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Factors influencing recruitment to an occupational fitness program.

Factors influencing participation in an employee fitness program have been studied in a group of 535 early recruits for a Health Fitness Center established at the headquarters office of a larger corporation. The overall participation rate (20% of eligible staff with convenient access to the facility) was much as in previous reports. Interest was relatively equal in men and in women. Typical recruits were middle-aged non-smokers who had previously been active elsewhere. Men had an above average maximum oxygen intake and muscle strength, but were also somewhat overweight and fat. Women were closer to their actuarial ideal weight, but had relatively lower levels of cardiorespiratory and muscular fitness than the men. Program acceptability factors (traveling time, hours of work, and cost) had little effect on participation. Subjects perceived that they were active for health, fitness, competition (men), and appearance (women). General and specific health beliefs were well-developed, but bore surprisingly little relationship to health practices and outcomes. It is thus argued that the shaping of attitudes by trial of an exercise program may be a more effective tactic for increasing exercise participation than general campaigns designed to change attitudes and values.

Adult

Family crisis care: a home-based intervention program for child abuse.

Community awareness of child abuse and neglect has greatly increased. The documentation of an upward trend in the number of reported and confirmed child abuse and neglect cases in Hawaii reflects the need for additional programs to respond to this growing concern. Clinical nurse specialists in psychiatric and mental health nursing have developed an intensive home-based crisis interaction and family education program, Family Crisis Care. The program accepts only families referred by Child Protective Services in which at least one child is in imminent danger of being placed in foster, group, or institutional care. The goal of Family Crisis is to prevent the out-of-home placement of children through intensive, in-home intervention and to teach families new problem-solving skills to prevent future crises. The program has been effective in maintaining the child within the home, reducing physical punishment and other problem factors in the family, improving communication and problem-solving skills, and increasing use of community resources.

Adult

Residential program characteristics for completion of treatment by adolescent drug abusers.

The relationship to treatment outcome (as measured by the National Institute of Drug Abuse Client-Oriented Data Acquisition Process [NIDA-CODAP] Reasons for Discharge classification) of specific characteristics and elements of 22 drug-free residential programs for adolescents is reported. Admission and discharge data were obtained from NIDA-CODAP on 2,532 adolescents in the 22 programs. A partial cross-validation study was conducted by analyzing separately for two annual client subsamples. The program, not the individual client, was the unit of analysis. When three differences between programs in their client populations were "partialed out" the following characteristics of programs were found to predict positively to outcome (a lower treatment failure rate) to a statistically significant degree: the number of years that the counselors had worked in the programs; the number of volunteer staff in direct service (client contact); the proportion of clients receiving bodily and mental relaxation techniques: the counselors' perceptions that their programs accept or encourage relatively more spontaneous personal expressiveness, including expression of anger by clients, in staff-client relationships, but encourage less client "autonomy" (to be self-sufficient and independent with regard to making their own decisions); the counselors report that providing practical assistance in solving clients' real-life problems is useful. There was a high degree of replication of these findings across the two annual subsamples of clients. These findings for adolescents in residential programs are compared with findings reported in a parallel study of treatment outcome for adolescents in outpatient programs.

Adolescent

Community acceptance of residential programs for developmentally disabled persons.

Deinstitutionalization and the ensuing establishment of residence programs for developmentally disabled persons has stimulated both community support and opposition. The present study considers changes in the levels of community acceptance after residence programs are established, sources of program support and opposition, and strategies used to overcome community opposition. The data are based upon responses to a survey of all community residence programs in New York (n = 459). The findings indicate marked and consistent shifts toward the acceptance of established residence programs.

Adult

Developing culturally sensitive HIV/AIDS and substance abuse prevention curricula for Native American youth.

In 1990, researchers and health care professionals joined with members of several southwestern Native American communities to form an HIV/AIDS and substance abuse prevention partnership. Culturally sensitive approaches to theory-based interventions were developed into highly replicable, structured, school-based and community-based intervention programs. Process evaluations indicated high levels of program acceptance and fidelity. Outcome evaluations demonstrated significant positive preventive intervention effects among participants. This article reports how NAPPASA school prevention curricula were developed and discusses three critical processes in developing these successful curricula: 1) selection of integrative theory to address the multi-dimensional antecedents of HIV/AIDS and substance abuse among Native Americans, 2) use of ethnographic methodology to obtain intensive input from target groups and community members to ensure cultural and developmental sensitivity in the curriculum, and 3) use of process and outcome evaluations of pilot and field trials to develop an optimal curriculum.

Adolescent

FORTRAN source listing for simulating three-dimensional convergent beam patterns with absorption by the Bloch wave method.

The FORTRAN source code is given for a computer program that calculates the two-dimensional intensity distribution in convergent-beam transmission electron microdiffraction (CBED) patterns from perfect crystals. The program uses the eigenvalue or Bloch-wave method. It allows three-dimensional dynamical diffraction, and so includes all higher-order Laue zone effects without approximation. No symmetry reduction is included. The program accepts noncentrosymmetric or centrosymmetric crystal structures and allows absorption corrections to be included. It uses the "EISPACK" subroutines for the diagonalisation of a general complex matrix. Up to 100 CBED disks may be included. The code is also available via "Bitnet."

Electron Probe Microanalysis

Experiences of a health team working in a new urban settlement area in Istanbul.

A project aiming at creating a model for comprehensive maternal and child health care for urban underdeveloped areas was started in a new settlement area of migrants in the vicinity of Istanbul. The project had an impact on health care status, particularly among infants and children, but the results indicated that more effort was needed to reach the mothers. It was noted that building space and the appearance of the work place influenced the prestige of the team. Absentee problems could be partly surmounted by repeated home visits. Based on this experience, it was concluded that health services in underdeveloped areas need to be supported by non medical personnel to act as home visitors and as mediators between the community and the health team. It was also concluded that an established recording system to include both clinical data and attendance is needed to define the cases who need special care.

Adult

A PC-based computer program for quality assessment of INAA results of emission and air particulate samples.

A PC-based computer program for quality assessment (QAS) of results obtained by neutron activation analysis (NAA) is described. Program QAS is designed for the quality assurance system based on a routine use of certified reference materials (CRMs) with similar matrix composition as the samples analyzed together with each sample batch. The results obtained for CRMs samples are then compared with certified (true) values and with the results obtained for particular CRM in previous analysis runs. Five various tests are applied to check the quality of NAA results (for CRM and, consequently, for real samples) obtained for a particular analysis run. Control charts for elemental concentrations found in CRM and ranges of results for duplicate aliquots of CRM are displayed to visualize possible discrepancies. The program accepts files transported from gamma-ray spectrometric system ND 683 (based on a PDP 11 computer), extracts and stores reference material results, and prepares a work spreadsheet for each set of results to avoid typist and other kinds of errors.

Air Pollution

A program to facilitate cytotoxicity assay data reduction.

A report of a program which performs the initial computational reduction of the raw data from a cytotoxicity assay and outputs the reduced data as an image of the arrangement of the assay(s) upon the microwell plate. The program accepts the raw data either as manual or diskette file input.

Algorithms

A PC program for classification into one of several groups on the basis of longitudinal data.

A stand-alone, menu-driven PC program, ZCLASS, written in GAUSS386i, for classifying subjects into one of several distinct, existing groups on the basis of longitudinal data is described, illustrated, and made available to interested readers. The program accepts data from studies where common times of measurement are planned, but missing data are accommodated in that one or more measurement sequences may be incomplete.

Anthropometry

Mortality in acute gynecology: a developing country perspective.

Over a 20-month period 109 deaths were recorded in the Acute Gynecology Ward, Kenyatta National Hospital, Nairobi; a rate of 5 deaths per month. Forty-one percent of the deaths were directly attributable to pregnancy and 46% were due to malignancy (mainly cervical carcinoma). Of the dead, 12.4% were teenagers and 63% below 35 years in age. They were generally of low parity. A tragic picture is presented of death of young women in their prime from almost entirely preventable causes. The need for improved maternal care, including family planning and cytological screening for cervical carcinoma is discussed and emphasized.

Abortion, Septic

Effects of father-daughter contact on use of pregnancy services by Mexican, Mexican-American, and Anglo adolescents.

This study describes whether frequency and quality of father-daughter contact during adolescent pregnancy differ by ethnicity, whether this contact affects health behavior, and how ethnicity conditions the relationship between contact and behavior. Health behavior is defined as timing of pregnancy test and first prenatal visit. Data were gathered from a sample of 105 Anglo, Mexican-American, and Mexican adolescents interviewed at mid-pregnancy. Almost twice as many Mexicans (64%) as Mexican-Americans never saw their fathers (p less than 0.03). Girls living with their fathers obtained pregnancy tests significantly later (p less than 0.01) than those living independently. This relationship was maintained when ethnicity was held constant (p less than 0.01). When quality of contact was included, the relationship between residency with father and timing of pregnancy test became even stronger (p less than 0.003).

Adolescent

Effects of social supports on attitudes and health behaviors of pregnant adolescents.

The influence of social support on maternal attitudes and behaviors was assessed in 57 third-trimester adolescent women attending an urban prenatal clinic. Sociodemographic characteristics, social support, self-esteem, and feelings about pregnancy were measured by questionnaire. The support and influence of the adolescent father was emphasized. Social support was measured as a multidimensional construct derived by a priori and empirical procedures. The outcomes measured were the amount of prenatal care, attendance at scheduled postpartum appointments, and pleasure with the pregnancy. Stepwise multiple-regression analyses were used to assess the contributions of the predictor to criterion variables. Pleasure with pregnancy was positively associated with the receipt of assistance from the adolescent's mother, favorable opinions of friends, and satisfaction with living arrangements. Attendance at postpartum visits was associated with high self-esteem. Notably absent as significant contributors were sociodemographic characteristics, receipt of emotional and tangible support from the adolescent father, and expectation of aid from social-assistance programs.

Adolescent

Adolescents' willingness to use a school-based clinic in view of expressed health concerns.

A health needs assessment was developed to facilitate implementation of a comprehensive school-based adolescent clinic. Students were asked about their willingness to use a school-based clinic for certain health and emotional problems. Six hundred students in grades 9 through 12 completed anonymous self-administered questionnaires. Twenty-eight percent of respondents reported recently feeling depressed; 12% reported a prior suicide attempt. Twenty-five percent of students felt they were overweight. Of 56% who had experienced intercourse at least once, only one third had ever used birth control. Twenty-one percent smoked cigarettes and 27% marijuana, 24% used other drugs, and 38% used alcohol. Students who reported depression and past suicide attempts were significantly (p less than or equal to 0.001) more willing to use the clinic for counseling needs than students not so reporting. Those with perceived weight problems reported more willingness to use a school clinic for nutrition information than those who did not feel overweight. Currently sexually active students were also more willing (p less than or equal to 0.001) than nonsexually active students to use the clinic for sexuality information and sexually transmitted disease screens. Respondents who used drugs, alcohol, or cigarettes, however, were no more willing than nonsubstance-using peers to use clinic services for relevant health information.

Adolescent

School-based clinic use and other factors affecting adolescent contraceptive behavior.

Adolescent risk taking, preventive behavior, and contraceptive use were investigated using a self-administered questionnaire in a sample of 260 inner-city high school students targeted by a school-based health clinic. Multivariate models consisting of individual and environmental variables significantly predicted sexual activity and contraceptive use. Older age at first intercourse, higher number of welfare benefits received by the household (including Medicaid, food stamps, and free or reduced price lunch), and use of the school-based clinic were significant positive predictors of more frequent contraceptive use by adolescents. Results of our study suggest that programs may be having some success in encouraging and enabling sexually active adolescents to use contraception and to use it more consistently. Rigorous program evaluations should help program planners and policy makers design and refine adolescent pregnancy-prevention efforts.

Adolescent

Incentives and their influence on appointment compliance in a teenage family-planning clinic.

The purpose of this study was to ascertain whether or not the family-planning compliance patterns of indigent adolescents could be influenced by various types of incentives. From February 1988 through January 1989, 534 postpartum inner city teenagers, aged 12-19, who delivered at a large city-county public hospital, participated. Teens were randomly assigned to two treatment groups that either offered a coupon for milk for the infant or a gift for the teenage mother if they returned for their postpartum visit 4-6 weeks after delivery. A third group, which used no incentive for appointment keeping, acted as a control. Although overall compliance was low, a significant relationship was found between type of program incentive and compliance outcome. The program using milk coupons as an incentive had the best compliance rate. This incentive appeared to be most effective with black adolescents. Such incentive programs, although not without controversy, offer a potential way to enhance postpartum contraceptive appointment-keeping compliance in a high-risk population.

Adolescent