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Biomedical subjects

Howard P Greenwald

Publications and source records attributed to Howard P Greenwald.

7 recordsLinked to original sources
PubMed2006

Youth development, community engagement, and reducing risk behavior.

This article examines behaviors and attitudes associated with the "Youth Development Model," widely cited as a means of promoting resistance among young people to adverse environmental influences. Focusing on tobacco use as an example of high-risk behavior, the research reported here (1) tests the statistical independence of individual Youth Development Model dimensions, and (2) assesses their relationships to tobacco-related attitudes and behavior. The "engagement" dimension, reflecting strong ties of youths with the broader community, most clearly distinguishes risk reduction interventions based on the Youth Development Model. Two exploratory studies indicate that, among dimensions associated with this model, engagement is the least readily measurable and the least consistent and robust as a predictor of tobacco-related attitudes and behavior. Editors' Strategic Implications: The authors present an important challenge to the increasingly prevalent Youth Development Model. The results of the two studies call for a better conceptual and operational understanding of engagement, which must precede its successful application in reducing risky behavior among young people.

Adolescent↗
PubMed2004

The importance of public sector health care in an underserved population.

California's employed Latinos are less likely to have private health insurance than most other segments of the US population and face a variety of other barriers to obtaining health care. To better understand the availability and adequacy of health services for these individuals, researchers analyzed data from a telephone survey of 1,000 randomly-selected, employed adults. Among all survey respondents, a significant percentage obtained their health care from sources fully or partially dependent on government financing. Among the uninsured (30.7 percent of the sample), a majority of those who had a regular source of care received services from publicly-supported providers. Dissatisfaction with care was infrequent (less than 5 percent of the total sample) and apparently no greater among those receiving care from public sources than among those served by private doctors. These findings underscore the importance of the public sector in providing health care for the underserved, the high quality of the services provided (or partially supported) by the public sector, and the seriousness of the consequences for the disadvantaged should public support for their healthcare diminish.

Adult↗
PubMed2003

Evaluating the California Wellness Foundation's Health Improvement Initiative: a logic model approach.

The difficulties of conducting randomized trials to evaluate community-based initiatives have led some researchers to argue in favor of a case study "logic model" approach to evaluation. This article describes a case study logic approach adopted for the evaluation of one community initiative, the Health Improvement Initiative (HII) funded by the California Wellness Foundation (TCWF). The HII is a comprehensive, community-based initiative designed to improve population health by implementing and sustaining community-level systems changes. Nine communities received funding to create broad-based community coalitions (Health Partnerships) that were charged with developing and implementing action plans around systems change. The HII is being evaluated using a case-study logic-model approach that uses quantitative and qualitative data to construct indicators of coalition functioning, systems changes, and population health. By examining the relationship between these indicators over time, it should be possible to determine if any changes in intermediate or long-term outcomes are associated with Health Partnership activities.

California↗
PubMed2002

Putting a new face on managed care. Consumers need convincing about quality issues.

Widespread consumer suspicion about the quality of managed care indicates that marketers still have work to do Research shows that women identify personal relationships with physicians, medical expertise, speed of access, and comprehensiveness of service as important signs of quality when selecting a managed care plan for their families. Based on existing research findings and new focus group data, this article provides guidelines for promoting an association of quality with managed care, particularly among women.

Consumer Behavior↗
PubMed1991

Interethnic differences in pain perception.

While several investigators have reported relationships between ethnic background and expression of pain, such relationships are in fact highly problematical. Few studies of pain and ethnicity have used quantitative measures of pain combined with multivariate methods of data analysis. Most have focussed on populations which, unlike many in the United States today, are characterized by highly distinct ethnic groups. The study reported here interviewed 536 persons recently treated for forms of cancer known to cause significant pain. Pain was assessed using standard, well validated instruments, including Graphic Rating Scales anchored in several alternative time-frames and the McGill Pain Questionnaire. The study took place in an area with a low proportion of recent immigrants and only small concentrations of distinct ethnic minorities. No statistically significant relationships were observed between ethnic identity and measures of pain sensation. However, pain described in affective terms according to the McGill Pain Questionnaire did vary among ethnicities. This observation suggests that cultures associated with specific ethnic identities still condition individual expression of pain despite the high degree of assimilation that has occurred among ethnic groups in the United States.

Adult↗
PubMedDate not supplied

The California wellness foundation's Health Improvement Initiative: evaluation findings and lessons learned.

PURPOSE: To evaluate the effect of the Health Improvement Initiative (HII), a 5-year grantmaking initiative funded by The California Wellness Foundation designed to identify the critical factors needed to bring about population health improvements through community-level systems change. DESIGN: The evaluation of the HII used a case-study, logic-model approach to make inferences about the effect of each community coalition (Health Partnership) on its target community. The primary outcome measure was the creation of significant and sustainable community-level systems change. SETTING: The HII included nine communities in California that received funding to create broad-based Health Partnerships. SUBJECTS: Primary data were collected from a variety of Initiative stakeholders by key informant interviews, closed-ended surveys, and participant observation. INTERVENTION: The HII provided funding over 5 years to nine Health Partnerships that were intended to be a driving force in implementing community-level systems change. The ultimate objective of the systems change process was to improve "population health, " broadly defined to include social economic, and cultural determinants of health, in addition to traditional health status indicators. MEASURES: Both qualitative and quantitative techniques were used to assess the effect of the HII on key community systems. The primary outcomes were qualitative descriptions of community-level changes. RESULTS: At the end of the 5 years of HII funding, six of the nine Partnerships had played a critical role in implementing sustainable systems changes that would likely have a significant effect in their target communities. CONCLUSION: The HII was successful in promoting community-level systems change in the majority of funded communities, although the evidence was mixed regarding the role of the Partnerships in bringing about these changes.

California↗