A population comparison of participants and nonparticipants in a health survey

Objectives. This study examined the characteristics of Air Force recruits willing to take part in a health survey vs those unwilling to participate. Methods. US Air Force recruits undergoing basic military training (n = 32144) were surveyed regarding demographic and health variables. Results. Respondents indicating an unwillingness to participate in a health survey reported less healthy lifestyles than those willing the participate. Prediction equations modeling the characteristics of those engaging in 4 risky behaviors were nearly identical regardless of whether those refusing to participate were included. Conclusions. Results suggest that, despite some low estimates of health behaviors due to response bias, relationships between most risk factors are generally unaffected by those not responding to health surveys

Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey

Abstract Background Direct-to-consumer (DTC) marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. Methods We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65%) was conducted by the Food and Drug Administration (FDA). Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC) medicines taken as well as demographic and personal health information. Results Of 771 respondents who met study criteria, 195 (25%) were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009) even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4). Conclusion There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for therapeutic duplication or overmedication.</p

Get fit with the grizzlies: A community-school-home initiative to fight childhood obesity

Background: Professional sport organizations in the United States have notable celebrity status, and several teams have used this star power to collaborate with local school districts toward the goal of affecting children\u27s health. Program effectiveness is unknown due to the absence of comprehensive evaluations for these initiatives. The Memphis Grizzlies, the city\u27s National Basketball Association franchise, launched Get Fit with the Grizzlies, a 6-week, curricular addition focusing on nutrition and physical activity for the fourth and fifth grades in Memphis City Schools (MCS). The health-infused mini-unit was delivered by physical education teachers during their classes. The purpose of this study was to evaluate the Get Fit program effectiveness.Methods: Survey research was employed which measured health knowledge acquisition and health behavior change using a matched pre/posttest design in randomly chosen schools (n = 11) from all elementary schools in the MCS system (N = 110). The total number of matched pre/posttests (n = 888) equaled approximately 5% of the total fourth-/fifth-grade population. McNemar\u27s test for significance (p \u3c .05) was applied. Odds ratios were calculated for each question.Results: Analyses confirmed that there was significant health knowledge acquisition (7 of 8 questions) with odds ratios confirming moderate to strong associations. Seven out of 10 health behavior change questions significantly improved after intervention, whereas odds ratios indicated a low level of association after intervention.Conclusions: This community-school-home initiative using a professional team\u27s celebrity platform within a certain locale is largely overlooked by school districts and should be considered as a positive strategy to confront childhood obesity. © 2010, American School Health Association

Strategies for retaining study participants in behavioral intervention trials: Retention experiences of the NIH behavior change consortium

Failing to retain an adequate number of study participants in behavioral intervention trials poses a threat to interpretation of study results and its external validity. This qualitative investigation describes the retention strategies promoted by the recruitment and retention committee of the Behavior Change Consortium, a group of 15 university-based sites funded by the National Institutes of Health to implement studies targeted toward disease prevention through behavior change. During biannual meetings, focus groups were conducted with all sites to determine barriers encountered in retaining study participants and strategies employed to address these barriers. All of the retention strategies reported were combined into 8 thematic retention categories. Those categories perceived to be most effective for retaining study participants were summarized and consistencies noted among site populations across the life course (e.g., older adults, adults, children, and adolescents). Further, possible discrepancies between site populations of varying health statuses are discussed, and an ecological framework is proposed for use in future investigations on retention. © 2005 by The Society of Behavioral Medicine

Indomethacin reduces the risks of severe intraventricular hemorrhage

A prospective, random selection, double-blind clinical trial was carried out to determine the efficacy of indomethacin in preventing periventricular-intraventricular hemorrhage (PV-IVH). Babies who were born in our institution, had birth weights ≤1500 gm, and had no PV-IVH or grade 1 PV-IVH were given either placebo (n=70) or indomethacin (n=71), 0.2 mg/kg intravenously at 6 hours of age and 0.1 mg/kg at 18 and 30 hours. Two major outcomes were determined: the development of grades 2 to 4 PV-IVH and the development of severe PV-IVH (i.e., hemorrhages with blood filling >50% of the ventricles and in some cases with associated parenchymal echodensities). Grades 2 to 4 PV-IVH occurred in 16 (23%) of the indomethacin group and 27 (39%) of the placebo group ( p<0.03). The incidence of severe PV-IVH was 3% in the indomethacin-treated babies and 14% in the control group ( p<0.02). The influence of other perinatal factors on the incidence of grades 2 to 4 or severe PV-IVH was determined by stepwise logistic regression. Placebo use, early grade 1 PV-IVH, lower birth weight, and higher fraction of inspired oxygen at 6 hours of life were associated with higher estimated odds of the development of grades 2 to 4 PV-IVH. Placebo use, male gender, lower 5-minute Apgar score, and a large base deficit were predictive of severe PV-IVH. Estimated odds ratios of severe PV-IVH with placebo use and male gender were 11.251 and 91, respectively. Thus indomethacin prophylaxis reduced the relative risk of grades 2 to 4 PV-IVH and severe PV-IVH, but other perinatal variables contributed significantly to the overall risk of PV-IVH

Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage

Bedside microcomputer-derived, minute-to-minute mean arterial pressure (MAP) values during the first 48 hours of life were studied in 100 preterm babies with birth weight ≤1500 gm. In those babies (n=72) with no periventricular-intraventricular hemorrhage (PV-IVH) or with grade 1 PV-IVH, the MAP values increased during the study period, with minute-to-minute variation and interval undulation. The MAP values in those with birth weight>1000 gm were higher than in those of lower birth weight. Infants in whom grades 2 to 4 PV-IVH developed (n=28) had consistently lower MAP values during the study period. Minute-to-minute variability, expressed as the average of the coefficients of variation at 15-minute intervals, did not differ between birth weight groups, nor did they differ between the PV-IVH group and their matched control subjects. However, those with PV-IVH spent a greater percentage of time, with a coefficient of variation≥13% or <3%, than their matched control subjects spent (p<0.005). This study provides reference data for MAP changes in premature babies. The observed MAP changes in those with PV-IVH lend support to a significant role for MAP alterations in the pathogenesis of PV-IVH