J. David Holcomb

Tailored messages for breast and cervical cancer screening of low-income and minority women using medical records data

Barriers to screening and early detection often result in cancers in low-income and minority women diagnosed at stages too advanced for optimal treatment. This randomized controlled trial examined whether a personalized form (PF) letter containing generic cancer information and a personalized tailored (PT) letter containing minimally tailored individualized risk factor information based on medical records data affected breast and cervical cancer screening among 1574 urban low-income and minority women. The personalized form-letter group was significantly more likely to schedule a screening appointment and to have undergone a Pap test and mammography within 1 year after the intervention than were the tailored letter and control groups (P<0.001 for all comparisons). Personalized tailored letters that contain individualized cancer risk factor information may decrease the likelihood of receiving cancer screening among medically underserved low-income and minority women, but personalized form letters that contain generic cancer information may improve these rates in this disadvantaged population.

The State of School Heart Health Education: A Review of the Literature

The evidence and presence of modifiable risk factors asso ciated with heart disease has heightened interest among health educators in developing prevention oriented programs. In an attempt to assist in planning future curriculum efforts and research in this area a literature re view was conducted. It is presented and organized within the following three major categories: 1. incidence of cardiovascular risk factors (in the school age population); 2. need for health education (the status of adoles cent health and problems of motivation); and 3. evaluations of current heart projects (knowledge, attitudes and behavioral outcomes). A few clas sic articles were included: the primary literature reviewed was that of the past 10 years. The following conclusions were drawn: 1. there is a need to be concerned about the cardiovascular health of young people; 2. the need for educational programs about proven methods of prevention is well documented; 3. studies have found that adolescents do not have suf ficient knowledge upon which to make healthful decisions related to pre venting cardiovascular disease; 4. research has demonstrated that well de signed programs can be effective in increasing health knowledge and pro moting positive attitudes; 5. some programs have encouraged behavioral change; 6. most programs ha ve proven too expensive to become integral components of the curricula; and 7. further educational research must be conducted so that health education might by the end of this decade play a significant role in the reduction of the morbidity and mortality inflicted by cardiovascular disease.

Development of a Multicultural Sensitivity Scale

Abstract The purpose of this investigation was to develop a scale that would provide a valid and reliable measure of multicultural sensitivity of teachers toward their students. A 52-item survey developed by Ford (1979) to assess multicultural sensitivity in public school teachers was tested by administering the instrument to 150 nurses. The measure was determined to be unidimensional using factor analysis. Items with factor loadings on that single factor greater than .44 were retained for a shortened instrument (21 items). The shortened instrument, entitled the Multicultural Sensitivity Scale (MSS), was administered to 31 secondary school health educators attending a summer institute in a major medical center. The internal consistency of the shortened form was .89 in the sample of nurses and .90 in the sample of school health educators (Chronbachs alpha). The test-retest reliability of the shortened instrument was .92 in the sample of school health educators over a two week period. The MSS was shown to ...

The Health Teaching Self-Efficacy Scale

Abstract Banduras Social Cognitive Theory was tested in a group of 31 school health teachers attending a summer institute in a major medical center. The Health Teaching Self-Efficacy (HTSE) Scale was devised to measure perceived deficits in ability at pretest and changes in self-efficacy in response to intervention. The 35-item measure proved to have hightest-retestreliability (r = .82) and high internal consistency (Chronbachs alpha = .96). The measure was determined to be unidimensional using factor analysis. HTSE scores were significantly higher at pretest for health teachers having five or more years of experience, those who taught health as a separate class, and those who devoted at least 80 percent of their time to teaching health. HTSE scores were highly correlated with concurrent self-reports of Health Teaching Strategies used in the classroom (r = .75). Strategies derived from Social Cognitive Theory were perceived to be more difficult than traditional teaching methods. Health teachers were mor...

Development and Implementation of a Health Behavioral Counseling Curriculum for Physician Assistant Cancer Education

A health behavioral counseling curriculum grounded in Motivational Interviewing and the Transtheoretical Model of behavior change was developed to enhance knowledge and clinical skill among physician assistant (PA) students in managing cancer risk behaviors. A literature and curriculum review informed course content, teaching strategies, and learning activities. The course was evaluated over two pilot years. Students demonstrated increased knowledge and skills regarding the basic principles of the intervention models. The course was integrated into the pre-clinical year of PA training and will be disseminated, beginning with a faculty development workshop for all PA training programs in Texas, USA.

Faculty appointments, promotions, and tenure policies in the allied health professions.

The number of patients with cancer and the number of patients with bone metastases are increasing recently. Patients with bone metastases frequently develop skeletal related events (SREs; i.e.,pathological fracture, surgery to bone, and paralysis). SREs have been associated with Activities of daily living (ADL) and Quality of life (QOL). When the ADL decrease, chemotherapy cannot be administered in some patients. Then, the ADL are associated with the prognosis. Various interventions are required in order to improve the ADL of patients with bone metastases. In this study, we describe the way to evaluate the pathologic fracture risk before the start of rehabilitation, the team approach in medical care, exercise therapy, patient education, and environment and adjustment to improve the ADL and the QOL of patients with bone metastases.

Training school counselors in substance abuse risk reduction techniques for use with children and adolescents.

A training project prepared school counselors for expanded roles in the prevention, early detection, and appropriate referral of students at high risk of substance abuse. The project trained middle and high school counselors to work as facilitators of support groups for students at greatest risk for substance abuse; the results were: 1) greater perceived self-efficacy, comfort, confidence, and competence by counselors as a result of Initial, Experiential, and Concurrent training, and 2) improved ability to use group counseling techniques as a result of training.

The Detection of Feline Class I and Class II MHC Homologue Molecules and Genes by Biochemical and Molecular Genetic Techniques

Although we previously reported that cats apparently have MHC systems with limited polymorphism because they have relatively low MLC responses and fail to develop lymphocytotoxic antibodies in response to transfusion or pregnancy that can be used for conventional MHC typing (1), the presence on feline cells of class I and class II I-E-type MHC homologues has now been demonstrated using cross-reacting monoclonal antibodies (MoAb) and DNA probes.