==================================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