Health Promotion Council

Abstract Introduction: Obesity, which has important implications for cancer risk and outcomes, is the cumulative effect of diet and physical activity behaviors. Many adults, especially those from racial and ethnic minority groups, do not meet the recommended guidelines for these behaviors. Previous research has shown that cancer risk information is effective at motivating early detection, but empirical data are not available on the effects of risk factor information on prevention behaviors. Purpose: We conducted a randomized trial to evaluate the effects of alternate forms of risk factor education on prevention behaviors in a community-based sample of African American adults (n=212). Methods: This study was conducted as part of an academic-community partnership; the intervention protocols were developed collaboratively by a multi-disciplinary investigative team consisting of academic and community investigators. The integrated risk counseling (IRC) protocol provided education about the overlap in behavioral risk factors for cancer and cardiovascular disease and the disease-specific (DSC) protocol only provided education about behavioral risk factors for cardiovascular disease. Elements from motivational interviewing were incorporated into IRC and DSC; interactive activities were included in both protocols to develop and enhance skills for increasing fruit and vegetable intake and physical activity. Adherence to recommendations for fruit and vegetable intake and physical activity were evaluated by self-report by telephone at baseline and at 1-month following intervention. We predicted that IRC would lead to greater adherence rates compared to DSC. Regression analyses, using an intent-to-treat approach were conducted to evaluate adherence rates for behavioral outcomes while controlling for baseline levels. Results: Compared to DSC, IRC was associated with increased adherence rates for fruit intake only (OR=1.85, 95% CI=0.99, 3.44, p=0.05). At baseline, 37.4% of participants who were randomized to IRC met the recommended guidelines for fruit intake, but at follow-up 57.4% were adherent. There were no significant changes in adherence rates for fruit intake among those who were randomized to DSC (31.1% versus 41.5%). Conclusions: Our findings suggest that integrated risk factor education leads to improved behavioral prevention for some outcomes. Making multiple behavioral changes simultaneously may be particularly difficult. Citation Format: Melanie S. Jefferson, Benita Weathers, Scarlett Bellamy, Ernestine Delmoor, Vanessa Briggs, Jerry Johnson, Rodney Rogers, Joseph Purnell, Chanita Hughes-Halbert. Effects of integrated risk counseling on cancer prevention behaviors. [abstract]. In: Proceedings of the Eleventh Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2012 Oct 16-19; Anaheim, CA. Philadelphia (PA): AACR; Cancer Prev Res 2012;5(11 Suppl):Abstract nr A06.

Objectives. Local asthma prevalence, especially in high-risk areas, may vary greatly from those estimated by national or regional data and targeted, community-specific approaches may be needed to assess the burden of childhood asthma. The Philadelphia Merck Childhood Asthma Network project sought to understand the local prevalence of asthma in Philadelphia communities and schools of low-income, disadvantaged children utilizing a grassroots approach that would access traditionally hard-to-reach families. Methods. Two asthma-screening methodologies were implemented using the Brief Pediatric Asthma Screen. Door-to-door screening was conducted in disadvantaged neighborhoods by community health workers. School screening was implemented in each class through partnership with the school principals and teachers in disadvantaged neighborhoods within the same target area. Results. A total of 2368 children were screened through door-to-door methodology and 5563 children were screened in the schools. Door-to-door screening revealed asthma prevalence of 21.7%, with an additional 4.9% reporting symptoms consistent with asthma. School screening results revealed a higher prevalence with more than a quarter (27.5%) of the students screened positive for asthma. An additional 16.7% had symptoms indicative of asthma. Conclusions. Both methods were able to successfully identify children with asthma in hard-to-reach populations. These methods can easily be replicated in other cities and the results can be used to inform programs, services, and policy developments.

Using a simulated anthrax exposure scenario, the Philadelphia Department of Public Health tested how rapidly and accurately a head-of-household (HoH) point of dispensing (PoD) site with an express dispensing line could provide medication to heads of households collecting antibiotics for all household members. The 8 pretrained PoD leadership staff trained the other 42 PoD staff in the hour before the field trial. During the 2-hour field trial, proxy-HoHs used scripts with pertinent information describing household members to complete a HoH PoD intake form. PoD staff, 6 with medical training, used the form to direct HoHs to either express dispensing, where only adult dosing of ciprofloxacin was provided for each household member, or to screening, where targeted information was collected before antibiotics were dispensed. In 2 hours, 717 individual HoHs picked up medication for a total of 2,120 household members (average household size = 2.96 persons) with a throughput rate of 1,060 person-medication doses dispensed per hour. Among 616 (86%) HoHs with a recorded PoD transit time, the 294 express-line-eligible HoHs passed through twice as fast as the 322 HoHs who required screening (medians = 3 versus 8 minutes, respectively, p < 0.01). Ninety-seven percent of people were accurately prescribed antibiotics. HoH PoDs, using a limited number of medically trained staff, can rapidly and accurately provide medication to a large population. The express dispensing line speeded transit time without compromising medication dispensing accuracy. Dispensing medications to HoHs can be an accurate and effective way to reach large populations during a public health emergency.

A program to provide teenage family planning clinic patients with special services designed to improve their ability to practice contraception effectively and avoid conception produced neither of these expected effects. Two types of special services were tested in nine clinics: one, to promote greater involvement of the teenager's family through special counseling sessions (family support); and the other, to provide more frequent contact between the teenager and clinic staff through telephone calls (periodic support). The services were provided in the six weeks following the first clinic visit. Only 36 percent of the girls who agreed to be in the family support group attended any counseling sessions, and only five percent of them came with a parent. Participation was greater in the periodic support group--84 percent of teenagers in the group received the follow-up phone calls. During the 15 months following the initial clinic visit, there were no significant differences in regularity of contraceptive use and pregnancy rates between the teenagers who received the special support services and those who received only the regular clinic services. About 40 percent of the special-service groups reported always using a contraceptive method during the study period, compared with 48 percent of controls; and about 40 percent of the former said they had rarely or never used a method, compared with 27 percent of the latter. The cumulative 15-month pregnancy rate was about 13 percent in both the special-service and the control groups.

The People's Republic of China is potentially a vast market for foreign goods and services and a potent source of exports for the world community. The recent thaw in Sino-American relations, among other factors, has caused a growing awareness of this potential. At the same time, growing Chinese economic strength and stability-coupled with the present Chinese domestic and world political situation-have caused China to deal increasingly in Western markets.