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PubMed1994

AIDS-related risk behavior and behavior change in a sexually active, heterosexual sample: a test of three models of prevention.

Because a cure and a vaccine for the human immunodeficiency virus (HIV) are not expected for at least several years, prevention of AIDS is the only means of reducing the spread of the disease. While education, information, and persuasion may be changing the HIV-related attitudes and even behaviors of some individuals, without a theoretical framework, the reasons why some individuals have changed and why other individuals have not changed are elusive. Three social-psychological models that have been applied to health-related behavior--the Health Belief Model (HBM), the Ajzen-Fishbein attitude-behavior model (AFM), and Leventhal et al.'s Self-Regulatory Model (SRM)--are tested in this study. The extent to which each model's variables are related to self-reported behavior change related to HIV and current HIV-related behavior are compared. Results indicate that the SRM and AFM contributed significantly to predicting risk behavior change, and that the HBM and AFM contributed significantly to predicting current risk behavior, after controlling for risk behavior change. Significant predictors of risk behavior change included timeline, identity, and self-efficacy from the SRM; sexual impulse (a barrier) from the HBM; and attitudes about the behaviors from the AFM. Significant predictors of current risk behavior included several barriers from the HBM and negative attitude about risk-reducing behaviors from the AFM.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Mediators of lifestyle behavior change in Native Hawaiians: initial findings from the Native Hawaiian Diabetes Intervention Program.

OBJECTIVE: To examine the association of stage of change with diet and exercise behaviors in response to a lifestyle intervention for Native Hawaiians (NHs). RESEARCH DESIGN AND METHODS: A family ('ohana) support lifestyle intervention was compared with a standard intervention in NHs with or at risk for diabetes in two rural communities in Hawaii (n = 147). Stage of change, as a hypothesized mediator of behavior change, and dietary and exercise behaviors were measured at baseline and at 1 year postintervention. RESULTS: Stage of change was significantly associated with positive dietary and exercise behaviors. NHs receiving the 'ohana support (OS) intervention were more likely to advance from pre-action to action/maintenance for fat intake and physical activity than the group who received the standard intervention. Participants in the OS group who advanced from pre-action to action/maintenance showed more improvement in fat intake and physical activity than those in the standard group. CONCLUSIONS: These initial findings suggest that stage of change is an important factor in mediating lifestyle behavior changes in persons with or at risk for diabetes and merits further study among minority populations at high risk for diabetes.

Adult↗
PubMed2003

Behavioral change for blood pressure control among urban and rural adults in Taiwan.

In exploring the mechanisms of behavioral change for hypertension control, a study based on the transtheoretical model was carried out in Taiwan in 2000, with a sample of 350 hypertensive adults living in Taipei urban and rural areas. The relationships among stages of change, processes of change, and demographic factors were analyzed for six health behaviors: low-fat food consumption, alcohol use, smoking, physical activity, weight control and routine blood pressure check-ups. The results showed that rural populations had greater difficulty than urban populations in avoiding smoking and engaging in physical activity, and the processes of change being used by urban populations were significantly greater than rural populations for diet, physical activity and routine blood pressure check-up. Individuals who use more processes of change will be more inclined to move from the pre-contemplation stage to the maintenance stage. Social liberation, self-reevaluation and counterconditioning were very important processes for changing diet behavior, engaging in physical activity and checking blood pressure on a regular basis.

Adult↗
PubMed1996

Sexual behavioral changes in Alzheimer disease.

The frequency and correlates of sexual behavioral changes in Alzheimer disease (AD) were assessed in two studies. In the first study, we reviewed the medical records of 135 consecutive community-living patients who fit the criteria of the National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer Disease and Related Disorders Association for probable or possible AD, and we asked spouses to complete a questionnaire that included two questions about sexual activity. Indifference to sexual activity was reported by 70% of the spouses, and sexual behavioral modifications were reported by 50%. No correlation was found between sexual changes and the general characteristics of the patients, the severity of the disease, or depressive symptomatology. Sexual changes were correlated to the severity of behavioral and mood disorders, mainly to a reduction of activity and emotional deficit. Seventy-seven of the patients had a second examination after an interval of 18.9 +/- 9.9 months. The links between sexual changes and the other variables were similar to those found by the first examination. In the second study, a questionnaire was sent by mail to the spouses of 100 patients. No relationship was found between sexual changes and the severity of cognitive deficits, previous sexual agreement, age, or gender. Sexual changes were considered a factor of maladjustment for the couple by 46% of the spouses.

Aged↗
PubMed2006

Uganda's HIV prevention success: the role of sexual behavior change and the national response.

There has been considerable interest in understanding what may have led to Uganda's dramatic decline in HIV prevalence, one of the world's earliest and most compelling AIDS prevention successes. Survey and other data suggest that a decline in multi-partner sexual behavior is the behavioral change most likely associated with HIV decline. It appears that behavior change programs, particularly involving extensive promotion of "zero grazing" (faithfulness and partner reduction), largely developed by the Ugandan government and local NGOs including faith-based, women's, people-living-with-AIDS and other community-based groups, contributed to the early declines in casual/multiple sexual partnerships and HIV incidence and, along with other factors including condom use, to the subsequent sharp decline in HIV prevalence. Yet the debate over "what happened in Uganda" continues, often involving divisive abstinence-versus-condoms rhetoric, which appears more related to the culture wars in the USA than to African social reality.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Early intervention in the path to alcohol problems through conduct problems: treatment involvement and child behavior change.

A program for the prevention of conduct problems among preschool-age sons of alcoholic fathers was implemented to interrupt what is likely to be a major mediating factor in the development of alcoholism in later years. A population-based sample of 42 families participated in a 10-month intervention involving parent training and marital problem solving. Differences in treatment outcome were examined, with the expectation that level of treatment involvement--entailing both level of participation and level of investment--would account for variability in child outcome at termination. Significant changes in positive and negative child behaviors were observed only within the group of families who completed the program and where the mothers demonstrated a higher level of treatment investment. When pretreatment child, parent, and family predictors of child behavior change were accounted for, subsequent analyses identified maternal treatment investment as a significant predictor of child outcome.

Alcoholism↗
PubMedDate not supplied

Behavioral changes in Huntington Disease.

OBJECTIVES: This study aimed to gain a better understanding of behavioral abnormalities in Huntington disease (HD) and to develop a method for reliably assessing these changes. BACKGROUND: Behavioral changes are a central feature of HD and often cause considerable distress and difficulty to patients and their relatives. However, they have received little attention from research despite their prevalence and clinical significance. METHODS: One hundred thirty-four patients with HD were assessed using the Problem Behaviors Assessment for Huntington Disease (PBA-HD), an instrument for rating the presence, severity and frequency of behavioral abnormalities in HD. RESULTS: The findings confirm that behavioral problems are common among patients with HD. The most common symptoms were loss of energy and initiative, poor perseverance and quality of work, impaired judgment, poor self-care and emotional blunting. Affective symptoms such as depression, anxiety and irritability occurred in around half the patients studied. Psychotic symptoms (hallucinations and delusions) were rarely reported. Factor analysis distinguished three clusters of behavioral symptoms, which were interpreted respectively as reflecting Apathy, Depression and Irritability. The 'Apathy' factor was highly correlated with duration of illness, whereas no such relationship was observed for the 'Depression' and 'Irritability' factors. CONCLUSIONS: The results suggest that certain behavioral changes are fundamental to the progression of HD, whereas others have a more complex relationship to the disease process. The findings have implications for the choice of behavioral measures used to evaluate efficacy of therapeutic interventions.

Adult↗
PubMed1996

[Behavioral changes induced by repeated administration of mazindol, an anorexiant, in rats].

Behavioral changes in locomotor activity and stereotyped behaviors induced by daily administration (for 7 days) of mazindol (5 and 10 mg/kg, po) were compared with those induced by methamphetamine (10 mg/kg) in rats. On day 1, mazindol increased locomotor activity, which was enhanced by daily administrations. Stereotyped behaviors were also induced by mazindol, which became more marked following daily administrations. Methamphetamine markedly increased stereotyped behavior rather than locomotor activity on day 1, and the effects were not enhanced by daily administrations. The increased locomotor activity and stereotyped behaviors caused by mazindol and methamphetamine were markedly reduced by the dopamine receptor antagonist pimozide (0.1-0.4 mg/kg, ip) in a dose-dependent manner. These results suggest that repeated mazindol administration enhances locomotor-stimulant and stereotypy-producing effects, which are mediated by the central dopaminergic system.

Animals↗
PubMed2005

Understanding health behavior change among couples: an interdependence and communal coping approach.

Marriage is a ubiquitous social status that consistently is linked to health. Despite this, there has been very little theory development or related research on the extent to which couple members are jointly motivated to and actively engage in health-enhancing behaviors. In this paper we propose an integrative model, based on interdependence theory and communal coping perspectives, that explicitly considers dyadic processes as determinants of couple behavior. Our integrated model applies these constructs to consider how couple dynamics might influence adoption of risk-reducing health habits. Accordingly, we suggest that the couple's interdependence can transform motivation from doing what is in the best interest of the self (person-centered), to doing even selfless actions that are best for the continuation of the relationship (relationship-centered). In turn, this transformation can lead to enhanced motivation for the couple to cope communally or act cooperatively in adopting health-enhancing behavior change. Implications for research related to couples and health behavior change are also highlighted.

Adaptation, Psychological↗
PubMed1978

[Behavioral changes in the rats following inhalation of mercury vapor (author's transl)].

The present study was designed to determine critical brain mercury concentrations associated with specific behavioral changes during exposure to mercury vapor. Rats exposed to 3 mg of Hg/m3 for 3 hours, 5 days per week, for 15-42 weeks, showed a decline in conditioned avoidance response. The latency of escape response also increased in pole climb shock escape. The time to the onset of effects varied from 12 to 39 weeks among 14 rats exposed to mercury. All rats recovered to preexposure baseline within 12 weeks after the termination of exposure. A significantly poor behavioral performance was noticed in rats with brain mercury concentration of approximately 20 microgram Hg/g. Behavioral recovery was seen when the mercury concentrations decreased to 10 microgram Hg/g brain tissue. These results suggest that the critical concentration of inorganic mercury in the brain associated with behavioral changes in the rat ranges about 10 ppm to 20 ppm. In spite of the high concentration of mercury, the nervous tissues of rats in this experiment with mercury vapor intoxication were normal.

Animals↗
PubMed2000

Research on adherence, behavior change, and mental health: a workshop overview.

The National Institute of Mental Health sponsored a research workshop in 1999 to examine the potential of various theoretical approaches for enhancing adherence and behavior change, with special attention to mental disorders as mediators and outcomes. Complementary, multiple levels of analysis--including individual, small-group, community, and cultural perspectives--were considered. Working groups identified problems and gaps in knowledge that if addressed would transform adherence and behavior change from overlooked or nuisance variables to critical variables in research on mental and medical disorders.

Behavior Therapy↗
PubMedDate not supplied

Factors associated with health behavior change among residents 50 to 96 years of age in Rancho Bernardo, California.

Alterations in personal health habits can prevent disease and reduce morbidity and mortality. We examined the association between self-reported healthy behavioral change and age, sex chronic disease, plasma cholesterol, and body mass index in an older Caucasian population in southern California. Overall, about two thirds of respondents reported decreased dietary salt or fat intake over the last 15 years, whereas one third reported increased frequency of exercise. Women were more likely than men to report increasing exercise, changing diet, or reading self-help materials. Individuals 50-69 years of age reported more positive health behavior changes than those 70 years and older. Those with diabetes and hypertension were more likely to decrease salt intake, but less likely to increase exercise than those without disease. Hypertensive and diabetic men, but not women, were also more likely to change their diet or read self-help materials than their peers without disease. The presence of risk factors for cardiovascular disease, such as obesity, elevated serum cholesterol, diabetes, and hypertension, were generally associated with positive alterations in diet and inversely related to increasing exercise.

Aged↗
PubMedDate not supplied

Changing behavior: a challenge for reproductive health awareness.

Social marketing applies commercial sector ideas to programs to change behavior. It involves a mindset that is customer-focused; a process that starts with customers and continually returns to them for validation; and concepts to make change happen. Customer behavior models guide strategy. One useful model is based on stages of change and four behavioral influences: perceived benefits, perceived costs, the influence of others, and perceived behavioral control.

Awareness↗
PubMed2004

The case for integrating behavior change, client-centered practice and other evidence-based models into geriatric care management.

This paper describes the complexities of engaging a frail, elderly population in the process of behavior change to improve daily functioning. Implementation of a brief Purchase of Services (POS) benefit supplementing usual geriatric care management in an integrated, not-for-profit HMO environment is used to illustrate these complexities. Findings from the first two years of the four-year study of the intervention showed that one-third of the group of 541 study participants who were randomized as eligible to participate refused these free, enhanced services. The reasons for these refusals are examined, and a case is made for incorporating behavior change theory into traditional geriatric care management practice for cognitively intact clients in order to facilitate acceptance of needed services and increased patient autonomy.

Activities of Daily Living↗
PubMed2002

High-soluble-fiber foods in conjunction with a telephone-based, personalized behavior change support service result in favorable changes in lipids and lifestyles after 7 weeks.

OBJECTIVE: To evaluate whether an intervention of foods high in soluble fiber from psyllium and/or oats plus a telephone-based, personalized behavior change support service improves serum lipids and elicits cholesterol-managing lifestyle changes vs usual care. DESIGN: 7-week randomized, controlled intervention. SUBJECTS/SETTING: 150 moderately hypercholesterolemic men and women, age range 25 to 70 years. INTERVENTION: The intervention group consumed 4 servings/day of high-fiber foods and had weekly telephone conversations with a personal coach who offered support and guidance in making lifestyle changes consistent with the National Cholesterol Education Program's (NCEP) cholesterol-lowering guidelines. The usual care group received a handout describing the NCEP Step-1 diet. MAIN OUTCOME MEASURES: Serum lipids and lipoproteins and self-reported lifestyle changes. STATISTICAL ANALYSES: For physiologic and dietary changes, mixed linear models for repeated measures were applied. Models were simplified using analysis of covariance where age in years was the covariate. Traditional general linear models were used to assess lifestyle changes. RESULTS: In the intervention group total cholesterol (TC) decreased 5.6%, low-density lipoprotein (LDL) cholesterol 7.1%, LDL/high-density lipoprotein (HDL) cholesterol ratio 5.6%, and triglycerides (TG) 14.2% (P<.0167); decreases in TC and LDL were significantly different from the usual care group. In the usual care group TC decreased 1.9%, LDL 1.2%, LDL/HDL 1.9%, and TG 4.4% (all not significant). The intervention group also reported an increase in their knowledge, ability, and confidence to make cholesterol-managing diet and exercise changes compared with the usual care group (P<.05). The intervention group had a greater decrease in energy intake from saturated fat (-1.6%) and increase in soluble fiber intake (7.3%) than the usual care group (P<.05). The intervention group reported an increase in exercise vs the usual care group (P<.05). Both intervention and control groups had a minimal reduction (<1%) in body weight compared with baseline (P<.0167). APPLICATIONS/CONCLUSIONS: A 7-week intervention that includes both functional foods and individualized, interactive support for behavior change could be an effective model for dietitians to use with patients at risk for CVD, pending results of long-term studies.

Adult↗