Buddhists' religious and health practices.

A web survey of Buddhists' religious practices and beliefs, and health history and practices was conducted with 886 Buddhist respondents. Eighty-two percent were residents of the USA. Ninety-nine percent practiced Buddhist meditation and 70% had attended a formal retreat for intensive meditation practice. Eighty-six percent were converts to Buddhism and had been a Buddhist for a median of 9 years. Sixty-eight percent of respondents rated their health as very good or excellent. A one-point increase on a Buddhist Devoutness Index was associated with a 15% increase in the odds of being a non-smoker and an 11% increase in the odds of being in good to excellent health.

A web-based survey of the relationship between buddhist religious practices, health, and psychological characteristics: research methods and preliminary results.

A Web-based survey was conducted to study the religious and health practices, medical history and psychological characteristics among Buddhist practitioners. This report describes the development, advertisement, administration and preliminary results of the survey. Over 1200 Buddhist practitioners responded. Electronic advertisements were the most effective means of recruiting participants. Survey participants were mostly well educated with high incomes and white. Participants engaged in Buddhist practices such as meditation, attending meetings and obtaining instruction from a monk or nun, and practiced healthful behaviors such as regular physical activity and not smoking. Buddhist meditative practice was related to psychological mindfulness and general health.

The effectiveness of an abuse assessment protocol in public health prenatal clinics.

OBJECTIVES: This study evaluated whether incorporation of an abuse assessment protocol into the routine procedures of the prenatal clinics of a large urban public health department led to increased referral for and assessment, identification, and documentation of abuse. METHODS: Evaluation was conducted at 3 matched prenatal clinics serving a total of 12,000 maternity patients per year. Two clinics used the abuse protocol and 1 did not. An audit was performed at the clinics on a randomly selected sample of 540 maternity patient charts for the 15 months before the protocol was initiated and of 540 records for the 15 months after the protocol was introduced. Ninety-six percent of the patients represented in the sample were Latina. RESULTS: At the clinics using the protocol, abuse assessment increased from 0 to 88%. Detection of abuse increased from 0.8% to 7%. There were no changes at the comparison clinic. CONCLUSIONS: Incorporation of an abuse assessment protocol into the routine procedures of public health department prenatal clinics increases the assessment, identification, and documentation of and referral for abuse among pregnant women. An abuse protocol should be a routine part of maternity care.

Severity of spousal and intimate partner abuse to pregnant Hispanic women.

Abuse to pregnant women can result in complications to maternal and child health. This study assessed the severity of intimate male partner abuse to Hispanic pregnant women receiving prenatal care at an urban public health department. The mean age of the 329 pregnant, abused Hispanic women was 24 years. The women had an average of eight years of education, annual incomes of less than $10,000, and most spoke only Spanish. In all, 30 percent of the women had been threatened with death, 18 percent had been threatened with a knife or gun, 80 percent had been shaken or roughly handled, 71 percent pushed or shoved, and 64 percent slapped on the face and head. Pregnant, abused Hispanic women experience abuse of sufficient severity to pose a risk to maternal and child health. Prenatal care provides a window of opportunity for routine abuse assessment and counseling for low-income, Hispanic pregnant women.

Peer and community leader education to prevent youth violence.

The program described here tests the effectiveness of a community-based and school-based program to reduce violence among African-American and Hispanic adolescents. The program methods are based on social network theory research, which has found that key lay people in communities can be identified and trained to carry out prevention programs. The educational content is based on theories suggesting that characteristics of healthy, adaptive individuals and communities can be taught. A violence-prevention leadership program is provided to a cohort of middle-school student peer leaders and their parents and for the leaders of the neighborhoods around the middle schools. Three matched pairs of urban middle-school attendance zones were randomly assigned to receive either the intervention or serve as a nonintervention control group. Surveys, interviews, and observations were conducted with the peer leaders, their parents, community leaders, and community residents. Sixty-six percent of the peer leaders reported that they had hit someone in the past 30 days. Twenty-six percent of the sixth-graders had punched or beaten someone in the past 30 days. Within the past year, 6% of the adults had slapped or kicked someone. Within the past 30 days, 14% of the sixth-graders had been punched or beaten. Within the past year, 6% of the adults had been punched or beaten. A large percentage of adolescents are victims and perpetrators of violence and are exposed to violence in their neighborhoods. Violence-prevention strategies can be implemented through collaborations among health departments, community-based organizations, universities, and schools.

A test of the John Henryism hypothesis: cholesterol and blood pressure.

The personality predisposition "John Henryism" (JH) is a self-perception that one can meet demands of the environment through hard work and determination. The JH scale measures "efficacy of mental and physical vigor, commitment to hard work, and determination to reach one's goals." Previous research found an increased prevalence of hypertension among African-Americans with high JH scores and low socioeconomic status (SES). Six hundred fifty-three adult African-Americans in a church-based cardiovascular risk factor screening program completed the JH questionnaire. The prevalence of cholesterol greater than or equal to 240 mg/dl was highest (27%) among the high-JH/low-SES group when adjusted for age, sex, and body mass index. High JH/low SES was not associated with a greater prevalence of high blood pressure. Findings of this study suggest the need for additional research on John Henryism, socioeconomic factors, and cardiovascular risk among randomly selected samples of geographically and economically diverse African-Americans.

Peer education in friendship cliques: prevention of adolescent smoking.

The use of the term 'peer' teacher in adolescent health education programs has been applied with a variety of definitions. In some programs student teachers have been in the same grade as those they instructed; in others, they have been older students teaching lower grade students. The method of selection of student teachers has also varied. In some programs, a popular vote of students has been used to choose the student teachers; in other programs, the adult teachers and principals have chosen the student teachers. The purpose of the program reported here was to conduct smoking prevention education in friendship cliques taught by the clique's peer leaders. The friendship cliques and their peer leaders were identified by a computerized algorithm analysis of responses to a friendship questionnaire. The curriculum focused on social skills to prevent smoking and consisted of 8 weeks of education during the sixth and seventh grade years of 347 adolescents. The program evaluation compared the friendship cliques with 'model' students identified by school officials who taught their classmates and adult teachers instructing their students. The prevention rates of friendship cliques suggest that research studying this approach is needed. A practical means of identifying friendship cliques and their leaders is suggested.

Epidemiology of hypertension and hypertensive target-organ damage in the United States.

Hypertension and hypertension-related cardiovascular renal sequelae remain major clinical and public health problems in the United States, particularly among African Americans. Compared with whites, African Americans have higher incidence and prevalence rates for hypertension; these differentials are more pronounced in young adult women. Among the very old, race differentials in hypertension prevalence rates are less pronounced. The reasons for the epidemic hypertension rates in the United States are largely environmental: obesity, physical inactivity, high salt and alcohol intake, and psychosocial stress have all been identified as causes. Obesity and physical inactivity probably account for a significant proportion of the premature excess hypertension in African Americans relative to white women. Putative genetic differences between African Americans and whites are unlikely to account for the differential in hypertension rates. During the last 20 years tremendous strides have been made in the identification, treatment, and control of hypertension in the African-American community. Yet, there is further progress to be made. Preventing hypertension precursor conditions (ie, obesity, excess salt intake, psychosocial stressors), normalizing blood pressure levels (less than 140/90 mm Hg), reducing the prevalence of severe hypertension (greater than 160/90 mm Hg), and linking psychosocial correlates of blood pressure to cardiovascular-renal physiology (ie, salt sensitivity) remain as major challenges for those involved in hypertension management and research in African-American communities.

Cardiovascular risk factor prevalence in African-American adult screenees for a church-based cholesterol education program: the Northeast Oklahoma City Cholesterol Education Program.

The status of selected cardiovascular risk factors was ascertained in a consecutive sample of 661 (222 men and 439 women) African-American adults who were screened for the Northeast Oklahoma City Cholesterol Education Program, a church-based cholesterol intervention program. Hypertension was present in 48.4% and 44.7% of men and women, respectively. Average systolic blood pressure levels were similar in men and women (132.0 vs 131.5 mm Hg, P = 0.40) although average diastolic blood pressure levels were higher in men (84.0 vs 81.1 mm Hg; P < .0001). A substantial proportion of the screenees were unaware of their hypertension, and blood pressure normalization (SBP < 140 and DBP < 90 mm Hg) was uncommon in drug-treated hypertensives. Average cholesterol levels were slightly higher in women compared to men (206.0 vs 199.6 mg/dL, P = 0.11). The majority of persons with elevated cholesterol levels (> or = 240 mg/dL) were unaware of their condition and were infrequently treated with cholesterol-lowering drugs. Overweight was highly prevalent, was more common with advancing age, and was related to the presence of hypertension in both men and women. In addition, a strong linear relation between overweight and blood pressure was present in both sexes. Overweight was more common in young men (< 35 years old) compared to age-matched women; however, women were increasingly more overweight than men after 35-44 years of age. In fact, by age 65, 90% of the women were overweight. These data indicate an excessive prevalence and high mean levels of modifiable cardiovascular risk factors in these church-attending African-American adults. Because churches are a central institution in most African-American communities, and their congregations appear to have an excessive cardiovascular disease risk factor burden, churches may be appropriate sites for the implementation of community-based risk factor control programs.

A church-based cholesterol education program.

The leading cause of death among black people in the United States is coronary heart disease, accounting for about 25 percent of the deaths. The Task Force on Black and Minority Health formed by the Secretary of Health and Human Services in 1985 subsequently recommended increased efforts to reduce risk factors for coronary heart disease in the black population. A stated focus of the National Heart, Lung, and Blood Institute's National Cholesterol Education Program has been that of reaching minority groups. This report describes a pilot cholesterol education program conducted in black churches by trained members of those churches. Cholesterol screening, using a Reflotron, and other coronary heart disease risk factor screening was conducted in six churches with predominantly black members and at a neighborhood library. A total of 348 persons with cholesterol levels of 200 milligrams per deciliter (mg per dl) or higher were identified. At the time of screening, all were provided brief counseling on lowering their cholesterol and were given a copy of the screening results. Half of those identified, all members of one church, were invited to attend a 6-week nutrition education class of 1 hour each week about techniques to lower blood cholesterol. Information about cholesterol was also mailed to them. They were designated as the education group. Persons in the church were trained to teach the classes. A report of the screening results was sent to the personal physicians of the remaining 174 people in other churches who had cholesterol levels of 200 mg per dl or higher. This group served as a usual care comparison group.Six months after the initial screening, members of both groups were invited for followup screening.Among the 75 percent of the education group who returned for followup screening there was a 23.4 mg per dl (10 percent) decrease in the mean cholesterol level. Thirty-six percent of the usual care group returned for followup screening; their mean cholesterol level had decreased 38.7 mg per dl (16 percent).In this study, the support of churches provided access to large numbers of people. The mean serum cholesterol reductions occurring with both screening and referral and screening and education were statistically significant and large enough to be of clinical importance.The authors recommend that the approach taken in this study be investigated further by the National Cholesterol Education Program as a model for reaching the black population with coronary heart disease risk reduction programs.

Research publication trends in health education journals.

The study presented here reviews the trends in the publication of research reports from 1957-1978 in the official journals of four professional organizations of health education: International Journal of Health Education (IJHE), Health Education Monographs, Health Education and Journal of School Health. Each article was classified into one of five categories: programme evaluation research, general research, professional preparation, literature reviews, and other. The percentage of articles in each category was calculated and graphed in 4-5 year intervals to show the twenty-two year trends. The results of this study show that the IJHE has led in the publication of research articles. During the 22 year period 30.83% of the articles IJHE has published were research reports. IJHE also showed the largest increase (30.37%) from the earliest period to the most recent, especially in the category programme evaluation research (17%). For all four journals combined, 5.18% of the articles published were on professional preparation, 3.2% were literature reviews and 69.95% were programme descriptions, conceptual or theoretical articles and other non-research topics. Although there are trends towards an increase in the publication of research reports in health education journals, during the period covered less than one-third of the articles in any of the journals reviewed was devoted to research.