Cancer screening practices of Cajun and non-Cajun women in Terrebonne Parish, Louisiana.

A survey was undertaken to learn about cancer screening practices of adult women residing in Houma, Louisiana, many of whom are of Cajun descent. The women were identified using a telephone sampling procedure and interviewed about their use of screening mammography, clinical breast examinations, Pap smears, and other factors. Interviews were completed for 50 women aged 50 to 75 years. Forty-eight percent (24 of 50) were self-identified Cajuns, 34% were non-Cajun white, 14% were black, and 4% were of other races. Only 42% of the Cajun women and 41% of non-Cajun white women reported having had a mammogram in the last year. The Cajun women were less educated on average (P < .05) and were less likely to use cancer screening tests and more likely to smoke, although the latter differences were not significant (P > .05). In view of their geographical isolation and unique culture, more research is needed to identify barriers to preventive health services in Cajun communities.

Quality of home use of oral rehydration solutions: results from seven HEALTHCOM sites.

This study examined the volume of oral rehydration solutions given to children during diarrhea and the length of time the solutions are administered. It also attempted to test the importance of individual and contextual factors--especially mothers' knowledge--in explaining the administration of oral rehydration solutions. Data about the treatment of an episode of child diarrhea within the last three months were collected from large samples of mothers in seven sites in Africa, Asia, and Latin America. The results showed that oral rehydration solutions were given in smaller volumes and for shorter periods of time than recommended. The majority of children received at least a glass (200-250 ml) of solution on the first day, but few received more than that. Daily administration of packet-based solutions or of sugar-salt solutions (promoted in two of the countries) during diarrhea was generally quite low, ranging from 16 to 60% of cases given an oral rehydration solution. However, in four out of six sites, at least half of the children with diarrhea for more than one day were given an oral rehydration solution for more than one day. The majority of children were given some form of other fluids (e.g. more water, special teas, or continued breastfeeding), but their value in preventing dehydration was not clear because the volume of other fluids given could not be assessed. Few of the hypothesized predictors of administration explained the variation in volume or duration of ORS/SSS administration within any specific country or across sites. The research points to the need for more information on the decision process used by mothers when treating their children's diarrhea and on outside factors influencing this process.

The impact of the Healthcom mass media campaign on timely initiation of breastfeeding in Jordan.

Initiation of breastfeeding within several hours after a child's birth increases the likelihood of exclusive breastfeeding and longer duration of breastfeeding. However, common beliefs among mothers and health-care providers and routine hospital practices can constrain timely breastfeeding initiation. This article examines the impact of a mass media breastfeeding campaign in Jordan within the context of other activities occurring during and after the child's birth. The campaign had a positive impact on all mothers' knowledge, and on timely initiation of breastfeeding for home and public hospital deliveries, but not for those in private hospitals. The findings indicate that a communication campaign can bring about change in breastfeeding initiation behavior, but that providing mothers with information should be but one part of an integrated program to ensure that hospital and midwife policies and practices support timely initiation.

PIP: The study aim was to examine the role of mass communication in increasing timely initiation of breast feeding after a birth in Jordan through 1) a 2-day seminar on lactation management for health professionals, and 2) 2 intensive television and radio campaigns aired between May 15 and July 15, 1989 and from mid-March through April 1990. Surveys were conducted before the media campaign in August and September 1988 and after in July and August 1990. 930 interviews were carried out in 1988 among mothers under 35 years of age with a child under 2 years of age; and 777 women with children under 20 months of age in 1990. Sample were weighted because of differences. The results showed that breast feeding significantly from 90.5% to 97.2%. Among breast feeding mothers, timely initiation increased significantly from 40% to 54%; timely initiation increased significantly only in public hospitals and home births. Knowledge about initiation of breast feeding within 6 hours of the birth increased from 51% to 75%. Only 5% of mothers were unexposed. There was a low, significant correlation between campaigns exposure in 1990 and knowledge. Logistic regression analysis, controlling for demographic predictors of breast-feeding initiation, showed that changes in initiation were related to media exposure in general and exposure to the campaigns. Women with high media exposure were significantly more likely to initiate breast feeding within 6 hours of the birth, if the birth was after the media campaign. Significant predictors of breast-feeding initiation were rooming in, delivery without use of anesthesia, withholding of supplementary feedings during the first 3 days, health personnel's advice to the mother about breast-feeding initiation, and a day or early evening birth. Surprisingly, a strong positive predictor of timely initiation was a mother's having received formula to take home. Those less likely to initiate breast feeding within the first 6 hours were urban mothers and those with a first child; although both urban and rural mothers showed increased timely initiation, there were larger increases outside the city and among experienced mothers. Delayed initiation was influenced more by policies and routine practices than individual impacts. Independent predictors of timely initiation, that were interrelated, were parity, residence, and where the child was born, which when controlled for, showed that rural, experienced mothers showed a significantly greater change in timing behavior. Caution is urged in applying these findings to other countries, or applying these findings to supplementation or duration of breast feeding. A careful media campaign must also be supported with appropriate hospital policies and routines.

Knowledge of oral rehydration and response to diarrhea: a comparison among healthcom sites.

This article examines evidence for the relationship between knowledge of diarrhea and oral rehydration and treatments given for diarrhea among young children in seven different research sites. The evidence comes from cross-sectional analyses of household surveys conducted for the evaluation of oral rehydration programs. The cross-site comparisons show that mothers or caretakers who understand most about the dangers of diarrhea are not more likely to treat the diarrhea, but that those who understand the benefits of using oral rehydration are more likely to give fluids, particularly oral rehydration solutions, than those without such understanding.