Restricted accessResearch articleFirst published online 2010-5
Developing Culturally Tailored Health Belief-Based Intervention Materials to Improve Child and Parent Participation in a Cardiovascular Screening Program
The Coronary Artery Risk Detection in Appalachian Communities Project was developed to reduce children’s future cardiovascular risk by implementing a school-based screening program statewide. Despite the elimination of environmental barriers related to screening cost and accessibility, only half of eligible children participate in the program each year. The authors used the theory of planned behavior to identify health beliefs associated with screening participation. This article describes the process used to identify community health beliefs and the development of theoretically based materials to increase participation. Focus groups and individual interviews were conducted to identify core health beliefs held by parents, community leaders, and children (Phase I). Data obtained were used to expand and revise a Health Beliefs Questionnaire, which was distributed to larger samples (Phase II). This information was used to design recruitment materials that emphasized the benefits of screening while directly addressing potential belief-based barriers to screening participation (Phase III).
Ajzen, I. ( 1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.
2.
Baranowski, T., Cullen, K.W., & Baranowski, J. (1999). Psychosocial correlates of dietary intake: Advancing dietary intervention. Annual Review of Nutrition, 19, 17-40.
3.
Beale, D.A., & Manstead, A.S. (1991). Predicting mothers’ intentions to limit frequency of infants’ sugar intake: Testing the theory of planed behavior. Journal of Applied Social Psychology , 21, 409-431.
4.
Brouse, C.H., Basch, C.E., Wolf, R.L., & Shmukler, C. ( 2004). Barriers to colorectal cancer screening: An educational diagnosis. Journal of Cancer Education, 19(3), 170-173.
5.
Centers for Disease Control and Prevention. ( 2005). Profiling the leading causes of death in the United States. The leading causes of death and their risk factors. Retrieved January 18, 2006, from http://www.cdc.gov/nccdphp/publications/factsheets/ChronicDisease/pdfs/00/ChronicDiseaseAllStates.pdf.
6.
Centers for Disease Control and Prevention. ( 2006). Chronic disease-West Virginia: Leading causes of death . Retrieved March 23, 2006, from http://www.cdc.gov/nccdphp/publications/factsheets/ChronicDisease/west_virginia.htm
7.
Clark, P.G., Nigg, C.R., Greene, G., Riebe, D., Saunders, S.D., & Members of the SENIOR Project Team. ( 2002). The Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR): Translating theory into research. Health Education Research, 17(5), 552-561.
8.
Cooper, R., Cutler, J., Desvigne-Nickens, P., Fortmann, S.T., Friedman, L., Havlik, R., et al. (2002). Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States. Circulation, 102, 3137-3147.
9.
Courneya, K.S., & McAuley, E. ( 1995). Cognitive mediators of the social influence-exercise adherence relationship: A test of the theory of planned behavior. Journal of Behavioral Medicine, 18(5), 499-515.
10.
Courneya, K.S., Plotnikoff, R.C., Hoyt, S.B., & Birkett, N.J. ( 2000). Social support and the theory of planned behavior exercise domain. American Journal of Health Behavior, 24(4), 300-308.
11.
Creedy, D.K., Ludlow, T., Beggs, J., Collis, D., Irvine, D., Price, D., et al. (2005). Perceptions of psychosocial support groups by parents who have a child with diabetes: A needs analysis. Collegian, 12(2), 28-32.
12.
Creswell, J. W., & Plano Clark, V. L. (2006). Designing and conducting mixed-methods research. Thousand Oaks, CA: Sage. Demerath, E., Muratova, V., Spangler, E., Li, J., Minor, V., & Neal, W. (2006). School-based obesity screening in rural Appalachia. Unpublished manuscript.
13.
Deskins, S., Harris, C.V., Bradlyn, A.S., Cottrell, L., Coffman, J.W., & Olexa, J. ( 2006). Preventive care in Appalachia: Use of the theory of planned behavior to identify barriers to participation in cholesterol screenings among West Virginians. Journal of Rural Health, 22(4), 367-374.
14.
Domel, S.B., Thompson, W.O., Davis, H.C., Baranowski, T., Leonard, S.B., & Baranowski, J. (1996). Psychosocial predictors of fruit and vegetable consumption among elementary school children. Health Education Research, 11(3), 299-308.
15.
Edmundson, E., Paracel, G.S., Feldman, H.A., Elder, J., Perry, C.L., Johnson, C.C., et al. (1996). The effects of the Child and Adolescent Trial for Cardiovascular Health upon psychosocial determinants of diet and physical activity behavior. Preventive Medicine, 25, 442-454.
16.
Eller, R. ( 1982). Miners, millhands, and mountaineers: Industrialization of the Appalachian South 1880-1930. Knoxville: University of Tennessee Press.
17.
Fila, S.A., & Smith, C. ( 2006). Applying the theory of planned behavior to healthy eating behaviors in urban NativeAmerican youth. International Journal of Behavioral Nutrition and Physical Activity, 3(11), 1-10.
18.
Godin, G., Valois, P., Lepage, L., & Desharnais, R. (1992). Predictors of smoking behaviour: An application of Ajzen’s theory of planned behaviour. British Journal of Addiction, 87(9), 1335-1343.
19.
Harris, C.V., Bradlyn, A.S., Coffman, J., Yeater, R., Cottrell, L., & Deskins, S. ( 2006, May). Development of a theory-based obesity prevention program for high risk families. Paper presented to the annual meeting of the Society for Prevention Research, San Antonio, TX.
20.
Health Resources and Services Administration. (n.d.). Geospatial data warehouse. Retrieved March 23, 2006, from http://datawarehouse.hrsa.gov/ReportTool.htm
21.
Hollingshead, A.B., & Redlich, F.C. ( 1958). Social class and mental illness: A community study. New York: John Wiley.
22.
Janz, N.K., & Becker, M.H. ( 1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1-47.
23.
Jibaja-Weiss, M.L., Volk, R.J., Kingery, P., Smith, Q.W., & Holcomb, J.D. ( 2003). Tailored messages for breast and cervical cancer screening of low-income and minority women using medical records data. Patient Educational Counseling, 50(2), 123-132.
24.
Johnson, R.B., & Onwuegbuzie, A.J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher , 33(7), 14-26.
25.
Lewis, B.A., Marcus, B.H., Pate, R.R., & Dunn, A.L. ( 2002). Psychosocial mediators of physical activity behavior among adults and children. American Journal of Preventive Medicine, 23(2S), 26-35.
26.
Muratova, V., Demerath, E., Spangler, E., Ogershok, P., Elliott, E., Minor, V., et al. (2002). The relation of obesity to cardiovascular risk factors among children: The CARDIAC Project. West Virginia Medical Journal, 98, 263-267.
27.
Murphy, S.L. ( 2000). Deaths: Final data for 1998. National Vital Statistics Report, 48, 1-105.
28.
Neal, W.A., Demerath, E., Gonzales, E., Spangler, E., Minor, V.E., Stollings, R., et al. (2001). Coronary Artery Risk Detection in Appalachian Communities (CARDIAC): Preliminary findings. West Virginia Medical Journal, 97(2), 102-105.
29.
Nicklas, T.A., von Duvillard, S.P., & Berenson, G.S. (2002). Tracking of serum lipids and lipproteins from childhood to dyslipidemia in adults: The Bogalusa Heart Study. International Journal of Sports Medicine, 23(Suppl.), s39-s43.
30.
Ogden, C.L., Flegal, K.M., Carroll, M.D., & Johnson, C.L. ( 2002). Prevalence and trends in overweight among US children and adolescents, 1999-2000. Journal of the American Medical Association, 288(14), 1728-1732.
31.
Preston, J.D., & Guseman, P.B. ( 1979). A comparison of the findings of different methods for identifying community leaders. Journal of Community Developmental Sociology, 10, 51-62.
Reimer, K., Smith, C., Reicks, M., Henry, H., Atwell, J., & Thomas, R. ( 2004). Child feeding strategies relating to fruits and vegetables according to stage of change in AfricanAmerican Women. Public Health and Nutrition, 7(4), 505-512.
34.
Richards, R., & Smith, C. ( 2007). Environmental, parental, and personal influences on food choice, access, and overweight status among homeless children. Social Science & Medicine, 65, 1572-1583.
35.
Riportella-Muller, R., Selby-Harrington, M.L., Richardson, L.A., Donato, P.L., & Quade, D. ( 1996). Barriers to the use of preventive health care services for children. Public Health Report, 111(1), 71-77.
36.
Rippetoe, P.A., & Rogers, R.W. ( 1987). Effects of components of protection-motivation theory on adaptive and maladaptive coping with a health threat. Journal of Personality and Social Psychology, 52(3), 596-604.
37.
Rogers, E. M. (1971). Diffusion of Innovations. London: Free Press. Santoli, J. M., Rodewald, L. E., Maes, E. F., Battaglia, M. P., & Coronado, V. G. (1999). Vaccines for Children Program, United States, 1997. Pediatrics, 104(2), e15.
38.
Strickland, J., & Strickland, D.L. (1996). Barriers to preventive health services for minority households in the rural south. Journal of Rural Health, 12(3), 206-217.
39.
U.S. Census Bureau. (2000a). American factfinder. Fact sheet for West Virginia. Retrieved March 30, 2006, from http://factfinder.census.gov/ U.S. Census Bureau. (2000b). American factfinder. Median household income in 1999. Retrieved February 9, 2006, from http://factfinder.census.gov/
40.
U.S. Census Bureau. (2000c). American factfinder, urban and rural. Retrieved December 21, 2005, from http://www.factfinder.census.gov/
41.
Videon, T.M., & Manning, C.K. ( 2003). Influences on adolescent eating patterns: The importance of family meals. Journal of Adolescent Health, 32, 365-373.
42.
Walker, R., Lucas, W., & Crespo, R. (1994). The West Virginia Rural Cancer Prevention Project. Cancer Practice, 2(6), 421-426. Waters, E. B., Haby, M. M., Wake, M., & Salmon, L. A. (2000). Public health and preventive healthcare in children: Current practices of Victorian GPs and barriers to participation. Medical Journal of Australia, 173(2), 68-71.
43.
Webber, L.S., Srinivasan, S.R., Wattingney, W.A., & Berenson, G.S. (1991). Tracking of serum lipids and lipoproteins from childhood to adulthood: The Bogalusa Heart Study. American Journal of Epidemiology, 133, 884-849.
44.
West Virginia Bureau of Public Health, Division of Health Promotion and Chronic Disease. (n.d.). Obesity in West Virginia. Retrieved April 26, 2005, from http://www.wvdhhr.org/bph/ oehp/obesity/section2.htm
45.
West Virginia Department of Health and Human Resources. (n.d.). West Virginia diabetes strategic plan, 2002-2007. Diabetes in West Virginia. Retrieved January 17, 2006 from http://www.wvdhhr.org/bph/oehp/diabetes/plan/diabetes_wv.pdf
46.
Yawn, B.P., Wollan, P., Scanlon, P.D., & Kurland, M. ( 2003). Outcome results of a school-based screening program for under-treated asthma. Annals of Allergy, Asthma, & Immunology , 90(5), 508-515.
