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Health Education Research - current issue

Moderators and mediators of behaviour change in a lifestyle program for treated hypertensives: a randomized controlled trial (ADAPT)
Burke, V., Beilin, L. J., Cutt, H. E., Mansour, J., Mori, T. A. Tue, 08 Jul 2008 00:00:00 -0000
We aimed to examine moderators and mediators of behaviour change in a cognitive lifestyle program for drug-treated overweight hypertensives in Perth, Australia. We collected data at baseline, 4 months (post-intervention) and 1-year follow-up in a randomized controlled trial of a program that focused on weight loss, diet, and exercise. Mediation analysis used regression models that estimate indirect effects with bootstrapped confidence limits. Outcomes examined were saturated fat intake (% energy) and physical activity (hours per week). In total, 90/118 individuals randomized to usual care and 102/123 to the program-completed follow-up. Sex was a moderator of response post-intervention for diet and physical activity, with a greater response among women with usual care and among men with the program. Change in self-efficacy was a mediator of dietary change post-intervention [effect size (ES) –0.055, 95% confidence interval (CI) –0.125, –0.005] and at follow-up (ES 0.054, 95% CI –0.127, –0.005), and in physical activity post-intervention (ES 0.059, 95% CI 0.003, 0.147). These findings highlight different responses of men and women to the program, and the importance of self-efficacy as a mediator. Mediators for physical activity in the longer term should be investigated in other models, with appropriate cognitive measurements, in future trials.
Storage of household firearms: an examination of the attitudes and beliefs of married women with children
Johnson, R. M., Runyan, C. W., Coyne-Beasley, T., Lewis, M. A., Bowling, J. M. Tue, 08 Jul 2008 00:00:00 -0000
Although safe firearm storage is a promising injury prevention strategy, many parents do not keep their firearms unloaded and locked up. Using the theory of planned behavior as a guiding conceptual framework, this study examines factors associated with safe storage among married women with children and who have firearms in their homes. Data come from a national telephone survey (n = 185). We examined beliefs about defensive firearm use, subjective norms, perceived behavioral control and firearm storage practices. A Wilcoxon–Mann–Whitney test was conducted to assess associations between psychosocial factors and firearm storage practices. Women were highly motivated to keep firearms stored safely. Those reporting safe storage practices had more favorable attitudes, more supportive subjective norms and higher perceptions of behavioral control than those without safe storage. One-fourth believed a firearm would prevent a family member from being hurt in case of a break-in, 58% believed a firearm could scare off a burglar. Some 63% said they leave decisions about firearm storage to their husbands. Women were highly motivated to store firearms safely as evidenced by favorable attitudes, supportive subjective norms and high perceptions of behavioral control. This was especially true for those reporting safer storage practices.
Will patients agree to have their literacy skills assessed in clinical practice?
Ryan, J. G., Leguen, F., Weiss, B. D., Albury, S., Jennings, T., Velez, F., Salibi, N. Tue, 08 Jul 2008 00:00:00 -0000
If health providers are aware of their patients' literacy skills, they can more appropriately tailor their communication with patients. Few providers, however, assess patient's literacy skills for fear of offending patients, but no research has ever determined if patients object to such assessments. Our objectives were to determine the percentage of patients seen for routine health care that would agree to undergo literacy assessment and if satisfaction of patients differs in practices that perform literacy assessments versus practices that do not. We randomized 20 private and public medical practices to an intervention group that implemented literacy assessments with the Newest Vital Sign and a control group that did not. For intervention practices, we noted the percentage of patients agreeing to undergo the assessment. For both intervention and control practices, we assessed patient satisfaction. Of 289 patients asked to undergo literacy assessment in the intervention practices, 284 (98.3%) agreed to do so, including 125 (46.1%) with low or possibly low literacy skills. There was no difference in satisfaction between the intervention group and the control group. We conclude that patients are willing to undergo literacy assessments during routine office visits and performing such assessments does not decrease patient satisfaction.

Public Health News From Medical News Today

Link Found Between Bisphenol A And Metabolic Syndrome In Human Tissue
Sun, 07 Sep 2008 07:00:00 -0700
New research from the University of Cincinnati (UC) implicates the primary chemical used to produce hard plastics - bisphenol A (BPA) - as a risk factor for metabolic syndrome and its consequences. In a laboratory study, using fresh human fat tissues, the UC team found that BPA suppresses a key hormone, adiponectin, which is responsible for regulating insulin sensitivity in the body and puts people at a substantially higher risk for metabolic syndrome.
Serious Injury In Children Prevented By Both Child Safety Seats And Lap-And-Shoulder Seat Belts
Sun, 07 Sep 2008 06:00:00 -0700
For young children, all states currently require the use of child safety seats, and the minimum age and weight requirements to graduate to seat belts has been increasing over time. A new study in the journal Economic Inquiry reveals that lap-and-shoulder seat belts perform as well as child safety seats in preventing serious injury. However, safety seats tend to be better at reducing less serious injuries. Steven D.
New Think Tank Tackles Health Policy And Professionalism Issues - Indiana University School Of Medicine And Riley Hospital For Children
Sun, 07 Sep 2008 00:00:00 -0700
Quick turnaround research on the hottest topics of the day related to health policy, medical professionalism, medical education, and physician practice is the goal of the Center for Health Policy and Professionalism Research (CHPPR), recently created as an innovative think tank at the Indiana University School of Medicine and Riley Hospital for Children.

Public Health News Headlines from Johns Hopkins

Malaria Researchers Identify New Mosquito Virus
tmparson@jhsph.edu (Office of Communications) Fri, 22 Aug 2008 12:00:00 -0400
Researchers at the Johns Hopkins Bloomberg School of Public Health?s Malaria Research Institute have identified a previously unknown virus that is infectious to Anopheles gambiae?the mosquito primarily responsible for transmitting malaria. According to the researchers, the discovered virus could one day be used to pass on new genetic information to An. gambiae mosquitoes as part of a strategy to control malaria, which kills over one million people worldwide each year.
De Beers African Health Scholars Named
nwoodwri@jhsph.edu (Office of Communications) Thu, 24 Jul 2008 15:00:00 -0400
De Beers African Health Scholars Named
Older Patients More Satisfied with Care When Accompanied to Medical Visits
paffairs@jhsph.edu (Office of Communications) Mon, 14 Jul 2008 16:30:00 -0400
A study by researchers at the Johns Hopkins Bloomberg School of Public Health found that 38 percent of Medicare beneficiaries are accompanied to routine medical visits. These accompanied beneficiaries tended to be older, sicker and less educated but more satisfied with their health care provider compared to unaccompanied patients. The study is published in the July 14 edition of Archives of Internal Medicine.

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