American journal of preventive medicine
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Prevention is being promoted as a means to improve health status and to save health care costs. Economic evaluations of prevention (i.e., cost-effectiveness and cost-benefit analyses) indicate that some prevention activities, like many treatments, do not save money, although many are relatively cost-effective. It has been suggested, however, that prevention is held to a higher standard than treatment because prevention programs are expected to demonstrate cost savings, and that the methods of economic evaluation understate the cost-effectiveness of prevention. Although the converse assertion is less commonly made, economic evaluations may also overstate the cost-effectiveness of prevention. The purpose of this article is to examine how the methods of economic evaluation may systematically understate, or overstate, the cost-effectiveness (or net benefits) of prevention. ⋯ We conclude that the methods of economic evaluation may both understate and overstate the cost-effectiveness of prevention.
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Factors associated with practicing five health promotion behaviors (sleeping 7-8 hours per night, eating break-fast, exercising three times per week, and abstaining from alcohol and tobacco use) were identified in 243 low-income Black and Latina women whose children were enrolled in Head Start programs in South Central Los Angeles. ⋯ These findings suggest that a range of factors may be related to healthy and unhealthy lifestyles in low-income, ethnic minority women and that environmental stressors, such as exposure to violence, may significantly affect health promotion behavior in these groups.
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In this study, low-income perimenopausal African-American women were surveyed to determine knowledge of menopause and hormone replacement therapy (HRT). ⋯ The lack of knowledge about menopause, HRT, and lifetime risks of heart disease suggests that low-income African-American women need better information for decision making about prevention. However, this sample knew the rank order of major health risks. Health information to the public and culturally relevant patient education are critical prerequisites to any preventive behavioral strategies in this population. Further research should identify culturally based expectations of disease risk and efficacy of prevention strategy to tailor messages to particular subpopulations.
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This study examines 10 culturally relevant indices of physical, psychological, and social function in order to specify and quantify their influence on the multidimensional functional health of low-income Black older women who have a medical diagnosis of osteoarthritis and no known history of coexisting medical conditions that would cause severe debilitation. Using a non-experimental, correlational design, cross-sectional data were obtained in individual face-to-face interviews. A nonprobability sample of 100 low-income, community-living Black older female participants of two local senior centers were interviewed for analysis. ⋯ This combination of variables explained 45% of the variance in functional health. Depression was highly correlated with other predictors and explained the largest amount of variance. Findings emphasize the need for enhanced education of providers to stimulate development of health promotion/disease prevention programs that will decrease the occurrence and effects of depression, joint pathology, and physical immobility, thereby improving health-related outcomes for Black older women who have osteoarthritis.
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Randomized Controlled Trial Clinical Trial
Supporting Adolescents with Guidance and Employment (SAGE).
Supporting Adolescents with Guidance and Employment (SAGE) is a multifaceted, community-based violence-prevention program. Its target is African-American male adolescents in Durham, North Carolina. Public health professionals, county government officials, and local businessmen collaborated in its development and implementation. ⋯ Youths in each program condition were similar with respect to key demographic and behavioral characteristics. The key components of the SAGE program represent increasingly popular but untested approaches. Preliminary results reveal that these youths are involved in violent behavior both as perpetrators and as victims.