Abstrak: Purpose: National smoking cessation practice guidelines offer recommendations regarding the processes and structure of care. Facilities routinely measure the processes of care but not the structure of care. This pilot study assessed the structure of smoking cessation care at Veterans Health Administration facilities.

Methods: Key informants at 18 sites completed a brief checklist survey adapted from national smoking cessation guidelines. Responses were compared with detailed site surveys.

Results: Guideline adherence was seen in identifying smokers and treating inpatient smokers. Areas of low adherence include offering incentives and defining staff responsibilities. The checklist survey showed poor correspondence with the detailed survey, with low agreement on systematic screening (kappa = .21) and higher agreement on primary care prescribing authority (kappa = .53).

Discussion: This pilot survey provides a potential rapid method for assessing adherence to systems recommendations from the national smoking cessation guidelines. The relatively low agreement with a more detailed survey suggests that the two surveys may have been measuring different aspects of smoking cessation care.

Abstrak: Purpose: To identify factors predictive of smoking cessation among adults with chronic obstructive pulmonary disease (COPD). Data from the 1997 to 2002 National Health Interview Surveys were analyzed for adults at least 25 years of age with COPD using logistic regression.

Results: Of the adults with COPD, 36.2% were current smokers. Of the current smokers and former smokers who had quit smoking during the past year, 22.9% reported not receiving cessation advice from a health care professional during the past year Although half of smokers with COPD had attempted to quit during the past year, only 14.6% were successful. Attempting to quit was negatively associated with heavy drinking but positively associated with being younger and having cardiovascular diseases, lung cancer, and activity limitation due to lung problems. Factors predictive of successful cessation included being at least 65 years old, not being poor, and activity limitation due to lung problems.

Conclusion: This study underscores the importance of continuing to develop smoking cessation strategies for COPD patients and implementing clinical guidelines on smoking cessation among health care providers.

Abstrak: This study aimed to determine the predictors of contraceptive use among married female youths and their husbands using the behavioral theory of the Health Belief Model (HBM). A community-based survey was conducted in a rural area of Myanmar in 2008. A total of 444 respondents (222 couples) were interviewed separately using a pretested, structured questionnaire. Significant predictors of contraceptive use were determined by univariate and multivariate analysis. Wife's HBM perception was a highly significant predictor of contraceptive use in married youths (adjusted odds ratio = 10; 95% confidence interval = 2.7, 37.6). Wives aged 20 to 24 years and having their own income, experience of spousal communication, and shorter distance from home to health center were also significant predictors of contraceptive use. A poor agreement on HBM perception between wife and husband was noted. This study highlights the importance of HBM perceptions, wife's income, spousal communication, and geographic barriers in contraceptive use among married youths in rural Myanmar.

Abstrak: The present study investigates the prevalence of reproductive health morbidities, treatment-seeking behavior, and its association with sociodemographic correlates among unmarried and married adolescent girls of Sikkim. The study sample includes 1250 adolescent girls randomly selected from both urban and rural blocks of the State. Information on socioeconomic and demographic characteristics, prevalence of reproductive health morbidities, and treatment-seeking behavior was collected using standard pretested questionnaires.

Results: of the study indicate that the prevalence of reproductive health morbidities among both married and unmarried girls is quite high. Age, media exposure, and economic status emerged as significant correlates of treatment-seeking practices among both married and unmarried girls. High prevalence of reproductive health morbidity in this vulnerable group, particularly in rural settings, requires urgent intervention of health planners. This study reinforces an indirect and mediatory role of socioeconomic and demographic factors in the prevalence of reproductive health morbidities and associated treatment-seeking behaviors.

Abstrak: Purpose: Research examining the relationship between human immunodeficiency virus (HIV)-related risk behavior and negative affective states has netted mixed findings. The present study examined the potential moderating role of gender and sexual orientation on negative affect and HIV-related risk behavior.

Design: Measures of depression, anxiety, and HIV-related risk behavior were collected from participants at the time of pretest counseling. Analysis of variance was used to examine HIV-related risk behavior as a function of negative affect levels and gender and behavioral sexual orientation.

Setting: The study was conducted through a community-based, anonymous HIV counseling and testing site.

Subjects: Participants included 185 consecutively recruited men and women presenting for HIV testing.

Measures: Participants completed a structured interview regarding HIV-related risk behavior, the Center for Epidemiological Studies Depressed Mood Scale, and the Beck Anxiety Inventory.

Results: Greater HlV-related risk behavior was associated with high levels of anxiety and moderate or high levels of depression for bisexual women. Greater HIV-related risk behavior was also associated with low levels of anxiety and mild to moderate levels of depression for bisexual men.

Conclusions: The relationship between negative affective states and HIV-related risk behavior may vary as a function of gender and behavioral sexual orientation. Better understanding of the relationship between negative affect and risk behavior may be achieved through consideration of these sources of variation.

Abstrak: Purpose: Public-private partnerships may help to promote healthy diets. We assessed customers' exposure to and the acceptability of a Dutch public-private healthy diet campaign in butcher's shops and investigated the effects on the purchase of lean meat and the use of liquid cooking margarine and potential behavioral determinants.

Methods: The pretest-posttest control group design included 486 customers (242 experimental and 244 control) of butcher shops representing 64% of the original sample. Campaign exposure, acceptability, and behavioral effects were measured by a questionnaire.

Results: Seventy-one percent of the customers noticed the campaign. Scores on the acceptability were positive to very positive. Regression analysis revealed that customers in the experimental condition evaluated the campaign better (B = .415; p < .05) and felt more encouraged to buy lean meat (B = .252; p < .05) than customers in the control condition. No effects on behavior were found.

Discussion: Study design limitations included possible campaign exposure of control group participants. The study shows the feasibility and acceptability of a joint health-promoting activity through a public-private partnership, but there were no effects on behavior.

Abstrak: Purpose: To assess the status of U.S. military retirees and their spouses 38 to 64 years of age relative to select Healthy People 2010 objectives and to identify sociodemographic characteristics associated with select health behaviors.

Design: Cross-sectional analyses with self-reported standardized measures from the U.S. Department of Defense Population Health Survey, 2003.

Setting: The continental United States.

Subjects: U.S. military retirees and their spouses 38 to 64 years of age.

Measures: Data for this study were self-reported responses to the Population Health Survey. Dichotomous variables were created to indicate whether each Healthy People 2010 objective had been met. Each objective was measurable with the survey by using the definitions set forth in Healthy People 2010. These objectives included healthy weight and obesity based on body mass index (height and weight); daily fruit, vegetable, and grain-product consumption; physical inactivity, moderate physical activity, and vigorous physical activity; binge drinking; cigarette use; and smoking-cessation attempts.

Results: The study population did not meet any of the Healthy People 2010 objectives included in this study. Sociodemographic characteristics that were associated with this result included being male, not having a college degree, and a less-than-excellent self-reported general health status.

Conclusion: Health-promotion interventions are needed to improve the health status of this population and to achieve the goals set forth in Healthy People 2010.

Abstrak: Purpose: To examine the application of the transtheoretical model (TTM) to fruit and vegetable consumption among economically disadvantaged African-American adolescents.

Methods: Scales for measuring decisional balance, situational self-efficacy, and processes of change for fruit and vegetable consumption were developed and pretested with 57 economically disadvantaged African-American adolescents. The scales and measures for assessing stages of change, demographic variables, and fruit and vegetable consumption were administered to a separate sample of 262 participants. t-tests for independent samples and analysis of variance were used to examine differences in TTM variables and fruit and vegetable consumption across stages of change.

Results: Two-factor solutions for decisional balance and processes of change and a three-factor solution for situational self-efficacy provided the best fit to the data. Alpha coefficients of reliability for the scales ranged from .77 (experiential change processes) to .91 (pros). Participants in action-maintenance stages evidenced higher pros, self-efficacy, and fruit and vegetable consumption and significantly lower cons than did participants in precontemplation and contemplation-preparation stages. Also, participants in action-maintenance stages used processes of change more frequently than did those in precontemplation-contemplation-preparation stages. The use of experiential and behavioral processes within these stages did not differ significantly, as posited.

Discussion: Observed differences in TTM variables and fruit and vegetable consumption by stage of change in this sample of economically disadvantaged African-American adolescents were consistent with theory and previous applications of the model to fruit and vegetable consumption in adults. With replication studies, the TTM may be appropriate for designing interventions to increase fruit and vegetable consumption among this population.

Abstrak: Introduction: . Women suffer disproportionately from depression, which has a high prevalence in developing countries. Sociodemographic factors are associated with depression, some of which may be modifiable and lead to better outcomes for depression among women.

Objectives: . To determine sociodemographic factors associated with depression among women of reproductive age in Karachi.

Methods: . A case control study was conducted on 376 women in 2 hospitals in Karachi. Patients were diagnosed by psychiatrists and family physicians by Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria and SRQ20.

Results: . The odds for women with depression being married for >5 years, being abused by in-laws, spending ≤3 hours per day with their spouses, and being just satisfied or not satisfied with their married life was more than that for controls.

Conclusion: . The authors' findings highlight the important modifiable risk factors for depression, which if addressed will help decrease the burden of depression among women.