American Journal of Health Promotion

This study examined the broader use of a print-media intervention, which was previously shown to be effective at promoting physical activity to participants recruited from a regional Australian community, as a strategy suitable for a more diverse statewide population sample.

Participants were randomly selected adults who responded to a telephone interview conducted by the New South Wales Health Department and consented to participate in a randomized controlled trial. Consenters were allocated to either intervention (n = 361) or control (n = 358) conditions. The intervention, a personalized letter plus stage-targeted booklets, was sent 1 week postbaseline. Data were collected via telephone interview at baseline and 2 and 8 months and were analyzed using repeated measures analysis of variance (ANOVA) and χ² statistics.

The groups were similar at baseline (mean age 43 ± 3 years; 64% women). Process evaluation showed high intervention recall (76% at 2 months) and high follow-up response rates (>85% at 8 months) were achieved. Nonsignificant increases in physical activity were observed (F _1,719 = 2.18, p = .14).

A single mailing of stage-targeted print materials was not effective in promoting increases in physical activity among participants selected from the statewide population. Future research could examine how the effectiveness of print media might be enhanced, possibly by using supplementary media, community-based prompts, or other incentives.

To evaluate the acceptability and feasibility of a lifestyle physical activity program for people with spinal cord injury (SCI).

Sixteen nonexercising adult volunteers with SCI participated in a single group pre-post–test of the “Be Active in Life Program” comprising stage-matched educational materials, home visit by a nurse, construction of a personal plan to increase activity, and four follow-up phone calls. Program acceptability, stage of change, barriers to health-promoting activities, abilities for health practices, health, depression, and muscle strength were rated. Physical activity was monitored using actigraphy and a self-report record.

Participants rated the program positively, although some preferred a structured exercise approach. Eighty-one percent of participants progressed in stage of change and 60% increased physical activity. There were significant changes in motivational barriers, exercise self-efficacy, self-rated health, and muscle strength.

Lifestyle physical activity is feasible and acceptable and could be effective in promoting greater physical activity among people with SCI.

To test the effectiveness of a video to teach patients about prostate cancer screening and treatment in a clinic setting.

A staged, two-group, pretest-posttest quasi-experimental design was used. Questionnaires were completed before and after a routine doctor's appointment in a Veteran's Administration clinic. The experimental group (n = 52) viewed the video, and the control group (n = 52) received usual care only. The two groups were similar in age, education, race, and quality of life.

Knowledge increased significantly from pretest to posttest for the experimental group, but not for the control group (p < .001). More patients in the experimental group changed their preference for prostate-specific antigen (PSA) screening (31% experimental vs. 2% control, p = .002), indicating the patients were impacted by the information presented. Viewing the video did not stimulate increased discussion with the physician or lengthen appointment time.

The video was effective in improving knowledge about a complex topic and changing some patients' preference for PSA testing without frightening or confusing patients.

Prenatal smoking cessation will not eliminate health risks if women continue to be exposed to passive smoking. This study compared the risks of secondhand smoke (SHS) exposure for low-income prenatal nonsmokers, abstainers, and smokers.

A questionnaire was administered to 225 pregnant women. Exposure to six sources of SHS was compared across smoking groups using chi-square and multivariate logistic regression.

In adjusted analyses, patterns of SHS exposure were consistent. Abstainers were at lower risk of exposure than smokers for all sources except for having a partner who smoked. Abstainers were at higher risk of exposure than nonsmokers for most sources. For example, 11.7% of nonsmokers were exposed to <4 hours of SHS daily compared with 33.3% of abstainers (adjusted odds ratio = .32, 95% confidence interval = .12–.88). Mean number of exposures for nonsmokers, abstainers, and smokers were 1.4, 2.7, and 4.2, respectively (p < .001).

Interventions need to address the full range of health risks posed by cigarette smoke exposure during pregnancy.

To examine cognitive responses to a 4-month health promotion program targeting diet and physical activity in recently cohabiting couples.

A three-group randomized controlled trial: no intervention (Controls), interactive group sessions and mail-outs (Interactive), and one group session followed by mail-outs (Mail).

Australian research studies unit.

Seventy-eight of 137 couples cohabiting for <2 years, recruited by advertising, completed the study.

Stages of change; health beliefs; self-efficacy; and perceived barriers to change evaluated by questionnaires at baseline, postintervention, and 1-year follow-up. Data were analyzed using mixed models, factor analysis, and linear regression.

In the Mail group, the perceived importance of barriers to dietary change decreased by 19% at postintervention and 16% at 1-year follow-up; dietary self-efficacy increased by 9% and 3%, respectively. In the Interactive group, the perceived importance of barriers to dietary change decreased by 26% and 20%, and dietary self-efficacy increased by 14% and 12%, respectively. Similar trends for physical activity were not statistically significant. However, changes in self-efficacy and perceived barriers to change significantly predicted dietary and physical activity behaviors. A preponderance of higher socio-economic groups and the proportion of drop-out may have biased results.

Health promotion using partners' support and targeting diet and physical activity improves associated cognitive variables in couples. Most improvements were greater and more sustained with interactive group sessions.

This study assessed the impact on stair use of four sequential environmental interventions: (1) installing new carpet and painting the walls, (2) adding framed artwork on stair landings, (3) displaying motivational signs throughout the building, and (4) adding a stereo system and playing various types of music in the stairwell.

We conducted a longitudinal study with no comparison group to evaluate the impact of environmental changes on stairway use. The setting was the main stairwell in the Centers for Disease Control and Prevention's (CDC) Rhodes Building in Atlanta, Georgia. Proximity sensors were installed in each stairwell entry to monitor traffic. The subjects were 554 permanent CDC employees and 110 temporary employees. Changes in stairwell use by intervention were evaluated.

Both motivational signs and music significantly increased stair use by 8.9% over baseline (p < .05). The increase in sign use occurred in the first 3 months of the intervention, whereas the increase in music occurred after the first 3 months.

These data suggest that physical improvements to a stairwell, signage that encourages stair use, and music may increase physical activity among building occupants.

To illustrate a formula to estimate the amount of risk reduction required to break even on a corporate health promotion program.

A case study design was implemented. Base year (2001) health risk and medical expenditure data from the company, along with published information on the relationships between employee demographics, health risks, and medical expenditures, were used to forecast demographics, risks, and expenditures for 2002 through 2011 and estimate the required amount of risk reduction.

Motorola.

52,124 domestic employees.

Demographics included age, gender, race, and job type. Health risks for 2001 were measured via health risk appraisal. Risks were noted as either high or low and related to exercise/eating habits, body weight, blood pressure, blood sugar levels, cholesterol levels, depression, stress, smoking/drinking habits, and seat belt use. Medical claims for 2001 were used to calculate medical expenditures per employee.

Assuming a $282 per employee program cost, Motorola employees would need to reduce their lifestyle-related health risks by 1.08% to 1.42% per year to break even on health promotion programming, depending upon the discount rate. Higher or lower program investments would change the risk reduction percentages.

Employers can use information from published studies, along with their own data, to estimate the amount of risk reduction required to break even on their health promotion programs.

To analyze the characteristics of the articles reviewed in the DataBase section of the American Journal of Health Promotion and to summarize this review in tabular format.

All 350 entries in the American Journal of Health Promotion DataBase section beginning with issue 1:3 (Winter 1987) through issue 17:3 (January/February 2003) were included in this review.

Every study summarized in the DataBase section was included. Five duplicate sets of entries existed in the DataBase section. One entry from each set was excluded based upon author consensus. Thus, this review includes 345 unique entries.

All data reported in the DataBase section (e.g., sample sizes, measurement tools, study duration), as well as additional data derived directly from the studies (i.e., cross-sectional versus longitudinal study design, unit of analysis, and study topic) were entered in SPSS 11.5 for PC (SPSS, Inc, Chicago, Illinois).

Data were synthesized to identify the frequency of entry by research question, research design and internal validity rating, unit of analysis, measurement tool(s), and health topics addressed.

The majority of articles included in the DataBase received the highest research design rating, had robust sample sizes, and were of a meaningful duration. Additionally, a wide variety of topics were addressed. Overall, these strengths indicate that a solid foundation of research has been established on many of the most critical issues facing the health promotion field.