American journal of preventive medicine
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The Richmond Youth Against Violence Project teaches middle school students in the Richmond Public Schools knowledge, attitudes, and skills for reducing their involvement in violence. These students are primarily African Americans, many of whom come from low-income, single-parent households in neighborhoods with high rates of crime and drug use. The program, "Responding in Peaceful and Positive Ways," employs a developmentally anchored health promotion model. ⋯ Many have also engaged in risk behaviors; 70% of the boys and 44% of the girls reported being in a fight in the preceding 30 days. The impact of the curriculum is being examined. The program has provided valuable lessons about conducting community-based research, particularly designing, implementing, and evaluating prevention programs.
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Race, ethnicity, and gender are significant indicators of occupational status, general health status, and thus, occupational health status. Although African-American women constitute only 6.8% of the total U. S. labor force, they hold 20% of the jobs in the health care industry and are disproportionately represented in those jobs that have the highest levels of workplace exposure to hazards. ⋯ In order to gain insight into the effects of race and gender on the occupational health status of African-American women health care workers, this article uses three data sources that provide different but complementary sources of information on the demographic characteristics of workers, location of categories of occupations, working conditions of jobs, and other job and worker characteristics. Given the concentration of African-American women in health care positions where there exists a greater likelihood of being exposed to occupational hazards, it is therefore both logical and appropriate for primary care physicians, especially those engaged in office-based practices, to identify this target population for special services and to be more aware of the type of health issues with which these patients are more likely to present and to experience during their working lives. Health care providers have a responsibility to assess occupational factors related to a patient's health problems and to incorporate this information into their treatment protocols and into the design and explanation of each patient's care plan.
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Randomized Controlled Trial Clinical Trial
Evaluation of a hospital-based youth violence intervention.
To decrease adolescent morbidity and mortality and improve the quality of life, a violence-prevention consultation is offered to hospitalized victims of nondomestic violence. The context is a violence-prevention team approach to patient assessment, treatment, and follow-up. Psychoeducational counseling emphasizes the individual through a cognitive behavioral approach and also recognizes the individual in the proximal social setting through referrals to community resources. ⋯ No statistically significant differences between intervention subjects and nonintervention controls in terms of baseline variables have been observed. For inner-city adolescent victims of violent assaults, a hospital-based intervention offers a unique opportunity for reduction of the incidence of reinjury. We describe the elements of the intervention, including the theoretical basis and implementation; detail the overall evaluation design including modifications; and present preliminary analyses of baseline data.
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Previously published reports strongly suggest that being overweight is a risk factor for coronary heart disease, hypertension, diabetes, gallstones, and osteoarthritis in women. Substantial health care and medication costs are associated with these chronic health conditions. We used an incidence-based analysis to estimate the excess costs associated with women maintaining an overweight status during the 25-year period from age 40 to 65 years. ⋯ The results of this study indicate that an estimated $16 billion will be spent during the next 25 years treating health outcomes associated with overweight in middle-aged women in the United States. Thus, a substantial health burden is associated with the increasing prevalence of overweight women in the United States. Preventing excess coronary heart disease, gall-stones, osteoarthritis, hypertension, and diabetes through prevention of weight gain, particularly among reproductive-aged women, may be a cost-effective strategy.
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Self Enhancement, Inc., is a grassroots, community-service organization working in the most disadvantaged high-risk community in Portland, Oregon. Its violence-prevention program targets middle-school and high-school students by providing classroom and community activities to these young people. These activities are designed to enhance protective factors and build resilience in youths to enable them to attain healthy and productive lives and to resist the threats of gangs, violence, and drugs. ⋯ Baseline indicators of violence-related behaviors clearly indicate the need for intervention in this highly disadvantaged, African-American community. Through its historical presence and recent program development efforts, Self Enhancement, Inc., is well positioned to make a difference in the lives of these young people. The equivalence of program and comparison group students on baseline indicators of violence bodes well for an unequivocal assessment of program effectiveness over time.