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Can health education increase uptake of cervical smear testing among Asian women?

OBJECTIVES: To determine the effects of three different methods of providing health education on the uptake of cervical smear testing among Asian women, and to evaluate the acceptability of different health education materials. DESIGN: Prospective cohort study over one year of effects of written materials by post, personal visit to give written materials, and personal visit to show a video on the uptake of smear testing. Techniques included a personally administered questionnaire. SETTING: Leicester, a city with a large Asian population. SUBJECTS: 737 randomly selected Asian women aged 18 to 52 who were not recorded on the central cytology laboratory's computer as ever having had a cervical smear test. 159 declined to participate or were not contactable. INTERVENTIONS: Women were randomised into four groups: visited and shown a video (263), visited and shown a leaflet and fact sheet (219), posted a leaflet and fact sheet (131), not contacted at all (124). MAIN OUTCOME MEASURES: Cervical smear test recorded on computer within four months after intervention. RESULTS: 57 (37%, 26% of group) of the women visited and given leaflets and 80 (47%, 30% of group) shown the video attended for cervical smears. Only six (5%) of those who were not contacted and 14 (11%) of those sent leaflets had a smear test during the study. CONCLUSION: Health education interventions increased the uptake of cervical cytology among Asian women in Leicester who had never been tested. Personal visits were most effective irrespective of the health education materials used, but there was some evidence that home viewed videos may be particularly effective in one of the most hard to reach groups: Urdu speaking, Pakistani Moslems. Written translated materials sent by post were ineffective.

Adolescent↗

Improved intermediate clinical outcomes from participation in a diabetes health education program.

Diabetes self-management education programs are an essential strategy for improving health behaviors of adults with diabetes and, therefore, intermediate clinical outcomes. We conducted a retrospective observational study using a case:control design to estimate the impact of participation in a diabetes health education program on glycemic and lipid levels, accounting for nonrandom participation of adults with diabetes in the program ("regression to the mean"). Adults with diabetes in a group-model managed care organization who attended the diabetes health education program during the period January 1, 2003, through June 30, 2004 ("participants"), were randomly matched with 4 adults with diabetes who did not participate ("nonparticipants"). Participants (N=1991) and nonparticipants (N=7964) were matched on age group, gender, mean hemoglobin A1c (Hb A1c) (or low-density lipoprotein) in the 6 months prior to the class (or randomly selected index month for nonparticipants), and primary care practice where the patients received regular care. On average, participants had significantly (P < .05) worse glycemic and lipid levels in the 6 months prior to participation compared to nonparticipants. Participation in the diabetes education program significantly improved glycemic and lipid levels between baseline and follow-up periods above the improvement attributable to regression to the mean. For example, nonparticipants with baseline Hb A1c levels greater than 10.0% had improved Hb A1c levels of -1.7% (P < .01); however, among participants, mean Hb A1c levels improved an additional -1.6% (P < .01). Overall, the evidence suggests that participation in a multifactorial diabetes health education program significantly improved glycemic and lipid levels in the short-term, particularly among participants with extremely adverse Hb A1c or low-density lipoprotein levels prior to participation.

Adult↗

Relationships between wellness role modeling and professional training in health education.

The relationship between wellness role modeling and health education was examined in a university setting. Comparisons were made between the following groups: 1) new health science majors and advanced majors; 2) new health science majors and new majors in other fields; 3) advanced health science majors and advanced majors in other fields; and 4) health science education faculty and the previously tested groups. Each group responded to a valid and reliable wellness instrument (University of Wisconsin/La Crosse Wellness Inventory). Differences between groups were determined using means, analysis of variance and Scheffe's post-hoc test. Results indicated that no statistically significant difference existed among student groups indicating that just traditional academic exposure to health science/education does not produce positive role models. The faculty were significant potential role models but apparently failed to communicate this positive wellness philosophy to students.

Analysis of Variance↗

Marketing impact of health education programs.

A study evaluating whether a lay public education program caused initiation of health-related behaviors was conducted at the Cleveland Clinic Foundation. Attendees of three individual "Health Talks" were surveyed: endometriosis (n = 78), men's health (n = 62) and cancer (n = 57). Participants were surveyed at three points: (a) before the talk, (b) immediately following the talk and (c) six weeks after the talk concerning their knowledge and health behaviors. The results indicated that community health education produces a substantial improvement in health-related knowledge and after attending the seminars, 81.3% of respondents initiated a positive health behavior. Of interest to health care marketers are the 30.8% of attendees who initiated health behaviors which have marketing implications.

Female↗

Women's health education: the first step to self-care.

Changes in health care emphasize the importance of individuals assuming more responsibility for their own health. Although the concept of health connotes the absence of disease, it also includes the individual's ability to adapt to stressors, manage roles and activities daily, and live life in an exuberant way. Although research supports the relationship of health education and self-care, more must be done to understand what motivates individuals to pursue healthy lifestyles. Women's health education is the first step to self-care and improving the health of women and their families.

Female↗

[Health education: an experience in the Secretaria de Salud of the São Paulo State].

The authors make a detailed analysis of social research and educational programs carried on in the last 10 years by the Public Health Education Service, an agency of the São Paulo State Health Department. They emphasize the priorities that have been established and achievements made in the field of health education. They show how educational activities have generally been centered around teaching, especially the biological sciences, aiming at the adoption by the individual of standards considered adequate to attain greater well-being. From this point of view, educational activities take on an authoritarian character, stemming from an asymmetrical relationship between technical personnel and the population, which limits the evolution a real health awareness. In the authors' opinion, health education--in the present historical, political, and social context of Brazil and particularly of São Paulo State--requires that priorities be established, based on the main health needs of the majority of the population, through mechanisms that ensure the active participation of the community.

Brazil↗

[An health education program for patients admitted to CCU for an acute coronary event].

UNLABELLED: In spite of the broad recognition of the importance of health education, time for structured one-to -one initiatives of health education during the hospital stay is limited. The organization of an health education meeting for patients admitted to CCU for an acute coronary event is described. METHODS: The planning and implementation of the initiative lasted two years and involved 7 nurses and one doctor. The organization required efforts related to the event itself (preparation of training aids, identification or contents and methods for delivery) but also organizative changes. Dietitians in fact had to be involved because the healthy diet recommended was different from the hospital diet. The assessment of the effectiveness of the health education was also planned: administration of a questionnaire to explore lifestyles and knowledge of the illness before and after the meeting; phone interviews after 3, 6 and 12 months from the meeting. RESULTS: Since may 2003, in the first 3 years 74 meetings have been organised, involving 507 patients and 329 relatives. Each meeting lasts 2 hours and contents delivered encompass the coronary event, risk factors and their modification, healthy lifestyles. Initial preliminary results on the impact of the meeting on lifestyle changes are promising. Initiatives are ongoing to include this activity among officially recognised nursing activities.

Angina, Unstable↗

[Continuing evaluation of health educational activities in Aarau and Nyon].

In view of the numerous and diverse health-education interventions within the NRP 1A, a comparably diverse set of evaluation instruments had to be developed. The continuing evaluation of health-education technics is a complex and resource-consuming process. However, it has the advantage to deliver continuously the data base for the optimization of the different activities. The two main aspects of the continuing health-education evaluation system within the NRP 1A are the statistical documentation of all participating individuals and the measurement of the effects of mass-media campaigns.

Cardiovascular Diseases↗

Impact of health education on knowledge and attitudes of Saudi paramedical students toward HIV/AIDS.

OBJECTIVE: To assess the impact of health education on the knowledge and attitudes of paramedical students in Saudi Arabia toward HIV/AIDS. METHODS: We carried out an interventional study on a sample selected from students of health institutes and health colleges in Saudi Arabia during the calendar year 2002-2003. RESULTS: The intervention shows a positive effect on students' knowledge regarding means of transmission of HIV and means of protection from HIV/AIDS. Furthermore, it has a positive impact on students' attitudes toward accepting discussion of AIDS topics with others, acceptance of home care for HIV infected family member and acceptance of HIV-infected individual's right at work. Preference of confidentiality was also significantly increased after intervention. CONCLUSION: Health education intervention has a positive impact on students' knowledge and attitudes towards HIV/AIDS and we recommend a nationwide health education program on HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

Oral health education needs of diabetic patients in Ibadan.

Previous studies on this group showed very high perceived oral health needs of diabetics. The author therefore considered it necessary to investigate their oral health education needs. This study seeks to highlight the oral health knowledge, attitude and practices of the group with the view of designing a dental health education programme which can be incorporated into the already existing health education programme for diabetics. The study was conducted on a sample of 120 adult registered diabetic patients from the two diabetes clinics in Ibadan, University College Hospital (U.C.H.) and Ring Road Government Hospital. The study also included fifty healthy adult non-diabetic volunteers for comparism. Glycaemic control was determined by estimating their fasting blood glucose F.B.G. Four trained interviewers interviewed the participants on their oral health knowledge, attitude and practices as well as on vulnerability factors such as educational status, gender, occupation, location and age. Nineteen (19) diabetic patients and fourteen (14) non-diabetic participants were excluded from the study. This study highlights the comparable oral health knowledge, attitude and practices of diabetic patients with the non-diabetic participants. The study shows the good knowledge of all groups on the frequency of tooth cleaning (86.1%, 84.6% and 95.2%), their poor knowledge on the necessity of regular dental clinic attendance (25%, 23.1% and 45.2%) and the effect of diet on their oral health (2.8%, 31% and 29%). Less than 50% of the subjects knew the cause of periodontal disease. Majority of diabetic patients do not know factors in diabetics that can contribute to oral ill health and most importantly quite a number of diabetics (53.9% and 46.8%) were not aware of the need for glyceamic control to prevent and control oral infections in diabetics. The positively established attitudes of many subjects towards oral health is unequivocal. The habit of tooth cleaning either with toothbrush and paste or with chewing stick is entrenched in the participants. The influence of educational status was highly significant on the frequency of tooth-brushing. Removal of calculus being the highest perceived need in a previous study, in this group, is not consistent with the regular tooth cleaning habits expressed in this study. However, previous researchers have emphasised the efficiency rather than frequency of cleaning as the more important aspect of tooth cleaning. Thus, this study seems to have confirmed previous studies. This study brings into focus the establishment of a positive attitude prior to knowledge without it being followed up with a health directed behaviour.

Attitude to Health↗

Qualitative sample extensiveness in health education research.

The use of qualitative methods is increasing in the health education literature, and there is need for more information on these methods and their use. This investigation looks at qualitative sampling practices as reported in the 93 qualitative or mixed-method studies published in Health Education & Behavior from 1980 to 2000. It focuses particularly on the extensiveness of sampling in this research (i.e., the volume and diversity of information collected about the phenomenon of interest). Among these studies, individual interviews averaged 104 +/- 134 informants (range 2 to 720) and 92 +/- 39 minutes. Focused group interviews averaged 10 groups (range 1 to 40) and 90 +/- 25 minutes. Observational studies usually occurred in multiple sites and involved approximately 16 to 24 months of fieldwork. Document analysis extensiveness varied considerably on a variety of indicators. Future qualitative research would benefit from more complete consideration and fuller reporting of sample extensiveness.

Bibliometrics↗