Pap smear screening among Asian Pacific Islander women in a multisite community-based cancer screening program.

This study assessed screening completion rates (SCR) and sociodemographic factors associated with Pap test screening among previously nonadherent, foreign-born Asian Pacific Islander (API) women across four sites participating in a community-based cancer screening program called ENCOREplus. At intake, 926 out of 1,140 women were nonadherent to recommended Pap test screening guidelines. Most participants were age 51 and older, had a high school education or higher, had been in the U.

Health care providers' assessments of the quality of advanced-cancer care in Latin American medical institutions: a comparison of predictors in five countries: Argentina, Brazil, Cuba, Mexico, and Peru.

This paper describes an innovative Pan-American survey on advanced-cancer care and examines the quality-of-care provided by Latin American institutions. A convenience sample of 777 physicians and nurses who treat cancer patients in Argentina, Brazil, Cuba, Mexico, and Peru were surveyed. Providers were identified through mass mailings, distribution at professional meetings and conferences, collaboration with regional institutions, professional organizations, and PAHO and online posting.

Factors associated with hospital mortality in traumatic injuries: incentive for trauma care integration.

Objectives: The main aim of this study was to contrast the variation in mortality between trauma centres (TCs) and non-trauma hospitals (NTHs) in Texas, and among TCs by sociodemographic and economic factors of trauma cases.

Study Design: Difference in fatality due to trauma by hospital type was studied for all injured cases hospitalized over a 2-year period.

Methods: The outcome measure was mortality following an injury for cases that survived the impact and were treated in any hospital.

What predicts the quality of advanced cancer care in Latin America? A look at five countries: Argentina, Brazil, Cuba, Mexico, and Peru.

Cancer is now a leading cause of death among adults in most Latin American nations. Yet, until recently, there has been limited research on the quality of, and access to, advanced cancer care in developing regions such as Latin America. This landmark, cross-national study assessed the quality of advanced cancer care in five Latin American countries by surveying a convenience sample of 777 physicians and nurses, and identifying the most salient influences on their quality-of-care assessments based on multiple linear regression analyses.

Regionalized trauma care system in Texas: implications for redesigning trauma systems.

Background: The aim of this investigation was to evaluate the theoretical framework of regionalized trauma care that places highest expertise at Level I and II Trauma Centers.

Material/methods: To document appropriateness of regionalization the authors examined outcomes of all injured cases hospitalized over 2 years in trauma centers in Texas. The outcome measure was survival following an injury for cases that were treated in any trauma center.

Mail versus internet surveys: determinants of method of response preferences among health professionals.

The authors evaluated determinants of response to Internet-based surveys in a sample (n = 5600) of Texas healthcare professionals. Participants were given the option of responding by mail or over the Web (response, 66%). Internet respondents were younger (p < .

An urban community's preferences for hypothetical outcomes of analgesic pain treatment.

We assessed preferences of urban residents regarding hypothetical treatment outcomes related to analgesic use to determine how well subjects understood the severity of the outcomes, describe community preferences for these outcomes, and identify predictors of preferences. In a cross-sectional telephone survey, we obtained mean ratings for hypothetical outcomes that included two dimensions of clinical pain (pain severity and potential side effects): A=moderate pain, three side effects; B=mild pain, three side effects; C=moderate pain, one side effect. We focused on 111 respondents who rated Outcome A, moderate pain with three side effects, as the worst condition (the logical choice).

Pain in aging community-dwelling adults in the United States: non-Hispanic whites, non-Hispanic blacks, and Hispanics.

Unlabelled: Racial and ethnic disparities in healthcare persist in the U.S. Although pain is one of the most prevalent and disabling symptoms of disease, only a few studies have assessed disparities in pain in large racially and ethnically diverse, middle- to late aged community samples, thus limiting the generalizability of study findings in broader populations.

Pain, depression, and fatigue in community-dwelling adults with and without a history of cancer.

The State of the Science Report by the National Cancer Institute on Symptom Management in Cancer identified gaps in understanding the epidemiology of pain, depression, and fatigue, and called for studies that will identify the extent of risk for these symptoms among those with cancer relative to other populations. Using year 2000 data from the Health and Retirement Study, a survey of a nationally representative sample of adults aged > or =50, we evaluated whether respondents with a history of cancer had excess risk for pain, depression, and fatigue compared to those without a history of cancer. We also compared clustering/co-occurrence of symptoms.

Validation of an asthma questionnaire for use in healthcare workers.

Background: Previous studies have described increased occurrence of asthma among healthcare workers, but to our knowledge there are no validated survey questionnaires with which to study this occupational group.

Aims: To develop, validate, and refine a new survey instrument on asthma for use in epidemiological studies of healthcare workers.

Methods: An initial draft questionnaire, designed by a multidisciplinary team, used previously validated questions where possible; the occupational exposure section was developed by updating health services specific chemical lists through hospital walk-through surveys and review of material safety data sheets.

Policy incongruence and public health professionals' dissonance: the case of immigrants and welfare policy.

The steady increase in immigrants to the United States has fueled a critical analysis of the process of allocation of health and social benefits to these newcomers. The myriad of interests and values surrounding this issue precipitated the formulation and adoption of the Personal Responsibility and Work Opportunity (Welfare Reform) Act of 1996. This dramatic welfare reform impacts federal, state, and local agencies that are required to determine the eligibility of benefits and manage the attendant consequences to the public as well as members of this vulnerable group.

Access to health care in a rural area of the Philippines.

This study reports the results of a household survey requested by the mayor and community health officials in an under-served and understudied rural town in the Philippines. The study examines the extent and determinants of access to care. Results showed that 15% had a check-up in the previous year, despite 63% reporting a family history of chronic diseases.

Measuring health state preferences for hemophilia: development of a disease-specific utility instrument.

Generic and disease-specific instruments have been used to assess health-related quality of life (HRQoL) in hemophilia. However, HRQoL measures also need to reflect patient preferences for various hemophilia health states. The goal of this project was to develop a disease-specific utility instrument that measures patient preferences for various health states unique to hemophilia.

Perceptions of analgesic use and side effects: what the public values in pain management.

In this population-based telephone survey, we evaluated the attitudes of 302 adults toward analgesic use and related side effects. Over half (68%) reported prior experience with 2 or more side effects. Vomiting (34%), confusion (32%), and nausea (17%) were ranked as the worst side effects.

Factors associated with health-related quality of life among an older population in a largely rural western region.

Context: As elderly people become a larger proportion of the rural population, it is important to identify those at risk for poor health. Predictors of health-related quality of life can be useful in designing interventions.

Purpose: One objective of the present study was to profile the health-related quality of life of community-dwelling, elderly people in a southwestern region of the United States.

Predictors of nurses' acceptance of an intravenous catheter safety device.

Background: It is important to determine the factors that predict whether nurses accept and use a new intravenous (IV) safety device because there are approximately 800,000 needlesticks per year with the risk of contracting a life-threatening bloodborne disease such as HIV or hepatitis C.

Objectives: To determine the predictors of nurses' acceptance of the Protectiv Plus IV catheter safety needle device at a teaching hospital in Texas.

Method: A one-time cross-sectional survey of nurses (N = 742) was conducted using a 34-item questionnaire.

Expanding the scope of health reform: application in the United States.

Since the demise of the Clinton national health plan in the early 1990s, a number of states in the US have continued to pursue health reform. The reforms reflect the on-going debate in the US and throughout the world over market-minimizing versus market-maximizing strategies to improve healthcare systems. This paper describes the limits of this debate and supports a broader view that focuses on how health policy can improve population health.

Impact of pain on self-rated health in the community-dwelling older adults.

This study examined the impact of pain on self-rated health status in the community-dwelling older adults using the 1993 public release data of the Asset and Health Dynamics Among the Oldest Old (AHEAD). AHEAD is a population-based household survey designed to examine the dynamic interactions between health, family, and economic variables among US older adults. Results showed that 33% of the older adults reported frequent pain and 20% reported significant pain resulting in activity limitation.

Perceptions of sedentary African-American women about continuous versus intermittent walking.

To meet current physical activity recommendations, a person may chose to adopt a continuous or an intermittent physical activity program, as long as they accumulate 30 minutes of moderate-intensity physical activity most days of the week. Sixty-four sedentary African-American women were surveyed to assess whether perceptions about continuous and intermittent walking programs differed. Specifically, we assessed whether perceptions of self-efficacy, outcome expectations, social support, and the environment varied with respect to walking programs.

Prevalence of and risk factors for hypertension in a rural area of the Philippines.

This study reports on a community health survey conducted among > or =30 year old rural residents of San Antonio, Nueva Ecija, Philippines, to serve as a basis for tailoring health programs for hypertension in the community. The focus of the analyses is the assessment of the prevalence of and risk factors for hypertension. A cluster survey was conducted among 336 residents in May 1998.

Barriers to care among racial/ethnic groups under managed care.

We describe barriers to care reported by racial/ethnic groups and explore the extent to which barriers vary between persons enrolled in managed care and those in non-managed care plans, using data from the 1996 Medical Expenditure Panel Survey (MEPS). Most respondents expressed satisfaction with their care; however, a substantial percentage reported experiencing barriers. Minorities, particularly Hispanics and Asian Americans, were more likely than non-Hispanic whites were to report barriers.

A framework for assessing practice-oriented scholarship in schools of public health.

Within many schools of public health, substantial ambiguity surrounds the process of defining and rewarding faculty contributions to practice-oriented scholarly activities. Ernest L. Boyer introduced a powerful and compelling new paradigm for assessing the core domains of scholarship: the scholarships of discovery, integration, teaching, and application.