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ABSTRACT: The objective was to develop, pretest and validate a disease-specific quality of life questionnaire for potentially curable patients with esophageal carcinoma, for use with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) in order to assess the quality of life associated with the various treatment modalities available for this disease. Questionnaire development phase Patients were enrolled in three centres. Literature reviews, patients, family members, and health care professionals generated 195 items: symptoms (55); emotions (53); physical functioning (17); activities of daily living (ADL) (48); and leisure/social (22). Thirty-eight patients identified items of importance and assigned importance ratings on a 5-point Likert scale. Impact scores were calculated as frequency times mean item importance. Item impact scores<20/100 were excluded. Pearson's correlation co-efficients compared domains with the Medical Outcomes Study SF-20 (MOS SF-20). Fifteen items remained. Questionnaire validation phase EORTC QLQ-C30, Esophageal Quality of Life Questionnaire (EQOL), MOS SF-36 and a Global Rating of Change Questionnaire were completed at baseline, 1 week after baseline but prior to any treatment, 1 month, 3 months, and 6 months after treatment began. Reliability was assessed using paired samples correlations. Responsiveness was assessed between mean scores of changed and unchanged patients, and a responsiveness index was calculated. The MOS SF-36 was used for criterion validity. Construct validity included four a priori predictions. Sixty-five patients were enrolled in four centres in the validation phase. Paired samples correlations were high for all domains (0.749-0.889) indicating good reliability. Symptom, physical function and social domains were responsive to change at all time intervals (P<0.05). Emotional function was responsive at 1 and 3 months, activities of daily living (ADLs) at 1 and 6 months. Magnitude of change was significant when direction of change was stated. Between better and worse, magnitude of change was significant in all domains except at 6 months in symptoms, emotional and physical domains. The minimal clinically important difference was consistently around 0.5 for all domains. Minimal, moderate and large effect ranges were established. Only 2/16 time intervals had poor correlations with the SF-36, establishing criterion validity. Of the four a priori predictions for construct validity, only the second part of one prediction, in the emotional function domain, was not confirmed. We have developed a 15-item questionnaire (EQOL) which has good reliability, responsiveness and validity and is now in use in studies in Canadian centres with the EORTC QLQ-C30.
Diseases of the Esophagus 01/2007; 20(3):191-201. · 1.81 Impact Factor
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ABSTRACT: The tobacco industry denies that their marketing is targeted at young nonsmokers, but it seems more probable that tobacco advertising and promotion influences the attitudes of nonsmoking adolescents, and makes them more likely to try smoking.
To assess the effects of tobacco advertising and promotion on nonsmoking adolescents' future smoking behaviour.
We searched the Cochrane Tobacco Group specialized register, the Cochrane Central Register of Controlled Trials, MEDLINE, the Cochrane Library, Sociological Abstracts, PsycLIT, ERIC, WorldCat, Dissertation Abstracts, ABI Inform and Current Contents to August 2002.
We selected longitudinal studies that assessed individuals' smoking behaviour and exposure to advertising, receptivity or attitudes to tobacco advertising, or brand awareness at baseline, and assessed smoking behaviour at follow-ups. Participants were adolescents aged 18 or younger who were not regular smokers at baseline.
Studies were prescreened for relevance by one reviewer. Two reviewers independently assessed relevant studies for inclusion. Data were extracted by one reviewer and checked by a second.
Nine longitudinal studies that followed up a total of over 12,000 baseline nonsmokers met inclusion criteria. The studies measured exposure or receptivity to advertising and promotion in a variety of ways, including having a favourite advertisement or an index of receptivity based on awareness of advertising and ownership of a promotional item. One study measured the number of tobacco advertisements in magazines read by participants. All studies assessed smoking behaviour change in participants who reported not smoking at baseline. In all studies the nonsmoking adolescents who were more aware of tobacco advertising or receptive to it, were more likely to have experimented with cigarettes or become smokers at follow-up. There was variation in the strength of association, and the degree to which potential confounders were controlled for.
Longitudinal studies consistently suggest that exposure to tobacco advertising and promotion is associated with the likelihood that adolescents will start to smoke. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and smoking behaviours observed, as well as the theoretical plausibility regarding the impact of advertising, we conclude that tobacco advertising and promotion increases the likelihood that adolescents will start to smoke.
Cochrane database of systematic reviews (Online) 02/2003; · 5.72 Impact Factor
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ABSTRACT: The idea for the workshop described in this paper emerged from recommendations identified at the 1997 Workshop on Research, Policy and Program Planning on Sun Protective Behaviours. At the 1997 workshop, participants developed a set of recommendations for research initiatives related to sun protection efforts in Canada. One of the primary recommendations was to develop a standard set of definitions and core items to assess sun-related behaviours. In response, the authors of this paper agreed to co-chair the 1998 Canadian National Workshop on Measurement of Sun-Related Behaviours. The purpose of this workshop was to develop consensus on a standard set of measures for program evaluation and for monitoring of sun exposure and protective behaviours in Canada.
Chronic diseases in Canada 02/1999; 20(2):96-100. · 0.98 Impact Factor
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ABSTRACT: Given the rapidity of change in both higher education and health care, re-examining the values and precepts that undergird the profession of college health is an ongoing need. Reported in this article are the results of a structured process in which a group of college health professionals from California, along with others interested in the health of college students, examined several trends affecting higher education and health; considered possible scenarios for these sectors; created a shared vision for the future of college health; and developed strategies useful in attaining that vision. The results of these deliberations are presented as a set of principles that, if followed, should increase the likelihood that college health centers will be responsive to user needs. Although the article is based on a California-based conference, the principles discussed are almost certainly valuable for all in college health.
Journal of American College Health 06/1997; 45(6):289-93. · 1.45 Impact Factor
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ABSTRACT: Health risk behaviors among students attending 4-year colleges in California were examined. The Youth Risk Behavior Survey for College Students was administered in a two-stage (29 universities, 5,652 students) random sample. All campuses and 3,810 (69%) students participated in the survey. In the 30 days preceding the survey, 36.7% of the students had binged at least once while drinking; 25.3% had driven after consuming alcohol; 32% had ridden in a car with someone who had been drinking; 17.6% had used marijuana; and 6% had carried a knife, gun, or club. More than half of the students who were sexually active and not married or living with a primary partner had not used a condom the last time they had sexual intercourse. Only 5% of regular bicycle riders always wore a helmet. Fewer than half (44%) reported aerobic physical activity on 3 or more of the preceding 7 days. The results of this study indicate a substantial amount of serious, risky health behaviors among California college students.
Journal of American College Health 06/1997; 45(6):265-72. · 1.45 Impact Factor
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Melanoma Research - MELANOMA RES. 01/1997; 7.
