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Biomedical subjects

J A Mamon

Publications and source records attributed to J A Mamon.

12 recordsLinked to original sources
PubMed1990

Inner-city women at risk for cervical cancer: behavioral and utilization factors related to inadequate screening.

This study investigated the relationships between health care utilization, knowledge, attitudes, sociodemographic characteristics, and adequacy of cervical cancer screening among a random sample of women from inner-city neighborhoods with high rates of cervical cancer mortality. Of 416 women interviewed, 30.3% reported hysterectomies; women with intact uteri (N = 290) are the subjects of this analysis. Over two-fifths (44.1%) reported not receiving adequate Pap testing during the previous 4 years. Compared with adequately screened women, they were more likely to be 45 years or older, have no medical insurance, report never having been to an obstetrician-gynecologist, recall never having been told by a medical provider how often to get a Pap test, rely on providers for adequate screening, report not seeking care as often as they think they should, have less knowledge of risk factors for cervical cancer, and believe that women should get Pap tests less than yearly. Separate models for younger and older women showed that these factors vary by age, demonstrating the need for interventions to be sensitive to age subgroups. These findings suggest that cancer control activities should place more emphasis on motivating women as well as influencing the health care delivery system to maximize reductions in cervical cancer.

Adolescent↗
PubMed1989

Knowledge, attitudes, and reported practices of medical students and house staff regarding the diagnosis and treatment of alcoholism.

Although alcoholism is prevalent in both general and inpatient populations, barriers to its timely diagnosis and effective treatment exist. These are often attributed to physicians' inadequate understanding and skill development and negative attitudes toward the disease. All Johns Hopkins' medical students and house staff, during 1986 through 1987, received a self-administered survey of their attitudes, skills, perceived role responsibility, knowledge, and reported practices with regard to alcoholism. Results indicate a strong relationship between perceived role responsibility, confidence in skills, and reported screening and referral practices among students and house staff. Knowledge levels strengthened the association between skills and practices for medical students. House staff perceived less of a responsibility for screening than medical students. There was a trend toward lower confidence and more negative attitudes among house staff than medical students. The results point to areas where educational interventions can be improved to enhance quality of care and outcomes for this major chronic disease.

Alcoholism↗
PubMed1989

Prevalence, detection, and treatment of alcoholism in hospitalized patients.

As part of an institution-wide program to enhance the education of physicians in diagnosing and treating alcohol dependence and abuse, a comprehensive survey was conducted in which all new admissions to the adult inpatient services of The Johns Hopkins Hospital were screened for alcoholism. The prevalence of screen-positive alcoholism, by department, was as follows: medicine (25%), psychiatry (30%), neurology (19%), obstetrics-gynecology (12.5%), and surgery (23%). Detection rates by the house staff and faculty physicians caring for those patients who screened positively were less than 25% in surgery and obstetrics-gynecology, between 25% and 50% in neurology and medicine, and greater than 50% in psychiatry. However, physicians were less likely to identify as alcoholic those patients with higher incomes, higher education, or private medical insurance; women; and those who denied heavy alcohol intake. Physician-instituted treatment rates for those patients diagnosed by the physician as having nonrecovered alcoholism were less than 50% in surgery and obstetrics-gynecology, between 50% and 75% in medicine and neurology, and 100% in psychiatry. The extent to which the physicians intervened while the patient was hospitalized correlated with the patient's reported change in alcohol use after discharge. Recommendations based on these data are being incorporated into the medical education curriculum.

Adult↗
PubMed1987

Identifying coronary-prone behavior in adolescents using the Bortner Self-Rating Scale.

Brief measures to identify coronary-prone (Type-A) behavior in young persons are greatly needed for longitudinal epidemiologic study of cardiovascular diseases. We examined the suitability of a modified 14-item Bortner Self-rating Scale (ABS) for use in an adolescent population. Responses of 549 racially mixed, low to middle income urban high school students were analyzed to see if ABS measurement properties matched those of the parent version. Construct validity was explored by correlating ABS scores with measures of anger expression, social support, life satisfaction, academic achievement and blood pressure. Results disclosed that the distribution and factor structure of adolescent ABS responses closely resembled findings obtained with adults. Scale validity was supported by significant associations of ABS scores with degree of overt anger expression, lack of social support, and dissatisfaction with school and life in and life in general. Academic achievement and blood pressure were found not to correlate with adolescent ABS scores. Possible race and sex differences are considered.

Adolescent↗
PubMed1987

Utility of the health belief model in examining medication compliance among psychiatric outpatients.

This study investigates the relationship between health beliefs and medication compliance among a group of psychiatric outpatients who were prescribed antipsychotic drug regimens. The method of study was an interview with 107 outpatients discharged from two Veterans Administration Medical Centers. The health belief model (HBM) served as an organizing framework to explore the relationships among perceptions of illness severity, susceptibility, benefits and barriers of treatment, cues to action, and medication compliance. The results provide a systematic description of health beliefs reported by psychiatric outpatients. Analyses examine the ability of beliefs to predict compliance and affirm the model's theoretical cogency and appropriateness for use with psychiatric outpatients. Regression analysis showed that 20% of the total variance in compliance could be explained when all components of the HBM were examined together. The study supported the concepts that psychiatric outpatients hold identifiable patterns of health beliefs and attitudes and that the health belief framework functions best when utilized as an integrated model to examine compliance.

Adult↗
PubMed1985

Impact of breast self-examination planned educational messages on social network communications: an exploratory study.

This two-part study examined the effect of college women's participation in a breast self-examination (BSE) educational program on discussion of BSE with specific members of their social network. In addition, the characteristics of college women who did report discussion with others were investigated as was the relationship between this discussion and the participants' mothers' breast cancer screening behaviors. Results suggest that a BSE education intervention which includes explicit messages to encourage discussion with social network members is effective in increasing communication with mothers, sisters and friends. College women who discussed BSE with their mothers were more likely to have mothers who have a high quality BSE practice and who state an intention to request a clinical breast examination at their next physician visit. The limitations of this study are discussed with recommendations for future research.

Adult↗
PubMed1985

Improving frequency and proficiency of breast self-examination: effectiveness of an education program.

A randomized trial to improve breast self-examination (BSE) performance among college-age women was developed and results evaluated at a large public university. The major intervention was a BSE group education session conducted in classroom and workshop settings. The pre-intervention and six-months-after experimental-control comparisons show that: current performance of BSE increased by 26 per cent, bi-monthly or more often BSE performance increased by 29 per cent, and performance proficiency improved by 22 per cent. A change index, adjusting for each group's level on these three measures at pre-intervention, showed higher levels of change; 57 per cent, 36 per cent, and 28 per cent, respectively. A significantly larger proportion of women in the experimental group discussed BSE with others than women in the control groups. The "talked to" mothers, compared to the "not talked to" mothers performed BSE more regularly, in more positions, and spent more time on the examination. The results from this study suggest that properly targeted educational programs can significantly improve early detection behaviors in women. In addition, the evaluation protocol defined proficiency measures and validated measurement tools. Subsequent studies need to examine the relation of proficiency measures to detection of abnormality and subsequent effect on morbidity and mortality, so that the debate about BSE efficacy can be scientifically addressed.

Adult↗
PubMed1982

Integration of theory, practitioner standards, literature findings, and baseline data: a case study in planning breast self-examination education.

Delineation of the planning process necessary for designing sound education programs aimed at changes in health behavior continues to be a primary concern of health educators. Careful planning will ultimately maximize the application of existing evidence and identify areas in need of further research and evaluation. This paper discusses the preliminary and refinement planning phases involved in the design of an educational program for a three-year breast self-examination demonstration/evaluation project. The initial phase involved review of empirical data of previous studies, and application of behavioral science theory and standards of professional practice. The refinement phase involved the application of results from a community diagnostic baseline survey of the target population. Factors found to correlate with BSE practice were integrated into the educational strategies: group sessions in classes and informal workshops, a breast exam clinic, and mass media activities.

Breast↗
PubMed1977

The use of public transportation in urban areas: toward a causal model.

In this study, using the statistical models recently introduced by Goodman, we analyze the reasons why individuals choose the car or public transportation for the journey to work and draw out some of the implications of our analysis for public policy. Building on the work of Schnore, we develop a model in which both structural and individual variables are interrelated and show that the structural contexts within which individuals make decisions about their choice are crucial. We also show that, while status differentials are largely accounted for by income differences, male preferences for the automobile tend not to be due either to the structural variables or to income differences. Our findings suggest that present policies designed to induce people to shift to public transportation for the journey to work are not likely to be effective, since they do nothing to alter present cost differentials between the two modes.

Automobiles↗
PubMedDate not supplied

Breast self-examination by young women: I. Characteristics associated with frequency.

We surveyed a stratified random sample of college women (n = 869) to investigate correlates of the frequency of breast self-examination (BSE) in two young, relatively low risk populations, undergraduate and graduate women. The findings from this study compared to those from studies on older women suggest that certain factors are associated with BSE frequency for women of all ages (i.e., confidence in one's ability to perform the exam and exposure to information on breast cancer). There also appear to be distinct factors associated with the frequency of BSE performances among women within specific age-groups. For the younger, undergraduate women, attitudinal barriers; medical services use; skill knowledge; perception of personal control in detecting lumps; reinforcement through clinical breast exam; and the discussion of BSE with others were important factors in accounting for the variation in frequency of BSE performance. For the graduate women, in addition to confidence in one's ability to perform the test and exposure to breast cancer messages, one's perceived susceptibility, knowledge of risk factors, and perception of personal control in detecting lumps were important. The independent variables examined within each age-group accounted for a substantial amount of the variance in the dependent measure (34 percent and 42 percent, respectively, for undergraduate and graduate women), as compared to previous research, which has explained only 7-15 percent of the variance in BSE performance. This tends to validate our approach of using a multidimensional conceptual framework drawn from existing theoretical orientations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Breast self-examination by young women: II. Characteristics associated with proficiency.

Studying a stratified random sample of university women (n = 869) we investigated the correlates of proficiency (i.e., the correctness or competence) of breast self-examination (BSE). A 19-item BSE quality index score was developed based on the recommended steps a woman should perform when doing the exam in the three BSE positions. A comprehensive set of independent variables including knowledge, attitudes and perceptions, personal characteristics, and environmental factors were studied. While proficiency scores for both undergraduates and graduates were relatively low, the mean score for graduates was significantly higher than for undergraduates. This study corroborates the few recent studies that indicate that frequency of performance is not highly correlated with proficiency (relationships were r = .14 and .04, respectively, for undergraduate and graduate women). Bivariate and multivariate regression analyses demonstrate that the relevance of such factors varies by age (undergraduate and graduate). Results of the regression model indicate that the skill knowledge variable regarding time of month BSE should be performed, awareness of BSE, perceived effect of cancer detection, and perceived benefit of BSE were predictors of more proficient practice for undergraduates. Knowledge of time of month to do BSE and mammogram as a detection technology and discussion of BSE with others were important for graduate women. The independent variables examined accounted for 22 percent and 30 percent of the variance, respectively, for undergraduate and graduate women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗