The effect of the 2005 British Columbia (BC) smoking cessation mass media campaign on a panel (N = 1,341) of 20-30-year-old smokers' attitudes is evaluated. The 5-week campaign consisted of posters, television, and radio ads about the health benefits of cessation. Small impacts on the panel's attitudes toward the adverse impacts of smoking were found, with greater impacts found for those who had no plans to quit smoking at the initial interview. As smokers with no plans to quit increasingly recognized the adverse impacts of smoking, they also increasingly agreed that they use smoking as a coping mechanism. Smokers with plans to quit at the initial interview already were well aware of smoking's adverse impacts. Respondents recalling the campaign poster, which presented a healthy alternative to smoking, decreased their perception of smoking as a coping mechanism and devalued their attachment to smoking. Evidence was found that media ad recall mediates unobserved predictors of attitudes toward smoking.
The objective of this study was to evaluate the impact of the 2005 British Columbia Ministry of Health Smoking Cessation Mass Media Campaign on short-term smoking behavior.
National cross-sectional data are used with a quasi-experimental approach to test the impact of the campaign.
Findings indicate that prevalence and average number of cigarettes smoked per day deviated upward from trend for the rest of Canada (P = .08; P = .01) but not for British Columbia. They also indicate that British Columbia smokers in lower risk groups reduced their average daily consumption of cigarettes over and above the 1999-2004 trend (-2.23; P = .10), whereas smokers in the rest of Canada did not, and that British Columbia smokers in high-risk groups did not increase their average daily consumption of cigarettes over and above the 1999-2004 trend, whereas smokers in the rest of Canada did (2.97; P = .01).
The overall poorer performance of high-risk groups is attributed to high exposure to cigarette smoking, which reduces a smoker's chances of successful cessation. In particular, high-risk groups are by definition more likely to be exposed to smoking by peers, but are also less likely to work in workplaces with smoking bans, which are shown to have a substantial impact on prevalence. Results suggest that for mass media campaigns to be more effective with high-risk groups, they need to be combined with other incentives, and that more prolonged interventions should be considered.
The rate of obesity and associated risk factors in Canadian youth is increasing at an alarming rate. Nutrition plays an important role in weight maintenance. This study reports the effectiveness of Action Schools! BC---Healthy Eating, a school-based fruit and vegetable (FV) intervention, in effecting change in: 1) students' intake of FV, 2) students' knowledge, attitudes and perceptions regarding FV, and 3) students' willingness to try new FV.
Five schools that represented geographic, socio-economic and size variation were recruited as Action Schools! BC--Healthy Eating intervention schools. A second set of five schools were selected as matched healthy eating usual practice schools. Student outcomes were measured at baseline and at 12-week follow-up using self-report questionnaires. Classroom logs and progress reports were used to assess implementation dose and fidelity. The intervention included school-wide activities based on individualized Action Plans addressing goals across six Action Zones.
Significant differences were found between conditions over time while controlling for baseline levels. Fruit servings, FV servings, FV variety, and percent of FV tried from a fixed list increased in intervention schools. Teachers implemented a mean of 64% of requested classroom dose, and school Action Teams implemented activities across 80% of the whole-school model.
A whole-school framework can impact FV intake, but results were modest due to implementation issues. Further implementation and evaluation are necessary to fully understand the effectiveness of this initiative.
The Healthy Heart Kit (HHK) is a risk management and patient education kit for the prevention of cardiovascular disease (CVD) and the promotion of CV health. There are currently no published data examining predictors of HHK use by physicians. The main objective of this study was to examine the association between physicians' characteristics (socio-demographic, cognitive, and behavioural) and the use of the HHK.
All registered family physicians in Alberta (n=3068) were invited to participate in the "Healthy Heart Kit" Study. Consenting physicians (n=153) received the Kit and were requested to use it for two months. At the end of this period, a questionnaire collected data on the frequency of Kit use by physicians, as well as socio-demographic, cognitive, and behavioural variables pertaining to the physicians.
The questionnaire was returned by 115 physicians (follow-up rate = 75%). On a scale ranging from 0 to 100, the mean score of Kit use was 61 [SD=26]. A multiple linear regression showed that "agreement with the Kit" and the degree of "confidence in using the Kit" was strongly associated with Kit use, explaining 46% of the variability for Kit use. Time since graduation was inversely associated with Kit use, and a trend was observed for smaller practices to be associated with lower use.
Given these findings, future research and practice should explore innovative strategies to gain initial agreement among physicians to employ such clinical tools. Participation of older physicians and solo-practitioners in this process should be emphasized.
Although HIV/AIDS prevention has presented challenges over the past 25 years, prevention does work! To be most effective, however, prevention must be specific to the culture and the nature of the community. Building the capacity of a community for prevention efforts is not an easy process. If capacity is to be sustained, it must be practical and utilize the resources that already exist in the community. Attitudes vary across communities; resources vary, political climates are constantly varied and changing. Communities are fluid-always changing, adapting, growing. They are "ready" for different things at different times. Readiness is a key issue! This article presents a model that has experienced a high level of success in building community capacity for effective prevention/intervention for HIV/AIDS and offers case studies for review. The Community Readiness Model provides both quantitative and qualitative information in a user-friendly structure that guides a community through the process of understanding the importance of the measure of readiness. The model identifies readiness- appropriate strategies, provides readiness scores for evaluation, and most important, involves community stakeholders in the process. The article will demonstrate the importance of developing strategies consistent with readiness levels for more cost-effective and successful prevention efforts.
Public awareness of the warning signs of stroke is important. As part of an educational campaign using mass media, the Heart and Stroke Foundation of Ontario conducted public opinion polling in 4 communities to track the level of awareness of the warning signs of stroke and to determine the impact of different media strategies.
Telephone surveys were conducted among members of the general public in 1 control and 3 test communities before and after mass media campaigns. The main outcome measure used to determine effectiveness of the campaigns was the ability to name > or =2 warning signs of stroke.
In communities exposed to television advertising, ability to name the warning signs of stroke increased significantly. There was no significant change in the community receiving print (newspaper) advertising, and the control community experienced a decrease. Television increased the knowledge of both men and women and of people with less than a secondary school education but not of those > or =65 years of age. Intermittent, low-level television advertising was as effective as continuous, high-level television advertising.
Results of this survey can be used to guide mass media-buying strategies for public health education.
The Alaska Education and Research Towards Health (EARTH) Study assessed cancer risk among 3,821 Alaska Native people (AN). We present the prevalence of selected cancer risk factors and comparison with Healthy People 2010 goals. Participants completed extensive computer-assisted self-administered questionnaires on diet, physical activity, tobacco and alcohol use, cancer screening, family history of cancer, and environmental exposures. Measurement data were collected on blood pressure, height, weight, waist/hip circumference, fasting serum lipids, and glucose. Cancer risk factors are high for the Alaska EARTH study population. For all risk factors studied except for vegetable consumption, Alaska EARTH Study participants did not meet Healthy People 2010 goals. This study is unique in providing questionnaire and measurement data of cancer risk factors on a larger study sample than any previous study among AN living in Alaska. Data show that the prevalence of most cancer risk factors exceeded national recommendations. Given the disease disparities that exist for the AN population, these data provide important baseline data that can be used to target health interventions and reduce health disparities.
Conseil canadien d'agrément des services de santé, Développement des marchés nationaux et internationaux, candidat au doctorat en santé publique, Faculté de médecine, Université de Montréal. email@example.com
The objective of this pan-Canadian study was to evaluate the feasibility of developing a set of accreditation standards supported by an accreditation process for public health in Canada.
Twenty-four telephone interviews were conducted, recorded, transcribed and analyzed.
The scope of public health implied in respondents' answers included health protection, health promotion, disease prevention and surveillance. A large majority of the experts were in favour of implementing accreditation in public health. Of these, close to two thirds answered that public health needed its own standards to address some of the current gaps. People in health systems were faster to question the relevance of separate standards for public health to avoid creating artificial barriers within the continuum of care. Respondents who opposed an accreditation process for public health cited the lack of capacity currently in the system. Yet, proponents argued that accreditation could actually be used as a capacity-building tool and assist "to fight the tyranny of the urgent". Some identified the actual process of developing accreditation standards for public health as being a valuable exercise.
It appears that public health in Canada would benefit from an accreditation process developed in consultation with the field, to enhance visibility, capacity building, and performance through pan-Canadian standards which would also have to be flexible enough to accommodate specific provincial and local contexts.
In this study, we explore how client and family caregiver 'empowerment' is interpreted by home-care nurses talking about their practice with palliative (and to a lesser extent, non-palliative) clients and families. We draw on secondary analysis of qualitative data collected through in-person interviews with 27 home-care nurses from a western Canadian health authority. First, we illustrate how the practice ideal of empowerment, in the sense of 'respecting autonomy and choices', can be understood as reflecting home-care nurses' needs to mitigate the emotional impact of feeling unable to effectively help palliative clients/families. Then, we illustrate how the practice ideal of empowerment, in the sense of 'promoting independence', can be understood to accomplish the need to shift responsibility for particular care tasks to clients and family members. Lastly, home-care nurses, talk about 'promoting choices' is also investigated. 'Choice' was framed narrowly with respect to allowing palliative clients and families to determine visit time and frequency. Findings are discussed in relation to the concept of 'responsibilization'.