Predictive validity of the attitudes toward medical help-seeking scale.

OBJECTIVE: This study examines the predictive validity of the action/intention subscale of the attitudes toward seeking medical help scale in a college sample. PARTICIPANTS: Participants were 51 female undergraduates recruited from psychology classes. Data were collected at two time points between January and April, 2011. METHODS: Students completed the attitudes subscale and a measure of medical contacts twice, over a two month interval. RESULTS: Internal consistency and test-retest reliability of the measure were supported. Correlations between time one attitudes and medical contacts/intentions at time two provide evidence for predictive validity of the measure. CONCLUSION: This relatively brief, psychometrically sound measure of attitudes toward medical help seeking can be used to identify individuals who may be reluctant to seek health care and to assess the effectiveness of health education programs.

Urban ethnic minority women's attendance at health clinic vs. church based exercise programs.

Older, sedentary, urban-living, ethnic minority women are at high risk for preventable disease, but it is difficult to engage this population in health promotion efforts. This study tested two methods of engaging Hispanic and African American women, who were at high risk for cardiovascular disease, in a 10-week aerobic fitness program. The program was offered to 76 participants, in either a women's health clinic or a church. Attendance was the primary dependent variable and was recorded at each exercise session. Other variables, including the Baecke Questionnaire of Habitual Physical Activity, Fat Frequency Questionnaire, Self-Efficacy for Exercise Behaviors Scale, Social Support and Exercise Survey, and Psychological General Well-Being Schedule, were measured prior to the intervention, at the end of the 10-week program, and at 3-month follow-up. Age predicted attendance, independently of site. Women in the highest age quartile (50 - 70 years) attended more than twice as many exercise sessions compared to women in the lowest age quartile (17 - 27 years). The relationship between older age and attendance was particularly strong for Hispanic women. Church parishioners were primarily women over the age of 40, making it impossible to disentangle the relative effect of locale. These findings are relevant for clinicians who design exercise programs targeting older, ethnic, minority women. Administrators who design exercise programs for urban-living women should consider age of the target population when selecting the most conducive setting.

Efficacy and cost-effectiveness of a clinic-based counseling intervention tested in an ethnically diverse sample of pregnant smokers.

OBJECTIVE: Rates of cigarette smoking are higher among women who receive obstetric care through publicly funded prenatal clinics. This study compared smoking outcomes for pregnant women (n=105) who were randomized to receive either usual care (standard cessation advice from the health care provider) or an intervention conducted in the prenatal clinic consisting of 1.5 h of counseling plus telephone follow-up delivered by a masters prepared mental health counselor. METHODS: Subjects were 105 low income, predominantly Hispanic, pregnant patients in an urban prenatal clinic. Smoking outcomes were assessed at end of pregnancy and 6 months post-partum. RESULTS: At follow-up, 28.3% and 9.4% of participants in the experimental intervention and 9.6% and 3.8% of patients in usual care were abstinent at end of pregnancy (p=.015) and 6 months post-partum, respectively (p=.251). Cost of the intervention was $56 per patient and cost to produce a non-smoker at end of pregnancy was $299. CONCLUSIONS: This model for intervention was cost-effective and was associated with significantly lower smoking rates at end of pregnancy. PRACTICAL IMPLICATIONS: If these findings are replicated, prenatal clinics could offer the option for intensive smoking cessation treatment by training mental health counselors to deliver one extended smoking cessation counseling session.

Spontaneous smoking cessation during pregnancy among ethnic minority women: a preliminary investigation.

This study examined the postpartum relapse rates and characteristics of pregnant women who stopped smoking without professional intervention. Baseline characteristics of women who spontaneously quit were compared to women who continued to smoke. Women who spontaneously quit were also randomized to a psychotherapy relapse prevention treatment, or to usual care. The sample was ethnically diverse, containing 141 low-income women who were predominantly Hispanic, 23% (n=33) of whom spontaneously quit smoking. The variables that significantly differentiated between "spontaneous quitters" and ongoing smokers were entered into a regression analysis, which revealed that higher self-confidence, smoking fewer cigarettes per day, and younger age accounted for 25% of the variance in spontaneous cessation. Adding the psychotherapy intervention conferred no additional protection against relapse in this subgroup of spontaneous quitters. The six-month abstinence rate of 36% is similar to that found in Caucasian and higher-income populations. These results extend research with pregnant smokers to a new population and may have implications for healthcare providers and policy makers.

Student nurses view an abortion client: attitude and context effects.

PIP: Two studies of attitudes toward abortion were conducted 1) to determine the effects of religion and personal conviction on attitude, and 2) to determine the amount of stigma attached to an abortion patient. The total sample included 198 student nurses at 3 training hospitals in Connecticut. 191 were women; 62% were Roman Catholic. A "Conflict Situations and Decision-Making" booklet was administered. The booklet told the story of a married women who wants an abortion which is opposed by her husband. The number of children she had and the reasons for the abortion varied in 9 combinations. The booklet was followed by a population and birth planning questionnaire which further developed attitudinal measurement. The reason for wanting the abortion and the number of children most strongly affected evaluation of wife's decision. Frequency of church attendance corresponded negatively to support for wife and was more pronounced for Catholics. The second study utilized a "Personality Impressions" booklet containing several case profiles. 156 student nurses responded attitudinally to an abortion case, a mental patient, and a surgery patient. Personality ratings were more favorable for psychiatric or surgery patient than for an abortion.^ieng