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PubMedDate not supplied

Preventive health services use, lifestyle health behavior risks, and self-reported health status of women in Ohio by ethnicity and completed education status.

This study assessed the health status and behavior of college-educated and non-college-educated African American women and European American women in Ohio. Analyses focused on health services utilization, health status, and life style/health behaviors from the 1998 Ohio Family Health Survey. College-educated African American women used more preventive health services and had better health status than non-college-educated African American women. Even so, college-educated African American women still had higher body mass index values, lower health status, and higher percent currently smoking than college-educated European American women. We conclude that college-educated African American women may face unique barriers to implementing all types of health-promoting behaviors available consequent to their higher education. Partnerships with respected community institutions, such as churches, may help these women develop good health practices in their entire community as well as in themselves.

Adult↗
PubMed1994

[The Mini-Mental State Examination in a general population: impact of educational status].

To assess the influence of age and education on cognitive performance in our population, 530 adults were interviewed using the MMSE (Mini-Mental Status Examination). Education level, classified as illiterate, elementary and middle (< 8 years) and high (> 8 years), was a significant predictor of performance (p < 0.0001). Nevertheless, the total scores were not significantly different among the age-groups, young (< or = 50 years), middle age 51 to 64 years) and elderly (> or = 65 years). The reference cut-off values were taken from the fifth percent lowest score for each group: illiterate, 13; elementary and middle, 18; and high, 26. When compared to 94 patients with cognitive impairment, our cut-off values achieved high sensitivity (82.4% for illiterates; 75.6% for elementary and middle; 80% for high) and specificity (97.5% for illiterate; 96.6% for elementary and middle; 95.6% for high educational level). Education-specific reference values for the MMSE are necessary in interpreting individual test results in populations of low educational level, in order to reduce the false positive results.

Adolescent↗
PubMed2004

The association between educational status and risk factors related to cardiovascular disease in healthy individuals: The ATTICA study.

PURPOSE: The object of this work was to study the associations between education status and several cardiovascular risk factors in 2271 randomly selected male and female adults. METHODS: The formal education level was used as proxy for socio-economic status; the distribution of the risk factors and the prevalence of risk conditions were analyzed by the different levels of education-"low", "medium", and "high." The association between education level and the investigated measurements was tested by the application of multiple regression analysis. RESULTS: Two hundred and twenty (19.8%) males and 292 (25.3%) females were classified as "low", 471 (42.4%) males and 476 (41.3%) females as "medium", and 421 (37.8%) males and 386 (33.4%) females as "high" educated. Compared with those with "low" education, individuals who reported "high" education had 8% lower systolic (p < 0.001) and 4% lower diastolic (p < 0.001) blood pressure levels, 6% lower blood glucose levels (p < 0.001), 7% lower serum total cholesterol (p < 0.001), 6% higher HDL-cholesterol (p < 0.001), 22% lower lipoprotein-a levels (p < 0.001), 11% lower apoliprotein-B levels (p < 0.001), 15% lower triglycerides (p < 0.001), 45% lower hs-CRP (p < 0.001), 8% lower fibrinogen levels (p < 0.01), and 7% lower white blood cell count (p < 0.001). The associations regarding inflammation markers remained statistically significant even after adjustment for several potential confounders. CONCLUSIONS: Our findings suggest that in primary prevention it is important to focus our attention, especially, on people with low education, since they seem to be rather unprotected against the prevalence of several cardiovascular risk factors.

Adolescent↗
PubMed1991

Educational status and drinking patterns: how representative are college students?

Using data from a large, nationally representative sample, multiple regressions using sex, ethnicity, age and educational status showed that drinking patterns of college students differed significantly from those of dropouts, high school graduates and former college students. College students were more likely to use alcohol but tended to drink less quantity per drinking day than nonstudents of the same age. Sex differences were smaller among college students than among other groups, especially in proportions of abstainers. While whites were most likely to drink if they were in college, among blacks the college students were the least likely to drink. Age had little association with drinking. Conclusions based on in-school samples may not generalize well to nonschool populations and should be tested, if possible, using more representative databases.

Adolescent↗
PubMedDate not supplied

Recruitment of subjects for clinical trials after informed consent: does gender and educational status make a difference?

CONTEXT: Researchers and investigators have argued that getting fully informed written consent may not be possible in the developing countries where illiteracy is widespread. AIMS: To determine the percentage of patients who agree to participate in a trial after receiving either complete or partial information regarding a trial and to find out whether there were gender or educational status-related differences. To assess reasons for consenting or refusing and their depth of understanding of informed consent. SETTINGS AND DESIGN: A simulated clinical trial in two tertiary health care facilities on in-patients. METHODS AND MATERIAL: An informed consent form for a mock clinical trial of a drug was prepared. The detailed / partial procedure was explained to a purposive sample of selected in-patients and their consent was asked for. Patients were asked to free list the reasons for giving or withholding consent. Their depth of understanding was assessed using a questionnaire. Chi-square test was used for statistical analyses. RESULTS: The percentages of those consenting after full disclosure 29/102 (30%) and after partial disclosure 15/50 (30%) were the same. There was a significant (p=0.043) gender difference with a lesser percentage of females (30%) consenting to participation in a trial. Educational status did not alter this percentage. Most patients withheld consent because they did not want to give blood or take a new drug. Understanding of informed consent was poor in those who consented. CONCLUSIONS: The fact that only one-third of subjects are likely to give consent to participate in a trial needs to be considered while planning clinical trials with a large sample size. Gender but not educational status influences the number of subjects consenting for a study. Poor understanding of the elements of informed consent in patients necessitates evolving better methods of implementing consent procedures in India.

Adult↗
PubMed2001

Educational status and young Dutch gay men's beliefs about using condoms.

The higher levels of HIV risk behaviour that have been found in young gay men with lower socio-economic status (SES, among others defined as educational achievement) may result from unequal effects of safer sex interventions. We conducted semi-structured focus group interviews with an educationally diverse sample of 113 young gay men living in The Netherlands. The objective was to bring to light men's salient ('accessible') beliefs about using condoms since information about beliefs might facilitate the formulation of 'personally relevant' safer sex messages that enhance in-depth message processing. We found several educational differences in the areas of knowledge about HIV preventive behaviour, cognitive schemas about the factors involved in HIV transmission, perceived pros and cons of using condoms, perceived social pressure to use condoms and feelings of being in control of protective action. This may suggest that, for intervention efforts to be effective in motivating the diversity of young gay men to engage in safer sex, interventions should convey tailor-made messages that match recipients' educational degree. Several implications for the formulation of such messages are discussed.

Adolescent↗
PubMed1998

Educational status and resources for child care as predictors of TBE vaccination coverage in schoolchildren of an endemic area in Austria.

Since the introduction of the Austrian tick-borne encephalitis (TBE) vaccination program in 1981 vaccination coverage of children has not been investigated sufficiently. Numerous socioeconomic and demographic factors have been identified as being associated with low vaccination coverage in childhood for most vaccinations. This study focuses on parental educational status and on resources for child care as determinants of tick-borne encephalitis (TBE) vaccination coverage of schoolchildren in an endemic TBE area of Austria. The target population were children in the first, fourth and seventh year of school education in Styria, Austria. Therefore, the sample consisting of 2470 children was divided into three age groups, children aged 7, 10 and 13 years. We performed a representative cross-sectional study. The information concerning the vaccination status of each child was recorded by means of an anonymous questionnaire given to the parents by the classroom teachers. This procedure ensured a high overall response rate of 79.8%. The prevalence of at least one TBE vaccination was 93.9% for the 7 year old, 97.8% for the 10 and 97.9% for the 13 year old. The lowest vaccination rates were found in families with four or more children (94.0%) and for those children who had unemployed parents (92.9%). The multivariate analysis indicates that TBE vaccination coverage is affected by a large number of children in the family (p = 0.0003), an urban place of residence (p = 0.0001) and by a low level of education of the mother (p = 0.013). The results suggest that, though overall high coverage in schoolchildren, vaccination programmes should be focused on large and socially deprived families.

Adolescent↗
PubMed1985

The health and educational status of adolescents with congenital rubella syndrome.

As part of a longitudinal study of children with congenital rubella syndrome, 53 adolescents between 16 and 18 years of age were surveyed to determine their health and educational status. The findings were compared with those at the 18-months evaluation. At 16 to 18 years neurosensory impairments, cerebral dysfunction and organic behaviour syndromes were predominant, but the majority of children had multiple handicaps. A higher proportion had hearing loss. Although all the hearing-impaired children were begun in oral-based educational programs, 90 per cent of those with severe to profound hearing-loss diagnosed before the age of 18 months had changed to total or manual communication. Those with mild to moderate hearing-loss diagnosed after 18 months primarily communicate orally. The educational implications of these findings are discussed.

Adolescent↗
PubMed1992

Educational status and blood pressure: the Second National Health and Nutrition Examination Survey, 1976-1980, and the Hispanic Health and Nutrition Examination Survey, 1982-1984.

An inverse association between socioeconomic status, as measured by years of education, and blood pressure has been reported in a number of studies. However, two secular trends may have changed the nature of this relation: a higher mean level of education in the population and intervention for high blood pressure in the community. Given that education is the most commonly used indicator of social class and measurement is a critical issue in epidemiologic research, a study was initiated to examine the validity of education for predicting blood pressure among 11,554 examined persons aged 25-74 years from the Second National Health and Nutrition Examination Survey (1976-1980) or the Hispanic Health and Nutrition Examination Survey (1982-1984). In univariate analysis, a consistent, inverse association between education and blood pressure was found for whites and blacks, but not for Mexican Americans. After adjustment for age and body mass, the effect persisted only for systolic blood pressure in whites. The association of education and blood pressure was positive in Mexican-American females. Education was inversely related to hypertensive status in whites and in black females. These findings suggest that information on education may be of little value for identifying populations at risk of high blood pressure, particularly if age and body mass are known. However, information on education may be of considerable value in the design and implementation of appropriate interventions.

Adult↗
PubMed1997

Duration of general practice consultations: association with patient occupational and educational status.

Past studies have demonstrated that the majority of health care visits are made to general practitioners, and that socio-economically disadvantaged individuals are significantly more likely to use such services. Relatively little is known, however, about the quality of general practice care provided to patients of different socio-economic status. The specific aims of the study were to determine whether an association existed between consultation duration and patient educational and occupational status, and if an association was evident, to determine the extent of association after taking into account a range of identified confounding variables and the effect of a clustered sample design. Consecutive consultations from a randomly selected sample of general practitioners were audiotaped and their durations measured electronically. Patient education and occupational status were obtained by questionnaire. Information concerning a range of additional patient, practitioner and consultation variables was also assessed in order to identify possible confounders of the association between consultation duration and patient occupational and educational status. No association was evident between consultation duration and level of patient educational qualification. Independent of identified confounding variables and the effect of a clustered sample design, general practitioners spent less time with those patients employed in unskilled occupations. Unskilled patients received 2.1 min or 21% less time per consultation than patients in professional occupations. The odds of patients in unskilled occupations receiving a long consultation (> 10 min) were 26% less than the odds of patients in professional occupations. The finding of an occupational status differential in the duration of general practice consultations suggests that socio-economically disadvantaged patients may not be receiving the health care they require. Further research is required to confirm these findings and to identify whether similar differentials are evident in more specific elements of general practice care.

Adult↗
PubMed1997

Palliative care in undergraduate medical education. Status report and future directions.

OBJECTIVE: To describe the status of palliative care education in the undergraduate medical curriculum and to offer recommendations for improvement. DATA SOURCES: Review of literature on palliative care and of recently submitted grants on medical education for end-of-life care. STUDY SELECTION: English-language reports of educational programs targeted toward medical students were examined, as well as surveys of medical schools. DATA EXTRACTION: Studies were reviewed by the authors to assess the quality of the educational program, evaluation methodology, and conclusions. From over 9000 citations on palliative care and related topics that were retrieved from MEDLINE searches from 1980 through 1995, and from reviewing 14 palliative care journals published from 1985 through 1996, 310 articles were identified that addressed medical education for end-of-life care, and 180 were carefully examined. DATA SYNTHESIS: While nearly all medical schools offer some formal teaching about end-of-life care, there is considerable evidence that current training is inadequate, most strikingly in the clinical years. Teaching about palliative care is received favorably by students, positively influences student attitudes, and enhances communication skills. However, curricular offerings are not well integrated; the major teaching format is the lecture; formal teaching is predominantly preclinical; clinical experiences are mostly elective; there is little attention to home care, hospice, and nursing home care; role models are few; and students are not encouraged to examine their personal reactions to these clinical experiences. CONCLUSIONS: The increasing attention to palliative care education has created major opportunities for improving education about care at the end of life. Educational programs should be rigorously evaluated to identify best educational practices.

Cultural Diversity↗