[Deficiency of intestinal lactase in a Nahua population: alternatives for programs of nutritional intervention in the region].
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Adolescent↗
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Results for “Population Programs”
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Survey of Canadian urban public health prenatal programs goals objectives, populations served and outcome measures.
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Canada↗
[A study of the health status of the population within a program of scientific and technical cooperation of the members of the Council of Mutual Economic Assistance].
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Child↗
The changing student population in diploma programs.
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Adolescent↗
Preventive dental programs for school-age children in 8 countries: pilot survey, 1979.
This paper reports the results of a pilot project, sponsored by the FDI Working Group on Oral Health Promotion, which was designed to describe preventive dental programs for school-age children in 10 countries. A mail questionnaire was developed to obtain information about program philosophy, target population, preventive program components, promotion and educational methods, barriers to program development, program priorities and evaluation methods. In this pilot phase, a total of 27 questionnaires were returned from 8 countries (Argentina, Federal Republic of Germany, France, Japan, Singapore, Sweden, Thailand, United Kingdom). Respondents generally recognized the need to include three major program elements in order to build comprehensive programs, primary preventive measures, early detection and treatment services, and instructional activities for children and adults. Financial problems were cited most frequently as barriers to program development, followed by manpower, public acceptance, policy decisions, policy-maker attitudes, legal constraints and transportation. The domain of educational problems associated with initiating and maintaining children's preventive dental programs is broad and diverse. Educational problems, roles and methods seemed to be pervasive, cutting across all program components. Although the greatest educational emphasis appeared to be on oral hygiene, the need was also recognized to include educational components for each dental program element or service, such as fluoride rinsing. Educational needs related not only to children, but to policy-makers, dental and other health professionals and program and school personnel. The FDI Working Group has expanded the survey and collected data from a much larger number of countries during 1979-1981. Results of the larger survey will be presented at the Annual World Dental Congress of the FDI in Vienna, 1982.
Asia↗
[Dental caries in a school population with a program of periodical rinses with sodium fluoride].
OBJECTIVE: To appraise the level of school-children's dental health after five years in operation of the buccal-dental health programme, in which children received fortnightly rinses of sodium fluoride at 0.2%. DESIGN: A crossover study. School survey of the 1993-4 academic year. PARTICIPANTS: A total of 1,674 school-children belonging to the first (6 years old), third (8), fifth (10) and eighth (13) years of EGB (basic) in the thirteen schools in this city. MEASUREMENTS AND MAIN RESULTS: Two odontologists checked the children according to the W.H.O. norms. The Index of individuals free of caries and the prevalence of caries were calculated. The first index showed its highest value at 10 (78.4%) and its lowest at 8 (53.34%). CAOD showed its lowest level at 6 years old (0.02%) and progressively rose to 13 (1.41). COD went up from 6 (0.96) to 8 (1.09) and afterwards went down till 13 years old (0.05). The restoration index was low in worn out teeth and particularly high in permanent ones (68.08%) at 13. CONCLUSIONS: The caries indexes are lower than in the majority of studies carried out in Spain, being most similar to a study carried out in the county of Mayorga de Campos (Valladolid) in 1988, where fluoridated water exists in a natural form (0.67-0.87 mg/litre), as well as to other areas in Catalonia where the same fluoride rinses were performed.
Adolescent↗
Screening programs in the population at large and in high-risk groups.
Existing guidelines for colorectal cancer screening in standard risk patients are reviewed, as well as the data on which they are based. A family history of colorectal cancer or significant adenoma increases the risk above that of standard risk individuals. Risk assessment and surveillance in higher risk individuals are discussed.
Adenomatous Polyps↗
The use and impact of incentives in population-based smoking cessation programs: a review.
PURPOSE: This review discusses current published literature on population-based smoking cessation interventions that involve incentives and examines whether such interventions are effective in reducing the prevalence of smoking. SEARCH METHOD: Studies published between 1975 and Spring 1997 were identified through a computerized search of four electronic databases (MEDLINE, HEALTH, CINAHL, and PSYCINFO) and reference lists of key articles using the following key words: (smoking cessation OR quit smoking) AND (contest OR competition OR incentive OR lottery OR quit and win). This search yielded 79 articles. To be included, studies had to be published in English and had to have presented either quit rates or participation rates for an incentive-based program that used population-based recruitment. Of the 79 articles, 17 met these criteria. FINDINGS: Population-based interventions generally attract 1 to 2% of the target population, but these participation rates can potentially be increased through the use of innovative recruitment techniques. No specific type of recruitment strategy was shown to be consistently more effective than others. There is no evidence that particular types of incentives are able to influence participation or quit rates, but the size of an incentive does appear to be important, with larger incentives viewed as more effectively motivating smokers to quit and stay smoke free than smaller ones. Estimates of the cost per quitter have ranged from less than $20 to over $400. There are some indications that the costs of such programs compare favorably with smoking cessation classes or clinic-based approaches. CONCLUSION: Incentive-based smoking cessation programs that target an entire community have the advantage of reaching a large and diverse group of smokers. They may, however, attract only smokers who are already motivated to quit. Realistically, incentive-based programs aimed at the general population can expect 1% of all their smokers to quit smoking. Quit rates among participants may initially be high (i.e., mean quit rate of 34% at 1-month follow-up) but decrease over time (i.e., mean rate of 23% at 1 year). The results of this review suggest a continued need to establish standard and valid criteria for the evaluation of smoking cessation interventions. Methodological differences among existing studies make them difficult to compare and interpret.
Canada↗
Examining male roles in population policies and family planning programs.
"This paper will discuss the following: why population policies and programs have traditionally focused on women; what the limitations of current male contraceptives are and why research into new methods [has] proved unfruitful; and why these policies and programs would be more productive if they were to direct more attention toward men."
Contraception↗
A literature review of cardiovascular disease management programs in managed care populations.
OBJECTIVES: (1) To review the literature on cardiovascular disease management programs in managed care populations, (2) compare the rigor of the studies and their findings by disease state, and (3) posit directions for future research. SUMMARY: A total of 20 studies conducted in managed care populations were reviewed: 5 in patients with congestive heart failure (CHF), 9 in hypertensive patients, and 6 in hyperlipidemia and/or coronary artery disease (hyperlipidemia- CAD) patients. Management of CHF involved multifaceted programs that included the participation of multiple health care professionals, patient and physician education, promotion of intensive drug therapy and lifestyle modifications, and close patient monitoring. The most common CHF management strategies were case management and physician education, with an emphasis on close patient monitoring. Hypertension and hyperlipidemia-CAD intervention programs focused on chronic outpatient management and regular follow-up, with an emphasis on self-management skills. These programs were managed through regular and periodic interventions, including pharmacist-managed clinics and automated provider notices. Many of the studies employed "before-after" comparisons in the absence of a truly experimental design and posed significant limitations due to variations in the outcomes measured, lack of transparent disease severity stratification, and variation across types of managed care organizations. CONCLUSION: A number of cardiovascular disease management strategies in the literature reported promising results. Many of the multidisciplinary CHF disease management programs were more complex than were programs for hypertension and hyperlipidemia-CAD, due, at least in part, to the nature and severity of the disease. A lack of agreement on appropriate economic and clinical outcomes for evaluating the effectiveness of cardiovascular disease management strategies is readily apparent.
Cardiovascular Diseases↗
A capture-recapture technique to estimate the size of the injecting drug user population attending syringe exchange programs: AjUDE-Brasil II Project.
This paper presents the results of a study with a two-occasion capture-recapture design. The data are part of the AjUDE-Brasil II Project, carried out in 2000-2001. Estimation of the size of the IDU population attending a syringe-exchange program (SEP) in São José do Rio Preto, Salvador, and Porto Alegre, Brazil, was performed using Chao's model. Capture probabilities were also estimated. For Porto Alegre a comparison of the results from the AjUDE-Brasil I and AjUDE-Brasil II Projects was performed. Results are also presented for error rates secondary to the choice of matching criteria.
Brazil↗
The EPIGRAM computer program for analyzing mortality and population data sets.
EPIGRAM is a computer program designed to improve access to State-level underlying cause mortality data. The program produces results for population, deaths, death rate, age-adjusted death rate, years of potential life lost (YPLL), YPLL rate, and confidence intervals. Results can be compared variously among age groups, counties, causes of death, races, regions, and years. The program's menu-driven interface facilitates the selection or modification of analysis parameters. Current selections are retained so the user can modify one parameter at a time. Based on the parameters that the user selects, the program produces a series of tables, one for each instance of a particular parameter. Each output table has columns for male, female, and both sexes combined, and an indefinite number of user-defined rows for age groups, causes of death, counties, races, regions, or years. EPIGRAM has major advantages over other methods for analyzing mortality and population data. The program uses relatively small amounts of memory and disk space, executes rapidly, is flexible, can be used by inexperienced computer users, provides online help screens and tutorials, and runs under DOS or UNIX without modification. The program currently is used to analyze mortality and population data for Texas. Although it is not currently available for distribution, support is being sought for its evaluation and possible implementation in State health departments to analyze data for other States, or other data sets, such as hospital discharge data or cancer incidence data.
Cause of Death↗
Factors related to non-attendance in a population based melanoma screening program.
A total of 127 non-attenders in a population-based melanoma screening program, 58 women and 69 men, were asked in a telephone interview about reasons for non-attendance. Of those, 105 also completed a mailed questionnaire, measuring perceived susceptibility to and knowledge about melanoma. During the same period, attenders (n = 286) at the screening clinic completed the same questionnaire. The most commonly reported reasons for non-attendance were 'I forgot about it', 'lack of time' and 'no need for examination'. A majority of non-attenders held a positive attitude towards preventive programs in general and to the present invitation. Most of the improvements suggested by the non-attenders were strategies to reduce practical barriers. Non-attenders scored lower than attenders on perceived susceptibility. High and equal levels of knowledge about melanoma were found among attenders and non-attenders. Men were more likely to be non-attenders. Higher perceived susceptibility and a higher level of knowledge about melanoma were found among women as compared to men. The results suggests that there is potential to increase attendance in future melanoma programs by reducing practical barriers.
Adult↗
Two-year results of a randomized controlled trial of a health promotion program in a retiree population: the Bank of America Study.
OBJECTIVE: To evaluate the effectiveness of a health promotion program in a retiree population in terms of health risk reduction and reduction in medical costs. DESIGN: Randomized controlled trial. SUBJECTS: Bank of America retirees (n = 4,712), divided into 33 retiree club regions, were randomized into 3 groups and followed for 24 months by patient report and claims experience. Group 1, the intervention group, received a low-cost ($30/year), individualized, serially reinforcing health promotion program including risk appraisal, recommendation letters, and self-management materials, delivered entirely through the mail. Group 2 received risk appraisals only, without feedback, for the first 12 months and subsequently the full intervention for the second 12 months. Group 3 was followed with claims data only. Participation rates of 57% at 1 year and 47% at 2 years were achieved. MAIN RESULTS: Overall health risk scores improved by 12% at 12 months compared with control (p < 0.001) and by 23% (from baseline) at 24 months (p < 0.001). Individual health habit changes were favorable for all parameters studied, and were highly statistically significant for most variables. Similar health risk reductions were seen in age groups of 55 to 65 years, 65 to 75 years, and over 75. Cost reduction differences were more than 20% by self-report (p < 0.01) and 10% by claims experience (p = 0.02) at 12 months. For the randomized controlled period of the first 12 months, reductions averaged $164 in the intervention group contrasted with an average increase of $15 in the combined control groups. CONCLUSION: Risk reduction programs directed at retiree populations can improve health risk status and can reduce costs.
Age Factors↗
Negative predictive value of a population-based preschool vision screening program.
BACKGROUND: The Enhanced Vision Screening Program is a population-based vision screening program that has, at present, examined 59,782 children. Its main goal is to detect amblyopia, strabismus, and high refractive errors. An average of 11,910 4 1/2- to 5 1/2-year-old children are screened yearly. The current study determines the negative predictive value of the screening program: For a subject having passed the vision screening test, what is the probability of not having amblyopia, strabismus, or high refractive errors? METHODS: Of the 11,734 subjects who passed the vision screening, 200 were randomly chosen to undergo a strictly defined gold standard examination by an orthoptist and an ophthalmologist. RESULTS: Of the 200 randomly chosen subjects, 157 underwent the gold standard evaluation. The negative predictive value of the Enhanced Vision Screening Program was 97.6% for any potentially vision-threatening ocular condition. It was 98.7% if we considered only the visually significant ocular problems that the test was designed to detect. CONCLUSION: Because the negative predictive value of the Enhanced Vision Screening Program is not 100%, some children with amblyopia, strabismus, or refractive errors are missed. Occasionally, a rare, potentially vision-threatening condition may go undetected. Parents should be made aware of this when they receive the results of the vision screening.
Child↗
Cultural issues in the development of cancer control programs for American Indian populations.
Cancer is the third-leading cause of death among American Indians. The persistent disadvantage in cancer survival rates among American Indian populations emphasizes the importance of developing effective cancer control programs for prevention and early detection. However, substantial cultural differences between American Indians and whites can affect the success of these programs. This paper examines the concept of cultural sensitivity in the context of developing cancer control programs for American Indian populations. It explores fundamental differences in beliefs, behaviors, and values between American Indian and white majority cultures, and presents examples of culturally sensitive health education programs. The paper highlights insights and experiences gained in developing the North Carolina Native American Cervical Cancer Prevention Project, and gives recommendations for the development of future programs.
Cause of Death↗
Population strategies to enhance physical activity: the Minnesota Heart Health Program.
A population-wide, community-based program in cardiovascular disease prevention, the Minnesota Heart Health Program (MHHP), has been designed to promote more frequent and vigorous physical activity in North American communities, along with improved eating and smoking patterns. The physical activity component of this broad-based education strategy is based on the facilitation which physical activity provides to lowering of other risk characteristics for heart disease and its enhancement of other healthy behaviors and on the potential for prevention of elevated risk in the first place. The rationale for a population strategy to complement medical approaches to prevention is that exercise patterns are largely socially learned and culturally determined. The MHHP Physical Activity Program is implemented through three major education strategies: direct education, community organization, and mass communications. Early results from this 10-year project indicate that it is feasible to enter U.S. communities and to involve their leadership actively in MHHP activities of health promotion. Moreover, attitudes, knowledge, awareness, participation, and behaviors related to exercise and eating patterns appear to be changed by the program. Nevertheless, there are problems in the design, implementation, analysis and interpretation of population changes in physical activity and other health behaviors in community demonstration programs. These issues, along with their solutions, should provide useful information for medical science and for the public health about population strategies of disease prevention and health promotion.
Adolescent↗
Mary J. Nielubowicz Essay Award. Population-based needs assessment in the design of patient education programs.
The population-based needs assessment discussed in this paper was conducted as part of a larger study evaluating the status of the patient and family education program at a military treatment facility. The purpose of the assessment was to describe the congruence of patient epidemiologically defined educational needs with patient education program offerings. A seven-step theoretical framework for conducting population-based needs assessments by Declercq, Bichell, and Center guided data collection and data analysis. Results of the analysis were used to provide evidence-based guidance to the military treatment facility's Executive Steering Council on improving patient health care outcomes through redesign and institutionalization of the patient education program. The population-based needs assessment provides a viable avenue for delineation of disease patterns, prioritization of health education needs, and design of effective patient education, health promotion, and disease prevention programs in support of the Department of Defense Military Health System Optimization Plan.
Adolescent↗