A randomized clinical trial evaluating online interventions to improve fruit and vegetable consumption.

Objectives: We assessed change in fruit and vegetable intake in a population-based sample, comparing an online untailored program (arm 1) with a tailored behavioral intervention (arm 2) and with a tailored behavioral intervention plus motivational interviewing-based counseling via e-mail (arm 3).

Methods: We conducted a randomized controlled intervention trial, enrolling members aged 21 to 65 years from 5 health plans in Seattle, Washington; Denver, Colorado; Minneapolis, Minnesota; Detroit, Michigan; and Atlanta, Georgia. Participants reported fruit and vegetable intake at baseline and at 3, 6, and 12 months.

Methods for characterizing fine particulate matter using ground observations and remotely sensed data: potential use for environmental public health surveillance.

This study describes and demonstrates different techniques for surface fitting daily environmental hazards data of particulate matter with aerodynamic diameter less than or equal to 2.5 microm (PM2.5) for the purpose of integrating respiratory health and environmental data for the Centers for Disease Control and Prevention (CDC) pilot study of Health and Environment Linked for Information Exchange (HELIX)-Atlanta.

Effect of incentives and mailing features on online health program enrollment.

Background: With the growing use of Internet-based interventions, strategies are needed to encourage broader participation. This study examined the effects of combinations of monetary incentives and mailing characteristics on enrollment, retention, and cost effectiveness for an online health program.

Methods: In 2004, a recruitment letter was mailed to randomly selected Midwestern integrated health system members aged 21-65 and stratified by gender and race/ethnicity; recipients were randomly pre-assigned to one of 24 combinations of incentives and various mailing characteristics.

Gender differences in asthma experience and disease care in a managed care organization.

The purpose of this study was to describe gender differences in asthma in a managed care organization. We collected data from a patient survey, electronic administrative data, and hard-copy chart reviews. Women reported significantly lower general health status, more symptoms and greater severity of asthma, more activity limitations, more use of asthma-relieving medications, and more acute visits for asthma than men.

The Role of Research in Integrated Health Care Systems: The HMO Research Network.

Integrated care systems have unique advantages for conducting research. The HMO Research Network (HMORN) includes research centers associated with 13 large integrated care systems whose research focuses on improving health and health care delivery using the extraordinary platform provided by these health systems. We conducted literature reviews and surveys and interviews with directors of HMORN research centers, research investigators, and selected support staff in order to identify the characteristics of the research in HMORN centers and to present examples of how this research has affected health and health policy.

Testing for prostate and colorectal cancer: comparison of self-report and medical record audit.

Background: Self-reported data are often used to determine cancer screening test utilization, but self-report may be inaccurate.

Methods: We interviewed members of three health maintenance organizations and reviewed their medical records for information on digital rectal exam (DRE), prostate-specific antigen (PSA) test, fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy (response rate 65%). We calculated the sensitivity, specificity, concordance, and kappa statistic to compare the two sources for black men (n = 363), white and other men (n = 847), and women (n = 920) by study location.

Factors Associated with Smoking Cessation Among Quit Smart(™) Participants.

Objectives: To evaluate social and program factors associated with the one-year smoking cessation rate among participants of a smoking cessation program at a managed care organization (MCO).

Methods: As implemented at this MCO, the Quit Smart(™) program incorporated group sessions taught by health educators, discount vouchers for nicotine replacement patches, self-help manuals, and a relaxation audiotape. A survey of 97 patients who participated in the program during 1999 or 2000 or both was administered one year after these participants completed the program.

Is vaginal douching associated with preterm delivery?

Background: To examine the hypothesized association between vaginal douching and preterm delivery, we conducted a study among women in a managed care organization in Atlanta, GA.

Methods: We drew a stratified random sample of 262 preterm (20-36 weeks' gestation) and 804 term deliveries that occurred between January 1996 and April 1997. Data were collected from telephone interviews and medical records.