The feasibility of a web-based surveillance system to collect health risk behavior data from college students.

This study examined the feasibility of collecting health risk behavior data from undergraduate students using a Web-based survey. Undergraduates were randomly selected and assigned randomly to a mail survey group and a Web survey group. There were no statistically significant differences between the two groups for demographics, response rates, item completion, and item completion errors. Yet differences were found for response time and sensitive item completion. This is the first study to demonstrate the feasibility of collecting health risk behavior data from undergraduates using the Web. Undergraduates are just as likely to respond to a Web survey compared with a mail survey and more likely to answer socially threatening items using this method. Also, the Web format and protocol required less time to administer. Researchers and practitioners conducting health survey research with college students or other homogeneous populations who have access to e-mail and the Web should consider using a Web-based survey design as an altemative to a mail, self-administered survey. In such a population, a Web-based survey should not discourage participation, particularly if participants are interested in the questionnaire content.

Graduating medical students' exercise prescription competence as perceived by deans and directors of medical education in the United States: implications for Healthy People 2010.

OBJECTIVES: This study examined perceptions of deans and directors of medical education at 128 allopathic schools of medicine in the US about the importance of physical activity and exercise topics, and their perceptions about the competence of graduating medical students to perform six fundamental skills related to exercise prescription. Healthy People 2010 recommends that clinicians counsel all patients about regular physical activity. However, in previous studies physicians identified lack of training as a barrier to physical activity counseling, and they questioned their own ability to advise patients properly. METHODS: Using the 17-item Exercise and Physical Activity Competence Questionnaire, data were collected from 72 of 128 medical schools, for a response rate of 56%. RESULTS: While 58% of respondents indicated their typical graduate was competent in conducting a patient evaluation for the purpose of approving that patient to begin an exercise program, only 10% said their students could design an exercise prescription. Only 6% of respondents reported that their school provided a core course addressing the American College of Sports Medicine Guidelines for Exercise Testing and Prescription. CONCLUSIONS: Findings suggest a need for more undergraduate medical training in physical activity and exercise prescription.

The SiteLegend: twelve components of a new strategy for providing website documentation.

The World Wide Web continues to evolve dramatically with an estimated 57 million users in the United States. Some two-thirds of Internet users in the United States searched for health information the past year, with 90% indicating they found the information they sought. Thus, health and medical information represents the single most popular topic on the Web, surpassing all other categories. Yet, few measures exist to ensure the accuracy of information provided to children and adults through such sites. Some existing quality control measures such as assessment instruments, authoritative guidelines, and seal of approval systems provide screening mechanisms, but none of these measures guarantees protection for users. This article proposes a new approach to ensuring full and accurate disclosure of information about a website. Referred to as a SiteLegend, the approach uses a hyperlink to fully inform consumers regarding 12 essential components of website. This article describes each of the 12 essential components, then provides an example of an active online link that illustrates actual use of the SiteLegend hyperlink approach.

An evaluation of client satisfaction with training programs and technical assistance provided by Florida's Coordinated School Health Program Office.

Client or customer satisfaction surveys assess the perceived quality of programs, products, services, and employee performance. Such assessments prove beneficial for evaluation and planning purposes. This survey examined the satisfaction of clients using the programs, services, and technical assistance provided through the Coordinated School Health Program Office (CSHPO) in the Florida Department of Education. Using the 42-item Client Satisfaction Survey, data were collected in summer 1999 from 300 of 574 clients (52.3%) who attended training sessions or sought technical assistance from CSHPO during 1996-1999. More than two-thirds (67.2%) of clients rated the training program as "very good" or "excellent" at increasing their understanding about the concept of a coordinated school health program. Overall, 69.7% of clients rated the training programs they attended as "very good" or "excellent." Resource materials and staff effectiveness rated positively as well. Findings confirmed client satisfaction with CSHPO's training programs, technical assistance, and staff. Information obtained through the client satisfaction survey can be used by CSHPO to assist in future program planning and resource allocations.

The Florida School Violence Policies and Programs Study.

The Florida School Violence Policies and Programs Study (FSVPPS) assessed characteristics of violence prevention and control policies and education programs in Florida's 67 public school districts. Data were collected using the Florida School Violence Policies and Programs Questionnaire (FSVPPQ). Instruments used in the national School Health Policies and Programs Study (SHPPS) served as the framework for item development. A questionnaire designed to solicit information about violence policies and education programs was mailed to all 67 school districts in Florida during spring 1996. Sixty-seven key informants were selected by asking district office personnel to identify the person with primary responsibility for violence prevention activities in their district. Fifty-five school districts returned completed questionnaires, yielding a usable response rate of 82%. Respondents included personnel of superintendent rank, district administrators and directors, instructional specialists, principals, and "Safe & Drug Free Schools" coordinators. Participating school districts were evenly distributed geographically across Florida. The FSVPPS data reported in this paper include administrative and programmatic information about violence prevention education.

Home health care workers' attitudes toward the elderly.

This study examined home health care workers' attitudes toward the elderly and their elderly clients. Data were collected from a convenience sample of 106 home health care workers in South Central Florida in October 1994, using the Attitudes Toward the Elderly Questionnaire (ATE). Estimated internal consistency reliability of the scale was .60, using Cronbach's alpha. Findings suggest that home health care workers have positive attitudes toward the elderly, their elderly clients, and provide a reasonable level of service for them. Also, findings suggest that overall the attitudes and perceptions among urban and rural home health care workers are similar.

Adolescents' perceptions of health concerns: an exploratory study among rural midwestern youth.

This exploratory investigation examined health concerns of adolescents and their perceptions of their peers' health concerns. Data were collected from a convenient sample of 419 high school students in rural southern Illinois in May 1990, using the Adolescent Health Concerns Inventory (AHCI). The AHCI contains 150 health-related items, grouped into 12 topical subscales. Analysis of the 150 items found statistically significant differences for all but 2 items: use of alcohol and acne. Analysis of the 12 subscales found that students believed other teenagers were concerned more about issues related to substance use and abuse, human sexuality, and personal health than about the issues they reported as concerns for themselves or their best friends. These findings indicate what health issues students are personally concerned about. They also suggest that students believe their personal health concerns differ from the health concerns of their best friends and other teenagers.

Creating a virtual materials and resources index for health education using the World Wide Web.

The Internet represents the principal system for distributing information worldwide, offering health educators a powerful communications medium. This article describes an assignment that teaches students how to use the World Wide Web (WWW). The first part provides an overview of the Internet, its principal services. browser software, and Netscape Navigator. The second part describes the assignment, complete with instructional objectives, computer facilities used to implement the strategy, and a summary of classroom and laboratory activities. The third part describes procedures for teaching students how to use the WWW. Students learn how to explore the WWW and to develop a customized virtual directory of health materials and resources using Netscape Navigator Bookmark tools. Recommendations on how the approach can be modified are offered.

Development of the Adolescent Health Concerns Inventory.

Health concerns of adolescents are important factors to consider when developing and implementing school health education programs. In addition, an understanding of adolescent concerns compared to their teachers' and parents' beliefs about adolescents' concerns may enhance communication between adolescents and adults. Despite the need to identify the health concerns of adolescents and beliefs about them among parents and teachers, few instruments exist. The inventory described in this article is one approach to assessing adolescent health concerns. Three forms of the Adolescent Health Concerns Inventory (AHCI) were developed to assess: (1) the health concerns of adolescents, (2) teachers' beliefs about adolescent health concerns, and (3) parents' beliefs about adolescent health concerns. The final version of the instrument contained 150 health-related items grouped into 12 topical subscales. Reliability estimates for the 12 subscales as measured by Cronbach's alpha ranged from .76 to .92. A panel of experts was used to assess content validity. Construct validity was assessed using principal components factor analysis. All items were positively loaded on factor 1. Readability was estimated at the eighth grade as measured by the SMOG readability formula. Psychometric characteristics of the instrument and recommendations for the use of the ACHI are presented.

[Risk estimates of tuberculosis infection in BCG-vaccinated populations]. / Estimativa do risco de infecção tuberculosa em populações vacinadas pelo BCG.

The revaccination of schoolchildren can restore the residual allergy induced by vaccination in the first years of life but can not modify the allergy resulting from a natural infection. So revaccination in this population should indicate the group infected by the Koch bacilli. To assess the applicability of these assumptions in estimating the risk of tuberculosis infection in regions with high BCG coverage a study was undertaken on schoolchildren between 6 and 9 years of age who were attending the municipal schools in the east zone of S. Paulo City, in the course of the first semester of 1988. Of 11,455 who were vaccinated only 7,470 were tested with PPD, revaccinated and retested ten weeks later; 3,314 of these were vaccinated in the first trimester of life with a half dose and 4,156 received a full dose at later ages (75% during the first year, 20% during the second and 5% during the third). In comparing the results pre and post vaccination by correlation table, the calculation of infection was made according to the criteria of the original method and to the modifications made by the authors under separate cover for those vaccinated in the first trimester and those vaccinated later. The risk of infection was 0.35% and 0.37%, respectively, for the original model and 0.45% and 0.49% for the modified model. The referential was 0.55%. The difference between model and age or with the referential was not significant (p > 0.005). Data suggest that the method is applicable to estimate the risk of tuberculosis infection in schoolchildren vaccinated with a full dose of BCG during the first year of life.

[Estimate of the prevalence of tuberculosis infection among vaccinated school-children by the Bhattacharya's method]. / Estimativa da prevalência de infecção tuberculosa em escolares vacinados com BCG, por meio de método de Bhattacharya.

The successful application of Bhattacharya's method (decomposition of frequency distribution into normal components by a graphic method) in the analysis of the results of tuberculin test performed on a population sensitized by "anonymous" strains of mycobacteria, suggested the possibility of its application to two samples of BCG vaccinated school-children, living in the city of S. Paulo (Brazil). One of the sample groups, vaccinated between the second and seventh years of life, was surveyed in 1982 and the other, vaccinated during the first year of life, was surveyed in 1988. In both populations it was possible to characterize the normal component corresponding to children infected by tuberculous bacilli and to quantify them. In the first one, the average size of the reactions was 17.40 mm, the standard deviation 3.72 mm and the proportion of infected children 7.71%, against 4.85% in the unvaccinated control group; otherwise, in the population surveyed in 1988, the average size was 17.00 mm, the standard deviation 4.67 mm and the proportion of infected children amounted to 4.14% against 4.48% in the control group. It is concluded that the method permits the estimation of the prevalence of tuberculosis infection among BCG-vaccinated school-children, provided that the vaccine has been given during the first year of life.

Rural home health care workers' attitudes toward the elderly: a replication study.

We collected data from 548 rural home health care workers in Southern Illinois in 1990 to replicate a study conducted in 1988 designed to identify and assess the attitudes of those workers toward the elderly and their elderly clients. Subjects were asked to respond to a fifteen item, self-report questionnaire. Reliability of the scale was estimated at .79, using Cronbach's alpha. Readability was estimated at the sixth-grade reading level as measured by the SMOG Readability Formula. Chi-square statistics were used to determine whether there were any differences between the 1988 and 1990 data sets, with a significance level of .003, using the Bonferroni correction procedures. Results were similar for both the 1988 and 1990 data sets. For example, whereas 31.8% of the 1988 respondents agreed with the statement: "most of my clients are pretty much the same," 30.5% of the 1990 respondents agreed. The findings from this study indicate that attitudes toward the elderly among this population of home health care workers have remained relatively consistent over this two year period.

Diagnóstico e encaminhamento para tratamento de casos de tuberculose, numa área do Município de Säo Paulo; resumo

Os autores, integrados com o Distrito Sanitário de Santo Amaro (Secretaria de Saúde do Estado de Säo Paulo), estäo realizando um trabalho de investigaçäo e encaminhamento para tratamento de casos de tuberculose. O objetivo é contribuir para a descoberta de casos de tuberculose em sintomáticos respiratórios adultos, através de exame baciloscópico de escarro, nos Postos de Atendimento Médico, do Departamento de Saúde da Comunidade, Regiäo Sul. Demonstram que é possível, apenas com os recursos a nível local, viabilizar um projeto de aumento da atuaçäo dos Postos de Atendimento Médico da Prefeitura de Säo Paulo, nos programas de Saúde Pública