THE disappearance of area health authorities in 1982 means major changes and new problems for health education services. Most significant will be the changes in scale of provision locally. The splitting or merging of existing services is a trend away from evolved unit structure. There will also be the problem of negotiating afresh budgets for health education in a financial climate which promises to be specially difficult at re-organisation. The fate of community medicine is another important factor. What happens to community medicine at reorganisation will have major influence on health education. One inevitable setback will be the severing of existing ties with local education authorities (LEAs). New services will not equate with LEA territories. What is at stake to some extent is established LEA/NHS collaboration in the field of schools' health education.
One hundred and twenty six journalists and programme-makers were interviewed to ascertain their views about the effectiveness of the Government's campaign in early 1987 to inform the public about the risks from Aids. The majority view was that it was a good all-round campaign focused on the public at large and on several at-risk groups. It was also thought to have been acceptable to the public. But a sizeable minority of media professionals felt that more selective targeting would have been desirable, and that the information was not specific enough. Another criticism concerned the lack of an adequate follow-up. There was general agreement that before the campaign the public knew little about Aids, and that afterwards they were better informed, in particular about the prevalence of Aids and the existence of high-risk groups. Overall, however, respondents underestimated the campaign's achievements in increasing knowledge, while overestimating changes in attitudes and behaviour. Recommendations were made about the format and content of TV programmes for future public information campaigns concerning AIDS.
THIS paper is a précis of current thinking relating to solvent abuse, more erroneously known as glue-sniffing. Reference is made to the practice of solvent abuse and early clinical effects are detailed. A strategy is outlined in which schools and the community at large can tailor a programme to fit their own particular needs. Examples of educational objectives are included and some practical questions for educators are discussed. Solvent abuse is defined as the intentional inhalation of volatile substances for non-medical purposes.
AN increasing number of cases of solvent abuse in West Yorkshire has led to the adop tion of a common system of recording, and of guidelines for medical examination. It is argued that solvent abuse is a problem with recognised socio- medical hazards, and that it requires the attention of a range of agencies. Health educators are deemed to have a primary role in increasing understanding of solvent abuse among groups working with juveniles.
This study describes how 402 child home accidents happened. It is based on home interviews of parents of children under five who attended a hospital accident and emergency department in a multi-racial area of west London. From the parents' account, the majority of these common domestic accidents--falls, poisoning, cuts, burns and scalds--happened when parental supervision was reduced, rather than because of household hazards. The implications for prevention are to give better emotional and financial support to parents rather than adopting traditional health education interventions to alter the environment.
Objective: To examine factors that influence the effectiveness and quality of implementation of evidence-based family-focused adolescent substance use prevention programmes delivered in health care settings and to assess the effects of programme choice versus programme assignment on programme delivery.
Design: Strengthening Families Program: For Parents and Youth 10–14 (SFP) and Family Matters (FM) were delivered as part of a randomized longitudinal prevention study designed to assess the influence of programme choice versus assignment to programme on study recruitment, retention and adolescent substance use outcomes. Families were initially randomized to a choice (FM or SFP) or assigned study condition (FM, SFP or control group).
Setting: Families with an 11-year-old child were randomly selected from health plan membership databases of four large managed care medical centres in the San Francisco California Bay area; 494 ethnically diverse families enrolled in study programmes.
Method: A mixed-method case study was conducted to assess procedures used to maximize implementation quality and fidelity. Programme monitoring was conducted to assess differences in programme delivery for families in the choice versus assigned study condition.
Results: Programme fidelity improved over time. Families who chose FM (versus being assigned to the programme) completed the programme in a shorter period and spent more time implementing programme activities. SFP ‘choice’ families (versus assigned) attended more programme sessions.
Conclusion: Fidelity assessment data can be successfully utilized for ongoing quality improvement of programme delivery. Programme choice appears to increase family engagement in programmes. Future effectiveness trials should assess approaches to integrate evidence-based family prevention programmes with adolescent health services.
The failure of doctors to identify patients who drink to excess has been attributed to inadequate education, negative attitudes towards problem drinkers and pessimism about treatment. As part of an early intervention programme at the York District Hospital, doctors were given brief alcohol education and encouraged to screen patients for alcohol problems. At subsequent evaluation doctors were well-informed about the nature and extent of alcohol problems and had positive attitudes to screening patients. Their performance did not reflect their views, however, with only 29 per cent of patients being screened. It is suggested that it is not unfavourable attitudes towards alcohol problems but doctors' perception of their role which determines their treatment of problem drinkers.
Objective: The purpose of this study was to determine whether parents’ and children’s reports of parenting practices were correlated, whether the reports were differentially associated with alcohol use, and which report had the strongest association with alcohol use.
Method: We carried out a cross-sectional and longitudinal study in public schools in Chicago, IL. Participants included 1373 ethnically diverse students and parents involved in an alcohol use prevention intervention. Surveys were conducted with sixth-grade and eighth-grade students. Mixed-effects regression analyses were used to model relationships cross-sectionally and longitudinally.
Results: Parents’ and children’s perceptions of parenting practices, while significantly correlated, were not strongly associated. Analyses within each parenting domain found parents’ report of parental monitoring and children’s reports of alcohol-specific communication, general communication and relationship satisfaction were associated with alcohol use behaviours and intentions. After adjusting for all other parenting practices, parents’ report of parental monitoring and children’s report of alcohol-specific communication were most strongly related to alcohol use behaviours and intentions both cross-sectionally and longitudinally.
Conclusions: When comparing results across studies, it is important to identify whose report was used, parent or child, as the results may differ based on the reporter. Studies with limited resources may consider using parents’ reports about parental monitoring and using children’s reports for alcohol-specific communication, general communication and relationship satisfaction.
Objective To determine if weight status affects the relationship between weight-related beliefs and consumption of sugar-sweetened beverages (SSB) and fast and convenience store food purchases (FCFP).
Design Observational, cross-sectional.
Setting Twin Cities Metropolitan area, Minnesota, USA.
Methods Body composition and psychosocial survey were obtained for 345 adolescents. General Linear Models tested adjusted (age and sex) associations between weight-related beliefs and consumption of SSB and FCFP. Significant associations were tested for moderation by weight status.
Results SSB was positively related to perceptions that people worry too much about their weight (β = 0.103, p = 0.016), with no moderation present. FCFP were positively associated to perceived barriers to maintaining a healthy weight (β = 0.042, p = 0.004) with a subsequent significant interaction by weight status. Stratified models showed a significant association between perceived barriers to a healthy weight and FCFP for overweight adolescents (β = 0.345, p = 0.022).
Conclusions Addressing perceived barriers to a healthy diet may lead to important risk reduction.
IN 1981 the West Midlands Health services undertook a publicity campaign aimed at helping women to under stand more about keeping healthy during pregnancy and encouraging them to seek early ante-natal care. A series of full page advertisements on ante-natal care were placed in local newspapers in the Region. Set out here are the findings of two studies of the impact of the publicity campaign. The first shows how far people's knowledge of what to do during pregnancy was altered by the publicity, and the second shows what people thought of the adver tisements themselves and the further information sent to them on request.
The results of the first survey showed that two weeks after the advertising campaign, more women who took the newspaper in which the advertisement appeared answered correctly questions about the health topics covered in the advertisement compared with women who did not take the newspaper.
The second survey showed that the advertisements were well received by those who sent in for more informa tion about the topics covered in the advertisements. The pamphlets sent to them on request, and selected by health education officers as suitable, contained in many cases material people welcomed and had not received from any other source.
However, many people said that they would have liked to have received information on topics not covered in the pamphlets, such as the events of childbirth, feeding and problems of child development.
It was recommended that the Book of the child, produced by the Scottish Health Education Group, should be distributed during the antenatal period, and be evaluated as an alternative to current material in use.
An analysis of the number of and type of calls received by an AIDS advice line over a seven month period is presented. Variations in the number of calls received and differences in the types of questions asked by different sections of the population are examined. The results indicate that the number of calls received is strongly related to television publicity, and that different age and sex groups ask different questions about AIDS. There are also differences in the types of questions asked by homosexual and heterosexual callers. The results of the analysis have important implications for health education about AIDS.
Objective: To solicit school principals’ and teachers’ perspectives on children’s screen-related sedentary behaviour and to identify possible solutions to reduce sedentary behaviours among school-aged children.
Method: In-person interviews using a semi-structured interview guide were conducted with school principals and grades five and six classroom teachers in 14 randomly selected elementary schools in London and Middlesex County, Ontario. Fourteen principals and 39 classroom teachers participated in the study. Inductive content analysis was performed independently by two researchers.
Results: Both principals and teachers were very concerned about children’s excessive screen viewing activities, but they did not perceive that they could play a key role in reducing these behaviours. Key barriers were identified to reducing screen-related sedentary behaviour and to children’s active living both at and away from school. They included competing demands from other subjects, limited gym resources/space within the school, a lack of control over the home environment, and a perception that parents were poor role models. Notwithstanding the above barriers, principals and teachers still recommended increasing children’s daily physical activity both within and outside of school hours. Furthermore, they stressed the need for parents to play a key role in reducing their children’s screen-related sedentary behaviours and increasing their level of physical activity.
Conclusion: School principals and teachers were very concerned about excessive screen-related behaviour among school-aged children when away from school and suggested that interventions should emphasize increasing daily physical education, promoting recreational sports at or away from school, and engaging parents in regulating screen time at home.
An education programme on AIDS has been established in West Glamorgan. It was designed to provide an information network amongst health authority staff which would reach as wide an audience as possible. The programme has been organised on a direct contact approach because of the limitations of other methods of disseminating information to large groups of people. The initial success of the programme has led to its extension among other interested groups in West Glamorgan such as the prison population, drug groups, and members of the gay community. The programme is to continue and be updated on a regular basis.
An arguable over-reaction to the threat of AIDS a year ago has been replaced by over-complacency. Research findings are extensively reviewed, and it is argued that information on heterosexual spread is still insufficient to make confident predictions of its ultimate extent. However, areas for health education can be identified, and future priorities are suggested.
The current state of knowledge about acquired immune deficiency syndrome (AIDS) is outlined, and current health education advice summarised. Arguments for an intensive, integrated health education campaign to allay fear and promote preventive action are presented.
Between May 1985 and June 1986 a case control study of late and early antenatal bookings took place in two South Wales hospitals, one urban and one rural. The study examined respondents' opinions on the importance of early hospital antenatal care and the optimum time for a booking visit. Respondents were asked to state the major influence on their opinions regarding antenatal care. It was found that the majority of both late and early attenders thought that early hospital antenatal care was important, but of these many, particularly late attenders, had no accurate idea of the advisable gestation for first attendance. The most frequently mentioned influence on the respondents' opinions was health service literature provided during antenatal care. Some of these booklets gave no specific advice on when the first hospital visit should take place.
THE readability of two antenatal education books which are widely distributed to expectant mothers was assessed. There were some significant differences, and it was anticipated that this would be reflected in the levels of information imparted to the mothers, particularly when they were analysed by social class. In practice the differences were small, and the only one of significance was that the book which was believed to be more readable and more attractive in format resulted in higher knowledge scores in social classes I and II, but not in social classes III to V. Possible explanations for this are discussed.
Clear benefit in terms of knowledge was demonstrated when mothers received a book in advance of their attendance at the antenatal booking clinic. They arrived better prepared and better informed, with knowledge to help the healthy development of the foetus at an early stage in pregnancy. The additional postage costs in sending out booklets is considered justifiable.
THE health education caravan at the Newcastle Summer Exhibi tion was used as a venue to offer rubella antibody screening.
A true cross-section of the fer tile female population had the test performed and showed an immunity rate of 82%.
Of those proved to be suscept ible, there was only limited com pliance with the suggestion that immunisation should be sought from their GP.
Increases in patient knowledge after reading booklets about rheumatoid arthritis demonstrated the effectiveness of written material as a teaching aid. Two groups of patients (35 and 37 in number) in a specialist hospital acted as their own controls. Group A, after reading a booklet produced by the Arthritis and Rheumatism Council, increased their scores by a mean of 21 per cent. Group B, after reading a booklet produced by the Leeds Health Education Service, and containing substantially more information, achieved a 45 per cent average increase, indicating that this is the more effective of the two. Overall low scores before reading indicate a need for more patient education.
Objective: To examine substance-related attitudes and behaviours among college students across an academic semester.
Design: Pre–post quasi-experimental survey design.
Setting: A large University in the Midwestern United States.
Method: Surveys were completed by 299 undergraduates enrolled in three courses: drugs and behaviour, abnormal psychology, and normal personality theories.
Results: Although students that were enrolled in the drug course were not more knowledgeable about drugs than others at baseline, their knowledge increased by semester’s end, while the others’ did not. Perceived prevalence of alcohol use was more accurate and became increasingly accurate among drugs and behaviour students. Class enrolment, gender, and baseline substance use were associated with baseline attitudes and behaviours as well as changes over time.
Conclusion: This study offers implications for substance use education opportunities on college campuses.
A survey of staff attitudes to smoking and facilities for smokers and non-smokers at Westminster Hospital and associated buildings revealed widespread support for firmer measures to limit and control smoking on health service premises. The survey was eventually undertaken with the agreement of staff side union representatives who had initially resisted the health authority's wish to implement a policy on smoking. In the event, the results provided support to the TUC's 1981 Resolution calling for increased smoking restrictions in workplaces as part of an overall policy to reduce smoking prevalence among working people, which has been followed up in local initiatives by unions throughout the country.