyspnea management strategies, without structured exercise training or other components of a comprehensive pulmonary rehabilitation program, is not sufficient to produce significant improvement in dyspnea, exercise tolerance, health-related quality of well-being, anxiety, or depression.

Aged↗
PubMed1993

Measurement of dyspnoea in chronic obstructive pulmonary disease.

This paper reviews the assessment of shortness of breath in chronic obstructive pulmonary disease (COPD). The validity criteria for evaluating measures of dyspnoea are discussed and a description and critique of current measures of shortness of breath are offered. Across studies, dyspnoea measures are moderately correlated with pulmonary function (e.g. FEV1.0 and FVC), psychological function, and walking tests (6 min walk). In addition, dyspnoea measures tend to be correlated with one another. The need for standardisation of dyspnoea measures for research and clinical practice is identified as an important objective for future work.

Activities of Daily Living↗
PubMed1990

The inside scoop on the stuff called snuff: an interview study of 94 adult male smokeless tobacco users.

This interview study collected information from 94 adult males about a variety of factors related to their smokeless tobacco (ST) habit. Eighty-nine percent of this sample used moist snuff and most analyses focused on this group. Three measures of self-reported snuff use were intercorrelated and compared to a saliva cotinine assay. Correlations demonstrated potential usefulness of measures such as number of dips per day when biochemical measures are not practical. A majority (68%) of the Ss reported attempts to quit smokeless tobacco use, but relapsed from 1 to 3 months later. Ninety-six percent of snuff users reported awareness of cancer and other oral health risks and 56% reported an intention to quit in the next 12 months. A majority (67%) of subjects report receptivity to receiving advice to quit from medical and dental providers although only one-third had received such advice. The results are discussed in terms of designing an effective cessation intervention in dental clinics for ST users.

Adolescent↗
PubMed1990

Dental office practices for tobacco users: independent practice and HMO clinics.

Surveys of independent dental practitioners and health maintenance organization (HMO) dentists and their adult male patients in Oregon found that cessation information and advice was being given to tobacco-using patients, especially smokeless tobacco users, and that the tobacco users surveyed expressed interest in obtaining help to quit. Oral health providers expressed an interest in further training in how to help their tobacco-using patients to quit.

Adult↗
PubMedDate not supplied

Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives.

This study assessed patient awareness and use--as well as obstacles to use--of HMO- and community-based psychosocial support services designed for cancer patients. Participants were a randomly selected group of patients from a large Northwest HMO, with breast (N=145), prostate (N=151), or colon cancer (N=72), and their oncology and urology providers (N=29). Patient awareness was highest for HMO-based services (68-90%) and lower for community- (33%) or Internet-based (10-14%) services, and use rates were low across all services (range 2-8%). Providers reported referring 70% of their patients to HMO cancer support services, but their estimates of actual patient use of these services (40%) were inflated. Providers reported few barriers to referring patients to support services. The most commonly reported patient barriers to using such services were already having adequate support, lack of awareness of the service, and lack of provider referral. Results of regression analyses suggest that education, physician referral, social support, and spirituality may be important influences on use of cancer support services. This study takes a first step toward understanding patient use of existing cancer support services and suggests ways to increase participation in these services.

Adult↗