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A STUDY
OF THE IMPLEMENTATION OF HIV EDUCATION PROGRAMS IN PENNSYLVANIA
SCHOOLS
- Bernard J. Healey, Ph.D.
This study focused on the implementation of
Human Immunodeficiency Virus (HIV) education programs in public
schools in Pennsylvania. The study was done in two parts. Part I
consisted of a questionnaire mailed to all school superintendents in
Pennsylvania, containing twenty-five questions about the
superintendent and his or her implementation of HIV education
programs. Part II consisted of personal interviews conducted with
superintendents from twenty randomly selected school districts in
Pennsylvania. Results revealed that schools in Pennsylvania were
offering limited hours of HIV education. Safer sex is usually not
discussed in the schools until high school and the individual
responsible for HIV education responsibilities in the school
district has been inadequately prepared for the task. There was no
evidence in any of the school districts of an evaluation process for
the HIV education program. The school districts need help in
obtaining information about the incidence of AIDS in the county
where the school district is located and resources to support the
HIV education program. There has been little in continuing education
about HIV in Pennsylvania schools since 1987. Further,
superintendents who received HIV education and were aware of the
number of cases of AIDS in the county where the school district was
located placed a strong emphasis on HIV education for students [J
Wellness Perspectives 1996; 12(3), 132-139].
For a copy of the full publication contact:
Bernard J. Healey, Ph.D.
THE USE
OF PREVALENCE DATA TO UNITE THE COMMUNITY IN PREVENTION PROGRAMS
- Bernard J. Healey, Ph.D.
This study examined the prevalence of cigarette
smoking in a three-county area of northeastern Pennsylvania. More
than 14,000 questionnaires have been returned, and results reveal
that 5,411 children have experimented with cigarettes and 2,962 of
those children continue smoking today. Cigarette experimentation
begins as early as age 5 in northeastern Pennsylvania, with the
highest number of children (19.8%) experimenting by age 12. This
experimentation occurs less frequently among females in the lower
grades and more frequently among females in the later years of high
school. The results of this study were used to unite the health
community of northeastern Pennsylvania in a number of prevention
initiatives.
For a copy of the full publication contact:
Bernard J. Healey, Ph.D.
DEAR
FDA: HERE'S MORE AMUNITION FOR YOUR RESTRICTIONS ON TOBACCO PRODUCT
ADVERTISEMENTS
- Bernard J. Healey, Ph.D.
- Edward J. Schoen, Ph.D.
On August 28, 1996, the Food and Drug
Administration (FDA) promulgated its final regulations restricting
the ability of tobacco companies to promote and advertise cigarettes
and smokeless tobacco products to children and adolescents. While
some believe the FDA should go even further in limiting tobacco
product advertising, commercial speech decisions of the Supreme
Court of the United States impose limits on the authority of the FDA
to regulate advertising and may handcuff the FDA from imposing
greater restrictions.
A study was undertaken to ascertain the use of
tobacco products, alcohol and marijuana by children in Northeastern
Pennsylvania. A letter was sent to several school superintendents
requesting permission to survey all students in grades four through
twelve. Six school districts, representing 15,543 students, agreed
to allow the survey to be completed in their respective school
districts. A questionnaire was developed and given to the
cooperating school districts for administration.
This study found that 44.9% of the children
tried alcohol, 37.3% experimented with cigarettes, 20.4% continue to
smoke today, 8.3% have used smokeless tobacco, and 15. 7% have used
marijuana. The mean age for trying these products is 11.5 for
cigarette use, 11.5 for smokeless tobacco, 11.6for alcohol and 13.5
for experimentation with marijuana. There was an association between
using tobacco, using alcohol and then using marijuana. Cigarettes
are the first drugs used by children followed by smokeless tobacco,
alcohol and finally marijuana.
Part I of this paper examines the
constitutionality of the FDA 's restrictions on tobacco product
advertising and promotion in light of decisions of the Supreme Court
of the United States protecting commercial speech. Part II of this
paper demonstrates that cigarettes are a "Gateway Drug, " and
questions whether the FDA 's regulations went far enough.
For a copy of the full publication contact:
Bernard J. Healey, Ph.D.
MAMMOGRAPHY UTILIZATION AMONG WOMEN AGES 40 T0 74
- Fevzi Akinci, Ph.D.
- Bernard J. Healey, Ph.D.
This paper examines the status of mammography
screening and factors related to its utilization among women ages 40
to 74. Responses from 5,548 women aged 40-74 who participated in
the 1992 National Health Interview Survey Cancer Control Supplement
were studied. Bivariate and multiple logistic regression analyses
were performed to estimate the odds ratios of mammography use as a
function of demographic and other predictor variables. The data
indicated that 40% of women aged 40-74 reported ever having had a
mammography. High income, having a regular source of health care,
individuals' preventive orientation, and age (50-64) were strong
predictors of mammography use. Low educational attainment, being
widowed, residence in a rural area, and living in the South were
found to be strongly associated with less likelihood of having had a
mammography. Despite the anecdotal and empirical evidence that the
proportion of women ever having had mammography has dramatically
increased in the past several years, our analyses suggest that
mammography utilization varies greatly across levels of predictive
variables considered in this study. In order to achieve and
maintain high rates of mammography utilization, public health
programs should especially target those women with low incomes and
education and women with no regular source of medical care.
For a copy of the full publication contact:
Bernard J. Healey, Ph.D.
THE
COST-EFFECTIVENESS OF MAMMOGRAPHY SCREENING FOR WOMEN AT AGE 50
- Fevzi Akinci, Ph.D.
- Bernard, J. Healey, Ph.D
This paper investigates the cost-effectiveness
of mammography screening for women aged 50. A Markov model was used
to compare two hypothetical groups of women, one with annual
screening and the other without screening. Cost-effectiveness was
expressed as marginal cost per life saved (MCLS) and sensitivity
analyses were performed to test several model assumptions. Assuming
a 30 percent reduction in breast cancer mortality in the screened
group and a 10-year follow-up, the MCLS was estimated to be
$26,083. The findings provide further evidence on the
cost-effectiveness of mammography screening and may be useful in
planning effective public health interventions.
For a copy of the full publication contact:
Bernard J. Healey, Ph.D.
COMMUNITY HEALTH ASSESSMENT: A CATALYST FOR THE IMPROVEMENT OF
COMMUNITY HEALTH
- Bernard J. Healey, Ph.D.
- Fevzi Akinci, Ph.D.
The new focus in health care is the assessment
of the health of an entire community in order to better understand
its unique health problems. This study surveyed the health of an
entire city in Pennsylvania with the intent to use the data to
develop innovative health programs to improve the health status of
residents of the city. A second purpose of the study was to
discover if the availability of this health information could be
used to attract resources from managed health care organizations in
the city to develop innovative programs to improve the resident’s
health.
The survey instrument was a questionnaire that
contained questions concerning residents’ perceptions of the health
status of the city, a description of their own health behaviors, and
demographic information about each family in the city. The City of
Wilkes Barre has a population of 43,000 in approximately 17,000
housing units.
There was a final response of 4,040 surveys
representing a 23.6 percent response rate.
Managed health care providers in the city were
very interested in the initial descriptive data from the community
health assessment. Several new health programs have been developed
as a result of this primary data.
One community health problem uncovered by the
survey was one of the highest adult tobacco use rates (43%) in the
nation. The survey also found that 58 percent of the respondents
had smoked at least 100 cigarettes in their lifetime. A study
conducted last year about children’s cigarette use in Wilkes-Barre
found 37 percent of the children experimenting with cigarettes with
the mean age of experimentation being 11.2 years of age.
These results were used to bring together
several health agencies, including managed health care, in the
development of a tobacco cessation program for adults and a tobacco
education program for city residents. A free nicotine replacement
program combined with motivational counseling will be offered to all
adults in the city who want to stop using tobacco. This cessation
program will be supplemented by an intensive educational program to
be offered to all children in the public and private schools in the
City of Wilkes- Barre. The results are still being analyzed and
additional health programs will be accomplished collaboratively in
this city.
For a copy of the full publication contact:
Bernard J. Healey, Ph.D.
LEADERSHIP IN COMMUNITY HEALTH: A CASE STUDY
- Bernard J. Healey, Ph.D.
Health care costs can be reduced by better
management of scarce health care resources. However, this does not
necessarily mean better health for the individual. On the other
hand, expansion of health care programs with the goal of prevention
can make the individual healthier and in the long-run reduce the
cost of health care. The very rapid growth in managed health care
plans, with their emphasis on controlling health care costs, may
provide an opportunity for an expansion in preventive health care
programs.
This case study of a new graduate program in
health administration examines the results of the role the
educational program can play in coalition building among various
agencies to better the health of the community. The goal of this
program is to produce graduates equipped with administrative skills
and a thorough understanding of the value of well developed
community wellness programs.
The accomplishments of this graduate program
include the formation of a proactive regional wellness council, the
production of a video tape about reducing adolescent high-risk
health behaviors distributed to every school district in
Pennsylvania, and the implementation of a number of additional
community health initiatives developed by this graduate program.
This study provides evidence that a graduate program in health care
administration can provide a leadership role in the production of
better health for communities overall.
For a copy of the full publication contact:
Bernard J. Healey, Ph.D.
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