Influencing physicians: the three critical elements of a successful strategy. (1/225)

This activity is designed for leaders and managers of healthcare organizations, particularly those involved in the development of physician incentive and physician management programs. GOAL: To describe the challenges inherent in influencing physicians and review the essential elements of any successful strategy for achieving physician support and participation. OBJECTIVES: 1. Describe the reasons why healthcare organizations and medical groups need to influence physicians to be successful. 2. Cite the reasons why it is difficult to influence physicians. 3. Review the current strategies healthcare organizations and medical groups use to influence physicians. 4. Outline the three essential elements of any program designed to influence physicians.  (+info)

Tolerance in a rigorous science. (2/225)

Scientists often evaluate other people's theories by the same standards they apply to their own work; it is as though scientists may believe that these criteria are independent of their own personal priorities and standards. As a result of this probably implicit belief, they sometimes may make less useful judgments than they otherwise might if they were able and willing to evaluate a specific theory at least partly in terms of the standards appropriate to that theory. Journal editors can play an especially constructive role in managing this diversity of standards and opinion.  (+info)

Tobacco industry tactics for resisting public policy on health. (3/225)

The tactics used by the tobacco industry to resist government regulation of its products include conducting public relations campaigns, buying scientific and other expertise to create controversy about established facts, funding political parties, hiring lobbyists to influence policy, using front groups and allied industries to oppose tobacco control measures, pre-empting strong legislation by pressing for the adoption of voluntary codes or weaker laws, and corrupting public officials. Formerly secret internal tobacco industry documents provide evidence of a 50-year conspiracy to "resist smoking restrictions, restore smoker confidence and preserve product liability defence". The documents reveal industry-wide collusion on legal, political and socially important issues to the tobacco industry and clearly demonstrate that the industry is not disposed to act ethically or responsibly. Societal action is therefore required to ensure that the public health takes precedence over corporate profits. Recommendations for reducing the political influence of the tobacco industry include the following. Every tobacco company in every market should publicly disclose what it knew about the addictiveness and harm caused by tobacco, when it obtained this information, and what it did about it. The industry should be required to guarantee internationally recognized basic consumer rights to its customers. Trade associations and other industry groupings established to deceive the public should be disbanded. These recommendations should be incorporated into WHO's Framework Convention on Tobacco Control.  (+info)

'If you pay, we'll operate immediately'. (4/225)

OBJECTIVES: To study the attitudes of health care staff in four postcommunist countries towards taking gifts from their clients--and their confessed experience of actually taking such gifts. DESIGN: Survey questionnaire administered to officials including health care staff, supplemented by focus-group discussions with the general public. SETTING: Ukraine, Bulgaria, Slovakia and the Czech Republic. PARTICIPANTS: A quota sample of 1,307 officials including 292 health care staff, supplemented by stratified national random samples of 4,778 ordinary members of the public and in-depth interviews or focus-group discussions involving another 323. MAIN MEASUREMENTS: Explicit justifications and willingness to accept offers, reported frequency of offers, and personal confessions to accepting "money and expensive presents" as well as smaller gifts. RESULTS: Health care staff were far more inclined than the average official or public servant to accept "money or an expensive present" if offered, far more inclined to justify asking clients for "extra payments", and far more inclined to confess that they had actually taken gifts from clients recently. Judged by their own confessions, hospital doctors were only rivalled by traffic police and customs officials for taking money or expensive gifts from their clients. CONCLUSIONS: Poor pay does not explain why doctors so often took large gifts from their clients. Moral self justification, opportunity, and bargaining power are much more effective explanations.  (+info)

Effects of persuasive message order on coping with breast cancer information. (5/225)

The current study explored the impact of varying the order of message components on coping with breast cancer information. In a 2 x 2 x 2 factorial design, threat information, coping information and order of information were manipulated. College students read persuasive essays that varied in emphasis on threat of developing breast cancer and effectiveness of breast self-examination (BSE) in averting the threat of cancer. Participants who read the high-threat message reported higher intentions to perform BSE, more rational problem solving and more hopelessness than did those who read a low-threat message. The coping information messages produced a similar pattern of results. In addition, those who read the high-coping message reported less fatalism than did participants who read the low-coping message. When threat information was presented first, the high-threat message led to less hopelessness and reliance on religious faith than when the coping information was presented first. These results demonstrate the threatening health information energizes one to act in both adaptive and maladaptive ways, and that coping information decreases the tendency to respond maladaptively to the health threat. They also suggest that the order of presentation of the information may affect the extent to which people respond adaptively.  (+info)

Community involvement at what cost?--local appraisal of a pan-European nutrition promotion programme in low-income neighbourhoods. (6/225)

In the UK, government has committed itself to improving health and reducing inequalities in health. For the first time, issues such as food poverty will be addressed by tackling the causes of poverty and wider determinants of ill health. The time has never been better, therefore, for health and local authorities to work collaboratively to promote and improve health. Community involvement is also paramount to sustainable programmes. However, such a dramatic shift in policy and greater emphasis on public health requires health professionals themselves to adopt a different approach. The World Health Organization (WHO) recommends a health promotion approach as a framework for action. But despite the existence of this framework there is little evidence that a wider understanding of health promotion and the necessary practical experience has been achieved. This has weakened the potential impact of health promotion and has possibly encouraged inappropriate use of health promotion principles in practice. The European Food and Shopping Research Project (SUPER project) was established under the WHO European network of Healthy Cities to help local projects implement the principles of health promotion (WHO, 1986). This paper describes the SUPER project and its implementation in Liverpool (1989-1997), where levels of unemployment, deprivation and ill health are amongst the highest in the UK. Participation in SUPER is appraised to identify the various benefits and obstacles involved and to identify links with progress at the local level. This appraisal is discussed and the use, and potential misuse, of participatory appraisal techniques to elicit information and mobilize communities is examined.  (+info)

Smoking trends in adolescence: report on a Greek school-based, peer-led intervention aimed at prevention. (7/225)

This article presents a school-based, peer-led programme aiming at smoking prevention among Greek adolescents. The intervention was based on the social influence approach, and utilized 28 students' personal sensitization for the development of audio-visual material, which was presented to the remaining students of the two experimental schools (n = 440). The effectiveness of the intervention was assessed by means of experimental and control (n = 217) students' completion of a questionnaire prior to, immediately after and 3 months after the intervention. The Repeated Measures Analysis of Variance (MANOVAR) showed declines in the experimental group's smoking behaviour and intention to smoke immediately after, but not 3 months after the intervention, and more lasting changes in this group's knowledge of addiction and anti-smoking attitude. These effects were not observed for the control group. Programme evaluation and the implementation of health education programmes in the Greek school curriculum are discussed in the light of these findings.  (+info)

The adolescent sexual world and AIDS prevention: a democratic approach to programme design in Zimbabwe. (8/225)

The main aim of this study was to redress the under-representation of adolescent attitudes in AIDS prevention programme design and to discuss the implications of a democratic sexuality education approach within a health promotion context. The study surveyed the attitudes of adolescents (average age 16 years) on sex-related topics such as culture, marriage, sexual behaviour and sex education, identified similarities and differences in attitudes according to gender and socio-economic environments, and examined sources of students' knowledge of selected sex-related topics. Questionnaires were completed by 3429 secondary school students from different backgrounds. Findings showed significant differences in attitude related to gender and socio-economic settings and also in sources of information. The study drew on a democratic sexuality education approach. Using this approach, adolescents review ideological perspectives and decide which are most appropriate for them as guides in making decisions about their own lives. This type of education is fully consistent with the principles of democratic living and gives guidance to teenagers who are trying to decide how to live a healthy life. Study results suggest that programmers would be well advised to collect information from the adolescents' psycho-social-economic environment and link it with good governance and civil society strategies in developing AIDS prevention programmes that involve the adolescent in making lifestyle decisions. To achieve a more supportive environment for AIDS prevention, this approach can link adolescent attitudes and health promotion action to advocate for public policy reform, gender equality, multi-dimensional partnerships and social marketing.  (+info)