Effects of a social-network method for group assignment strategies on peer-led tobacco prevention programs in schools

OBJECTIVES: Our study tested the effectiveness of network methods for identifying opinion leaders and for constructing groups. METHODS: Three conditions-random, teacher, and network--ere randomly assigned to 84 6th-grade classrooms within 16 schools. Pre- and postcurriculum data on mediators of tobacco use were collected from 1961 students. Peer leaders in the network condition were identified by student nominations, and those leaders were matched with the students who nominated them. RESULTS: Students in the network condition relative to the random condition liked the prevention program more and had improved attitudes (beta = -0.06; P <.01), improved self-efficacy (beta = -0.10; P <.001), and decreased intention to smoke (adjusted odds ratio [OR] = 0.46; 95% confidence interval [CI] = 0.38, 0.55). CONCLUSIONS: The network method was the most effective way to structure the program. Future programs may refine this technique and use it in other settings.     

The inclusion of patient testimonials in decision aids: effects on treatment choices.

BACKGROUND: Decision aids often provide statistical information and patient testimonials to guide treatment choices. This raises the possibility that the testimonials will overwhelm the statistical information. METHODS: Prospective jurors in Philadelphia County were presented with hypothetical statistical information about the percentage of angina patients who benefit from angioplasty and bypass surgery (50% and 75%, respectively). They were also given written testimonials from hypothetical patients who had benefited or not benefited from each of the two treatments. The numbers of patients benefiting and not benefiting were varied to be either proportionate to the statistical information or disproportionate. In study 1, all participants received 1 testimonial from a patient who had benefited from angioplasty and 1 from a patient who had not. Participants receiving the proportionate questionnaire version were also given 3 testimonials from patients who benefited from bypass surgery and 1 from a patient who did not, coinciding with the hypothetical statistical information. In contrast, participants receiving the disproportionate questionnaire version received only 1 testimonial from a patient who benefited from surgery and 1 from a patient who did not. In study 2, all participants received 2 examples of patients who benefited from angioplasty and 2 who did not. Participants with the proportionate questionnaire version received the same testimonials regarding surgery as in study 1. Those receiving the disproportionate questionnaire version received 2 testimonials from patients who benefited from bypass and 2 from patients who did not. Finally, a separate set of participants in study 2 received a questionnaire with no testimonials. RESULTS: In study 1, 30% of participants receiving the disproportionate questionnaire version chose bypass surgery versus 44% of those receiving the proportionate questionnaire (P = 0.002 by chi2). In study 2, 34% of participants receiving the disproportionate questionnaire version chose bypass surgery versus 37% of those receiving the proportionate questionnaire (P = 0.59 by chi2). Of those receiving no patient testimonials, 58% chose bypass surgery. CONCLUSIONS: The inclusion of written patient testimonials significantly influenced hypothetical treatment choices. Efforts to make the mix of positive versus negative testimonials proportionate to statistical information may, under some circumstances, affect choices in ways that cannot automatically be assumed to be optimal.     

江西省大中专院校健康教育师资艾滋病认识现况调查

[目的 ]了解江西省大中专院校健康教育教师的艾滋病认知状况和学校开展艾滋病预防健康教育的建议。 [方法 ] 2 0 0 3年 1月对江西省部分大中专院校的健康教育教师进行了问卷调查。 [结果 ]调查 84人 ,对艾滋病、性病相关知识平均得分 85 .7分 ,但对个别专业知识认识不够 ;90 %以上教师愿意承担在学校开展艾滋病健康教育及相关教育工作 ,认为当地健康教育重点人群是大学生 ,工作中的主要困难是领导不重视 ,缺乏合适的教学资料 ;多数人希望得到有关教育技巧方面的培训。 [结论 ]应进一步加强对学校健康教育师资的培训 ,重点培训教育技巧 ,社会各界和学校领导要加强对学校开展预防艾滋病健康教育的认识     

California teachers perceive school gardens as an effective nutritional tool to promote healthful eating habits

This study assessed elementary school teachers' perceived attitudes and barriers associated with school gardens, as well as the purpose and use of gardens in schools, specifically in relation to the link between gardens and nutrition. The questionnaire was mailed to California fourth-grade teachers at schools with gardens (N = 1,665). The response rate was 36% (n = 592). Teachers perceived the garden to be somewhat to very effective at enhancing academic performance, physical activity, language arts, and healthful eating habits. Nutrition was taught with the use of the garden by 47% of responding teachers. This research provides evidence for needed standards-based curricula materials and teacher training in relation to gardening and nutrition. The results from this study will contribute to development of needed resources and methods by which to encourage the use of gardens and nutrition education in schools.     

中国五地中小学校健康教育现状及其需求

  目的  调查2020年中国5个地区学校健康教育执行情况及其存在问题,为中小学健康教育相关规范制度的进一步修订和完善提供一定数据和理论支持。  方法  采用分层整群随机抽样方法,选取新疆维吾尔自治区乌鲁木齐市(1 295名)、海南省海口市(448名)、河北省石家庄市(788名)、四川省成都市(728名)和江苏省苏州市(793名)5个地区的4 052名学生进行网上问卷调查,了解学校健康教育实施和学生健康教育需求情况。  结果  有89.98%学生使用了统一的健康教育教材,63.50%的学生每周上1次健康教育课。学校健康教育中获得健康知识主要来源、使用统一教材、课时安排、授课教师在地区和学段间差异有统计学意义(χ2值分别为54.98,40.97,590.08,1 061.12;50.70,47.68,356.09,193.30,P值均 < 0.05)。学生健康知识主要来源为学校/教师(92.47%)。健康教育课授课教师主要是班主任(30.03%)。学生感兴趣的健康教育内容在性别、学段间差异均有统计学意义(χ2值分别为20.91,35.90,P值均 < 0.05),各地区间差异无统计学意义(P>0.05)。学生希望获取健康知识途径在地区和学段间差异均有统计学意义(χ2值分别为177.29,32.37,P值均 < 0.05)。  结论  学校健康教育现状良好,但需积极培养高素质健康教育教师队伍;同时各地应根据自身实际和学生需求,开展有针对性的健康教育活动,提高学生健康素养水平。     

Teacher tobacco use and tobacco use prevention in two regions in India: results of the Global School Personnel Survey

BACKGROUND: This paper compares tobacco use patterns and tobacco use prevention efforts among teachers in two Indian states with high versus low prevalence of tobacco use. METHODS: Data from the Global School Personnel Survey compared tobacco use patterns and tobacco use prevention activities among teachers from the Indian states of Maharashtra (N = 954) and Bihar (N = 524). RESULTS: 78% of teachers in Bihar and 31% from Maharashtra were current tobacco users. Tobacco control policies were virtually non-existent in schools in Bihar, while in Maharashtra, over one-fourth of teachers reported that tobacco use was prohibited among both students and teachers. Few teachers in Bihar taught their students about tobacco use prevention, while such teaching was more common in Maharashtra. In Maharashtra, teaching about tobacco use prevention was significantly associated with not currently using tobacco (P < 0.0001), having a policy specifically prohibiting tobacco use among students (P < 0.0001), and having a policy specifically prohibiting tobacco use among school personnel (P < 0.0001). CONCLUSIONS: This study has clear implications for implementation of tobacco control policies in Indian schools and further underscores the need for infrastructure support for tobacco use prevention in developing countries such as India, where tobacco use threatens to contribute to a growing proportion of the burden of disease worldwide.     

Social contextual factors and tobacco use among Indian teachers: Insights from the Bihar School Teachers' Study

ObjectiveTobacco use within India has significant effects on the global burden of tobacco-related disease. As role models and opinion leaders, teachers are at the forefront of tobacco control efforts, yet little is known about their own tobacco use. This study examines the association between factors in the social environment and tobacco use among teachers in Bihar, India.MethodsThe study was based on the Bihar School Teachers’ Study baseline survey. Seventy-two Bihar government schools (grades 8-10) were randomly selected for the study and all school personnel were invited to complete the survey in June/July in 2009 and 2010. We assessed the relation between social contextual factors and current smoking/smokeless tobacco use by fitting a series of logistic regression models.ResultsAfter controlling for clustering of teachers in schools and other covariates, our results showed teachers with one or more coworkers who used tobacco were twice as likely to be smokeless tobacco users as teachers with no co-workers who used tobacco. Teachers who reported rules prohibiting smoking at home were significantly less likely to smoke than teachers without such rules. Older male teachers also had significantly greater odds of smoking/using smokeless tobacco.ConclusionThese findings provide direction for future interventions targeting the social context.     

中小学校结核病健康教育现状分析

目的了解中小学校结核病健康教育现状,为更好地开展学校结核病健康教育提供参考依据。方法通过分层目的性抽样和随机整群抽样,对2个省3个县的676名学校健康教育相关教师和3127名学生进行问卷调查,并对其中2个县的4名行政部门领导、8名学校负责人和64名教师分别进行深入访谈和小组访谈。结果教师和中学生、小学生对结核病防治核心信息的正确掌握率分别为47.9%、36.1%和38.3%。学校健康教育专职教师占44.8%。92.6%的教师未接受过结核病健康教育方面的培训。39.8%的教师既往从未讲授过结核病相关的防治知识。学校结核病健康教育主要障碍为教师缺乏培训、教材和教学设备的缺乏。影响学校结核病健康教育工作开展的因素有教学能力、态度、政府和学校重视程度及学生的兴趣等。结论当前学校结核病健康教育工作亟待加强,需要卫生和教育部门的紧密配合,完善师资队伍和能力建设,开发和提供更多的教育资源,并建立稳定、持续的经费保障机制。     

A comparison between instructional experience and performance of teachers and nurses delivering a smoking prevention program.

This paper focuses on the implementation evaluation strategy of a smoking prevention program and examines differences in instructional experience and implementation of the grade six curriculum in relation to provider type. Arbaseline, nurses (n = 40), compared with teachers (n = 39), reported (a) less previous classroom teaching experience, (b) greater reliance on lecturing and audio/visual materials, (c) less use of small group classroom activities, and (d) less confidence using small group and role playing methods in the classroom. More nurses than teachers believed smoking to be a significant problem in the schools. Nurses had less confidence than teachers in their ability to teach the smoking prevention curriculum. Nonetheless, behavioural observation indicated that nurses implemented the curriculum more completely. However, teachers, at least those who received workshop training, showed some evidence of greater utilization of teaching styles thought to be desirable.     

Local school district adoption of state-recommended policies on HIV prevention education

BACKGROUND: This study evaluated the extent to which school districts in Massachusetts adopted HIV education policies consistent with state education agency recommendations, and whether adoption of state-recommended policy language was associated with other core components of school-based HIV prevention programs such as staff development, curriculum, and implementation characteristics. METHODS: A census of health coordinators (n = 251) and high school HIV teachers (n = 174) in randomly selected schools in Massachusetts were surveyed. Chi-squares and analysis of variance (ANOVAs) were used to analyze data. RESULTS: Most districts' policies fully incorporated state-recommended language for training HIV teachers (62%), providing HIV education within comprehensive sexuality education (62%), and providing skills-based instruction (57%). Districts adopting state-recommended policies were significantly more likely to have trained more HIV teachers (82% vs. 59% of teachers trained; P < 0.001), provided HIV education to a greater percentage of students (90% vs. 50% of students educated; P < 0.001), and adopted research-based curricula (44% vs. 27%; P < 0.01). High school teachers who received training and those using research-based curricula covered more HIV prevention topics and used more skills-based instructional methods than those who did not receive training or did not use research-based curricula (P < 0.01). CONCLUSIONS: Results suggest that strong, state-level HIV prevention education policy recommendations can help shape local school health policy and, when adopted locally, can positively influence the reach and quality of HIV education.     

The Association Between Socio-Ecological Factors and Having an After-School Physical Activity Program

BACKGROUND: After-school physical activity (PA) programs promote PA among youth. Few studies have used socio-ecological health models to identify barriers and facilitators of after-school PA programs. This study examined which socio-ecological factors are associated with having an after-school PA program. METHODS: A questionnaire was administered to key representatives of 114 elementary and 129 secondary schools. The association between socio-ecological factors and having an after-school PA program was analyzed at school level. RESULTS: In both types of schools more knowledge about community schools was positively associated with having an after-school PA program (odds ratio [OR] = 1.96; 95% confidence interval [CI] = 1.18-3.27; OR = 1.88; 95% CI = 1.27-2.80, respectively). In elementary schools, environmental factors associated with having an after-school PA program included PA facilities (OR = 4.98; 95% CI = 1.08-23.05), a PA working group (OR = 3.37; 95% CI = 1.02-11.10), agreements with the community (OR = 1.60; 95% CI = 1.05-2.43), shortage of human resources (OR = 0.57; 95% CI = 0.37-0.89) and lack of support from teachers (OR = 0.51; 95% CI = 0.33-0.80). In secondary schools, environmental factors included the presence of a remunerated coordinator (OR = 5.12; 95% CI = 1.38-19.10) and partnerships with "sport and PA leaders" (OR = 3.54; 95% CI = 1.01-12.41). CONCLUSION: Having an after-school PA program was associated with personal and environmental factors, which supports the use of socio-ecological frameworks for explorative and intervention studies aiming to increase after-school PA programs.     

The need for public education on HPV and cervical cancer prevention in Asia. Opinions of experts at the AOGIN conference

Asia accounts for more than half of all cases of cervical cancer registered globally and improving prevention is urgently needed. A range of tools and strategies is now available to effectively prevent this disease, including two new prophylactic HPV vaccines approved and recommended for adolescents and young women. However, without communication these tools may have little impact on disease burden. The conferences of the Asia Oceania Research Organisation in Genital Infection and Neoplasia (AOGIN) bring together clinicians and scientists whose work is related to genital infections, particularly HPV, cervical dysplasia and neoplasia, as well as other anogenital cancers, with the aim of improving communication on prevention through human papillomavirus (HPV) vaccination and screening in Asian countries. The scope of this year's AOGIN conference was to extend education to include health workers, family doctors, paediatricians, governmental health agencies, and the general public through patients' testimonials that can reach out to women raising awareness of this silent disease. Community based initiatives and awareness campaigns were also reported, and can empower the people to engage in a dialog with local governments towards prioritization of cancer prevention programs, achieving more for the public than isolated actions. Parents and teachers are encouraged to communicate about these issues within families and schools. Evidence was discussed that males can participate in cervical cancer control as well, and prevention programs involving men should not be neglected as they may reduce genital disease burden in women. Opinion leaders proposed prevention measures to be considered for governmental decisions. While each country develops a locally appropriate policy for cervical cancer control there is a need to revise these programs regularly, as knowledge increases in response to public need, as well as to gather evidence about disease burden and the effectiveness of education and interventions. In conclusion, AOGIN is committed to improve communication with patients, health authorities, professional organizations and opinion leaders towards strengthening cervical cancer prevention in Asia, to achieve a timely steep reduction in this cancer.     

Tobacco Use Prevention Education (TUPE) Programs in the State of Florida: correlates and predictors of teachers' perceptions of program effectiveness

In Florida, data from telephone surveys were used to identify correlates and predictors of teachers' perceptions of the effectiveness of tobacco use prevention education (TUPE) prior to the implementation of the Tobacco Pilot Project (TPP). A 40% random sample of public middle and high schools yielded 296 middle school teachers (MST) and 282 high school teachers (HST). Higher perceived program effectiveness ratings were associated with: using peer leaders, frequent evaluations, parental involvement, few barriers, high student interest, and low tolerance norms for tobacco use. The importance of program features and implementation contexts to teachers' perceived program effectiveness ratings is highlighted.     

Targeting school tobacco policy: lessons from the Acadiana Coalition of Teens Against Tobacco (ACTT)

This case study examines the comparative effect of no-use school tobacco policies and restricted-use tobacco policies on teacher and student smoking behaviors and attitudes. Data from teachers (n = 1,041) and ninth-grade students (n = 4,763) at 20 schools in five districts in southern Louisiana were available. No significant difference was observed between teacher smoking (11% vs. 13%, p = .42) or student smoking (24.6% vs. 25.2%, p = .75) at no-use versus restricted-use policy schools. The proportion of teachers smoking on campus at no-use or restricted-use schools was not significantly different. Teachers at restricted-use schools were however less concerned about students seeing teachers smoke and less supportive of a no-use policy than teachers at no-use schools. Tobacco use policies are often not promoted, and enforcement of policies impacting teachers is complex. Changing social norms for smoking at high schools through policy promotion and enforcement is understudied.     

Sexuality education in fifth and sixth grades in U.S. public schools, 1999

CONTEXT: While policymakers, educators and parents recognize the need for family life and sexuality education during children's formative years and before adolescence, there is little nationally representative information on the timing and content of such instruction in elementary schools. METHODS: In 1999, data were gathered from 1, 789 fifth- and sixth-grade teachers as part of a nationally representative survey of 5,543 public school teachers in grades 5-12. Based on the responses of 617 fifth- and sixth-grade teachers who said they teach sexuality education, analyses were carried out on the topics and skills sexuality education teachers taught, the grades in which they taught them, their teaching approaches, the pressures they experienced, whether they received support from parents, the community and school administrators, and their needs. RESULTS: Seventy-two percent of fifth- and sixth-grade teachers report that sexuality education is taught in their schools at one or both grades. Fifty-six percent of teachers say that the subject is taught in grade five and 64% in grade six. More than 75% of teachers who teach sexuality education in these grades cover puberty, HIV and AIDS transmission and issues such as how alcohol and drugs affect behavior and how to stick with a decision. However, when schools that do not provide sexuality education are taken into account, even most of these topics are taught in only a little more than half of fifth- and sixth-grade classrooms. All other topics are much less likely to be covered. Teaching of all topics is less prevalent at these grades than teachers think it should be. Gaps between what teachers say they are teaching and teachers' recommendations for what should be taught and by what grade are especially large for such topics as sexual abuse, sexual orientation, abortion, birth control and condom use for STD prevention. A substantial proportion of teachers recommend that these topics be taught at grade six or earlier. More than half (57%) of fifth- and sixth-grade sexuality education teachers cover the topic of abstinence from intercourse--17% as the only option for protection against pregnancy and STDs and 40% as the best alternative or one option for such protection. Forty-six percent of teachers report that one of their top three problems in teaching sexuality education is pressure, whether from the community, parents or school administrators. More than 40% of teachers report a need for some type of assistance with materials, factual information or teaching strategies. CONCLUSIONS: A large proportion of schools are doing little to prepare students in grades five and six for puberty, much less for dealing with pressures and decisions regarding sexual activity Sexuality education teachers often feel unsupported by the community, parents or school administrators.     

A randomized trial of opinion leader endorsement in a survey of orthopaedic surgeons: effect on primary response rates

BACKGROUND: Opinion leaders have been shown to have significant influence on the practice of health professionals and patient outcomes. METHODS: Using focus groups, key informants, and sampling to redundancy techniques, we developed a questionnaire of surgeons' preferences in the treatment of tibial shaft fractures. Twenty-two well-respected and widely known orthopaedic traumatologists endorsed the questionnaire. We randomized 395 surgeon members of the Orthopaedic Trauma Association to receive either a questionnaire that included a letter informing them of the opinion leaders' endorsement, or a questionnaire without the endorsement. RESULTS: Surgeons who received the letter of endorsement had a significantly lower response rate at 2, 4, and 8 weeks. The absolute difference in response rates was 7.8% (4.6% versus 12.4%, P < 0.05) at 2 weeks, 13.1% at 4 weeks (28.6% versus 41.7% P < 0.02), and 12.3% at 8 weeks (47.5% versus 59.8% P = 0.02). CONCLUSIONS: The addition of a letter listing expert surgeons who endorse the survey lead to significantly lower primary response rates. Those interested in influencing physician responses cannot always assume a positive effect from endorsement by opinion leaders     

Patterns of tobacco use amongst school teachers

Indulgence in tobacco is a known health risk. The example of school teachers in this regard is likely to have far reaching influence on their pupils and the community. A cross sectional study among 257 teachers from 30 schools revealed that as high as 51.0% teachers consumed tobacco in one form or the other. Smoking was the most popular form of tobacco use (72%). Marked gender differences were noted with 73.9%. Male teachers hooked to tobacco habit in comparison to 13.9% of female teachers. Educational qualification had paradoxical effect on tobacco habit as fewer (20.0%) graduate teachers used tobacco in comparison to non graduate teachers (55.7%). However proportion of Post graduate teachers consuming tobacco was still higher (64.2%). Initiation to tobacco habit in majority began at age 21 years and beyond. Common reasons given for tobacco consumption were curiosity (37.9%), to be social (22.0%), enjoyment (21.2%), to relieve stress (8.17%) and improving performance (5.8%). 21.9% smokers consumed more than 20 cigarettes a day. More than four fifth teachers consciously avoided tobacco use in school premises. Nearly half (45.3%) of tobacco users reported reduction in tobacco use in preceding two years. By and large teachers (92.4%) were aware of harmful consequences of tobacco on health. But only in 29.6% it was a cause for concern. 71.2% respondents intended to give up tobacco habit. 33.7% smokers were aware of hazards of passive smoking to others.     

Efficacy of training and fidelity of implementation of the life skills training program

This study assessed the effectiveness of a model for diffusing the Life Skills Training (LST) Program into middle schools, examined implementation fidelity, and explored factors associated with involvement in training and program implementation. A convenience sample of master trainers (n = 44) and teachers (n = 45) from 16 Kentucky counties participated. Teachers were observed for content and process fidelity, and trainers and teachers completed questionnaires to assess factors related to training and program implementation. More than one-fourth (27%) of master trainers conducted training sessions, and 60% of teachers taught the curriculum. While implementation fidelity was relatively high, teachers were less likely to use the more innovative elements of the program. Trainers and teachers who conducted training and/or taught the LST Program were more enthusiastic toward the program than those who did nothing beyond being trained.     

某市小学教师脑力负荷状况及其相关因素的调查

目的 探讨某市小学教师脑力负荷的分布特征及其主要影响因素.方法 采用随机整群抽样的方法抽取397名某市城区和郊区小学教师,采用经信度、效度验证的任务负荷指数(NASA-TLX)评价量表测量其脑力负荷水平.结果 某市女性小学教师脑力负荷得分( 64.34+10.56)较男性(61.73±9.77)高,差异有统计学意义(P＜0.05);～35岁组小学教师脑力负荷水平最高(65.66±10.42),年龄＜35岁时,脑力负荷与年龄呈正相关(r=0.146,P＜0.05);年龄＞35岁时,脑力负荷与年龄呈负相关(r=-0.190,P＜0.05);文化程度越高的小学教师感到的脑力负荷越大(偏回归系数B=1.524,标准偏回归系数β=0.111,P＜0.05);每天工作时间越长,小学教师脑力负荷越大,且对脑力负荷的影响最大(偏回归系数B=4.659,标准偏回归系数β=0.223,P＜0.01).结论 南昌市小学教师脑力负荷水平与年龄、学历以及每天工作时间密切相关,每天工作时间是影响其脑力负荷水平的重要危险因素,减少每天工作时间特别使其控制在8h以内可能是减轻小学教师脑力负荷的有效措施.