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Are maternal health behaviors related to preschool children's adjustment? A preliminary report.

Little is known about how parental health behaviors affect others within the family. This study examined the relationship of mothers' health behaviors to mothers' reports of their preschool children's mental health. Mothers (n = 89) of 2 and 3 year olds completed a mail survey assessing a variety of health related measures. Children's adjustment was assessed by the Child Behavior Checklist, a well established measure of child adjustment. The Personal Lifestyle Questionnaire and Perceived Stress Scale were also contained in the survey. Most mothers were white, married, and had attended college. After entering control variables (income, work status, and perceived stress) in regression analyses, mothers' overall health behaviors were significantly related to total child behavioral/emotional problems. These preliminary findings suggest that the health behaviors of mothers may be related to children's mental health, but the direction of the relationship should be tested further in longitudinal research.

Adaptation, Psychological↗

The social significance of routine health behavior in Tamang daily life.

Programs to promote behavioral change among non-Western people sometimes emphasize individual cognitive processes at the expense of social practices. While health beliefs are important, it is equally important to understand the language and the pattern of relationships that affect routine health behaviors. In rural central Nepal we conducted a health survey of 265 Tamang people, followed by a series of 22 in-depth interviews focused on diarrhea and related illnesses. This paper describes the nomenclature used and automatic health behaviors enacted, in response to diarrheal illnesses in Tamang villages. We draw on the work of Anthony Giddens to show that routine health behavior is embedded in specific social relationships that in turn help to structure many aspects of Tamang daily life. We discuss the significance of routine Tamang health behavior in light of oral rehydration therapy programs.

Adult↗

Identifying high school students' health behaviors: development of a survey.

A health survey developed to profile high school students for the purpose of assisting in program planning emphasized everyday health behaviors instead of focusing on high-risk behaviors (e.g., drinking, drugs, safety, or sexuality). The questionnaire was a voluntary 20-item survey that could be completed during a 15-minute homeroom period. A total of 1,401 students completed the questionnaire. Findings were shared with students, teachers, staff, and parents. Teachers and staff members were given a prepared response sheet that addressed each of the concerns identified. They were encouraged to have discussions about these behaviors with students during the homeroom period, as time and interest allowed. Response to the survey has been very positive, and a number of changes have been incorporated into the school health program as a result of the findings. One of these changes is a teen clinic that opened in April 1999. The findings also proved very useful in facilitating awareness of student behaviors and assisted in identifying ways the school nurse could assist students in improving their health and well-being.

Adolescent↗

Social support and health behavior in hostile black and white men and women in CARDIA. Coronary Artery Risk Development in Young Adults.

OBJECTIVE: These cross-sectional analyses of the Coronary Artery Risk Development in Young Adults (CARDIA) data were stimulated by previous CARDIA analyses that showed an adverse association between hostility and several health behaviors: physical activity, cigarette smoking, alcohol consumption, and caloric intake, in both black and white men and women, such that the higher the hostility, the worse the health behavior profile. The current study investigated whether high social support was associated with better health behavior than low social support in individuals with high hostility scores. METHODS: The subjects were 5115 healthy black and white men and women ranging in age from 18 to 30 years. The hypothesis was that the association between hostility and certain adverse health behaviors would be diminished in the presence of high social support. Race-gender specific median cutpoints of the Cook-Medley Hostility scale and an index of social support defined levels of high and low hostility and social support. RESULTS: After controlling for age and body mass index (BMI), support was positively associated with more exercise in all groups except black women, but when coupled with high hostility, this positive association between support and exercise remained only in men. White women with high support were less often smokers but this association did not hold when examined only in the high-hostile group. Black men and white women with high support in the presence of high hostility consumed more alcohol, but the amount was moderate. CONCLUSIONS: We conclude that social support in the presence of high hostility only sometimes reduces the association of hostility to adverse health behaviors and that these effects are complex. Additional research investigating types of social support on health behavior in different race-gender groups is advocated.

Adolescent↗

Relations between preventive health behavior and hardiness.

To estimate the relationship between hardiness and preventive health behaviors a hardiness scale and a health hazard appraisal were administered to 211 college students. Multiple regression analysis indicated that modest amounts of variance on the hardiness measures were explained by the components of the health-hazard appraisals. Indications are that the concepts of hardiness and preventive health behavior are related and need further clarification.

Adult↗

Clustering women's health behaviors.

This study attempts to characterize health lifestyles by subgrouping women with similar behavior patterns. Data on background, health behaviors, and perceptions were collected via phone interview from 1,075 Israeli women aged 50 to 74. From a cluster analysis conducted on health behaviors, three clusters emerged: a "health promoting" cluster (44.1%), women adhering to recommended behaviors; an "inactive" cluster (40.3%), women engaging in neither health-promoting nor compromising behaviors; and an "ambivalent" cluster (15.4%), women engaging somewhat in both health-promoting and compromising behaviors. Clustering was cross-tabulated by demographic and perceptual variables, further validating the subgrouping. The cluster solution was also validated by predicting another health behavior (mammography screening) for which there was an external validating source. Findings are discussed in comparison to published cluster solutions, culminating in suggestions for intervention alternatives. The concept of lifestyle was deemed appropriate to summarize the clustering of these behavioral, perceptual, and structural variables.

Aged↗

Serum carotenoids and clustering of adverse health behaviors in American adults.

OBJECTIVE: To determine the association between clustering of adverse health behaviors (cigarette smoking, alcohol intake, and sedentarism) and serum carotenoids in a representative sample of white, Black, and Hispanic Americans. METHODS: Data (n=6,218) from the Third US National Health and Nutrition Examination Survey were utilized for this investigation. Adjusted gender-specific linear regression analyses were used. RESULTS: Increase in clustering of adverse health behaviors was associated with decreased serum concentrations of a-carotene, b-carotene, bcryptoxanthine, and luteine/zeaxanthene in the 3 racial/ethnic groups (P<0.05). CONCLUSION: Persons with multiple adverse health behaviors should be advised to increase fruit and vegetable consumption, as primary sources of chemopreventive antioxidants.

Adult↗

Patterns of health behavior in U.S. adults.

BACKGROUND: Associations between health-related behaviors are important for two reasons. First, disease prevention and health promotion depend on understanding both prevalence of health behaviors and associations among such behaviors. Second, behaviors may have synergistic effects on disease risk. METHODS: We document patterns of adherence to recommendations concerning five behaviors (physical activity, tobacco use, alcohol consumption, fruit and vegetable consumption, and dietary fat intake) in U.S. adults (n = 15,425) using data from the Third National Health and Nutrition Examination Survey. Division of individuals into categories associated with adherence or nonadherence to lifestyle recommendations results in 32 patterns of adherence/nonadherence. RESULTS: Proportions of U.S. adults with 21 of 32 behavior patterns characterized here deviated from proportions expected if health behaviors are independent of each other. The two extreme patterns, all adherence (5.9%) and all nonadherence (4.9%), were found in about double the proportion expected. Age, gender, race/ethnicity, education, and income were associated with a number of patterns, including the two extremes. CONCLUSIONS: This analysis of behavior patterns highlights population subgroups of public health importance, provides a benchmark for studies of multivariate associations between health behaviors, and supports a multidimensional model of health behavior.

Adult↗

Network composition and health behaviors among older Samoan women.

PURPOSE: The purpose of this article is to explore how kin and nonkin social support networks influence health behaviors among older Samoan women. METHOD: Using a cross-sectional survey design, 290 Samoan women who were age 50 years and older were interviewed. Using separate logistic regressions, each health behavior was regressed on age and kin and nonkin social support networks after controlling for background characteristics and health status. RESULTS: In multivariate analyses, higher scores on kin increased the likelihood of never salting food, getting screened for diabetes in the past year, and having had a mammogram in the past 2 years, whereas higher scores on nonkin increased the likelihood of exercising at all and ever trying to lose weight. DISCUSSION: Kin networks positively affect mostly chronic disease-related health behaviors, whereas nonkin networks positively affect mostly lifestyle-related health behaviors.

Age Factors↗

Health behavior change among office workers: an exploratory study to prevent repetitive strain injuries.

The purpose of this evidence-based study is to investigate the impact of a multi-component intervention on health behavior change among office/computer workers in preventing repetitive strain injuries. Forty office workers employed in an administrative office in Michigan participated in this project. The subjects completed a comprehensive questionnaire at three different times in 1994 and 1995. The intervention took place between time 2 and time 3 and included posters, e-mail tips, mini-workshops, and activities of a Wellness Ergonomic Team. A theoretical model was tested to identify factors influencing healthy behaviors. Study findings revealed positive behavior change for 62% of the participants. The factors most strongly related to health behavior change appear to be self-efficacy, the intention to change one's behavior, and perceived health status. Better understanding of health behavior change coupled with ergonomic modifications is a significant step toward the prevention of repetitive strain injuries resulting from computer use.

Administrative Personnel↗

Health behavior, perceptions, practices, and decision making: sub-national and socio-demographic differentials in Bangladesh, 1995.

The study examines health behavior, perceptions, practices, and decision making using data from the 1995 Health and Demographic Survey conducted by the Bangladesh Bureau of Statistics. Knowledge about causes of diarrhea and food contamination were higher than knowledge about causes of nightblindness and worm infestation but this knowledge is inadequate. The household's economic condition and the respondent's education were found to be positively associated with disease knowledge and food contamination; the same is also true for health behavior and practices. Sub-national variation in disease knowledge and food contamination exists but did not correspond always with the health behavior and practices. Decisions regarding treatment of disease were made by the husband and wife together in two-thirds of the cases, however, it was not uniform across socio-demographic and sub-national categories.

Bangladesh↗

Perceived morbidity as a determinant of health behavior.

It is hypothesized that perceived morbidity, a concept closely related to perceived vulnerability, is an important determinant of health behaviors. In this cross-sectional study (N = 2740), perceived morbidity was conceptualized as a categorical variable defining six distinct morbidity groups: the hypertension, high cholesterol, angina pectoris, heart attack, stroke and 'morbidity-free' groups. We used analyses of covariance to identify differences in health behaviors between the six groups; the analyses were done separately for middle-aged (40-60 years old) and older ( greater than 60 years old) respondents. Results show that perceived morbidity had a significant effect on fat consumption (P less than 0.001) and on physical activity (P < 0.01). In both age ranges, the morbidity-free group had the highest fat consumption; among the middle-aged respondents, the level of physical activity was significantly lower in the morbidity-free group than in the heart attack group. Furthermore, respondents in the high cholesterol group showed consistently a 'better' health behavior than people in the hypertension group. Overall, these results suggest that the concept of perceived morbidity may be useful in explaining inter-individual differences in health behaviors.

Adolescent↗

Teaching motivational interviewing to first-year medical students to improve counseling skills in health behavior change.

OBJECTIVE: To examine the effectiveness of motivational interviewing training on improving medical students' knowledge of and confidence in their ability to counsel patients regarding health behavior change. SUBJECTS AND METHODS: In the spring of 2002, 42 first-year medical students participated in a counseling course on health behavior change. Three small groups focused on learning and practicing motivational interviewing techniques using brief lectures, interactive class activities, student role-plays, and simulated patients. Students completed an identical precourse and postcourse questionnaire that measured their confidence and knowledge regarding counseling skills in health behavior change. RESULTS: The medical students reported improved confidence in their understanding of motivational interviewing after participation in the course (very confident, 77%) compared with before the course (very confident, 2%). Each of the 8 confidence items were compared before and after the course using a signed rank test. All comparisons indicated a significant improvement (P < .001) in confidence. Regarding knowledge-based questions, students showed significant improvement; 31% of students answered all the questions correctly before the course, and 56% answered all the questions correctly after the course (P = .004). CONCLUSION: These results show that teaching motivational interviewing techniques to first-year medical students can enhance student confidence in and knowledge of providing counseling to patients regarding health behavior change.

Counseling↗

Creating healthy environments: household-based health behaviors of contemporary Mexican American women.

This article describes the household-based health behaviors of a sample of contemporary Mexican American women.1 Using the Household Production of Health (HHPH) as a conceptual framework and ethnographic methods of inquiry, 13 moderately to highly acculturated women of Mexican ancestry participated in multiple interviews about their health beliefs and household health behaviors. This article examines the findings related to the following research question: What are the health-producing and help-seeking behaviors (proximate determinants of health) used by Mexican American women to produce health? Themes focusing on creating healthy environments and treating illness are discussed. Awareness of the activities that women use to create and support household health can enhance the practice of nurses interested in supporting women's health work and improving health outcomes in the Mexican American community.

Acculturation↗

The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends.

GOALS: The aim of this study was to examine the effect of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends, and to determine whether a cancer diagnosis could be a teachable moment for intervention. MATERIALS AND METHODS: This was a cross-sectional study of the health behaviors of individuals taking part in a cancer fundraising event. The questionnaire was completed by 657 participants. MAIN RESULTS: Participants were 81.4% women, had a mean age of 46 years, and comprised of 17.2% cancer survivors. For cancer survivors, 31.3% reported an increase in physical activity, 50% of smokers quit, and 59 to 72% reported dietary improvements within 1 month of diagnosis. Significant differences in behavior change were found by age, but not by gender or education. For individuals without cancer, 24.3% reported improved physical activity and the majority reported some dietary changes. A greater proportion of family and friends who perceived they were at greater risk of developing cancer increased physical activity and sun-smart behavior but did not improve dietary habits. CONCLUSIONS: The results indicate that the cancer survivors made significantly more positive health behavior changes compared to the non-cancer group. For this sample, a personal diagnosis of cancer, or a diagnosis in a family member or friend, may have acted as a 'cue to action' to improve lifestyle health behaviors. This field of research is still at an early stage, and further studies are needed to confirm if this situation could be useful as a 'teachable moment' for intervention purposes.

Adult↗

Preventive health behaviors among spousal caregivers.

BACKGROUND: The physical and emotional burden of caring for a functionally impaired spouse may adversely affect the preventive health behavior of the caregiver. This study explores the relationship between caregiving and lifestyle health behaviors and use of preventive services. METHODS: The Caregiver Health Effects Study identified spousal caregivers among a sample of more than 3,000 married, community-dwelling older persons, from four counties in the United States, who were enrollees in the Cardiovascular Health Study. High-level caregivers were defined as having a spouse with an ADL impairment (n = 212) and moderate-level caregivers, a spouse with one or more IADL impairments (n = 222). For each caregiver, a control, matched for age and gender, was selected (n = 385). Structured interviews were conducted in the home, following enrollment. RESULTS: Being a high-level caregiver significantly increased the odds of not getting enough rest, not having enough time to exercise, not having time to rest to recuperate from illness, and forgetting to take prescription medications, compared with noncaregivers. These findings did not hold for moderate-level caregivers. The odds were not significantly different for either level of caregiver compared with noncaregivers for missing meals, missing doctor appointments, missing flu shots, and not refilling medications. Larger proportions of caregivers with a strong sense of control had good preventive health behaviors, compared with caregivers with a weak sense of control.

Activities of Daily Living↗

Frequent dieting among adolescents: psychosocial and health behavior correlates.

OBJECTIVES: The present study examined correlates of frequent dieting in 33,393 adolescents. It was hypothesized that frequent dieting would be correlated with negative psychosocial and health behavior outcomes. METHODS: A comprehensive, school-based health behavior survey was administered in 1987 to public school students in grades 7 through 12 in Minnesota. Students self-reported dieting behavior; substance use; suicidal, sexual, and delinquent behavior; family and peer concerns; sick days; and abuse history. Differences on psychosocial and health behavior risk factors by dieting frequency and by purging status were assessed with multivariate logistic regression, with body mass index and demographic variables controlled. RESULTS: Dieting frequency was associated with history of binge eating (females: odds ratio [OR] = 1.46, males: OR = 1.53); poor body image (females: OR = 0.56, males: OR = 0.63); lower connectedness to others (females: OR = 0.79); greater alcohol use (females: OR = 1.17); and greater tobacco use (females: OR = 1.08). Purging status was independently associated with negative risk factors in both males and females. CONCLUSIONS: These findings suggest that frequent dieting efforts in adolescents should not be viewed in isolation, but rather in the broader context of health and risk-taking behaviors.

Adolescent↗

The effect of retirement on mental health and health behaviors: the Kaiser Permanente Retirement Study.

To assess the short-term effect of retirement on mental health and health behaviors of members of a health maintenance organization aged 60-66, questionnaires were completed in 1985 and 1987 by employed members planning to retire during the study period and those not planning to retire. Mental health and health behaviors of members who actually retired (n = 320) were compared with those members who did not retire (n = 275). Using logistic regression controlling for age, gender, marital status, and education, we found that retired members were more likely to have lower stress levels and to engage in regular exercise more often as compared to those who did not retire during the study period. Retired women were more likely to report no alcohol problems as compared to nonretired women. There were no differences between the groups on self-reported mental health status, coping, depression, smoking, alcohol consumption, and frequency of drunkenness. These findings underscore the importance of assessing positive benefits associated with retirement and call for further evaluation of whether these benefits persist over time.

Aged↗