Prevention perspectives: From Vermont to Washington.

Discusses efforts to integrate preventive strategies into US health care systems, citing the annual Vermont Conference on the Primary Prevention of Psychopathology and the establishment in 1977 of the President's Commission on Mental Health as examples of such efforts. Articles by J. M. McGinnis, W. S. Cohen, and C. Lenfant and M. Schweizer (see PA, Vol 73:1705, 2593, and 1698, respectively) are reviewed that were written by individuals in a position to know the current status of prevention activities within the government, to anticipate future directions of health care, to suggest a place for prevention within this system, and to outline the role that professions can play in the process of developing comprehensive public policy. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two pathways to prevention.

Health promotion and disease prevention programs are becoming important components of contemporary health care. There are at least 2 pathways to the enhancement of population health status through disease prevention. The first pathway requires the early diagnosis and treatment of disease. The second pathway promotes healthy lifestyles and disregards the requirement that a condition must be diagnosed before intervention is recommended. Data from several evaluations suggest that prevention efforts that rely on diagnosis have produced somewhat limited benefits, whereas primary prevention efforts may have substantial benefits. Current health policy places greater emphasis on secondary prevention. The objectives of improved population health might be better achieved by devoting relatively more resources to primary prevention through the promotion of healthy behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some thoughts on health promotion.

Defines health promotion as the planned use of resources to encourage the maintenance and enhancement of health and prevention of disease. A study by G. J. Botvin (1980) is described in which the psychological factors affecting cigarette smoking in adolescents were examined. The study illustrated the relationship between psychological knowledge and health promotion. It is suggested that health promotion is an area in behavioral medicine with applications for applied social psychology and for applied psychological research. (French abstract) (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the Special Section on Dissemination: Dissemination Research and Research Dissemination: How Can We Close the Gap?

One of the greatest challenges facing health promotion and disease prevention is translating research findings into evidence-based public health and clinical practices that are actively disseminated and widely adopted. Despite the tremendous strides made in developing effective disease prevention and control programs, there has been little study of effective dissemination of evidence-based programs to and adoption by community, public health, and clinical practice settings. This special section provides a venue in which to highlight exemplary dissemination research efforts while also identifying limitations in research to date and framing important future research questions. This issue establishes a resource for investigators interested in dissemination research, with relevance to health psychology. In this sense, it can serve as a benchmark by which to examine subsequent progress. The 6 articles reflect the state of the science in dissemination research for the promotion and adoption of health behavior change interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managed care, school health programs, and adolescent health services: opportunities for health promotion

The rapid expansion of managed care creates opportunities and dilemmas for those involved in school health and adolescent health promotion. Managed care organizations (MCOs), public health agencies, and school and adolescent health providers share certain common goals and priorities including an emphasis on prevention, cost-effectiveness, and quality of care--and a willingness to explore innovative approaches to health promotion and disease prevention. However, MCOs often face conflicting challenges, balancing the goals of cost containment and investment in prevention. In considering support for school health programs, MCOs will be interested in evidence about the effectiveness of services in improving health and/or reducing medical expenditures. Mechanisms for improving prevention efforts within MCOs include quality assurance systems to monitor the performance of health plans, practice guidelines from professional organizations, and the contracting process between payers and health care providers. Development of partnerships between MCOs and schools will be a challenge given competing priorities, variation in managed care arrangements, structural differences between MCOs and schools, and variability in services provided by school health programs.     

A framework for health promotion and disease prevention programs.

There is a disquieting sense that many theoretically based health behavior change programs have been only minimally effective. Part of the problem may be that most current theories have considerable overlap, primarily focus on intraindividual and other individual-level variables, and tend to neglect the environment and issues related to program implementation. A framework is developed for health promotion and disease prevention programs that makes use of epidemiological and health indicator data and Healthy People 2000 goals to prioritize efforts, provides a schema to formulate programs on the basis of timing (prevention) and level of intervention, and addresses the marketing approach to target and implement programs. The framework integrates current theories to guide marketing and phases of research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary prevention of cardiovascular disease: Communitywide strategies for youth.

National interest in health promotion and disease prevention has led naturally to a concern with primary prevention and with youth. This attention to youth has been particularly notable in efforts to prevent injuries and chronic diseases. Specific behavior patterns that are learned in childhood and adolescence are implicated in the development of chronic diseases. These behavior patterns logically become the targets for early intervention. Over the past two decades, studies on the prevention of cardiovascular disease (CVD), the primary cause of mortality in the Western world, have become numerous and comprehensive and have included substantial work with youth. This article provides a rationale for that focus. We review promising communitywide strategies for youth and argue that communitywide strategies ought to be most efficient and efficacious for primary prevention. Both interest in and research on communitywide strategies are relatively recent; consequently, few strategies can be recommended unequivocally. The need for future research in this area by multidisciplinary teams is identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Behavioral health: A handbook of health enhancement and disease prevention.

Reviews the book, Behavioral health: A handbook of health enhancement and disease prevention edited by Joseph D. Matarazzo, Sharlene M. Weiss, J. Alan Herd, Neal E. Miller, and Stephen M. Weiss (1984). The term "behavioral health" is defined in this book as an interdisciplinary field dedicated to promoting a philosophy of health that stresses individual responsibility in the application of behavioral and biomedical science knowledge and techniques to the maintenance of health and the prevention of illness and dysfunction by a variety of self-initiated or shared activities. Overall, this book is a superb contribution to the field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical activity and exercise: Recent advances and current challenges.

This article presents an overview of major developments in physical activity and exercise for health promotion and disease prevention during the past 10 years. The importance of physical activity to physical and mental health was increasingly recognized. Assessment methods appropriate for diverse population groups were developed, and understanding of correlates of regular physical activity improved. Many studies focused on moderate activity that can be integrated into people's everyday lives. Research in community, school, and health care settings demonstrated that interventions based on cognitive-behavioral theories can change physical activity. Nevertheless, physical activity remained at low levels in most population subgroups throughout the past decade. Psychologists can make important contributions to efforts to address this ongoing challenge to public health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventive health practices of African American women

Preventive health practices of African American women (AAW) have been little studied. This study explores the participation of middle-income AAW in health promotion/disease prevention behavior. In-depth, audiotape, and semi-structured interviews were held with 36 AAW between the ages of 26 and 75 years. Results indicated that the majority of the women participated in diet control behavior for health purposes. Participation in weight management and exercise behavior was less extensive. The women were involved in other types of preventive health practices to keep healthy. The findings reveal the need for increased educational efforts in the areas of weight management, exercise behavior, mammography, and in the practice of breast self-examination. Results of the study have implications for researchers, educators, and clinicians.     

Health promotion in the community: Development of a curriculum for predoctoral clinical psychologists.

There is increasing evidence that life-style choices play a major role in premature illness and death from cardiovascular disease and cancer. Skyrocketing health care costs have promoted interest in health promotion activities. Although clinical psychologists appear to be in a unique position to contribute to health promotion activities, predoctoral training programs in clinical psychology have not generally included health promotion as a significant component. My colleagues and I are developing a curriculum for predoctoral clinical psychologists in the area of health promotion. Our emphasis on community interventions, rather than office- or hospital-based interventions, is consistent with the National Institutes of Health's funding of cardiovascular disease prevention programs at Stanford, Pawtucket, and Minnesota and appears valid from both a public health perspective and a psychological perspective. Our curriculum currently includes didactic and research components, as well as two community health promotion projects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral factors affecting HIV prevention for adolescent and young adult IDUs

Epidemiological and sociobehavioral data regarding HIV-related risk and injection drug use among adolescents and young adults are examined to provide insight and assistance to nurses delivering preventive intervention and community and clinical care. The increase in HIV/AIDS cases among injection drug users (IDUs), adolescents, and African Americans strongly suggests that clinical care providers acquire a better understanding of the sociocultural and behavioral context within which health care is provided. Transition into injection drug use, high-risk injecting and sexual behaviors, sociodemographic differences, and the importance of social networks are discussed. Nurses are encouraged to provide health promotion, disease prevention messages, and health care to IDUs in small nontraditional clinical settings and to seek out the assistance of the IDUs' social network to increase adherence and compliance to complex prevention and therapeutic efforts.     

Obstacles to community health promotion

The health transition ushered into the world in this century calls for a reorientation of traditional health services to manage the new causes of morbidity and mortality, renewing interest in disease prevention and health promotion. Community-based health promotion emphasizes prevention and community participation with people's empowerment to overturn current inequities and increase control over their health. Encouraged worldwide by the World Health Organization for the last two decades, some community health promotion programs have been implemented and lessons learned. However, the shift in focus required means nothing less than a paradigm change demanding not only a reorientation of professional training, but also a reorganization of social structures in communities. This article discusses nine of the interrelated obstacles that must be overcome to further develop community health promotion.     

Motivational interviewing in health promotion: It sounds like something is changing.

Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been applied in public health, medical, and health promotion settings. This article provides an overview of MI, outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed, nuances associated with the use of MI in health promotion and chronic disease prevention are described, and future directions are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupational health promotion in Germany--2: Prevention of musculoskeletal disorders

As a major part of a detailed study about worksite health promotion and disease prevention the standard of prevention programmes for musculoskeletal disorders was investigated. Only every 10th company doesn't offer such programmes. Within these programmes the prevention concept is based on a reduced narrow understanding of musculoskeletal disorders, mainly focussed on behavioural biomechanical risk factors. The organisational aspects of the programmes are well designed. The number of programme participants in relation to epidemiological measures is low. Scientific evaluation of the health benefits of the worksite health programmes is rare.     

Awards for Distinguished Contribution to Psychology in Public Interest.

Discusses the contributions made by L. C. Leviton and P. H. DeLeon, the 1993 recipients of the Awards for Distinguished Contribution to Psychology in the Public Interest presented by the American Psychological Association. Leviton is awarded for her studies of the behavioral variables involved in AIDS prevention and worksite health promotion, and the methodological issues that arise in doing public interest research. DeLeon is recognized for his efforts to harness the contributions of behavioral science research and mental health practice to support needed reforms in the health, education, and well-being of underserved, neglected, and racial and ethnic minority groups. A biography of each recipient is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Uncertainty orientation and protection motivation theory: The role of individual differences in health compliance.

An experiment was designed to determine the influence of uncertainty orientation (R. M. Sorrentini and J. C. Short, 1986) on compliance with diagnostic health behavior. 155 Ss read 1 version of an education essay on a disease and diagnostic response. Threat and efficacy information were manipulated. Consistent with protection motivation theory (R. W. Robers, 1983), uncertainty-oriented Ss sought more health-related information as threat and efficacy increased. Certainty-oriented Ss, however, sought more health-related information as threat or efficacy, but not both, increased. Individual differences were also found on adaptive measures and ineffective alternative responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human papillomavirus type 11 recombinant L1 capsomeres induce virus-neutralizing antibodies

The human papillomavirus type 11 (HPV-11) L1 major capsid protein can be trypsinized to generate recombinant capsomeres that retain HPV genotype-restricted capsid antigenicity (M. Li, T. P. Cripe, P. A. Estes, M. K. Lyon, R. C. Rose, and R. L. Garcea, J. Virol. 71:2988-2995, 1997). In the present study, HPV-11 virion-neutralizing monoclonal antibodies H11.F1 and H11.H3, previously characterized as recognizing two distinct HPV-11 capsid-neutralizing antigenic domains (S. W. Ludmerer, D. Benincasa, and G. E. Mark III, J. Virol. 70:4791-4794, 1996), were each found to be highly immunoreactive with trypsin-generated capsomeres in an enzyme-linked immunosorbent assay (ELISA). Capsomeres were used to generate high-titer polyclonal immune sera that demonstrated HPV genotype-restricted reactivity by ELISA. The capsomere antisera were then tested in an in vitro infectivity assay and found to neutralize HPV-11 virions. In this assay, HPV-11 capsomere polyclonal antisera exhibited neutralization titers (10(-5) to 10(-6)) comparable to those obtained with a virion-neutralizing antiserum raised previously against intact HPV-11 VLPs (R. C. Rose, R. C. Reichman, and W. Bonnez, J. Gen. Virol. 75:2075-2079, 1994). These results indicate that highly immunogenic, genotype-restricted HPV capsid-neutralizing antigenic domains are contained entirely within capsomeres. Thus, capsomeres may be viable vaccine candidates for the prevention of HPV disease.     

Primary care for healthy aging

The need to promote and maintain health will intensify with larger numbers of older adults seeking not just a long life but a healthy life as well. With a shift from a model of illness and cure to a model of wellness and care, the advanced practice nurse is the ideal health professional to implement a model of health care shaped by a philosophy of both primary and long-term care for the older population. This model includes (a) thoroughly integrated strategies for health promotion and disease prevention, (b) interdisciplinary, comprehensive geriatric assessment, (c) care management for integration and coordination of services, and (d) emphasis on function and quality of life as outcomes of treatment.     

DNA methylation and the promotion of flowering by vernalization

We have tested the hypothesis that the promotion of flowering by prolonged exposure to low temperatures (vernalization) is mediated by DNA demethylation [Burn, J. E., Bagnall, D. J., Metzger, J. M., Dennis, E. S. & Peacock, W. J. (1993) Proc. Natl. Acad. Sci. USA 90, 287-291]. Arabidopsis plants that have reduced levels of DNA methylation because of the presence of a methyltransferase (METI) antisense gene flowered earlier than untransformed control plants, without the need for a cold treatment. Decreased DNA methylation mutants (ddm1) also flowered earlier than the wild-type progenitor under conditions where they respond to vernalization. We conclude that demethylation of DNA is sufficient to cause early flowering, and we have found that the promotion of flowering is directly proportional to the decrease in methylation in METI antisense lines. The early-flowering phenotype was inherited in sexual progeny, even when the antisense transgene had been lost by segregation. Methyltransferase antisense plants with low DNA methylation levels responded to a low-temperature treatment by flowering even earlier than their untreated siblings indicating that the promotion of flowering by cold and by demethylation was additive when neither treatment saturated the early-flowering response. As in untransformed control plants, the cold-induced early-flowering signal was reset in progeny of METI antisense plants. These observations suggest that the demethylation brought about by a METI antisense can account for some properties of vernalization, but not for the need for revernalization in each generation.