Nell H Gottlieb

• University of Texas at Austin

Background: While the interest of health promotion researchers in change methods directed at the target population has a long tradition, interest in change methods directed at the environment is still developing. In this survey, the focus is on methods for environmental change; especially about how these are composed of methods for individual chan...

Objective: To examine differences between light and heavier smoking vocational/technical students in tobacco use, related behaviors, and cessation. Design: Cross-sectional. Setting and Methods: Two hundred and four smokers attending two vocational/technical colleges in east Texas, USA, completed an anonymous survey during a regularly scheduled clas...

The purpose of this study was to examine differences in parental feeding practices according to ethnicity/race, household income, parent education level, acculturation (for Hispanic participants only), and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program among parents living in a southern st...

Child- and family-serving programs such as the Special Supplemental Nutrition program for Women, Infants, and Children (WIC) design and conduct interventions to improve the health of their clients through better nutrition. But these programs present a significant opportunity to improve physical activity levels in the preschool population as well, a...

This study was conducted to evaluate the Walk Texas! Clinical Counseling Guide for Nutrition, which is a brief, stage-based nutritional counseling guide designed for use in clinical settings. This study utilized a pre-test post-test quasi-experimental design, with two intervention and two comparison clinics that were matched for size and ethnicity....

Purpose Present a 10-year update of the ecologic model of health promotion published by Richard et al. in the American Journal of Health Promotion in 1996. Approach We adapted and simplified the model by leaving out settings, focusing on levels, and incorporating interpersonal and individual levels and agents that are in control of environmental c...

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure...

This study explored preschooler feeding practices and beliefs among Spanish- and English-speaking WIC participants in Texas. The Preschooler Feeding Questionnaire examined 9 dimensions of the parent-child feeding interaction among 235 caregivers. Results from ANOVA and post hoc analyses demonstrated significant differences in reported preschooler f...

Since the Lalonde report, contemporary public-health theory has given steadily more attention to the role of environments in influencing health status. Environments, both social and physical, influence health directly or through complex interactions with behavior, genetics and health-care systems. They are also important for public-health because e...

The authors examined college student opinions of no-smoking policies, secondhand smoke, and smoking in public places. A convenience sample of 1,188 (66.4% female; 26.9% White, 64.1% Black, and 9.0% Hispanic) students attending 5 Texas colleges volunteered to complete a 60-item anonymous survey on tobacco attitudes and behaviors. Results of our stud...

This study examined the personal experiences of twenty 14-to-19-year-old Texas youth cited for tobacco possession and attending a court-mandated tobacco awareness class. Guided by labeling theory, focus group questions addressed the process of citation, how youth viewed themselves following citation, how parents and peers viewed youth following cit...

Although the health communication program feedback cycle is frequently referenced, the steps for moving between or within the sections of the model in a public health environment are rarely described. We detail the process by which the Texas Tobacco Research Consortium implemented the stage of "assessing effectiveness and making refinement" and exp...

For people living with heart failure, levels of health exist along a continuum in correlation with the illness experience. A focus on health promotion rather than only disease or symptom management expands opportunities for self-care and presents an emerging paradigm shift in the care of people with heart failure. Results from 2 studies revealed th...

Health education practitioners often form and provide support to partnerships directed toward public health goals. The authors viewed the start-up of a state health department/multiuniversity partnership for the evaluation of the state's tobacco settlement pilot project using the lens of the Tuckman four-stage model of group development. The four s...

To test: (1) whether citation under the Minors in Possession (MIP) law, vicarious citation (knowing someone who was cited), and threat of driving licence suspension are associated with decreased intentions to smoke next year; and (2) whether the policy is differentially enforced. 28,249 white, Hispanic, and African American students in grades 6-12...

This case study examines a nonlegislative task force as it struggled to reach internal consensus despite external political constraints. The study highlights the convergence of politics and science, revealing complex issues likely to be confronted by advocates and public health officials. Three themes capture participants' experiences: context, siz...

Purpose This study tested a conceptual model based on research supporting the relationship between the predictors of hardiness, supervisor support, and group cohesion and the criterions of job stress and job satisfaction and between the predictor of job stress and the criterion of job satisfaction. Design The study employed a cross-sectional resea...

Better understanding of the cognitive framework for decision making among legislators is important for advocacy of health-promoting legislation. In 1994, the authors surveyed state legislators from North Carolina, Texas, and Vermont concerning their beliefs and intentions related to voting for a hypothetical measure to enforce legislation preventin...

Nutritional behaviors and physical activity can influence risk for the development and prognosis of cancer. This study reports findings of a literature review and a survey of nutrition and physical activity counseling practices of family practice (FP) residents. 110 FP residents (response rate = 93.2%) from four clinics that received funding from t...

Objectives: To examine quantitative effect of office system and educational intervention in selected preventive health services (PHS) in primary care practices and whether effectiveness differed by study and intervention characteristics. Methods: Fifty studies that conducted officebased interventions for improving PHS were retrieved from various co...

Tobacco use is the chief avoidable cause of death in the United States. Physicians, however, are not routinely assessing this risk and providing counseling for risk reduction. This study examines tobacco cessation counseling practices among family practice residents and explores the determinants of residents' smoking-counseling behaviors and counse...

This article tests a theoretically driven model of the relationship between work environment, specifically, management practices, and employee mental health, specifically depression. It draws on theoretical perspectives connecting work environment and stress, and on others linking stress and depression. It also examines sense of coherence as a poss...

To determine whether the implementation of the Put Prevention Into Practice (PPIP) office-based system would increase the delivery rates of specific clinical preventive services among demonstration clinics. Chart review was conducted before (n=372) and 33 to 39 months after (n=376) the implementation of the PPIP office-based system in two community...

Put Prevention Into Practice (PPIP) consists of a kit of office-based tools intended to support the provision of preventive services by primary care providers. The purpose of this study was to examine the institutionalization of PPIP within five primary care clinics funded by the Texas Department of Health to implement PPIP, and to examine the orga...

Introduction: Put Prevention Into Practice (PPIP) consists of a kit of office-based tools intended to support the provision of preventive services by primary care providers. The purpose of this study was to examine the institutionalization of PPIP within five primary care clinics funded by the Texas Department of Health to implement PPIP, and to ex...

The extent to which employees rely on the worksite exclusively for health promotion programs was examined in a cross-sectional study of 10 federal worksites. Responses were received from 3,403 of the 5,757 employees surveyed (59%). Fewer than 10% of employees exclusively used agency programs for physical fitness, nutrition, substance abuse, smoking...

A qualitative survey on the collaborative experiences of colleges and universities, state-level organizations, and school districts related to comprehensive school health programs in 12 states found four primary collaborative outcomes: training, consultation, research, and networking. Five common dimensions of collaboration also were identified: in...

The goal of this study was to evaluate the relationship between culture and attitudes about cervical cancer screening among young American Indian women living and working in northeast Oklahoma. A cohort of 199 American Indian women, ages 18-40, were surveyed to determine their blood quantum, self-identification, and beliefs and practices regarding...

Documentation of clinical preventive services at 9 Texas family practice residency programs, community health centers, and public health regional clinics was examined. Assessment of 11 risks, counseling on those risks, and timeliness of 8 screening tests and immunizations were abstracted. Documentation of clinicians' risk assessment focused on toba...

Put Prevention Into Practice (PPIP) is a program designed to improve the delivery of clinical preventive services by primary care providers, through the use of specific office materials for providers and clinic staff, as well as an educational booklet for patients. The purpose of this study was to identify potential predictors of successful initiat...

Higher education can play a significant role in efforts to enhance, promote, and disseminate coordinated school health programs, according to the authors, who discuss both successful collaborations and common stumbling blocks.

Purpose To summarize and provide a critical review of worksite health promotion program evaluations published between 1968 and 1994 that addressed the health impact of worksite smoking cessation programs and smoking policies. Methods A comprehensive literature search conducted under the auspices of the Centers for Disease Control and Prevention id...

Heart Partners uses a straightforward, interpersonal approach to increase acceptance and use of innovations in school health promotion. In accord with the linkage model of innovation diffusion, developers of a new program or technology (i.e., resource system) simply designate and train selected members to be recruiters and allies of individual advo...

This study analyzed influences on state legislators' decisions about cigarette tax increase votes using a research strategy based on political science and social-psychological models. Legislators from three states representing a spectrum of tobacco interests participated in personal interviews concerned with tobacco control legislation (n = 444). M...

This study describes state legislators' knowledge, attitudes, and voting intentions with regard to tobacco-related issues. A cross-sectional survey of state legislators was conducted in North Carolina, Texas, and Vermont in 1994. Most legislators agreed that secondhand smoke can cause lung cancer in nonsmokers, and a majority believed that smokers...

The predictive validity of state legislators' behavioral intentions in relation to their votes on tobacco control legislation was assessed by using the theory of planned behavior (I. Ajzen, 1991). Intentions to vote for cigarette tax increases were measured through interviews in the summer of 1994. A bill containing cigarette tax increases was cons...

To determine state legislators' perceptions about health and tobacco lobbyists, their frequency of contact with these lobbyists, and the amount of campaign contributions from health professional organisations and the tobacco industry. Cross-sectional study. State legislators from North Carolina, Texas, and Vermont (USA), serving in 1994. Perception...

As health promotion methods are proven effective, the diffusion and widespread implementation of successful programs can significantly reduce behaviors that pose risks to health within a targeted population. The Smart Choices Diffusion Project developed and evaluated a dissemination intervention program that targeted 128 school districts in east Te...

This paper presents the results of theory-based intervention strategies to increase the adoption of a tobacco prevention program. The adoption intervention followed a series of dissemination intervention strategies targeted at 128 school districts in Texas. Informed by Social Cognitive Theory, the intervention provided opportunities for districts t...

Settings--community, worksite, schools, and healthcare sites--constitute an important dimension of health education/health promotion policy and programs and for research about program needs, feasibility, efficacy, and effectiveness. These settings vary in the extent of coverage of and relationships with their respective constituencies, valued outco...

Purpose The purpose of this study was to operationalize adopter characteristics identified by Rogers and assess their relationship to the adoption and implementation of health innovations in schools. Design A two-year cohort study of teachers was used following introduction of a new health promotion program. Subjects From a randomly selected stat...

An empirical examination of teacher receptivity to and practice of tobacco prevention education provides the foundation for comprehensive staff development to increase diffusion of drug prevention education curricula. Randomly-selected first grade Texas teachers (n = 313) were asked to complete a questionnaire during the first and second years of t...

The practice norms of community physicians and dentists in the Lehigh Valley of Pennsylvania for counseling about smoking cessation were surveyed. In addition, 1,373 residents in the valley were interviewed by telephone about the smoking counseling behaviors of their dentists and physicians. These activities were conducted as part of the planning f...

Fifty state and local coalitions that carry out the Smoke Free Class of 2000 program of the American Cancer Society, American Heart Association and American Lung Association were surveyed in 1990. Almost all (95%) rated themselves moderately or very active and a total of 88 900 second grade teachers were estimated to have received the materials. Th...

Data from a sample of 338 male university varsity and intramural football and baseball players were used to specify a model of smokeless tobacco (SLT) use based on the Theory of Reasoned Action. Differences between athletes who did and did not intend to use SLT within the next 2 weeks were found for nine of 12 outcome beliefs, nine of 12 outcome ev...

This study investigates the implementation of a restrictive smoking policy in decentralized worksites. A model which includes four elements--concept, context, process, and outcomes--is used as a framework for identifying characteristics that influence implementation. The organization studied was a state human services agency with approximately 400...

Despite national objectives for extending health promotion programs to blue-collar workers and to small work sites, baseline behavior information for planning such programs is lacking. This study seeks to describe the health risks and norms specific to a population of male, blue-collar gas pipeline workers in remote sites. These workers (n = 395) c...

The first year of the Texas Triagency Coalition Smoke-Free Class of 2000 project (SFC2000) in Texas was evaluated using a descriptive model developed from diffusion theory. Tobacco-prevention education (TPE) materials were to be made available to all first grade teachers within the state. A random sample survey of 213 teachers indicated that 96 (44...

To examine the smokeless tobacco (ST) and smoking practices of collegiate varsity and intramural baseball players, 284 undergraduate athletes at two major Southwestern universities were surveyed using a questionnaire previously developed to measure use among this population. About one-fourth of all athletes were current ST users and 4% smokers. Ove...

The stages-of-change model for smoking cessation was specified using interview and biochemical data from a sample of Mexican—American smokers in south Texas. Factor analysis of items measuring the processes of change for smoking indicated the stability of the structure of these constructs for this population. The scales discriminated among groups o...

Three successive cross-sectional surveys were used to measure the impact of a restrictive smoking policy on employee smoking patterns, perceived exposure to environmental tobacco smoke, attitudes about the policy, and smoking-related norms in a large decentralized state agency. No significant change was detected in smoking prevalence, the proportio...

Smoking control is a key element of worksite health promotion. This three-stage study in a large state human services agency included a baseline survey, an assessment of the effects of competition on recruitment to a self-help cessation program, and examination of the outcome of the cessation program. In stage 1, scales for measuring smoking-relate...

The present study examined the prevalence, correlates, and perceived impact of smoking policies among private employers and public agencies in Texas. An identical survey instrument was administered to two groups of Texas employers: a random sample of private industries and all state agencies (excluding universities). Response rates were 62% (n = 42...

Even with the passage of state safety belt laws, primary care physicians can contribute to their patients' safety by brief interventions. The present study explores the prevalence of such action with adult patients and tests the power of constructs taken from social learning theory to explain physicians' behavior. These constructs included self-eff...

A survey was mailed to 2000 randomly selected students at four campuses in a southern mid-western state. The survey examined college students' knowledge, attitudes and beliefs regarding AIDS, their sexual activity, safer sex practices, prosocial actions they would be willing to take and preferred channels of communication for additional information...

This article reports data from a random sample survey designed to estimate the extent of employee health promotion activities in Texas. Factors, resources, and barriers which might be associated with the adoption of these activities also are examined. The respondents reported more traditional health and safety activities than those dealing with hea...

We examined attitudes and practices related to stress management in a random sample of Texas primary care physicians. Two fifths of the physicians indicated that avoiding undue stress was very important, and more than one third reported that they gathered information about stress on a routine basis. Over two thirds of the physicians said that they...

We analyzed data from the 1982 Texas Behavioral Risk Factor Survey by sex and age to suggest strategies for the design and implementation of risk reduction programs. Men were more likely than women to report heavy drinking (76 percent versus 62 percent), drinking and driving (11 percent versus 3 percent), smoking (34 percent versus 27 percent), bei...

Our finding that ethnicity is associated with smoking, relative weight, and physical activity, largely attributable to differences in social and health resources, has important implications for health promotion practice. Our research documents the importance of extending and adapting health promotion services to disadvantaged ethnic populations. Ap...

The Social Learning Theory concepts of self-efficacy and outcome expectations were used to study physician practice regarding patients' smoking, alcohol problems, OTC drug problems, and illicit drug use in a random sample of Texas primary care physicians. The highest proportion of physicians took histories and counseled patients regarding the abuse...

In the nine years since an entire issue of Health Education Quarterly (then Health Education Monographs) was devoted to considering ethical issues in health education, several important social changes have occurred which have substantially influenced the practice of that discipline. New practice contexts and ethical issues have resulted, which requ...

This research specifies a model for lifestyle health behavior which includes socialization, social environmental and cognitive influences on smoking, alcohol use and exercise. Survey respondents were participants in university conditioning classes, academic health classes and a community fitness program. Of the socialization influences, drinking by...

The relative contribution of sex, ethnicity, social class, parental exercise and heart health knowledge to the variability of sporting activities reported by Texas 7th and 8th grade students in 1980 was examined to study the cultural patterns of exercise that might relate to future risk for heart disease. Girls were more likely than boys to partici...

The relationships of ethnicity, sex and father's occupation with heart health knowledge and nutrition behavior were studied in Texas seventh and eighth grade students. A questionnaire was administered to 2,695 children in schools chosen to represent the urban/rural and ethnic mix of the state population. The findings indicated a strong need for hea...

This case study reports a communitywide effort to reduce the fragmentation and duplication of child health services in Boston. Consensus was first reached on what basic health services should be offered and where--school or community--they would be most efficiently and effectively delivered. The planning group then developed strategies to coordinat...

The relationships among social structure, stress, social support, life-style health behavior, and health status are explored in this multivariate analysis of data from the National Survey of Personal Health Practices and Consequences. Path analyses showed social structural factors to influence life-style practices both directly and indirectly throu...

The Horn-Waingrow smoking typology was partially replicated in a sample of college women. Findings from regression analyses, using the types as dependent variables and the smoking behavior of parents and peers, age, the age smoking begun regularly, frequency and amount of smoking as independent variables, supported the notion of a sociological-phar...

In the United States, smoking for women has followed a different pattern for women than for men, and the literature suggests that it, as a 'masculine' behavior, may serve as a role-delineating function for women. This research examines the relationship between sex of smoking parents and peers and the smoking behavior of college women. Having a moth...

Smoking behavior was examined among college students at 34 New England colleges. Women were more often smokers (44%) than men (32%) and were also more likely to smoke daily than men (23 vs. 16%). Men in private colleges were significantly less likely to smoke (22%) than those in public colleges (26%). At both public and private colleges, women were...

The association among social and economic characteristics, use of the health care system, health habits, life problems, and reported health status are examined in a survey of Greater Boston area residents. The respondents are classified according to their residence in the core city, the remainder of the city, the inner suburbs, or the outer suburba...

A survey of the Boston metropolitan area correlated drinking patterns with sex, age, race, marital status and social class; findings were compared with previous studies in Boston, San Francisco and nationwide.

This article has no abstract; the first 100 words appear below. The Department annually surveys the immunization status of children entering kindergarten in Massachusetts. For 1974–75, the results¹ compared favorably with national averages² for that year but showed pockets of low immunization in the inner city. For the 8499 children entering kinder...

The primary purpose of the study was to identify relationships among sources of interpersonal influence, putative psychological mediators, and physical activity. The moderation of these relationships by age, body composition, and educational attainment was also evaluated. Responses from 1224 employees were collected through an online survey at a ma...

This methods-oriented dissertation focuses on the psychometric evaluation of the Feeding Your Preschooler Questionnaire (FYPQ) designed to assess the eating habits and diet quality of young children. Parental proxy reports (n=135) were obtained through pen and pencil administration of the FYPQ and an in-person interview using a 24- hour food recall...