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PubMed2001

Validation of the SADL questionnaire.

OBJECTIVE: To cross-validate the psychometric characteristics of the Satisfaction with Amplification in Daily Life (SADL) questionnaire (Cox & Alexander, 1999), and to explore the SADL's construct validity. DESIGN: Thirteen private practice Audiology clinics each distributed SADL questionnaires, by mail, to 20 adults who had recently obtained hearing aids. The completed questionnaires were returned to a central site and subject anonymity was assured. There were 196 usable responses. RESULTS: Psychometric characteristics of the items were found to be very similar to those reported previously. Thus, the internal validity of the instrument was strongly supported. The assumption that the SADL quantifies satisfaction by assessing its components was evaluated by examining the relationship between SADL scores and scores on a traditional single-item satisfaction measure. A logical and statistically significant relationship was seen between the two measures, thereby supporting the construct validity of both types of data. For private-pay clients, satisfaction scores were very similar to the interim norms published by Cox and Alexander (1999). However, clients whose hearing aids were partly or fully purchased by insurance or benefits programs tended to be more satisfied than interim norms for third-party pay clients derived 5 yr ago. For most types of clients, there was a tendency toward more satisfaction in the Negative Features subscale than observed in our previous research. CONCLUSIONS: Both construct and internal validity of the SADL questionnaire were supported by this research. The previously published interim norms appear to be mostly appropriate for private-pay clients, but might require adjustment in the Negative Features subscale. Further research is needed to explore the relationship between satisfaction and device purchase issues (third-party versus private pay).

Adult↗

PubMed1992

Quality of life in inflammatory bowel disease.

Quality of life with inflammatory bowel disease has not been well examined. Recently, a questionnaire to determine subjective health status for patients with inflammatory bowel disease has been developed and verified. To examine the quality of life in a group of "well" outpatients with inflammatory bowel disease, we developed a self-administered form of this questionnaire containing 36 questions identifiable to five dimensions: systemic symptoms, bowel symptoms, functional impairment, social impairment, and emotional function. We identified outpatients with inflammatory bowel disease through the local chapter of the Ileitis and Colitis Foundation and distributed 396 questionnaires, by mail, with 182 being returned completed (46% response rate). Forty-eight age- and sex-matched controls filled out and returned an identical questionnaire. Response options for each question were framed on a seven-point scale in which 7 represented best function and 1 represented worst function. Male-to-female ratio and mean age were similar to those of controls for the inflammatory bowel disease group. In each dimension, as well as globally, the quality of life of patients with inflammatory bowel disease was significantly worse than that for their age- and sex-matched controls. In conclusion, this survey demonstrates that inflammatory bowel disease adversely affects quality of life in a highly motivated group of "well" outpatients when compared to an age- and sex-matched population.

Activities of Daily Living↗

PubMed1999

STD testing policies and practices in U.S. city and county jails.

BACKGROUND AND OBJECTIVES: Studies have shown that sexually transmitted disease (STD) rates are high in the incarcerated population. However, little is known about STD testing policies or practices in jails. GOAL: To assess STD testing policies and practices in jails. STUDY DESIGN: The Division of STD Prevention developed and distributed an e-mail survey to 94 counties reporting more than 40 primary and secondary cases in 1996 or having cities with more than 200,000 persons. State and local STD program managers completed the assessment in collaboration with health departments and the main jail facilities in the selected counties. RESULTS: Most facilities (52-77%) had a policy for STD screening based only on symptoms or by arrestee request, and in these facilities, 0.2% to 6% of arrestees were tested. Facilities having a policy of offering routine testing tested only 3% to 45% of arrestees. Large facilities, facilities using public providers, and facilities routinely testing for syphilis using Stat RPR tested significantly more arrestees (P<0.05). Approximately half of the arrestees were released within 48 hours after intake, whereas 45% of facilities did not have STD testing results until after 48 hours. CONCLUSION: Most facilities had a policy for STD screening based only on symptoms or by arrestee request. Facilities having a policy of routine STD testing are not testing most of the arrestees. There is a small window (<48 hours) for STD testing and treatment before release. Smaller jails and facilities using private providers may need additional resources to increase STD testing levels. Correctional facilities should be considered an important setting for STD public health intervention where routine rapid STD screening and treatment on-site could be implemented.

Female↗

PubMed2003

Absolute versus relative values: effects on family practitioners and psychiatrists.

BACKGROUND: Research demonstrates that religious values clearly impact on the judgments made by physicians and their patients. One basic dichotomy--belief in ethical values that do not change (absolute values) versus belief in values that change depending on the situation (relative values)--has recently been experimentally associated with different ethical decision-making patterns. METHODS: An anonymous, randomized, national survey and 1-week response prompt with 1-month follow-up mailing as necessary were distributed to nationwide samples of board-certified American family practitioners and psychiatrists. Physicians answered descriptive questions and standardized personality assessments and responded to three vignettes describing ethically sensitive scenarios concerning birth control medication for sexually active single women, euthanasia, and abortion. RESULTS: Response rates were 34% for psychiatrists and 38% for family practitioners. Family practitioners and absolutists were significantly more supportive of religious activities and had more religious parents than psychiatrists and relativists. Furthermore, family practitioners and absolutists were less approving of the vignettes than other groups. CONCLUSION: Family practitioners were more supportive of religious activities than psychiatrists as reported in previous research. The absolute versus relative value dichotomy is a useful concept in examining physician attitudes as they affect health care and personal behavior. However, questions concerning place of worship attendance and giving in addition to specific religious value labels may be more efficient experimentally. Physicians should be aware of their own biases in discussions with patients, families, and other health care providers.

Abortion, Induced↗

PubMed2004

The expanding role of the transplant pharmacist in the multidisciplinary practice of transplantation.

INTRODUCTION: The burgeoning clinical discipline and growth of organ transplantation has resulted in an expansion in the number of healthcare specialists to support clinical care and research. The past 10 yrs have seen a dramatic increase in the number of immunosuppressive agents and other medications used in transplantation, resulting in more complex medication regimens and greater potential for interactions, adverse effects and increased costs. PURPOSE: To determine how transplant pharmacists are being integrated into transplant clinical practice. Transplant centres were identified through UNOS Transplant Administrators Committee list serve. A survey was then distributed via e-mail to 159 individuals representing 118 solid organ transplant centres. RESULTS: Forty-one (35%) of the 118 centres responded, with 36 evaluable surveys. Of the 36 centres, 28 (78%) had transplant pharmacist support and eight did not have a pharmacist dedicated to transplant (two of the eight were recruiting). A majority of the respondents had multi-organ transplant responsibilities. Eighty-six per cent of pharmacists were involved in kidney transplant, 71% in liver, 50% in pancreas, 25% in heart, and 7% in lung. Pharmacist salaries were most often funded by a department of pharmacy (74%), followed by college of pharmacy (12%), transplant centre (8%) and department of surgery (6%). Almost all of the pharmacist's clinical practice time focused on post-transplant care (99%). The average percentage of the pharmacist's time was: 43% inpatient, 15% outpatient, 14% research, 6% other transplant related, and 22% non-transplant related. Of the 28 pharmacists, 25 had a PharmD degree, two a BS and one had a PhD in Pharmacy. The average number of organs transplanted among the responding centres was 99 kidneys, 45 livers, 28 pancreas, 14 heart, and 26 lungs. The number of transplants did not differ between the programmes with pharmacist clinical support vs. those without designated pharmacist support. CONCLUSION: The survey indicates that many solid organ transplant centres have incorporated transplant pharmacists into the multidisciplinary transplant clinical team. Transplant pharmacists are funded most often by the hospital pharmacy. Most transplant pharmacists spend the majority of their time in clinical practice, but also play a key role in research.

Humans↗

PubMed1999

Educational experiences and quality of life of gastroenterology fellows in the United States.

OBJECTIVE: The objective of this study was to investigate the education and quality of life of United States gastroenterology fellows. METHODS: A 3-page, 74-question survey incorporating a 5-point Likert scale was designed. All US gastroenterology fellowship program directors were contacted by mail and asked to distribute the survey to graduating fellows. Surveys were sent on 3/29/1998 and collected until 6/1/98. RESULTS: Fellows who would not train at the same institution again had less supervision, clinical instruction, research mentorship, and support services than those who would. Fellows who had loans had lower personal satisfaction scores than those who did not. Fellows who did not hold second jobs (moonlight) had higher job satisfaction scores. Those with vision or dental insurance had higher job and personal satisfaction scores. Regarding quality of life, only 23% of fellows agreed they were not overworked, 23% agreed they were not stressed, 25% agreed they were financially stable, 54% agreed they were happy with fellowship, and 84% agreed they were happy with their career choice. Regarding education, 56% agreed there was more emphasis on productivity than on education, 39% agreed they received adequate mentorship for research, 86% agreed there was adequate supervision, 48% of fellows agreed they had autonomy in making clinical decisions, and 41% agreed they had continuity of care in seeing patients. CONCLUSIONS: Most fellows were happy about their career choice and clinical instruction, but there were deficiencies regarding quality of life (stress, overwork, financial security), education (research support, continuity of care) and job benefits (health coverage).

Adult↗

PubMed2006

Teaching of posterior composite resin restorations in undergraduate dental schools in Ireland and the United Kingdom.

PURPOSE: The aim of this study was to investigate the current teaching of posterior composite resin restorations to undergraduate dental students in Ireland and the United Kingdom (UK). The investigation was a follow-up to a survey undertaken in 1997. MATERIALS AND METHODS: A questionnaire was distributed by e-mail to the Heads of Departments of Restorative Dentistry/Units of Operative Dentistry in each of the 15 dental schools with undergraduate dental degree programmes in Ireland and the UK. The questionnaire sought information relating to the teaching of posterior composite resin restorations in each dental school. RESULTS: Fifteen completed questionnaires were returned (response rate = 100%). All schools (n = 15) taught the placement of composite resin restorations in occlusal cavities, 14 schools taught composite resin placement in two-surface occlusoproximal cavities and nine schools taught composite resin placement in three-surface occlusoproximal cavities. Respondents anticipated that the amount of preclinical teaching of posterior composite resin placement will increase twofold over the next 5 years, whilst the corresponding teaching of amalgam will fall to two-thirds its current level. Variation was found between dental schools in the teaching of the principles of cavity design, contraindications to placement, indications for lining and basing techniques, matrix and wedging techniques, and the use of curing lights. CONCLUSIONS: The amount of teaching of posterior composite resin restorations in undergraduate dental schools in Ireland and the UK has increased since the time of a previous survey in 1997. Composite resin may soon equal or overtake amalgam as the material of choice when restoring posterior cavities in Irish and UK dental schools. There was, however, much variation in the nature and extent of the teaching and the techniques taught.

Composite Resins↗

PubMed1986

Effects of long-term preservation of frankia strains on infectivity, effectivity, and in vitro nitrogenase activity.

Frankia strain HFP ArI3 which had been preserved for 27 months by being lyophilized, frozen in glycerol, or stored in complex medium was successfully used as an inoculum after being subcultured for inducing nodulation and nitrogen fixation of Alnus rubra. Glycerol-preserved HFP ArI3 produced significantly lower rates of nitrogenase activity than did lyophilized or complex-medium-preserved inocula. Bacteria that had been preserved by all three methods were successfully induced to fix atmospheric nitrogen by being cultured in nitrogen-free medium. Subculturing of these cells in nitrogen-free medium a second and third time yielded increasing rates of nitrogenase activity. Initial nitrogenase activity was detected on days 5, 4, and 3 during the first, second, and third subcultures after preservation, respectively. Maximum activity was observed on days 11, 10, and 8 during the first, second, and third subcultures, respectively. A description is given of standard culture techniques used in our laboratory for Frankia isolates, and methods used to distribute Frankia cultures by mail are described.

Journal Article↗

PubMed2005

A survey of the interactions between psychiatry residency programs and the pharmaceutical industry.

OBJECTIVE: The authors report a survey of the American Association of Directors of Psychiatry Residency Training (AADPRT) on interactions between the pharmaceutical industry and psychiatry residency programs. METHODS: American Association of Directors of Psychiatry Residency Training membership was anonymously surveyed by e-mail and by paper distribution at the 2002 annual meeting. RESULTS: Twenty-seven percent of AADPRT members participated. Lunches for residents were the most common interaction, reported by 93% of programs, nearly all of which permitted literature and gifts to be distributed. Only 4% required faculty to be present. Retreats (27%) and travel funds (34%) were sponsored less frequently. One third of programs had written policies governing these interactions, but half of respondents did not know if their parent institutions had such policies. A minority of programs (40%) had formal didactic instruction for residents on this topic. Support for more information, direction, and teaching was widespread. CONCLUSIONS: The authors recommend more structured teaching and the establishment of formal program and institutional policies to govern these interactions.

Adolescent Psychiatry↗

PubMedDate not supplied

Students' and residents' perceptions regarding technology in medical training.

OBJECTIVE: This pilot study provides firsthand feedback from medical students and residents in training regarding their perceptions of technology in medicine. METHOD: The authors distributed an e-mail invitation to an anonymous Web-based survey to medical students and residents in two different U.S. training institutions. RESULTS: Respondents unanimously expressed that technology skills were important in medical training and felt it most important to learn about electronic medical records and accessing scientific information on the Internet. At the point of patient care, trainees' preferred reference sources were the Internet and PDA, in that order. Most clinical trainees felt PDAs were critical in patient care and met their clinical needs, and they were most likely to use them for medication reference. The majority of trainees preferred printed media over digital media for initial learning, but the converse for referencing. Instructor-led small groups were viewed as the best environment in which to receive instruction. CONCLUSIONS: Trainees in medical education are technologically savvy and provide invaluable feedback regarding initiation, development and refinement of technological systems in medical training.

Attitude↗

PubMed1993

A comparison of self-perceived clinical competencies in primary care residency graduates.

One hundred seventy-eight graduates from four primary care residency training programs with common hospital sites (medicine/pediatrics, 72; family medicine, 29; pediatrics, 35; and internal medicine, 42) responded to a mailed survey questionnaire regarding distribution of professional time and self-perceived clinical competencies. Most of the internists, family physicians, and internist/pediatricians (MED/PED) were in primary care, and 57% of the pediatricians were subspecialists. Respondents rated each of 24 clinical vignettes as to their level of comfort in managing the patient problems presented. MED/PED and pediatricians responded similarly to all the infant, child, and adolescent cases. Family physicians were less comfortable in managing the complicated neonatal situations but more comfortable with adolescent health care than the MED/PED or pediatricians. MED/PED reported greater comfort than family physicians in complex internal medicine issues, but less than internists in intensive care and geriatric consultation. Significant differences in reported competency existed among these primary care practitioners despite substantially overlapping training backgrounds.

Adolescent↗

PubMed2004

Operative surgical education: results of a society of surgical oncology fellowship survey and proposal for an operative database.

BACKGROUND: Preparation of surgical trainees for oncological operative procedures is challenging. The purpose of this survey was to focus on identifying methods and resources used by trainees to prepare for procedures and to ascess the need for additional educational tools. METHODS: A 34-item survey was mailed electronically to 97 surgical oncology fellows at 14 Society of Surgical Oncology-approved training programs. General surgery residents at an affiliate training program (n = 65) and residents attending an American Board of Surgery In-Training Examination review course (n = 129) were polled via hard-copy mailings. The survey was distributed with the Dillman method. Self-education practices, factors influencing operative education, and strengths/weaknesses of available resources were identified. RESULTS: Response rates were 56% and 78% for fellows and residents, respectively. Trainees prepare for more than 50% of cases they perform (82%; 169 of 205), devoting up to 1 hour (87%; 178 of 205) in review the evening before a procedure (64%; 131 of 205). Time availability and attending of record were dominant factors influencing resident preparation, whereas case complexity was the most important variable motivating fellows. Surgical atlases, texts, anatomical references, and case discussion with attending staff were the most useful and available resources rated by trainees. Skills stations were recognized as the least valuable. Critical assessment of six educational resources identified no one particular area for improvement. CONCLUSIONS: There is a need for contemporary operative educational tools, incorporating time-sensitive and procedure-specific needs of surgical trainees preparing for oncological operative procedures.

Computer-Assisted Instruction↗

PubMed2004

Physical growth charts from birth to six years of age in Japanese twins.

BACKGROUND: The purpose of this study was to analyze the characteristics of the physical growth of twins in childhood and to present growth charts of Japanese twins. METHODS: The subjects consisted of 2029 pairs of normally developed Japanese twins. Growth data were obtained by mailed or hand-distributed questionnaires. Factors that affect body weight and height/length at selected ages were analyzed by stepwise regression analysis. Selected percentiles of body weight, height/length, and body mass index were calculated according to sex, and growth curves were drawn using a spline function. The size deficit of the twins compared to the standards for the general population of Japan was calculated. RESULTS: Gestational age, parity, zygosity, and birth order affected physical growth in varying degrees, although the overall effects themselves were small and mostly disappeared by one year of age. Growth charts of the twins present growth at selected percentiles from birth to 6 years of age according to sex. The size deficit of the twins was largest at birth: more than 20% for weight and approximately 6% for length compared to the 50th percentile of the standard for the general population of Japan. These deficits decreased rapidly in the first 6 to 12 months, and were found to be as low as 0-2% at 4 to 6 years of age. CONCLUSION: Growth charts specifically for twins are needed, at least for the first 1 to 3 years of age but not beyond the age of 6 years.

Age Distribution↗

PubMed2002

[Effects of social support on the mental health of mothers with infants].

OBJECTIVE: We surmised that increase in stress in mothers having infants might be due to decline of social support under circumstances where nuclear family households now predominate. The present study was therefore conducted to analyze relations between stress reactions of mothers having infants, their recognition of social support, and negative feelings toward their baby and child care, a major factor in the burden of childcare. METHODS: The subject were 909 mothers having infants in nuclear families who lived in I city in Osaka Prefecture. Health examinations of infants at the ages of 4 months, 1 year and 6 months, and 3 years and 6 months were utilized. Questionnaires titled "Survey on Childcare" were distributed in advance by mail to parents of the infants included in the health examinations and collected at the health examinations. The survey period was August to September 2000. Personal background variables and, psychological investigation items, including mental health in terms of stress reactions, negative feelings toward childcare as a factor in the burden of childcare, and a support network scale were surveyed and analyzed. RESULTS: The mothers with infants were judged to be in a stressful state from the average mental health scores in all groups. Multiparas had significantly higher negative feelings toward childcare scores. Regarding the age groups of children, a significantly decreasing recognition of a support network as well as significantly increasing negative feelings toward childcare were observed with the growth of children. There was a positive correlation between negative feelings toward childcare and stress reactions. The recognition of social support was negatively correlated with stress reactions and negative feelings toward childcare. CONCLUSION: The study revealed that mothers having infants are in a stressful state and that the recognition of stress is related to negative feelings toward childcare and the recognition of a support network. The feeling of sufficient support lowers the level of stress arising from childcare, and facilitates avoiding or coping with problems, thereby promoting mothers' physical and mental health. This is important for continuation and fulfillment of childcare.

Adult↗

PubMed2006

Survey on the clinical skills of osteopathic medical students.

As part of the standard-setting methods used by the National Board of Osteopathic Medical Examiners for its Comprehensive Osteopathic Medical Licensing Examination clinical skills performance evaluation (COMLEX-USA Level 2-PE), a self-administered survey was distributed electronically and by mail to deans of colleges of osteopathic medicine, directors of graduate medical education programs, osteopathic medical students, and experts chosen demographically to represent osteopathic physicians in the United States. Groups were asked to rate fourth-year osteopathic medical students and interns on their clinical skills and acceptable pass rates and expected pass rates on the COMLEX-USA Level 2-PE. The surveys were not used systematically to compute the passing standards but to provide additional support for their validity. The viewpoints of the deans differed from those of the students, osteopathic graduate medical education program directors, and experts regarding clinical skills proficiencies and acceptable pass rates. However, all of the groups agreed that, on average, some students and interns do not have adequate clinical skills. These results provide additional support for requiring acceptable performance on a comprehensive clinical skills examination before admission to osteopathic graduate medical education programs.

Attitude of Health Personnel↗

PubMed2006

[Health practice and total mortality among middle-aged and elderly residents in Sukagawa, Japan].

PURPOSE: The present study aimed to clarify the relationship of total mortality with the HPI (health practices index: the additive index of five health practices) and lifestyle among elderly residents in a Japanese cohort. METHODS: A population-based prospective study was conducted in Sukagawa City of Fukushima Prefecture, Japan. Self-administered questionnaires were distributed and collected via mail. One-third of the city residents aged 40-69 years and over 70 years were randomly selected. Baseline surveys were conducted in February 2001 for the '40-69 cohort' and in July for the 'over 70 cohort'. Among 8746 subjects in the '40-69 cohort' and 2718 in the 'over 70 cohort', 5,657 (64.7%) and 2,019 (74.3%) responded, respectively. The questionnaires consisted of items on 'Alameda seven health practices' (weight, sleeping, smoking, drinking, breakfast, exercise, snacking), medical history, perceived health status, and home bound status of the 'over 70 aged cohort'. We followed the younger cohort for 3 years and 7 months and the elderly cohort for 3 years and 3 months until the end of October 2004, and checked their survival status using a municipal resident registry. Analysis of factors associated with total mortality one year after the baseline survey employed a simple chi2 test, Kaplan-Meier survival analysis, and the Cox proportional-hazards model to compute relative risks (RRs). The HPI was the additive index of five health practices: weight, sleeping, smoking, drinking, exercise. RESULTS: 1. No significant association was observed between lifestyle and total mortality in the '40-69 cohort'. However, there were significant links between total mortality in the 'over 70 cohort' and HPI and exercise. 2. The Kaplan-Meier curves for the 'over 70 cohort' showed higher survival for the group with higher HPI scores. Again, results of the Cox proportional-hazards model showed no factor significantly associated with the total mortality of the '40-69 cohort'. For the 'over 70 cohort', HPI, age, sex, subjective health and housebound status were associated. Medical history did not show any significant influence. For each of 'the Alameda 7 health practices', exercise was associated with all-cause mortality. CONCLUSION: 1. Maintaining good health practices improves life prognosis of the elderly. 2. The HPI is an useful indicator of life prognosis. 3. Promotion of exercise and prevention of becoming housebound are important for improving life prognosis.

Adult↗

PubMed2003

Menstrual irregularity in female military cadets: comparison of data utilizing short-term and long-term recall.

STUDY OBJECTIVES: (1) To assess menstrual function in freshman cadets at a structured, rigorous military college utilizing a weekly e-mail questionnaire, (2) to compare these results to longer-term recall results from written questionnaires completed at the start and end of the same year, and (3) to determine if a relationship exists between personality attributes and menstrual regularity in this setting. DESIGN, SETTING, PARTICIPANTS: A questionnaire developed by the investigators about menstrual function was distributed weekly via e-mail and completed satisfactorily by 116 female freshman at the United States Military Academy (USMA), class of 1995. These data were compared to questionnaires completed by this same cohort at the start and end of the year, as well as to personality questionnaires distributed to some of these cadets as part of a larger study. Pearson's chi-square and analysis of variance were performed to determine statistical significance. RESULTS: Weekly e-mail data revealed that only 1.7% of cadets had regular menstrual periods throughout the whole year. The remaining 98.3% were irregular: 10.3% mildly, 35.3% moderately, 30.2% severely, and 22.4% extremely irregular. Only 0.8% of subjects did not menstruate at all during the year. In comparison, on long-term recall data, 90% reported some change in menstrual function, with 48% specifically reporting menstrual irregularity. Those with the greatest irregularity prior to USMA and those who expected greater irregularity at USMA reported the greatest irregularity during the year. Irregularity was associated with coping and with commitment to health on personality questionnaires. CONCLUSIONS: On data collected via weekly e-mail, almost all freshman females at USMA experienced menstrual irregularity. This data, utilizing short-term recall, yielded different, more dramatic results than the data utilizing long-term recall. A link between menstrual irregularity and both coping and commitment suggests that menstrual irregularity may be adaptive in this environment.

Adolescent↗

PubMedDate not supplied

A direct mailing to teenage males about condom use: its impact on knowledge, attitudes and sexual behavior.

In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention.

Adolescent↗