Low back pain in physical therapists: a cultural approach to analysis and intervention

Low back pain is one of the most prevalent work related injuries in the physical therapy profession. New graduates and therapists working in rehabilitation and acute care hospitals are at the highest risk for developing low back pain [9]. Although physical therapists are trained in maintaining proper body mechanics and preventing work related injuries, between 30% and 63% of therapists will experience low back pain at some point in their careers [2,4,9]. The culture of physical therapy is one of the primary factors contributing to this problem, with many therapists reporting that their decision to use back pain preventive strategies depends on their colleagues' use of these strategies. The authors will use Green and Kreuter's PRECEDE-PROCEED model to identify behavioral, environmental, educational and ecological factors contributing to the problem; then will propose a health promotion intervention using the social action theory at the community level to decrease work-related low back pain in physical therapists while simultaneously addressing the culture of physical therapy.     

Emerging Issues From Job Relocation in the High Tech Field:

This presentation sets forth a proposal for expanded Employee Assistance Program services when the employee works for an organization that requires repeated geographical transfers and field assignments. Relocating employees and family members are at high risk for developing a range of problems which may show up in the workplace as inefficiency on the job, high absenteeism, reduced productivity and a high turnover rate. The authors conclude that current services do not attend to the pressing need for support, education and problem identification. They suggest preventive strategies which may be utilized to address the needs of the relocating family.     

Measuring risk and protective factors for substance use,delinquency, and other adolescent problem behaviors. The Communities That Care Youth Survey

Risk and protective factors predictive of adolescent problem behaviors such as substance abuse and delinquency are promising targets for preventive intervention. Community planners should assess and target risk and protective factors when designing prevention programs. This study describes the development, reliability, and validity of a self-report survey instrument for adolescents ages 11 to 18 that measures an array of risk and protective factors across multiple ecological domains as well as adolescent problem behaviors. The instrument can be used to assess the epidemiology of risk and protection in youth populations and to prioritize specific risk and protective factors in specific populations as targets for preventive intervention.     

Beliefs About and Attitudes Toward Gambling in French-Speaking Switzerland

The present study aims to analyze attitudes and beliefs of the French-speaking general Swiss population (n = 2500; female n = 1280; mean age = 43 years) as regards gambling, which are to date almost exclusively studied in the North American and Australian contexts. Beliefs related to gambling include the perception of the effectiveness of preventive measures toward gambling, the comparative risk assessment of different addictive behaviors, the perceived risks of different types of gambling and attitudes are related to the gambler’s personality. The general population perceived gambling rather negatively and was conscious of the potential risks of gambling; indeed, 59.0% of the sample identified gambling as an addictive practice. Slot machines were estimated to bear the highest risk. Compared with women and older people, men and young people indicated more positive beliefs about gambling; they perceived gambling as less addictive, supported structural preventive measures less often, and perceived gambling as a less serious problem for society. Gamblers were more likely to put their practices into perspective, perceiving gambling more positively than non-gamblers. General population surveys on such beliefs can deliver insights into preventive actions that should be targeted to young men who showed more favorable views of gambling, which have been shown to be associated with increased risk for problematic gambling.     

Translating family-focused prevention science into public health impact

Underage drinking is a pervasive problem in the United States, with serious consequences for youth, families, communities, and society as a whole. Family-focused preventive interventions for children and adolescents have shown potential for reducing underage drinking and other problem behaviors. Research findings indicate that clear advances have been made, in terms of both the number of evidence-based interventions available, and in the quality of the methods used to evaluate them. To fully reap the benefits of such preventive interventions and achieve public health impact, the findings of family-focused preventive intervention science must be translated into real-world, community practices. This type of translation can be enhanced through four sets of translational impact factors-effectiveness of interventions, extensiveness of their population coverage, efficiency of interventions, and engagement of eligible populations, with sustained quality intervention implementation. Findings from studies conducted by researchers at the Partnerships in Prevention Science Institute and other empirical work highlight the importance of these factors. A model for community- university partnerships has been developed that potentially can facilitate the dissemination and public health impact of universal interventions to prevent underage drinking and other problem behaviors. This model fits well within a comprehensive strategic framework for promoting effective prevention.     

Preventing Juvenile Delinquency Through Early Family Intervention

ABSTRACT

Any professional working in the field of juvenile corrections can attest to the impact of family dynamics in contributing to and maintaining delinquent behavior, and studies have for years linked family dysfunction with the problem of juvenile delinquency. While most research has been done by professionals in other fields, social workers frequently provide intervention with these families. This article offers an overview of the aspects of family dysfunction which increase the risk of juvenile delinquency and offers suggestions for social work intervention in four areas: identification of families at risk, early intervention, service delivery, and preventive education. All may be considered preventive methods if used effectively.     

Unintentional injury: A major health problem for young children and youth

This article reviews data on childhood injury and explains how unintentional injuries have become the leading health problem for young children in the United States and a major health problem in teenage years. The article discusses the major types of childhood injuries, trends over time, and variations by location and social, behavioral, and familial risk factors. Results of epidemiological and sociobehavioral research on injury are followed by a discussion of policy considerations in the attempts to deal with childhood injury and its consequences. This includes a discussion of major ways to prevent injuries, a review of government activities, and recommendations for future efforts. Her research interests include child safety, preventive health behaviors, access to health care services, and health policy. She received her Ph.D. from Brown University in sociology in 1976. Her research interests include child safety, preventive health behavior, international health, and alternative health care models. She received her D.Sc. from Johns Hopkins University in 1985.     

Substance Abuse among African-American Children: A Developmental Framework for Identifying Intervention Strategies

Abstract

Substance abuse has devastating effects on the lives of African-American children and adolescents who are both directly and indirectly victims of this problem. This article discusses child and adolescent substance abuse from a psychosocial developmental perspective within an Africentric paradigm. The authors explore contributing and intervention factors related to substance abuse that impact developmental milestones. They delineate preventive tactics for addressing the problem of substance abuse and delineate implications for social work practice.     

Future directions for research into the psychological determinants of problem gambling patterns

Abstract

Rapid increases in the availability of gambling have led to an increased recognition of problem gambling as a major public health concern. A growing body of empirical research has contributed greatly to current knowledge; however, most has centered on prevalence and on risk factors for problem gambling. In this paper, the authors argue for the need to extend the investigative scope of the gambling studies field to improve understanding the natural course of problem gambling over time and to the identification of psychosocial determinants of gambling patterns. Elucidating these issues would constitute an important first step in refining preventive and therapeutic efforts toward curbing possible increases in problem gambling and attendant consequences. Important research areas and methodologies identified in this paper are: large‐scale prospective studies using repeated measures, investigations into factors that may protect from or facilitate progression to problem gambling, especially factors that may be amenable to change, and broadening research samples to community‐based regular gamblers, particularly subclinical (in transition) individuals.     

"Macho men" and preventive health care: implications for older men in different social classes

The gender paradox in mortality--where men die earlier than women despite having more socioeconomic resources--may be partly explained by men's lower levels of preventive health care. Stereotypical notions of masculinity reduce preventive health care; however, the relationship between masculinity, socioeconomic status (SES), and preventive health care is unknown. Using the Wisconsin Longitudinal Study, the authors conduct a population-based assessment of masculinity beliefs and preventive health care, including whether these relationships vary by SES. The results show that men with strong masculinity beliefs are half as likely as men with more moderate masculinity beliefs to receive preventive care. Furthermore, in contrast to the well-established SES gradient in health, men with strong masculinity beliefs do not benefit from higher education and their probability of obtaining preventive health care decreases as their occupational status, wealth, and/or income increases. Masculinity may be a partial explanation for the paradox of men's lower life expectancy, despite their higher SES.     

Lessons from the Grey Area: A Closer Inspection of At-risk Gamblers

The study takes a closer look at at-risk gamblers, with the objective to see how they differ from no-risk gamblers. The data comes from a national gambling survey in 2002, and the age group is 15–74 years. The sample consists of 4188 current gamblers with no current gambling problems or pathology. The analysis includes cross-tabulations and a logistic regression. The results show that at-risk gamblers differed substantially from no-risk gamblers in terms of demographic characteristics, gambling behaviour and the presence of other assumed risk factors. Demographic segments with a higher risk of falling into the at-risk group are men, young people, divorced or single people, and non-western immigrants. Furthermore, gambling problems in the family, beginners luck and misconceptions about winning chances significantly increased the odds for at-risk gambling. The study concludes that at-risk gamblers deserve more attention from research, that their similarity with problem gamblers increases the likelihood that many of them will eventually develop a gambling problem, and that their tendency to be superstitious about winning chances might be exploited in preventive work.     

The Health Status of Elderly People and the New Direction of Health Services

The projected increase of people in Japan aged 75 years and older in the years to come implies the increase of the disabled elderly. Thus, the core of societal preparation for the aging of the population is generally considered to be the expansion of services for the disabled elderly. However, gerontological studies on the health status of the elderly conducted in Japan show that the prevalence of disability is quite low and even decreasing. Relative to the services for the disabled elderly, preventive services for the healthy elderly have long been overlooked. In 1994, the Metropolitan Tokyo Government organized a task force to develop a new health education program as the preventive health service for the healthy urban elderly. A preliminary plan outlining the health education program consisting of propagation with a booklet, on-the-job training of practitioners, and development of new curricula and teaching materials was proposed by the authors for discussion within the task force. Although the inquiry has just begun and the plan is still nascent, it seems adequate to fit the needs for preventive health services in the near future.     

The health status of elderly people and the new direction of health services

The projected increase of people in Japan aged 75 years and older in the years to come implies the increase of the disabled elderly. Thus, the core of societal preparation for the aging of the population is generally considered to be the expansion of services for the disabled elderly. However, gerontological studies on the health status of the elderly conducted in Japan show that the prevalence of disability is quite low and even decreasing. Relative to the services for the disabled elderly, preventive services for the healthy elderly have long been overlooked. In 1994, the Metropolitan Tokyo Government organized a task force to develop a new health education program as the preventive health service for the healthy urban elderly. A preliminary plan outlining the health education program--consisting of propagation with a booklet, on-the-job training of practitioners, and development of new curricula and teaching materials--was proposed by the authors for discussion within the task force. Although the inquiry has just begun and the plan is still nascent, it seems adequate to fit the needs for preventive health services in the near future.     

Applicability of the Social Development Model to Urban Ethnic Minority Youth: Examining the Relationship between External Constraints,Family Socialization,and Problem Behaviors

The development of preventive interventions targeting adolescent problem behaviors requires a thorough understanding of risk and protective factors for such behaviors. However, few studies examine whether different cultural and ethnic groups share these factors. This study is an attempt to fill a gap in research by examining similarities and differences in risk factors across racial and ethnic groups. The social development model has shown promise in organizing predictors of problem behaviors. This article investigates whether a version of that model can be generalized to youth in different racial and ethnic groups (N=2,055, age range from 11 to 15), including African American (n=478), Asian Pacific Islander (API) American (n=491), multiracial (n=442), and European American (n=644) youth. The results demonstrate that common risk factors can be applied to adolescents, regardless of their race and ethnicity. The findings also demonstrate that there are racial and ethnic differences in the magnitudes of relationships among factors that affect problem behaviors. Further study is warranted to develop a better understanding of these differential magnitudes.     

Lead poisoning: The continuing epidemic

The toxicity of lead has been known since antiquity, although its deleterious effects at very low levels, especially for children, have been studied and documented only in this last quarter century. This review provides a brief overlook of the history of lead poisoning, its prenatal and postnatal health effects in children, environmental sources of lead (to which poor and minority group children are disproportionately exposed), legislative and governmental initiatives up to the present, and the efforts needed now to reduce or eliminate exposure to lead and to diagnose and treat lead poisoned children more effectively—at least until preventive measures have dramatically curtailed the pervasiveness of the disease.     

Promoting responsible gambling via prevention messages: insights from the evaluation of actual European messages

Prevention messages are short sentences supposed to broadcast preventive intentions. Three types of messages are noticeable: messages correcting erroneous beliefs, messages informing about the risks and messages promoting responsible gambling. While the results in the literature about messages promoting results are alerting, they are frequently used in European prevention campaigns. The present study relied on language and semantics models to evaluate the communicative and preventive values of 14 messages: 7 were actual European prevention messages and 7 messages were created for the study. Overall, 339 participants answered an online questionnaire in which they evaluated the communicative value of one of the messages and then ranked all the messages according to their preventive level. Results showed that messages informing about the risks and messages correcting erroneous beliefs have a higher level of communicative value than messages promoting responsible gambling. Indeed, the latter are judged as more ambiguous and as less preventive than the two other types of messages. As models of conversational pragmatics suggest that ambiguous messages convey at least two interpretations, the article discusses the possibility that individuals comprehend these messages as incentives to control their impulses (prevention) and incentives to control the game (promotion).     

Developing a framework for identifying individual and organizational risk factors for the prevention of violence in the health-care sector

The problem of violence at work has received considerable attention in recent years. According to Swedish statistics, personnel in the health-care sector are the most affected. The purpose of this paper is to present a framework or model for studies of workplace violence, and to demonstrate its application to the analysis of violence in health-care settings. The model treats violence as a process comprising of several stages/sub-events, and shows how this process is influenced by underlying structural (rather permanent) and situational (generally temporary) risk factors. Understanding the diversity in the process provides a basis for analysis of connections between interacting factors at different stages. Risk management (hazard identification, risk analysis, and preventive counter-measures) should be integrated into the work situation and operations of an organization.     

Using Peer Educators for a Classroom-Based AIDS Program

Abstract

In view of recent prevalence and other data regarding alcohol use by college students this article considers whether or not alcohol represents a problem or a changeable problem for these students and/or their colleges. On the one hand, drinking is deeply embedded in the traditions of college life; it does serve some beneficial purposes; and it is often regarded as an accepted, if not expected, part of adolescence. Furthermore, drinking behavior in college is a poor predictor of eventual alcoholism. On the other hand, both difficulty in identifying problem drinking and ambivalence over false positive diagnoses have contributed to a preoccupation with alcoholism, and a denial of subclinical or preclinical but nonetheless real problems. New ways of defining what constitutes an “alcohol” problem, as well as ways of remedying and preventing the problem are discussed. College health personnel are needed to continue their traditional diagnostic and referral functions, but must expand their roles to include involvement with other disciplines in proactive preventive and educational programming.     

A family-based, developmental-ecological preventive intervention for high-risk adolescents

Family-based preventive intervention has emerged as a promising modality for preventing antisocial behavior problems in youth. This article introduces an intensive, family-based preventive intervention for high-risk adolescents: Multidimensional Family Prevention. Multidimensional Family Prevention combines the advantages of standard prevention models (curriculum based and protection focused) with those of psychosocial treatment models (assessment based and problem focused). The model's main features are described: theoretical foundations (risk and protection theory, developmental psychopathology, ecological theory), guidelines for constructing a multidomain prevention program (family and peer relationships, school and prosocial activities, drug use and health issues, cultural themes), and strategies for tailoring and implementing five flexible intervention modules (adolescent, parent, interactional, extended family, extrafamilial). Implemented in the family's home, the intervention works to create a resilient family environment that supports the basic adolescent developmental goals of renegotiated attachment bonds within the family and durable connections with prosocial institutions.     

A SEMI-PARAMETRIC MODEL FOR ASYMMETRIC INFORMATION IN HEALTH PLAN MARKETS

Two sources of asymmetric information in health markets are adverse selection where only individuals know their illness probability and their preventive effort to reduce illness probabilities. This effort is not observed by insurers, and thus individuals cannot be adequately compensated for their effort. I investigate whether asymmetric information plays a role in health care markets through a semi-parametric model that allows both adverse selection and preventive effort. I find that preventive effort plays a role in illness probabilities. If the United States implements universal health coverage, the currently uninsured population will exert less preventive effort, and their illness probabilities will increase. (JEL I11 , C14 )