Journal of community health
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The Ceasefire Oregon gun turn in program was initiated to educate the community regarding violence through a gun turn-in program with voluntary surrender of firearms, educational efforts about violence, and institution of public safety policies. The community board of directors was composed of multiple community leadership organizations. A multi-intervention education, outreach and media program consisting of distribution of brochures, presentations, school education programs, and workshops was implemented throughout the year in addition to the gun turn-in program held in May for two days. ⋯ The most common reasons for participating in the gun turn in were obtaining gift certificates and not wanting the gun any more. A successful community grassroots program, Ceasefire Oregon has shown sustainability over six years with increased participation secondary to education, advertising and incentives. Community and statewide efforts can assist with building the infrastructure for programs, however more tools for quantitative performance program evaluation would facilitate measuring the impact on the community.
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Cesarean section rates vary among states from approximately 15% to over 26% of all deliveries. Since it is unlikely that patient factors alone contribute to this wide variation, other non-clinical factors that are unique to each state must influence cesarean section decisions. To explore if provider workforce and specialty was associated with differences in statewide cesarean rates, we compared statewide cesarean rates for 1996 with (1) the volume of deliveries in a state per board-certified obstetrician; (2) percentage of deliveries performed in the state by nurse midwives, and (3) the percentage of family physicians in the state performing obstetrics. ⋯ As the percentage of family physicians offering obstetric services increased in a state, the rate of cesarean delivery for that state declined. This effect appeared to be independent of other provider effects, state rurality, or statewide income. Family physician participation in obstetrics is unlikely to be the cause for lower cesarean rates, but is likely a marker for a medical environment and practice style that supports non-operative obstetric care.
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This article reports the results of a patient-satisfaction survey administered by interview to 2045 adults discharged from several major public and private hospitals in Turkey. The direct measurement of patient-satisfaction is a new phenomenon for this country. An instrument was designed similar to those available in the United States and administered during exit interviews. ⋯ Relationships and percentages within and among the five public and two private hospitals are reported. Several statistically significant differences were found between the hospitals, with the private hospitals achieving the greatest satisfaction on most of the quality of services issues examined. Future recommendations outline the need to take into account the public's perception of these hospitals and enhancing customer satisfaction as a means of increasing service utilization.
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The purpose of this study was to identify family physicians' firearm safety counseling beliefs and behaviors. A survey was mailed to a random sample of 600 members of the American Academy of Family Physicians. A three wave mailing technique was used to maximize the response rate and yielded 271 usable surveys (55% response rate). ⋯ The majority (78%) of family physicians lacked formal training on how to counsel patients about firearm safety and 49% believed more time should be spent in residency programs on firearm safety counseling. The majority (84%) of respondents never or rarely counseled patients on firearm safety and 50% believed firearm safety counseling should be a low priority in their delivery of primary care. The majority of respondents did not regularly counsel patients about firearm safety, did not believe firearm safety counseling should be a priority, and did not believe firearm safety counseling would be effective in reducing firearm-related trauma.
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Effective campaigns are desperately needed to combat the serious social problem of teen pregnancy. However, public health campaigns are most often noted for failures, rather than successes. One reason for a campaign failing to have the intended effect is lack of theoretical guidance at the formative evaluation stage. ⋯ Six focus groups were conducted to determine knowledge, attitudes, beliefs, and recommendations for effective campaigns to deter teen pregnancy. The results indicate that campaign messages need to combat positive attitudes toward pregnancy, negative attitudes toward birth control, the perception of personal invulnerability, and emphasize the negative consequences of sexual intercourse. This study's findings also suggest that campaigns with these messages need to start at an early age in order to effectively prevent teen pregnancy.