43 resultados para Health attitudes.
Resumo:
Background. Early Childhood Caries (ECC) is the most common chronic infectious disease of childhood worldwide. Seven of ten American children have one or more decayed or filled primary teeth by age five. ECC prevalence is especially high in lower socio-economic ethnic populations. Commonly recognized as a diet-induced disease, focal etiological factors include cariogenic bacteria, fermentable carbohydrates, and a susceptible newly erupted tooth. Sequencing of breast and/or bottle feeding and introduction of beikost come at a time when children's defense mechanisms and, perhaps maternal direction of children's dietary patterns, are not yet fully developed or mature. To date, most research has examined biological factors, while maternal factors, especially psychosocial ones, have received scant attention. Objective. To examine the association of psychosocial factors in terms of maternal nutrition and oral health knowledge, attitudes, and beliefs, as well as social support and self-efficacy (KABS2) in a population of socio-economically disadvantaged infants and young children. A secondary aim was to describe ECC prevalence in this population. Methods. This study examined cross-sectionally the relationship between selected maternal psychosocial variables and ECC in a convenience sample of Mexican-American women and very young children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in San Antonio, Texas. Mothers were surveyed by use of a criteria- and content-valid, reliable questionnaire, and dental examinations were conducted on 191 children, aged 5 to 47 months old. Results. Thirty-nine percent of the children had ECC. As assessed on a 30-question scale, women in whose children were diagnosed with ECC were found to demonstrate lower Knowledge ( p=0.03), Attitudes (p=0.02), Beliefs (p=0.04), and Social Support (p<0.01) scores, compared to women whose children were found to be caries-free. No differences in Self-Efficacy scores were found between the groups. Conclusions. These data indicate that current etiological model depicting relevant factors associated with ECC in Mexican-American infants and children of low socio-economic status should be broadened to include consideration of maternal psychosocial factors such as nutrition and oral health knowledge, attitudes, beliefs, and social support, and that these factors should be considered when planning educational approaches to reduce the occurrence of ECC. ^
Resumo:
Objective. To evaluate a school-based intervention aimed at the primary prevention of negative eating attitudes and behaviors among preadolescent girls, and to revise curriculum lessons based on quantitative and qualitative findings. ^ Intervention Design. A formative evaluation was conducted on four Team: Bee Me curriculum lessons at a Houston elementary school. Evaluation focused on program satisfaction and short-term effect on knowledge and eating attitudes and behaviors. ^ Results. Sixteen girls participated in the five-day project. Statistically significant improvements in overall knowledge were observed (p<0.05), however only modest changes were observed in eating attitudes and behaviors. Program satisfaction was high among student participants and the teacher who implemented it. Insight for future modifications to this program and for similar interventions was provided by the students and teacher. ^ Conclusions. This program led to positive trends in outcome variables; however longer and more intensive testing of this program is needed to better evaluate its effectiveness.^
Resumo:
Influenza and pneumonia together comprise the seventh leading cause of death among adults in the U.S and were responsible for 65,163 deaths in 2003 and an average of 36,000 deaths per year in the United States from 1990 to 1999. Vaccination is efficacious and cost-effective in terms of preventing the infection and reducing both health care costs and productivity losses associated with influenza illness. The vaccine shortage of 2004–2005 resulted in a 39% decrease in the influenza vaccine supplies. During the fall of 2004, we conducted a nationwide, random-digit dialing, telephonic-interview survey of 1,202 adults aged 18 years and older to ascertain influenza vaccine knowledge, attitude and behavior. Of the 1,202 total interviewed subjects, 44.7% had received or intended to receive vaccine at the time of the survey (2004–05) and 39.6% had received the influenza vaccine the previous year (2003–04). Receipt of vaccine increased with previous receipt of the influenza vaccine (OR 13.17, 95% CI 8.65–20.08), increased motivation status (OR 7.58, 95% CI 4.03–14.25), subjective risk status (OR 3.33, 95% CI 2.23–4.97), age (OR 1.83, 95% CI 1.22–2.75) and previous receipt of the pneumococcal vaccine (OR 1.75, 95% CI 1.02–3.0). The influenza vaccine shortage of 2004–05 did not have a negative impact on the vaccination rates of study population. In addition to the increased rates, a large majority of respondents were also aware of the shortage of influenza vaccine during the 2004–05 season, about the indications for receiving the influenza vaccine, about alternative methods to prevent contracting the influenza and increased motivation to receive the vaccine. ^
Resumo:
This study explored the health, education, social assets, needs, attitudes, and behaviors of residents of Ferrocarril #4, a small urban community in Tamaulipas, Mexico. A collaborative Participatory Action Research approach was used to emphasize community involvement. Using Triangulation to ensure validity, qualitative methods included key informant in depth interviews, participant observation and participatory discussion groups with women and men. A personal interview with a probability sample of women was done. The median age of interviewees was 37 years. The majority was married or had a partner. Over half of respondents completed grades 6-9. Employed women (25%) earned a median weekly salary equivalent to ∼56 USD. Women with health insurance (67.7%) were covered mainly through Social Security and Seguro Popular. One in 5 reported bad health. Barriers to care were primarily money and transportation. To improve health care, women wanted a full service clinic in or close to the community and affordable health care. Socially, 28% of respondents had no close friends in the community and most did not participate in beneficial community activities. Many women did not socialize with others and help from neighbors was situational. Primary school teachers lacked parental support and it interfered with classroom efforts. Healthy community discussion groups focused on personal and environmental hygiene and safety. Valuable assets exist in the community. To date, collaborative efforts resulted in a school First Aid station, a school nurse visit weekly, posting of emergency contact phone numbers in the school and community center, and development of a student health information form. ^
Resumo:
The purpose of this study was to develop a better understanding of police officer attitudes towards the mentally ill and what impact that might have on their behavior. Focused on the effects of Crisis Intervention Team (CIT) training on Houston police officers, this research wanted to determine if CIT training decreases attitudes of authoritarianism and increases attitudes of self-efficacy in dealing with the mentally ill—other factors assessed were age, years of service, ethnicity, and gender. Results confirmed that CIT training had an effect on an officer's attitudes with CIT officers being less authoritarian and having more self-efficacy with respect to dealing with the mentally ill as compared to non-CIT officers. Because of these results, this study could offer support in tailoring training programs to have successful officer-mentally ill person interactions. ^
Resumo:
Objective. To examine and evaluate racial and ethnic disparities in glycemic control among HRS respondents with diabetes aged 55-94 years. ^ Methods. The HRS Diabetes 2003 database provides data on blood-drawn glycemic control and self-reported demographics, socioeconomic status, clinical, health access and self-care characteristics. 1,141 non-Hispanic White, non-Hispanic Black, and Hispanic respondents were included in multiple logistic regression of glycemic control. ^ Results. The rate of poor control was significantly higher among Blacks (61.5%, 105/171) and Hispanics (65.3% 72/110) than among Whites (45.0% 387/860) (p < 0.01). After controlling for influential covariates and interactions, Blacks and Hispanics had a three-fold increased risk for poor control compared to Whites when duration was five years or less. ^ Conclusions. Clinical and self-perception variables, like duration, medication, and self-rated poor diabetes control affected glycemic control independent of race and ethnicity, but there remains unexplained racial and ethnic disparities for newly-diagnosed individuals. This is the first study to find an interaction between duration and race and ethnicity on glycemic control. Future research should incorporate cultural beliefs and attitudes about diabetes control that may explain the racial and ethnic disparity. ^
Resumo:
The disparate burden of breast cancer-related morbidity and mortality experienced by African American women compared with women of other races is a topic of intense debate in the medical and public health arenas. The anomaly is consistently attributed to the fact that at diagnosis, a large proportion of African American women have advanced-stage disease. Extensive research has documented the impacts of cultural factors and of socioeconomic factors in shaping African American women's breast-health practices; however, there is another factor of a more subtle influence that might have some role in establishing these women's vulnerability to this disease: the lack of or perceived lack of partner support. Themes expressed in the research literature reflect that many African American breast cancer patients and survivors consider their male partners as being apathetic and nonsupportive. ^ The purpose of this study was to learn how African American couples' ethnographic paradigms and cultural explanatory model of breast cancer frame the male partners' responses to the women's diagnosis and to assess his ability to cope and willingness to adapt to the subsequent challenges. The goal of the study was to determine whether these men's coping and adaptation skills positively or negatively affect the women's self-care attitudes and behaviors. ^ This study involved 4 African American couples in which the woman was a breast cancer survivor. Participants were recruited through a community-based cancer support group and a church-based cancer support group. Recruitment sessions were held at regular meetings of these organizations. Accrual took 2 months. In separate sessions, each male partner and each survivor completed a demographic survey and a questionnaire and were interviewed. Additionally, the couples were asked to participate in a communications activity (Adinkra). This activity was not done to fulfill any part of the study purpose and was not included in the data analysis; rather, it was done to assess its potential use as an intervention to promote dialogue between African American partners about the experience of breast cancer. ^ The questionnaire was analyzed on the basis of a coding schema and the interview responses were analyzed on the principles of hermeneutic phenomenology. In both cases, the instruments were used to determine whether the partner's coping skills reflected a compassionate attitude (positive response) versus an apathetic attitude (negative response) and whether his adaptation skills reflected supportive behaviors (the positive response) versus nonsupportive behaviors (the negative response). Overall, the women's responses showed that they perceived of their partners as being compassionate, yet nonsupportive, and the partner's perceived of themselves likewise. Only half of the women said that their partners' coping and adaptation abilities enabled them to relinquish traditional concepts of control and focus on their own well-being. ^ The themes that emerged indicate that African American men's attitudes and behaviors regarding his female partner's diagnosis of breast cancer and his ability to cope and willingness to adapt are influenced by their ritualistic mantras, folk beliefs, religious teachings/spiritual values, existential ideologies, socioeconomic status, and environmental factors and by their established perceptions of what causes breast cancer, what the treatments and outcomes are, and how the disease affects the entire family, particularly him. These findings imply that a culturally specific intervention might be useful in educating African American men about breast cancer and their roles in supporting their female partners, physically and psychologically, during diagnosis, treatment, and recovery. ^
Resumo:
Despite the recent decline in adolescent pregnancy rates, adolescent pregnancy continues to be a significant public health issue in the United States. The United States consistently reports the highest rate of adolescent pregnancy among developed countries. Adolescent mothers are more likely to have multiple pregnancies, to access welfare and other social services, and to be unmarried. Teen mothers are less likely to complete high school, enter college, and typically command much less earning power throughout their lifetime as compared to women who delay childbirth until later. Moreover, the United States spends approximately $9.1 billion annually on teen pregnancies. ^ Additionally disconcerting is recent data which demonstrates that the decline in teen pregnancy rates is leveling off and that the rate of adolescent pregnancy has increased for the first time since 1993. Contraceptive use is a key component to the prevention of adolescent pregnancy. Contraceptive nonuse and failure result in unintended pregnancies among adolescents. This review sought to assess the levels of knowledge and attitudes toward contraception among adolescent females.^ Levels of knowledge of contraception among adolescents are tolerable; however, there is substantial room for improvement. Misperceptions about the side effects and mechanisms of action of contraception are pervasive among this population. Adolescents who have low levels of knowledge regarding contraception tend to discontinue usage or use inconsistently. Attitudes toward contraception are greatly influenced by levels of knowledge. As a result, adolescents tend to develop more positive attitudes as misperceptions are abated. Moreover, clear disparities persist among adolescents with minority and young adolescents being at increased risk of pregnancy, poor contraceptive use, and insufficient knowledge about contraception.^ Understanding the level of knowledge of and attitudes toward contraceptives among adolescents is essential to the development of effective pregnancy prevention programs. In order to effectively reduce adolescent pregnancy, prevention initiatives must target the vulnerable populations and incorporate the necessary cultural components.^
Resumo:
This dissertation examined the impact of acculturation and the influence of the family (specifically parenting practices) on Hispanic youth's sexual behavior and reproductive health and is presented in the form of three papers. In the first paper, we assessed the reliability and validity of the Bicultural Acculturation Scale/Language Proficiency (BAS/LP) subscale for use among Hispanic middle school-aged youth. The purpose of the second paper was to examine the associations between initiation of vaginal intercourse, parental monitoring, and parent-child communication while controlling for acculturation and other recognized covariates. Finally, the purpose of the third dissertation paper was to examine HPV vaccine knowledge, attitudes, and acceptability among Hispanic mothers and girls using strategic focus groups. The three papers will jointly extend the knowledge about Hispanic youth and their parents regarding both sexual initiation and uptake of the HPV vaccine. In addition, findings from the papers can inform the development of interventions for Hispanic youth and their parents to delay sexual initiation and increase HPV vaccine uptake.^
Resumo:
Purpose. The purpose of this study was to determine if the change in Medicaid reimbursements in Texas affected the activity level of the enrolled providers or changed the attitudes of dentists towards Medicaid. ^ Methods. A letter with instructions for completing a survey online was sent to a random sample of 415 general and 325 pediatric dentists (500 dentists originally sampled by Blackwelder plus 240 additional dentists). The survey consisted of 27 questions about Medicaid. ^ Results. Surveys from 98 (13.2%) of dentists were collected, with 57 (17.5%) from pediatric dentists and 37(9%) from general dentists. Our results were compared to the study by Blackwelder et al, which reported attitudes of Texas dentists toward the Medicaid program prior to the reimbursement change. Our data indicates an increase in Medicaid activity among enrolled providers (58.6% activity to 94.8% activity) with greater percent change among pediatric dentists (61.8% to 97.5%) compared to general dentists (53.3% to 80%). Also, the proportion of enrolled active Medicaid providers spending greater then 10% of their time with Medicaid has increased (76.9% to 87.3%). Furthermore, pediatric dentists spending greater then 50% of their time with Medicaid increased from 30.9% to 38.5%, and general dentists from 18.4% to 37.5%. Perceived barriers appear to be similar to past studies. ^ Conclusions. Our survey indicated the change in Medicaid reimbursements did increase the activity level of enrolled Medicaid providers and it appears that active Medicaid providers are spending more time with Medicaid patients.^
Resumo:
HIV incidence has not changed since the introduction of the pandemic. Daily 14,000 persons are infected with HIV and 25 to 50% of the HIV-infected population and subgroups respectively are estimated to be unaware of their HIV diagnosis. Perinatally-infected HIV-positive youth, aged 13-24 years, have survived unexpectedly into adulthood, have had unique HIV disclosure experiences and now face HIV disclosure issues of adulthood and perhaps parenthood. Despite new effective HIV therapies, no HIV prevention plan exists that has diminished the rate of new HIV infections. HIV stigma and lack of universal HIV reporting laws dissuade timely HIV disclosure. Missed HIV disclosure perpetuates HIV transmission and infection. Understanding the attitudes and beliefs of HIV disclosure among perinatally-infected HIV-positive youth and their caregivers may uncover reasons to HIV disclosure delays, avoidance and intentions. The Care to Share HIV Disclosure study was designed to identify the attitudes and beliefs of HIV disclosure among HIV-positve youth (aged 13-24 years), who were infected from birth and who knew their HIV diagnosis, along with their caregivers. Twenty-six participants (15 youth and 11 caregivers) completed the theory-based questionnaires of a 21-item multiple choice survey on HIV disclosure framed in the Theory of Reasoned Action and Theory of Planned Behavior and included an additional open-ended survey that applied the Transactional Model of Stress and Coping to address youth's and caregivers' HIV disclosure experiences. Youth were found to have a selective unfavorable HIV disclosure outcome when among referents of close friends. However youth did believe in HIV partner notification. For caregivers, it mattered who disclosed the HIV illness to the youth. HIV stigma was of concern based on the youths' tendency to believe in keeping HIV a secret and their caregivers' ambivalence to HIV secrecy. However, favorable HIV disclosure outcomes were identified for both youth and caregivers the potential for HIV disclosure: when seeking HIV knowledge, when around caregivers and close family and in situations of perceived controllability as when helping others learn about HIV. These findings unveil HIV disclosure attitudes and beliefs within this population and may reveal the attributes that may inhibit or promote HIV disclosure behaviors. HIV disclosure studies that address attitudes and beliefs among larger populations of youth and HIV-infected persons are necessary to identify effective individual, group and society approaches that would promote timely, responsible and meaningful HIV disclosure methods that promote a healthy identity and interrupt HIV transmission.^
Resumo:
Latinos have the highest teen birth rate nationally. Cameron County, Texas is primarily Latino (Mexican-American). This mixed-method study (n=43) examines Mexican-American parents of adolescents' beliefs, attitudes and practices regarding communication with their adolescent children about sex. Social Cognitive Theory (SCT) constructs self-efficacy, behavioral determinism, environment, outcome expectations and reciprocal determinism can be influences on frequency and quality of parent-adolescent sex communication.^ This study describes Mexican-American parents' of adolescents recollections of their own experiences associated with learning about sexuality. It also examines the attitudes and practices regarding communication about sex and the self-efficacy and behavioral capability of participants to teach their adolescent children about sex and sexually transmitted infections. ^ Negative childhood experiences (shame, lies and trauma) of the parents in this study played a key role in terms of their desire to communicate more comprehensively about sexuality with their own children than did their parents. While participants' reported low self-efficacy and behavioral capability to communicate with their adolescent children about sex, they reported relatively high frequency and quality of communication, with 75% of participants receiving a high quality score and over 44% reporting frequent communication with their adolescent children about sex. A Chi square analysis and Fisher's Exact Score revealed no association between acculturation status, gender or having a child who has mothered/fathered a baby and the frequency or quality of communication about sex with adolescent children. Study participants also gave specific recommendations for method, content and setting of sex education for their children and themselves. Promotora delivery of information and education in a comfortable, culturally appropriate neighborhood setting, as well as parent –child learning sessions were identified as possible approaches to address improve self-efficacy and behavioral capability of parents communicating with their adolescent children about sex.^ The results of this analysis provide public health practitioners and interested community entities data to identify and develop interventions that use a theoretical, evidence-based framework for culturally appropriate interventions to encourage and equip Mexican-American parents to effectively communicate with their adolescent children about sexuality, and ultimately to address the high rates of teen pregnancy in this U.S.-Mexico border community. ^
Resumo:
Perceptions of chief executive officers (CEOs) of Texas Catholic health care institutions regarding the poor and the provision of Catholic health care were the focus for this study. A total of 40 health care administrators were asked to participate in a survey. Thirty-seven CEOs responded, including seven religious superiors, six health system CEOs and 24 hospital CEOs. Survey items concerning Catholic health for the poor centered on obligations and responsibilities of Catholic hospitals, means of achieving those obligations, and assessment of whether hospitals' objectives were being met. In addition, respondents' attitudes and beliefs about poor people in general were examined. Independent variables were CEO type, gender, religious preference, member of a religious order, and educational preparation. For purposes of analysis, most survey items were classified by level of consensus exhibited by respondents. The respondents to this survey agreed on most issues concerning poor people and the provision of Catholic health care. However, there were areas of disagreement particularly in Part I of the survey which dealt with responsibility/obligation, means/methods, and assessment of health care delivery for the poor. ^
Resumo:
Tenth grade students in a lower income neighborhood Houston school were surveyed on violence related beliefs, attitudes, and coping ability. Self-administered questionnaires were used to collect information for scale scores for statistical analysis.^ One hundred twenty six students participated of which 60% were Hispanic, 18% Black, 18% White, 2 American Indians, and 3 Asian/Pacific persons. There were 60 males, mean age 16.03, and 66 females, mean age 15.49. One-half of the sample reported repeating a grade, 53.4% of males, and 47% of females. Females' self-reported grades were slightly higher than males.^ Measures of student acceptance of violence and ability to handle conflict peacefully were studied in relation to student responses to questions about five areas: parental monitoring of the student, parent type of punishment, optimism about future prospects, frustration tolerance, and perceived peer group attitudes and practices.^ Significant gender differences included males having higher violence acceptance scores and females higher on coping with conflict peacefully. No significant race differences or gender interactions were found.^ Females' scores on future orientation were inversely related to their scores on the measure of acceptance of violence. For males, parents' punishment and perceived peer attitudes were positively related to their acceptance of violence, p $<$.0083.^ Female handling of conflict was significantly related to frustration tolerance and optimism; not significant were perceived peer attitudes, parent monitoring or punishment method. For males significantly related to handling conflict were perceived peer attitudes, parental monitoring, and severity of punishment, with the last two terms having a significant interaction effect, and inversely correlated (less monitoring, harsher punishment explained lower ability to handle conflict). ^
Resumo:
African-Americans make up twelve percent of the United States population, yet they experience morbidity and mortality at a rate that, in some cases, is disproportionate to their numbers. There are numerous health areas, including cancer, in which disparities exist. There are also numerous reasons which have been suggested to explain the high rates of cancer morbidity and mortality experienced by African-Americans. Among the reasons given to explain these differences are lack of knowledge and lack of access to medical care (1). This study sought to increase the knowledge, attitudes, and behavioral intentions of African-American women attending a Baptist church in Houston with regard to cervical cancer, breast cancer, Pap smear, and mammography. It was hypothesized that a church-based cancer education program would produce the desired change in knowledge, attitudes, and behavioral intentions.^ The quasi-experimental design of the study was untreated control group with pretest and posttest and untreated control group with posttest only. Female members of Mount Ararat Baptist Church took part in an eight-week, cancer education program based on social cognitive theory. Baseline data were collected before the start of the program at Mount Ararat and at Solid Rock Baptist Church, control group one. At the end of the program, the follow-up survey was administered at the program church, control church one, and in a third church, Damascus Missionary Baptist Church, which served as the posttest only group. The data were analyzed by Fisher's exact and paired t-test to determine if the program supported the project's hypotheses.^ Results of data analyses supported the major study hypotheses, the exception being behavioral intention to have Pap smear performed. Although the program appeared to have generally influenced changes in the desired direction, the results are limited due to the quasi-experimental design and small sample size. Longer term studies with larger sample sizes are needed to more fully develop and evaluate programs which impact the health of African-Americans. ^