Biomedical subjects

P L Pirie

Publications and source records attributed to P L Pirie.

At least 37 records · Page 2Linked to original sources

PubMed1992

Impact of a community health promotion program on existing organizations: the Minnesota Heart Health Program.

A community organization strategy was used in the delivery of health education programs by the Minnesota Heart Health Program (MHHP). The effectiveness of the approach was evaluated to determine whether an enhanced health promotion delivery system had developed in MHHP communities by the end of the intervention period or whether the intervention had suppressed community efforts. 'Social connectedness' among providers, as measured by health promotion network size, also was expected to be higher in intervention communities. Six Midwestern communities were studied: the MHHP communities of Mankato, MN and Fargo, ND--Moorhead, MN with two matched comparison communities for each (Winona, MN, St Cloud, MN and Eau Claire, WI, Sioux Falls, SD). Nine areas of health promotion were assessed, including the five heart disease risk factor areas where education campaigns had been implemented (smoking cessation, weight loss, eating patterns, exercise, and heart disease education and screening) and four other areas where community programs are common (chemical dependency; home, personal and drivers' safety; stress management; and cancer education and screening). Indicators of the health promotion delivery system were developed (program options and program participation), and data were collected in separate surveys of 438 community organization providers and 320 larger worksites in the six communities. Results showed no suppression of health promotion delivery systems in MHHP communities. Instead, the survey of larger worksites showed that there was greater participation in heart disease health promotion and greater 'social connectedness' among worksites in both intervention communities. Also, there were more heart disease health promotion programs in the larger intervention community of Fargo-Moorhead. In the community organization survey, results favored the larger intervention community over its comparison communities in heart disease health promotion program options and in 'social connectedness' but not in program participation. However, survey results favored one of the comparison communities (Winona) over the smaller intervention community (Mankato) on all indicators in this survey. The greater impact of the MHHP intervention at worksites suggests that institutionalization may be more likely in stable organizations whose current needs and interests fit the goals of the intervention activity.

Adult↗

PubMed1992

Do weight concerns hinder smoking cessation efforts?

This study examined the hypothesis that weight concerns interfere with smoking cessation efforts. Four hundred fifty-nine women screened for participation in a smoking cessation treatment program completed Stunkard's Three Factor Eating Questionnaire (1981), measures of smoking-specific weight gain concern, and smoking history measures. Success in current cessation efforts was assessed 6 months following treatment. The restraint subscale of the TFEQ was associated with lower baseline level of nicotine dependence, a history of smoking fewer cigarettes, and longer prior periods of successful smoking abstinence. Baseline level of nicotine dependence and treatment group were significant predictors of smoking cessation at 6 months posttreatment. Restraint score was marginally predictive of higher rates of abstinence from smoking at 6 months when baseline level of nicotine dependence and treatment group were controlled. These results do not support the hypothesis that weight concerns interfere with smoking cessation attempts.

Adult↗

PubMed1992

Postpartum relapse to smoking: a prospective study.

A substantial proportion of women who quit smoking during pregnancy will relapse in postpartum. In order to better understand the psychosocial factors which precipitate relapse to smoking we conducted a prospective study of postpartum smoking relapse among a cohort (N = 106) of women who quit smoking during pregnancy. Participants were surveyed by telephone after the 28th week of pregnancy, and at 6 weeks and 6 months postpartum. Point prevalence estimates of smoking relapse indicated that at 6 weeks and 6 months follow-up, 24% (n = 26) and 40% (n = 42), respectively, of the women had returned to regular smoking. Spouse's smoking status, social support, decreases in self-efficacy, and the types of coping strategies used to resist smoking in pregnancy and postpartum predicted relapse to smoking in postpartum. Longitudinal data indicated that relapse occurred relatively gradually suggesting that early postpartum is not too late to encourage new mothers to remain abstinent.

Adolescent↗

PubMed1992

Brief supportive telephone outreach as a recruitment and intervention strategy for smoking cessation.

BACKGROUND: Formal efforts to recruit smokers into cessation programs have failed to reach large segments of the smoking population. Telephone intervention may represent a viable strategy to promote smoking cessation. An even more promising approach may be a combination of brief telephone support and outreach to identified smokers. METHODS: Telephone support for smoking cessation was provided to four identified smoker populations in Bloomington, Minn, one of three Minnesota Heart Health Program education communities. Smokers were randomly assigned to an intervention consisting of two 15-minute telephone calls approximately 1 to 3 weeks apart or to a nonintervention control. RESULTS: At the 6-month follow-up, a significant overall effect was found in favor of the intervention condition for both self-reported and cotinine-validated quitting. Differences between intervention and control conditions were no longer significant at 18 months. CONCLUSIONS: Smokers' receptivity to telephone intervention was at least moderately encouraging. The cost of intervention could be relatively low if trained volunteers initiated telephone calls. However, more intensive telephone intervention and support may be needed to produce lasting changes in smoking prevalence.

Adolescent↗

PubMed1992

Smoking cessation in women concerned about weight.

BACKGROUND: Weight gain after smoking cessation is often cited by women smokers as a primary reason for not attempting to quit smoking or for relapsing after a cessation attempt. METHODS: A randomized trial of 417 women smokers was conducted to test the addition of two weight control strategies to a smoking cessation program. Participants received the standard smoking cessation program, the program plus nicotine gum, the program plus behavioral weight control, or the program plus both nicotine gum and behavioral weight control. Weight and smoking status were measured at the end of treatment and at 6 and 12 months posttreatment. RESULTS: Smoking cessation rates were highest in the group receiving the smoking cessation program plus nicotine gum. Weight gain did not vary by treatment condition, so its effect on relapse could not be examined by group. There was no significant relationship between weight gained and relapse in individuals. CONCLUSIONS: The added behavioral weight control program was attractive to the participants and did not reduce smoking cessation rates. However, it did not produce the expected effect on weight, thereby restricting our ability to examine the effect of weight control on smoking cessation and relapse.

Adult↗

PubMed1991

Worksite health promotion in four Midwest cities.

A survey of worksite health promotion activities in nine areas of health was conducted in four Midwest cities--Winona and St. Cloud, MN; Eau Claire, WI and Sioux Falls, SD to determine how many worksites are involved in these activities; how many different kinds of programs they offer; and whether or not worksite involvement is growing in these areas of health. All worksites with over 100 employees were surveyed with a completion rate of 96% for eligible worksites. Comparing program offerings at worksites with such offerings by other community providers, we find worksites provide 40% of the total of such programs to adults. They tend to operate most programs independently of other community providers. Exercise and smoking cessation programs are most commonly offered. Worksites in the four communities significantly differed in the number of exercise program options offered and in the prevalence of worksite involvement in home, personal and drivers' safety programs. Compared to national survey results, worksites in these Midwest cities show a lower level of participation in heart disease and cancer screening activities. There is a high rate of dropout among current providers of heart disease screening activities and few nonproviders are initiating programs. Program initiation among nonproviders is highest in smoking cessation, weight loss and nutrition. Program growth among current providers is high in the areas of chemical dependency, exercise and personal, home and drivers' safety.

Data Collection↗

PubMed1991

A comparison of self-help approaches to smoking cessation.

The current study evaluated the effectiveness of widely used self-help materials for quitting smoking. Five hundred and seventy smokers volunteered during a baseline survey to participate in the evaluation. After random assignment, 200 were mailed National Cancer Institute (NCI) "Quit for Good" materials, 200 the Minnesota "Quit and Win" program, and the remaining 170 were assigned to a nonintervention control condition. Results at 7-month follow-up failed to indicate treatment effects either for abstinence or for reported quit attempts. A number of smokers quit prior to the mailing of self-help materials, suggesting that a telephone prompt in itself may have been an important stimulus to cessation. Overall abstinence at follow-up was 10%. Contrary to expectation, successful participants were less likely to use a number of specific preparation strategies for quitting. The results are instructive in providing a large-scale assessment of self-help materials in a population of smokers that was not specifically seeking treatment.

Adult↗

PubMed1991

Gender differences in cigarette smoking and quitting in a cohort of young adults.

BACKGROUND: Smoking among young women is associated with a variety of negative health outcomes. Gender specific influences on smoking, quitting and attempting to quit are hypothesized to occur and may have implications for cessation programs. METHODS: Telephone surveys were conducted in a large (n = 6,711) cohort of young men and women (average age 19.2 years) which was first established in 1979 and has been resurveyed several times since then. Questions concerned smoking, successful and unsuccessful attempts to quit, withdrawal symptoms during quit attempts, and concerns about quitting. RESULTS: More women than men reported current smoking (26.5 vs 22.6 percent), but quitting attempts, successful and unsuccessful, were equally common. Withdrawal symptoms were reported equally, except for wanting to eat more than usual and weight gain, both of which were reported more often by women than men. Women smokers reported substantially more concern about weight gain if they quit smoking (57.9 vs 26.3 percent expressing concern). CONCLUSIONS: Targeted programs are needed to address issues of concern to young women smokers, particularly fear of gaining weight.

Adult↗

PubMed1991

The shortened premenstrual assessment form.

Research on the premenstrual syndrome (PMS) has been impeded by a lack of reliable and valid assessment techniques. The premenstrual assessment form (PAF), although a valid and reliable instrument, consists of 95 questions, requires extensive periods of time to complete and may be inappropriate for some clinical and research purposes. A study was designed to shorten the PAF and to test the validity and reliability of the shortened instrument. Twenty items that were most frequently reported to change during the week prior to menses were selected from the 95-item PAF form. The 20-item PAF form was administered at the baseline and 6- and 12-month follow-up clinic visits. A factor analysis identified three subscales: affect, water retention and pain. Our results showed that a shortened, 10-item version of the PAF had high internal consistency and reliability. A comparison of the symptoms on the 10-item PAF scale to reported nicotine withdrawal symptoms indicated that while the two correlated, the intercorrelation between the PAF subscales and the total PAF over time was higher. Thus, the 10-item PAF appears to measure a somewhat distinct and relatively stable set of symptoms. The 10-item PAF is a reliable and valid instrument that can be used to assess PMS when the study design or clinical need precludes the use of a 95-item PAF.

Adult↗

PubMed1991

Physician practice for cardiovascular disease risk-factor reduction in six upper Midwestern communities.

Preventive practice for coronary heart disease risk is increasingly accepted in the medical community. To determine the extent and characteristics of treatment advice for high blood pressure, blood cholesterol, and cigarette smoking, 274 randomly selected primary care physicians were interviewed by telephone in six Midwestern cities. Participation in the survey was 90%. Reported care for high blood pressure was consistent with national guidelines. Management of high blood cholesterol varied significantly among physicians and frequently differed from national recommendations. Although consensus existed on the importance of advising cigarette smoking cessation, reported approaches differed. The results observed indicate improved preventive practice compared with earlier surveys and recent national reports. Continued improvement, however, is needed in cholesterol and smoking-cessation management.

Blood Pressure↗

PubMed1991

Changes in physician practice for the prevention of cardiovascular disease.

To determine recent changes in physicians' practices for cardiovascular disease risk reduction, a randomly selected sample of practicing primary care physicians in the upper Midwest was interviewed by telephone in 1987 and again in 1989 (response rates, greater than 90%; N = 241). The reported mean cutoff levels for labeling a total serum cholesterol level as abnormal dropped from 5.84 to 5.43 mmol/L (226 to 210 mg/dL) and for initiating medication, from 7.34 to 6.54 mmol/L (284 to 253 mg/dL). The proportion of physicians using diuretics as preferred step 1 antihypertensive agents dropped from 60% to 32%. Preferences became evenly divided among diuretics, angiotensin-converting enzyme inhibitors, and beta-blockers. Advice about physical exercise changed little, but consensus among practicing physicians was high. Substantial improvements were found in smoking cessation activities. Practicing physicians are proving to be responsive to new scientific evidence and education in the prevention of cardiovascular disease.

Antihypertensive Agents↗

PubMed1990

An investigation of the cause of the eosinophilia-myalgia syndrome associated with tryptophan use.

BACKGROUND: The eosinophilia-myalgia syndrome is a newly recognized illness that has been associated with the consumption of tryptophan products. It is not known whether the cause is related to the tryptophan itself or to chemical constituents introduced by the manufacturing process. METHODS: To describe the epidemiology of the eosinophilia-myalgia syndrome further and elucidate a possible association with the manufacturing process, we conducted surveillance for the syndrome in Minnesota, a community survey of tryptophan use in Minneapolis-St. Paul, and a case-control study to assess potential risk factors, including the use of tryptophan from different manufacturers. We performed high-performance liquid chromatography on tryptophan samples to identify other chemical constituents. RESULTS: The prevalence of tryptophan use increased from 1980 to 1989 and was highest among women. Among the subjects for whom the source of the tryptophan was known, 29 of 30 case patients (97 percent) and 21 of 35 controls (60 percent) had consumed tryptophan manufactured by a single company (odds ratio, 19.3; 95 percent confidence interval, 2.5 to 844.9; P less than 0.001). This company used a fermentation process involving Bacillus amyloliquefaciens to manufacture tryptophan. Analysis of the manufacturing conditions according to the retail lot demonstrated an association between lots used by case patients and the use of reduced quantities of powdered carbon in a purification step (odds ratio, 9.0; 95 percent confidence interval, 1.1 to 84.6; P = 0.014), as well as the use of a new strain of B. amyloliquefaciens (Strain V) (odds ratio, 6.0; 95 percent confidence interval, 0.8 to 51.8; P = 0.04). There was a significant correlation (r = 0.78, P less than 0.001) between the reduced amount of powdered carbon used during manufacturing and the use of the new bacterial strain. High-performance liquid chromatography of this company's tryptophan demonstrated one absorbance peak (peak E) that was present in 9 of the 12 retail lots (75 percent) used by patients and 3 of 11 lots (27 percent) used by controls (odds ratio, 8.0; 95 percent confidence interval, 0.9 to 76.6; P = 0.022). CONCLUSIONS: The outbreak of the eosinophilia-myalgia syndrome in 1989 resulted from the ingestion of a chemical constituent that was associated with specific tryptophan-manufacturing conditions at one company. The chemical constituent represented by peak E may contribute to the pathogenesis of the eosinophilia-myalgia syndrome, or it may be a surrogate for another chemical that induces the syndrome.

Adolescent↗

PubMed1990

Postpartum smoking relapse.

While it has been established that many women quit smoking during pregnancy, little is known about postpartum maintenance of smoking cessation and relapse. A sample of 567 women were surveyed at about 6 months postpartum in order to (a) describe the patterns of smoking relapse; (b) assess the perceived importance of smoking cessation in pregnancy and postpartum; and (c) identify potentially high risk situations for smoking relapse. Results indicate that about half (56%) of the women who quit smoking during pregnancy relapse to smoking by 30 days postpartum. Most of these relapses occur in the company of other smokers. Socializing and/or living with a smoker had a powerful negative impact on ability to maintain abstinence in postpartum. Smoking cessation programs for pregnant women should emphasize the importance of continued abstinence in postpartum.

Adolescent↗

PubMed1989

Tracking and attrition in longitudinal school-based smoking prevention research.

Research in the development of school-based smoking prevention programs has resulted in a set of approaches of known short-term efficacy. Further evaluation of these approaches now requires long-term follow-up of participants. To minimize the problems caused by attrition in these longitudinal studies, investigators have developed techniques for tracking study participants. Based primarily on the use of the telephone, mail, and public documents, these methods require good background information on both the study participants and their parents. This article summarizes the experience of three teams of researchers engaged in such follow-up studies. These investigators have identified the types of background information most useful in long-term follow-up of participants, have developed a set of strategies to obtain such background information, and have developed methods for successfully tracking participants after a lapse of several years.

Adolescent↗

PubMed1989

Validity of telephone surveys in assessing cigarette smoking in young adults.

Self-reports of cigarette smoking in a sample of young adults, aged 17 to 21 (n = 359) obtained by telephone were validated by home interview and saliva cotinine measurement. While most subjects were in agreement for their reported behaviors, the telephone methodology underestimated cigarette smoking rates by 3 to 4 per cent. Reported quitting by telephone was an unstable category with 35 per cent of quitters reporting smoking on home interview. Reliance on telephone methods alone may underestimate smoking behavior. Validation of surveys, preferably by biochemical methods, is recommended.

Adolescent↗

PubMed1988

Effects of gender on type A assessment with the Matthews Youth Test for Health (MYTH).

This study investigated the influence of childrens' and teachers' sex on Type A assessment using the Matthews Youth Test for Health (MYTH). Two hundred and ten teachers and student teachers read vignettes describing the behavior of children reacting to challenges in a school environment. Teachers were randomly assigned to one of four vignettes: (1) male Type A child; (2) female Type A child; (3) male Type B child; (4) female Type B child. Higher MYTH scores were assigned to Type A compared with Type B children. However, among Type A children, male teachers assigned significantly lower MYTH scores to girls than to boys; the MYTH ratings made by female teachers for Type A children were equivalent for boys and girls. These results suggest that the sex of the child and the teacher interact significantly to influence aspects of Type A assessment, but that classification overall reflects observed behavior.

Adult↗

PubMed1988

Smoking prevalence in a cohort of adolescents, including absentees, dropouts, and transfers.

This study reports daily smoking rates among older adolescents obtained by a unique follow-up of a cohort originally identified in the seventh grade. Those no longer in their original school districts were located and interviewed by telephone. Smoking rates among dropouts exceeded 70 per cent in all age-sex groups. Smoking rates among transfers were as high as those among absentees. Including these subgroups raised smoking prevalence rates among older adolescents substantially.

Absenteeism↗

PubMed1988

Predictors of non-adoption of cigarette smoking following experimentation.

The Childhood Antecedents of Smoking Study (CASS) investigated patterns of cigarette smoking among junior and senior high school students in an upper midwest school district. Four biannual school-based surveys were conducted over two years. A cohort of 72 smokers was identified and followed to determine who continued smoking and who quit. Discriminant analysis was used to study social, psychological, and environmental factors predictive of quitting smoking. Compared to continuing smokers, quitters reported having fewer friends and siblings who smoked, they were less likely to view the cigarette smoker's image as positive, and lived in families where parental involvement with teenagers was high (based on the reports of parents). These results are consistent with the view that social influences are strong determinants of patterns of adolescent smoking behaviour.

Adolescent↗