The continuing education program of voluntary health agencies.
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Education, Continuing↗
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Results for “Voluntary Programs”
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[Differences between opiate, multi-drug and amphetamine abusers in voluntary treatment programs].
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Adult↗
Tennessee's voluntary fluoridation program: a milestone in preventive dentistry.
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Fluoridation↗
[Evaluation of the program of voluntary family planning of the Instituto Mexicano del Seguro Social].
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Evaluation Studies as Topic↗
HIV antibody testing among adults in the United States: data from 1988 NHIS.
Data collected from 21,168 adults using the 1988 AIDS supplement to the National Health Interview Survey were examined to determine awareness of and experience with HIV antibody testing in the United States. Three-fourths of adults knew of the blood test for HIV antibodies; awareness was lower among Blacks, Hispanics, older adults, and those less educated. Overall, 17 percent of adults had been tested; of these, 73 percent because of blood donation, 14 percent through other non-voluntary programs (such as military induction), and 16 percent sought testing voluntarily. While a smaller proportion of Black and Hispanic adults had been tested, they were more likely than their White non-Hispanic counterparts to have been tested voluntarily. Persons who reported belonging to groups with high-risk behaviors were also more likely to have been voluntarily tested. Most of those tested voluntarily received their test results, but only one-third also received prevention information. Three percent of adults plan to be tested voluntarily in the next year; about half will seek testing through their doctor or health maintenance organization.
AIDS Serodiagnosis↗
[Chronometric study of a posturo-kinetic program associated with voluntary movement].
Posturo-kinetic programming was investigated by a simple reaction time paradigm. Standing subjects performed voluntary upper limb elevations differing by the importance of their destabilizing effect on the initial balance. It was shown that: The reaction time varied according to the destabilizing effect of the forthcoming movement. These variations were due to differences in the duration of postural adjustments which were shown to precede voluntary movement. Duration of pre-motor period, corresponding to delay between the response signal and the onset of the earliest postural adjustment, did not depend on parameters of the forthcoming movement.
Humans↗
HIV testing in prisoners: is mandatory testing mandatory?
We studied 977 newly incarcerated Oregon inmates to compare voluntary versus mandatory human immunodeficiency virus antibody (HIVAb) testing in the prison setting. All inmates were offered HIVAb counseling and testing. Blood drawn for routine syphilis serology from those who declined this offer was also tested for HIVAb after personal identifiers had been removed. Only 1.2 percent (12) prisoners were HIV positive. However, 62.5 percent (611) inmates were at risk for HIV infection by being an intravenous drug user, a male homosexual, or hepatitis B core antibody (HBcAb) positive. The ratio of at-risk, as yet uninfected inmates to those already HIV infected was 53 to 1. Two-thirds of all inmates including those at-risk chose to receive counseling and testing. In areas where most at-risk inmates are not yet infected, it may be more appropriate for HIV prevention activities in prison to focus on voluntary programs that emphasize education and counseling rather than mandatory programs that emphasize testing.
Adolescent↗
Quality assessment of cyclosporine monitoring by 32 Canadian laboratories.
The Canadian Quality Assurance Program was initiated in June 1989, and is a voluntary program which currently encompasses all 32 laboratories involved in the measurement of cyclosporine (CsA) across Canada. Two whole blood samples from control or clinical patients (kidney, liver and heart) containing unknown concentrations of CsA are circulated to each participating laboratory monthly, and analyzed by all techniques employed within that laboratory. Four analytical methods are currently employed: HPLC (n = 4). Sandimmun SP (n = 3), CycloTrac SP (n = 27) and TDx (n = 3). Four laboratories reported survey results in more than one methodology. Results from all participating centers are analyzed monthly. The mean, SD, standard deviation index and range are reported to each laboratory with information coded to preserve confidentiality. Accuracy, precision, recovery, analytical specificity, linearity and blank studies have been performed. This report covers the period from June 1989 to April 1990.
Canada↗
Caries diagnosis and risk assessment. A review of preventive strategies and management.
The scientific basis for caries risk assessment, prevention and treatment on an individual patient basis requires further development, specification and continuing validation. Still, current technologies and techniques, taken together, can provide enhanced capabilities over those that have been employed traditionally. Undoubtedly, the clinical tools for carrying out these responsibilities will be refined and expanded in the future in response to the changing clinical profile of caries in the population. For example, bacteriologic testing methods have become easier and more reliable, and will become more widely used. Other effective methods to detect the early, pre-cavitation stage of caries also should become more available in the future. Practitioners will be continually challenged and responsible for evaluating the effectiveness and value of emerging technologies in their practices and in light of their patients' needs. But how can this be accomplished best? Effectiveness claims will be made for new drugs and devices that come onto the market. There are several sources of information to assist the practitioner in making such decisions. The American Dental Association acceptance programs (voluntary) and the U.S. Food and Drug Administration compliance programs (law) provide standards and guidance as to product safety and effectiveness. Without such determinations, the practitioner must judge independently product claims and clinical studies. Marketing materials by themselves (advertisements, videos, pamphlets) may not be sufficient evidence of effectiveness particularly when scientific references supporting claims either are not provided or are inadequate. Peer-reviewed scientific literature in publications of the major scientific and professional associations can be viewed as generally reliable. Changing the way dental caries is managed in clinical practice will require integrating new scientific information and technology into workable clinical procedures. Dental education and third-party reimbursement issues must be addressed also but are beyond the scope of this document. Given that disease patterns are always changing in the population, dentists need to modify practice decisions using risk assessment. Ultimately, the goal for dentistry is that adult patients also will enjoy the same low level of caries experience that many children enjoy today.
Adolescent↗
Advocacy and compliance factors in a voluntary selective screening program.
To evaluate factors responsible for compliance with a voluntary selective screening program, we surveyed 495 participants and 212 nonparticipants in a screening program for Tay-Sachs disease. Knowledge about the program and motivation are the most important factors in compliance. The primary incentive for participation was to avoid having abnormal children in future generations.
Adult↗
Health and weight control management among wrestlers. A proposed program for high school athletes.
Weight loss is a part of any competitive sport which matches participants of equal weight or sports where participating at lower weights or with a thinner body habitus is considered an advantage. For some wrestlers, weight loss is excessive and often accomplished by methods that lead to loss of lean body mass and total body water. There is convincing evidence that this excessive weight loss is unhealthy for all individuals who follow these practices. Even greater harm is experienced by high school wrestlers who have not yet completed their growth and development. These health consequences include growth retardation, decreased academic performance, altered endocrine or hormonal function and damage to many vital organs. "cycling" of weight results in decrease in strength, power and endurance which would effect adversely a wrestler's likelihood of success. The VHSL has begun an educational program to inform coaches, wrestlers and parents about the hazards inherent in these weight loss practices. History suggests that education alone will not alter the present practices of weight loss. Therefore a weight management program similar to ones initiated in other states is being pursued by the VHSL. The pilot program this year is scheduled to be followed next year by a more wide-spread voluntary program across the Commonwealth.(ABSTRACT TRUNCATED AT 250 WORDS)
Adipose Tissue↗
Mass mammography screening: using an information system to track participation and identify target populations.
This article describes the 1991 American Cancer Society Greater Tampa Bay Breast Screening Program and an information system developed to track participants from the point of inquiry to mammography results. Information from three sources was linked to create a comprehensive data base, including participant demographics, mammography history, perceived risks of breast cancer, barriers to mammography, and mammography results. This comprehensive data base allowed investigators to describe the 11,134 participants and to assess the program's impact. The analysis suggested that women older than 65 years are underrepresented in this voluntary program. Black women were less likely to participate, as were women in lower income and education groups. To reduce mortality effectively, leaders of mass screening programs need to develop creative strategies for reaching these high-risk groups. Effective information systems can identify program weaknesses and track the impact of changes.
Adult↗
The impact of a drug information sheet on the understanding and attitude of patients about drugs.
A proposed Food and Drug Administration program to require written information with prescription drugs could cost $500 million annually; the American Medical Association has implemented a similar, voluntary program costing more than $3 million. However, the educational impact of written drug information has not been studied. We evaluated one-page drug information sheets using an objective examination. The baseline score of 71 patients was 3.9 of 6.0. Patients tested before and one day after receiving the drug sheet improved their score by +1.4. In the second phase, patients randomized to receive the drug sheet improved their score after one month by +1.1; those not given the sheet had no improvement. Changes in attitudes and incidence of reported adverse effects seemed to be random and unrelated to the information sheet. Thus, a drug information sheet may be a useful adjunct to patient education.
Attitude↗
Reducing the number of uninsured by subsidizing employment-based health insurance. Results from a pilot study.
OBJECTIVE: To evaluate whether employers who do not provide health insurance would offer such benefits after a 50% reduction in the price of health insurance. DESIGN: Using a survey of 530 firms at two sites in New York State, we estimate the number of firms that added insurance during 1988 as a percentage of firms that were eligible for the subsidy. We use this proportion as an estimate for the number of firms that would have added insurance in the absence of the subsidy program. We then estimate the number of firms adding insurance during the initial year of the program, 1989. SETTING: The subsidized health insurance pilot projects were available in Brooklyn and in the Albany-Plattsburgh-Poughkeepsie region of New York State. INTERVENTION: New York State subsidized the price of health insurance, reducing it by 50%. Eligible employers were responsible for paying the remaining portion of the premium. RESULTS: The subsidized health insurance products increased the number of small firms (under 20 employees) offering insurance by a small amount, approximately a 3.5 percentage point increase. When fully implemented and assuming all eligible employers were aware of the program, the subsidy would increase the proportion of firms offering insurance by 16.5 percentage points. We view this as an upper boundary. CONCLUSIONS: Increased program visibility and allowing the employee to share in the premium payment may increase the number of employers offering insurance. Even under ideal conditions, however, the results highlight the limitations of voluntary programs to increase the number of employers offering health insurance.
Health Benefit Plans, Employee↗
Future plans for quality assurance in radiation oncology in the United States.
The Patterns of Care Study (PCS) is conducting continuing surveys in key disease sites that will monitor changes in processes and outcome of care from 1973 to 1985. The PCS will conduct a process survey in 1984 that will provide the baseline data for the quality assessment survey program available to individual facilities in the United States in 1985. This program will be conducted through the American College of Radiology and operated by the joint ACR-ASTR Quality Assessment Committee which includes representatives from the American Association of Physicists in Medicine. It will be a voluntary program that will be paid for by the facility requesting assessment. The feedback will be confidential and constructed in a manner as to maximally help the facility recognize areas where improvements can be made. We are continuing to work with licensing accrediting groups such as the Joint Commission on Accreditation of Hospitals (JCAH) and the American College of Surgeons' cancer accreditation program to advise them of the service we will be providing, and to obtain their recognition and recommendation of this service. This program will provide a means of meaningful quality assessment for the individual facility, and the opportunity for each facility to improve the quality of their care. In addition, through these surveys we will continue to monitor changes in the national benchmarks for processes and outcomes of care of key disease sites in which radiation therapy plays an important interventional role.
Female↗
Mammography quality assurance programs.
A quality assurance program is an integral part of a department of radiology, but certain examinations require a more specialized approach than others. The need for greater quality control in mammography was recognized by the American College of Radiology in 1987. The voluntary program developed by this organization has greatly improved the overall quality of mammography in almost three fourths of the facilities in this country. The principles of this initiative now have been adopted by various state and federal agencies, but a uniform approach has not yet been finalized. Optimally, the best aspects of all of these programs will be integrated, resulting in satisfactory image quality, acceptable dosimetry, and an appropriate level of interpretive accuracy in all mammography installations.
Accreditation↗
The impaired physician, Part II: Missouri State Physicians Health Program.
Missouri Physicians Health Program (MPHP) was established to help impaired physicians return to healthy personal and professional lives. One percent of Missouri physicians will suffer some sort of impairment; ie: substance abuse, or dependency of drugs or alcohol within a year. This is a confidential voluntary program. This program of early referral, intervention, treatment and monitoring advocacy has been highly successful. The average recovery rate in this study of 75 participants was 92%.
Female↗
Who comes to a voluntary depression screening program?
OBJECTIVE: The purpose of this study was to describe who comes to a voluntary depression screening program by analyzing findings from the 1992 National Depression Screening Day. METHOD: Survey results from 5,367 adult volunteers at 345 facilities were analyzed. The authors examined the prevalence of depression detected at the screening test and sociodemographic characteristics and treatment history of the respondents. They also estimated the percentage of these individuals who would actually have a diagnosis of major depression (positive predictive value). The main assessment measure was the Zung Self-Rating Depression Scale. RESULTS: Of all participants, 76.6% (N = 4,109) had at least minimal depressive symptoms (score of at least 50 on the Zung depression scale), 53.3% (N = 2,859) had at least moderate symptoms (score of at least 60), and 22.6% (N = 1,214) had severe symptoms (score of at least 70). Few of the depressed respondents were currently in treatment for a mental health problem. The positive predictive value of a screening test diagnosis of depression was between 92.5% and 95.5% when a cutoff score of 60 was used to indicate depression and between 88.7% and 92.3% when a cutoff score of 50 was used. CONCLUSIONS: Voluntary screening tests, as exemplified by results from the National Depression Screening Day, provide a good opportunity for identifying previously unidentified and untreated individuals with depression.
Adolescent↗