Amaya M. Gillespie

Adolescents' experiences of smoking cessation.

Recent prevalence rates show that by Year 10 (ages 14-16 years), 15% of students are smoking each day. As the majority of young people do not smoke, schools have traditionally provided an emphasis on prevention. However, the prevalence of daily smoking increases from 15 to 31% across the last 3 years of secondary school, suggesting a need for cessation programs. Therefore, a study of smoking cessation among students was conducted with 2877 Year 10 students in Queensland, Australia. Results of the survey showed that students (i) moderately under-estimated the number of smoking peers who had tried to stop smoking (perceived as 42%, reported as 55%), and (ii) over-estimated the success their smoking peers have (perceived as 29%, reported as 13.6%). The majority of adolescents (57.5%) reported that they had done something to influence a student not to smoke in the last 12 months, including 29% of the smokers. Among those who were current smokers, 64% wanted to stop smoking and 55% had tried to stop in the past year. Withdrawal symptoms were frequently reported among adolescent smokers and more males than females reported being stressed and depressed as a result of their efforts to quit. Intention to quit in the next year was associated with high confidence in ability to quit. These issues deserve attention in prevention programs and the development of age appropriate cessation material for adolescents should have high priority.

Evaluation of a Three-Year School-Based Intervention to Increase Adolescent Sun Protection

The efficacy of a school-based intervention was evaluated using a randomized controlled trial in Australia. In consecutive grades (8, 9, and 10), students in the intervention group received components of a program that addressed issues related to the need to protect yourself from the sun, behavioral strategies related to using sunprotective measures, personal and social images of having a tan, the use of sun-safe clothing, and howto change their schools through forms of structural change. Pre-and postintervention measures among junior high school students showed greatest improvement in the intervention group’s knowledge scores and minimal changes in sun protection behavior from Grade 8 to Grade 9, which were not maintained through Grade 10. Results of the study highlight some limitations of school-based interventions for changing sun protection behaviors.

Community perceptions about the important signs of early melanoma

BACKGROUND Detecting melanoma early often relies on patient concern about a particular pigmented lesion. However, it is not clear what specific features the public views as being important. OBJECTIVE Our purpose was to explore the importance persons place on various features of skin lesions when looking for early signs of melanoma. METHODS This study comprised 1148 respondents (participation rate, 78%) from 60 rural communities in Queensland, Australia, who participated in a telephone interview. RESULTS The following features were considered important and are listed in order of importance: change in the lesion (clearly identified as the most important), more than one color, uneven edges, elevation, large size (the last three of equal importance), and hairiness of the lesion. Age, sex, education, self-efficacy, perceived knowledge, and recent self-examination influenced importance levels, but having a recent skin examination by a family physician did not. CONCLUSION To increase the skin self-examination skills of the community, guidelines may have to become more specific and all opportunities fully utilized to educate the public.

Barriers to health promotion activities in public hospitals

Abstract: Despite the central role hospitals have in the health care system, relatively few health promotion activities are conducted in Australian public hospitals. This study investigated the types of obstacles that were perceived to inhibit health promotion activities in hospitals. A questionnaire for self‐completion was sent to medical superintendents in all public hospitals in Queensland and 112 questionnaires were returned (92.6 per cent response rate). The results indicated that lack of finance, lack of interest by relevant others, and needs (for appropriate programs, training and patient receptivity) were the barriers reported by superintendents. The barriers of ‘interest’ and ‘needs’ were related to a lack of written policies in some areas, but not directly to levels of other health promotion activities being conducted in the hospitals. Success in facilitating health promotion programs in hospitals will need to include a change in the environment, in particular the views of medical superintendents. The combination of attitude change and the availability of a motivated person (such as a health promotion officer) to lead the activities may be needed in order to produce an increase in the level of health promotion in public hospitals.

Reviewing the needs of unemployed youth in smoking intervention programmes

In Australia, the impact of unemployment on adolescent smoking behaviour continues to present a major public health problem. Traditional prevention programmes in both primary and secondary schools appear to be achieving a delay in the onset of smoking. However, smoking rates of young people who are unemployed are unacceptably higher than those of in-school youth. This paper provides a review of the published literature, showing that there has been little effort to address smoking patterns or experiences of quitting for this target group. While the provision of employment opportunities or skill training for this group is important, these strategies will not eliminate the problem of smoking. Steps must be taken to encourage research into the development of tailored programmes for unemployed youth who smoke. These programmes must be carefully considered and evaluated and meet the needs of this diverse group of young people.

Measurement of community beliefs about colorectal cancer.

Few educational campaigns have focused on bowel cancer, though studies have indicated that members of the community need and want current information about relevant issues. In order to facilitate research in this area, reliable and valid measures of community attitudes are needed. Content validity of a survey instrument was obtained through use of a Delphi process with Directors of Education from the Australia Cancer Council and focus group discussions with informed members of the public. The subsequent survey of community perceptions about colorectal cancer included a broad range of content areas related to the risk of bowel cancer, preventing and coping with bowel cancer and beliefs about susceptibility and severity. The construct validity of these content areas was investigated by use of a factor analysis and confirmation of an association with related predictor variables. Two measures related to personal influence and anticipated coping responses showed favourable psychometric properties, including moderate to high levels of internal consistency and test-retest reliability. A test of the concurrent validity of these measures requires further development of instruments related to colorectal cancer or adaptation of measures from other areas of health research.

Australian students' preferences for school-based smoking cessation programs.

Estimates of daily smoking as high as 15 percent by Year 10 students (average age 15) suggest there is an urgent need to focus attention on the formulation of school-based cessation programs for young smokers, as an adjunct to existing prevention focused programs which serve the majority of young non-smokers. The purpose of this study was to gather recommendations from student smokers (in the middle high school years, about 15 years of age) which may be used in the design of school-based smoking cessation programs. This study investigated the opinions of 2865 smoking and nonsmoking Year 10 students drawn from twenty-one metropolitan high schools in Brisbane, Australia. The majority of students, including smokers, were supportive of school-based smoking cessation programs. Smokers reported a preference for the program to be voluntary, to be accessible during school time, and facilitated by other students or non-teaching personnel. A clear preference for individualized attempts to quit over more structured or group programs was evident. The majority of smokers reported that they preferred to quit on their own. They, however, also recognized the value of assistance from a supportive friend or being in a group of students who helped one other. In general, male and female students expressed the same preferences regarding methods of quitting. Males, however, appeared more difficult to motivate and more skeptical of quitting programs. Specific ideas for identifying students who may have higher support needs when quitting are provided.

Students’ Attitudes to Quitting

Studies of student smoking have indicated high rates of initiation and a lack of concern about the immediate health effects. Few adolescents smokers succeed in quitting, though the prevalence is infrequently reported. A recent survey of adolescent smokers in Brisbane, Queensland was conducted to examine quitting by students and the feasibility of smoking cessation programs in schools. Results of intercept interviews with smokers who attend secondary school showed that over a one year period the majority had tried to quit and found it difficult. They were familiar with a range of quit programs and had favourable opinions of them. These young smokers were found to be concerned about the effects of smoking, interested in quitting and receptive to programs being offered at school.

Strategies to improve the frequency and coverage of skin self examination conducted in small communities

A three group randomised control trial assessed the impact of a self-help booklet and a community skin check competition on the frequency and coverage of skin examinations conducted upon Queenslanders who already report that they check their skin. Attitudinal and behavioural measures were collected in pre-test and post-test postal surveys.