PubMed HealthSearch

SEARCH · PubMed Health

Results for “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.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

Infant Health and Development Program for low birth weight, premature infants: program elements, family participation, and child intelligence.

The Infant Health and Development Program was an eight-site randomized controlled trial testing the efficacy of early intervention to enhance the cognitive, behavioral, and health status of low birth weight, premature infants. The 377 intervention families received for the first 3 years of life: (1) pediatric follow-up, (2) home visits, (3) parent support groups, and (4) a systematic educational program provided in specialized child development centers. The control group (n = 608) received the same pediatric follow-up and referral services only. This paper describes the delivery of the intervention and its outcomes. A Family Participation Index that was the sum of participation frequencies in each of the program modalities unique to the intervention revealed that program implementation was not different across the eight sites. Index scores did not vary systematically with mother's ethnicity, age, or education or with child's birth weight, gender, or neonatal health status; but they were positively related to children's IQ scores at age 3. Only 1.9% of children of families in the highest tercile of participation scored in the mentally retarded range (IQ less than or equal to 70), whereas 3.5% and 13% of children in the middle and lowest participation terciles, respectively, scored in the retarded range. Similar findings were obtained for borderline intellectual functioning. These findings are consistent with previous research linking intensity of intervention services with degree of positive cognitive outcomes for high-risk infants. The determinants of variations in individual family participation remain unknown.

Child Day Care Centers

Skin cancer awareness programs: success of a statewide program of education and screening in Ohio.

Skin cancer has been increasingly identified as an important public health concern. Dramatic increases in the incidence of skin malignancies have led the dermatologic community in Ohio to organize a statewide program of education and free public screenings. The program reached multiple geographic areas throughout Ohio. Educational programs were presented on television and radio, in newspapers, in independent programs, and in schools. Skin cancer screenings ultimately evaluated 5,492 patients. Six hundred and twenty-three patients were found to have suspected malignancies, while an additional 1,647 patients were found to have premalignant lesions of skin. A total of 2,370 patients were therefore found to have significant findings (43.2%). These results emphasize the need for public education concerning this condition.

Health Education

Applying the criteria for the development of health promotion and education programs to AIDS risk reduction programs for gay men.

As a result of the AIDS (Acquired Immune Deficiency Syndrome) epidemic, many community health agencies are faced with the task of planning and implementing programs to prevent or reduce the risks of HIV (Human Immunodeficiency Virus) infection. Furthermore, the urgency of AIDS will force community groups to develop prevention programs prior to an analysis of substantial data relating to intervention efficacy. By using the five criteria for the development of health promotion and education programs enumerated by the American Public Health Association, planners can benefit from the experience of past health promotion initiatives, and insure a comprehensive approach to planning. The authors describe, using specific examples, how these criteria were used to develop and implement an AIDS risk reduction program for gay and bisexual men.

Acquired Immunodeficiency Syndrome

In vitro fertilization program based on programmed cycles monitored by ultrasound only.

OBJECTIVE: Programmed oocyte retrieval was performed in order to make the in vitro fertilization (IVF) program cheaper and work of the IVF team easier. METHOD: In a group of 77 patients included in the IVF program, the menstrual cycle was modified with estrogen-progesterone contraceptive pills. For this reason, it was possible to start the stimulation protocol in all patients on the same day. The stimulation protocol was a combination of clomiphene (100 mg) for 5 days and HMG (150 IU) every other day. Cycles were monitored by ultrasound only. RESULT: The implantation rate per embryo transfer was 22.4%. The number of embryos per embryo transfer was low (2.6 +/- 1.4) and eliminated the need for cryopreservation. Fertilization rate (82%) and embryo transfer rate (87%) were high. The take home baby rate was 14.3%. CONCLUSION: Seventy percent of all punctures were performed in 3 days in the middle of the week. In our conditions, programmed oocyte retrieval is associated with significant economic benefits.

Clinical Protocols

Program adherence and coping strategies as predictors of success in a smoking treatment program.

Ninety-four participants in a 6-week behaviorally oriented smoking cessation program were administered weekly questionnaires assessing their use of the major program recommendations and other quitting strategies throughout treatment. An "affect-regulation" coping inventory was administered at the beginning and end of treatment as well. Adequate adherence was reported for most of the program recommendations. Although a composite measure of adherence did not predict quitting success, adherence and coping assessments were associated with maintenance of treatment gains. Short-term maintenance was associated with an extensive affect-regulation repertoire and use of "stimulus control" strategies during the program, and long-term maintenance was associated with consistent self-monitoring of smoking during treatment. These prospective findings highlight some behavioral characteristics that may be useful targets in future efforts to foster maintenance of smoking behavior change.

Adaptation, Psychological

A model to nationally replicate a locally successful rural family caregiver program: the Volunteer Information Provider Program.

A local program can be successfully transplanted beyond state lines if it contains the seeds for its own dissemination and replication. One such program, the Volunteer Information Provider Program (VIPP), was first piloted in Missouri and then disseminated to 20 states. The strategy, steps taken, and key elements of this successful model are delineated. The VIPP, a rural family caregiver program, was utilized, in just the dissemination phase, by 657 professionals and volunteers to aid 7,213 rural family caregivers across the United States.

Aged

Epidemiologic programs for computers and calculators. A microcomputer program for multiple logistic regression by unconditional and conditional maximum likelihood methods.

A frequent procedure in matched case-control studies is to report results from the multivariate unmatched analyses if they do not differ substantially from the ones obtained after conditioning on the matching variables. Although conceptually simple, this rule requires that an extensive series of logistic regression models be evaluated by both the conditional and unconditional maximum likelihood methods. Most computer programs for logistic regression employ only one maximum likelihood method, which requires that the analyses be performed in separate steps. This paper describes a Pascal microcomputer (IBM PC) program that performs multiple logistic regression by both maximum likelihood estimation methods, which obviates the need for switching between programs to obtain relative risk estimates from both matched and unmatched analyses. The program calculates most standard statistics and allows factoring of categorical or continuous variables by two distinct methods of contrast. A built-in, descriptive statistics option allows the user to inspect the distribution of cases and controls across categories of any given variable.

Algorithms

A model for the objective assessment of clinical training programs: the initial application to two pulmonary medicine fellowship programs.

A model is presented for the objective assessment of clinical training programs. The model documents the clinical trainee's experience by the diagnoses seen and procedures performed during a full year of experience. It also surveys faculty impressions of the trainee's experience and their judgment of what is necessary to constitute an adequate experience. In the pilot study applying this model to two pulmonary medicine fellowship programs, several important observations were made: (1) faculty members may not have an accurate perception of the fellow's actual clinical experience, (2) faculty impressions of the fellow's experience often do not correspond to their own conception of an adequate clinical experience, (3) interprogram variability exists, (4) pulmonary fellows may have inadequate experience with certain invasive procedures. These observations suggest that wilder application of such a model could provide valuable information to program directors and subspecialty boards. In addition, directors of pulmonary disease training programs have been asked by the American Board of Internal Medicine to establish systems to evaluate, document, and substantiate those components of overall clinical competence considered essential for certification in the subspecialty. The model presented here provides an accurate and efficient means for such evaluation and documentation.

Clinical Competence

The national high blood pressure education program: a description of its utility as a generic program model.

The National High Blood Pressure Education Program recently celebrated its tenth anniversary. It is timely and appropriate to assess progress toward the realization of its mission and to examine the critical elements of this large-scale, community-based intervention program. This article describes the origin of the National Program, the planning process and models used in undertaking this national health education effort, the application of theoretical models, and approaches used to evaluate the effort. The lessons learned and the application of the National Program as a model for health education interventions are offered.

Cardiovascular Diseases

A technology for program maintenance: programming key researcher behaviors in a student housing cooperative.

Behavioral researchers play critical, but often unanalyzed, roles in the programs they develop. Unless they replace their key activities with standardized procedures, their continued participation may be essential to program success--a situation that is often not only impractical but may be prohibitively expensive and disliked by local staff. This study was conducted in a student housing cooperative that is dependent on close researcher supervision for its continued health and survival. A key activity of the co-op researchers was to provide public recognition for good job performance by co-op members. The purposes of this study were (a) to replace that idiosyncratic recognition with systematic procedures so members, instead of the researchers, would provide public recognition to each other for good job performance; and (b) to evaluate those procedures by comparing job performance when member-delivered recognition was provided and when it was not. When the procedures were in place, job performance increased and fines for poor job performance and complaining at meetings decreased. This study suggests that procedures can be developed to reduce program reliance on the researcher that are effective, inexpensive, sustainable, and acceptable to the participants--a first step toward developing a technology of program maintenance.

Activities of Daily Living

Use of an interactive teaching program to teach medical workers, about MUMPS programming.

The MUMPS computer language is widely and increasingly used for medical applications. It is useful for medical students and others in the medical environment to have an understanding of such languages that can help them perform their jobs well. The author is therefore making available an interactive teaching program to instruct such people in the MUMPS computer language. Use of the teaching program is reported for 19 novice MUMPS programmers and compared with results for two experienced programmers. Free-text comments by the novices emphasize areas in which they had difficulty. There is a considerable variation in the mean time taken by the novices to answer the questions, and in the number of questions repeated because of erroneous answers. Most novices found the teaching program very helpful. A copy of the Standard MUMPS teaching program and the QUEST driver on which it is based has been sent to 24 institutions, including six in Europe and one in Japan, for further use.

Allied Health Personnel

The diet, nutrition, and cancer program of the NCI National Cancer Program.

In November 1974, in response to a mandate in the revised National Cancer Act of 1974, a plan was introduced for the formation of a Diet, Nutrition, and Cancer Program. Dr. Frank J. Rauscher, Director of the National Cancer Institute, selected a group of scientists who defined the goals of the program and recommended the appointment of a program director and of an advisory committee. These recommendations were accepted, and an Advisory Committee, reflecting a cross-section of scientific expertise, has been selected. To recommend a well-balanced program, it will be necessary for the Advisory Committee to assess the current state of the art of nutrition in cancer etiology and therapy and to be apprised of current opportunities, needs, and resources. Toward this end, a literature survey project has been initiated and two specialized workshops have been held.

Diet

The Dentofacial Deformity Program of the University of Michigan: organization, analysis of data, and benefits of program.

The Dentofacial Deformity Program of the University of Michigan was established in 1984 to provide a consulting service for the diagnosis, treatment recommendations, and management of patients with dentofacial deformities. This program was designed as a service commitment for the patient, referring doctors, and the medical and dental communities. Educational and research aspects of the program provide benefits for orthodontic and oral and maxillofacial surgery graduate students, and the dental school faculty. The organization, data analysis, and education, research, and service benefits of this program are discussed.

Adolescent

The genetic risk screening, education, and referral program: a model program for training of health professionals.

This report describes a statewide program which trains family-planning personnel to provide genetic risk screening, to educate clients about potential genetic risks, and to make appropriate referrals to genetics centers. The program is unique in that training and service delivery are all done within the structure and agencies of the family-planning councils of Pennsylvania. Through the collaboration of the Pennsylvania Department of Health, the family-planning councils, and trainers from clinical genetics centers, a uniform and comprehensive program for training and service delivery has evolved. This program now provides genetic risk screening for nearly 100,000 women/year, many of whom are from groups typically underserved by genetics services.

Curriculum

Evaluating productivity in clinical research programs: the National Cancer Institute's (NCI) Community Clinical Oncology Program (CCOP).

This paper outlines an approach to studying productivity in clinical research programs that incorporates environmental, organizational, provider, and patient specific factors in the model of production process. We describe how this approach has been applied to the National Cancer Institute's (NCI) Community Clinical Oncology Programs (CCOPs). Next, a practical evaluative model of the productive process in CCOPs is outlined and its use in evaluation and monitoring performance in CCOPs is discussed. Each level of the model is described and a number of factors potentially affecting each level are explored. Finally, we discuss the strengths and weaknesses of this approach and show how management can use it to study and improve the productivity of clinical research programs.

Catchment Area, Health

Do smoking prevention programs really work? Attrition and the internal and external validity of an evaluation of a refusal skills training program.

This study investigated the effects of a smoking prevention program that emphasized refusal skills training on 1730 adolescents in three high schools and six middle schools. Classes within these schools were randomly assigned to treatment or no-treatment conditions to avoid confounding schools with treatment condition. The effects of attrition on the internal and external validity of the study were examined. Although the results indicated an apparent effect of the program at the 1-year follow-up in deterring continued smoking among those who were smoking at pretest, this result may have been due to a higher rate of attrition among high-rate smokers in the treatment condition than in the control condition. Attrition also affected external validity. Across both conditions, subjects who were smoking at pretest and who were at risk to smoke were more likely to be missing at follow-up. The program did have an effect on the refusal skills of participants and the validity of this effect was not jeopardized by differential attrition.

Adolescent

How generalizable are the effects of smoking prevention programs? Refusal skills training and parent messages in a teacher-administered program.

This study investigated both substantive and methodological issues associated with school-based smoking prevention programs. Substantive issues included the efficacy of a refusal skills training curriculum and of parent messages mailed to students' homes. Methodological issues included the effects of assigning classrooms versus entire schools to experimental conditions and determination of the effects of attrition on internal and external validity. Results revealed differential impact for different subgroups of adolescents. The refusal skills program produced lower rates of smoking than the control condition for students who were smokers at the pretreatment assessment but may have produced detrimental effects among males who were nonsmokers at pretest. The provision of parent messages did not affect outcome. Method of assignment (schools versus classrooms) failed to produce significant effects, and attrition did not affect internal validity. However, the above differential findings, as well as the impact of attrition on external validity, raise questions concerning the generalizability of smoking prevention programs.

Adolescent

Programmed follicular stimulation reduces cycle cost and stress with no compromise in cycle quality: use of a modified programmed protocol.

To reduce cycle cost and patient/staff stress in an ongoing in vitro fertilization (IVF) program, we have utilized a modified "programmed" (PP) follicle stimulation protocol with limited monitoring. We have compared our PP results with those using a conventional, individualized, and fully monitored protocol (OP) in order to show that PP does not compromise the quality of care. Hormonal presuppression made possible an arbitrary starting day for the cycle. In 80% of the cycles, oocyte retrieval (OR) was performed on the planned day or 1 day later. There was no statistically significant difference between the two regimens in oocyte/embryo numbers, quality or pregnancy rates. The cycle cost was significantly reduced. In addition, patient stress was lessened because of the reasonable predictability of cycle timing. We conclude that PP has significant financial and emotional advantages for the patient over OP but does not appear to diminish the chance for pregnancy in an IVF cycle. PP also allows program staff to manage time more effectively, thereby reducing staff stress.

Clinical Protocols