Biomedical subjects

J E Lubben

Publications and source records attributed to J E Lubben.

30 records · Page 2Linked to original sources

PubMed1988

Health promotion for the rural elderly.

There has been increased interest in developing health promotion programs for the rural elderly as a means to foster successful aging. The present study describes one such program and identifies rural and urban differences in health promotion activities. Data come from the California Preventive Health Care for the Aging Program (PHCAP) which is one of the oldest and largest such programs in the United States. A sample of over 5,000 PHCAP clients was drawn from rural, semi-rural and urban projects. Though the rural and urban clients differed significantly with respect to demographic characteristics, differences in health promotion practices were relatively minor. However, the health promotion practices of semi-rural residents differed considerably from that in rural projects. Though less disabled, semi-rural clients received a greater scope of health promotion activities than rural clients. The authors discuss possible site, practitioner and client factors which may have accounted for rural health promotion activities being more restricted. Regardless of project site, the California PHCAP detected many health problems and a majority of clients were referred to other health professionals for treatment.

Aged↗

PubMed1988

Gender differences in the relationship of widowhood and psychological well-being among low income elderly.

The present study examined the influence of widowhood on the psychological well-being of low income elderly women and men while controlling for a number of mediating variables. Both widows and widowers were found to have lower psychological well-being than their married counterparts once health and social network differences were controlled. Health status and social networks were the major predictors of psychological well-being. Married women reported many more stress related ailments than any other group. Among women, friends contributed more to psychological well-being than family contact. Among men, family rather than friends were more highly correlated with psychological well-being. Implications for clinical practice and future research are discussed.

Adaptation, Psychological↗

PubMed1988

The partialization strategy: an empirical reformulation of demonstration project planning.

The demonstration project approach to planning is described and analyzed. Reasons for its frequent failure as a chosen strategy are delineated. The article introduces the concept of partialization as a broader framework for understanding and using demonstration projects. Four key elements for implementing the partialization strategy through selecting an appropriate initial demonstration site are delineated: success potential, access, linkage, and acceptance by the larger population. Partialization in this context examined two research case studies. The case studies provide specific illustrations of how partialization, when conducted as postulated, facilitated desired diffusion of innovations.

California↗

PubMed1988

Male Chinese drinking behavior in Los Angeles.

The purpose of this research was to identify the characteristics that distinguish male Chinese drinkers from abstainers and to clarify differences between Chinese men who drink limited amounts of alcohol and those who drink more heavily. A random sample of 218 adult Chinese men was interviewed using a schedule based on a national study of drinking behavior. The stereotype of Chinese as limited drinkers was partially supported by the data. Approximately 22% of the sample were abstainers whereas only 14% were heavy drinkers. Light drinkers were the modal category. A logistic regression model was used to evaluate the relative importance of the significant characteristics of drinkers and abstainers. Parents' drinking behavior influenced respondent's drinking behavior, and drinkers tended to like to go to parties. Chinese men with higher education were more apt to be drinkers. A second logistic regression model was used to identify the predictive variables related to the level of drinking. Chinese men who go to bars and who have friends who drink were the most likely to be heavy drinkers.

Adult↗

PubMed1988

Exploring Filipino American drinking behavior.

The purpose of this article was to explore characteristics distinguishing levels of drinking by Filipino Americans. A sample of 298 adult Filipinos was interviewed using a schedule based on a national study of drinking behavior and attitudes. Approximately 50% of the female sample were abstainers while 80% of the men were drinkers. Heavy drinking was almost exclusively a male activity. Thus, two models of Filipino drinking were examined. Logistic regression was used to identify social factors distinguishing female drinkers from abstainers. A second model clarified the influence of similar characteristics on male Filipinos who drank limited amounts of alcohol and those who drank heavily. The only variable significant in both models was regular participation in religious service.

Adult↗

PubMed1988

Predicting Japanese American drinking behavior.

Empirical data on Japanese American drinking behavior are scarce. The present study was a random sample (N = 295) of households in Los Angeles with Japanese surnames. Japanese Americans born in the United States tended to drink less than those born in Japan. The study also observed significant gender differences in Japanese American drinking behavior which were attributed to ascribed social roles. Other demographic and social determinants of drinking were examined through two logistic regression models. The first model predicted drinking (as opposed to abstaining), while the other distinguished heavy drinkers from those who drank alcohol in more moderate amounts. Potential reference groups (e.g., parents, friends, church groups, etc.) were often significant in predicting whether and how much a Japanese American drank.

Adult↗

PubMed1987

Models for delivering long term care.

Five models are presented for delivering Long Term Care to frail elderly persons. The framework uses basic microeconomic concepts to describe different incentives at work in the five models. Unique features of each model are described and clinical studies reviewed suggesting when a particular option might the most appropriate. Additional research questions are raised by the framework.

Aged↗

PubMedDate not supplied

Comparisons between dentist ratings and self-ratings of dental appearance in an elderly population.

Little is known about dental appearance in terms of the elderly population. The purpose of this paper is to compare self-reported dental appearance with dentist-rated appearance for individuals over 65. The subjects (N = 550) were participants in the Los Angeles based Medicare Screening and Health Promotion Trial. Most were female (57.3%), white (89.0%), and married (62.0%), with a mean age of 74.5 years. About one-third had incomes greater than $25,000. Results are based on a 45 minute telephone interview and onsite dental screening. Findings show that 40% of the self-ratings on a five point scale were higher than the dentist ratings, and 22% were lower. Bivariate analyses showed that both sets of ratings were related to dental status variables, self-reported health, and education. High self-ratings were also associated with being white and having a positive mental health status, while high dentist ratings were associated with patients who were younger, married, and who had higher income and social network scores. Comparison of results from two multiple regressions showed unique predictors for the self-ratings (marital status and GOHAI scores) and for the dentist ratings (sex and income). These discrepancies can raise barriers to effective treatment planning in the elderly, which could affect utilization and satisfaction.

Age Factors↗

PubMedDate not supplied

Enrolling community physicians and their patients in a study of prevention in the elderly.

Enrollment of senior citizens in a community Medicare demonstration project to explore the efficacy of preventive health screening and health education was accomplished by using a two-stage process. This process consisted of initial communication with community physicians through the University of California at Los Angeles Clinical Faculty Association to establish credibility for the program. Physicians who agreed to participate then selected potential participants to receive, by mail, a description of the study and an introductory letter from their own physician. Followup and actual enrollment of participants was then handled by the study team. A total of 57.6 percent of the elderly people approached agreed to participate in the study.

Aged↗

PubMedDate not supplied

A statewide preventive health care program for the aged.

Because of the rising percentage of elderly in the population and the cost of health care expenditures, interest has increased in preventive health care services for the aging. Although the effectiveness of such programs is still being discussed by policy makers, the number of preventive health programs for the elderly is increasing. One of the oldest and largest preventive health programs for the elderly in the United States, the California Preventive Health Care for the Aging Program (PHCAP) is analyzed. The typical PHCAP participant was white, female, between 70 and 79 years of age, and living in an urban area. More than half (59 percent) of the PHCAP participants had some kind of private medical insurance in addition to Medicare coverage. Seventy-seven percent of the participants had seen a physician within the previous year. The most frequently reported chronic conditions were arthritis (31 percent), hypertension (24 percent), cardiovascular problems (13 percent), and vision and hearing problems (18 and 11 percent). Twenty-seven percent of the population were hypertensive; 7 percent of these had moderate to severe hypertension. Eighty percent of the participants were identified as having at least one problem; 40 percent were referred to a physician. Frequently, public health programs need to be evaluated without the benefit of a controlled trial design. This analysis of a statewide preventive health care program for the aging, PHCAP, shows the program's effectiveness in detecting a large number of health problems and making extensive referrals to other health professionals, particularly physicians. These findings should be useful to health practitioners and policy makers developing similar statewide programs for the elderly.

Aged↗

PubMedDate not supplied

Hypertension in elderly people in a preventive health program.

Control of hypertension is increasingly being recognized as a significant component of any preventive health care program for the elderly because of the high prevalence of hypertension in this group and its impact on health, particularly cardiovascular diseases. This study evaluates the hypertension screening component in one of the oldest and largest health promotion programs for the elderly in the United States, the Preventive Health Care for the Aging Program (PHCAP) in California. Our findings show that 26.7% of PHCAP participants had hypertensive readings on examination. Of these, 20% had mild hypertension, 5.6% moderate hypertension, and 1.1% severe hypertension. Urban participants were more likely than rural participants to have hypertension. Of those with severe hypertension, living alone was a significant factor when controlling for other variables. Overall, 40.2% of the hypertensive patients were not aware of their hypertension, and whites and Hispanics were less aware than blacks of their hypertensive status. Men were also less aware than women. These findings suggest ways to improve hypertension control programs for healthy elderly people who are self-referred to community-based preventive health care programs.

Aged↗

PubMedDate not supplied

Health promotion and disease prevention for older adults: opportunity for change or preaching to the converted?

Health promotion and disease prevention for the elderly offer the potential for improving the quality of life for the growing population of older adults, while reducing the economic burden on the health system. Whether this potential can be realized depends, in part, on whether those older adults whose health behaviors put them at risk actually use preventive services when offered the opportunity. In 1988 the Health Care Financing Administration began a series of health promotion demonstrations to address health issues related to older adults. This article reports on program participation at one of the five demonstration sites. Over 1,900 community-dwelling Medicare beneficiaries who receive their health care through fee-for-service providers were enrolled in the demonstration. These enrollees were randomly assigned to control and experimental groups, with the latter offered health screening and promotion services. Nine hundred-seventy-three of the experimental subjects and 938 of the control subjects completed a lengthy telephone interview, which determined each person's use of preventive services and practices. Although all 973 experimental subjects were invited by letter and follow-up telephone calls to attend these free-of-charge, Medicare-provided sessions, not everyone attended. We analyzed 17 health behaviors of those who attended the first session and those who did not. Those engaging in these preventive behaviors were neither more nor less likely to attend the screening services. Thus, we found neither "favorable" nor "unfavorable" selection bias in the use of these preventive services.

Adult↗