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PubMedDate not supplied

Evaluation of the reorganization of a public health nursing division.

From 1986 to 1988, the Nursing Division of the Hamilton-Wentworth Department of Public Health Services undertook an analysis of our present organizational structure, incorporating knowledge from current literature, community trends and staff perceptions. From this analysis, a division-wide reorganization was implemented from the current practice in which the Public Health Nurse (PHN) delivered nursing care across all ages and stages (generalist role) to one organized by target populations. These events were described in an earlier article. As part of the plan for reorganization, the nurse management team implemented an evaluation process which included five components: 1) an internal staff survey; 2) an external agency survey; 3) a program-specific activity analysis; 4) a program-specific measure of knowledge change and; 5) a longitudinal job satisfaction survey. This article describes this evaluation and presents implications for the future.

Educational Measurement↗
PubMed1990

The effect of an educational program on knowledge & attitudes about blood pressure by junior high school students: a pilot project.

This study tested the effectiveness of a 10 minute videotape and complementary print program guide on the knowledge and attitudes of junior high school students about blood pressure (BP). A randomized two group pre-test, post-test and delayed post-test design was used. The experimental group received an educational session on BP, designed for this study, which consisted of a 40-minute session, comprised of a 10-minute video presentation and discussion by the teacher on BP (guided by the program guide). The educational session was effective in improving students knowledge of BP at one week post-test; however, this positive effect did not persist at the three month post-test. Student interest in, or knowledge of, their own BP was not obviously affected by the session. The findings were interpreted in light of Social Learning Theory (SLT) and the PRECEDE Model of Health Education (PMHE). In testing the effect of one component of an educational program, i.e., the videotape and teacher lesson the environmental determinants of behaviour change could not be addressed in this study. The educational session was able, however, to achieve the desired knowledge change. The 10-minute videotape and complementary print program guide was shown to be a viable educational tool and can therefore be utilized as a resource in a broader multi-faceted program of cardiovascular (CV) health promotion.

Adolescent↗
PubMed1988

Cardiac transplantation: the changing faces of immunosuppression.

Many advances have been made in immunosuppressive therapy and other aspects of cardiac transplant management since the first cardiac transplantation was performed in the late 1960s. The cellular immune response and rejection process are better understood. This knowledge changed the way existing drugs were used to control rejection and led to the development of new drugs that could more effectively control the rejection process. Early drug protocols used combinations of azathioprine, antilymphocyte globulin, and steroids. Later protocols used combinations of cyclosporine, steroids, and antithymocyte globulin. After problems related to cyclosporine were identified, protocols came full circle. They now include drugs that were used in earlier protocols, as well as cyclosporine. The purpose of this article is to describe how protocols for immunosuppressive therapy have evolved based on our expanded knowledge of immunosuppression and methods of best using new and old drugs to achieve this goal.

Heart Transplantation↗
PubMed1979

Does continuing medical education improve the quality of medical care? A look at the evidence.

Although continuing education has a long tradition within the medical profession, mandated continuing medical education is of very recent origin. The conceptual framework used to justify continuing medical education is that it exposes physicians to new knowledge, changes physician behavior, and favorably alters patient outcomes. Considerable evidence exists that physician knowledge can be increased, and that behavior can be changed, but there is very little to show an effect on patient outcomes. The effectiveness of continuing medical education is further clouded by such issues as consumerism, licensure politics, and professional standards review organization legislation. Family physicians should have a role in determining the outcome of the continuing medical education debate, as participants, as policy-setters, and as informed critics.

Behavior↗
PubMed1977

Reducing the risk of cardiovascular disease: effects of a community-based campaign on knowledge and behavior.

In 1972 the Stanford Heart Disease Prevention Program launched a three-community field study. A multimedia campaign was conducted for two years in two California communities (Watsonville and Gilroy), in one of which (Watsonville) it was supplemented by an intensive-instruction program with high-risk subjects. A third community (Tracy) was used as a control. The campaigns were designed to increase participants' knowledge of the risk factors for cardiovascular disease, to change such risk-producing behavior as cigarette smoking, and to decrease the participants' dietary intake of calories, salt, sugar, saturated fat, and cholesterol. Results of a sample survey indicate that substantial gains in knowledge, in behavioral modification, and in the estimated risk of cardiovascular disease can be produced by both methods of intervention. The intensive-instruction program, when combined with the mass-medica campaign, emerged as the most effective for those participants who were initially evaluated to be at high risk. The results after two years of intervention are reported for effects on knowledge and behavioral change for the total participant samples and for the high-risk subsamples in each of the three communities.

Attitude to Health↗
PubMed1994

The influence of dissemination of information on the changes of knowledge, attitude and acceptance of hepatitis B vaccination among hospital personnel in Chulalongkorn Hospital.

Lack of knowledge and negative attitudes were the main reasons for refusal, in a vaccination programme against hepatitis B using plasma-derived vaccine which was offered to the hospital personnel of Chulalongkorn University Hospital, Bangkok. Therefore, to ascertain whether an educational intervention among hospital personnel is effective in modifying acceptance of the vaccine, a quasi-experimental design (using a before and after approach) was used to compare the knowledge, attitudes and acceptance rate of hepatitis B vaccination among 1,915 hospital personnel. After dissemination of information, knowledge and attitudes improved significantly, and acceptance rates were increased from 56.9% to 77.7% (P < 0.0000). More specific educational efforts should be started before launching vaccination programmes of this kind in order to increase acceptance.

Diffusion of Innovation↗
PubMedDate not supplied

The effectiveness of video-based interventions in promoting condom acquisition among STD clinic patients.

GOAL OF THIS STUDY: This study examined the effectiveness of video-based patient education interventions on promoting condom use among men and women seeking services at a large public STD clinic in New York City. METHODS: Culturally sensitive video-based interventions designed to promote safer sex behaviors were evaluated in a randomized study of black and Hispanic male and female STD clinic patients. Subjects (n = 1,653) were randomly assigned to one of three groups: 1) control, 2) video viewing, and 3) video viewing followed by participation in an interactive group session led by a trained facilitator. The authors examined 1) the effectiveness of interventions in increasing STD and condom-related knowledge, positive attitudes about condoms, human immunodeficiency virus/STD risk perceptions, and self-efficacy and 2) the relationships among these variables, level of intervention, and condom acquisition, a behavioral measure of condom use. RESULTS: Compared with a control group, subjects assigned to video viewing demonstrated greater knowledge about condoms and STDs, more positive attitudes about condom use, increased human immunodeficiency virus/STD risk perceptions, greater self-efficacy, and higher rates of condom acquisition. Subjects assigned to video viewing followed by interactive sessions demonstrated still further increases in risk perceptions, self-efficacy, and condom acquisition, but not in knowledge or condom attitudes. A significant proportion of the association between the behavioral outcome of condom acquisition and level of intervention is attributable to the impact of interventions on risk perception and self-efficacy. CONCLUSIONS: Based on extensive formative research that identified barriers to safer sex behaviors, video-based interventions were developed to promote condom use among black and Hispanic men and women attending STD clinics. Designed to be integrated into clinic services, these interventions help improve knowledge, promote positive attitudes about condoms, and increase condom acquisition among individuals at high risk of acquiring and transmitting human immunodeficiency virus infection and other STDs.

Black or African American↗
PubMed1989

Evaluation of training effects on teacher attitudes and concerns prior to implementing a human sexuality education program.

Teacher changes in knowledge, attitudes, and concerns about teaching a new human sexuality education curriculum due to inservice training were examined; 59 middle school teachers were surveyed before and after one week of training. Significant (p less than .05) increases in knowledge, perceptions of importance of teaching the curriculum, intent to teach, and level of comfort with course content suggest areas of positive learner changes. Effects were not noted for sexual orientation (liberal vs. conservative) or responsibility for student outcomes. Relationships (p less than .05) were noted between comfort, importance, responsibility, and intent to teach with expectations of how students, colleagues, administrators, parents, and community would respond, as well as perceptions of curriculum congruence with teaching style and the adequacy of preparation to teach the curriculum. Few responses were associated with teacher personal characteristics.

Attitude to Health↗
PubMed1987

Campaign against AIDS in Switzerland: evaluation of a nationwide educational programme.

The campaign against the spread of the acquired immune deficiency syndrome (AIDS) in Switzerland includes a nationwide educational programme. A booklet about AIDS was mailed to every Swiss household in March 1986, and in 1987 there has been a mass media campaign promoting the use of condoms. We evaluated the results of the first phase--the distribution of the booklet--using a separate sample pretest and post-test design. The pretest was carried out 15 days before the booklet was mailed (sample n = 1056) and the post-test two months after the booklet was mailed (n = 1278). Of the population aged 20-69, to whom the book was sent, 56% read the booklet. For those who read the booklet compared with those who did not the results showed an improvement in knowledge and a better understanding of the risks of specific behaviours and of exposed groups and thus less fear of becoming infected through daily activities. The mean indices of knowledge and beliefs were significantly different when tested by the Kruskal-Wallis method. Having better information does not imply that people will change their behaviour, but both the high reading rate and the increase in knowledge suggest that the Swiss educational programme reached its objectives. Moreover, the success of this campaign helps to support other campaigns that are being developed to promote the use of condoms.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Experience of HIV prevention interventions among female sex workers in Delhi, India.

This paper describes the effect of HIV prevention intervention among female sex workers in Delhi. Over a 2-year period we found a marked increase in condom use with little increase in HIV seroprevalence. The prevalence of HIV infection did not increase during the study period (1 positive among 701 in 1988 vs 1 positive in 600 in 1990).

Female↗
PubMed1997

Improvement in AIDS knowledge, perceptions and risk behaviours over a short period in a rural community of Senegal.

The objective of this paper is to assess knowledge, perceptions and behavioural changes in response to AIDS in a rural community in the south of Senegal, comparing 2 cross-sectional surveys using standardized questionnaires and performed in 1990-1992 and 1994. An AIDS-related knowledge score was built using 4 questions about routes of HIV transmission, ranging from 0 to 4. The score increased between the 2 surveys from 1.6 to 2.1 for men (P = 0.006) and from 0.8 to 2.6 for women (P < 10(-4)). The proportion of those who responded 'I don't know' to the 4 questions dealing with routes of AIDS transmission decreased from 24% to 14% on the average for men and from 66% to 20% on the average for women. The proportion of men who declared casual sex partners in the past 12 months decreased from 39% to 21% (P = 0.01). However, the proportion remained stable for women (from 15% to 18%). These results show that despite a relatively low level of HIV infection (0.8% of all adults), AIDS-related knowledge increased and at-risk behaviour decreased in a rural area of west Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1992

A longitudinal evaluation of computer-assisted instruction on contraception for college students.

This study assessed changes in contraceptive knowledge of 58 white female undergraduate college students following use of a computer-assisted instruction (CAI) program on contraceptive methods. The CAI program consisted of a personal-computer-based instructional lesson covering facts about and appropriate use of oral contraceptives and barrier methods, and myths about sexuality and sexually transmitted diseases. Baseline contraceptive knowledge was first compared with 171 white female undergraduate students. This comparison indicated that, overall, there were knowledge deficits regarding the safety of oral contraceptives and what to do if oral contraceptives are not used correctly. At immediate posttest, significant knowledge gains were observed for danger signs associated with using oral contraceptives, the rationale for triphasic and biphasic pills, potential medication synergism, health benefits of using oral contraceptives, potential contraceptive effect of withdrawal, and the reasons women stop using the pill. At six-month follow-up, students evidenced long-term knowledge gains on duration of pill use, the rationale for triphasics and biphasics, appropriate contingencies for missing two days of the pill, danger signs associated with using contraceptives, medication synergism, and health benefits of using oral contraceptives. The results of the evaluation are considered in the context of the widely held assumption that young women's contraceptive failure is unrelated to knowledge deficits about methods of birth control.

Adolescent↗
PubMed1990

Changes in knowledge, attitudes, and behavior as a result of a community-based AIDS prevention program.

The study evaluates the outcome of a California-based AIDS prevention program, "Stop AIDS." Community discussion groups focusing on information, attitudes, and behavior associated with HIV infection and transmission were conducted in one-time, 3 1/2-hour sessions. Participants completed different versions of the AIDS Prevention Test before and after the discussion group. Significant positive shifts in information, attitudes, and behavior were observed as a function of the discussion group participation. Whereas pretest knowledge correlated with pretest behavior and posttest knowledge, only pretest behavior correlated with the crucial variable of posttest intended behavior. When changes from pretest to posttest were analyzed, both information and attitude change correlated to changes in behavior. The intervention and evaluation procedures are proposed as a replicable national model for community-based AIDS prevention programs.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Short-term effects of teenage parenting programs on knowledge and attitudes.

The short-term effects of teenage parenting programs upon the knowledge and attitudes of pregnant teenagers were assessed. The programs studied produced a significant change in the teenagers' knowledge of sexuality and child development while having no apparent effect on the teenagers' parenting attitudes. The implications of producing changes in knowledge without accompanying changes in attitudes are discussed.

Adolescent↗