A field test of the Cougar Home Safety Assessment (version 2.0) in the homes of older persons living alone

Objective: The purpose of this study was to develop and field test the Cougar Home Safety Assessment version 2.0 (Cougar 2.0). Method: First, the Cougar 2.0 was adapted and developed from the Cougar 1.0 — a tool made for a prior study. The Cougar 2.0 was then field tested in the residences of 44 older adults who lived alone. Additionally, the residents and a panel of occupational therapy home care specialists completed questionnaires about the assessment. Results: A number of concerning safety hazards were identified. An overall mean safety score of 89% was obtained. Fire risk criteria were the most unsafe. Favourable face validity feedback was obtained. Conclusion: There is a need for occupational therapy home safety assessment for older people who live alone. The Cougar 2.0 appears to be a valid tool in this regard. The Cougar Home Safety Assessment series is available at: http://www.misericordia.edu/misericordia_pg_sub.cfm?sub_page_id=935&subcat_id=108&page_id=338     

Home Care Safety Markers: A Scoping Review

Safety in home care is a new research frontier, and one in which demand for services continues to rise. A scoping review of the home care literature on chronic obstructive pulmonary disease and congestive heart failure was thus completed to identify safety markers that could serve to develop our understanding of safety in this sector. Results generated seven safety markers: (a) Home alone; (b) A fixed agenda in a foreign language; (c) Strangers in the home; (d) The butcher, the baker, the candlestick maker; (e) Medication mania; (f) Out of pocket: The cost of caring at home; and (g) My health for yours: Declining caregiver health.     

The Effect of AIDS Peer Health Education on Knowledge,Attitudes, and Practices of Secondary School Students in Khartoum,Sudan

BackgroundPeer education seeks to enroll students in persuasive communication programs aiming at AIDS prevention. Providing information about AIDS prevention methods can lead to behavioral change and also a potential reduction in unsafe sexual behavior, particularly among young people.ObjectiveThis study aims to assess the role of peer education interventions in improving awareness, attitudes, and practices of secondary school students and peer educators towards AIDS.MethodsThis is a pre-and post-study. The study was conducted among 400 students who were randomly selected from 10 gender-balanced schools. They received the information from trained peer educators. 200 peers carried out the intervention (20 peers from each school), which was conducted in phases. The intervention required coordinating with official concerned stakeholders, preparing teaching aids, and four days of training workshops for the peer educators. The data was analyzed using the Statistical Package for Social Science program (SPSS). A paired sample t-test was obtained and utilized to interpret the changes observed in pre- and post-intervention knowledge, attitude, and practice.ResultsThe study showed that the intervention program improved participants'' knowledge from 75.5% to 83.2%. This improvement was with specific regard to the following: the causative agent of AIDs (p = 0.017), which improved from 77.7% to 81.5%; the spread of HIV through mosquitos (p = 0.001), which showed an increase from 12.7% to 23.8%; the program focused on the concept of the HIV carrier (p = 0.001), and also on the AIDS risk when having multiple sex partners, (p = 0.001), showing an increase of 47.5% to 83.5%. Following the knowledge test, the attitudes of students significantly increased from 70% to 83% with regards to youth vulnerability to HIV (p = 0.001), while scored dropped from 15.7% to 8.5% concerning the topic of HIV voluntary testing (p = 0.001). The practices of students changed from 70% to 83% when prompted about shaking the hands of an HIV infected person and also from 84.8% to 87.7% about sharing food with an HIV infected person (p > 0.05).ConclusionThe study concluded that school peer education is an effective approach to inform students of unsafe sexual behavior with regards to HIV/AIDS. It is clear that peer education enables significant improvements to be made with regards to the knowledge, attitudes, and practices of the students.     

Whole Grain Nutrition Education Program Improves Whole Grain Knowledge and Behaviors Among Community-Residing Older Adults

U.S. older adults are not meeting the recommendation for whole grain (WG) intake. This pilot study determined the influence that a WG nutrition education program for community-residing adults aged 60?+?years has on WG knowledge and behaviors. The program included WG education and discussion, participation in hands-on activities and taste testing. Participants were mostly white, females. Total grain and WG dietary intake frequencies (WG frequency; p?≤?0.001), and “knowledge score” increased from PRE to POST (p?≤?0.001). Participants in PowerPoint-based classes had a higher “knowledge scores” at POST (p?=?0.002). Nearly all (n?=?139, 88.5%) intended to eat more WG foods, with almost two-thirds (n?=?93, 59.3%) reporting a “strong” intention to do so. There was a positive association between strength of intention to eat WG foods and “WG frequency” at POST (r?=?0.435, p?≤?0.001). Results suggest that this WG program is an effective strategy for improving WG knowledge and behaviors among older adults.     

Exploring the influence of family level and socio-demographic factors on women’s decision-making ability over access to reproductive health care services in Balkh province,Afghanistan

Abstract

In this paper, we analyze the family level and socio-demographic factors affecting women’s decision-making ability over access to reproductive health care services in rural communities of Balkh province, Afghanistan. A questionnaire survey was conducted with a total of 176 married women. Using logistic regression analysis, we found that four out of seven variables significantly influenced women’s decision-making ability over access to Reproductive Health Care Services (RHCS): extended family structure (OR = 14.31, p?<?0.01), husbands accompanying their wives to RHCS (OR = 4.12, p?<?0.05), discussing issues related to reproductive health with partner (OR = 3.57, p?<?0.05), and distance from home to a health facility (OR =0.86, p?<?0.01). Therefore, some policies or programs designed to improve husband-wife communication, in particular fostering discussions related to reproductive health and encouraging husbands to accompany their wives to health centers, are recommended to improve women’s decision-making ability over access to RHCS.     

Changing social and HIV/AIDS risk behaviours: Effects of life skills education among urban street youths

Abstract

The objective of this study was to examine the effect of a life skills education intervention among male and female youth in Ibadan, Nigeria, on knowledge about prevention and safe sexual practices, sexual roles and responsibilities, HIV/AIDS, money management, assertiveness and communication through follow-up interviews four weeks and eight weeks following the intervention. The participants were 98 males and females, and part of an initial survey of social and health problems of street youths in Ibadan, Nigeria. They were locality-separated, with consecutive assignments to two groups of experimental (n?=?54, exposure to a manual driven life skills education) and control (n?=?44, non-exposure to life skills education, but attention given) participants, and evaluated subsequently at four weeks and then at eight-week follow-ups. At the four-week post-intervention assessment, the experimental group showed significantly increased scores in the knowledge of antisocial behaviour prevention (p < 0.01), about HIV/AIDS (p < 0.001), about safe sexual practices (p < 0.001), about social roles and responsibilities and about assertiveness and communication (p < 0.01). At eight-week follow-up assessment, substantial significant reductions in reported antisocial and unsafe sexual behaviours were observed across the experimental group compared with the control group. The results suggest that street youths can be empowered through life skills education but with limitation to safe sexual practices over a sustained period of time in Nigeria.     

A Trial of an All‐Terrain Vehicle Safety Education Video in a Community‐Based Hunter Education Program

Purpose: All‐terrain vehicle (ATV) injury is an increasingly serious problem, particularly among rural youth. There have been repeated calls for ATV safety education, but little study regarding optimal methods or content for such education. The purpose of this study was to determine if an ATV safety video was effective in increasing ATV safety knowledge when used in a community‐based statewide hunter education program. Methods: During the baseline phase, surveys focusing on ATV safety were distributed to students in the Arkansas hunter safety program in 2006. In the intervention phase a year later, an ATV safety video on DVD was provided for use in required hunter education courses across Arkansas. The same survey was administered to hunter education students before and after the course. Findings: In the baseline phase, 1,641 precourse and 1,374 postcourse surveys were returned and analyzed. In the intervention phase, 708 precourse and 694 postcourse surveys were completed. Student knowledge of ATV safety after watching the video was higher than in preintervention classes. Knowledge of appropriate helmet usage increased from 95% to 98.8% (P < .0001). Awareness of the importance of not carrying a passenger behind the driver increased from 59.5% to 91.1% (P < .0001). Awareness of importance of hands‐on ATV rider training increased from 82.1% to 92.4% (P < .0001). Conclusions: A brief ATV safety video used in a hunter education course increased ATV safety knowledge on most measures. A statewide hunter education program appears to be a useful venue for ATV safety education.     

Home Safety Program for Older Adults

A disproportionately high number of older adults are involved in home accidents at considerable cost to both the individual and the nation. Preventive measures are cost-effective and easy to accomplish, and occupational therapists are uniquely qualified to educate older adults about ways to modify their environment or activities of daily living to lessen the risk of accidental injury. This article describes the developmcnt and operation of a Home Safety Program for Older. Adults in an agency on aging in Charlottesville, VA. The program has two components: safety improvements for individual homes, and community education. Funding, services and staff are discussed and recommendations are made for replication.     

Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety

Objective: In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors. Methods: We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smoke-free. 1,116 patients provided adequate data. Results: Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home. Conclusion: In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention.     

Successes in sexual health communications development,programmatic implementation and evaluation in the Torres Strait region 2006 to 2012

Objective: To evaluate the Indigenous sexual health promotion program in the Torres Strait 2006–2012 that culminated in an education‐entertainment radio drama, Kasa Por Yarn (KPY). Methods: A mixed methods approach applied to unpublished program documents and program‐derived peer‐reviewed publications was utilised. Results: Early initiatives established a strong partnership with Torres Strait Islander stakeholders. Significant community engagement throughout ensured a positive process. Telephone survey data (n=100, TSI, 15–24 years) found: 95% had heard of KPY and 80% listened to 2 or more episodes (reach); 86% recalled storylines/characters (recall); and 54% talked about KPY to family/friends (resonance). There was improvement in sexual health knowledge scores (p<0.00) in the 15–19‐year‐old Torres Strait Islander population between 2007 and 2012. The 2012 15–24‐year‐old population exposed to KPY had higher sexual health knowledge scores compared with those unexposed (p=0.02). Conclusions: This is an uncommon comprehensive evaluation of population‐based sexual health communications strategies delivered over years in a remote Australian setting. The findings are encouraging but demonstrate that positive shifts take time and are incremental. Implications: In addition to clinical strategies, strategic and sustained investment in sexual health promotion expertise that leads community partnership and program development is required to reduce youth risk and prevent HIV/AIDS in remote populations.     

Physician Training in Agricultural Safety and Health

ABSTRACT

This paper describes the Emory Agromedicine Training Project, a component of Occupational Medicine residency training at Emory University since 1991. The Project places occupational medicine residents in rural settings, where they perform a range of activities: working on farms, service visits to farms, grand rounds presentations to rural hospitals, public presentations in farm communities, and clinical service in the migrant health program. In addition they complete a directed reading syllabus and a research project. The rotation has been successful in building the residents' knowledge of agricultural safety and health, instilling positive attitudes toward the field, and achieving desired behaviors and skills. In addition, strong statewide networking was accomplished through this initiative. Areas of limited success include the small number of residents trained, some resident dissatisfaction with intense travel requirements and security concerns, and inability to secure long-term funding. We conclude that agricultural safety and health is highly suitable for inclusion in occupational medicine training, and this model should be extended to primary care specialties such as family practice.     

An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families

We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting.     

A Culturally Sensitive and Theory-Based Intervention on Prevention and Management of Diabetes: A Cluster Randomized Control Trial

Type 2 diabetes is an emerging concern in Kenya. This clustered-randomized trial of peri-urban communities included a theory-based and culturally sensitive intervention to improve diabetes knowledge, health beliefs, dietary intake, physical activity, and weight status among Kenyan adults. Those in the intervention group (IG) received a culturally sensitive diabetes education intervention which applied the Health Belief Model in changing knowledge, health beliefs and behavior. Participants attended daily education sessions for 5 days, each lasting 3 h and received mobile phone messages for an additional 4 weeks. The control group (CG) received standard education on COVID-19. Data was collected at baseline, post-intervention (1 week), and follow-up assessment (5 weeks). Linear mixed effect analysis was performed to assess within and across group differences. Compared to the control, IG significantly increased diabetes knowledge (p < 0.001), health beliefs including perceived susceptibility (p = 0.05), perceived benefits (p = 0.04) and self-efficacy (p = 0.02). IG decreased consumption of oils (p = 0.03), refined grains (p = 0.01), and increased intake of fruits (p = 0.01). Perceived barriers, physical activity, and weight status were not significantly different between both groups. The findings demonstrate the potential of diabetes education in improving diabetes knowledge, health beliefs, and in changing dietary intake of among adults in Kenya.     

Intervening to Improve Health Indicators Among Australian Farm Families

ABSTRACT

The Sustainable Farm Families project (http://www.sustainablefarmfamilies.org.au/) was a 3-year demonstration and education project designed to influence farmer behavior with respect to family health and well-being among cropping and grazing farmers in Victoria, New South Wales, and South Australia, Australia. The project was conducted by the Western District Health Service, Hamilton, Australia, in partnership with farmers; Farm Management 500 (peer discussion group); the Victorian Farmers Federation; Royal Melbourne Institute of Technology; and Land Connect. During the 3 years of the project, 128 farmers—men (70) and women (58)—were enrolled. The project utilized a combination of small group workshops, individualized health action plans, and health education opportunities to encourage farm safety and health behavior changes and to elicit sustained improvements in the following health indicators: body mass index (BMI), total cholesterol, fasting blood glucose, and blood pressure. Mean changes in these health indicators were analyzed using repeated measures analysis of variance (ANOVA) and McNemar's test compared the proportion of individuals with elevated indicators. Among participants with elevated values at baseline, the following average reductions were observed: BMI 0.44 kg/m² (p = .0034), total cholesterol 48.7 mg/dl (p < .0001), blood glucose 10.1 mg/dl (p = .0016), systolic blood pressure 12.5 mm Hg (p < .0001), and diastolic blood pressure 5.0 mm Hg (p = .0007). The proportion of participants with elevated total cholesterol at baseline decreased after 24 months (p < .001). Such findings suggest that proactive intervention by farmer associations, rural health services, and government agencies may be an effective vehicle for promoting voluntary farm safety and health behavior change while empowering farm families to achieve measurable reductions in important health risk factors.     

The Impact of a Culinary Coaching Telemedicine Program on Home Cooking and Emotional Well-Being during the COVID-19 Pandemic

The coronavirus pandemic enforced social restrictions with abrupt impacts on mental health and changes to health behaviors. From a randomized clinical trial, we assessed the impact of culinary education on home cooking practices, coping strategies and resiliency during the first wave of the COVID-19 pandemic (March/April 2020). Participants (n = 28) were aged 25–70 years with a BMI of 27.5–35 kg/m². The intervention consisted of 12 weekly 30-min one-on-one telemedicine culinary coaching sessions. Coping strategies were assessed through the Brief Coping with Problems Experienced Inventory, and resiliency using the Brief Resilient Coping Scale. Home cooking practices were assessed through qualitative analysis. The average use of self-care as a coping strategy by the intervention group was 6.14 (1.66), compared to the control with 4.64 (1.69); p = 0.03. While more intervention participants had high (n = 5) and medium (n = 8) resiliency compared to controls (n = 4, n = 6, respectively), this difference was not significant (p = 0.33). Intervention participants reported using home cooking skills such as meal planning and time saving techniques during the pandemic. The key findings were that culinary coaching via telemedicine may be an effective intervention for teaching home cooking skills and promoting the use of self-care as a coping strategy during times of stress, including the COVID-19 pandemic.     

Impact of a short,culturally relevant training course on cancer knowledge and confidence in Western Australia's Aboriginal Health Professionals

Objective: To develop, deliver and evaluate a cancer education course for Indigenous Health Professionals. Method: The cancer education course combines expert presentations, interactive sessions and visits to local cancer treatment centres. Three four‐day courses have been run, in both metropolitan and regional Western Australia (WA). Cancer knowledge and confidence were measured at baseline, course completion and at follow‐up (six to eight months). Data were analysed within subject. Results: Thirty‐five Aboriginal Health Professionals have completed the program, most from rural or remote WA. All confidence items significantly improved at course completion (p<0.005), but improvements for only two items, ‘I know what cancer is’ and ‘I can describe the different common cancers’, were sustained at follow‐up (p<0.05). Knowledge of treatment (p<0.05), screening (p<0.05) and the most common cancers in women (p<0.005) were significantly greater after course completion, but increased knowledge was not sustained at follow‐up. Conclusion: Demand for places suggests that Aboriginal Health Professionals are interested in developing knowledge, skills and confidence in cancer control. Attendance increased understanding of cancer and improved cancer knowledge however this was not maintained. Implications: A short, culturally relevant training course increases cancer knowledge and confidence, however, ongoing education is needed to maintain this.     

Psychosocial Correlates of Health Literacy Among Older Patients With Coronary Heart Disease

This study examined psychosocial correlates of health literacy (HL) scores among older patients with coronary heart disease (CHD). A cross-sectional survey assessed psychosocial factors relating to the following: self-efficacy (i.e., perception of ability to perform a specified behavior) for diet, exercise, medication, and for a future attempt to quit smoking; social support; social stigma; appointment attendance; knowledge of heart problems; and understanding of health information. Health literacy was measured by the Rapid Estimate of Adult Literacy in Medicine (REALM). Of 321 patients, 70 had a REALM score in the low HL range (<60). When adjusting for demographics, a lower REALM score was significantly associated with reports of increased difficulty understanding health information (p < .001), less knowledge of heart problems (p = .002), increased discomfort about asking for explanations of health information (p = .014), less support with discussing health problems (p = .020). Patients with CHD and low HL are likely to face psychosocial challenges when managing their health problems. In order to encourage these individuals to seek help, health professionals need to be aware of the psychosocial characteristics of patients with low HL. These individuals may need behavioral support to increase both their self-efficacy and their understanding of their medical condition.     

Evaluation of Nutrition Knowledge of Pregnant Women before and after Nutrition Education according to Sociodemographic Characteristics

ABSTRACT

The aim of this cross-sectional study is to evaluate the effect of nutrition education on nutritional knowledge levels of pregnant women. The study was undertaken on a sample of pregnant women (i = 743) attending health centers in Istanbul for prenatal care. Nutrition knowledge scores were significantly higher in posttest (23.0) than pretest (16.0) after receiving nutrition education (p < .001). Significant differences in pretest (p < .05) but not posttest (p > .05) scores were found for factors, such as education level, work status, and the number of pregnancies; significant differences in both test scores were found for age and nutrition information (p < .05). In conclusion, pregnant women need to be given adequate and appropriate nutrition education for maternal and child health according to sociodemographic characteristics.