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Biomedical subjects

R Michielutte

Publications and source records attributed to R Michielutte.

At least 55 records · Page 3Linked to original sources
PubMed1990

Readability of the public education literature on cancer prevention and detection.

This paper presents an analysis of the readability level of the educational literature on cancer prevention and early detection. Cancer education brochures and pamphlets were obtained from the American Cancer Society, the National Cancer Institute, private companies, public nonprofit agencies, and state health departments. A total of 183 brochures and pamphlets were examined and reading level (SMOG) scores were computed for 159 of them. The average reading level of the printed cancer education materials was found to be between 10th and 11th grade, with little overall variation by publishing agency, topic, cancer site, focus, or target population. In general, the results suggest that much of the cancer education literature may be of limited value in providing information to the low-income, low-education population.

Female↗
PubMed1990

Development of a direct education workshop for cervical cancer prevention in high risk women: the Forsyth County project.

With funding from the National Cancer Institute, a public health education program was developed with the primary objective of increasing the proportion of black women in Forsyth County, North Carolina, who receive Pap smears on a regular basis. This paper reports on the development and implementation of the direct education component of the program. The content of the workshop was based on community analysis of current knowledge, attitudes, and behaviors in the target population, and a review of relevant literature on cervical cancer and the Pap smear. Methods for presentation of the content were refined through three pilot tests. Audiovisual materials were also developed to illustrate key points. The direct education component of the program was designed to function as a short workshop and includes an overview of healthy lifestyles, coverage of the importance of early detection of cancer, a description and discussion of the pelvic exam and the Pap smear, and a discussion of common barriers to obtaining Pap smears on a regular basis. Evaluation of the workshop emphasizes process measures, including a questionnaire to collect demographic information and impressions of the presentation. Interim results of the evaluation are discussed.

Adolescent↗
PubMed1990

Knowledge and attitudes about cervical cancer and the Pap smear among 10th-grade girls.

Data from questionnaires completed by 419 10th-grade girls were analyzed as part of a school health education program. The questionnaire was designed to collect knowledge of, attitudes toward, and experiences with cancer and cancer prevention. Data were collected from randomly selected health classes preceding a presentation on breast and cervical cancer prevention. Results showed that the girls were pessimistic about chances of surviving cancer and did not differentiate survival by type or site of the cancer. Although there was considerable confusion about its purpose, 27.6% reported having had a Papanicolaou smear within the past year and 79.2% correctly identified the Pap smear as a test for cancer.

Adolescent↗
PubMed1989

Helping students respond to stressful interactions with cancer patients and their families: a pilot program.

This pilot program was designed to help medical students improve their ability to respond to the psychological needs of cancer patients and their families. Third-year students on the hematology/oncology rotation were offered a series of seminars dealing with the psychological and social impact of cancer on patients and their families. The goal of these seminars was to help the students develop working knowledge, understanding, and skills for dealing with cancer patients and families. The seminars used didactic input, videotaped interactions, and guided discussion. Experienced counselors, with the help of an oncologist, led the seminars. Findings from this pilot program suggest that medical students can benefit from specific training in the psychosocial aspects of cancer.

Communication↗
PubMed1989

The effect of a preterm birth prevention program in 17 rural and three urban counties in northwest North Carolina.

The results of a program of low birthweight prevention in 17 rural (20,727 births) and three urban counties (15,561 births) for calendar years 1985 and 1986 are described. Records for women in the program were matched with birth certificate data by computer. Rural and urban women in and out of the program were compared by race on the following risk factors: age less than 18 years, unmarried, education less than 12 years, Medicaid recipient, not WIC recipient, inadequate prenatal care, and previous fetal or live born death. Adjusting for these risk factors, logistic regression was used to estimate program effects on low birthweight (LBW), very low birthweight (VLBW), and preterm low birthweight (PLBW) among rural women. There was a statistically significant difference (p less than or equal to 0.01) favoring women in the program for very low birthweight and preterm low birthweight in white women, and low birthweight and preterm low birthweight in nonwhite women. The differences in rural areas exceed those in urban areas for all but one mean, very low birthweight births among white women.

Adolescent↗
PubMed1988

Identification of women at high risk for preterm-low-birthweight births.

Preterm-low-birthweight births comprise a subset of extremely high-risk low-birthweight infants. While numerous studies have evaluated risk factors to predict an individual's chance of a high-risk pregnancy, few have identified risk factors specifically related to preterm-low-birthweight births. Risk factors for preterm-low-birthweight births were analyzed in a sample of 11,623 women from northwest North Carolina enrolled in a low-birth-weight prevention program. Significant risk factors for preterm-low-birthweight births in this population were identified, and weights were assigned to each factor. Application of the weighting system to each patient's specific risk factors identifies women at high risk for a preterm-low-birthweight birth and assists in the determination of appropriate intervention. These data make use of all current information in the low-birthweight births prevention project. Prospective assessment of the scoring system as the project continues should improve the ability to identify and intervene with women at highest risk for a preterm-low-birthweight birth.

Adult↗
PubMed1988

A comparison of women in and out of a prematurity prevention project in a North Carolina perinatal care region.

We assessed a prematurity prevention project in a North Carolina region with 21,000 annual births in terms of its impact on low birthweight. Project records were matched to birth certificates in order to compare characteristics of women in and out of the program who received prenatal care from private providers. A logistic regression analysis, in which the effects of race, marital status, age, and other risk factors for low birthweight were statistically controlled, showed that women not in the project were 1.32 times (95% Confidence Interval 1.14, 1.54) as likely as project participants to have a birth under 2500 grams. The relative risk for non-participants for a birth under 1500 grams was 1.87 (95% CI 1.25, 2.80). Strengths and limitations of the study are discussed. The results are consistent with previous work examining the etiologies of low birthweight in private versus public patients.

Adolescent↗
PubMed1987

Regional program for prevention of premature birth in northwestern North Carolina.

We present our experience with introducing and implementing a prematurity prevention program in a 20-county region in northwest North Carolina. The program is based on the risk assessment and educational model. In the first 25 months of results available, 17,370 births occurred in women enrolled in the project. During 1985, 42.5% of all births in the region occurred in the project. During the time span examined, a downward trend was seen for rates of low birth weight births in public and private patients and for very low birth weight births in private patients. During 1985, private births in the project were significantly less likely to be low birth weight or very low birth weight than private births to women not in the project. These results suggest that regional implementation of prematurity prevention programs is feasible and that such programs are particularly appropriate for private patients.

Costs and Cost Analysis↗
PubMed1985

Noncompliance in screening follow-up among family planning clinic patients with cervical dysplasia.

This investigation estimated the extent of noncompliance with follow-up to screening for cervical dysplasia at a public health family planning clinic. Available data also permitted examination of the relationship between selected background characteristics and compliance with follow-up. Noncompliance was defined as failure to respond to notification of an abnormal cervical smear (Class III, IV, or V) by failing either to make a follow-up appointment or to keep such an appointment after it was made. The sample consisted of 177 women with abnormal cervical smears who were screened at the Forsyth County Family Planning Clinic between January 1, 1980, and June 30, 1981. Information on the women's compliance with the request for follow-up was obtained from a file specifically kept for this purpose by the clinic nurse. Background characteristics were obtained by reviewing clinic records. Results indicated that approximately 17% of the sample was noncompliant. Noncompliant patients were more likely to be unmarried, less educated, younger, and to have fewer total health problems than women who returned for follow-up. Logistic regression analysis revealed that the number of health problems and educational attainment were the most important predictors of noncompliance.

Adolescent↗
PubMed1984

Knowledge of diabetes and glaucoma in a rural North Carolina community.

Effective use of time, money, and personnel in the delivery of health care services to rural areas requires baseline information on the target population with respect to the problem being addressed. Prior to the initiation of an educational program on diabetes and glaucoma, the Public Health Department of Davie County, North Carolina, conducted a survey of county residents to determine knowledge, attitudes, and practices concerning these illnesses. The goals of the survey were to determine (1) basic knowledge with respect to the nature of each illness, symptoms, and high-risk groups, (2) the stigma attached to each illness, and (3) health practices in terms of previous tests for diabetes and glaucoma and whether or not the respondents know where to go for such tests. Information was obtained through a telephone survey of randomly sampled households in Davie County. Results of the survey indicated that the level of knowledge for both diabetes and glaucoma is particularly low with respect to identification of high-risk groups and symptoms, and approximately one-quarter of all respondents felt there was some stigma attached to diabetes and glaucoma. The lowest levels of knowledge were observed in the youngest and oldest respondents, males, the unmarried, and those with low levels of educational attainment. The differences in knowledge by age, marital status, and sex were found to be partially a function of differing levels of educational attainment. These data have provided information useful in the selection of content areas for the programs and in the identification of target populations for special emphasis.

Adolescent↗
PubMed1984

Weight-for-height indices as measures of adiposity in children.

This study examines the weight-for-height index q = w/h lambda where the parameter lambda is chosen to maximize the correlation of q with triceps skinfold thickness, and thus provide an indirect measure of adiposity. Using a sample of 1668 children ages 5-12 years, we estimate lambda by an iterative procedure in each age/sex category. We find that lambda does not vary simply across the age/sex categories, and that the correlation of q and skinfold thickness is never more than marginally greater than that of the Quetelet index w/h2. We indicate that almost identical properties will be evidenced by the more general two-parameter index w alpha/h beta. Our conclusion is that there is no weight-for-height index generally useful as an indirect measure of adiposity in children.

Adipose Tissue↗
PubMed1984

The relationship between weight-height indices and the triceps skinfold measure among children age 5 to 12.

This study examines several weight for height indices--Quetelet's index W/H2, W/H, and Rohrer's index W/H3--for their appropriateness in estimating adiposity among young children. Data were obtained for a sample of 1,668 children age 5-12 residing in Forsyth County, North Carolina. Although W/H2 was found to be the most useful of these indices, the results suggest that no index, including the tricep skinfold measure, can be considered completely satisfactory in estimating adiposity among children.

Body Height↗
PubMed1984

Informed consent: patient information forms in chemotherapy trials.

Documentation of informed consent by patients entering clinical trials is an ethical and legal necessity. Federal regulations and judicial opinions have led to increasingly lengthy, detailed "consent" forms, yet published studies demonstrate that patients remain confused about the nature and anticipated consequences of study entry. It has been suggested that more detail may even alarm or further confuse patients. Seventy-five women undergoing chemotherapy for advanced breast cancer participated in this study which assessed patient preference for long-, medium-, or short-form length, and whether form length preference correlated with patient characteristics or indicators of patient autonomy in decision-making or physician dependency. Patient preferences for information were not predicted by the patient autonomy or physician dependency scores or by age, marital status, or level of education. The majority of patients expressed a preference for more detailed information about their treatment, yet a majority of patients given detailed forms answered questions basic to the study design incorrectly, irrespective of educational level. The increased detail included in the long forms was not reported to increase stress compared to the short forms. Patient information forms are a principal tool for informing patients for consent but if they are to perform their desired function they must be designed more carefully and evaluated more thoroughly than in the past.

Age Factors↗
PubMed1982

Children's perceptions of cancer in comparison to other chronic illnesses.

Research which deals with beliefs and feelings about cancer suggests that cancer is somewhat unique among chronic illnesses with respect to the intensity of negative feelings and stigma attached to this disease. The research results to date fit well in the context of the health belief model and indicate that cancer is extremely high in perceived severity, moderate in perceived susceptibility, and extremely low in perceived benefits of preventive and treatment programs. This paper reports the results of a study which used the semantic differential technique to determine a sample of seventh-grade students' perceptions of cancer in comparison to heart disease, diabetes, and mental illness. The results indicated that children generally view cancer as higher in severity (except for heart disease), higher in susceptibility, and lower in benefits of treatment than the other illnesses. Perceptions did not differ by sex, socio-economic background, or knowledge of cancer. However, in addition to perceiving cancer as being very high in severity and feeling pessimistic about the chances of recovering, black children believe they are personally more susceptible than do white children. In general, this combination of perceptions provides a unique stigma to cancer as a fearsome chronic disease with little hope of cure. The low perceived benefits of treatment presents a barrier to action which has important implications for health education programs.

Adolescent↗
PubMed1982

Racial differences in knowledge of cancer: a pilot study.

The present study examined the reported sources of information on cancer and the level of cancer knowledge for a sample of black and white adults. Black respondents had significantly less knowledge and the relationship between race and cancer knowledge persisted even when controlling for education, sex, and age. Possible reasons for the observed difference include (a) the tendency for blacks to obtain information on cancer from television and radio, while whites rely more on printed materials, (b) differences in the quality of education received by black and white adults, and (c) a possible lack of motivation on the part of black respondents to acquire knowledge of cancer due to lower access to medical care. Intervention programs designed to provide all blacks with information about cancer should take into account the preferred sources of information, and should be oriented toward reducing the barriers to taking action related to prevention and early detection as well as increasing perceptions of the benefits of taking such action.

Black or African American↗
PubMed1982

A comparison of height, weight, and triceps skinfold thickness of children ages 5-12 in Michigan (1978), Forsyth County North Carolina (1978), and HANES I (1971-1974).

Height, weight, and triceps skinfold measurements were made on 1,668 Forsyth County, North Carolina students ages 5-12 during 1978. These data were compared to a representative sample of Michigan children taken during the same year and to their United States counterparts in HANES I (1971-74). The North Carolina children more closely resembled their US counterparts than did the Michigan group, casting doubt on the secular trend toward heavier children suggested by the Michigan researchers. (Am J Public Health 1982; 72:730-733.)

Black or African American↗
PubMed1981

An analysis of empathy in medical students before and following clinical experience.

The nature and direction of changes in empathy as measured by Hogan's empathy scale was explored over time (1975, 1976, and 1979) for medical students in the class of 1979 at the Bowman Gray School of Medicine. Results indicated that empathy scores declined slightly over time, correlated negatively with Medical College Admission Test scores, and were unrelated to academic performance or performance on Part I or Part II examinations of the National Board of Medical Examiners.

Achievement↗