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The importance of age as a context for understanding African-American women's mammography screening behavior.

INTRODUCTION: Although several studies have explored reasons for lower mammography screening rates among African-American women generally, none has addressed the effect of age as a context for interpreting these reasons. This study examines the association of predisposing, reinforcing, and enabling factors with recent screening mammography behavior for different age groups of African-American women. METHODS: Data are from stratified random sample household surveys of women in two Florida communities (n = 648). Bivariate, log linear, and multivariate logistic regression analyses were performed separately for three different age groups: 40-49, 50-64, and > or = 65. RESULTS: Age was found to be a key context for distinguishing factors associated with having a recent mammogram: Knowledge of screening guidelines and exposure to information about breast screening on radio or television were the most important factors that distinguished the youngest group. Having health insurance and level of education were important factors for the middle group. The most noteworthy differences were found for the oldest group for whom physician recommendation for a mammogram and confidence in being able to get a mammogram were the only significant factors associated with having a recent mammogram. CONCLUSIONS: This study confirms the need to tailor breast screening initiatives to specific age groups of African-American women.

Adult↗
PubMed1997

Magnetic therapy is ineffective for the treatment of snoring and obstructive sleep apnea syndrome.

Snoring and the obstructive sleep apnea syndrome are common and chronic ailments with potentially serious medical complications. There are several accepted treatments, but these can be uncomfortable, inconvenient, and expensive. A number of alternative treatments have been reported to be beneficial in the treatment of obstructive sleep apnea and snoring. They are advertised in magazines, on the radio and television, and on the Internet. The lay press is reporting about the effectiveness of these treatments without the benefit of clinical trials or scientific studies. Among the therapies currently being promoted for the treatment of snoring and sleep apnea is biomagnetic therapy. Unlike many of the other treatments which have not undergone scientific evaluation, biomagnetic therapy has been evaluated in the past. In fact, the evaluation of biomagnetic therapy is one of the first controlled scientific investigations found in the literature. This report showed that magnet therapy had no medicinal value. Despite this clear evidence, magnetic therapy continues to be utilized today and currently is being promoted for the treatment of snoring and sleep apnea. At out Sleep Disorder Center, we have had the opportunity to evaluate a patient with severe obstructive sleep apnea both before and after treatment with magnetic therapy, as well as with conventional therapy. Our study clearly indicates there was no benefit from magnetic therapy in this case. While alternative therapy may be helpful in the treatment of certain medical conditions, extreme care must be exercised to prevent inappropriate treatment or undertreat-ment of significant medical problems. Close clinical follow-up and controlled studies are important in determining the effectiveness of therapies.

Complementary Therapies↗
PubMed1997

Risk factors of low dietary vitamin A intake among children in the Sudan.

We examined the determinants of dietary vitamin A intake among Sudanese children, information which is important for designing effective interventions based on the dietary approach. Children under the age of two years were at greater risk of consuming a diet low in vitamin A compared with children who were five years or older. Compared with children from relatively affluent households, those from poorer households were about twice as likely to consume low levels of carotenoid or preformed vitamin A. Low vitamin A intake was also significantly associated with lack of running water, a latrine, radio, or television in the household, and inversely associated with maternal or paternal illiteracy and with cleanliness of the child subjectively assessed by the interviewer. As expected, breastfed children in the first two years of life were likely to consume lower levels of preformed vitamin A and carotenoid from food (excluding breast milk) compared with non-breastfed children. Low vitamin A intake was more prevalent in the dry months of the year. Efforts to increase accessibility to vitamin A containing food, combined with nutrition education campaigns and public health programmes directed at improving sanitation and reducing infection are necessary as part of the long-term solution to the problem of vitamin A deficiency.

Age Factors↗
PubMed1997

Puerto Rican patients travel to Puerto Rico: assessing the effect on clinical care.

OBJECTIVE: To examine travel habits of Puerto Rican patients and assess the potential effect of this travel on their health care. DESIGN: Interview and survey of patients. SETTING: Urban medical clinic. PATIENTS: Two hundred consecutive, self-identified Puerto Rican patients presenting for follow-up care. INTERVENTION: Immediately prior to a follow-up office visit, patients were interviewed in either Spanish or English. MEASUREMENTS: The patients' age, sex, education level, employment status, and place of birth were recorded. The patients were asked questions concerning the principle place of residence of their family members, their ability to speak English, and their preferences in television and radio programs. Patients who had visited Puerto Rico were asked about the duration and purpose of their most recent trip and about the health care they received in Puerto Rico. Chi-square testing was applied to categorical data and t tests for continuous data; P values were calculated using the SPSS statistical analysis program. RESULTS: Of the 200 subjects, 110 (55%) had traveled to Puerto Rico in the last five years and 90 (45%) had not. The patients who traveled were more likely to have been born in Puerto Rico, less likely to speak English, and less likely to listen to English-language programs. A majority of the patients who traveled to Puerto Rico visited for a month or less (80%) and did not experience a change in health care (78%). In comparison, however, a majority (59%) of the patients who visited for longer than a month did experience a major change in their health care status (P < .00001). CONCLUSIONS: Puerto Rican patients, particularly those born in Puerto Rico with stronger cultural "ties" to the island, frequently return to Puerto Rico. Patients who visit for longer than a month often experience changes in care which are likely to have significant effect on their health. Clinicians caring for Puerto Rican patients should ask about upcoming visits to Puerto Rico and take steps to assure continuous and coordinated medical care.

Aged↗
PubMed1997

The opinions and experiences of family physicians regarding direct-to-consumer advertising.

BACKGROUND: The use of direct-to-consumer advertising (DTCA) by pharmaceutical companies is increasing. Our study examines the opinions and experiences of family physicians concerning DTCA. METHODS: A survey instrument designed to elicit the opinions, experiences, and perceptions of family physicians about DTCA was sent to a 2% (N = 880) systematic sampling of active physician members of the American Academy of Family Physicians. Descriptive statistics were used to analyze responses with t tests and chi 2 tests for independence used to examine subgroup response differences. RESULTS: Four hundred fifty-four (52%) physicians responded to the survey. Most physicians (95%) had encountered DTCA personally, and had been approached by an average of 7 patients over the previous 6 months with requests for specific prescription drugs. Prescription antihistamines and antihypertensive drugs were the most commonly requested. Overall, 80% of the physician respondents believed that print DTCA was not a good idea, while 84% expressed negative feelings about television and radio advertising. Both groups cited "misleading biased view" and "increased costs" as the most common disadvantages. Some reported benefits included "better informed patients" and "promoting physician-patient communication." CONCLUSIONS: Overall, the study group physicians had negative feelings about DTCA in both print and electronic media. Studies directly examining patient perspectives, as well as cost benefits, are necessary to test the validity of the physicians' perceptions about DTCA.

Advertising↗
PubMed1998

Call 1-888-NOT-2-LATE: promoting emergency contraception in the United States.

In 1997, the nonprofit Reproductive Health Technologies Project and the Office of Population Research at Princeton University, together with the communications firm Elgin DDB, planned and executed a mass media campaign to advertise the Emergency Contraception Hotline and more generally to further awareness of emergency contraception as a last chance means of pregnancy prevention in the United State. We produced a variety of public service announcements (PSAs) including television and radio spots in English and Spanish and several print versions adaptable for newspapers and magazines as well as outdoor settings such as billboards, transit shelters, and the sides of buses. Working with local coalitions, we succeeded in placing the PSAs free of charge in six pilot cities. We also generated coverage about the campaign in local and national news outlets. We chronicle the development of the media campaign, discuss the challenges and obstacles faced, and conclude with a review of the principal lessons learned.

Advertising↗
PubMed2006

BC Walks: replication of a communitywide physical activity campaign.

INTRODUCTION: Individuals not engaging in recommended amounts of moderate-intensity physical activity are deemed insufficiently active and are at greater risk of chronic disease. Social marketing strategies may promote positive changes in physical activity levels among insufficiently active individuals. METHODS: A quasi-experimental design was used to determine whether the results of a previous communitywide physical activity social marketing campaign conducted in Wheeling, WVa (population, 31,420) could be replicated in the larger community of Broome County, New York (population, 200,536). BC Walks promoted 30 minutes or more of moderate-intensity daily walking among insufficiently active residents of Broome County, New York, aged 40 to 65 years. Promotion activities included paid advertising, media relations, and community health activities. Impact was determined by preintervention and postintervention random-digit-dial cohort telephone surveys in intervention and comparison counties. We assessed demographics, walking behavior, moderate and vigorous physical activity, and campaign awareness. RESULTS: The paid advertising included 4835 television and 3245 radio gross rating points and 10 quarter-page newspaper advertisements. News media relations resulted in 28 television news stories, 5 radio stories, 10 newspaper stories, and 125 television news promotions. Exposure to the campaign was reported by 78% of Broome County survey respondents. Sixteen percent of Broome County participants changed from nonactive to active walkers; 11% changed from nonactive to active walkers in the comparison county (adjusted odds ratio, 1.71; 95% confidence interval, 0.99-2.95). Forty-seven percent of Broome County respondents reported any increase in total weekly walking time, compared with 36% for the comparison county (adjusted odds ratio, 1.66; 95% confidence interval, 1.14-2.44). CONCLUSION: The BC Walks campaign replicated the earlier Wheeling Walks initiative, although increases in walking were smaller in the BC Walks campaign.

Adult↗
PubMed1992

Media sources of HIV/AIDS information in injecting drug users.

We report on media habits of 797 members of a sample of 1245 injecting drug users interviewed in Sydney, Australia. While preferred hours of television viewing and radio listening were similar to those of the general population, the preferred channels and stations were different. These findings could assist in targeting injecting drug users with information about HIV/AIDS prevention. However as the self-regulatory advertising process has constrained broadcast and publication of overt messages directed at homosexual and bisexual men, similar restrictions may prevent optimal mass media approaches to educating this other important group at risk of HIV infection.

Acquired Immunodeficiency Syndrome↗