Lessons for increasing awareness and use of booster seats in a Latino community.
(17/83)
OBJECTIVES: Latino children are more likely to be unrestrained passengers in motor vehicles than non-Latino children, but little is known about the use of booster seats in Latino families. This study investigates Latino parents' knowledge, attitudes and beliefs about booster seats, barriers to booster seat use, and effective strategies for message delivery in the Latino community. METHODS: Two focus groups were conducted with Spanish speaking parents. Information was obtained through a written survey and moderated discussions. RESULTS: Parents were widely misinformed about recommended guidelines for booster seat use, and the majority of participants did not own a booster seat. Parents identified a lack of information, the cost of booster seats, resistance to use by the child or the father, limited space in the vehicle, and unavailability of shoulder belts as barriers to booster seat use. Participants felt that learning more about the new Washington state booster seat law and its consequences would increase booster seat use. Public health messages felt to be effective were those in Spanish, delivered by credible spokespeople such as physicians and teachers, and utilizing the Spanish media. CONCLUSIONS: Campaigns to promote booster seats in the Latino community should be culturally specific, and clear guidelines for booster seat use should be given in Spanish. Legislation may be an important incentive for using booster seats, though reducing their cost and providing strategies to address child resistance and physical constraints of some vehicles are also important. (+info)
Our unrequited love for simple explanation.
(18/83)
In the complex and often perplexing field of perinatology, it is often tempting to extrapolate the results of the latest published study to our daily clinical practice, especially when the study appears to provide simple answers to difficult questions. This tendency is further encouraged by sensational media coverage and commentaries that, by necessity, further simplify the issues and hype the speculation. Without a critical appraisal of the study population, methodology, analysis and conclusions stated, globalizing a single study's results to anyone's clinical practice can be well-intentioned but misguided. As an example, approximately 1 year ago the results of an NICHD study involving home uterine activity monitoring (HUAM) were released. The study concluded that, while the likelihood of preterm delivery increased with an increased baseline frequency of uterine contractions, measurement of this contractility was not a clinically efficient predictor of preterm delivery. Through the media and editorials that followed, the study results became translated so as to indicate that HUAM was not effective in preventing preterm delivery or improving perinatal outcomes. In our desire for a simple and definitive conclusion on HUAM, key facts about this study were forgotten. In the NICHD study, uterine contraction data were blinded to both physician and patient, and only intermittent preterm monitoring was used with no provision for emergency monitoring; a study design that guaranteed patient management and outcomes would not be affected by HUAM. Using the NICHD HUAM study as an example to be learned from, we should be more critical and independent in our appraisal of published trials. Evidence-based medicine is only useful when we pay as much attention to the methodology as we do to the results. (+info)
How adolescents use technology for health information: implications for health professionals from focus group studies.
(19/83)
BACKGROUND: Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth. OBJECTIVE: To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents. METHODS: Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes. RESULTS: Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2) enhancing connection to youths by extending ways and times when practitioners are available; and (3) fostering critical appraisal skills among youths for evaluating the quality of health information. CONCLUSIONS: This study helps illuminate adolescent health-information needs, their use of information technologies, and emerging roles for health professionals. The findings can inform the design and more-effective use of eHealth applications for adolescent populations. (+info)
Anxiety and support in breast cancer: is this different for affluent and deprived women? A questionnaire study.
(20/83)
A postal questionnaire was sent to affluent and deprived women with breast cancer in order to compare psychosocial aspects of care with the purpose of understanding the balance of care and explaining why deprived women have poorer outcomes. Data were collected regarding reported sources of information, SF-36 scores and ongoing causes of anxiety. The results demonstrate that affluent women were more likely to have received information from their hospital specialist (94.8 vs 76.0%) and from a breast care nurse (70.1 vs 40.0%) than deprived women. They were also more likely to have received information from magazines (50.6 vs 33.0%), newspapers (45.5 vs 22.0%) and television news (45.5 vs 26.0%). Deprived women had poorer SF-36 scores than affluent women, and reported greater anxiety about money (12.2 vs 2.8%), other health problems (22.1 vs 8.2%) and family problems (17.5 vs 6.9%). Personal and professional support is clearly important for patients with breast cancer. Health professionals need to be aware of the greater psychological distress demonstrated by deprived women, even some years after diagnosis with breast cancer, and seek to address it. (+info)
On the use and value of new media and how medical students assess their effectiveness in learning anatomy.
(21/83)
The new media have become widely used tools in medical instruction today. But are they regarded as useful by students training to become medical doctors? What are students' most important criteria for a good CD-ROM or valuable Internet resources? To answer these questions, and to obtain definite data on the use of new media, we distributed a questionnaire to preclinical medical and dental students of the Johannes Gutenberg University in Mainz, Germany. The evaluation of 397 questionnaires demonstrates that 94.9% of the students use personal computers; 91.6% of the 85.8% who own a computer have access to the Internet. The Internet is used at least once a week by 70.1% of students for private and by 59.9% for study purposes. Offers of course-relevant material (Workshop Anatomy for the Internet) are of major interest. CD-ROMs with anatomy applications are used by 58.9% of the students. The subjective effectiveness regarding various aspects of learning using books versus CD-ROMs is compared and the students' views of the importance of different features of electronic media are outlined, including course-relevant high-resolution and quality material, key word search, state-of-the-art information, and clearly laid-out tables. The findings of this survey demonstrate high student demand for computer-aided instruction and anatomy applications offered on the Internet and on CD-ROMs. The students' main focus of interest was found to be examination-relevant material and supplemental study material for courses offered locally. The present results may serve as a basis for the development of valuable educational aids. (+info)
Digital government and public health.
(22/83)
Digital government is typically defined as the production and delivery of information and services inside government and between government and the public using a range of information and communication technologies. Two types of government relationships with other entities are government-to-citizen and government-to-government relationships. Both offer opportunities and challenges. Assessment of a public health agency's readiness for digital government includes examination of technical, managerial, and political capabilities. Public health agencies are especially challenged by a lack of funding for technical infrastructure and expertise, by privacy and security issues, and by lack of Internet access for low-income and marginalized populations. Public health agencies understand the difficulties of working across agencies and levels of government, but the development of new, integrated e-programs will require more than technical change - it will require a profound change in paradigm. (+info)
A multifaceted intervention to improve antimicrobial prescribing for upper respiratory tract infections in a small rural community.
(23/83)
BACKGROUND: Antibiotic prescribing for upper respiratory tract infections (URTIs) is widespread, is often inappropriate, and may contribute to antibiotic resistance among community-acquired pathogens, such as Streptococcus pneumoniae. METHODS: A multifaceted intervention involving health care professionals and patients was introduced to a small rural Utah community and included the repetitive use of printed diagnostic and treatment algorithms by professionals. Data on the quantity and class of antibiotic prescribing, which were collected from multiple sources, were measured for the intervention period (from January through June) in 2001 and compared with data for the baseline period during the same months in 2000. RESULTS: Medicaid claims data revealed that the percentage of patients in the community who received antibiotics for URTIs during the intervention period was 15.6% less than that for the baseline period, whereas the percentage in the rest of rural Utah was relatively stable, with a 1.5% decrease (P=.006). The greatest impact of the intervention was on prescribing for acute bronchitis (decreases of 56.1% and 1.7% in the community and rural Utah, respectively; P=.024) and on prescribing of macrolides (decreases of 13.4% and 0.2% in the community and rural Utah, respectively; P<.001). Community pharmacy data likewise revealed a 17.5% decrease in the rate of antibiotic prescribing during the intervention period (P<.001), with the largest decrease observed for macrolide prescribing (50.9%; P<.001). Chart review data, in contrast, revealed no significant decrease in the percentage of patients with URTI who were prescribed an antibiotic (3.8%; P=.49), although there was a significant decrease of 11.2% in macrolide use (P=.045). CONCLUSIONS: A multifaceted intervention involving the repetitive use of printed algorithms resulted in modest improvements in antibiotic prescribing for outpatient URTIs, although one data source did not corroborate this. However, macrolide prescribing decreased sharply, irrespective of the source of data. (+info)
You might as well smoke; the misleading and harmful public message about smokeless tobacco.
(24/83)
BACKGROUND: Compared to smoking cigarettes, use of Western smokeless tobacco (ST) products is associated with a very small risk of life-threatening disease (with estimates in the range of a few percent of the risk from smoking, or even less). This means that smokers can realize substantial health benefits by switching to ST, an obvious substitute. But consumers and policy makers have little chance of learning that ST is much less dangerous than smoking because popular information provided by experts and advocates overstates the health risks from ST relative to cigarettes. METHODS: To examine the extent of this overstatement in one medium, we conducted a systematic review of websites containing information about ST and health risks. We examined the content of 316 relevant websites identified by a Google search. RESULTS: We found that when any substantive information about the risk from ST is given, the risk is almost universally conflated with the risk from cigarettes. Accurate comparative risk information was quite rare, provided by only a handful of websites, all appearing low in our search results (i.e., of low popularity and thus unlikely to be found by someone searching for information). About 1/3 of the websites, including various authoritative entities, explicitly claimed that ST is as bad as or worse than cigarettes. Most of the other sites made statements that imply the risks are comparable. CONCLUSION: Through these websites, and presumably other information provided by the same government, advocacy, and educational organizations, ST users are told, in effect, that they might as well switch to smoking if they like it a bit more. Smokers and policy makers are told there is no potential for harm reduction. These messages are clearly false and likely harmful, representing violations of ethical standards. (+info)