Alvin E. Winder

A multi-city community based smoking research intervention project in the African-American population.

Objective: To carry out a community-based research approach to determine the most effective educational interventions to reduce smoking among African-American smokers. The intervention included preparation of the community, planning and developing a model of change, and developing a community-based intervention. The study population consisted of 2,544 randomly selected adult African-American smokers residing in four sites in the northeastern and southeastern parts of the United States. The research design provided a comparison of active intervention sites with passive control sites as well as low income and moderate income areas. Major Outcome Measures: Point prevalence of non-smoking at the time of interview; Period prevalence of non-smoking at the time of interview; Period prevalence of quit attempts in the prior six months; Number of smoke-free days in the prior six months; Number of cigarettes smoked daily at the time of interview. Results: Based upon a survey eighteen months after baseline data was collected, all four measures of cigarette smoking behavior showed a strong statistically significant reduction of personal smoking behavior among those receiving active interventions versus the passive group. On the basis of process variable analysis, direct contact with the project staff in the prior six months was significantly higher in the active intervention areas. There was only a small non-significant increase in personal smoking behavior in moderate income groups as opposed to low income groups. Conclusion: An analysis of process variables strongly suggests that, within this African-American Community, “hands on” or “face to face” approaches along with mass media, mailings, and other less personal approaches were more effective in reducing personal smoking behavior than media, mailings, and other impersonal approaches alone addressed to large audiences.

Patient counseling: Clarifying a woman's choice for breast reconstruction

Abstract Over half a million women in the United States are currently living with mastectomies, yet fewer than 1% have availed themselves of breast reconstruction. The fact that so few women take advantage of this simple and effective surgical procedure, suggests a need for patient counselors to address the issue of how to help women who have undergone mastectomy clarify their choice for reconstruction. This paper points out some of the major obstacles that stand in the way of a woman making an informed choice. These obstacles include a lack of knowledge about the procedure, the womans negative psychological response to her mastectomy as well as her response to some of the negative beliefs society attributes to her as a mastectomy patient. The patient counselor and patient educator must understand the nature of these obstacles. The counselor must also be able to provide the mastectomy patient with the knowledge and the psychological help she needs. This design for effective counseling with mastectomy patients can prepare the way for a large number of women to make a truly informed choice about their future.

T-groups and therapy groups in a changing society

In what case do you like reading so much? What about the type of the t groups and therapy groups in a changing society book? The needs to read? Well, everybody has their own reason why should read some books. Mostly, it will relate to their necessity to get knowledge from the book and want to read just to get entertainment. Novels, story book, and other entertaining books become so popular this day. Besides, the scientific books will also be the best reason to choose, especially for the students, teachers, doctors, businessman, and other professions who are fond of reading.

Mass Media Usage among Black Smokers: A First Look

This article discusses preliminary results of a National Cancer Institute-sponsored pilot baseline survey in 1989 of smoking knowledge, attitude and habits among black smokers in four major U.S. cities: two in the North (Springfield, Massachusetts and Hartford, Connecticut) and two in the South (Durham, North Carolina and Columbia, South Carolina). It focuses on mass media readership, viewing and listening habits and a preliminary discussion of their application to practice.

The Mouse That Roared: A Case History of Community Organization for Health Practice

This article presents a case study of a health education process, community organization, that deals with an issue of health protection. The issue concerns herbicide spraying along rights-of- way in Leverett, Massachusetts. The intervention team consisted of the author and a graduate class in community organization. The case study provides a description of the community and history of the problem, the nature of the intervention team, the theoretical and conceptual model held by the intervention team, a description of the intervention, assessment of outcomes, and implications for theory and practice. The intervention extended over a period of 6 months. The intervention represented, for the intervention team, an opportunity to learn community organ ization and community education skills through active participation in the community. Both the nature and the effects of the intervention are described and discussed.

Influence of American Tobacco Imports on Smoking Rates among Women and Youth in Asia

This study addresses the question: has the opening of their markets to American tobacco products in Japan, South Korea, and Taiwan led to an increase in smoking behavior among women and youth? The data on smoking rates for women and youth is presented. This data was obtained for each country before markets were opened to the importation of American tobacco products through the agency of non-governmental organizations in these countries. Comparison data was obtained from similar Asian countries whose markets were not opened. The data from Japan, South Korea, and Taiwan show a sizeable increase in smoking rates for women and youth. The authors believe, based upon anecdotal data, that importation of tobacco products combined with aggressive marketing and advertising by American firms is, in a good measure, responsible for the reported increase.

Cancer Prevention (Smoking) in the Black Population: A Community Research/Intervention Model

There is evidence of a strong relationship between certain cancers and cigarette smoking. The incidence rates for important smoking-related cancers of the lung, esophagus, larynx, and pancreas are higher in Blacks than in Whites in the United States, and a greater proportion of Blacks smoke cigarettes.

Collaboration: An Alternative Value and its Implications for Health Education

It is the purpose of this paper to define health as a value, to give the value a specific content and meaning and to discuss the implications of the definition of health for the field of health education. The goal of good health cannot be achieved in societies that live by either the value of competition or collectivism. An alternative value, collaboration, can lead to healthful behavior. Collaboration is defined as involving consciousness, choice, commitment and caring. Health educators who are committed to this value tend to share a social ecological perspective. This perspective requires that they help people challenge health damaging conditions and provide opportunities for them to work toward health promoting activities.

Risk assessment-risk perception: who shall decide?

Since the Chernobyl disaster, the people of the world have become concerned with environmental pollution and its effect on their health and safety. This article addresses a fundamental question arising from that concern, namely, how safe is safe enough and who should make this decision? The controversy arising from this question is between the private stakeholders and the technicians who assess risk, control information and influence public policy and both the publics perception of risk and their desire to participate directly in public policy decisions affecting their health and safety. This article proposes a solution to this controversy that is relevant to all people, since all people are stakeholders in a fair and balanced solution.

APACT: Its Organization and Impact on Resistance to U.S. Tobacco Imperialism.

This article presents a case study of the formation and first year activities of the Asia Pacific Association for the Control of Tobacco Products (APACT). The case study is organized around five key concepts that address the organizing activity that led this coalition of antismoking groups to create a multinational association in the Asia Pacific region. These concepts are need, team building, funding, management and program development. APACT was born out of the need for Asia Pacific anti-smoking groups to resist US trade sanctions. Sanctions which the US threatened to apply to a number of Asia Pacific nations if those nations refused to eliminate trade barriers to US tobacco marketing and sales. The development of APACTs social action program and its impact is presented for the year 1989–90. Also included is a brief statement of APACTs five-year plan for controlling tobacco related diseases.