The impact of professional education on nursing behavior in the practice setting.
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Diabetes Mellitus↗
Biomedical subjects
F C Wheeler
Publications and source records attributed to F C Wheeler.
Evaluation of the Heart To Heart Project: lessons from a community-based chronic disease prevention project.
PURPOSE: To present an evaluation of a 5-year, community-based, chronic disease prevention project managed by a state health department to determine whether the department could replicate similar previous projects that had received more funding and other resources. DESIGN: The evaluation used a matched comparison design and a review of archive and interview data. SETTING: Florence, South Carolina (population: 56,240). SUBJECTS: A random sample of 1642 persons in Florence (and 1551 in the comparison) who responded to a risk factor questionnaire and underwent a physical assessment; 70.7% of baseline subjects participated in the postintervention. Forty key persons were interviewed concerning project effectiveness. INTERVENTIONS BY PROJECT: Walk-a-thons, a speakers' bureau, media messages, restaurant food labeling, and cooking seminars. More than 31,000 participants were involved in 585 activities. MEASURES: Questionnaires focused on hypertension, obesity, high cholesterol, smoking, and exercise. Physical assessments determined lipid, lipoprotein, apolipoprotein, and blood pressure levels. Analysis of covariance was used for baseline and postintervention comparisons. Content analysis was used on archive and interview data. RESULTS: The project had a slightly favorable intervention effect on cholesterol and smoking, but failed to have an effect on other risk factors for cardiovascular disease. The project influenced community awareness, enlisted influential community members, and fostered linkages among local health services. CONCLUSIONS: Health departments can be instrumental in community risk reduction programming; however, they may not replicate projects having greater resources.
Cardiovascular Diseases↗
Behavioral and demographic correlates of diabetes, hypertension and overweight among the Catawba Indian Nation.
OBJECTIVE: In 1998, the Catawba Diabetes and Health Survey (CDHS) was conducted among adult members of the Catawba Indian Nation living in the Carolinas to determine the prevalence of diabetes and other health conditions, and to assess the population's health-related behaviors. DESIGN: A population-based sample of adult members of the Catawba Indian Nation (N = 633) were surveyed by telephone or in person regarding health status and health-related behaviors. Logistic regression was used to determine demographic and behavioral correlates of diabetes, hypertension, and overweight among the Catawba. RESULTS: Age-adjusted prevalence rates of self-reported diabetes, hypertension and overweight were 12.3%, 29.1%, and 63.8%, respectively. Older age was related to diabetes, hypertension, and overweight (P<.0001 each), and heavier weight status was related to diabetes (P = .026) and hypertension (P<.0001). Nearly 40% of the Catawba are physically inactive (29.5% men, 46.5% women). Physical inactivity was related to diabetes and hypertension among men only, and related to overweight among women only (P<.05 each). Current smoking was inversely related to overweight among men and women (P = .002). Dietary behavior was not associated with the health outcomes. CONCLUSION: Given the high rates of overweight and physical inactivity, reducing the rates of both may be very important for the health of the Catawba, considering their association with diabetes and hypertension.
Adult↗
Evaluating South Carolina's community cardiovascular disease prevention project.
A community cardiovascular disease prevention program was undertaken as a cooperative effort of the South Carolina Department of Health and Environmental Control and the Centers for Disease Control of the Public Health Service. As part of the evaluation of the project, a large scale community health survey was conducted by the State and Federal agencies. The successful design and implementation of the survey, which included telephone and in-home interviews as well as clinical assessments of participants, is described. Interview response rates were adequate, although physical assessments were completed on only 61 percent of those interviewed. Households without telephones were difficult and costly to identify, and young adults were difficult to locate for survey participation. The survey produced baseline data for program planning and for measuring the success of ongoing intervention efforts. Survey data also have been used to estimate the prevalence of selected cardiovascular disease risk factors.
Adolescent↗
The biologic effects of polystyrene latex particles administered intravenously to rats--a collaborative study.
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Aerosols↗
The validity of self-reported hypertension and correlates of hypertension awareness among blacks and whites within the stroke belt.
Hypertension surveillance activities increasingly are relying on information obtained by self-report. However, limited information is available concerning the validity of such data, especially among populations residing within the stroke belt. We used interview information and blood pressure measurements from the South Carolina Cardiovascular Disease Prevention Project to determine the validity of self-reported hypertension and the correlates of hypertension awareness among 2,210 whites and 704 blacks who participated in the program in 1987. The sensitivity, specificity, positive predictive value, and negative predictive value of self-reported hypertension were 79%, 91%, 76%, and 93% among white women; 82%, 88%, 79%, and 89% among black women; 62%, 91%, 75%, and 85% among white men; and 72%, 89%, 78%, and 85% among black men, respectively. Groups with highest sensitivity included women, persons older than age 39 years, and those who had seen a physician for preventive care within the last year. Correlates of hypertension awareness included an older age, visit to a physician for preventive care, and a family history of high blood pressure. Among hypertensive blacks, overweight persons were substantially more likely than nonoverweight persons to be aware of their hypertension (odds ratio [OR] = 4.6, 95% confidence intervals [CI] = 1.9, 10.7 in black women and OR = 4.4, 95% CI = 1.0, 17.9 in black men). The validity of self-reported hypertension was relatively high in all race-sex groups. There is a need to increase hypertension awareness among hypertensive blacks who are not overweight.
Adult↗
Changes in blood cholesterol awareness: final results from the South Carolina Cardiovascular Disease Prevention Project.
We examined changes in five indicators of blood cholesterol awareness in two comparable biracial communities in South Carolina. One community received three years of cholesterol education and intervention activities implemented by a state health department and the other served as a comparison. Cross-sectional, interviewer-administered, random digit-dialed telephone surveys of 11,070 adults 18 years and older were conducted in 1987, 1988, 1989, and 1991. Changes in community levels of knowledge, preventive behavior, risk awareness, and treatment were assessed and compared between the two communities with analysis of covariance techniques that adjusted for age, race, and sex. Significant increases in knowledge, behavior, and risk awareness were observed for most groups defined by race, sex, or age in both communities. Significant net intervention increases between 1987 and 1991 were seen for knowledge of good cholesterol level (+16.4%, P < .001); behavioral action of ever having blood cholesterol checked (+18.6%, P < .001); and knowledge of personal level of blood cholesterol (+16.0%, P < .01). These results suggest that a community-wide blood cholesterol screening and education program can be effective in increasing blood cholesterol knowledge, risk awareness, and preventive behavior, thus serving as part of a public health strategy to lower and treat high blood cholesterol levels in a community.
Adolescent↗
Legislative Cardiovascular Health Check: a multidisciplinary health promotion experience for South Carolina lawmakers.
The South Carolina Department of Health and Environmental Control has conducted a Legislative Cardiovascular Health Check for the past 4 years. The primary purpose of the event, held in the lobby of the State Capitol Building, is to increase the awareness of State legislators about the leading causes of death in South Carolina and about community-based health promotion services that are available. The health check emphasizes the relationship between modifiable risk factors and the development of heart disease, cancer, and stroke. These legislative events are organized by State health department staff members, but they are conducted by local health department personnel from throughout South Carolina. This approach is intended to build the capacity of these local staff members to communicate more effectively with their legislators and to carry out similar events at the county or community level. The health check is staffed by a trained multidisciplinary team, including persons designated as legislative liaisons. The liaison people contact legislators prior to the event and provide them with health status data specific to their respective districts. The Legislative Cardiovascular Health Checks have been attended by members of the General Assembly and their staffs, members of the Governor's staff and the Lieutenant Governor's office, and other employees of the State Capitol. An average of 380 people have participated annually. Screening activities have included blood pressure and blood cholesterol checks, with risk factor counseling and educational materials provided to each screened participant. During the past year, activities were expanded to include a variety of interactive exhibits related to nutrition, exercise, and smoking. Feedback from participants has been positive. The Legislative Cardiovascular Health Check is encouraged and supported by the upper management of the State health department and is now established as an annual event of mutual benefit to legislators and to State and local health department staff members.
Blood Pressure↗
Self-reported frequency of serum cholesterol testing, awareness of test results, and laboratory cholesterol values in two South Carolina communities.
Self-reported frequency of cholesterol testing and awareness of test results were collected from 5,246 adults 18 years and older in two semirural communities in South Carolina. Serum cholesterol was also measured for about 60 percent of this group. More than half of these persons had serum cholesterol values greater than 200 milligrams per deciliter (mg per dL) and 21 percent had values greater than 240 mg per dL. One-third of the population had had their cholesterol level measured within the past year; 40 percent reported that their cholesterol level had never been measured. Among persons whose cholesterol was 240 mg per dL or more, 39 percent reported that their cholesterol had never been measured or that they did not know if it had been measured, 37 percent reported that their cholesterol had been measured but that they were not told that it was high, and 18 percent reported that their cholesterol had been measured and that they were advised to reduce it. Among persons whose cholesterol was 200 mg per dL or more, and who reported that they had cardiovascular disease, 25 percent reported that they were advised to reduce their cholesterol. These results emphasize the need to increase the proportion of the population who have had their cholesterol level measured, who know their test results, and who have been properly counseled about the results.
Adult↗
Demographic and educational differences in smoking in a tobacco-growing state.
National studies have documented an excessive rate of cigarette smoking in black men; however, a 1987 survey conducted in two urban areas in South Carolina documents a high rate of smoking in young white men with fewer than 12 years of education (67%; 95% confidence interval [CI] = 58.3, 75.7). Differences in smoking rates by educational level were significant only for those younger than 40. Young blacks were less likely to smoke and smoked fewer cigarettes than whites. As a result, the population burden of cigarettes in young black men with fewer than 12 years of education was only 27% of the burden carried by their white peers. Television, physicians, and radio were all seen as likely sources of health information to prevent heart disease, but newspapers were less likely to be cited by those younger than 40 or by those with fewer than 12 years of education. Reported physician counseling for smoking cessation did not differ significantly by race, sex, or educational level of the patient, but reported counseling was higher for individuals with a personal history of cardiovascular disease (odds ratio [OR] = 2.32, CI = 1.27, 4.25) and somewhat lower for the elderly. We highlight the population burden of cigarettes, a predictor of the eventual disease burden attributable to smoking, as a useful priority measure for smoking intervention efforts.
Adolescent↗