Sara A. Pyle

The validity of self-rated health as a measure of health status among young military personnel: Evidence from a cross-sectional survey

BackgroundSingle item questions about self ratings of overall health status are widely used in both military and civilian surveys. Limited information is available to date that examines what relationships exist between self-rated health, health status and health related behaviors among relatively young, healthy individuals.MethodsThe current study uses the population of active duty United States Air Force recruits (N = 31,108). Participants completed surveys that asked about health behaviors and health states and were rated their health on a continuum from poor to excellent.ResultsRatings of health were consistently lower for those who used tobacco (F = 241.7, p < .001), reported binge drinking (F = 69.0, p < .001), reported drinking and driving (F = 19.4, p < .001), reported taking health risks (F = 109.4, p < .001), were depressed (F = 256.1, p < .001) and were overweight (F = 39.5, p < .001).ConclusionGiven the consistent relationship between self-rated overall health and factors important to military health and fitness, self-rated health appears to be a valid measure of health status among young military troops.

Physician assessment of patient smoking in Indonesia: a public health priority

Objective: To explore Indonesian physician’s smoking behaviours, their attitudes and clinical practices towards smoking cessation. Design: Cross-sectional survey. Setting: Physicians working in Jogjakarta Province, Indonesia, between October and December 2003. Subjects: 447 of 690 (65%) physicians with clinical responsibilities responded to the survey (236 men, 211 women), of which 15% were medical faculty, 35% residents and 50% community physicians. Results: 22% of male (n = 50) and 1% of female (n = 2) physicians were current smokers. Approximately 72% of physicians did not routinely ask about their patient’s smoking status. A majority of physicians (80%) believed that smoking up to 10 cigarettes a day was not harmful for health. The predictors for asking patients about smoking were being male, a non-smoker and a medical resident. The odds of advising patients to quit were significantly greater among physicians who perceived themselves as sufficiently trained in smoking cessation. Conclusions: Lack of training in smoking cessation seems to be a major obstacle to physicians actively engaging in smoking cessation activities. Indonesian physicians need to be educated on the importance of routinely asking their patients about their tobacco use and offering practical advice on how to quit smoking.

Attitudes and Beliefs of Adolescents and Parents Regarding Adolescent Suicide

OBJECTIVE: The goal was to understand the attitudes, beliefs, and perceptions of adolescents and parents of adolescents, from a variety of backgrounds, regarding adolescent suicide. METHODS: This qualitative study used focus groups to elicit the thoughts of distinct sociodemographic groups. A professional moderator guided the sessions by using a semistructured script. All groups were audiotaped. The transcripts and transcript summaries were analyzed for recurrent themes. The study was performed in community centers and schools in Chicago, Illinois (urban), and the Kansas City, Kansas, area (suburban and rural). A total of 66 adolescents (13–18 years of age) and 30 parents of adolescents participated in 13 focus groups. RESULTS: Both adolescents and parents recognized adolescent suicide as a major problem, but not for their own communities. All parent and adolescent groups identified many risk factors for suicide. Most adolescents reported drug and alcohol use as risk factors for suicide. However, parents often viewed drug and alcohol use as normal adolescent behavior. Both adolescent and parent groups suggested securing or removing guns if an adolescent was known to be suicidal. All participants requested information about adolescent suicide. CONCLUSIONS: Adolescents and parents need help understanding that suicide is an underidentified problem in their own communities. Both adolescents and parents are interested in learning more about how to identify and to intervene with a suicidal adolescent. Pediatricians are well positioned to provide this information in the office and in the community.

Smoking and Body Weight as Markers of Fitness for Duty among U.S. Military Personnel

BACKGROUND Both tobacco and overweight present serious threats to public health. Although the military has targeted both health issues, only weight status is included in tests of fitness. This study contrasted the relative utility of body weight and smoking as markers for fitness for duty. METHODS Using data from the 2002 Department of Defense Survey of Health-Related Behaviors among Military Personnel (N = 12,149; 24.7% female), troops were categorized according to weight (underweight, healthy weight, overweight, or obese) and smoking status (never smoker, former smoker, or current smoker). RESULTS Logistic models were developed to examine the usefulness of smoking status and weight status as predictors of items assessing four domains of military fitness for duty, namely, physical health, mental health, substance abuse, and legal problems. Smoking status was a consistent and strong predictor of items within all four fitness domains. In contrast, weight status was not a consistent predictor of fitness. CONCLUSION The military should consider adding smoking status to assessments of military fitness. Also, given that underweight and not overweight status predicted negative outcomes among military members, the services should consider revising their weight status fitness standards.

Family Rules About Exposure to Environmental Tobacco Smoke.

Environmental tobacco smoke (ETS) is detrimental to the health of children. It is important for families to implement rules that limit the exposure of children both within the home and in the community. The current study used a diverse sample of participants from pediatric clinics in a large metropolitan area to explore what restrictions families place on tobacco use in their home and in the community (e.g., restaurants, trains). In general, minority ethnic groups were less likely than their Caucasian peers to limit exposure to ETS outside of the home, even when income and education were taken into account. Income and education had a consistent inverse relationship to the endorsement of home smoking rules. It was not surprising that smoking status of the parents and the presence of smokers in the home were related to fewer home smoking rules. Implications for communitybased interventions on the dangers of ETS are discussed.

Cigarette Use among Two Cohorts of U.S. Air Force Recruits, Compared with Secular Trends

This study provides a comparison of cigarette smoking among two cohorts of U.S. Air Force recruits. The first cohort, Air Force 1, entered the military between August 1995 and August 1996. The second cohort, Air Force 2, entered between October 1999 and September 2000. Cigarette use significantly increased among both men (7.0-percentage point increase) and women (7.3-percentage point increase) between the two cohorts. This difference remained statistically significant in models adjusted for demographic differences between the two groups of recruits. Direct standardization methods were then used to compare rates in both Air Force surveys with rates of current smoking reported for a national sample from the Behavioral Risk Factor Surveillance System surveys from the same years. Although the average number of cigarettes smoked and years of smoking decreased between the two cohorts, troops from Air Force 2 reported being less motivated to quit. This study suggests that efforts to reduce smoking among junior enlisted troops in the Air Force should be bolstered.

ENVIRONMENTAL CHARACTERISTICS AND PHYSICAL ACTIVITY IN RACIAL/ETHNIC MINORITY AND EURO-AMERICAN COLLEGE STUDENTS '

Little is known about the relations of environmental characteristics and physical activity of college students, especially students from diverse racial or ethnic backgrounds. Associations were examined between environmental characteristics and moderate and vigorous activity in racial or ethnic minority (n = 418; M age = 24.3 ± 4.5 yr.; 54.2% women) and Euro-American (n = 297; M age = 23.5 ± 4.4 yr.; 49.7% women) college students. Participants completed questionnaires assessing demographic measures, physical activity, exercise equipment at home, neighborhood characteristics, and convenient places for physical activity. Moderate and vigorous activity participation was similar between the two groups even though racial or ethnic minorities had less supportive home and neighborhood environments for activity and fewer convenient facilities. Greater moderate and vigorous activity were related with more convenient facilities in racial or ethnic minorities. Vigorous activity was associated with better neighborhood characteristics for Euro-Americans. The findings can inform the design and implementation of environmental approaches to promoting activity of college students from diverse ethnic backgrounds.

Connected Kids at Head Start: Taking Office-Based Violence Prevention to the Community

OBJECTIVE: The goal was to assess the acceptability and appropriateness of using a violence prevention curriculum, Connected Kids: Safe, Strong, Secure, at Head Start centers. METHODS: Eight 90-minute focus groups (4 parent groups and 4 family advocate groups) were conducted at 2 Head Start centers. Each discussion was audiotaped, transcribed, and analyzed for major themes. RESULTS: A total of 63 adults (38 family advocates [92% female] and 25 parents [100% female]) participated in the 8 groups. Family advocates and parents agreed that Head Start was an important source of parenting advice and of referrals to community resources. Connected Kids topics were well received, although potential parental resistance to gun safety and discipline materials was identified. The positive nature of the advice was important to both types of groups. Brochures were generally well liked, but all groups thought that they should be linked directly to community resource information and offered as part of tailored education. Various venues for curriculum use were suggested, and formats involving multiple media were requested. Although Head Start serves preschool-aged children, parents and family advocates valued access to the full range of Connected Kids materials (for ages 0–18 years). Family advocates emphasized that supplementary materials on background information and delivery methods would be essential for effective implementation of Connected Kids at Head Start. CONCLUSIONS: Head Start family advocates and parents found the Connected Kids curriculum desirable. Although modifications might improve its usefulness, the curriculum seems acceptable and appropriate for the Head Start environment.