OBJECTIVETo assess the feasibility of employing an ecologically guided childhood obesity relevant surveillance system.METHODSCross-sectional qualitative and quantitative data were collected from 31 organizational representatives across 28 unique organizations and/or departments from three purposively sampled communities in the Capital Health Region in Alberta, Canada.RESULTSAll the organizational representatives surveyed reported awareness of childhood obesity and 36% reported participation in child obesity initiatives. Data to support a surveillance system are available but not in a suitable format, and privacy legislation present significant barriers. Interest in developing and sustaining an ecologically based surveillance system was low (18%).CONCLUSIONDue to the heterogeneity of available data and limited vision for the development and implementation of a surveillance system, the application of an ecologically based surveillance system relevant to childhood obesity may be constrained. Broad-based awareness of childhood obesity by a wide range of organizations could assist in establishing an effective coalition to address this issue over the long term by supporting the establishment of a surveillance system.

Évaluer la pertinence d’un système écologique de surveillance de l’obésité infantile. Des données transversales qualitatives et quantitatives ont été recueillies auprès de 31 représentants issus de 28 organismes ou services au sein de trois collectivités choisies dans la région sanitaire d’Edmonton (Capital Health) en Alberta, Canada. Tous les représentants interrogés ont affirmé être au courant du problème de l’obésité infantile et 36 % ont déclaré prendre part à des initiatives visant à le contrer. Des données utiles à un tel système de surveillance existent, mais elles ne sont pas dans un format adéquat et les lois sur la protection des renseignements personnels posent des obstacles énormes. L’intérêt pour créer et soutenir un système de surveillance à caractère écologique s’est révélé faible (18 %). Les données disponibles étant hétérogènes et la vision nécessaire pour créer et entretenir un tel système de surveillance étant absente, la mise en place de ce dernier risque d’être compromise. Il faudrait, pour lutter à long terme contre le problème de l’obésité infantile, qu’un vaste éventail d’organismes sensibilisés à la question se concertent pour mettre sur pied un système de surveillance.

Using a mail survey, we collected data on attitudes and opinions about school drug/sexuality education from 606 individuals representing 106 junior and senior high schools in Illinois. Respondents from five role groups (principals, district administrators, school board members, teachers and parents) completed questions regarding perceptions of student risk behaviors and effects of school health programs in four areas: drug/alcohol use, tobacco use, AIDS/STDs and teen pregnancy, For each program area, we analyzed six constructs across respondent groups: perceived seriousness of problem, perceived prevalence of problem, perceived acceptance of school program, perceived program effectiveness on student attitudes and behavior, and satisfaction with school program. To test role differences, MANOVA and random-effects regression model analyses were performed. Significant differences in role perceptions were found for all constructs except perceived program effectiveness on student attitudes. Overall, teachers and parents responded similarly to each other and different from other groups. They tended to be less satisfied with school programs, view programs as less effective and perceive other role groups as less accepting. We discuss the discrepancy in role perceptions in the context of diffusion theory, application to designing interventions, and potential impact on school program decisions, implementation and maintenance of change.

This study examined race differences in changes in source of long-term care. We addressed the following questions: (1) Are there differences between African Americans and Whites in the patterns of transitions among community longterm care, institutionalization, and death? (2) Are there differences between African American and White populations in sociodemographic characteristics and functional limitations influencing source of long-term care in a two-year follow-up sample? (3) Controlling for socioeconomic status, health status, level of informal care, and demographic variables, are there differences between African Americans and Whites in patterns of change to informal and mixed (informal and formal) care among community-dwelling frail older persons? and, (4) What are the predictors of change patterns within African American and White populations of older frail persons? The source of data is the longitudinal component of the 1982-1984 National Long Term Care Survey (NLTCS). Results of multinomial logistic analysis indicate few differences in change patterns, despite differences in the context of care among African American and White frail older persons.

We assess the role played by two types of self-selection in accounting for the influence of a television series on smoking cessation. De facto selection is based on respondents' regular channel viewing habits that can expose them to the series. Motivated self-selection takes place when viewers deliberately select to watch television programming because it meets their desire to quit smoking. Self-selection also can be viewed as a methodological artifact, spuriously accounting for the association between the airing of the series and smoking cessation among the target audience. Subjects were a probability sample of Chicago smokers who regularly watch the evening news on one of the network channels. The intervention was a televised self-help smoking cessation program broadcast on one of the network channels over 20 days. Using nested covariance structure models for the analysis, we conclude that 1) de facto selection had no influence on exposure to the program; 2) motivated selection had no influence on exposure to the program; 3) the program reduced smoking; and 4) this effect cannot be attributed solely to the methodological artifact of self-selection, although motivation to quit smoking did have the strongest influence on attempts to quit.

The National Long-Term Care Survey, 1982-1984, and the Informal Caregivers Survey were used to test the importance of caregiver burden for risk of admission to a nursing home. This study was based on a subsample of 940 older persons with sole spouse or adult child caregivers in 1982. Using logistic regression, nursing home entrants (127) were compared to 624 continuous community residents. Characteristics of the older person included age, race (White), and number of instrumental activities of daily living limitations. Predictors related to the caregiving context included caregiver burden and use of formal services.

This article integrates the results of a series of prospective studies that used data from the 1982-1984 National Long Term Care Survey to (a) provide a comprehensive view of the effects of caregiver burden over a two-year period, (b) suggest ways in which caregiver burden intersects with the continuum of care, and (c) explore the implications for long-term care research and policy. Each dimension of caregiver burden had different consequences for each long-term care outcome. Neither personal nor inter-personal burden had an independent effect on changes in the informal task support network. Personal burden, but not interpersonal burden, influenced changes in the use of formal services. Interpersonal burden, but not personal burden, influenced nursing home admissions.

We used a national longitudinal probability sample of frail older persons and their caregivers to examine three questions: 1) What are the probabilities of transition to use of formal helpers over a two-year period? 2) What is the role of predisposing, enabling, older person's need, and caregiver's need variables in changes in the use of formal helpers? 3) Do determinants of change in the use of formal helpers vary by level of caregiver's burden? Results show a slight trend to increased use in formal help over time. Personal burden, but not interpersonal burden, had a lagged effect on increased use of formal services. Use of formal helpers was greater in situations combining high levels of older person's need, high levels of caregiver's personal burden, and insufficient support from the informal network.

This study examines predictors of stability and change in composition, size, and intensity of help of the informal task support networks of frail elders and their primary caregivers. The sources of data are the 1982 and 1984 National Long Term Care Surveys and the companion 1982 Informal Caregivers Survey. There was slightly more stability than change in the size and composition of family task support networks. We found little evidence that shifts in network composition were in the direction of including more distant kin. Changes in network size and intensity of help occurred in response to changes in health and functional status of the frail older person, but not in response to the level of burden of the primary caregiver.

This study examined the simultaneous effects of an elder's health, caregiver involvement, and stress on caregiver burden, addressing the questions: (a) What are the direct and indirect effects of level of elder's impairment, caregiver involvement, and stress on personal and interpersonal burden? (b) How do these relationships differ between spouse and adult-child caregivers? Data were from the 1982 National Long Term Care Survey. Results using linear structural relations analysis showed the effect of a frail elder's health and functioning on personal and interpersonal burden is mediated by task involvement and perceived global stress. Contrary to expectation, there were few differences in the direct effect of each dimension of health, functional limitations, cognitive status, and global health rating on each dimension of burden. Although the results suggested mean differences between spouse and adult child caregivers on key variables, there were no differences by family relationship in the system of relationships that comprise the process linking health and burden.