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TxD
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51:12
i exas Preventab g&
S Contents
Adult Health
Vaccine-Pre
Frank Bryant. Jr, MD, FAAFP Robert Bernstein, MD, FACP
Chairman Commissioner
Texas Board of Health
TEXAS STATE
DOCUMENTS COLLECTION
Vol. 51, No. 12
June 15, 1991
ProgramSurvey
ventable Disease Update
Bureau of Disease Control and Epidemiology,
1100 West 49th Street, Austin, Texas 78756 (512-458-7455)
ADULT HEALTH PROGRAM: LOCAL HEALTH DEPARTMENT*
IMPACT SURVEY REPORT
The TDH Adult Health Program
seeks to improve the health of
Texas citizens through primary
prevention and early identifica-
tion of chronic diseases such as
diabetes and hypertension. Per-
sons 16 years of age or older are
eligible for the program. Ser-
vices include risk assessment,
health screenings, health educa-
tion/information, referral and
follow-up, monitoring of known
diseases, and cancer diagnostic
reimbursement in selected ar-
eas. A risk assessment is com-
pleted by each client upon entry
into the program. Clients are
encouraged through screening,
health education, and counsel-
ing to modify the unhealthy be-
haviors identified in the risk as-
sessment.
METHODS
In August 1990, seven local
health departments* participated
in the design and implementa-
tion of an impact survey to evalu-
ate the risk assessment and health
education activities of the Adult
Health Program. The purposes
of the survey were to determine:
a) client recollection of behav-
ioral and physiologic risk fac-
tors identified during the initial
program visit, b) behavioral
changes made by clients after
the identification of risk factors
(eg, visits to personal physi-
cian, utilization of community
resources), and c) the client per-
ception of program efficacy.
The survey targeted randomly
selected clients who had enrolled
in the program six or more
months before the survey. Self-
administered questionnaires
were distributed to clients in
community and worksite clinics
and by mail. Instructions directed
clients to circle health risks iden-
tified during initial clinic visits
and to select statements con-
cerning risk-reducing actions un-
dertaken as a result of their vis-
its. Survey responses were based
solely on client recall of identi-
fied health risks.
RESULTS
Three hundred clients were asked
to participate; 269 returned com-
pleted survey forms (Table 1).
Females comprised 69% of the
sample. The predominant eth-
nic group was Hispanic (50%),
followed by whites (38%). The
majority of respondents were
over the age of 25 (96%); the
median age was 47.
Of the 269 survey respondents,
30 (11.2%) recalled having no
risk factors identified during
their initial health risk assess-
ment (Table 2). Of the 239 re-
maining respondents, 78 (32.7%)
recalled having one risk factor;
133 (55.6%), two to three risk
factors; and 28 (11.7%), four or
more risk factors. Of the 78
clients who recalled one identi-
fied risk factor, 50 (64.1%) re-
ported a behavior change or risk
reduction since enrollment in the
Adult Health Program; of the
133 who recalled two to three
risk factors, 114 (85.7%) re-
ported behavior change or risk
Texas Department of Health
OF NT DEP. LIBRARIES 76203
reduction in
and of those
or more risk
reported risk
more areas.
at least one area;
who recalled four
factors, 21 (75%)
reduction in one or
Table 3 lists selected risk fac-
tors, the number of respondents
with the specific risk factor, the
number and percent of those in-
dicating risk reduction or adop-
tion of risk-reducing behavior,
and examples of action taken by
the individuals toward reducing
risks. Excess weight (119) was
the most frequently identified
risk factor, followed by elevated
cholesterol (74), and hyperten-
sion (71). Of the 78 males sur-
veyed, five recalled being coun-
seled for failure to perform tes-
ticular self examinations, and
six recalled being counseled re-
garding the need for yearly digi-
tal prostate examinations.
When asked, "What did you do
about these health risks?", the
239 respondents who had identi-
fied health risks made the fol-
lowing responses: 76 (32%)
stated they went to their per-
sonal physicians; 12 (5%) went
to a community resource such as
Weight Watchers or Alcoholics
Anonymous; 103 (43%) stated
they adopted self-care actions
recommended or taught by the
program staff; 16 (7%) took no
* Participating health departments included:
City of Laredo, Victoria City-County,
Corpus Christi-Nueces County, Amarillo
Bi-City/County, Galveston County,
Hidalgo County, and Grayson County.