[Community participation in the National Program for Transmission Control of Chagas Disease].
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Animals↗
SEARCH · PubMed Health
Results for “Population Programs”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Implementing a perioperative nursing fellowship program.
The population of nurses in the United States is aging. After suffering high OR nurse vacancy rates for several years, leaders at the Inova Health System Implemented a nurse fellowship program. This six-month didactic and precepted learning program is aimed at experienced RNs who do not have OR experience but would like to work in the OR. Two years after implementation, the OR nurse vacancy rate in the health system has decreased from 27% to 15.5%.
Adult↗
Benefit of independent double reading in a population-based mammography screening program.
PURPOSE: To evaluate independent double reading in mammography screening and, specifically, the effect on breast cancer detection. MATERIALS AND METHODS: Mammographic studies of 11,343 women, aged 41-75 years, who participated in a population-based screening program were independently screened by two experienced radiologists. A retrospective analysis also was performed from notations made for patient recalls. RESULTS: Including follow-up of recalled women, 131 surgical biopsies were performed, which resulted in 76 histologically proved breast cancers. Fifty-six cancerous lesions were detected by both screeners. One screener detected 14 cancerous lesions alone, and the other detected six alone. Of the cancerous lesions detected by only one screener, 85% were stage 0 or 1, compared with 59% of those detected by both screeners. Double reading detected 15% (95% confidence interval, +/- 7%) more cancer cases with an almost unchanged positive predictive value of 0.6. CONCLUSION: Independent double reading does significantly increase sensitivity of mammography screening.
Adult↗
Facilitating the shift to population-based public health programs: innovation through the use of framework and logic model tools.
Program planning and evaluation are critical steps in using a population health approach. This paper outlines how logic models have been adapted within a health promotion framework to guide public health programs and facilitate program description. It is important that we take the time to describe clearly what we are doing, reflect on practice and elaborate the conceptual base for the new public health programs so that we can evaluate the impact of our work. Ongoing research is required to identify appropriate and measurable indicators that capture the process, as well as the outcome, of population-based health promotion.
Canada↗
Freedom from fat: a contemporary multi-component weight loss program for the general population of obese adults.
This report summarizes results for the first 2,037 participants in the Freedom from Fat (FFF) weight loss program. FFF combined nutrition education, a low-fat dietary pattern, exercise, behavioral self-management, and social support in a program designed to serve the general population of overweight and obese adults. Participants ranged in age from 18 to 84 and from ideal weight to massively obese. After enrolling, program participants attended professionally led weekly meetings as long as they wished. Participants were encouraged to keep daily food diaries, to reduce the proportion of calories from fat to 30% or less, to exercise at moderate intensity for 30 minutes a day 5 days a week, to keep graphic records of weight change and exercise, and to display their graphs at each weekly group meeting. Attrition rates were comparatively low for a large-scale program, with half of the participants still active in the fifth month and 22% still active after 1 year. Mean weight loss for obese participants (BMI 30 or greater) at 6 months was 7.3 kg (16.2 lb) for men and 5.3 kg (11.6 lb) for women. The best predictors of weight loss at 6 months were number of days per week in which food diaries were kept, baseline body mass index, number of minutes of exercise per week, and age.
Adult↗
Attitudes, beliefs, and knowledge as predictors of nonattendance in a Swedish population-based mammography screening program.
BACKGROUND: The effectiveness of mammography screening could be improved if factors that influence nonattendance were better understood. METHODS: We examined attitudes, beliefs, and knowledge in relation to nonattendance in a population-based mammography screening program, using a case-control design. Data were collected from November 1997 to March 1998 through telephone interviews with 434 nonattenders and 515 attenders identified in a population-based mammography register in central Sweden. The questions asked drew primarily upon the components constituting the Health Belief Model. RESULTS: Multivariate analysis showed that nonattendance was most common among women within the highest quartile of perceived emotional barriers, compared to women within the lowest quartile (OR = 4.81; 95% CI 2.96-7.82). Women who worried most about breast cancer were more likely to attend than those who worried least (OR = 0.09; 95% CI 0.02-0.31). Women with the highest scores of perceived benefits were more likely to attend than women with the lowest ones (OR = 0.35; 95% CI 0.08-0.75). Other factors associated with nonattendance were less knowledge about mammography and breast cancer, lack of advice from a health professional to participate, and very poor trust in health care. CONCLUSIONS: Our findings suggest that increased participation in outreach mammography screening programs can be achieved through enhancement of breast cancer awareness and possibly by reducing some of the modifiable barriers. mammography; mass screening; breast cancer; attitudes; Sweden.
Adult↗
Evaluation of the chronic disease self-management program in a Chinese population.
OBJECTIVE: This study evaluated the 6-week Chronic Disease Self-Management Program (CDSMP) in Hong Kong. METHODS: A total of 148 subjects with chronic illness were recruited. Subjects were matched on duration of illness and gender, and then randomly allocated to experimental and comparison groups. The experimental group participated in the CDSMP, while the comparison group joined a Tai-Chi interest class in a mass-activity format. Subjects completed evaluation questionnaires before beginning their program and 1 week following the program. RESULTS: Analysis of covariance showed that the CDSMP participants demonstrated significantly higher self-efficacy in managing their illness, used more cognitive methods to manage pain and symptoms, and felt more energetic than the subjects in the comparison group. The CDSMP participants also demonstrated changes in their profile of coping strategies, having a tendency to adopt the cognitive methods of diverting attention, reinterpreting pain, ignoring sensations, and making positive self-statements. CONCLUSION: The short-term evaluation results showed that the CDSMP primarily increased the self-efficacy, exercise behavior, and application of cognitive coping strategies of the participants. PRACTICE IMPLICATION: The effect of the CDSMP in a Chinese population is similar to that found in studies in Western cultures, and the CDSMP could be applied effectively in a Chinese population.
Adaptation, Psychological↗
Implications of the age range in a population-based BRCA1 testing program with eligibility based on family history of breast and ovarian cancer.
The current options available to BRCA1 mutation carriers can be classified as either cancer risk reduction or increased disease surveillance. Risk reduction might be preferable to young women. Increased surveillance might be more attractive to women when their cancer risk is highest. The aim of this report is to estimate the sensitivity, specificity and ability to detect carriers for a population-based BRCA1 testing program with eligibility based on family history of cancer, and examine the effect of age on the program's performance. A computer model was used to simulate the incidence of breast and ovarian cancer in a woman's family, based on her BRCA1 mutation carrier status. Age-specific estimates of the sensitivity and specificity for family history as an indicator of mutation status were applied to local population figures. Sensitivity of the program increased with the age of the proband and the size of her family. Sensitivity ranged from 0.33 for 20-year-olds with small families, to 0.98 for 60-year-olds with large families. Specificity was greater than 0.95, regardless of a woman's age or family size. If 0.12% of people carry a BRCA1 mutation, a province-wide testing program for people aged 20-69 with referrals based only on family history would have a sensitivity of 0.55. Only 2% of the genetic test results would be positive. The acceptability of a genetic testing program depends on its sensitivity and specificity, and on the options available to women who are found to carry a mutation. Compared with variation due to family size, the program sensitivity and specificity does not differ substantially amongst the various age groups.
Adult↗
A prospective dosage adjustment program in a geriatric population.
This article describes the successful implementation of a prospective drug dosage adjustment program that has achieved cost-containment, improved quality of patient care, and optimum usage of clinical pharmacy services. It has significantly reduced the number of unnecessary doses administered and lowered the possibility of adverse drug reactions.
Aged↗
Cumulative risk and population attributable fraction in prevention.
Compares the use of relative risk versus population attributable fraction in determining the target population for multirisk prevention programs in psychology. Results show that relative risk generally increases as a function of cumulative risk. Guided by this measure, prevention programs should target populations with the largest cumulative risk. However, relative risk does not account for the prevalence of a particular level of cumulative risk in the population. Therefore, because the largest cumulative risk is experienced by only a small portion of the population, prevention programs guided by this measure will not always have the greatest public health benefit to reduce the incidence of problem outcomes in the population. On the other hand, the population attributable fraction, which does take into account the prevalence of a particular level of cumulative risk, does not increase appreciably after a cumulative risk of one, two, or three because the majority of people in the population will experience these levels of cumulative risk. Guided by this measure, prevention programs that target the higher proportion of people who have a more moderate level of risk would have the maximum impact on the population. National data sets from Great Britain (the British Births Cohort Study [BCS]) and the United States (National Longitudinal Study of Youth [NLSY]) are used to explore this pattern of effects.
Adolescent↗
State funding of comprehensive primary medical care service programs for medically underserved populations.
OBJECTIVES: This study examined the availability of state funding for comprehensive primary care programs and the need for primary care subsidies for medically underserved communities. METHODS: A brief questionnaire was used to ask health agencies in all 50 states whether their state funded a program that met our definition of comprehensive primary medical care practice programs. An in-depth written survey instrument was then administered to the states with programs. RESULTS: Almost half of all states provide some funds for the development and/or operation of comprehensive primary medical care practices. Expenditures in most states were found to be relatively modest in comparison with both federal funding and the total level of unmet need for primary care. States that subsidize primary care practices tend to follow the model established under the federal health centers program. CONCLUSIONS: The findings suggest the continued viability of the health center model of care, as well as the presence of some state support for such a program. However, in light of limited state resources for the development and operation of comprehensive practices, a continued and significant federal effort is imperative.
Comprehensive Health Care↗
[Population and family planning programs in Byumba].
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Adolescent↗
Optimal design features for surveying low-income populations.
Improving Medicaid program effectiveness for underserved populations is hampered by low survey response rates. This study determined how to maximize Medicaid consumer satisfaction survey response rates to the Consumer Assessment of Health Plans Study (CAHPS) survey. In a public immunization clinic, 8 focus groups and 15 extended interviews were used to assess consumer-preferred survey design features and incentives. To test hypotheses, we conducted the following trial. Out of 10,733 total participants in a Kansas Medicaid managed care plan, 3,685 eligible for CAHPS were unduplicated by household. After randomization of the 968 households with valid addresses to one of three groups, a controlled trial was conducted to assess response rates to CAHPS survey formats and incentives. Response rates were 35% for a standard mailing, 44% for a user-friendly low-literacy mailing, and 64% for a user-friendly low-literacy mailing with a $10 contingent incentive. Both experimental arms significantly improved response compared with the control; the response rate of the mailing group with the incentive was higher than the response rate of the group receiving that mailing without any incentive (p<0.0001). Using consumer-based preferences significantly increased response rates to this Medicaid satisfaction survey. Raising CAHPS response rates may increase validity of Medicaid consumer satisfaction information.
Adolescent↗
A general program for estimation of haplotype frequencies from population diploid data.
The program which is written in FORTRAN estimates haplotype frequencies in two-locus and three-locus genetic systems from population diploid data. It is based on the gene counting method which leads to maximum likelihood estimates, and can be used whenever the possible antigens (one or more) on each chromosome can be specified for each person and for each locus, i.e., ABO-like systems and inclusions are permitted. The number of alleles per locus may be rather large, and both grouped and ungrouped data can be used. Log likelihoods are calculated on the basis of various assumptions, so that likelihood ratio tests can be carried out.
Chromosome Mapping↗
[Evaluation of the health knowledge among elderly regard to of smoking prevention program].
A population of elderly people is increasing of number systematically nowadays. Especially the oldest group of them e.g. individuals at the age of 80 and over is getting larger and larger. This situation appears to be a great challenge for institutions responsible for organizing public health care systems, especially to health education, because of perform special character of the old age. Aging is a natural process in human live, that causes gradual decline in functions of all organs. Healthy aging is a main objective in the health-education program a specially cope better with disability. The aim of the study was a self-evaluation oh health among elderly peoples, regard to smoking prevention. A group of 62 elderly patients was examined. During the study the questionnaire FACT-G was used. The results of the research showed that low self-assessment of health in people was connected a lot of difficulties in activity of daily living (ADL) and health education. In the healthy aging conceptions, "tobacco-free programs from WHO are very important.
Activities of Daily Living↗
Using developmental epidemiology to choose the target population for an intervention program in a high-risk neighborhood.
Used epidemiologic techniques to evaluate the appropriate recruitment strategy for an intervention in a high-risk inner-city neighborhood. Risk factor epidemiology can play a major role in the design of community interventions by assisting in the estimation of the potential effects of different recruitment strategies. The long-term goal of this intervention program for infants and young children was to improve outcomes in elementary school. Our results indicated that that among mothers in the catchment area, the relative risks associated with levels of maternal education for high prevalence disabilities were smaller than in the whole school district. These data suggest that recruiting any mother in the catchment neighborhood would result in more individuals who could benefit from the intervention receiving services and in a larger reduction in cases of developmental problems associated with the risk factor. That is, the study sample was defined by residence in a neighborhood rather than by individual risk factors to maximize the impact on the number of cases that could be prevented.
Affective Symptoms↗
Adequacy of a health program for the Nigerian population: a critique of the free health scheme in Oyo state 1979-1982.
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Evaluation Studies as Topic↗
Incidence of bloodstream infections due to Candida species and in vitro susceptibilities of isolates collected from 1998 to 2000 in a population-based active surveillance program.
To determine the incidence of Candida bloodstream infections (BSI) and antifungal drug resistance, population-based active laboratory surveillance was conducted from October 1998 through September 2000 in two areas of the United States (Baltimore, Md., and the state of Connecticut; combined population, 4.7 million). A total of 1,143 cases were detected, for an average adjusted annual incidence of 10 per 100,000 population or 1.5 per 10,000 hospital days. In 28% of patients, Candida BSI developed prior to or on the day of admission; only 36% of patients were in an intensive care unit at the time of diagnosis. No fewer than 78% of patients had a central catheter in place at the time of diagnosis, and 50% had undergone surgery within the previous 3 months. Candida albicans comprised 45% of the isolates, followed by C. glabrata (24%), C. parapsilosis (13%), and C. tropicalis (12%). Only 1.2% of C. albicans isolates were resistant to fluconazole (MIC, > or = 64 microg/ml), compared to 7% of C. glabrata isolates and 6% of C. tropicalis isolates. Only 0.9% of C. albicans isolates were resistant to itraconazole (MIC, > or = 1 micro g/ml), compared to 19.5% of C. glabrata isolates and 6% of C. tropicalis isolates. Only 4.3% of C. albicans isolates were resistant to flucytosine (MIC, > or = 32 microg/ml), compared to < 1% of C. parapsilosis and C. tropicalis isolates and no C. glabrata isolates. As determined by E-test, the MICs of amphotericin B were > or = 0.38 microg/ml for 10% of Candida isolates, > or =1 microg/ml for 1.7% of isolates, and > or = 2 microg/ml for 0.4% of isolates. Our findings highlight changes in the epidemiology of Candida BSI in the 1990s and provide a basis upon which to conduct further studies of selected high-risk subpopulations.
Adolescent↗