==================================HSR13================================== 13. Screening tools or risk scoring systems, especially but not limited to questionnaires and computer software, used by physicians or patients for health promotion, risk reduction, preventive medicine, health maintenance, etc. 1 UI - 87104270 AU - Tillotson JL ; Gorder DD ; DuChene AG ; Grambsch PV ; Wenz J TI - Quality control in the Multiple Risk Factor Intervention Trial Nutrition Modality. AB - One of the principal objectives of the MRFIT was to teach and motivate participants assigned to the SI group to adhere to a fat-controlled dietary regimen over the course of the trial. The magnitude of the trial (with more than 12,000 participants, half of them assigned to the SI protocol, to be followed for at least 6 years in 22 separate centers) presented new challenges for maintenance of quality control over a nutrition intervention program. Collection of data to monitor changes in dietary intake over time in SI and UC groups, as well as information to assess dietary adherence levels in SI participants also presented large-scale challenges in maintenance of quality control. The MRFIT formulated many of its initial nutrition intervention and data collection decisions based on experience of the earlier National Diet Heart Study (NDHS). In order to avoid coding 7-day dietary records by local clinic nutritionists (as in NDHS), the trial opted for collection of 24-hour dietary recalls that were coded centrally at the Nutrition Coding Center. It necessitated extra attention to training and certification of clinic nutritionist-interviewers to be certain that NCC coders had sufficiently precise information about all foods entered on dietary recall forms. Since dietary intake data were collected over a time span of approximately 10 years, procedures for updating the food composition database and coding rules were a necessity. Continuing attention to training and monitoring of performance of clinic nutritionist-interviewers also was important. The MRFIT nutrition intervention program was designed with the need for interclinic comparability of intervention techniques in mind. This required not only development of study-wide nutrition intervention materials, but also necessitated ongoing attention to staff training and monitoring procedures in order to ensure intercenter comparability of efforts. The success of the nutrition intervention modality depended upon the continuing efforts of the nutrition counselors not only to achieve dietary adherence but also to monitor levels of dietary adherence over time. The NDHS experience served as a springboard for designing the MRFIT nutrition intervention and data collection procedures. It is hoped that techniques for maintaining and monitoring quality control over the MRFIT nutrition modality as outlined in this chapter may prove useful to future planners. MH - Certification ; Clinical Trials/*STANDARDS ; Coronary Disease/*PREVENTION & CONTROL ; Data Collection/*STANDARDS ; *Diet ; Dietetics/EDUCATION ; Human ; Interviews/STANDARDS ; Nutrition/EDUCATION ; Patient Education ; Quality Control ; Recall ; Risk SO - Controlled Clin Trials 1986 Sep;7(3 Suppl):66S-90S 2 UI - 87099732 AU - Koonce JM ; Gold M ; Moroze M TI - Comparison of novice and experienced pilots using analog and digital flight displays. AB - Using 2 computer generated flight displays, 38 flight-naive persons and 18 experienced pilots were taught to perform 5 basic flight maneuvers. One display type used analog tapes to display the flight parameters while the other used digits. After learning to perform the maneuvers to the preset criteria using each of the display types, the subjects had to perform the same maneuvers to the same criterion level with the same displays while performing an aural side task. Overall, the digital displays were more difficult to learn to fly with than the analog displays, and the analog displays resulted in superior performances while under side task loading. MH - Aerospace Medicine/*INSTRUMENTATION ; Comparative Study ; Computers ; Computers, Analog ; *Data Display ; Female ; Human ; Information Systems/ INSTRUMENTATION ; Male ; Microcomputers SO - Aviat Space Environ Med 1986 Dec;57(12 Pt 1):1181-4 3 UI - 87084093 AU - Rakowski W TI - Personal health practices, health status, and expected control over future health. AB - Data from Wave 1 of the National Survey of Personal Health Practices and Consequences were used to examine the association between perceived control over future health and 13 health behavior indices. Analyses were conducted within three strata of health status, defined by a cross-tabulation of subjective and functional health ratings. Greater control expected over future health was associated with 11 of the 13 practices in the stratum of persons in best health, but with only 2 practices in the lowest and 3 practices in the middle health strata. Age, gender, education, and a regular source of health care were also important predictors. Overall, persons in the lowest health stratum had the fewest number and least consistent set of predictors of preventive practices. Although the rationales proposed for following preventive practices often rely upon individuals' favorable outlooks on their futures, the present data suggest that background health status may mediate the relationship. Health status can be viewed as a personal resource, which provides an opportunity for predispositions such as perceived control over future health to be consistently expressed in behavior. Attempts to develop theoretical frameworks and intervention programs that are applicable to several behaviors appear to face a difficult challenge, since few of the predictors were consistently related to more than a small number of the 13 practices. Health promotion programs may need to include health status as an additional characteristic around which to structure both the content of recruitment messages, and expectations for persons who will be relatively more easy or difficult to reach. MH - Adult ; Female ; *Health Promotion ; *Health Status ; *Health Surveys ; *Health ; Human ; *Life Style ; Male ; Middle Age ; Support, U.S. Gov't, P.H.S. ; Telephone SO - J Community Health 1986 Fall;11(3):189-203 4 UI - 87080691 AU - Menotti A ; Conti S ; Farchi G ; Giampaoli S ; Dima F ; Seccareccia F ; Giuli B ; Torsello S ; Morisi G ; Buongiorno A TI - The prediction of future health in healthy middle-aged men. AB - Two cohorts of men aged 49-59 at entry, representing cluster samples of two rural areas in Northern and Central Italy, for a total of 1712 subjects have been followed-up for 20 years within an epidemiological study originally designed for cardiovascular disease. After 20 years, only 41 men have been judged to have remained substancially healthy throughout the observation period, i.e. free from a number of major diseases. Univariate and multivariate analyses trying to predict the maintenance of health status showed that among 21 selected characteristics only the following one had a significant power: age, cigarette smoking (adverse effect) and vital capacity (favourable effect). A minor role was also played by the body mass index (adverse effect) and forced expiratory volume (favourable effect). Those who did not remain healthy exibited a greater increase in blood pressure and body mass index. MH - Adult ; *Forecasting ; *Health Status Indicators ; *Health Status ; *Health Surveys ; *Health ; Human ; Italy ; Male ; Middle Age ; Risk SO - Eur J Epidemiol 1986 Sep;2(3):233-9 5 UI - 87068200 AU - Thornberry OT ; Wilson RW ; Golden PM TI - The 1985 health promotion and disease prevention survey. AB - The National Center for Health Statistics, in collaboration with the Office of the Assistant Secretary for Health and other Federal Agencies, developed a questionnaire on health promotion and disease prevention for the 1985 National Health Interview Survey. The answers to the questionnaire, obtained from a probability sample of the civilian noninstitutionalized population of the United States, provide trend and baseline data to track progress toward the 1990 national health objectives. The questions concerned topics related to the objectives in the following areas: general health (including nutrition), injury control, high blood pressure, stress, exercise, smoking, alcohol use, oral health, occupational safety and health, and maternal health. Data from that survey have been used by Public Health Service authors to prepare a series of 11 articles. Five are presented in this issue of Public Health Reports; the remaining six will be published in the January-February 1987 issue of Public Health Reports. This paper, which introduces the series, provides a description of the objectives of the study, the survey methods employed, and the availability of public use data tapes. MH - Adolescence ; Adult ; Aged ; Female ; Government Agencies ; *Health Promotion ; *Health Surveys ; Human ; Life Style ; Male ; Middle Age ; *Primary Prevention ; Questionnaires ; Sampling Studies ; United States SO - Public Health Rep 1986 Nov-Dec;101(6):566-70 6 UI - 87032461 AU - Barmes DE ; Leous PA TI - Assessment of periodontal status by CPITN and its applicability to the development of long-term goals on periodontal health of the population. AB - CPITN data from 40 countries have been used to assess periodontal status at ages 12, 15 and 35-44 years. There are broad differences in the numbers of healthy sextants between developing countries and those which are highly industrialized. At 12 years this component of the Index could provide the basis of a global indicator of periodontal health--not less than 3 healthy sextants per child by the year 2000. At 15 years zero sextants with periodontal pockets is a feasible aim. It is less easy to set goals for periodontal health in adults. MH - Adolescence ; Adult ; Child ; Developing Countries ; Health Services Needs and Demand ; *Health Status ; *Health ; Human ; Periodontal Diseases/*OCCURRENCE ; *Periodontal Index SO - Int Dent J 1986 Sep;36(3):177-81 7 UI - 87019002 AU - McKinlay SM ; McKinlay JB TI - Aging in a 'healthy' population. AB - A five-year project, building on an ongoing epidemiological study of menopause in 2500 women, will examine the aging process in middle-aged and older men, women, and couples in Massachusetts. While past research on aging has usually focused on disease and has drawn on a self-selecting, usually clinical population, our study will examine healthy individuals randomly selected from the general population. This approach should allow for increased inferential power of findings on how positive adjustment to the aging process occurs. The project is multi-disciplinary, combining physiological measurements (hormone levels, bone densities, etc.) with psychosocial data, and draws on previous experience with community-based methods of collecting physiological and psychological information in large health surveys. MH - Aged ; *Aging ; Cross Sectional Studies ; Female ; *Health Status ; *Health ; Human ; Longitudinal Studies ; Male ; Massachusetts ; Menopause ; Middle Age ; *Population Surveillance ; Random Allocation SO - Soc Sci Med 1986;23(5):531-5 8 UI - 87007882 AU - Mayer PA ; Bauman KA TI - Health practices, problems, and needs in a population of Micronesian adolescents. AB - Saipan, one of many islands of the Pacific Trust Territory, depends on the United States for its medical care. The limited resources on the island have resulted in little medical attention for adolescents. This study surveyed 519 Saipan adolescents to determine their health practices, problems, and needs. Although these teenagers rarely saw physicians, they commonly reported health problems such as headaches, abdominal pain, and dental cavities. In the psychosocial arena, their problems involved parents, girlfriends/boyfriends, school, and suicidal thoughts. The health topics found to be of most interest included sex education, jobs, suicide prevention, drugs, and birth control. The most popular methods for learning about these subjects were books, movies, films, and school classes. There were high reported incidences of drug and alcohol problems among boys, and thoughts about suicide in all respondents. MH - Adolescence ; Adult ; Female ; Gastrointestinal Diseases/OCCURRENCE ; Headache/OCCURRENCE ; Health Education ; Health Services Needs and Demand ; *Health Surveys ; Human ; Male ; Micronesia ; Substance Abuse/ OCCURRENCE ; Suicide ; Support, Non-U.S. Gov't SO - J Adolesc Health Care 1986 Sep;7(5):338-41 9 UI - 86224412 AU - Friedman GD ; Collen MF ; Fireman BH TI - Multiphasic Health Checkup Evaluation: a 16-year follow-up. AB - The Multiphasic Health Checkup Evaluation Study, a long-term clinical trial, has been completed. A study group of 5156 men and women age 35-54 at entry was urged to have annual multiphasic health checkups (MHCs) for 16 years. A control group of 5557 comparable subjects was not so urged but was followed up in a comparable fashion. The mean and median number of MHCs per person were 6.8 and 6, respectively, in the study group and 2.8 and 1, respectively, in the control group. During 16 years the study group experienced a 30% reduction (p less than 0.05) in deaths from pre-specified "potentially postponable: causes, largely associated with lower death rates from colorectal cancer and hypertension. This reduction was most pronounced in the early years of the study. The two groups did not differ to a statistically significant degree in mortality from all other causes (84% of total mortality) or in total mortality. There was no difference in self-reported disability in the overall groups. In the setting of our prepaid health care plan where MHCs were already available on a voluntary basis, a program of urging middle-aged persons to undergo regular MHCs brought about a substantial reduction in mortality from preselected diseases. MH - Adult ; California ; Colonic Neoplasms/MORTALITY ; Comparative Study ; Female ; Follow-Up Studies ; Hospitalization ; Human ; Hypertension/ MORTALITY ; Male ; Middle Age ; Mortality ; Multiphasic Screening/ *STANDARDS ; Questionnaires ; Rectal Neoplasms/MORTALITY ; Support, Non-U.S. Gov't SO - J Chronic Dis 1986;39(6):453-63 10 UI - 86224705 AU - Baab D ; Weinstein P TI - Longitudinal evaluation of a self-inspection plaque index in periodontal recall patients. AB - This paper presents a controlled clinical trial to compare the effects of 2 programs for maintenance of oral hygiene after periodontal treatment. Oral hygiene instruction using a self-inspection plaque index was compared to traditional instruction using professional monitoring of disclosed plaque. 31 periodontal recall patients were randomly assigned to 2 groups. 15 patients in the self-inspection group were provided a manual that taught scoring of disclosed plaque on 6 teeth, a lighted dental mirror, and disclosing wafers. 16 patients in the traditional group were shown disclosed plaque in their own mouths, and were given feedback regarding oral hygiene skills. Instruction was given initially, at 2 weeks, at 1.5 months and at 3 months. The teeth were scaled at the start and at 3 months. Disclosed dentogingival plaque (before and after brushing), gingival bleeding on probing, and oral hygiene skills were assessed at 0, 1.5, 3 and 6 months. Initial mean plaque scores for only the self-inspection group decreased significantly at 1.5 months and were maintained throughout the study; however differences between groups were not observed at any time except at baseline. Gingival bleeding scores were low throughout the study for both groups. Results provide some evidence for the effectiveness of self-evaluation of disclosed plaque as a means for improving oral hygiene behavior in already-motivated patients. MH - Adult ; Aged ; Clinical Trials ; Comparative Study ; *Dental Health Surveys ; *Dental Plaque Index ; Female ; Health Education, Dental ; Human ; Male ; Middle Age ; Oral Hygiene ; Patient Education ; Periodontal Diseases/*PREVENTION & CONTROL/THERAPY ; Recurrence ; Scaling, Dental ; *Self Care ; Support, U.S. Gov't, P.H.S. ; Time Factors SO - J Clin Periodontol 1986 Apr;13(4):313-8 11 UI - 86209344 AU - Ross DA ; Vaughan JP TI - Health interview surveys in developing countries: a methodological review. AB - This review covers cross-sectional health interview surveys in which respondents were asked about their recent illness and their use of preventive and curative health services. Country survey results differed widely, for both morbidity prevalence estimates and health services utilization, reflecting major methodological differences as well as any true differences that may exist between the population groups studied. Comparison of morbidity and utilization rates is thus thwarted by the absence of standardization in survey methodology, methods of analysis, and the classification of results. A lack of theoretical studies upon which to base methodology choices combined with a general lack of rigor in applying the methodologies chosen has limited the interpretation of many surveys carried out to date. The review concludes with a series of specific recommendations for improving the survey methodology of future health interview surveys in less developed countries. MH - Cross Sectional Studies ; *Developing Countries ; *Health Planning ; *Health Planning Guidelines ; Health Services/UTILIZATION ; *Health Surveys ; Human ; Morbidity ; Preventive Health Services/UTILIZATION ; Rural Health ; Support, Non-U.S. Gov't ; Urban Health SO - Stud Fam Plann 1986 Mar-Apr;17(2):78-94 12 UI - 86185039 AU - Tape TG ; Mushlin AI TI - The utility of routine chest radiographs. AB - Although admission and preoperative chest radiography has been done for many years in various settings, existing data do not support its utility in enhancing patient care. Calculations based on estimates of the accuracy of chest radiographs and the likelihood of disease suggest that routine chest radiography may result in many more misleading than helpful results. Patients in whom chest radiographs are likely to improve outcome are best identified by a careful history and physical examination. We recommend that the practice of doing routine chest radiographs on admission and preoperatively be stopped and that the procedure be reserved for patients with clinical evidence of chest disease and patients having intrathoracic surgery. MH - Adult ; *Diagnostic Tests, Routine ; False Negative Reactions ; False Positive Reactions ; Hospitalization ; Human ; *Mass Chest X-Ray ; Patient Care Planning ; Preoperative Care ; Review ; Support, Non-U.S. Gov't ; Thoracic Radiography ; United States SO - Ann Intern Med 1986 May;104(5):663-70 13 UI - 86145372 AU - Petosa R ; Hyner G ; Melby C TI - Appropriate use of health risk appraisals with school-age children. AB - Health Risk Appraisals (HRAs) use personal risk assessment as an educational approach to encourage adoption of positive health-related behavior. An individual's behavior and health history are compared to morbidity and mortality tables to estimate a level of personal risk. Current trends suggest HRAs will continue to be popular with school health educators. Appropriate use of HRAs requires an understanding of the assumptions, interpretations, and limitations of these instruments. This article reviews the development, validity, and reliability of HRA methodology. The educational usefulness of HRAs designed for school-age populations is examined. Recommendations are offered to optimize the instructional benefits of HRAs while minimizing potential deficiencies. MH - Child ; Health Education ; *Health Status Indicators ; *Health Surveys ; Human ; Risk ; School Health Services ; Teaching SO - J Sch Health 1986 Feb;56(2):52-5 14 UI - 86117110 AU - Marcus AC ; Crane LA TI - Telephone surveys in public health research. AB - The last 10 years have seen increasing use of telephone surveys in public health research. This paper reviews issues of sampling, data quality, questionnaire development, scheduling of interviewers, respondent burden, interviewer effects, and the use of the computer in telephone interviewing. Throughout, the authors focus on findings from recent research, with particular emphasis on those studies suggesting new advances or protocols for conducting telephone health surveys. The findings of this review suggest four conclusions. First, telephone interviews can be highly recommended for follow-up interviews in panel surveys that use an initial face-to-face interview. Second, telephone surveys can be recommended as a viable alternative to costly face-to-face surveys in cross-sectional studies of the general population. Third, when the focus of the survey is on subgroups of the population that have both low telephone coverage and higher rates of nonresponse (e.g., low income and low education respondents), telephone interviews should be used more cautiously. In these situations, a dual sampling frame approach (using a combination of face-to-face and telephone interviewing) may be considered. Finally, computer-assisted telephone interviewing (CATI) represents one of the most important and innovative technologic advances in health survey research in recent years. The advantages of CATI in improving survey management are noteworthy and ideally suited for moderate- to large-sample surveys. CATI also provides an attractive (and largely untapped) resource for testing and refining other methodologic protocols in survey research. MH - Computers ; *Data Collection/STANDARDS ; Health Surveys/*METHODS ; Human ; Interviews/METHODS ; *Public Health ; Questionnaires ; *Telephone ; United States SO - Med Care 1986 Feb;24(2):97-112