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Introduction: Community action research and the prevention of alcohol problems at the local level

SUBSTANCE USE & MISUSE 2000年第1-2期35卷 1-10页

作者： Allamani, A Casswell, S Graham, K Holder, HD Holmila, M Larsson, S Nygaard, P Florence Hlth Agcy Alcohol Ctr Florence Italy Univ Auckland Alcohol & Publ Hlth Res Unit Auckland New Zealand Addict Res Fdn London England Prevent Res Ctr Berkeley CA USA STAKES Social Res Unit Alcohol Studies Helsinki Finland Univ Lund Malmo Sweden Aarhus Univ Ctr Alcohol & Drug Res Aarhus Denmark

Many community action projects from around the world exist to reduce alcohol problems at the local level. The role of research within this international movement is discussed within this introduction for the entire special issue on community action research in alcohol problem prevention. Previous community prevention programs have utilized a variety of prevention strategies: (a) an educational approach which focuses on changing behavior through changes in knowledge, attitudes, and information;and (b) an environmental approach which focuses on changing behavior through changes in the social and economic systems within a community. Many projects have used both approaches. This special issue provides a current overview of many types of community action projects from different countries and summarizes what has been learned to date from these experiences.

关键词：酒精中毒/预防和控制用户参与/方法健康教育/组织和管理健康知识态度实践卫生服务研究/组织和管理组织目标社会环境人类

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Impact of national immunization days on polio-related knowledge and practice of urban women in Bangladesh

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HEALTH POLICY AND PLANNING 1997年第4期12卷 363-371页

作者： Quaiyum, MA Tunon, C Baqui, AH Quayyum, Z Khatun, J Int Ctr Diarrhoeal Dis Res Hlth & Populat Extens Div MCH FP Extens Project Urban Dhaka 1000 Bangladesh Johns Hopkins Univ Sch Hyg & Publ Hlth Dept Int Hlth Baltimore MD USA

Bangladesh began to hold National Immunization Days (NIDs) from 1995 as part of the country's goat to eradicate poliomyelitis by the turn of the century. The NIDs brought together government agencies, the media, voluntary organisations and individual volunteers in social mobilization and service delivery activities. This paper assesses the impact of the first two polio NIDs in terms of the immunization coverage and change in knowledge about the disease among women living in Dhaka city, the capital of the country. Data were collected through pre-and post-NID cross-sectional surveys in a sample of one area of Dhaka city which included slum and non-slum households. Knowledge data were collected from 525 women with at least one child aged less than five years. The oral polio vaccine (OPV) coverage during NIDs was obtained from 720 children. Knowledge of polio as a vaccine preventable disease increased after NIDs among both slum and non-slum women. The knowledge gap between the two groups was significantly reduced. Field workers, who regularly visit women at their homes to promote health and family planning services, were the main source of information for the slum women while television was cited as the most important source of information by non-slum women. The study revealed that 88% of children under five years received at least one dose of oral polio vaccine (OPV) during NIDs, and 67% received two stipulated doses with no significant differences between slum (65%) and non-slum (69%) groups. In addition, 68% of the children contacted during the NIDs were given vitamin A supplementation. The study suggests that strategies like NID can be effectively used to tap into community resources and to generate political commitments for health programmes.

关键词：孟加拉国/流行病学横断面研究发展中国家健康教育/组织和管理健康知识态度实践免疫接种规划信息服务母亲/心理学脊髓灰质炎/流行病学脊髓灰质炎/预防和控制市区人口成年人儿童学龄前女(雌)性人类

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Knowing when but not how! - Mothers' perceptions and use of antibiotics in a rural area of Viet Nam

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TROPICAL DOCTOR 2000年第1期30卷 6-10页

作者： Halfvarsson, J Heijne, N Ljungman, P Ham, MN Holmgren, G Tomson, G Uong Bi Hospital Quang Ninh Province Viet Nam.

Given the world-wide focus on how to rationally use antibiotics, national drug policy programmes have been developed in many countries in order to minimize the environmental antibiotic pressure and thereby hopefully limit increasing bacterial resistance. This study investigated perceptions of antibiotics in a health system with weak drug regulation. The study was conducted in two rural communes in Viet Nam, with a drug market characterized by the increased accessibility and consumption of pharmaceuticals. The study focused on rural mothers' perceptions and use of antibiotics in the treatment of acute respiratory infections (ARI) in children 5 years and under. A combination of qualitative and quantitative methods were used including key informant interviews, focus group discussions, and interviews with mothers and drug vendors. The study demonstrated that using a combination of qualitative and quantitative methods gives a better understanding of the prevailing perceptions and use of antibiotics in communities. The results showed that the mothers recognized well the signs of severe ARI and that antibiotics were reserved for more severe illness episodes, where penicillin V and ampicillin were first drugs of choice. However, the mothers' perceptions and use of antibiotics reflects indigenization of antibiotics into traditional Vietnamese thinking and medical practice. This resulted in self-medication and a respect for antibiotics from the mothers point of view. A first step towards the rational use of antibiotics is already taken where mothers, as the health decisionmaker, know when to initiate antibiotic treatment and try to limit unnecessary use of antibiotics. The next step is to develop a well-functioning health education programme in order to promote the correct use of antibiotics for a successful clinical outcome. This requires acknowledgement of the mothers' culture based behaviour.

关键词：急性病抗菌药/治疗应用健康态度/人种学药物利用集中研讨小组健康教育/组织和管理健康知识态度实践医学东方传统母亲/教育母亲/心理学问卷调查呼吸道感染/药物疗法农村卫生/统计学和数值数据自我投药法/方法自我投药法/统计学和数值数据越南成年人儿童学龄前女(雌)性人类男(雄)性

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The other side of the story - Student narratives on the California drug, alcohol, and tobacco education programs

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EVALUATION REVIEW 1998年第1期22卷 95-117页

作者： D'emidio-Caston, M Brown, JH Univ Calif Santa Barbara Santa Barbara CA 93106 USA Ctr Educ Res & Dev Berkeley CA USA

Within the context of a large-scale, comprehensive evaluation of the California Drug Alcohol Tobacco Education (DATE) program this study sought to extend knowledge of student perceptions of prevention education using a naturalistic approach The constant comparative method was used to analyze 40 focus group interviews of risk and thriving groups conducted in II high, middle, and elementary school districts. This article presents three assertions generated solely from 490 "narrative stories" found in the data set. "At-risk" and "thriving" students at all three levels of schooling (a) use "story" to make sense of prevention education, and (b) distinguish use from abuse. High school students of both groups (c) believe that hearing only one side of the substance use/abuse story and strict expulsion policies further alienate students most in need of help. Implications for the use of story as an assessment tool are discussed, as are implications for substance use prevention policy.

关键词：酒精中毒/预防和控制加利福尼亚健康教育/方法健康教育/组织和管理结果评价(卫生保健)/方法方案评价随机分配吸烟/预防和控制学生物质相关性障碍/预防和控制青少年成年人儿童女(雌)性人类男(雄)性

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A COMMUNITY EDUCATION MONITORING-SYSTEM - METHODS FROM THE STANFORD-5-CITY-PROJECT, THE MINNESOTA-HEART-HEALTH-PROGRAM AND THE PAWTUCKET-HEART-HEALTH PROGRAM AND THE PAWTUCKET-HEART-HEALTH PROGRAM

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HEALTH EDUCATION RESEARCH 1993年第1期8卷 81-95页

作者： FLORA, JA LEFEBVRE, RC MURRAY, DM STONE, EJ ASSAF, A MITTELMARK, MB FINNEGAN, JR PROSPECT ASSOCIATES ROCKVILLE MD 20852 USA WAKE FOREST UNIV WINSTON SALEM NC 27103 USA BROWN UNIV PROVIDENCE RI 02912 USA NHLBI BETHESDA MD 20892 USA UNIV MINNESOTA MINNEAPOLIS MN 55455 USA

Understanding the process of behavior change interventions is critical to achieving campaign effectiveness and successful program replication. The present article presents a community education monitoring system (CEMS) using data from the Stanford Five-City Project (FCP), the Minnesota Heart Health Program (MHHP) and the Pawtucket Heart Health Program (PHHP). CEMS records the number and type of intervention activities, outcome objectives, targets of change (individual, organizational or environmental), channel(s) of dissemination and proportion of programs funded by the community. These data illustrate (1) the application of theory for each project, (2) data-based program administration, (3) feedback for revising programs and (4) type of reach or 'dose' information obtained from intervention monitoring. Process evaluations such as CEMS provide critical links between field realities and evaluation outcomes. This type of evaluation develops standards for measuring program reach and allows comparisons with other programs. CEMS also illustrates how programs enact theory. Validation studies are critical to the continued successful use of CEMS. The first step, however, is to develop a uniform way of describing complex multichannel behavior change programs. CEMS in a refined form should prove invaluable to health promotion program planners whether in research or service settings.

关键词：行为疗法心血管疾病/预防和控制心血管疾病/心理学数据收集健康行为健康教育/组织和管理健康促进/方法人类试点项目方案评价危险因素美国

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'We don't sing the chorus when the folksinger's here': the learning society and health care

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NURSE EDUCATION TODAY 2000年第3期20卷 227-232页

作者： Schuller, T Univ London Birkbeck Coll Fac Continuing Educ London WC1B 5DQ England

This paper reports on a study carried out as part of the Economic and Social Research Council's (ESRC's) Learning Society research programme. The study focused on continuing education and training (CET) in Scotland and covered four sectors, of which one was health care. The paper reports on qualitative evidence gathered from focus groups and individual interviews. it deals with three key issues: initial education and the implications for continuing education and training;markets, investment and the returns to GET;and cultural factors. The paper concludes with some key implications. (C) 2000 Harcourt Publishers Ltd.

关键词：文化教育护理继续/组织和管理集中研讨小组健康教育/组织和管理卫生服务使用研究/组织和管理苏格兰人类

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THE SWEDISH STUDY CIRCLE POSSIBILITIES FOR APPLICATION TO HEALTH-EDUCATION IN THE UNITED-STATES

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HEALTH EDUCATION RESEARCH 1991年第1期6卷 7-17页

作者： STROMBECK, R HLTHCARE EDUC ASSOCIATES 70 CAMPTON PL LAGUNA NIGUEL CA 92677 USA

There has been a growing recognition over the past decade of the need to broaden the focus of health promotion by placinggreater emphasis on the social context in which individual behavior change interventions occur. As a result, health educatorsare being required to look for innovative pedagogical methods to address this broader focus. A model of education that isused extensively in Sweden and that takes a broader approach to health matters is the study circle. Because of its simple,flexible structure and its capacity to address lifestyle as well as social and environmental factors, the study circle couldserve as a model for health education efforts undertaken in the United States. The first part of this article presents anoverview of the literature from the field of public health that calls for a broader concept of health promotion. The secondpart of the article looks at the principles and concepts of the study circle. The role of the study circle in health promotionis discussed and use of the method is illustrated in three different case examples. In addition, possibilities for applicationof the model to health education in the United States are also addressed.

关键词：健康行为健康教育/方法健康教育/组织和管理卫生政策健康促进/方法健康促进/组织和管理模型教育方案评价自助小组瑞典美国人类

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Heart healthy eating behaviors of children following a school-based intervention: A meta-analysis

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Comprehensive Child and Adolescent Nursing 1998年第1期21.0卷 35-48页

作者： Mcarthur, Donna Behler College of Nursing University of Arizona Tucson AZ United States College of Nursing University of Arizona Tucson AZ 85721-0203 P.O. Box 210203 United States

The purpose of this meta-analysis was to estimate the effects of school-based interventions on heart healthy eating behaviors of fourth and fifth grade students. The overall effect size (d value) across 12 studies was .24. The 95% confidence interval ranged from .174 to .301. It can be concluded that the school-based cardiovascular health promotion programs had a significant effect on the heart healthy eating behaviors of student participants. Recommendations include identification of reliable measures and inclusion of culturally diverse populations in future studies.

关键词：冠心病/膳食疗法冠心病/预防和控制膳食限制脂肪膳食纤维饮食习惯健康教育/组织和管理营养生理学/教育方案评价中小学生卫生保健服务/组织和管理儿童人类

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DEVELOPMENT OF A HEALTH-EDUCATION PROGRAM FOR PARENTS OF PRESCHOOL-CHILDREN WITH ASTHMA

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HEALTH EDUCATION RESEARCH 1993年第1期8卷 53-68页

作者： MESTERS, I MEERTENS, R CREBOLDER, H PARCEL, G UNIV LIMBURG DEPT GEN PRACTICE6200 MD MAASTRICHTNETHERLANDS UNIV TEXAS HLTH SCI CTRCTR HLTH PROMOT RES & DEVHOUSTONTX 77223

This paper presents the development and pilot testing of a self-management education program for parents of preschool children (0-4 years) with asthma, involving general practitioners, asthma nurses, community nurses and doctors of child health centers. The program intends to integrate education in the medical care provided to the child (and the parent). The program contains four manuals, one for each group of health care providers, and a booklet for parents. The manuals identify the educational tasks per discipline and regulate referral from one discipline to another. The booklet provides written information for parents. In the development of the program, representatives from both the target population and the providers of the education were involved in needs assessment surveys. Findings of these surveys were integrated into the design of the program. Then, a pilot study was conducted to test the efficacy of the program during group sessions. Findings indicate that the variables measured (knowledge, attitude, self-efficacy and self-management behaviors) improved significantly from pre- to post-test. Finally, the program was revised for the next phase in which the program will be evaluated in primary health care with a controlled trial.

关键词：成年人哮喘/预防和控制儿童学龄前健康教育/组织和管理健康知识态度实践人类婴儿婴儿新生需求估价单行本双亲/教育双亲/心理学试点项目规划制订问卷调查美国

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Peer-led and adult-led programs - Student perceptions

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JOURNAL OF DRUG EDUCATION 1999年第4期29卷 295-308页

作者： Erhard, R Tel Aviv Univ Sch Educ IL-69978 Tel Aviv Israel

This research examines whether peer-led prevention programs are preferable to adult-led programs. Participants were 2,447 students in 94 classes, from 31 schools running drug prevention programs. The schools were divided into two groups according to the model they used in their program: fifteen schools used peer-led model, while sixteen used the adult-led model. A 46-item questionnaire was constructed in order to examine the students' perception of the programs. The results show that all the input measures (content, atmosphere, openness, discipline, facilitators' competence) and the outcome measures (satisfaction, knowledge, avoidance, curiosity, personal relationship) were perceived as more positive in the peer-led model. The differences were small, but significant. While the findings suggest that the peer-led model has a somewhat greater potential for primary prevention, the differences found do not enable us to state with certainty that this model is preferable for primary prevention purposes.

关键词：健康教育/组织和管理同侪集群方案评价物质相关性障碍/预防和控制青少年成年人女(雌)性人类男(雄)性

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