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Results for “Health Behavior”

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PubMed1998

Fundamental mechanisms of managed behavioral health care.

Making sense of managed behavioral health care organizations (MBHOs) is difficult as they rapidly evolve in response to payer, member, legislative, and market demands. This article describes the basic mechanisms involved in managed behavioral health care's evolution, including the nature of carve-out organizations, carved-in services, the array of payment mechanisms between payer and MBHO, and between MBHO and mental health care providers. Additionally, types of delivery systems and mechanisms used to control utilization are outlined in the context of continuing health care change.

Health Care Sector↗

PubMedDate not supplied

Health behaviors of adolescents who have been diagnosed with cancer.

Many challenges related to the development and diagnosis of cancer are faced by adolescents with the disease. Adolescence is a developmental period for behaviors that risk health. The article describes behaviors that promote and risk health among adolescents who have been diagnosed with cancer. A paucity of studies exists on health-promoting and -risking behaviors among adolescents with cancer. Further studies are needed to explore and describe these adolescents' health-promoting and -risking behaviors. Health care professionals must comprehensively address these adolescents' health care needs related to the diagnosis of cancer as well as the developmental challenges of adolescence.

Adolescent↗

PubMed2006

Forty years on: teachers' assessments of children's personality traits predict self-reported health behaviors and outcomes at midlife.

A life span health-behavior model was investigated in this longitudinal study of personality influences on health. Teachers assessed 963 elementary schoolchildren on traits that formed scales assessing the dimensions of the five-factor (Big Five) model of personality. Smoking, alcohol use, body mass index (BMI), and self-rated health were assessed 40 years later in midlife. Childhood personality traits were significantly associated with all 4 outcomes, and the effects were consistently larger for women than men. For men and women, childhood Conscientiousness was associated with less adult smoking and better adult self-rated health and, for women only, with lower adult BMI. Mediation analyses suggested that the effects of Conscientiousness on self-rated health were partially mediated by smoking and BMI. These findings add to the growing evidence that childhood personality traits predict adult health outcomes and are discussed in terms of future testing of the life span health-behavior model.

Child↗

PubMed1995

Typological description of the chronic low back-pain syndrome using the Million Behavioral Health Inventory.

The Million Behavioral Health Inventory was administered to 67 individuals with chronic low back pain who participated in a rehabilitation program on pain and stress. Base-rate scores from the 20 scales, submitted to cluster analysis using Ward's minimum variance method, gave four subtypes. Discriminant analysis accurately classified 98.51% of the sample. The discriminant functions were interpreted and labeled as I: somatic distress and II: inhibition-dependency. The groups were then examined for differences and similarities with respect to those dimensions, and the groups were labeled I-introversive, II-denial/minimizers, III-conformers, and IV-severe psychophysiological reaction. The types were next compared across medical, vocational, and demographic data. With the exception of sex of subject, no other data were significant by type. The results were discussed, and recommendations for research were made.

Adaptation, Psychological↗

PubMed2001

Nursing professionals & career positioning in managed behavioral health care.

1. Managed behavioral health care has been successful in managing costs and use. Other strategies must be implemented to actually manage the care and health of individuals or the population. 2. Nursing professionals need to assess their competencies and enhance their personal skill sets to manage their careers successfully and be effective practitioners in the new health care environment. 3. Adaptation is critical. The survival of the psychiatric nursing profession depends on it.

Career Mobility↗

PubMed1995

General hospital psychiatry and the new behavioral health care delivery system.

Mental health care delivery has undergone substantial changes in recent years. This article reviews the evolution of managed care in the mental health care field and outlines managed behavioral health care techniques used in providing access to high-quality, cost-effective care. The expansion of general hospital psychiatry over the last 25 years is also reviewed. Current strengths of general hospital psychiatry which make it well positioned for an expanded role in behavioral health care delivery are examined. Recommendations are made for further improvements in the clinical, administrative, and financial aspects of general hospital psychiatry care delivery to prepare it for the integrated behavioral health care systems of tomorrow.

Behavior Therapy↗

PubMedDate not supplied

A criterion measurement model for health behavior change.

Researchers in the field of health behavior change have traditionally relied on a univariate criterion measure to evaluate the efficacy of an intervention. Such measures have superficial face validity but suffer from a number of problems: (a) lack of precise definitions; (b) poor statistical power; and (c) a lack of meaningfulness for some aspects of the problem. As an alternative, a theoretical model is developed that attempts to define more appropriate multivariate sets of dependent variables for the study of health behavior change. The model involves three separate constructs: Positive Evaluation Strength, Negative Evaluation Strength, and Habit Strength. The pattern of change for each construct is described across four stages of change: Precontemplation, Contemplation, Action, and Maintenance. For each construct, two thresholds are proposed representing the ability of the environment to modify the construct. Four tests of the model are provided from existing data sets. First, a structural model analysis was used to test if the proposed measurement model adequately fits the data. Second, a dynamic typology approach produced profiles of change that are consistent with the model. Third, a time series analysis provided support for the assumed model. Fourth, longitudinal, five-wave panel design was employed to test if the relation between the two cognitive variables (Pros and Cons) and the behavioral measure (Habit Strength) was consistent with the model. Implications for alternative intervention strategies are discussed.

Behavior, Addictive↗

PubMed2006

Application of the theory of planned behavior to understand intentions to engage in physical and psychosocial health behaviors after cancer diagnosis.

A cancer diagnosis can trigger change in both lifestyle behaviors and mental health outcomes such as 'growth' and 'benefit-finding'. Assuming changes in mental health outcomes are based upon changes in specific behaviors, the Theory of Planned Behavior (TPB) may facilitate understanding of post-diagnosis change in physical and psychosocial 'health' behaviors. Adults (n = 130) < or =2 years post-cancer diagnosis completed an internet survey. Current performance and future behavior intentions for two physical (e.g. eating a healthy diet) and four psychosocial (e.g. spending quality time with family/friends; engaging in spiritual or religious activities) health behaviors were assessed. TPB constructs (subjective norm, behavior attitudes, perceived behavioral control) for each of the six behaviors were also assessed. Multiple regression analyses indicated the set of TPB constructs accounted for an increment of 25-53% of variance in behavioral intentions beyond that accounted for by clinical and demographic variables. Among individual TPB constructs, behavioral attitude was most consistently associated with behavioral intentions while subjective norm was least consistently associated with behavioral intentions. The TPB could serve as a comprehensive model for understanding change in both physical and psychosocial health behaviors after cancer diagnosis and could suggest innovative approaches to developing interventions to enhance post-diagnosis 'growth' and 'benefit finding'.

Adaptation, Psychological↗

PubMedDate not supplied

Stages of change, decisional balance, and self-efficacy across four health behaviors in a worksite environment.

PURPOSE: This study examined differences in decisional balance and self-efficacy scores across the five stages of change and across four health behaviors (exercise, protection from sun exposure, smoking, and dietary fat consumption), and explored the relationship between the frequency of subjects at each stage across four health behaviors. DESIGN: Data for this study were collected as part of a health behavior survey of employees. SETTING: The study was conducted in a municipal government worksite in Arizona. SUBJECTS: A total of 393 employees completed the survey. The sample was predominantly white (84.9%) and male (64.4%), with an average age of 42.2 years and a median annual household income of between $40,000 and $59,999. MEASURES: Previously validated questions to measure stages of change, decisional balance, and self-efficacy were administered, along with questions about demographic variables. RESULTS: Significant differences were found for decisional balance and self-efficacy scores across the five stages of change, but they were not significantly different between the four health behaviors. A minority of subjects (18.6%) were in the same stage of change for all four health behaviors. CONCLUSIONS: This study provides preliminary evidence that there is considerable stage specificity across multiple health behaviors. Because employees at each stage of change possess differences in terms of their pros, cons, and self-efficacy, wellness programs need to focus on stage-specific interventions.

Adult↗

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↗

PubMed2006

Adolescent participation in preventive health behaviors, physical activity, and nutrition: differences across immigrant generations for Asians and Latinos compared with Whites.

OBJECTIVES: We investigated preventive health behaviors (bicycle helmet, seat belt, and sunscreen use), physical activity, television viewing or video game playing, and nutrition (fruit, vegetable, milk, and soda consumption) among Asian and Latino adolescents living in the United States; assessed trends across generations (first-, second-, and third-generation immigrants or later); and compared each generation with White adolescents. METHODS: We used data from 5801 adolescents aged 12 to 17 years in the representative 2001 California Health Interview Survey. RESULTS: In multivariate analysis, first-generation Asians measured worse than Whites for preventive health behaviors (lower participation), physical activity (less activity), and television viewing or video game playing (more hours), but improved across generations. For these same behaviors, Latinos were similar to or worse than Whites, and generally showed no improvement across generations. First-generation Asians and Latinos had healthier diets than Whites (higher fruit and vegetable consumption, lower soda consumption). With succeeding generations, Asians' fruit, vegetable, and soda consumption remained stable, but Latinos' fruit and vegetable consumption decreased and their soda consumption increased, so that by the third generation Latinos' nutrition was poorer than Whites'. CONCLUSIONS: For the health behaviors we examined, Asian adolescents' health behaviors either improved with each generation or remained better than that of Whites. Latino adolescents demonstrated generally worse preventive health behaviors than did Whites and, in the case of nutrition, a worsening across generations. Targeted interventions may be needed to address behavioral disparities.

Acculturation↗

PubMed1996

The effect of parental dental health behavior on that of their adolescent offspring.

This study was designed to investigate the effect of parental dental health behavior on that of their adolescent offspring. The data stemmed from The Norwegian Longitudinal Health Behavior Study performed in 1993 in the County of Hordaland in Norway and comprised separate questionnaires for both parents and a 16-year-old child in 436 family units. A compound measure of parental dental health behavior was applied in logistic regression analyses. The results showed that there were statistically significant associations of use of dental floss, tooth brushing, and drinking of non-sugared mineral water among parents and their adolescent offspring. No significant gender interaction in the association between same- or different-sex parent-adolescent dyads was observed. These findings indicate that parents function as social models for their offspring well into the adolescent period with regard to several dental health behaviors.

Adolescent↗

PubMed2002

Purpose-in-life and breast health behavior in Hispanic and Anglo women.

Hispanic and Anglo women differ in their practice of breast health behavior. A likely factor is differences in purpose-in-life (PIL) that influence motivation to achieve goals. To determine the relationship between PIL and breast health behavior, the PIL Test was modified and translated into Spanish, and the Breast Health Behavior Questionnaire (BHBQ) was generated. Both Spanish and English versions of the PIL Test and the BHBQ were measured in 40 Spanish and 40 Anglo women ages 20 to 49. Cronbach's alpha for the PIL Test were .86 for the English version and .72 for the Spanish; Cronbach's alpha for the BHBQ were .78 for the English and .70 for the Spanish version. There was a significant relationship between PIL and breast health behaviors in Anglo women but not in Hispanic women. Findings suggest further study of PIL in Hispanic women and may indicate a need for teaching the benefits of self-regulation to maintain health.

Adult↗

PubMed2000

Large employers' selection criteria in purchasing behavioral health benefits.

To determine the criteria other than cost large employers use in selecting and monitoring behavioral health benefits, this study interviewed 31 of 44 (70.4%) randomly selected corporations employing at least 5,000 workers. While more than 60% of employers considered administrative efficiency and provider access to be very influential in their selection of behavioral health benefits, only 12.9% (95% confidence interval 0.7%-25.1%) considered clinical outcomes. Employers who considered clinical outcomes in their purchasing decision reported significantly greater satisfaction with the quality and cost of their behavioral health benefits. Following selection, 38.7% of corporations used employee complaints to monitor quality problems in their behavioral health benefits; 3.2% used clinical outcomes. If society expects employers to purchase behavioral health care on the basis of quality as well as cost, more employers need better indicators of quality.

Adult↗

PubMed2002

[Health behavior of Polish adult population].

Health behavior and factors affecting this behavior have been studied in Poland. Survey was based on representative sample of adult population. Differences, as expected, were related to age, sex and social status. Behavior with regard to personal hygiene was most appropriate among women and young persons, and correlated most strongly with level of education. It has been found that health promotion campaigns are most effective if organized locally and not nationally, since local campaigns could be tailored to specific local conditions.

Adult↗

PubMed1993

Self-efficacy and health behavior among older adults.

Self-efficacy has a well-established, beneficial effect on health behavior and health status in young and middle-aged adults, but little is known about these relationships in older populations. We examined this issue as part of a randomized trial to determine the cost savings and changes in health-related quality of life associated with the provision and reimbursement of a preventive services package to 2,524 Medicare beneficiaries enrolled in Group Health Cooperative of Puget Sound. Baseline self-efficacy data were collected for all participants in five behavioral areas: exercise, dietary fat intake, weight control, alcohol intake, and smoking. Results reveal that efficacy and outcome expectations for these health behaviors are not independent. Correlational and factor analyses indicate two dimensions of efficacy expectations, one consisting of exercise, dietary fat, and weight control, and another consisting of smoking and alcohol consumption. Outcome expectations of the five behaviors form a single dimension. Older adults with high self-efficacy had lower health risk in all behaviors and better health. Regression analyses detected a positive association between socioeconomic status and health-related quality of life (p < .02), but the strength of the association declined (p < .11) after the self-efficacy measures entered the model, indicating that self-efficacy explains part of the association between socioeconomic status and health status. Interventions aimed at improving self-efficacy also may improve health status.

Age Factors↗

PubMed2005

Psychological distress, comorbidities, and health behaviors among U.S. adults with seizures: results from the 2002 National Health Interview Survey.

PURPOSE: To examine the association of seizures with health-related quality of life (HRQOL), physical and psychiatric comorbidities, and health behaviors. METHODS: We analyzed data obtained from adults aged 18 years or older (n = 30,445) who participated in the 2002 National Health Interview Survey, an ongoing, computer-assisted personal interview of the noninstitutionalized U.S. population. RESULTS: An estimated 1.4% of adults 18 years or older reported being told by a health care professional that they had seizures. Persons with seizures were significantly more likely than those without seizures to report lower levels of education, higher levels of unemployment, pain, hypersomnia and insomnia, and psychological distress (e.g., feelings of sadness, nervousness, hopelessness, and worthlessness). In addition, they were significantly more likely to report insufficient leisure-time physical activity as well as physical comorbidities such as cancer, arthritis, heart disease, stroke, asthma, severe headaches, lower back pain, and neck pain. CONCLUSIONS: Our findings suggest that it is advisable for health care professionals to assess psychiatric and physical comorbidities among patients with a history of seizures potentially to improve patient health outcomes. Furthermore, public health surveillance systems should include questions on seizures, epilepsy, and mental health to better examine associations among these disorders and to better identify populations meriting further assessment and intervention.

Adolescent↗

PubMed2000

Methods for identifying and assessing groups in health behavioral research.

Methods to study groups developed in other fields have much to contribute to the study of health behavior, including alcohol and substance use. This paper surveys group methods in order to demonstrate how attention to group levels of analysis can provide new insights about the context and causes of health behavior. The first major section of this paper focuses on the influences on health behavior associated with "naturally occurring groups" such as peer networks, families, workplaces, neighborhoods, churches, treatment groups and residential settings. Different aspects of group influence are discussed in terms of seven different features of social groups: history, structure, function, resources, process, norms and climate. The second major part of this paper is concerned with methods to identify meaningful subgroups in heterogeneous samples. Following an overview of taxonomic methods to identify and assign cases to groups, we highlight the potential for these methods to help address a number of fundamental theoretical problems in health behavioral research, including: describing cultural diversity, distinguishing response sets in survey research, controlling error in outcomes scores related to baseline differences, tracking trajectories of change, and revealing interactions among determinants of health behavior. The third and final section of the paper highlights specific applications of taxonomic and group-influence methodologies in intervention research, including design and analysis of randomized trials, studies of existing treatment settings and group-level variables involved in translational research.

Group Processes↗