ABSTRACT
Major changes are occurring in the health system in the United States. Currently the term managed care is most synonymous with this era of change. The Centers for Disease Control, as the nation's federal agency responsible for prevention of morbidity and premature mortality, offers its perspective on the issues and opportunities for prevention and community health promotion presented in managed care, describes some of its collaborative projects with public health agencies and managed care organizations, and discusses some of the prevention aspects of HEDIS 3.0.
Subject(s)
Centers for Disease Control and Prevention, U.S./organization & administration , Health Priorities , Managed Care Programs/organization & administration , Aged , Female , Health Benefit Plans, Employee/standards , Humans , Male , Managed Care Programs/standards , Managed Care Programs/trends , Medicaid , Quality Assurance, Health Care , Research Support as Topic , United StatesABSTRACT
PURPOSE: This article provides the foundation for a series of literature reviews that critically examine the effectiveness of worksite health promotion programs. This issue reviews the exercise, health risk appraisal, nutrition and cholesterol, and weight control literatures; a future issue will review the alcohol, HIV/AIDS, multicomponent program, seat belt, smoking, and stress management literatures. METHODS: The literature search used a four-step process that included a computerized database search, a reference search, a manual search of relevant health promotion journals, and the writing of the review by a recognized expert in the area being searched. The databases were searched from 1968 through 1994 and included Medline, Aidsline, Psychological Abstracts, Combined Health Information Database, Employee Benefits Infosource, National Prevention Evaluation Research Collection, National Resource Center on Worksite Health Promotion, National Technical Information Service, and the Substance Abuse Information database. A total of 288 articles were identified by the search, not including the 37 articles in the hypertension literature. Authors of each review were requested to incorporate additional studies not identified by the search, provide a research rating for each individual article, and a rating for the overall literature for their respective area. The authors reviewed 316 studies. FINDINGS: The overall ratings for the reviews reported in this issue were suggestive for exercise, weak for health risk appraisals, suggestive/indicative for both nutrition and cholesterol, and indicative for weight control. The ratings for the other reviews will be reported in the subsequent issue. CONCLUSIONS: Research reported in these reviews suggests the effectiveness of worksite health promotion programs, however, additional research is required to provide conclusive evidence of their impact.
Subject(s)
Health Promotion/methods , Occupational Health/statistics & numerical data , Program Evaluation , Health Knowledge, Attitudes, Practice , Health Promotion/organization & administration , Humans , Models, Organizational , Program Evaluation/methods , Program Evaluation/standards , Research Design , United StatesSubject(s)
Acquired Immunodeficiency Syndrome/prevention & control , Centers for Disease Control and Prevention, U.S./organization & administration , HIV Infections/prevention & control , Preventive Health Services/organization & administration , Budgets , Female , Financing, Government , Humans , Male , Organizational Policy , Preventive Health Services/economics , United StatesABSTRACT
Responding to the facts that (a) the AIDS epidemic is occurring among black and Hispanic populations disproportionately to their percentage of the U.S. population and (b) effective human immunodeficiency virus (HIV) prevention programs are racially, ethnically, and culturally relevant and sensitive, CDC in 1988 initiated a 5-year grant program for HIV prevention efforts by national racial and ethnic minority organizations and regional consortia of racial and ethnic minority organizations. A total of 33 organizations received first-year funds. Of the 32 grants that are ongoing, 15 primarily target blacks, 12 Hispanics, 4 Native Americans and Alaskan Natives, and 1 Asian Americans and Pacific Islanders. Some grants are for more than one racial or ethnic population. Programs may be categorized as (a) education programs within national non-AIDS organizations and their respective affiliate networks to increase their understanding, support, and community out-reach for HIV prevention; for example, National Urban League, Inc.; (b) programs providing specific HIV prevention expertise and technical assistance to community-based and other organizations; for example, National Minority AIDS Council; (c) HIV prevention programs emphasizing communications and media; for example, Hispanic Designers, Inc; and (d) prevention programs targeted to a specific racial or ethnic group within a geographic area; for example, Midwest Hispanic AIDS Coalition. As a result of these grants, substantial resources are being invested in prevention programs developed by and for racial and ethnic minorities. Other overall benefits include an expanded foundation of organizations to address AIDS and other health problems affecting these populations, strengthened interrelationships among HIV-focused and broader-based minority organizations, and extensive collaboration of private sector organizations with Federal and State public health and education agencies.
