Investigating the use of social media to help women from going back to smoking post-partum.

OBJECTIVE: To investigate the social factors that would help women who had quit smoking due to pregnancy from returning to smoking after delivery of their baby. METHODS: Women who attended their first antenatal check-up at a general public hospital were invited to participate in pre- and postpartum interviews. RESULTS: A total of 24 women were interviewed pre- and postpartum. They reported isolation as a factor that influenced how they dealt with stress. This stress was linked to relapse. The use of electronic media through the Internet was a way women could interact with the outside community without having to leave home. CONCLUSIONS: Women who had strong family relationships in geographic proximity were not as likely to use the computer to interact with relatives and friends. Women who did not have strong local and family ties that support their desire to not go back to smoking, reported using Facebook and other Internet activities to keep in touch while they stayed at home with their new infant. IMPLICATIONS: The use of electronic media may help facilitate interaction between new mothers, which could prevent isolation and relapse back to smoking after delivery. This mechanism might also be used to enhance skill-development and problem-solving by these women.

Social support patterns of collegiate athletes before and after injury.

CONTEXT: Social support has been identified as an important factor in facilitating recovery from injury. However, no previous authors have prospectively assessed the change in social support patterns before and after injury. OBJECTIVE: To examine the preinjury and postinjury social support patterns among male and female collegiate athletes. DESIGN: Prospective observational study. SETTING: A Big Ten Conference university. PATIENTS OR OTHER PARTICIPANTS: A total of 256 National Collegiate Athletic Association Division I male and female collegiate athletes aged 18 or older from 13 sports teams. MAIN OUTCOME MEASURE(S): Injury incidence was identified using the Sports Injury Monitoring System. Social support was measured using the 6-item Social Support Questionnaire. Data on preinjury and postinjury social support patterns were compared. RESULTS: Male athletes reported more sources of social support than female athletes, whereas female athletes had greater satisfaction with the support they received. Athletes' social support patterns changed after they became injured. Injured athletes reported relying more on coaches (P = .003), athletic trainers (P < .0001), and physicians (P = .003) for social support after they became injured. Athletes also reported greater postinjury satisfaction with social support received from friends (P = .019), coaches (P = .001), athletic trainers (P < .0001), and physicians (P = .003). CONCLUSIONS: Our findings identify an urgent need to better define the psychosocial needs of injured athletes and also strongly suggest that athletic trainers have a critical role in meeting these needs.

Using the theory of planned behavior to predict mothers' intentions to vaccinate their daughters against HPV.

This study assessed mothers' intentions to vaccinate their daughters against human papillomavirus (HPV) using the theory of planned behavior (TPB). Experience with sexually transmitted infections (STIs), beliefs about the vaccine encouraging sexual activity, and perception of daughters' risk for HPV were also examined for a relationship with intention. A random sample of mothers in a rural, Midwestern state were mailed a survey with questions pertaining to the intention to vaccinate. Attitudes were the strongest predictor of mothers' intentions to vaccinate, but intentions were not high. Subjective norms also influence intention. Mothers' risk perceptions, experience with STIs, and beliefs about the vaccine encouraging sexual activity were not related to intention. Mothers' perceptions of the daughters' risks for HPV were surprisingly low. This research provides a foundation for designing interventions to increase HPV vaccination rates. Further research should explore ways to influence mothers' attitudes and to uncover the referent groups mothers refer to for vaccination behavior.

Paths to leisure physical activity among adults with intellectual disabilities: self-efficacy and social support.

PURPOSE: This study tested a path model that included perceptions of social support and self-efficacy for leisure physical activity and leisure physical activity participation among adults with intellectual disabilities. DESIGN: A cross-sectional design was used. Data was collected via oral interview. SETTING: Community-based group, supported-living settings in one Midwestern state. SAMPLE: A total of 152 adults with mild to moderate intellectual disabilities, which provided a 39% response rate. MEASURES: Self-efficacy and social support (from family, residential staff and peers with disabilities) for leisure physical activity were assessed using self-reported scales. Leisure physical activity participation was measured with a self-reported checklist of the frequency of leisure physical activity participation. ANALYSIS: Path analysis was conducted for the entire sample and was repeated for younger and older age groups. RESULTS: The hypothesized model fit the data from each group. Social support and self-efficacy predicted physical activity participation, and self-efficacy served as a mediator between social support and physical activity. Significant sources of social support differed between groups; among younger participants, social support from family predicted physical activity, whereas, for the older group, social support from staff and peers predicted physical activity. CONCLUSION: Self-efficacy and social support for leisure physical activity are related to leisure physical activity participation among adults with intellectual disabilities who are receiving supported-living services. The results provide information to guide health promotion programs for this group.

Empowerment and sense of community: clarifying their relationship in community organizations.

The research reported here tested the factor structure of a measure for sense of community in community organizations, and it evaluated sense of community's potential as an empowering organizational characteristic within an organizational empowerment framework. Randomly selected community organization participants (N=561) were surveyed as part of a study of a substance abuse prevention initiative located in the northeastern United States. Confirmatory factor analysis verified the putative structure of the sense of community measure tailored to community organizations. Hierarchical regression analyses indicated that community organization sense of community significantly predicted intrapersonal empowerment after controlling for demographics, participation, alienation, and other empowering organizational characteristic. Findings imply that organizational sense of community should be considered as an empowering organizational characteristic in community-based health education.

Diagnosis and management costs of suspicious skin lesions from a population-based melanoma screening programme.

BACKGROUND: Recently, massive increases in health-care costs for the diagnosis and management of skin lesions have been observed (2000-05). The aim of this study was to describe the health system costs attributed to the diagnosis and management of suspicious skin lesions detected during a trial of a population melanoma screening programme (1998-2001). SETTING: Queensland, Australia. METHODS: Data from the trial and Medicare Australia were used to categorize and cost all suspicious skin lesions arising from the trial, which included general practitioner consultations, diagnosis/management and pathology. Comparisons were made with other screened and unscreened populations. RESULTS: Overall, 2982 lesions were treated within the trial producing a mean cost of Aus$118 per lesion. Excisions for benign lesions contributed the greatest proportion of total costs (45%). The total cost burden was approximately 10% higher for men than women, and 63% of overall costs were for persons aged >or=50 years. For diagnosis and management procedures, the estimated average cost per 1000 individuals was Aus$23,560 for men aged >or=50 years from the skin cancer screening trial, compared with Aus$26,967 for BreastScreen Australia and Aus$3042 for the National Cervical Screening Program. CONCLUSIONS: The proportion of costs for benign skin lesions and biopsies arising from the screening programme were no higher than in the two-year period outside the trial. While comparisons are difficult, it appears that diagnostic and management costs for skin cancer as a result of screening may be comparable with those for BreastScreen Australia, if screening is targeted at men aged >or=50 years.

The relationship between active living and health-related quality of life: income as a moderator.

This study used a moderator model to examine the relationship between active living and the physical components of health-related quality of life [i.e. overall physical component of quality of life (PQOL), physical functioning and ability to fulfill physical role] among a randomly selected sample of rural residents (n = 407) from the Midwestern US. Results showed that active living was associated with greater increases in health-related quality of life for those reporting lower income. The effect size of the relationship between active living and the PQOL for the low-income group was over 2 times the effect size for the high-income group. For physical functioning, the effect size of active living for the low-income group was greater than 3 times the effect size for the high-income group. Although active living behaviors have been demonstrated to be less prevalent among those of low socioeconomic status, this group may have the most to gain from these activities. Findings highlight the need for increased and specifically targeted promotion of active living interventions.

Australian public and smallpox.

A national survey of 1,001 Australians found that most were concerned about a bioterrorist attack and were ill-informed about smallpox prevention and response. Since general practitioners were commonly identified as the initial point of care, they should become a focus of bioterrorism response planning in Australia.

Tobacco outlet density, cigarette smoking prevalence, and demographics at the county level of analysis.

The geographic associations between tobacco outlet density, cigarette smoking prevalence, and demographic variables at the county unit of analysis were examined. End of year 2002 data were derived from licenses of 4745 tobacco selling retail outlets in all 99 Iowa counties. The 2000 census and the 2002 Iowa Behavioral Risk Factor Surveillance System (IBRFSS) were used to gather data for demographic variables and smoking prevalence rates. The IBRFSS telephone interviews were conducted from January through December in 2002 with a random sample of 3662 Iowa residents. As expected, results showed that counties with higher density of tobacco outlets and smoking prevalence also tended to have a higher percentage of minority residents. Contrary to previous studies, however, counties with higher tobacco outlet density and smoking prevalence also tended to have higher median household income. Findings are discussed in light of the state's low income inequality. Implications of the study and directions for future research are discussed.

Tobacco outlet density and demographics at the tract level of analysis in Iowa: implications for environmentally based prevention initiatives.

This study assessed the geographic association between tobacco outlet density and three demographic correlates-income, race, and ethnicity-at the tract level of analysis for one county in the Midwestern United States. Data for residential census tracts in a Midwestern U.S. county were derived from year 2003 licenses for 474 tobacco outlets. Demographic variables were based on 2000 census data. Census tracts with lower median household income, higher percent of African American residents, and higher percent of Latinos residents had greater density of tobacco selling retail outlets. Areas characterized by lower income and disproportionately more African Americans and Latinos have greater physical access to tobacco products. Physical access to tobacco is a critical public-health issue because, given that smokers have been shown to be price sensitive, lowering access costs (e.g., reduced travel time) is likely to increase consumption. Findings also suggest the need for structural or environmental interventions, i.e., tobacco outlet zoning laws, to mitigate the health consequences associated with tobacco use in certain populations and geographic regions.

Comparability of skin screening histories obtained by telephone interviews and mailed questionnaires: a randomized crossover study.

The comparability of information collected through telephone interviews and information collected through mailed questionnaires has not been well studied. As part of the first phase of a randomized controlled trial of population screening for melanoma in Queensland, Australia, the authors compared histories of skin examination reported in telephone interviews and self-administered mailed questionnaires. A total of 1,270 subjects each completed a telephone interview and a mailed questionnaire 1 month apart in 1999; 564 subjects received the interview first, and 706 received the mailed questionnaire first. Agreement between the two methods was 91.2% and 88.6% for whole-body skin examination by a physician in the last 12 months and the last 3 years, respectively, and 81.9% for whole-body skin self-examination in the last 12 months. Agreement was lower for "any" skin self-examination. Agreement between the two methods was similar regardless of whether the interview or the questionnaire was administered first. Missing data were less frequent for interviews (0.5%) than for mailed questionnaires (3.8%). Costs were estimated at A$9.55 (US$6.21) per completed interview and A$3.01 (US$1.96) per questionnaire. The similarity of results obtained using telephone interviews and mailed questionnaires, coupled with the substantially higher cost of telephone interviews, suggests that self-administered mailed questionnaires are an appropriate method of assessing this health behavior.

Efficacy and effectiveness of the smoking cessation program for pregnant women.

OBJECTIVES: The aim of randomized trial was to evaluate the effectiveness of anti-smoking counseling in the population of pregnant women from the maternity centers in Lódz, central Poland. MATERIALS AND METHODS: One hundred and forty nine current smokers and 56 spontaneous quitters were randomized into the smoking cessation intervention and 144 current smokers and 37 spontaneous quitters were included in the control group. The intervention program covered four midwife visits during pregnancy and one after delivery. The control units received standard written information about the health risk from maternal smoking to the fetus. RESULTS: The chance of quitting smoking by the women was significantly higher in the intervention group than in the control group (OR = 2.5; 95% CI 1.8-3.7). The difference in the mean infant birthweight between the quitters and non-quitters was 203.8 g (p = 0.01) in the intervention group and 198.2 g in the control group (p = 0.08). After controlling for socio-demographic characteristics that could affect the birthweight, the differences remained significant in the intervention group - 182.8 g (p = 0.02), whereas in the control group it was 92.4 g (p = 0.4). CONCLUSIONS: The midwife-assisted smoking cessation intervention seems to be an effective tool to help pregnant smokers make a decision to quit smoking.

Sunburn in Australian men with a history of non-melanoma skin cancer.

OBJECTIVE: To identify predictors of recent sunburn in north Australian men with a history of non-melanoma skin cancer (NMSC). METHODS: A survey of men with previous NMSC was conducted (n = 300, response rate 62%). RESULTS: Fifty-four percent of participants reported recent sunburn. Predictors identified included younger age, belief that NMSC is caused by childhood sun exposure, belief that sun protection will not help prevent further NMSC, wearing of casual clothes, and use of shade as the main sun-protection strategy. CONCLUSION: Health promotion messages should emphasize the importance of sun protection throughout life and the use of stringent sun-protection measures.

Smoking-cessation services in Iowa community pharmacies.

STUDY OBJECTIVE: To examine community pharmacy practice with regard to providing smoking-cessation counseling. DESIGN: Mailed survey. SETTING: Iowa community pharmacies. PARTICIPANTS: A stratified random sample of pharmacists statewide. MEASUREMENTS AND MAIN RESULTS: Descriptive statistics were computed for all study variables. Fisher exact test or chi2 analysis was performed on selected variables to determine the relationship of each item with pharmacists routinely offering smokers suggestions for quitting. Responses from 129 (38.2%) of 338 pharmacists indicated that although most felt it is important to offer smoking-cessation counseling, about half actually offer this service. Most pharmacists indicated they are prepared to provide counseling, but fewer than 25% had received formal training or were aware of national clinical practice guidelines. Those who had received specific training (p=0.020) or recently attended an educational program (p=0.014) on smoking cessation were more likely to counsel smokers. Primary barriers to providing counseling were lack of time, inability to identify smokers, low patient demand, and lack of reimbursement. CONCLUSION: Our findings suggest that opportunities exist for improving pharmacist education and reducing practice barriers in order to bridge the gap between pharmacists' knowledge and attitudes related to smoking-cessation counseling and their provision of patient counseling in community pharmacy practice.

The needs of cancer patients and their families from rural and remote areas of Queensland.

This study examines the impact of travelling for treatment on cancer patients and their families. Twenty-eight consecutive cancer patients, who were receiving radiation therapy treatment and 19 family carers, completed a structured needs assessment questionnaire and an in-depth interview. Both patients and carers reported moderate to high levels of unmet psychological need. Carers were found to have higher levels of anxiety than patients, although both groups had higher anxiety levels than the general population. Taking more responsibility for household tasks and organising new living arrangements for the family were the most frequently identified demands of a dual burden of caring. Nearly 40% of carers reported some disruption to their schedule and half reported experiencing financial difficulties. The qualitative interviews highlight the disruption that parents and children experience under the present system, particularly in relation to the demands of family life and the need to maintain some level of continuity and security for children.