Suchergebnisse

Purpose. The purpose of this study was to determine the extent of implementation of school health education curricula, to identify factors which enhanced or impeded implementation, and to examine the link between the adoption and implementation phases of the diffusion process. Design. The study used an experimental design; 22 school districts were randomly assigned to intervention and control conditions. Setting. The study was conducted in North Carolina. Subjects. All teachers in the study districts identified by their schools as "eligible to teach health" were included in the sample. Intervention. An in-depth training was conducted on the use of the middle school tobacco prevention curriculum that had been adopted. Measures. Three measures were used to assess implementation of the curricula. Independent variables of interest included organizational size and climate, teacher training, how long it took to make the adoption decision, and attitudes toward tobacco use prevention curricula. Response rates for these measures ranged from 44% to 78%. Results. Nonparametric correlations and regression modeling indicated that larger organizational size and teacher training were the strongest predictors of curricula implementation. A favorable organizational climate within school districts also improved implementation. Conclusions. While interventions to increase adoption of school health education curricula should focus on larger school districts, the majority of efforts to improve implementation should focus on smaller districts.

Purpose. The purpose of this study was to evaluate the effectiveness of a 1-week didactic and clinical skin cancer prevention training module. The evaluation assessed both the immediate and the 3-month effects of the module on nurse participants. In addition, this study assessed whether the module had any secondary effects on skin cancer practices, including perceived support from colleagues, resources, time, and perceived responsibility to conduct skin cancer screening activities and education. Methods. A quasi-experimental design with 32 intervention and 87 comparison subjects was employed. Instruments developed and validated specifically for this study were used to assess knowledge, self-efficacy, priority of skin cancer, and organizational level constructs. Results. The findings indicate that the module significantly increased general and prevention knowledge as well as screening ability; the increase was stable over time. The module was also found to improve self-efficacy to screen and to educate. There was no effect on the organizational-level constructs. Conclusions. Baseline knowledge assessments validated other studies indicating that nurses need more education about skin cancer. Despite promising results from program participants, system-level barriers could impose substantial barriers to implementation in health care practice. Knowledgeable nurses must educate their colleagues, their supervisors, and the public about the priority of skin cancer screening and develop strategies for creating organizational change to increase the likelihood that screening and patient education will occur for people at risk for skin cancer.