A critical assessment of the National Institutes of Health Consensus Development Program against the eras which shaped it

This research study offers a critical assessment of NIH's Consensus Development Program (CDP), focusing upon its historical and valuative bases and its institutionalization in response to social and political forces. The analysis encompasses systems-level, as well as interpersonal factors in the adoption of consensus as the mechanism for resolving scientific controversies in clinical practice application. Further, the evolution of the CDP is also considered from an ecological perspective as a reasoned adaptation by NIH to pressures from its supporters and clients for translating biomedical research into medical practice. The assessment examines federal science policy and institutional designs for the inclusion of the public interest and democratic deliberation.^ The study relies on three distinct approaches to social research. Conventional historical methods were utilized in the interpretation of social and political influences across eras on the evolution of the National Institutes of Health and its response to demands for accountability and relevance through its Consensus Development Program. An embedded single-case study was utilized for an empirical examination of the CDP mechanism through five exemplar conferences. Lastly, a sociohistorical approach was taken to the CDP in order to consider its responsiveness to the values of the eras which created and shaped it. An exploration of organizational behavior with considerations for institutional reform as a response to continuing political and social pressure, it is a study of organizational birth, growth, and response to demands from its environment. The study has explanatory import in its attempt to account for the creation, timing, and form of the CDP, relative to political, institutional, and cultural pressures, and predictive import thorough its historical view which provides a basis for informed speculation on the playing out of tensions between extramural and intermural scientists and the current demands for health care reform. ^

CIGARETTE SMOKING AMONG HIGH SCHOOL STUDENTS IN RURAL AREAS OF THAILAND

The purpose of this study was to identify the smoking prevalence among high school students in rural areas of Thailand and the factors associated with their smoking habits. The sample population was comprised of 946 volunteer students of both sexes enrolled in the twelfth grade classes of the 1981-82 school year in randomly chosen regional public high schools throughout the country. Data were obtained from a formal self-administered questionnaire survey. The comparisons were treated by classified smoking habits as "non-smoker," "trier," "ex-smoker," and "smoker."^ The study presented the low rate of cigarette smoking habits among female students, compared to male students. Significant differences of smoking-related habits were found among those who had exemplar models for smoking habits; fathers, siblings and peers were their reference groups. Parental approval was found to be a significant factor associated with students' smoking habits. The awareness of health hazards, the perceptions of the influence of cigarette advertisement, and the attitudes toward the concerns of government in cigarette manufacturing were also factors associated with cigarette smoking habits of high school subjects. ^