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PubMed1998

Designing and implementing an outcomes-based performance improvement project: behavioral health care.

1. All performance measurement and improvement initiatives should be planned. Planning should reveal the origins of the project, define and validate the project purpose, specify the desired effect of the project, develop project success measures, specify necessary resources, describe any constraints, anticipate problems, and specify milestones and deadlines. 2. An interdisciplinary team is usually created to implement the improvement project. This team is generally composed of staff from different disciplines, organizational entities, and levels throughout the facility. 3. Am improvement team typically consists of an executive coach, a team leader, a facilitator, and multiple team members. Sometimes a measurement specialist is included in the team. Additional subject matter experts serve as ad hoc team members as needed. 4. Data management is a process comprising the following discrete activities: determination of data needs, specification of indicators, definition of data elements, specification of data sources, creation of data collection instruments, determination of data analysis strategies, completion of a data collection plan, pilot testing of data collection and analysis, and modification of data management tactics based on the results of the pilot test. 5. There are two fundamental kinds of studies: quantitative and qualitative. Quantitative studies present numeric performance data, such as averages, correlations,and variation. Qualitative studies provide narrative data, such as content and theme analyses, and individual quotes. 6. Effective data collection requires valid and reliable data collection instruments and trained data collectors. 7. Analysis of performance data may be quantitative or qualitative and may compare an organization's performance to itself over time, as well as to external benchmarks. 8. Root cause analysis is based on tools such as the process flow diagram, cause-effect diagram, scatter diagram, Pareto analysis, and repetitive why to determine the causes of achieved performance. 9. Improvement ideas should be tested on a small scale by using a systematic approach such as the PDCA cycle. 10. Findings and results of performance measurement and improvement initiatives should be communicated to internal and external audiences via a variety of approaches.

Behavior Therapy↗
PubMed2005

Effects of culturally adapted parent management training on Latino youth behavioral health outcomes.

A randomized experimental test of the implementation feasibility and the efficacy of a culturally adapted Parent Management Training intervention was conducted with a sample of 73 Spanish-speaking Latino parents with middle-school-aged youth at risk for problem behaviors. Intervention feasibility was evaluated through weekly parent satisfaction ratings, intervention participation and attendance, and overall program satisfaction. Intervention effects were evaluated by examining changes in parenting and youth adjustment for the intervention and control groups between baseline and intervention termination approximately 5 months later. Findings provided strong evidence for the feasibility of delivering the intervention in a larger community context. The intervention produced benefits in both parenting outcomes (i.e., general parenting, skill encouragement, overall effective parenting) and youth outcomes (i.e., aggression, externalizing, likelihood of smoking and use of alcohol, marijuana, and other drugs). Differential effects of the intervention were based on youth nativity status.

Adaptation, Psychological↗
PubMed1997

Ethnic differences in psychosocial and health behavior correlates of dieting, purging, and binge eating in a population-based sample of adolescent females.

OBJECTIVE: To examine ethnic differences in factors associated with disordered eating behaviors. METHOD: Data were collected from 17,159 adolescent females who completed a school-based health survey conducted in 1987. RESULTS: In all ethnic groups, dieting was associated in bivariate analyses with weight dissatisfaction, perceived overweight, and low body pride. Purging was associated with weight dissatisfaction, perceived overweight, low body pride, greater suicide risk, and greater alcohol use. Binge eating was associated with weight dissatisfaction, perceived overweight, low body pride, lower family connectedness, greater peer acceptance concerns, and emotional stress. DISCUSSION: Body dissatisfaction and perceived overweight are consistent correlates of dieting and binge eating in adolescent females of diverse ethnic groups. Ethnic subculture does not appear to protect against the broader sociocultural factors that foster body dissatisfaction among adolescent females. Implications for understanding sociocultural influences on dieting, obesity, and eating disorders are discussed.

Adaptation, Psychological↗
PubMed1996

Weight loss maintenance in young adulthood: prevalence and correlations with health behavior and disease in a population-based sample of women aged 55-69 years.

OBJECTIVE: To describe the prevalence of weight loss maintenance and other weight change patterns in early adulthood (ages 18-50 years), and their association with disease prevalence in older age (average age 62 years). DESIGN: Cross-sectional survey. SUBJECTS: 17233 postmenopausal women aged 55-69 years. MEASUREMENTS: Weight change categories based on recalled body weight at age 18, 30, 40 and 50 years. RESULTS: Weight loss of 10% or more between ages 18 and 30 years followed by maintenance within 5% up to age 50 years, and weight loss of 10% or more followed by a 10% or more regain were equally common, yet rare, weight change patterns (1.6% and 1.8%, respectively). Among those who were overweight at age 18, maintaining a stable weight was associated with increased odds of diabetes (OR = 5.48) and hypertension (OR = 1.98), relative to normal weight-weight stable women. However, overweight women who lost weight had similar odds of diabetes and hypertension as normal weight-weight stable women. In both overweight and normal weight women, weight loss followed by regain was associated with higher odds of disease relative to weight stability. However, the highest odds of disease were associated with continuous weight gain or an initial weight gain that was maintained. CONCLUSIONS: Weight gain is associated with higher odds of disease compared to weight stability, which is associated with lowest odds of disease. Weight loss maintenance in the overweight is associated with lower odds of obesity-related diseases such as diabetes and hypertension.

Adolescent↗
PubMed1984

Health promotion for educators: impact on health behaviors, satisfaction, and general well-being.

A random sample of 117 teachers in three treatment schools and one control school participated in a health survey at the beginning and end of the spring semester. Teachers in the treatment schools participated in a 10-week health promotion program which emphasized exercise, stress management, and nutrition. Comparison of pre- and post-survey data indicated that teachers in the treatment schools increased their participation in vigorous exercise, improved their physical fitness, lost weight, lowered their blood pressure, reported a higher level of general well-being, and were better able to handle job stress.

Adult↗
PubMed1985

[Dental caries and dental health behavior in 6-and-10-year-old children].

The aim of the study was to investigate whether or not children with low and high caries experience are different concerning some features of preventive dental health behaviour. Regarding their dietary habits it could be established that the total daily intake of energy and nutrients can not differ between both caries groups, but that there seems to be a tendency to a higher intake during regular meals by children with low caries experience compared to their mates with high caries experience. In case of between-meal consumption it is just the reverse. It appears that there is also a difference in the choice of food products. Strikingly the consumption of sweets and sugar containing foods did not differ between the caries groups. Children with low caries experience use more fluoride tablets and seem to be a little more effective in plaque removal. In conclusion it is pointed out that the observed differences are too small to decide whether children in the low caries group behave more favourably as far as dental health is concerned.

Candy↗
PubMed2004

[Health pattern of elderly according to age group who living alone in an urban area].

PURPOSE: This study was conducted to identify the differences of health patterns; health-related characteristics, health behaviors, health problems, and self-care levels of elderly, living alone in an urban area according to age group. METHOD: The study design was a descriptive survey and the subjects were 1,800 elderly consisting of 937 young old, 704 middle old, and 159 old old. Data was collected from May to July 2003 using the structured questionnaire and analyzed by descriptive statistics, chi(2)-test, Fisher's exact probability test, ANOVA and Scheffe test using SPSS/PC. RESULT: The health related characteristics which involved body mass index, mental status, use of assistant devices, perceived health, concern of health, and social support were different among the groups and more aggravated by aging. Health behaviors and health problems were also significantly aggravated in the old old group. The self-care levels measured by ADL, physical activity, and self-care ability scores were also significantly decreased in the old old group. CONCLUSION: For the level of health status, health behaviors and self-care ability were significantly decreased by aging, health care services for the elderly should be planned considering the difference in the health pattern by age group.

Activities of Daily Living↗