Disparities in adolescent-physician views of teen health information concerns.

To enhance communications between physicians and adolescents, 600 middle school students and 99 physicians completed written questionnaires assessing the importance of 45 items from seven subscales: smoking; physical fitness; weight control; self-actualization; comparison with others; peer opinion; and communications. Adolescents rated the importance of knowing about items from each scale. Physicians rated how much importance they attached to each scale and their perception of the adolescents' ratings. Physicians placed more importance on each scale than did the adolescents, and they did not accurately judge the importance adolescents placed on the items. Physicians and adolescents differed significantly in the ratings of all but one scale, weight. With the exception of one scale (peer opinion), physicians estimated that adolescents would place less importance on the items in each scale than the adolescents actually reported. Our results suggest the need to concurrently consider adolescent-physician views when seeking to meet adolescents' health needs.

Ethical and philosophical issues in developing a health promotion consortium.

This case study describes the establishment and operation of a community-based health promotion consortium. The ethical implications of membership criteria, use of mailing lists, public education and policy, and communications are examined. The organization's responses to questions raised in these areas are discussed. Increased communication and sharing of ideas and experiences among health promotion consortia are recommended. Issues in the activities of health promotion consortia which require further philosophical and sociological examination are identified.

Learner characteristics associated with responses to film and interactive video lessons on smokeless tobacco.

To determine college students' cognitive and affective responses to alternative technologies for presenting a lesson on smokeless tobacco, and to learn if responses to experimental conditions were associated with gender, ethnicity, tobacco-use practices, and the practices of significant others, 162 undergraduate students were randomly assigned to either a control group (questionnaire only) or one of two experimental groups. Experimental subjects viewed a videotape or an interactive video version of the lesson and then completed a questionnaire to ascertain knowledge and attitude. Each main effect was significant for knowledge about smokeless tobacco [experimental condition (P less than 0.001); gender (P less than 0.024); and ethnicity (P less than 0.003)]. The interactive video group demonstrated the most accurate and comprehensive recall. Neither gender nor ethnicity interacted significantly with experimental condition, indicating that the effect of experimental condition is constant across gender and ethnicity. Attitudes to instructional formats did not vary significantly as a function of experimental condition or gender, but were associated with ethnicity (P less than 0.034). Again, neither gender nor ethnicity interacted significantly with experimental condition, suggesting that attitudes reflect a generalized view toward content irrespective of presentation mode. Responses to both experimental conditions were quite favorable. Items about present and past experiences with tobacco, with the exception of the "Do you smoke?" item, were not associated with total cognitive score or attitude.

A comparison of physician-patient views of teen prenatal information needs.

To help physicians provide supportive information to pregnant teens, 146 pregnant adolescents and 46 physicians completed self-administered questionnaires about prenatal and infant care. Teens placed great importance on knowing about prenatal and parenting behaviors. Teens and physicians generally attached similar importance to concerns across all items (p less than 0.45). Both groups considered similar items extremely important, with the exception of birth control, which was more frequently rated extremely important by physicians (p less than 0.001). However, physicians reported differences between the importance they attached and the importance they thought teens would attack to items (p less than 0.001). Physicians did not accurately estimate the importance teens would attribute to 23 of the 24 items (p less than 0.001), and they anticipated that the teens would attach significantly less importance to items than the teens actually attached. Psychosocial concerns, which physicians anticipated would be considered most important, were often minimized by teens. Responses were not significantly associated with physician age, sex, or level of training, thus suggesting the need to address patient information concerns at all levels of professional education.

PIP: To help physicians provide supportive information to pregnant teens, 146 pregnant adolescents and 46 physicians in Texas, US, completed self-administered questionnaires about prenatal and infant care. Teens placed great importance on knowing about prenatal and parenting behaviors. Teens and physicians generally attached similar importance to concerns across all items (p0.45). Both groups considered similar items extremely important, with the exception of birth control, which was more frequently rated extremely important by physicians (p0.001). However, physicians reported differences between the importance they attached and the importance they thought teens would attach to items (p0.001). Physicians did not accurately estimate the importance teens would attribute to 23 of the 24 items (p0.001), and they anticipated that the teens would attach significantly less importance to items than the teens actually attached. Psychosocial concerns, which physicians anticipated would be considered most important, were often minimized by teens. Responses were not significantly associated with physician age, sex, or level of training, thus suggesting the need to address patient information concerns at all levels of professional education.

Prenatal knowledge and informational priorities of pregnant adolescents.

One hundred and forty-six indigent pregnant adolescents (12 to 18 years of age) were asked to complete a questionnaire concerning their prenatal care priorities (Scale I) and their knowledge of correct perinatal behaviors (Scale II). On Scale I, over 75% of teens considered parenting skills, infant care, and diet extremely important. On Scale II correctly answered items focused on the need to avoid substance abuse and smoking during pregnancy, visit the doctor, and eat balanced meals. The mean number of correct answers, however, was only 11.8 out of a total possible scale of 18 items. Less than 50% correctly answered statements about the effects of weight gain and other health behaviors on risk for high blood pressure and toxemia, safety of laxatives during pregnancy, possibility of becoming pregnant again before resuming menstruation, and the safety of various physical activities. Performance on both knowledge and health priority scales showed correct health information was limited to basic concrete facts. Abstract and technical aspects of health care did not appear to be easily assimilated.

School health education for the chronically impaired individual.

Educators often find themselves confronted with the need to address health-related problems of chronically impaired students. Specific needs often are demonstrated by chronically impaired individuals. The roles and responsibilities of the classroom teacher with respect to meeting these needs are discussed. In addition, suggestions about how these concerns can be addressed through existing classroom health instruction are offered. Teachers can use the health curriculum to compliment the efforts of parents and health-care providers in informing, supplementing, and reinforcing disabled students' knowledge, attitudes, and skills. In this way, chronically impaired children can be assisted to meet present and future health needs in a manner conducive to optimal growth and development.

Attitudes toward health and illness. A comparison of adolescent, physician, teacher, and school nurse views.

To assist physicians, teachers, and school nurses in meeting adolescent health needs, 240 members of these three professional groups and 600 middle school students answered a self-administered questionnaire to assess student attitudes towards health and illness. chi 2 Analyses were employed to determine if response patterns varied as a function of the group. Incongruencies (p less than 0.05) were noted between students' and professionals' responses to all questions. Adolescents attributed more importance to their health, showed a better personal health status, expressed more worry about personal health and becoming sick and more concern about being sick, showed more feelings of responsibility for their health, and exhibited less frequent practice of harmful behaviors than adults anticipated that the students would report. Adults differed in their perceptions of the students' reported health status and the frequency of student worry about personal health and being sick. Findings are discussed in relation to the provision of more meaningful, comprehensive, multidisciplinary approaches to meeting adolescent health care needs and concerns.

Instructional design strategies for developing an interactive video educational program for pregnant teens: a pilot study.

One hundred forty-six teens attending an urban maternity hospital's prenatal clinic completed a questionnaire designed to assist in the development of educational programs utilizing computer-assisted television instruction or interactive video. Ninety-five percent of the teens agreed that additional information about desirable health behaviors during pregnancy would be helpful. Forty-six percent preferred obtaining information from a health professional at the hospital. Although 90% said that the race of the narrator for a film show was unimportant, responses regarding racial preference corresponded to the racial distribution of participants. Seventy-six percent of the teens preferred the narrator to be younger than 35 years of age, and 54% preferred a female narrator. Race was associated with video game experiences, preferences about the narrator's age and race, and favorite television shows. Age was not associated with responses to any of the questions. Although only 19% had ever used a computer, 98% stated they would like to try a computer with assistance. More than half (55%) knew how to type and 83% had played video games; of those who had played video games, 93% said they enjoyed doing so. Eighty-three percent of the respondents always or sometimes enjoyed cartoons. Favorite television shows and cartoon characters were identified. The design implications of the teens' preferences to the development of instruction using computers coupled with other emerging technologies are discussed.

A factor analysis of the informational concerns of adolescent cancer patients.

To acquire insights into the number and nature of different underlying concerns that motivated individual adolescent cancer patients' responses to health information items previously studied by Levenson and associates, exploratory factor analysis methodology was employed. Ten major aspects of the content domain emerged as important information needs of individual cancer patients: physical appearance, current treatment concerns, nonspecific cancer information, future outlook, familial implications, communication, health behavior, near-term expectations, teenage identification, and use of medications. Most factors failed to consistently relate to patient age, sex, race or diagnosis. Discussion focuses on the implications and suggested application of outcomes.

Assessing adolescent health needs: a factor analytic approach.

Advances in technology are rapidly expanding health educators' resources for presenting information tailored to meet individual health needs and interests. A self-administered questionnaire was given to 510 youths in grades 6 through 9 to ascertain adolescents' health concerns and thus develop more appropriate educational programs. Smoking, diet and weight control, physical fitness, and general health items were included. Factor analysis methods identified ten concerns; smoking, weight control, exercise effects, peer approval of appearance, preparatory health behaviors, planning and maintaining a personal health program, feeling good about oneself, communication issues, comparisons with others, and resistance to negative peer influences. Sex and grade were significantly associated with particular responses. Recommendations include the value of addressing each area of the content domain as it relates to health lessons to ensure that information is relevant to the needs and interests of individual adolescents.

Comparison of physician and patient perceptions of communications issues.

Sixty-three adolescent cancer patients and 53 physicians participated in a study designed to compare physician and patient perceptions of (1) the delivery of information at diagnosis, (2) patient reactions to treatment-related concerns, and (3) physician utilization patterns. Both patients and cancer center physicians appeared comfortable with the designation of the cancer center physicians as specific care providers for cancer-related issues and the community physicians as care providers for other health problems. however, differences in physician-patient perceptions were found in regard to the diagnostic period. Considerable disparity was also noted between physician and patient perceptions of tests and treatments, with physicians reporting significantly more patient fear, lack of understanding, discomfort, dissatisfaction with choice, and preoccupation with illness than was reported by the patients. Analysis of physician responses according to level of training showed concordance across all levels. Implications for continuing education are discussed and recommendations are offered.

Information preferences of cancer patients ages 11-20 years.

This study investigates by written questionnaire the information sources preferred by 63 adolescent cancer patients. Physicians were the most common source. Over half preferred private discussions with a health professional over other formats, and 68% indicated physicians as the health professional of choice. Sixty-eight percent wanted parents included. Only 35% indicated that additional information would be personally helpful, while 42% and 45%, respectively, stated that families and friends should have more information. No relationship between diagnosis or sex and the patients' responses was found. Newly diagnosed patients were less likely to perceive physicians as their main information sources or want additional information. Patients in active illness phases were also less desirous of additional information. Younger patients were more likely to prefer information only from parents, to avoid group discussions, and to negate wanting friends to receive additional information. Hispanics were most likely to want parents to have additional information and to request parental inclusion in discussions.

Adolescent cancer patient and physician responses to a questionnaire on patient concerns.

In order to help physicians provide informational support to young patients with cancer, 63 adolescent cancer patients and 53 physicians completed self-administered questionnaires; 30 disease-related information items were included on the questionnaire. Although physicians and patients agreed on one-half of the items, they differed significantly on the others. Physician responses were not significantly related to the physicians' level of training, suggesting that education programs on this topic should be required at all levels of medical training. Psychiatrists may have a role to play in designing these programs.

Sources of information about cancer as perceived by adolescent patients, parents, and physicians.

As survival time has been extended for young cancer patients, their informational needs have also increased. Using written questionnaires, we surveyed 63 adolescent patients, 60 parents, and 53 physicians to compare their perceptions of patient-communication patterns and current and preferred information sources. Physicians were the main current and preferred information sources noted by all three groups. Group discussions with patients the same age, films and television programs, and books were ranked as acceptable but less preferable sources by more than half of each group. More than 90% of the patients were usually accompanied by a parent. Patients most frequently sought their parents to discuss general concerns and cited parents as their second most frequently used source of disease-related information. Adolescents qualified their parental discussions more than was perceived by their parents (P less than 0.01) and viewed themselves as discussion initiators more frequently than did their parents (P less than 0.05). Parents were more likely than patients to prefer physicians as their child's information source (P less than 0.05). Physicians consistently underestimated their own and the parents' importance, believing instead that the patients relied more on peers. Fewer physicians than patients or parents favored including parents in discussion with health professionals (P less than 0.001).