American journal of preventive medicine
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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.
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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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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
Evaluation of a hospital-based youth violence intervention.
To decrease adolescent morbidity and mortality and improve the quality of life, a violence-prevention consultation is offered to hospitalized victims of nondomestic violence. The context is a violence-prevention team approach to patient assessment, treatment, and follow-up. Psychoeducational counseling emphasizes the individual through a cognitive behavioral approach and also recognizes the individual in the proximal social setting through referrals to community resources. ⋯ No statistically significant differences between intervention subjects and nonintervention controls in terms of baseline variables have been observed. For inner-city adolescent victims of violent assaults, a hospital-based intervention offers a unique opportunity for reduction of the incidence of reinjury. We describe the elements of the intervention, including the theoretical basis and implementation; detail the overall evaluation design including modifications; and present preliminary analyses of baseline data.