Collaborative research and action to control the geographic placement of outdoor advertising of alcohol and tobacco products in Chicago.

Community activists in Chicago believed their neighborhoods were being targeted by alcohol and tobacco outdoor advertisers, despite the Outdoor Advertising Association of America's voluntary code of principles, which claims to restrict the placement of ads for age-restricted products and prevent billboard saturation of urban neighborhoods. A research and action plan resulted from a 10-year collaborative partnership among Loyola University Chicago, the American Lung Association of Metropolitan Chicago (ALAMC), and community activists from a predominately African American church, St. Sabina Parish. In 1997 Loyola University and ALAMC researchers conducted a cross-sectional prevalence survey of alcohol and tobacco outdoor advertising. Computer mapping was used to locate all 4,247 licensed billboards in Chicago that were within 500- and 1,000-foot radiuses of schools, parks, and playlots. A 50% sample of billboards was visually surveyed and coded for advertising content. The percentage of alcohol and tobacco billboards within the 500- and 1,000-foot zones ranged from 0% to 54%. African American and Hispanic neighborhoods were disproportionately targeted for outdoor advertising of alcohol and tobacco. Data were used to convince the Chicago City Council to pass one of the nation's toughest anti-alcohol and tobacco billboard ordinances, based on zoning rather than advertising content. The ordinance was challenged in court by advertisers. Recent Supreme Court rulings made enactment of local billboard ordinances problematic. Nevertheless, the research, which resulted in specific legislative action, demonstrated the importance of linkages among academic, practice, and grassroots community groups in working together to diminish one of the social causes of health disparities.

The role of the nurse manager in ambulatory care: results of a national survey.

Increasing complexity in ambulatory care settings requires nurse managers who can function at higher levels. Little agreement currently exists regarding the role expectations and academic preparation needed for nurse managers in ambulatory care settings. The majority of surveyed ambulatory care nurse managers (40%) have an AD or diploma as their highest level of academic preparation, and have thus acquired the majority of their management skills in the practice setting. The authors express concern that there are pressures to employ non-nurses as managers in ambulatory health care settings and that ambulatory nurse managers are often seen as not needing advanced academic preparation. A wide variety of settings including university and community hospitals, outpatient departments, physician group practices and HMOs, currently employ nurse managers in their multidisciplinary ambulatory care sites. The majority of ambulatory care nurse managers describe their model of care as either the medical model or the functional model.

Dimensions of the staff nurse role in ambulatory care: Part IV--Developing nursing intensity measures, standards, clinical ladders, and QI programs.

Ambulatory care nurse executives must design valid mechanisms to support new models of nursing care delivery. Data from a national survey of practicing ambulatory care nurses can assist in this process. Research data can be used as a resource for developing ambulatory nursing intensity measures, standards, clinical ladders, and quality improvement programming. This is Part IV of a four-part series.

Dimensions of the staff nurse role in ambulatory care: Part III--Using research data to design new models of nursing care delivery.

A national survey of 606 practicing staff nurses provides the basis for a data set that delineates the desired future role for nurses in ambulatory care. The core dimensions of future practice can be used to develop new models of ambulatory nursing care delivery, such as primary prevention, primary health care, and primary nursing as well as a case management and paired-partners model. The final part in this series, which will be published in the September/October issue, will examine the development of nursing intensity measures, standards, clinical ladders, and quality improvement programs.

Dimensions of the staff nurse role in ambulatory care: Part II--Comparison of role dimensions in four ambulatory settings.

Ambulatory care nursing is one of the fastest growing and least studied areas of nursing practice. Information from a national survey of ambulatory nurses has been used to delineate the core dimensions of the current staff nurse role. Comparison of practice patterns of ambulatory staff nurses employed in university hospitals, community hospitals, physician group practices, and health maintenance organizations can provide insights for nurse managers interested in improving ambulatory nursing care delivery. Part III of this series, which will be published in the July/August 1995 issue, will examine how to use research data to design new models of nursing care delivery.

Dimensions of the staff nurse role in ambulatory care: Part I--Methodology and analysis of data on current staff nurse practice.

Defining the core dimensions of the current staff nurse role is a critical first step in demonstrating the worth of professional nurses in ambulatory settings. Data generated by a 1992 national survey of 606 ambulatory staff nurses provides insight into current practice. Managers may use this information to attract and retain staff nurses, remove barriers to clinical practice, and modify practice patterns to improve the quality of care in ambulatory settings. Part II of this series, which will be published in the May/June 1995 issue, will examine the scope and dimensions of the staff nurse role in different practice settings.

Tobacco and alcohol billboards in 50 Chicago neighborhoods: market segmentation to sell dangerous products to the poor.

This paper describes a study of billboard advertising of tobacco and alcohol products in the city of Chicago. All billboards were counted and their advertising themes noted. These data were matched with information on population and race from the 1990 census in order to document which geographic areas of the city, if any, had excess tobacco or alcohol billboards. The data revealed that minority wards were burdened with three times as many tobacco billboards and five times as many alcohol billboards when compared to white wards. The findings are congruent with studies conducted in other urban areas, which demonstrate a consistent pattern of tobacco and alcohol advertisers targeting poor and minority neighborhoods for outdoor advertising of their dangerous products. Chicago legislative initiatives based on the billboard study are described.