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Objectives. The purpose of this study was to identify circumstances in which biochemical assessments of smoking produce systematically higher or lower estimates of smoking than self-reports. A secondary aim was to evaluate different statistical approaches to analyzing variation in validity estimates. Methods. Literature searches and personal inquiries identified 26 published reports containing 51 comparisons between self-reported behavior and biochemical measures. The sensitivity and specificity of self-reports of smoking were calculated for each study as measures of accuracy. Results. Sensitivity ranged from 6% to 100% (mean = 87.5%), and specificity ranged from 33% to 100% (mean = 89.2%). Interviewer-administered questionnaires, observational studies, reports by adults, and biochemical validation with cotinine-plasma were associated with higher estimates of sensitivity and specificity. Conclusions. Self-reports of smoking are accurate in most studies. To improve accuracy, biochemical assessment, preferably with cotinine-plasma, should be considered in intervention studies and student population. [ABSTRACT FROM AUTHOR]

Objectives. The purpose of this study was to examine factors predictive of duration of work-related disability. Methods. Multivariate survival analysis techniques were used to conduct a population-based, retrospective cohort study on a random sample of 28 473 workers' compensation claims from Washington State filed for injuries occurring in 1987 to 1989. The principal outcome measure was length of time for which compensation for lost wages was paid, used as a surrogate for duration of temporary total disability. Results. The findings suggest that, even after adjusting for severity of injury, older age, female gender, and a diagnosis of carpal tunnel syndrome or back/neck sprain significantly predict longer duration of disability. Other predictors that were stable and significant, but involved lower magnitudes of effect included divorced marital status, firm size of fewer than 50 employees, higher county unemployment rates, and construction and agricultural work. Conclusions. Greater disability prevention efforts targeting these higher risk subgroups could have significant economic and public health effects. The greatest impact may be on claimants who remain disabled at 6 months after an injury that did not require hospitalization. [ABSTRACT FROM AUTHOR]

Objectives. To date, evaluations of community-based prevention programs have focused on assessing outcomes, not the process of organizing communities for health promotion. An approach was developed to analyze community organization efforts aimed at advancing community health objectives. These organizational processes are referred to as community activation. Methods. Information was gathered from 762 informants through a key informant survey conducted in 28 western communities. The data collected included informant ratings of community activation and information about interorganizational activities analyzed through network analytic techniques. Results. Activation levels, as measured by informant ratings, varied across communities. Program coordination, as measured by network analysis, occurred, on average, approximately 30% of the time. Higher income communities tended to be more activated than lower income communities. Conclusions. There is a widely recognized need for improved information about health-related community organization activities. It appears possible to gather such information through key informant surveys and to develop measures of community organization status that can be used in the evaluation of community health promotion programs. [ABSTRACT FROM AUTHOR]

Objectives. In national and local discussions of health care reform, there is disagreement about whether a national health insurance plan should he mandatory or voluntary. This study describes characteristics of low-income people who were more likely or less likely to be covered by a voluntary plan. Methods. Survey data were available from an evaluation of Washington State's Basic Health Plan, which offered subsidized health insurance to low-income residents. For those subjects who were eligible and uninsured at baseline, those who joined were compared with those who did not join on a variety of demographic and health-related characteristics. Results. There were substantial differences between those who did and did not join the Basic Health Plan. Those who did not enroll were generally less well-off, with less education, lower income, and worse health. Many had never had health insurance. Conclusions. If health care reform results in a voluntary plan, additional measures may be needed to ensure that less advantaged citizens have adequate access to health care. [ABSTRACT FROM AUTHOR]

Abstract: A pilot test of a survey of grocery store product displays was conducted to measure the amount of health-education information provided and the proportion of the display devoted to "healthier" products. Inter-rater reliability ranged between 0.73 and 0.78 for the healthiness indices and between 0.30 and 0.67 for the health education measures. Test-retest reliability ranged from 0.44 to 1.0. (Am J Public Health 1990; 80:709-711.) [ABSTRACT FROM AUTHOR]