As health promotion and disease prevention becomes more of the focus for the primary care patient, education materials will be in greater demand. Printed education materials can provide an easily accessible source of information for patients to learn from and refer to at home (Bernier and Yasko, 1991). With women composing the largest segment of the elderly population there is increasing need for women to participate in weight bearing physical activities to promote optimal health throughout the lifespan (Evans & Nies, 1997).

A strength training pamphlet was constructed using the Evaluating Printed Education Materials (EPEM) Model developed by Bernier and Yasko (1991). Nola Pender’s (1996) revised Health Promotion Model (HPM) was used as the theoretical framework. The pamphlet teaches the techniques of using strength training to prevent bone density loss. The nurse practitioners role was to develop a pamphlet on strength training which promotes wellness. The SMOG formula was used to place the pamphlet on a 7th grade reading level (McLaughlin, 1969).

National efforts have been directed toward the reduction of vaccine preventable diseases through improved immunization rates. The purpose of this study was to determine the
immunization status of a rural childhood population. Percent of children with up-to-date immunization series and individual antigens was calculated at the ages of 12 and 24 months, and school entry. Percent of children with age appropriate immunization series was calculated at the ages of 3, 5, 7, 16, and 19 months, and school entry. Data were compiled using
school-based Certification of Immunization Records of 122 kindergarten students in a rural school district in northwestern Pennsylvania.

With patient education receiving such emphasis in today’s health care arena, multi-instructional aids are widely used to enhance the patient education process. Printed patient education materials remain the most common tool to supplement oral instruction (Bernier & Yasko, 1991). Gestational diabetes mellitus (GDM) patients require education about lifestyle modifications such as weight control, diet, exercise, and tight glycemic control in order to lessen risks of both maternal and fetal/neonatal complications (Ryan, 1998). These patients also need information about prognostic considerations.

A patient education pamphlet was created following the Evaluating Printed Education Materials (EPEM) model developed by Bernier and Yasko (1991). This pamphlet is intended to reinforce oral instructions given to GDM patients referred for counseling to a hospital-based diabetes education center in northwestern Pennsylvania. The content of the pamphlet includes: the etiology of GDM, risk factors for developing GDM, screening tests to detect GDM, implications GDM has for the mother and the baby, maternal and fetal complications associated with GDM, management of GDM, and prognostic considerations of GDM. The McLauglin (1969) SMOG formula was used to place the pamphlet at the sixth grade reading level.

Literature indicates that pediculosis capitis is a common contagious communicable disease among school age children. It is only exceeded in frequency by the common cold. Presently, there is no pesticide treatment that is 100% effective. Recent studies have shown that some lice are becoming resistant to the recommended pesticides. To ensure effective treatment, three steps are involved: use of the lice killing product in the safest most effective way, meticulous removal of all nits (lice eggs) and the treatment of personal articles and the environment.

This study, utilizing a self-administered researcher designed questionnaire, first gathered information regarding current occurrences, screening practices, policies, and protocols used by elementary school nurses in Mercer and Crawford Counties in northwestern Pennsylvania. The sample consisted of 17 practicing school nurses with a mean 14.7 years of experience in this field. The results from this study indicated that these school nurses were not currently implementing all of the interventions needed to make up an effective pediculosis prevention program. These survey results were then incorporated into the development of a protocol to be utilized by school nurses as a guideline for pediculosis preventive practices.

Hysterectomy, the removal of the uterus, is one of the most common surgical procedures performed; after cesarean delivery, it is the second most frequently performed major surgical procedure in the U.S. Approximately 75% of all hysterectomies are performed in women between the ages of 20 and 49 years. The highest overall rate is in the southern states with the lowest rates consistently in the northeastern portion of the U.S. Hysterectomy is more often performed in African-Americans than in Caucasians and is more frequently performed by male gynecologists' than female gynecologists. One in five women in the United Kingdom will have a hysterectomy by the time they reach the age of sixty-five (Chapple, 1995). Hysterectomy is often the last resort for women suffering from problems affecting the uterus. The most common problems include: uterine fibroids, cancer, abnormal uterine bleeding, pain and endometriosis. A lot of effort is made by the patient and her health care provider to avoid unnecessary surgery. Once the decision for hysterectomy is made it is important for the woman to understand the surgery and its risks as well as what is to be expected after surgery (Berek, Adashi, & Hillard, 1996).

The purpose of this study was to design a pamphlet to educate women undergoing hysterectomy about their post-operative course; in order to improve recovery and facilitate satisfaction of stay.

Despite a recent decrease in the adolescent pregnancy rate, the United States continues to lead the industrialized world in this category. The two closest countries are the United Kingdom and Japan, reporting less than one-half the pregnancy rates of the United States (Foster, 1997). It has been suggested through research that knowledge of age-appropriate sexuality and reproductive health may help delay the onset of first coitus, thereby reducing the occurrence of unplanned adolescent pregnancy (Kirby, 1997).

A descriptive design was utilized to analyze the sex knowledge of pregnant or parenting adolescents. It was hypothesized that these adolescents lacked general knowledge of human sexuality and reproductive health. Research subjects were adolescent females ranging in age from 14 to 20 years. Some of these adolescents were participants in the Parenting Program offered by the City of Erie School District and some were clients of the Family Health Council, Inc. in Erie, PA.

Results of this research indicated a high degree of misinformation or lack of information regarding human sexuality and birth control. Knowledge of general reproductive health was low, as well as well as accurate information about methods of birth control. Utilizing Orem’s (1995) theory of self-care, a self-care deficit was identified.

Sexually transmitted diseases (STDs) and their sequelae are very important problems in the adolescent population. There are 3 million adolescents that contract STDs each year (Donovan, 1997).

The purpose of this study was to determine if primary care providers are counseling adolescents about STDs. The study is a quantitative descriptive study in rural northwestern Pennsylvania. It consisted of six demographic questions and 37 yes and no questions to determine the percentage of PCPs (a) providing adequate STD counseling, (b) performing adequate risk assessments, (c) using adequate interaction skills, and (d) who indicated they cover the topics risk of contracting a STD and sexual abstinence for prevention.

Forty eight questionnaires were mailed to primary care providers, 23 were returned, and 17 were entered into the study. Fifty nine percent of the subjects counseled. Nearly the same percentage of males and females counseled. PCPs aged 41-50, in practice 11-15 years, and were nurse practitioners did the most counseling. PCPs aged 31 to 40, in practice six to 10 years, and were a pediatrician did the least amount of counseling. All primary care providers who counseled (a) performed adequate risk assessments, (b) adequately discussed the risk reduction topics, and (c) covered the risk reduction topics entitled risk of contracting an STD and sexual abstinence for prevention. All primary care providers used adequate interaction skills.

Asthma is the most common serious chronic illness in children (Centers for Disease Control and Prevention, 1996). Asthma education has been found to increase the ability of children and their parents to effectively manage their asthma and decrease their morbidity (Evans et al., 1997). Asthma medications are not marked in any way to distinguish between inhalers for control and inhalers for acute symptoms, and are labelled with their generic name, brand name, or both. The names are often long and confusing. The control inhaler will not help to open the airways in an asthma attack. Children need to know which inhaler will help them when they have trouble breathing.

The purpose of this study was to determine if the addition of a symbolic label to bronchodilator inhalers facilitated learning about which inhaler to use for asthma attacks in an elementary school-based asthma education program. The method included a pretest-posttest design involving two groups of inner-city children with asthma in Erie, PA. Both the control and the experimental group received asthma education at school using the A+ Asthma Club curriculum, including oral instructions about their asthma medications. This curriculum is designed to be culturally sensitive for inner-city children. The experimental group added a star sticker to the bronchodilator inhaler to remind them to use this inhaler when they have trouble breathing. Children identified their inhaler more often by the star, the color, or the look of the inhaler than by the name, even after individual instruction.

The American College of Obstetricians recommends that all postmenopausal women consider Hormonal Replacement Therapy (American College of Obstetricians and Gynecologists, 1992). Although HRT has clearly been shown to have life-prolonging benefits, women remain skeptical (Salamone, Pressma, Seeley & Cauley, 1996) and treatment remains widely underutilized by the menopausal population (Rabin, 1998).

The purpose of this study was to identify the barriers that may influence a woman’s decision regarding HRT. By studying these barriers the nurse practitioner will have a better understanding of a women’s existing concerns, and can better assist her in making an informed decision.

A non-experimental descriptive study was conducted utilizing a questionnaire consisting of 19 questions. A convenience sample of 78 menopausal women were recruited from the northwestern region of Pennsylvania. Analysis consisted of compilation of total percentages from all respondents and comparison was made between HRT users versus nonusers in regard to demographic factors, health practices, knowledge, and attitudes.

Several underlying themes were identified. Sixty-seven (86%) of the participants reported that they knew what HRT was. Current users appear convinced of the potential role of HRT in the prevention of menopausal symptoms (70%), osteoporosis (67%), and cardiovascular disease (57%). Nonusers represented the largest group in this study and showed similar awareness of the role of HRT in menopausal symptoms ((65%) and osteoporosis (54%).

Nonusers appear to be skeptical and unconvinced of the potential role of HRT. The uncertainity expressed by the nonusers in this study about fear of cancer (31%), questionable safety (29%), and just not wanting to take HRT (35%) points to a need for balanced information and the opportunity for discussion of these complex issues. All PCP’s who care for women should fully discuss the positive and negative effects of HRT and identify and address the concerns, beliefs, and attidudes that may influence a woman’s decision regarding HRT.

Literature indicates that mammography is the single most effective method of screening for breast cancer. Several patient-related barriers to mammography for older women have been described (Costanza, 1994).

A survey of mature women was conducted in Chautauqua County, New York to determine if women who engaged in moderate physical activity, such as walking 15 to 30 minutes five to seven days per week also obtained yearly mammograms. The tool utilized was a researcher-developed survey that assessed the frequency of mammography screening as recommended by the American Cancer Society, and regular participation in moderate physical activity. The sample consisted of 66 mature women between the ages of 50 and 75. Most participants had a regular place for health care and most frequently went to a physician’s office for their health care. All the study participants were covered by some type of health insurance. Patient-related barriers to mammography screening reported by Weinberg et al. (1997) were not perceived as barriers by these research participants. The results of this study indicated that women who engaged in moderate physical activity were less likely to obtain yearly mammograms. The hypothesis that mature women who engage in the health promoting behavior of regular moderate exercise are more likely to obtain routine mammograms was rejected.