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The Community Health Promotion Grants Program, sponsored by the Henry J. Kaiser Family Foundation, represents a major health initiative that established 11 community health promotion projects. Successful implementation was characterized by several critical factors: (1) intervention activities; (2) community activation; (3) success in obtaining external funding; and (4) institutionalization. Analysis of the program was based on data from several sources: program reports, key informant surveys, and a community coalition survey. Results indicate that school-based programs focusing on adolescent health problems were the most successful in reaching the populations they were targeting. The majority of the programs were able to attract external funding, thereby adding to their initial resource base. The programs were less successful in generating health promotion activities and in achieving meaningful institutionalization in their communities.

Adolescent bonding - attachment to, commitment to, and involvement in conventional social activities - decreases the likelihood of engaging in some risk-taking behaviors. The extent to which bonding opportunities in the school environment affect individual's bonding and risk-taking behaviors is less explored. This study tested a model that includes individual and environmental indicators of bonding to predict cigarette smoking, drinking, drug use, and sexual activity among ninth grade students. Survey data representing students in 20 schools in seven western states are reported. Twelfth grade students' bonding and other demographic variables aggregated by school served as environmental indicators of bonding opportunities to predict ninth grade students' bonding and risk-taking behavior. Path analyses indicate the school environment has a direct influence on ninth grade students' bonding and, in turn, on the likelihood they will engage in risky behavior. Implications of these findings for future research directions and intervention design are discussed (J Sch Health. 1995;65(2):63-68), Among adolescents, behaviors such as substance use and unprotected sexual activity increase their risk for accidents, sexually transmitted diseases, other chronic diseases, and diminished academic performance.[1,2] While socio-environmental and psychological [...]

Context Case series demonstrate that bariatric surgery can be performed with a low rate of perioperative mortality (0.5%), but the rate among high-risk patients and the community at large is unknown. Objectives To evaluate the risk of early mortality among Medicare beneficiaries and to determine the relative risk of death among older patients. Design Retrospective cohort study. Setting and Patients All fee-for-service Medicare beneficiaries, 1997-2002. Main Outcome Measures Thirty-day, 90-day, and 1-year postsurgical all-cause mortality among patients undergoing bariatric procedures. Results A total of 16 155 patients underwent bariatric procedures (mean age, 47.7 years [SD, 11.3 years]; 75.8% women). The rates of 30-day, 90-day, and 1-year mortality were 2.0%, 2.8%, and 4.6%, respectively. Men had higher rates of early death than women (3.7% vs 1.5%, 4.8% vs 2.1%, and 7.5% vs 3.7% at 30 days, 90 days, and 1 year, respectively; P<.001). Mortality rates were greater for those aged 65 years or older compared with younger patients (4.8% vs 1.7% at 30 days, 6.9% vs 2.3% at 90 days, and 11.1% vs 3.9% at 1 year; P<.001). After adjustment for sex and comorbidity index, the odds of death within 90 days were 5-fold greater for older Medicare beneficiaries (aged ≥75 years; n = 136) than for those aged 65 to 74 years (n = 1381; odds ratio, 5.0; 95% confidence interval, 3.1-8.0). The odds of death at 90 days were 1.6 times higher (95% confidence interval, 1.3-2.0) for patients of surgeons with less than the median surgical volume of bariatric procedures (among Medicare beneficiaries during the study period) after adjusting for age, sex, and comorbidity index. Conclusions Among Medicare beneficiaries, the risk of early death after bariatric surgery is considerably higher than previously suggested and associated with advancing age, male sex, and lower surgeon volume of bariatric procedures. Patients aged 65 years or older had a substantially higher risk of death within the early postoperative period than younger patients. [ABSTRACT FROM AUTHOR]

Presents a study which described a partnership between an academic center and community-based organizations for the purpose of improving the health of older adults. Characteristics of an effective partnership; Role of the community advisory board; Trials conducted through the partnership.