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PubMed2005

Beginning with the application in mind: designing and planning health behavior change interventions to enhance dissemination.

Failing to retain an adequate number of study participants in behavioral intervention trials poses a threat to interpretation of study results and its external validity. This qualitative investigation describes the retention strategies promoted by the recruitment and retention committee of the Behavior Change Consortium, a group of 15 university-based sites funded by the National Institutes of Health to implement studies targeted toward disease prevention through behavior change. During biannual meetings, focus groups were conducted with all sites to determine barriers encountered in retaining study participants and strategies employed to address these barriers. All of the retention strategies reported were combined into 8 thematic retention categories. Those categories perceived to be most effective for retaining study participants were summarized and consistencies noted among site populations across the life course (e.g., older adults, adults, children, and adolescents). Further, possible discrepancies between site populations of varying health statuses are discussed, and an ecological framework is proposed for use in future investigations on retention.

Behavior Therapy↗

PubMedDate not supplied

A behavior change intervention for women in cardiac rehabilitation.

There is undeniable evidence for physical and psychosocial benefits of cardiac rehabilitation programs for individuals suffering from coronary heart disease. Yet, fewer women than men are referred to, begin, or complete cardiac rehabilitation programs. The numerous logistical, economic, and motivational barriers to healthy behavior change place women at risk for subsequent CHD events. To close this gender gap and improve outcomes, novel, efficacious, and individualized rehabilitative approaches for women with coronary heart disease are needed. The purpose of this article is to describe a theory-driven behavioral intervention designed exclusively for women with coronary heart disease. The 12-week intervention is being tested in a randomized controlled trial involving women referred to a cardiac rehabilitation program. The tenets of the Transtheoretical Model of behavior change and motivational interviewing guided the development and implementation of the stage-matched, individualized intervention to promote healthy behavior change for women with coronary heart disease. The ongoing trial will examine the efficacy of the intervention on physiological and psychosocial outcomes.

Behavior Therapy↗

PubMed2004

The eHealth Behavior Management Model: a stage-based approach to behavior change and management.

Although the Internet has become an important avenue for disseminating health information, theory-driven strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stage-specific information. It is here - at the point of stage-specific information - that behavioral intent in moving toward more active stages of change occurs. The eHealth Behavior Management Model is applied in three demonstration projects that focus on behavior management issues: parent-child nutrition education among participants in the U.S. Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children; asthma management among university staff and students; and human immunodeficiency virus prevention among South African women. Preliminary results have found the eHealth Behavior Management Model to be promising as a model for Internet-based behavior change programming. Further application and evaluation among other behavior and disease management issues are needed.

Adult↗

PubMed2000

Behavior change patterns and strategies distinguishing moderation drinking and abstinence during the natural resolution of alcohol problems without treatment.

Behavior change patterns and strategies involved in natural resolutions that resulted in stable moderation drinking or abstinence were investigated, using untreated problem drinkers with different drinking statuses. Participants' drinking practices and problems, resolution patterns, behavior-change strategies, and barriers to help seeking were assessed during structured interviews. Collaterals verified participants' reports. Most abstinent resolutions were initiated abruptly. Moderation resolutions were achieved more gradually and entailed changes in drinking practices like those emphasized in behavioral self-control treatments. Participants' desire to solve their own problem and concerns about available interventions deterred help seeking, even though help was widely available. These data suggest that variability exists in how drinking problems are resolved and that interventions should support the several successful resolution patterns.

Adaptation, Psychological↗

PubMedDate not supplied

Normative beliefs of health behavior professionals regarding the psychosocial and environmental factors that influence health behavior change related to smoking cessation, regular exercise, and weight loss.

PURPOSE: To examine the degree of consensus among health behavior change professionals regarding the personal and environmental factors they believe most strongly influence health behavior decisions related to smoking cessation, regular exercise, and weight loss. DESIGN: A factorial survey design was implemented. This method combines the positive elements from simple sample surveys and factorial experiment designs. A total of 44 independent psychosocial and environmental variables are used to randomly construct vignettes, or short stories, to collect dependent variable data. SUBJECTS: A probability sample of 311 health behavior change professionals was selected from the Society for Public Health Education, Inc., the Society of Behavioral Medicine, and faculty from the 1986 Harvard University Symposium on Health Promotion in the Work Place. MEASURES: Judgment ratings on the probability that the person described in each vignette would initiate the behavior in question. RESULTS: Multivariate analysis indicates that the multidimensional model explained approximately one half of the variance in the judgments across the three health behaviors (smoking cessation, R2 = .52; weight loss, R2 = .49; and regular exercise, R2 = .49). CONCLUSIONS: These data suggest a high degree of consensus among the sample regarding the personal and environmental factors that influence health behavior judgments. Here, the subjects perceive both behavioral intentions and self-efficacy as the most powerful determinants of judgments to initiate weight loss, regular exercise, and smoking cessation.

Attitude of Health Personnel↗

PubMed1987

Effects of adrenergic blockers on corticotropin-releasing factor-induced behavioral changes in rats.

The effects of adrenoreceptor blocking agents on corticotropin-releasing factor (CRF)-induced behavioral changes in rats were examined. The i.c.v. injection of 1 micrograms ovine CRF significantly increased the grooming frequency, number of occurrences of rearing and total distance moved. I.c.v. administered phentolamine at a dose of 10 nmol completely suppressed the increase in rearing and total distance moved induced by CRF without affecting the grooming frequency, whereas 100 nmol phentolamine significantly decreased the grooming frequency as well as the rearing and total distance moved. In contrast, propranolol reduced the increase in rearing induced by CRF only at a dose which induced ataxia in rats. The increases in rearing and total distance moved induced by CRF were reduced by 10 nmol of yohimbine and 100 nmol of prazosin. S.c. injection of caffeine (10 mg/kg) produced a significant increase in grooming frequency, rearing, and total movement. Administration of 10 nmol phentolamine and yohimbine did not affect these behavioral changes induced by caffeine, while 100 nmol prazosin suppressed them. Therefore, prazosin depressed the behavior of rats non-specifically. These results suggest that CRF-induced behavioral hyperactivity is mediated at least in part by alpha-noradrenergic, mainly alpha 2-noradrenergic, systems in the brain.

Animals↗

PubMed1983

Ethical theories for promoting health through behavioral change.

The various philosophical orientations for changing people's unhealthy behaviors are examined. The ethical theories of natural law, utilitarianism, paternalism and distributive justice are reviewed in relation to changing people's behaviors. Finally, the health educators' role in behavior change is examined and it is recommended that health educators may need to limit the conditions in which they intervene into the lives of others.

Behavior Control↗

PubMedDate not supplied

Tailoring interventions for health behavior change in breast cancer screening.

PURPOSE: Health professionals continue to seek strategies to help individuals increase health-promoting behaviors and decrease those behaviors related to unhealthy lifestyles. Various health behavior theories currently guide interventions that focus on health behavior changes. Of these, a tailored approach uses individual data on beliefs and behavior to guide the content and delivery of interventions. The purpose of this paper is to explain the usefulness of theories in tailoring health promotion messages to increase health-protecting behaviors. OVERVIEW: A brief overview of current popular theories that focus on individual behavior is presented, followed by illustrations of a tailored intervention approach for breast cancer screening. Applications of the tailored intervention approach in ongoing studies to increase breast cancer screening are described. CLINICAL IMPLICATIONS: Clinical implications of the ongoing projects suggest practical and widespread utility of tailoring health-promoting messages to increase healthy lifestyles. The tailored approach may be used by a multidisciplinary team to focus on the individual's unique factors to impact behavior change rather than to deliver the same standard message to all individuals.

Adult↗

PubMed2005

Patterns of sexual risk behavior change among sexually transmitted infection clinic patients.

Effective interventions to reduce sexually transmitted infection (STI) risk behaviors are most potent in the short term and are not uniformly effective for all people. The present study examined patterns of sexual behavior change among 238 men and 104 women who received risk reduction counseling in a public STI clinic and were followed for 9 months with a 1-year retrospective clinic chart abstraction for newly diagnosed STI. A two-stage, multivariate cluster analysis was performed on four risk behavior difference scores (follow-up - baseline) for 1-month, 3-month, 6-month, and 9-month follow-up frequencies of unprotected vaginal and anal intercourse. Cluster analysis identified three profile subgroups: Subgroup 1 had lower levels of risk behavior at all time points; Subgroup 2 had significant reductions in risk over time; and Subgroup 3 demonstrated significant increases in risk over time. Analyses on variables external to the cluster analysis found that the three profile subgroups differed on numbers of sex partners, substance use, sensation seeking, indicators of risk reduction motivation and behavioral skills, and contracting new STI. STI clinic patients with varying profiles of sexual behavior change were, therefore, differentiated by factors relevant to STI interventions.

Adult↗

PubMed1982

Communication and behavior change for cancer control.

Even though behavior can sometimes be changed in a planned way without clear understanding or its original causes, efforts to modify behavior will ultimately be more successful if they grow out of an understanding of causal processes. The literature and experience in communication of health information have identified a number of conditions which affect the likelihood of health education campaigns being effective. Conditions conductive to effective attitude and behavior change through communications are summarized below: (1) Novelty in the way the message is presented to attract attention. (2) Use of multiple channels of communication to increase the probability of reaching the target audience. (3) Pretesting of health messages to ensure that the information is understood by the target audience. (4) Repetition of the message by multiple sources of high credibility. (5) Targeting of specific behaviors to be changed rather than a general orientation. (6) Incorporation of specific behavioral instructions (e.g. tips on how to quit smoking), in the communications. In conclusion, we have attempted to suggest that measured against what prudence science leads us to expect, cancer information and education programs have been dramatically effective. The challenge before us is to evaluate, refine and expand these efforts to reduce cancer incidence and mortality.

Behavior↗

PubMed2026

Are There Any Effective Behavior Change Strategies for Communicating Genetic Risk in Obesity Prevention and Body Weight Reduction Interventions?

This systematic review examined how differences in intervention components may contribute to inconsistent findings in genetic risk communication studies, addressing obesity-related outcomes (e.g., weight reduction, nutrition behavior, exercise). The review was preregistered (PROSPERO #CRD42024524026) and followed PRISMA guidelines. Searches across eight databases identified 23 randomized controlled trials, covering 18 intervention trials. Risk of bias was assessed using the Risk of Bias 2 tool. A narrative synthesis was used to cluster studies by the content of intervention and control groups. Genetic risk communication alone (no behavioral counseling, addressing nutrition and exercise) or combined with phenotype-based risk was ineffective and sometimes counterproductive among low-risk individuals. When combined with personalized behavioral counseling, effectiveness improved, but only when compared to waitlist control groups or non-personalized behavioral counseling. Significant effects emerged in high-genetic risk subgroups within personalized behavioral counseling, using behavior change techniques such as problem-solving, feedback on behavior, self-monitoring, and environmental changes. The most promising results emerged from complex interventions integrating genetic risk communication into multiple sessions and combining numerous additional behavioral change techniques, such as social reward, cues/prompts, self-reward. Complex personalized interventions combining multiple behavior change techniques and prompting experiential genetic risk awareness show promise for improving weight, nutrition, and exercise-related outcomes.

Humans↗

PubMed1987

Temporal order sensitivity of associative neural and behavioral changes in Hermissenda.

Hermissenda's neural and behavioral changes produced by light-rotation pairings were assessed as a function of the temporal relations between visual and vestibular stimulation. The results of in vitro simulations of conditioning indicated that simultaneous pairings (synchronous onsets and offsets of light and caudal hair cell stimulation) resulted in significantly greater cumulative depolarization of Type B photoreceptors than did either forward (light preceded hair cell stimulation) or backward (hair cell stimulation preceded light) pairings. Further experiments revealed that the attenuation of cumulative depolarization produced by the forward and backward pairings reflected the asynchrony of stimulus offsets that characterize these conditioning sequences, rather than their onsets. Analogous behavioral experiments revealed that intact animals trained with forward or backward pairings exhibited significantly less conditioning than those trained with simultaneous pairings. Strong parallels between the magnitude of cumulative depolarization from in vitro conditioning studies and the behavioral results for intact animals were also observed in experiments in which stimulus onset synchrony was held constant but offsets were made asynchronous, and vice versa. Thus Hermissenda exhibits a sensitivity to the temporal arrangement of light and rotation, and the results of behavioral conditioning can be predicted accurately from the outcome of in vitro conditioning of the isolated nervous system.

Animals↗

PubMed2003

Identity shifts as turning points in health behavior change.

The authors used a grounded formal theory approach to synthesize the findings of 14 studies, with the goal of identifying common elements in qualitative studies of individuals' efforts to change a variety of unhealthy behaviors. The combined sample of 399 participants had experiences of weight loss, smoking cessation, and alcohol and drug-abuse recovery. Data were extracted from published reports and analyzed using grounded-theory techniques. In the provisional model, a value conflict in response to distressing accumulated evidence prompts a small step toward behavior change. If successful, an identity shift begins. Increased self-awareness and self-confidence fuel continued change. Numerous constraints to success are noted at each step. The links to previous conceptions of identity shift are discussed.

Health Behavior↗

PubMed2002

Utility of behavioral changes as markers of sexually transmitted disease risk reduction in sexually transmitted disease/HIV prevention trials.

Most sexually transmitted disease (STD)/HIV sexual risk reduction intervention trials are evaluated using behavioral outcomes as their main indicators of intervention effectiveness. How good are behavioral measures as surrogate markers for STD infection? Do the behavioral changes that are commonly assessed in risk reduction interventions accurately reflect changes in STD risk? We applied a mathematical model of STD/HIV transmission to empiric data from a large HIV prevention intervention to estimate pre- to postintervention changes in intervention participants' STD risk. We then used the coefficient of determination (R(2)) to assess the strength of association between changes in STD risk and changes in three behavioral measures: proportion of acts of intercourse for which condoms were used, number of sex partners, and number of acts of unprotected intercourse. The results indicate that change in the number of acts of unprotected intercourse is a superior marker of STD risk changes for less infectious STDs such as HIV, whereas change in the number of partners may be preferable for highly infectious STDs such as gonorrhea. Changes in the proportion of acts of intercourse for which condoms were used were not strongly correlated with changes in STD risk under most of the conditions examined in this analysis. The utility of different measures of sexual behavior change as markers for changes in STD risk and, hence, expected incidence, depends on the infectivity and prevalence of the target STD.

Female↗

PubMed2002

Mediators of physical activity behavior change among women with young children.

BACKGROUND: Women with children are less likely to engage in adequate physical activity (PA) than women without children. This study aimed to evaluate the efficacy of two strategies for promoting increased PA among mothers of preschool-aged children, and to explore the mediators of any resulting change in PA behavior. DESIGN: Controlled intervention trial incorporating repeated data collection from 554 women, randomized to one of three experimental conditions. Intervention Group 1 served as a control, while women in Groups 2 and 3 were given print information about overcoming PA barriers. Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children. The primary strategies included increasing partner support, social advocacy, and capacity building, and were implemented through collaboration among participants, researchers, and community organizations. MAIN OUTCOME MEASURES: Adequate physical activity (PA), self-efficacy (SE) and partner support (PS). RESULTS: Following the intervention, women in Group 3 were significantly more likely to meet guidelines for PA than controls (odds ratio [OR]=1.71, confidence interval [CI]=1.05-2.77)] after controlling for age and PA at baseline. After controlling for baseline PA, residualized change in SE (OR=1.86, CI=1.17-2.94) and PS (OR=2.29, CI=1.46-3.58) significantly predicted meeting guidelines. After controlling for residual change in PS and SE, the significant intervention effect was attenuated (Group 3 OR=1.40, CI=0.76-2.36), indicating that partner support and self-efficacy may be mediators of physical activity behavior change. CONCLUSIONS: The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA among mothers of young children.

Adult↗

PubMed2007

The role of social cognitive processing theory and optimism in positive psychosocial and physical behavior change after cancer diagnosis and treatment.

The physical and psychosocial 'health' behaviors of cancer patients have become a more pressing issue as 5-year survival rates continue to rise. This study investigated: (a) the extent of positive change in four psychosocial behaviors and two physical health behaviors, (b) the role of psychosocial predictors (drawn from theories of Social Cognitive Processing and optimism) in positive behavior change after cancer diagnosis and treatment, and (c) the possible influence of social desirability in reports of positive psychosocial and physical behavior change. The behavior showing the greatest positive change was time spent reflecting on life priorities; the behavior that was least likely to change after diagnosis and treatment was exercise. Optimism, social support, and cancer-related intrusions were positively associated with increases in physical health behaviors. Only optimism was positively associated with increases in psychosocial behaviors. Reports of positive change in physical and psychosocial behaviors were only modestly correlated. Social desirability was unrelated to reports of positive behavior change. Results are interpreted in light of theories of adaptation to cancer diagnosis and treatment.

Adaptation, Psychological↗

PubMed1996

A study of sexual behavior change in rural Senegal.

This study describes recent sociodemographic and behavioral changes in a rural community in Senegal and investigates how these changes may have modified the risk of HIV/STD transmission. The authors combine findings from two surveys: (a) a marriage survey among all adults of a rural community of approximately 7,000 inhabitants; and (b) a sexual practices survey conducted among a sample of the same population (165 men and 165 women) between 1989 and 1994. During the last 30 years--between 1955-64 and 1985-92--age at first marriage increased in the study area from 25 to 32 years for men and from 21 to 24 years for women. At the same time, age at first sexual intercourse decreased by approximately 10 years on average for men. As expected, this has led to an increase in premarital sexual activity, and we have documented both an increase in the percentage of individuals declaring sexual relations before marriage and, for men, an increase in the number of sexual partners before marriage. Multipartnership is more frequent among men than women (OR=4.4), among those who had their first intercourse at an early age (OR=3.3), among rural migrants (OR=2.7), and among those who had a good knowledge of AIDS. These findings show how recent changes in marriage, sexual behaviors, and seasonal migration have combined to increase the risk of HIV/STD infection within the community. Male rural migrants and their partners are particularly exposed.

Adult↗

PubMed2000

Methamphetamine-induced striatal dopamine release, behavior changes and neurotoxicity in BALB/c mice.

The behaviors associated with the neurotoxic effects of methamphetamine were evaluated in BALB/c mice. Hyperthermia and behavioral observations were measured 60 min after each subcutaneous injection of methamphetamine (4x4 or 8 mg/kg) or saline, each given 2 h apart. The behavioral observations included stereotyped behaviors, incidence of hemorrhage in breast, salivation and self-injurious behavior (SIB). Repeated administration of methamphetamine produced these behavioral changes and hyperthermia, but resulted in hypothermia by the final injection (8 mg/kg). In addition, the methamphetamine treatment induced a long-lasting dopamine depletion of similar magnitude in the 4 and 8 mg/kg-treated animals. In a time course study striatal monoamine levels were measured 60 min after each injection of these doses. The first and second injections of methamphetamine (8 mg/kg) produced a drastic increase in striatal 3-methoxytyramine; this failed to occur after the third or fourth injection of the same dose. In contrast, 4 mg/kg of methamphetamine also produced an increase in 3-methoxytyramine after the second and third injections of the drug and, in this case, these were maintained for the duration of the treatment. Striatal 3, 4-dihydroxyphenylacetic acid levels also drastically decreased following both doses of methamphetamine, suggesting inhibition of monoamine oxidase in striatum. Moreover, a single injection of methamphetamine increased striatal 2,3-dihydroxybenzoic acid formation. These results suggest that the incidence of hyperthermia, SIB and striatal dopamine neurotoxicity are closely linked to striatal dopamine release and inhibition of monoamine oxidase produced by methamphetamine in BALB/c mice.

3,4-Dihydroxyphenylacetic Acid↗