Biomedical subjects

J P Allegrante

Publications and source records attributed to J P Allegrante.

15 recordsLinked to original sources

PubMed1995

Health education intervention strategies: recommendations for future research.

While the ultimate goal of health education interventions is to positively influence health status, more proximal indicators of success are changes in intermediate outcomes, or impact. Because health education interventions work through intermediate outcomes, the linkage to health status is often assumed to be at a conceptual or theoretical level. The term health education intervention strategy is a heuristic device used to conceptualize and organize a large variety of activities. There is a wide range of studies and reports in the literature that either test specific intervention strategies or report on larger health education efforts combining several strategies. This article organizes the discussion to focus on individual-, community-, and policy-level interventions. Mass communications are also considered, and the authors comment on program planning issues that cut across specific interventions at the individual, community, and policy levels. Eleven recommendations are offered for future health education intervention research.

Community Health Services↗

PubMed1992

Supervised fitness walking in patients with osteoarthritis of the knee. A randomized, controlled trial.

OBJECTIVE: To assess the effect of a program of supervised fitness walking and patient education on functional status, pain, and use of medication in patients with osteoarthritis of the knee. DESIGN: An 8-week randomized, controlled trial. SETTING: Inpatient and outpatient services of an orthopedic hospital in an academic medical center. PATIENTS: A total of 102 patients with a documented diagnosis of primary osteoarthritis of one or both knees participated in the study. Data were obtained on 47 of 51 intervention patients and 45 of 51 control patients. INTERVENTIONS: An 8-week program of supervised fitness walking and patient education or standard routine medical care. MEASUREMENTS: Patients were evaluated and outcomes assessed before and after the intervention using a 6-minute test of walking distance and scores on the physical activity, arthritis impact, pain, and medication subscales of the Arthritis Impact Measurement Scale (AIMS). RESULTS: Patients randomly assigned to the walking program had a 70-meter increase in walking distance relative to their baseline assessment, which represents an improvement of 18.4% (95% Cl, 9.8% to 27.0%). In contrast, controls showed a 17-meter decrease in walking distance relative to their baseline assessment (P less than 0.001). Improvements in functional status as measured by the AIMS physical activity subscale were also observed in the walking group but not in the control group (P less than 0.001); patients assigned to the walking program improved 39% (Cl, 15.6% to 60.4%). Although changes in scores on the arthritis impact subscale were similar in the two groups (P = 0.093), the walking group experienced a decrease in arthritis pain of 27% (Cl, 9.6% to 41.4%) (P = 0.003). Medication use was less frequent in the walking group than in the control group at the post-test (P = 0.08). CONCLUSIONS: A program of supervised fitness walking and patient education can improve functional status without worsening pain or exacerbating arthritis-related symptoms in patients with osteoarthritis of the knee.

Adult↗

PubMed1992

Using faculty consensus to develop and implement a medical ethics course.

This report describes the development and implementation of a new required course in medical ethics for second-year medical students at the Cornell University Medical College, 1988-89 and 1989-90. The course was specifically designed to teach students who had not yet started their clinical clerkships to think critically and systematically about ethical issues faced by practicing physicians. The goals, structure, and content of the course were developed using an innovative technique, a planning model involving faculty consensus. The faculty members found the planning sessions intellectually challenging and enjoyable, and reported that the sessions added greatly to their teaching of the course. The students' evaluations over the first two years of the course (with 188 of the 201 students--94%--responding) documented the students' satisfaction with the content and the structure of the course, and their belief that the course had achieved its goals. The authors conclude that the faculty's participation in the planning process was crucial to the success of the course.

Consensus↗

PubMed1992

A three-year evaluation of the know your body program in inner-city schoolchildren.

The impact of the Know Your Body (KYB) comprehensive school health education program was evaluated in a sample of first through sixth-grade students from New York City, using two analytic strategies: a longitudinal cohort and a "posttest only" cohort. In both cohorts, program impact was examined between condition (i.e., KYB vs. no-treatment comparison group) as well as within condition (i.e., low, moderate, and high student exposure). Students in the longitudinal cohort (n = 1,209) who were exposed to high implementation teachers had significantly (p < .05) lower total plasma cholesterol and systolic blood pressure at 3-year posttest than comparison students. Students in the posttest only cohort (n = 3,066) who had high implementation teachers showed significantly (p < .05) lower total plasma cholesterol, systolic blood pressure, self-reported intake of meat and desserts, as well as higher health knowledge and self-reported intake of "heart healthy" foods and vegetables than comparison students. In both cohorts, program effects for several outcome variables were linearly related to level of student exposure to the curriculum, suggesting a dose-response effect. While several methodologic limitations may have influenced study outcomes, these data nonetheless appear to confirm that the KYB program can have a significant positive impact on the knowledge, behavior, and selected risk factors of students in primary grades and that efforts to disseminate and evaluate school health education programs should include strategies to monitor and enhance teacher implementation.

Blood Pressure↗

PubMed1992

The President's Committee on Health Education: a 20-year retrospective on its politics and policy impact.

The President's Committee on Health Education was created by Richard M. Nixon in September 1971 and submitted its final report in September 1973. The committee resulted from the convergence of (1) a perceived national domestic policy need in response to escalating medical costs, (2) Nixon's personal and political ambitions, and (3) the dynamic political context of the late 1960s and early 1970s. Its work led to both private and public initiatives designed to influence the public's health through education; its findings and recommendations also laid the foundation for the National Consumer Health Information and Health Promotion Act of 1976 and thus contributed significantly to the development of subsequent national policy in health promotion and disease prevention. This paper places the work and contributions of the committee into historical perspective by analyzing the committee's origins and methods and the underlying politics that shaped its work and final report. The impact of the President's Committee is traced from the emergence of health education in the early 1970s as a potentially cost-effective alternative to medical care to the pivotal role health education now plays in health promotion and disease prevention efforts.

Consumer Advocacy↗

PubMed1990

Impact of a school-based workplace health promotion program on morale of inner-city teachers.

Results from an evaluation study designed to assess the impact of a school-based, workplace health promotion program on the morale of inner-city school teachers are reported. Teachers in 10 schools completed a questionnaire measuring components of morale prior to and following the opportunity to participate in a series of health promotion programs. Programs included stress management, nutrition education, healthy back, fitness, weight control, and recreational activities. Data also were collected on teachers from a comparison group of schools in the same district. Measures of teachers' pretest and posttest perceptions of the school environment, particularly in terms of perceived control over work activities and participation (ie, empowerment, p less than .05) at posttest, indicated morale was enhanced in schools that implemented the program.

Absenteeism↗

PubMed1989

Vocational education students: a difficult-to-reach population at risk for smoking-related cancer.

Vocational education high school students comprise a significant proportion of the school-based population. Recent studies indicate vocational education students are at greater risk for cigarette smoking behavior than their non-vocational education counterparts. Vocational students have higher prevalence rates of smoking than do non-vocational students and are more likely to report that they expect to be smoking in the future. Characteristics of adolescents who participate in vocational education and their cigarette smoking behavior are reviewed, as well as the need to develop, implement, and evaluate new educational approaches designed to prevent cigarette smoking and the use of other tobacco products in this difficult-to-reach population.

Adolescent↗

PubMed1986

Ethical dilemmas in workplace health promotion.

In less than a decade, workplace health promotion programs designed to promote employee health and help reduce the high cost of health insurance premiums paid by business and industry have proliferated. Notwithstanding the latent benefits and cost savings that corporate management expects to gain from the investment in such programs, it is argued that workplace health promotion is not without potential misuse and that its goals and methods ought not to be above ethical scrutiny. Drawing on earlier work, we discuss how workplace health promotion may pose ethical problems related to social justice, protection of privacy, and social control. The attendant moral dilemmas for the professional whose responsibility it is to develop and implement such programs are also presented.

Ethics↗

PubMed1984