American journal of preventive medicine
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This study was carried out to determine the predisposing, enabling, and reinforcing factors related to practice behaviors in the prevention of adolescent pregnancy and sexually transmitted diseases (STDs), and to assess physicians' "ideal" history taking and service provision versus their actual practice in this clinical area. ⋯ Analysis of predisposing factors found that, for seven of 10 areas related to knowledge of the epidemiology of adolescent pregnancy and STDs, fewer than 50% of male physicians were able to give correct responses. All physicians believed this to be an important area for prevention, and 89% that prevention is possible, but only 62% believed that their own prevention efforts are effective. Respondents were about equally likely to view schools and physicians as having responsibility for prevention of adolescent pregnancy and STDs. Significant enabling factors included high levels of perceived personal comfort and skill, but time factors and opportunities to interact with adolescents sufficiently frequently to carry out prevention were seen as barriers. Most physicians (68%) agreed that the physician fee schedule was a negative reinforcing factor. Male physicians and those in rural practice were significantly more likely to have larger gaps between those preventive practices they saw as desirable and those they actually performed.
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Randomized Controlled Trial Clinical Trial
Perceived and measured availability of tobacco to youths in 14 Minnesota communities: the TPOP Study. Tobacco Policy Options for Prevention.
Availability of tobacco to young people is believed to be an important factor in the onset of tobacco use. We still do not have a complete picture of how tobacco is obtained by youths or how access can be curtailed. ⋯ These results suggest that sources of cigarettes shift from social to commercial with age and that sources of cigarettes for rural youths may be different than for urban youths.
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Historical Article
Incidence of infectious disease and the licensure of immunobiologics in the United States.
Our objective was to investigate the relationship of vaccine or toxoid licensure with the incidence of the target disease in the United States. ⋯ Historical data provide evidence of proof of efficacy of mass immunization for measles, polio, rubella, mumps, and pertussis, but not for diphtheria or tetanus.