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To assess support for 12 potential smoking cessation strategies among pregnant Australian Indigenous women and their antenatal care providers. Cross-sectional surveys of staff and women in antenatal services providing care for Indigenous women in the Northern Territory and New South Wales, Australia. Respondents were asked to indicate the extent to which each of a list of possible strategies would be helpful in supporting pregnant Indigenous women to quit smoking. Current smokers (n = 121) were less positive about the potential effectiveness of most of the 12 strategies than the providers (n = 127). For example, family support was considered helpful by 64% of smokers and 91% of providers; between 56 and 62% of smokers considered advice and support from midwives, doctors or Aboriginal Health Workers likely to be helpful, compared to 85-90% of providers. Rewards for quitting were considered helpful by 63% of smokers and 56% of providers, with smokers rating them more highly and providers rating them lower, than most other strategies. Quitline was least popular for both. This study is the first to explore views of pregnant Australian Indigenous women and their antenatal care providers on strategies to support smoking cessation. It has identified strategies which are acceptable to both providers and Indigenous women, and therefore have potential for implementation in routine care. Further research to explore their feasibility in real world settings, uptake by pregnant women and actual impact on smoking outcomes is urgently needed given the high prevalence of smoking among pregnant Indigenous women. Keywords Tobacco smoking * Smoking cessation * Indigenous * Consumer preference, Introduction Tobacco smoking among pregnant Aboriginal and Torres Strait Islander women remains three times as common as among non-Indigenous Australian pregnant women, with approximately 50% of women smoking during pregnancy [...]

Objective: This study examines the effectiveness and costs of follow-up phone calls in improving response rates to a community survey. Methods: Non-responders to a postal survey were randomly allocated to receive a phone call or no phone call. The resources used for the development and implementation of the survey were documented. The response rates and cost per level of follow-up contact examined. Results: Follow-up phone calls led to a statistical significant increase in the number of responses to a community-wide survey, relative to no phone call. This relative increase in responses (n=62 for the follow-up phone call group versus n=l for controls), did not increase the absolute survey response rate sufficiently (from 38.5% for two mailed surveys to 39.8% for two mailed surveys plus a phone call) to justify the phone call costs. Scenario analyses show increasing the initial response rate by 10% and conducting a second mailed survey achieves greater marginal cost savings than increasing the response rate to the second mailout or the follow-up phone calls. Conclusions: These results suggest a follow-up phone call was not cost effective. Survey research ought to primarily focus on obtaining optimal initial response rates by using strategies identified in a Cochrane meta-analytic review. Key words: response rate, non-response, survey, follow-up, cost, randomised controlled trial. Aust NZ J Public Health. 2010; 34:508-12 doi: 10.1111/j.1753-6405.2010.00598.x

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2008.06.004 Byline: Jane Adams (a), Lynne Parkinson (a), Rob W. Sanson-Fisher (a), Raoul A. Walsh (a)(b) Keywords: Smoking; Adolescence; Bogus pipeline; Carbon monoxide; Anonymity Abstract: Adolescent smoking prevalence is usually assessed via self-complete questionnaires. However, concern has been expressed about the validity of such self-report. One approach to increase validity involves the threat of biological validation, known as the bogus pipeline method (BPL).This study aimed to assess the effects of BPL, using an expired air carbon monoxide monitor, and of questionnaire anonymity on student smoking self-report data. High school students (n =801) were randomly allocated to one of four conditions: anonymous questionnaire+BPL, named questionnaire+BPL, anonymous questionnaire without BPL and named questionnaire without BPL. Overall, 37% of students agreed that questionnaires were a good way to obtain honest answers. In a logistic regression analysis, students in the BPL condition had significantly higher odds of reporting weekly smoking (OR=1.83 95% CI 1.27-2.65) and monthly smoking (OR=1.66 95% CI 1.21-2.28) but not of lifetime smoking compared with non-BPL students. Students in the named questionnaire condition had a significantly higher odds of reporting lifetime smoking (OR=1.49 95% CI 1.08-2.04) compared with anonymous students. Studies assessing current smoking patterns in adolescents should consider incorporating a BPL method. Author Affiliation: (a) Discipline of Health Behaviour Sciences, School of Medicine and Public Health, University of Newcastle, Callaghan NSW 2308, Australia (b) Centre for Health Research & Psycho-oncology (CHeRP), The Cancer Council NSW/University of Newcastle, Longworth Avenue, Wallsend NSW 2287, Australia

Objective: To assess the prevalence and predictors of perceived unmet needs among women diagnosed with breast cancer, with a particular focus on the impact of location (rural/urban). Method: A random sample of women in NSW diagnosed with breast cancer was surveyed during 1995-96. The Breast Cancer Patients' Needs Questionnaire (BR-CPNQ) explores patients' perceived needs across five domains: psychological, health information, physical/daily living, patient care/support and interpersonal communication. Items assessing breast cancer specific needs and access to services and resources were included. Of 235 eligible rural women, 134 (57%) consented to participate and 129 (55%) returned completed surveys. Of 196 eligible urban women, 102 (52%) consented to participate and 100 (51%) returned completed surveys. Results: For 12 of the 52 items, at least one-third of the sample reported ever having a moderate/high need for help. Of the 15 highest moderate or high unmet needs, 10 related to health information and three to psychological needs. There were few differences in the prevalence of needs reported by rural and urban women. Only in the physical/daily living domain were rural women more likely than urban women to report some need for help (OR=2.59, 95% CI 1.21-5.52). Conclusions: Unmet needs, particularly in the information and psycho-social domains, are reported by both rural and urban women with breast cancer, with sub-groups experiencing different types of needs. Implications: There is a need to develop and trial targeted and innovative strategies to meet the health information and psychological needs of women with breast cancer, and the physical/daily living needs of rural women diagnosed with breast cancer.

A number of sources are available to clinicians to help them communicate a life threatening diagnosis to patients. However many of the guidelines are written from the perspective of the expert or physicians and the receivers' perspective has been less documented. There are also substantial variations in recommendations. Database reference material from 1994-1997 is reviewed., Literature related to breaking bad news to medical patients was reviewed. An analysis of citations appearing between 1994 and August 1997 updated earlier work and indicated that a minority (24%) [...]

Clinicians are encouraged to adopt the best practices for conveying bad news to medical patients. It is difficult to alter clinical behavior of medical personnel, however it is found that clinicians are under-informed in this area. Clinicians should be provided with feedback on their performance and training guidelines should be disseminated., Steps to encourage clinicians to adopt the best practices for communicating bad news to patients are outlined. First, official, credible guidelines endorsed by key organizations or professional bodies, giving a [...]

Consensus guidelines and principals are reviewed for breaking bad news to patients. The setting, manner and initial meeting is discussed. The patient's understanding and emotional status should be documented. Patients should be encouraged to express their feelings and steps for nonverbal empathic communication are outlined. A review of the situation should be scheduled within 24 hours and support services and should be offered., Reviews of the literature on how to convey bad news to patients with serious diseases have identified a paucity of empirically based information to guide clinicians in undertaking this difficult [...]

Results of a study suggest a growing inequity exists in Australia in the spending on anti-smoking activities vs revenues from cigarette sales to minors. The research was to determine whether changes in government revenue from sale of cigarettes to minors and the proportion of the revenue spent in an effort to prevent adolescents from taking up the habit, 1990-93. One who starts smoking at 14 or before is five times as likely to die of lung cancer as one who starts at 24 or later and 15 times as likely to die of lung cancer as never-smokers.

Interventions with retailers to cut down on cigarette sales to minors in Australia have been studied in a randomized controlled trial. Neither intervention achieved significant improvements for the two key behavioral outcomes, which were requiring proof of age and displaying a warning sign. Knowing about the law was not shown to have an intervention effect. Interventions may have been partly successful in modifying attitudes of retailers. One group received an educational letter and the other received a threat of enforcement of laws followed by a visit from a public health officer.

Keywords: elderly people, home environmental hazards, injuries Introduction In both the United States and Australia, injury ranks sixth as a cause of death and morbidity in older people [1, 2]. [...]

Objectives. Outdoor workers are at high risk of developing skin cancer. Primary prevention in this group can potentially reduce the incidence of skin cancer, and also potentiates the spontaneous remission of existing solar keratoses. A randomized controlled trial was conducted to evaluate a solar protection intervention targeting outdoor workers. Methods. Outdoor workers are randomly allocated to an intervention (n = 65) or control group (n =77). The intervention group received individual skin screening by a dermatologist and participated in an education session. Pre- and posttest outcome measures included solar protection behavior (assessed using a validated diary), knowledge, and attitudes. Results. There was a significant increase (16%) in the percentage of outdoor workers who were using a high level of solar protection at posttest compared to pretest in the intervention group, but there was no change in the control group. Although both groups improved in their knowledge score, the intervention group showed a significantly greater improvement at posttest. No changes in attitudes were detected. Conclusions. The findings suggest that changes in solar protection are achievable with outdoor workers. (Am J Public Health. 1994;84:77-81), Preventive screening and education appear to be effective interventions for increasing outdoor workers' use of sun protection. Researchers assigned 65 workers to receive individual skin screening and education and 77 workers to no intervention for comparison. Pre-test skin damage, sun protection behavior and knowledge did not differ among the two groups. After the study, 66% of the intervention group used sun protection measures such as clothing/hats, shade and sunscreen lotion, compared to 49% of the comparison group. The proportion of workers using high levels of sun protection increased by 16% in the intervention group, while remaining stable in the comparison group. Both groups improved significantly in their average knowledge scores after the study. However, the intervention group significantly increased their scores by an average of 62%, compared to 58% in the comparison group. Neither group experienced attitude changes.

Print materials are common tools for public health education in New South Wales, but their effectiveness is rarely evaluated. A survey of sample materials showed the most cost-effective means to develop such materials were not commonly used, and their effectiveness was unreported. Health educators and administrators will need to note these results.

Objectives: To assess the prevalence, type, location of and injuries from home accidents, including falls and other accidents, and to explore whether variables including socio-demographic characteristics, medication use and home hazards were associated with all home accidents and falls. Method: 657 older people were interviewed about accidents in the previous four weeks. For a subsample (n=425), a home hazard check was completed. Results: Of the 10.1 accidents reported, 51% (n=51) were falls and 50% (n=50) were other accidents. The most common location for all accidents was outside (30%). Most resulted in minor injury to the legs (43%) or arms (39%). Medical treatment was sought for 14% of accidents. Having more than five hazards and infrequent home visits by healthcare providers were associated with having at least one accident and at least one fall. Use of a walking aid was also associated with falling. Conclusion: Rates of falls and other accidents are considerable. Implications: Work is required to confirm the importance of the relationships suggested and to provide data on the burden of injury associated with non-fall accidents. (Aust N Z J Public Health 2000; 24: 633-6)

Eighty-four breast cancer patients, 64 oncologists, and 140 oncology nurses rated the importance of 15 general principles and 12 recommended steps to guide clinicians in breaking bad news to patients. [...]