Health education quarterly
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While the Institute of Medicine's Report on The Future of Public Health provokes debate on public health issues in the United States, the Healthy Cities movement is one approach to addressing many of these issues. Healthy Cities Indiana began in 1988 and adapts the European and Canadian healthy cities experience within the sociopolitical context of Indiana and the United States. Six Indiana cities are collaborating with Indiana University School of Nursing and the Indiana Public Health Association in a process of urban health promotion. ⋯ Each step in the healthy cities process is described, highlighting examples from the Indiana experience, including an analysis of selected data describing the cities. The facilitators of a healthy city provide support to city leaders in other cities interested in becoming involved in the healthy cities process. Implications of healthy cities for health educators and other health professionals are suggested.
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Attribution theory is offered as a theoretical framework for generating and testing hypotheses about how people perceive and respond to the behavior of impaired driving. Recent work on the attribution of responsibility for alcohol-impaired driving indicates that the perceived seriousness of this behavior varies with the consequences and circumstances associated with it. In some instances, impaired driving is not considered to be particularly blameworthy, while in other instances, relatively minor variations in the event sequence have pronounced effects on the assignment of responsibility and punishment. ⋯ Other findings suggest that people are likely to deny the personal relevancy of situations involving impaired driving. The final section of the article discusses the program implications of this research. Specific attention is given to sources of attributional "error" and to how these inaccuracies might be identified and corrected within a prevention/intervention program context.
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It was hypothesized that a health education program for children with asthma aged 8-11 years that was delivered in elementary schools, would increase children's asthma management skills, self-efficacy and influence on parents' management decisions; reduce school absences and improve school performance. The study population consisted of 239 low-income, predominantly Hispanic and black children from 12 elementary schools (six experimental and six control) in New York City. Parents did not attend educational sessions but received written materials. ⋯ Follow-up data obtained one year after the program showed that compared to controls experimental group children had higher scores on an index of asthma management (p less than 0.05), greater self-efficacy with respect to asthma management skills (p less than 0.05), more influence on parents' asthma management decisions (p less than 0.05), better grades in school (p = 0.05), and fewer episodes of asthma (p less than 0.01) of shorter average duration (p less than 0.01). No differences were observed for changes in number of school absences. These findings show that asthma health education designed for delivery to children can significantly increase management skills, reduce symptoms of asthma, and improve school performance.
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Comparative Study
Recent sexually transmitted disease prevention efforts and their implications for AIDS health education.
In the absence of a cure or vaccine for acquired immune deficiency syndrome (AIDS) educational and social marketing efforts to reduce the transmission of Human T-lymphotropic type III/lymphadenopathy-associated virus (HTLV-III/LAV) are currently our best hope for controlling the disease. Since 1983, the Centers for Disease Control (CDC) has funded a series of research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexually transmitted diseases (STDs). Analysis of the first two studies which are now completed, and preliminary data from a third study, have documented dramatic changes in behavior, knowledge, and attitudes among clients in inner-city public health clinics. The authors describe the principles and underlying assumptions that have guided the design of their STD initiatives, drawing special attention to the implications for AIDS health education efforts.
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The effectiveness of health education is ultimately determined by whether it is implemented, and how it is implemented. Although a given health education innovation may be designed and experimentally assessed to promote well-being with some measure of effectiveness and efficiency, the actual impact of the innovation will depend upon the manner in which it is disseminated, initiated, and maintained. The implementation of health education programs in schools or elsewhere is a function of the types of innovations available, certain characteristics of those innovations that influence their use, and the manner in which the innovations are brought into practice. ⋯ The American system of public and private schools could be an agent vitally important to the realization of a second public health revolution. Indeed, in a democratic society, the implementation of health education in schools seems a condition necessary for such a revolution. By analyzing and learning from our own health education efforts, as well as the efforts of those experienced with implementing other types of educational innovations in schools, we might ensure that future populations are informed sufficiently about factors that influence their health and well-being.