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Biomedical subjects

N H Gottlieb

Publications and source records attributed to N H Gottlieb.

At least 37 records · Page 2Linked to original sources
PubMed1990

Impact of a restrictive work site smoking policy on smoking behavior, attitudes, and norms.

Three successive cross-sectional surveys were used to measure the impact of a restrictive smoking policy on employee smoking patterns, perceived exposure to environmental tobacco smoke, attitudes about the policy, and smoking-related norms in a large decentralized state agency. No significant change was detected in smoking prevalence, the proportion of smokers attempting to quit, or the total daily consumption of cigarettes by smokers. The daily consumption of cigarettes at work decreased significantly, from 16.9% to 4.9% smoking 15 or more cigarettes per day. The proportion of respondents bothered every day by coworkers' smoke dropped from 21.8% to 3.8%. Following policy implementation, the interaction between smokers and nonsmokers about smoking decreased. The findings suggest that restrictive work site smoking policies are effective at decreasing exposure to environmental tobacco smoke, but not, at least in the short run, at lowering smoking prevalence. Also, the decreased interaction regarding smoking may have the unintended consequence of reducing the perceived pressure on smokers to quit.

Black or African American↗
PubMed1990

A systematic effort to reduce smoking at the worksite.

Smoking control is a key element of worksite health promotion. This three-stage study in a large state human services agency included a baseline survey, an assessment of the effects of competition on recruitment to a self-help cessation program, and examination of the outcome of the cessation program. In stage 1, scales for measuring smoking-related attitudes and the social environment were developed and used to study norms for smoking. Regression analysis was used to ascertain correlates of smokers' intentions to quit and to join a self-help program and non-smoker assertiveness. In stage 2, an evaluation using a quasi-experimental design indicated that competition was moderately effective in increasing the recruitment of all employees to the Great American Smoke-Out (70 vs. 17%) and of smokers to a self-help cessation program (28 vs. 6%). In stage 3, the self-reported quit rate at the end of the program was 28% and the biochemically-verified six months' cessation rate was 7%. Efforts are needed to strengthen, using ethical means, the norms for not smoking at the worksite and to increase both the recruitment to and the effectiveness of smoking cessation programs.

Adult↗
PubMed1989

Smoking policies among private employers and public agencies in Texas: a statewide analysis.

The present study examined the prevalence, correlates, and perceived impact of smoking policies among private employers and public agencies in Texas. An identical survey instrument was administered to two groups of Texas employers: a random sample of private industries and all state agencies (excluding universities). Response rates were 62% (n = 420) for private industries and 73% (n = 130) for public agencies. Fifty-two percent of state agencies and 53% of private employers reported having a smoking policy, with the majority of policies having been implemented since 1986. Concern about employees' health or comfort was the most important reason for implementing a policy for both state agencies and private employers. Both groups believed that implementation of a policy resulted in fewer complaints from employees and less smoking in the workplace but had less impact on productivity or morale. This study on the prevalence of smoking policies in the workplace is the first to document that the majority of surveyed employers have a restrictive smoking policy in place. In addition, this study found minimal differences in the prevalence, rationale, and perceived benefits of smoking policies between private employers and state agencies.

Humans↗
PubMed1988

Predictors of safety belt initiative by primary care physicians. A social learning theory perspective.

Even with the passage of state safety belt laws, primary care physicians can contribute to their patients' safety by brief interventions. The present study explores the prevalence of such action with adult patients and tests the power of constructs taken from social learning theory to explain physicians' behavior. These constructs included self-efficacy, personal behavior (self-modeling) and three outcome expectations--expectation of patient follow-through, health impact, and impact of health promotion on the practice. Data were taken from a survey of Texas family physicians prior to enactment of the state law (n = 209). History-taking and advising were combined to form a single scale, "safety belt action." Prevalence of safety belt action was low. Overall, only 5% said they ask routinely about safety belts; 58.1% do not advise or discuss the risk even when they are aware of nonuse. Social learning theory variables accounted for 34% of the variance in safety-belt action after controlling for year of graduation in a hierarchical regression analysis. Self-efficacy was entered first, and it predicted 25% of the variance. The other social learning variables were entered together, and they predicted the additional 9% of the variance after controlling for year of graduation and self-efficacy. Of these other variables, only health impact was significant, however. These findings suggest several avenues for improving safety belt action and add evidence for the importance of outcome expectations over and above self-efficacy.

Adult↗
PubMed1987

Patients' substance abuse and the primary care physician: patterns of practice.

The Social Learning Theory concepts of self-efficacy and outcome expectations were used to study physician practice regarding patients' smoking, alcohol problems, OTC drug problems, and illicit drug use in a random sample of Texas primary care physicians. The highest proportion of physicians took histories and counseled patients regarding the abuse of cigarettes, followed by alcohol, OTC drugs, and illicit drugs. Outside referral was most likely for illicit drugs, followed by alcohol, OTC drugs, and smoking. Multivariate discriminant analysis showed year of graduation, specialty, self-efficacy, and outcome expectation for patient compliance to be predictive of many of the behavior/practice level combinations. More recently trained physicians, internists, and family practice specialists were more likely to practice in the substance abuse areas. Self-efficacy and outcome expectation were positively related to history-taking and counseling and negatively related to outside referral. Interventions to increase physicians' self-efficacy and expectations for patient compliance and to provide more realistic expectations for treatment "success" are needed, especially for physicians who are not recently trained. Further research to clarify the process by which physicians' cognitions of self-efficacy and outcome expectations influence their practice behavior is also recommended.

Alcoholism↗
PubMed1987

The business of health promotion: ethical issues and professional responsibilities.

In the nine years since an entire issue of Health Education Quarterly (then Health Education Monographs) was devoted to considering ethical issues in health education, several important social changes have occurred which have substantially influenced the practice of that discipline. New practice contexts and ethical issues have resulted, which require a fresh look at both these new issues as well as those addressed in the earlier monograph. The importance of understanding the principles underlying the ethical dilemmas raised by the authors is emphasized as a concern for both the individual practitioner as well as the profession of health education itself. Recommendations for personal and professional action are made by the authors.

Codes of Ethics↗
PubMed1986

The relative influence of health beliefs, parental and peer behaviors and exercise program participation on smoking, alcohol use and physical activity.

This research specifies a model for lifestyle health behavior which includes socialization, social environmental and cognitive influences on smoking, alcohol use and exercise. Survey respondents were participants in university conditioning classes, academic health classes and a community fitness program. Of the socialization influences, drinking by both parents was directly related to drinking by females and drinking by the mother to that of males. Physical activity level of the father was associated with the activity of both genders. Parental smoking was not related to that of the respondents. Income was positively correlated with alcohol consumption in both genders and with smoking among women. In the immediate environment, drinking and smoking by male and female friends were directly associated with that of both male and female respondents with congruent gender relationships being strongest. Exercise by male friends was positively associated with activity level for both genders, as was exercise by female friends for women only. For college students, program participation was related to lower alcohol consumption among men only and higher activity level for women only. It was not related to the likelihood of smoking. For cognitive factors, belief in the efficacy of lifestyle change was inversely related to alcohol consumption for both genders and to smoking for women. Susceptibility to heart disease was associated with a low exercise frequency and smoking, while generalized susceptibility was directly related to activity level and to smoking. Self control over health was positively related to activity level. With one exception, the peer modeling variables had the strongest relationships of any of the model elements in the multivariate analyses. Gender specificity for modeling of behavior was found for peers, but not for parents. These findings suggest that prevention programs incorporate strategies to maximize peer support for healthful behavior and to counteract the effects of unhealthful behavior modeled by peers. Interventions to increase beliefs in the efficacy of lifestyle change to reduce risk are appropriate to encourage behavior change. When the change is underway, discussion of lowered susceptibility as a function of program compliance should reinforce the new behavior.

Adolescent↗
PubMed1985

Sociocultural correlates of childhood sporting activities: their implications for heart health.

The relative contribution of sex, ethnicity, social class, parental exercise and heart health knowledge to the variability of sporting activities reported by Texas 7th and 8th grade students in 1980 was examined to study the cultural patterns of exercise that might relate to future risk for heart disease. Girls were more likely than boys to participate in activities with high aerobic potential. Relative to Mexican-Americans and Blacks, Anglos were more likely to engage in individual, non-competitive, aerobic-type activities. Multivariate analysis showed heart knowledge, parental exercise, sex, father's occupation and ethnicity to be significantly related to the overall frequency of exercise. Parental exercise had a stronger influence on the frequency of exercise among girls than boys. These findings suggest possible cultural mechanisms in the epidemiology of heart disease.

Adolescent↗
PubMed1984

Maximizing school health services in a time of fiscal restraint.

This case study reports a communitywide effort to reduce the fragmentation and duplication of child health services in Boston. Consensus was first reached on what basic health services should be offered and where--school or community--they would be most efficiently and effectively delivered. The planning group then developed strategies to coordinate a network for the delivery of these services. Implementation has begun. The Boston experience offers a mechanism to maximize school health services as available funding for them declines.

Boston↗
PubMed1984

The effects of ethnicity, sex and father's occupation on heart health knowledge and nutrition behavior of school children: the Texas youth health awareness survey.

The relationships of ethnicity, sex and father's occupation with heart health knowledge and nutrition behavior were studied in Texas seventh and eighth grade students. A questionnaire was administered to 2,695 children in schools chosen to represent the urban/rural and ethnic mix of the state population. The findings indicated a strong need for heart health education and for culturally-relevant nutrition education aimed at specific target groups defined by ethnicity, sex and leisure activity. Analysis of eating behavior at school and home confirmed the importance of school feeding programs on the health of minority and low income children.

Adolescent↗
PubMed1984

Life events, social network, life-style, and health: an analysis of the 1979 National Survey of Personal Health Practices and Consequences.

The relationships among social structure, stress, social support, life-style health behavior, and health status are explored in this multivariate analysis of data from the National Survey of Personal Health Practices and Consequences. Path analyses showed social structural factors to influence life-style practices both directly and indirectly through social network and negative life events. For women, social network and life events had direct relationships to health related life-style practices, while age and income acted both directly and indirectly through social network and, for income, through life events. Education was also directly related to life-style. For men, social network and education had the only direct effects on health practices, and age and income had indirect effects through network. We then examined the relative contributions of the social network index elements, life events, and demographic variables to each of the life-style practices. These analyses confirmed the importance of gender, education, age, and income to predicting life-style behaviors. Negative life events were associated with smoking for both men and women, sleep for women only, and physical activity and alcohol use for men, which suggests sex-specific norms for coping with stress. For both sexes, church attendance and marriage were associated with favorable smoking and alcoholic use, implicating cognitive social support or social control as a mediator of health promotion. Finally, analyses for each gender using health status as the outcome variable indicated that age, income, education, and life events affected health directly, while the effects of church attendance and marriage were likely mediated through smoking and alcohol behaviors.

Attitude to Health↗
PubMed1983

The determination of smoking types: evidence for a sociological-pharmacological continuum.

The Horn-Waingrow smoking typology was partially replicated in a sample of college women. Findings from regression analyses, using the types as dependent variables and the smoking behavior of parents and peers, age, the age smoking begun regularly, frequency and amount of smoking as independent variables, supported the notion of a sociological-pharmacological continuum underlying the types. Zero-order correlation of quitting influence factors with the types suggested different strategies for cessation based on the types and indicated the usefulness of the type concept.

Adult↗
PubMed1982

The effects of peer and parental smoking and age on the smoking careers of college women: a sex-related phenomenon.

In the United States, smoking for women has followed a different pattern for women than for men, and the literature suggests that it, as a 'masculine' behavior, may serve as a role-delineating function for women. This research examines the relationship between sex of smoking parents and peers and the smoking behavior of college women. Having a mother who smokes was significantly related to whether or not the daughter smokes, the age of onset, and the frequency of the daughter's smoking; the proportion of female friends who smoke, to the frequency and amount of the woman's smoking and to the degree of difficulty of quitting. Smoking by the father and male friends was not important. Also, the age of the woman was significantly to whether or not she ever smoked and to the age of onset of smoking. This likely reflects her experience of social norms regarding smoking by women and the publication of the first surgeon general's report on smoking and health. These findings support the notion of smoking as a role-related behavior for women. Further research is needed to extend these findings to men and other health behaviors.

Adult↗
PubMedDate not supplied

Predictors of state legislators' intentions to vote for cigarette tax increases.

BACKGROUND: This study analyzed influences on state legislators' decisions about cigarette tax increase votes using a research strategy based on political science and social-psychological models. METHODS: Legislators from three states representing a spectrum of tobacco interests participated in personal interviews concerned with tobacco control legislation (n = 444). Measures of potential predictors of voting intention were based on the consensus model of legislative decision-making and the theory of planned behavior. Multiple logistic regression methods were used to identify social-psychological and other predictors of intention to vote for cigarette tax increases. RESULTS: General attitudes and norms concerning cigarette tax increases predicted legislators' intention to vote for cigarette tax increases. More specific predictors included perceptions of public health impact and retail sales impact of cigarette tax increases. Constituent pressure was the strongest perceived social influence. Political party and state also were strong predictors of intention. Results were consistent with related research based on political science models. CONCLUSIONS: Legislators' votes on cigarette tax increases may be influenced by their perceptions of positive and negative outcomes of a cigarette tax increase and by perceived constituent pressures. This research model provides useful insights for theory and practice and should be refined in future tobacco control research.

Female↗
PubMedDate not supplied

Measures of American Indian traditionality and its relationship to cervical cancer screening.

The goal of this study was to evaluate the relationship between culture and attitudes about cervical cancer screening among young American Indian women living and working in northeast Oklahoma. A cohort of 199 American Indian women, ages 18-40, were surveyed to determine their blood quantum, self-identification, and beliefs and practices regarding traditional behavior in order to develop a traditional behavior scale (the degree to which an individual maintained traditional tribal ways or behaviors). The use of this scale indicated that the degree of American Indian blood quantum, blood quantum for primary tribe, and self-identification are correlated to the traditional behavior scale. The scale, however, was unable to predict intention to get a Pap test. Results indicate that it is useful to understand the variation of traditional behavior within the specific population group to be served when planning and implementing culturally appropriate interventions for American Indian women. It is also useful to evaluate which segments of the population current programs are reaching.

Acculturation↗