American journal of preventive medicine
-
Randomized Controlled Trial Clinical Trial
Effect of a cancer screening intervention conducted by lay health workers among inner-city women.
We conducted a randomized controlled trial to determine if an in-home educational intervention conducted by lay health workers (LHWs) could increase adherence among low-income, inner-city, African-American women to breast and cervical cancer screening schedules. ⋯ LHWs' intervention appeared to improve the rate at which inner-city women obtained CBEs and mammograms, but had no effect on Pap smears. A high attrition rate weakened our ability to make conclusive statements about the exact impact of the intervention.
-
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.
-
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.
-
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.
-
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.