Freelisting: A Technique for Enhancing the Community Health Needs Assessment

US health systems are required to conduct community health needs assessments (CHNAs). These assessments often rely solely on publicly reported disease prevalence data. The objective of this study was to identify a feasible qualitative method that can be implemented into CHNAs to confirm existing information and enhance them with new data and community narrative. Freelisting interviews were conducted in 2017 throughout a county in Pennsylvania. Individuals listed (1) things that improve health, (2) health problems, and (3) health barriers. Responses were grouped into like terms, Smith's salience index was calculated for each, subgroup variation was assessed. Community-reported health priorities were identified by salient terms juxtaposed with publicly reported disease prevalence data. 98 respondents throughout the county participated in freelisting interviews. Demographics resembled the population: median age 55, 46% female, 88% Caucasian, 9% uninsured. Salient terms that improve health included: "physical activity", "healthy eating", and "health services". Salient terms describing health problems included: "cardiovascular disease" and "spine and joint disease". Centers for Disease Control and Prevention (CDC)-reported chronic disease prevalence in the county included heart disease mortality (22% of deaths) and arthritis (26% of adults). Salient barriers to health included: "weight, physical activity, and dietary concerns", as well as "occupational concerns". This is in line with 2017 County Health Rankings related to obesity (reported 29%), however, while 10% were uninsured in the community, this was not a salient term. Freelisting can augment and inform CHNAs. In this single-county study, freelisting responses supported publicly available disease/mortality prevalence data and provided insight into community perceptions of health issues.

The implementation of a statewide bullying prevention program: preliminary findings from the field and the importance of coalitions

Bullying in schools has become recognized as a significant public health problem. The Olweus Bullying Prevention Program (OBPP) has been identified as an effective means to reduce bullying behavior in schools. The goal of this large population-based initiative was to reduce bullying by producing a quantifiable change in school climate using an established program and standardized measurement tool. Program participants over a 2-year period included 56,137 students and more than 2,400 teachers from 107 schools in 49 counties across Pennsylvania. An age cohorts design was used, and data from two equivalent age cohorts of students were compared at two or more points in time. After 1 to 2 years of program implementation, across cohorts, there were reductions in student self-reports of bullying others, and improvements in student perceptions of adults' responsiveness, and students' attitudes about bullying. This study is the largest bullying prevention initiative to date in the United States. This initiative reaffirms the efficacy of the OBPP, emphasizes the importance of an identified coalition, and highlights several positive outcomes. It is recommended that the OBPP be implemented through the establishment of community partnerships and coalitions as consistent with the public health model.

Two rapid-dose titrations of sertindole in patients with schizophrenia

The novel antipsychotic sertindole has demonstrated efficacy in psychosis with an extrapyramidal syndrome profile indistinguishable from placebo. Prior trials of sertindole have increased the dose by 4 mg every third day, whereas the present study evaluated the safety and tolerability of two, previously untested, more rapid dose escalation regimens. Sixteen schizophrenic inpatients entered a 4-day, single-blind placebo washout period in two consecutive groups. All patients received sertindole in 4-mg dose increments up to a maximum dose of 24 mg, which was maintained for 5 days. Dose increases were every other day for group 1 (N = 8) and daily for group 2 (N = 8). Adverse events, electrocardiograms, routine laboratory tests, and plasma sertindole concentrations were recorded. No patient was discontinued because of adverse events. The most frequent adverse events were tachycardia upon orthostatic challenge, nasal congestion, dry mouth, and headache; except for dry mouth, the incidence of these was greater in group 2. All cases of tachycardia were asymptomatic. No clinically significant laboratory abnormalities were detected in either group. In conclusion, 4-mg increases of sertindole every other day seems to be safe. Daily titration was, in general, not well tolerated.

Enhancing program review for evaluation and management

Program review has not received the attention it warrants as a program evaluation tool despite its wide use for evaluation and management purposes. The use of the program review will probably endure on the strength of its face validity and irrespective of other developments in the field of program evaluation. Evaluators should realize this and, accordingly, attempt to improve its effectiveness. This paper presents one organization's approach to achieving this objective through the explication of development principles, implementation guidelines and review items. This paper also discusses benefits that can be expected from a systematic development of this tool and presents various research directions and potentials in this area.

Comparison of Locus of Control in Freeloaders versus Nonfreeloaders

To determine the incidence of freeloading by college students and to compare the locus of control of freeloaders versus nonfreeloaders, 25 female and 20 male volunteers from introductory psychology were administered Levenson's Locus of Control Scale and were fingerprinted. The subjects were then allowed to cleanse their hands. Unobtrusive measures of whether the subjects obtained paper towels by operation of a crank towel dispenser or freeloaded from a stack of folded towels placed above the dispenser were obtained. 25 nonfreeloaders and 15 freeloaders were identified and compared on Levenson's Internal, Powerful Others, and Chance Scales. Freeloaders were significantly lower on the Chance Locus of Control scale than were the nonfreeloaders.