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Biomedical subjects

F J Kviz

Publications and source records attributed to F J Kviz.

At least 19 recordsLinked to original sources

Providers' smoking cessation attitudes and practices for older patients.

A mail survey of 136 providers in a health maintenance organization in the Chicago metropolitan area examined smoking cessation attitudes and performance of the 4As protocol (asking, advising, assisting, arranging) for patients aged 50 years or older. Asking about smoking was most frequent, followed by arranging, advising, and assisting. Physicians and nurse practitioners performed each of the 4As more often than did registered and licensed practical nurses. In multiple logistic regression analyses, provider type was the only significant predictor of asking about smoking. Advising, assisting, and arranging follow-ups were more likely to be performed by providers who perceived a sense of professional responsibility about older patients' smoking; advising was more likely for providers who perceived that they had enough time to advise older patients about smoking; and assisting and arranging were more likely for providers with a stronger sense of self-efficacy for helping older patients stop smoking.

Aging↗

Psychosocial factors and smoking cessation behaviors among smokers who have and have not ever tried to quit.

Relationships between smoking cessation behaviors and demographic characteristics and attitudes were analyzed among two groups of smokers, those who had and had not ever tried to quit. Telephone interviews were completed with 1501 smokers at baseline and at a 3 month follow-up. Multiple logistic regression analyses were used to identify factors that were associated with planning to quit, attempting to quit and quitting smoking within the two groups of smokers. Different patterns of correlates were found across groups and within the three outcome measures, indicating the potential importance of targeting interventions according to whether or not smokers have made a prior quit attempt. These findings also support the value of using multiple outcome measures in the smoking cessation process.

Adult↗

Asthma prevalence and risk factors in selected Head Start sites in Chicago.

Prevalence of and risk factors for asthma were examined in 1085 Head Start families at 18 Head Start sites in four high-risk community areas in 1994. A total of 13.9% of the families reported diagnosed asthma in their Head Start child and 18.8% reported that their child wheezed in the last 12 months. A total of 26.9% of respondents reported asthma in the immediate family of the child. Low birth weight (1500-2499 g), very low birth weight (<1500 g), and self-reported exposure to dampness or mold in the last 12 months were significantly associated with self-reported diagnosed asthma (OR = 1.93; 95% CI 1.17-8.73), (OR = 4.5; 95% CI 1.25-16.3), and (OR = 1.94; 95% CI 1.23-3.04), respectively. The young age of the children in Head Start, as well as the high prevalence of asthma in their families, suggest that the Head Start programs offer an unusual opportunity for asthma prevention programs.

Asthma↗

Age and stage of readiness for smoking cessation.

Using the 1992 National Health Interview Survey Cancer Control Supplement, relationships were analyzed between stage of readiness for smoking cessation and background characteristics, smoking behaviors, and smoking-related attitudes among smokers aged 18-29, 30-49, and > or = 50 years. For each age group, an ordinal logistic regression model was computed to identify correlates of readiness to quit. The youngest smokers had attitudes most favorable to being ready to try to quit smoking. For smokers aged 30-49, the influence of a medical provider and perceived health effects of smoking were important correlates of readiness. Among smokers 50 and older, those with realistic health consequences of smoking and those who perceived smoking as addictive were more likely to be ready to quit. The effectiveness of smoking cessation programs might be improved by matching interventions to a smoker's age and stage in the smoking cessation process.

Adolescent↗

Attitudes and practices for smoking cessation counseling by provider type and patient age.

Attitudes and self-reported practices for smoking cessation counseling among 145 providers at a health maintenance organization were compared among two provider groups, physicians/nurse practitioners and registered/licensed practical nurses, and across three patient age groups, < 50, 50-64, and > or = 65. Smoking cessation attitudes did not differ by provider type but they did differ by patient age, especially among the registered/licensed practical nurses, whose attitudes were least favorable for the oldest smokers (> or = 65). While smoking cessation practices did not differ by patient age, they did differ by provider type. Self-reported performance of the 4 As of smoking cessation practice (Ask, Advise, Assist, Arrange) was more frequent among the physicians/nurse practitioners than among the registered/licensed practical nurses. However, among both groups, asking and advising practices were reported more often than were assisting and arranging. In all cases, different attitudes were correlated with different practice behaviors for the two provider groups. Also, there were more significant correlations between age-specific attitudes and practices among the registered/licensed practical nurses than among the physicians/nurse practitioners. This was true especially regarding the oldest patients. The findings suggest a need for provider education, especially among registered/licensed practical nurses, about the benefits of smoking cessation for patients of all ages and the potential effectiveness of provider-based intervention strategies that are targeted toward specific age groups. The findings also suggest that assisting and arranging practices in particular need improvement among all types of providers.

Adult↗

Age and smoking cessation behaviors.

BACKGROUND: Predictors of smoking cessation behaviors during a 3-month period were examined among smokers in three age groups: 18 to 29, 30 to 49, and 50 years or older. METHODS: Using random-digit dialing, telephone interviews were completed with 1,644 smokers in the Chicago metropolitan area at baseline and at a 3-month follow-up. Multiple logistic regression was used to identify factors that predicted trying to quit smoking and quitting smoking within each age group and by stage of readiness to quit smoking. RESULTS: There were no significant differences by age in trying to quit smoking or in quitting smoking among smokers in the contemplation or preparation stages. However, there were important age differences in the factors that predicted those behaviors. In general, different factors predicted smoking cessation behaviors in each age group at each of three stages of the smoking cessation process (contemplation, preparation, and action). Also, within each age group, different factors predicted the behavior at each stage. CONCLUSIONS: The findings suggest that smokers of all ages are equally appropriate targets for smoking cessation interventions. Moreover, there are important age-related differences among smokers over the course of their smoking careers that should be considered when planning and implementing smoking cessation interventions.

Adolescent↗

Readiness of older adults to stop smoking in a televised intervention.

Smokers aged 60 and older who enrolled in a televised smoking cessation program were compared with older smokers in the target population, using data from telephone interviews. Multiple logistic regressions identified factors that differentiated older smokers at various stages of readiness to quit. Within the target population, smokers planning to quit someday (N = 238) were more likely to have had greater concern about health effects of smoking and perceived a stronger desire by others for them to quit than smokers with no such plan (N = 127). Compared with older smokers in the target population who were planning to quit someday, program registrants (N = 95) perceived greater severity of lung cancer, had greater concern about the health effects of smoking, perceived greater reduction of lung cancer risk from quitting, and had more determination to quit. These findings indicate important factors according to the stage in the smoking cessation process that must be considered when intervening with older smokers.

Aged↗

Age and readiness to quit smoking.

The relationship between planning to quit smoking within the next 3 months and demographic characteristics, smoking history, attitudes and beliefs about smoking cessation, and motivation was analyzed among smokers in three age groups: 18 to 29, 30 to 49, and 50 years or older. Using random-digit dialing, telephone interviews were completed with 2,353 smokers before initiating a self-help, minimal-contact intervention in the Chicago metropolitan area. Multiple logistic regression was used to identify factors that predicted planning to quit within the next 3 months. The two youngest age groups were most likely to have attitudes favorable to being ready to try to quit smoking (they were more concerned about health effects of smoking, perceived a greater reduction in the likelihood of getting lung cancer, were more determined to quit, and were more confident in their ability to quit). Among all three age groups, one-fourth or less planned to quit within the next 3 months, and desire to quit was the strongest predictor in each group. Among smokers who planned to quit someday, the oldest were most likely to plan to quit within the next 3 months. The findings show that there are important age-related differences in readiness to quit smoking that should be considered when planning and evaluating smoking cessation interventions.

Adult↗

Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department.

OBJECTIVE: Because some have advocated the use of emergency departments to administer delayed childhood immunizations, we evaluated the accuracy of immunization histories obtained in this setting by comparison with medical records of inner-city health care facilities. DESIGN: Questionnaires were orally administered to adults accompanying children to the emergency department. Individual medical records were reviewed. SETTING: Pediatric emergency department at Wyler Children's Hospital, University of Chicago and 68 inner-city primary care clinics. PATIENTS: Children aged 3 to 65 months registering for medical care. Of the sample, 98% were African American; 75% were Medicaid recipients. MAIN OUTCOME MEASURES: Adults' knowledge of immunization histories, immunization cards, and medical records compared with American Academy of Pediatrics/Immunization Practices Advisory Committee recommendations. RESULTS: Of the accompanying adults, 64% stated that their child's general immunization status was "up-to-date"; 65% of these had clinic records confirming that status. Only 8% of specific regimens stated by these adults accurately matched those found in clinic records. Moreover, 45% of adults accompanying children at least 16 months and older provided inaccurate information regarding previous receipt of measles immunization. CONCLUSION: Information provided by accompanying adults (from recall or from immunization cards) is inadequate to determine accurately which preschoolers in the pediatric emergency department are delayed in immunizations.

Chicago↗

Development of a scale to measure gender-role attitudes toward breast-feeding among primiparas.

Women's roles have undergone rapid transformation in recent decades and appear to affect the decision to breast-feed. Research in this area has been hampered by the lack of valid instruments to measure the relevant domains of gender-role related considerations. This study developed a scale to measure gender-role attitudes toward breast-feeding in primiparous women. Ninety-one married women, recruited during childbirth education classes in the Chicago metropolitan area, were surveyed by mail at eight weeks postpartum regarding their experiences as new mothers. Questionnaire items measuring infant feeding method (breast-feeding, bottle feeding) and attitudes toward breast-feeding were developed specifically for this investigation. Validity and reliability were assessed by structural equations analysis using LISREL. The LISREL fit statistics supported a one factor measurement model and combining the six items into a scale. Reliability analysis yielded a standardized alpha coefficient of .74. If results of future research are promising, the scale could be used to target new mothers with multiple roles for education and support and to evaluate interventions designed to promote positive breast-feeding attitudes and behavior.

Adult↗

Characteristics of participants in a televised smoking cessation intervention.

Participants in various components of a televised self-help smoking cessation program, based on the American Lung Association's Freedom From Smoking in 20 Days, are compared with a sample of the population of smokers to whom the intervention was addressed. Over 325,000 smokers in the target population were exposed to the program at some level. Most watched televised segments. Approximately 75,000 manuals were distributed and about 55,000 were used. Comparisons between participants and the targeted smoking population indicate that the intervention attracted those in the smoking population who are expected to be the majority of smokers by the Year 2000-blacks, females, and those with incomes under $13,000 per year. Participants with these characteristics were most likely to view the televised segments. Heavy smokers, females, and those with the most education were most likely to refer to the manual at least twice a week during the intervention. Older, nonblack participants and those with incomes of $13,000 or more per year were most likely to attend group support sessions outside the home. Overall, the patterns of association indicate that although a televised smoking cessation program can attract individuals similar to those projected to be smokers in 2000, participation in various components of the intervention will vary by demographic characteristics.

Adolescent↗

Psychosocial factors and enrollment in a televised smoking cessation program.

Registrants for a smoking cessation program on the evening television news in the Chicago metropolitan area were compared with other smokers in the population to identify psychosocial factors that distinguished registrants. Telephone interviews were conducted before the intervention with random samples of 641 registrants and 2,398 smokers who regularly viewed the evening news. A nested series of three contrasts compared registrants with (1) smokers who regularly viewed the evening television news on any channel, (2) smokers who were regular viewers of the evening news on the intervention channel, and (3) smokers who were regular viewers of the evening news on the intervention channel and were planning to quit smoking. Registration was associated with a smoker's cognitive appraisal of the quitting process, with registrants distinguished by (1) recognition of a need to act (perceived severity of and susceptibility to lung cancer), (2) high outcome expectancies for quitting as an effective means for health promotion, (3) realistic expectations about the effort required to quit, (4) concern about the burden of lung cancer on significant others and related social influence factors, and (5) motivation to quit smoking. The findings suggest that the effectiveness of minimal-contact intervention programs may be enhanced by targeting smokers according to their psychosocial characteristics and by cognitively preparing smokers to attempt to quit.

Adult↗

Mothers' health beliefs and use of well-baby services among a high-risk population.

The relationship between mothers' health beliefs and use of well-baby services among a poor, minority, high-risk population is reported. Data were collected from 61 black mothers attending a maternal-child clinic by interviews at the first and sixth months after the birth of their infants. The analysis focused on four health beliefs (susceptibility, severity, benefits, and efficacy) and two health behaviors (clinic visits and immunizations during the first 6 months). Although mothers' health beliefs were not predictive of clinic visits, health beliefs at the sixth month accounted for 30% of the variance in the number of immunizations. This relationship was dominated by perceived efficacy of immunizations and perceived benefits of well-baby services. The findings indicate a need to consider the nature and extent of possible changes in relationships between health beliefs and health behaviors over time.

Adolescent↗

Attitudes toward physician advertising among rural consumers.

The issue of whether physicians should advertise their services has been the subject of much debate among health policymakers. This study reports data from a survey of rural residents in Illinois regarding attitudes toward physician advertising and reasons for opposition or support of the practice. The results indicate neither strong opposition nor strong support for physician advertising. While those who are opposed are largely nonspecific regarding their reasons, those in favor primarily expect that it will aid in the selection of a physician. However, few respondents indicate a predisposition to shop for a physician. Although the major concern about physician advertising is a danger of false advertising by some physicians, it appears that the respondents are not trusting of advertising in general rather than of advertising by physicians in particular. These findings suggest that regardless of its potential advantages, physician advertising may be relatively ineffective because consumers may be inattentive, unresponsive, or distrusting .

Advertising↗

An evaluation of the index of medical underservice. Results from a rural consumer survey.

The validity of the Index of Medical Underservice (IMU) was evaluated by examining the ability of the IMU to discriminate among levels of need for health services reported by rural consumers in response to a mail survey questionnaire. It was hypothesized that if the IMU is a valid indicator of medical underservice, then where the IMU value for an area was relatively low, respondents would report relatively less access and availability of health services, less utilization of health services, a lower health status level, and less satisfaction with available health services. The IMU was not found to be an effective discriminator among levels of need for health services as reported by the survey respondents. Further, the dichotomous designation of areas as medically underserved or not medically underserved according to IMU values was found to display even less discriminatory ability. A comparison of areas at opposite extremes of the range of IMU values accounted for only a small proportion of the variance in six criterion measures. The findings raise serious questions about the utility of the IMU for determining funding priorities for health services programs. It is recommended that use and interpretation of the IMU be made with caution and supplemented by additional data as much as possible.

Consumer Behavior↗

Rural health care consumers' perceptions of the nurse practitioner role.

In a large-scale survey of rural consumers (n = 3,056), respondents were asked whether they would allow a nurse practitioner to perform each of 12 functions. The results indicate general acceptance of a broadly defined role for the nurse practitioner. Only two functions were not acceptable to a majority of the respondents. A factor analysis revealed two relatively weak factors, which were labeled nontraditional and traditional. Scores on a nurse practitioner acceptance scale, constructed from the 12 functions, were analyzed using analysis of variance and multiple regression. Acceptance of a nurse practitioner was greatest among respondents who are relatively young, male, whose income is relatively low, who are dissatisfied with the explanation of diagnosis and treatment they receive at their usual source of health care, and who are generally dissatisfied with their usual source of health care. None of these relationships, however, is strong.

Adolescent↗