In this study, seventy-four adolescents in either a school, community or hospital based drug intervention program received and eight to nine week structured fitness activity class as an integrated element of their respective prevention or treatment program. Prepost assessments indicated significant gains in the field fitness tests of one mile run, 1 minute situp, 1 minute pushup, percent fat and flexibility for the total sample. Based upon prepost change on the one mile run time (less than 1:00) subjects were categorized as improvers (n = 38) and non-improvers (n = 36). Improvers demonstrated a significant increase in the self concept risk factor (Piers Harris Self Concept Scale) and a significant decrease in anxiety and depression risk factors (General Well-Being Scale) compared to the non-improvers. At posttest, the improvers self reported substance use patterns were significantly lower compared to the non-improvers for percentage of the sample who were multiple drug users and alcohol uses per week and were significantly higher for the percentage of the sample demonstrating total abstinence. These findings are suggestive of the usefulness of physical training as a supplemental intervention for adolescent substance abusers.

Program evaluation data from school and community applications of a physical fitness drug prevention program is presented. A train-the-trainer methodology was applied to install the program in twenty-two settings within the state of Illinois. The physical training program consisted of exercise and educational modules delivered over a twelve-week time period that focused on learning values and life skills through exercise. Complete pre-post data were obtained on 329 participating youth at six school and community based sites. Significant increases were demonstrated in physical activity and physical fitness (cardiovascular endurance, strength, and flexibility). Youth self-report data indicated significant decreases in risk factors such as low self-concept, poor school attendance, anxiety, depression, and number of friends who use alcohol and drugs. There were significant reductions in the percentage of youth who used cigarettes, smokeless tobacco, and alcohol. It was concluded that a strong relationship was demonstrated for increased fitness leading to lowered risk factors and usage patterns. Likewise, the train-the-trainer model was shown to be an effective installation approach to expand fitness programming within prevention settings.

A random sample of 117 teachers in three treatment schools and one control school participated in a health survey at the beginning and end of the spring semester. Teachers in the treatment schools participated in a 10-week health promotion program which emphasized exercise, stress management, and nutrition. Comparison of pre-and post-survey data indicated that teachers in the treatment schools increased their participation in vigorous exercise, improved their physical fitness, lost weight, lowered their blood pressure, reported a higher level of general well-being, and were better able to handle job stress. (Am J Public Health 1984; 74:147-149.) Employee health promotion programs have become increasingly popular over the last decade,' but their evaluation has been inadequate.23 In this paper we present the results of a comprehensive evaluation of program effects in a health promotion program for educators. Materials and MethodsWe used a quasi-experimental design4-5 with three treatment schools and one control school selected by the administration of the school district which wanted to offer the program to all three school levels and to schools in different neighborhoods.* There was no prior consultation with the individual schools nor was there any attempt to ascertain whether any school was especially interested in health promotion. Measurements were obtained before and after a 10-week health promotion program. A second control school (elementary-middle class White neighborhood, predominately White faculty) was selected for an after-only study.More than 90 per cent of all faculties volunteered. Program participants were randomly selected from the list of volunteers: 87 in the treatment schools and 30 in the control school.** The average age was 38 ± 9.1 years; 73 per cent were women; 62 per cent were White; 26 per cent were Black; and 12 per cent were Hispanic. Of the 117 participants, 113 participated in the baseline and follow-up surveys. Due to missing data for some variables, the number of cases for each analysis may be somewhat less than the 113.Health knowledge was measured by a 30-item multiple choice test which covered a variety of physical fitness and health promotion concepts. Exercise participation was assessed with a self-administered seven-day physical activity *Characteristics of the three treatment schools were: I) elementaryHispanic neighborhood, primarily Hispanic faculty; 2) middle-predominantly Black neighborhood, primarily Black faculty; and 3) high school-affluent White neighborhood, primarily White faculty. The control school was a middle school in a mixed Black and White neighborhood with a mixed Black and White faculty. **The number of participants in each school was based on logistics. We believed that 30/school was the maximum number that could be accommodated in the intervention program due to staff constraints.

No abstract

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. University of Wisconsin Press andThe Board of Regents of the University of Wisconsin System are collaborating with JSTOR to digitize, preserve and extend access to The Journal of Human Resources. ABSTRACTPayments per enrolled Medicare beneficiary are much higher for high income elderly persons than for low income elderly persons. Payments are also much higher for elderly whites than for elderly blacks, particularly in the South. To determine whether these differences reflect differences in health status, educational levels, physical access to health care services, the financial deterrent of Medicare cost-sharing requirements, or other factors, this study analyzes physician and hospital utilization patterns of the elderly using 1969 data from the Health Interview Survey conducted by the National Center for Health Statistics.When Medicare was enacted in 1965, it was expected that the financial barrier to adequate medical care for the elderly would be removed, enabling them to seek medical attention commensurate with their need. In spite of Medicare, health care expenditures for the elderly still pose a large financial burden and continue to grow. Private payments for personal health care averaged $293 per elderly person in fiscal year 1966 and $560 per capita in fiscal year 1974 (including $75 in Medicare premiums) [1, p. 14].Concern has been expressed not only over the continued high level of medical expenses for the elderly, but also over the distribution of utilization of services generated by the cost-sharing provisions of Medicare. (See, for example, [2, 9, 12].) Under Part A of Medicare, the basic hospital insurance plan (BHI), beneficiaries are currently required to pay $92 for the first 60 days of care in the year and $23 per day from the 61st to 90th day. After that the beneficiary must I THE JOURNAL OF HUMAN RESOURCES draw on a "lifetime reserve" of 60 days, paying $46 per day after which Medicare coverage ceases. BHI also provides a similar pattern of coverage for stays in extended care facilities. Part B, the voluntary supplementary medical insurance plan (SMI), covers physicians' services and selected other types of care. Persons subscribing to this plan pay a monthly premium which pays for half the expected cost of the plan, as well as a $60 annual deductible and 20 percent of all "allowable charges." In addition, if the physician does not accept assignment of charges, the beneficiary must pay the excess over the allowable charge. Allowable charges are those considered customary and usual for a given service in a particular area. States may "buy-in" elderly Medicaid recipients to SMI by agreeing to pay all premiums and charges accruing to those individuals under SMI.W...