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PubMedDate not supplied

Health behavior changes in the United States, the United Kingdom, and France.

OBJECTIVE: To determine changes in health behaviors in the United States, the United Kingdom, and France over the previous two years. DESIGN: Cross-sectional survey of nationally representative samples. SETTING/PARTICIPANTS: Surveys conducted between June and November 1988 on persons aged 16 to 50 years in the United States (n = 1,940), the United Kingdom (n = 1,833), and France (n = 2,294) regarding health behaviors, attitudes toward health, and changes in health practices during the previous two years. MEASUREMENTS AND MAIN RESULTS: Using Bonferroni's adjustment for multiple comparisons, residents of the United States had significantly (p < 0.05) higher Quetelet indices and reported higher egg and red meat consumption, but had lower alcohol consumption, than did residents of either the United Kingdom or France. Americans were also significantly more likely to report attitudes accepting personal responsibility for their health and much more often endorsed the role of health behaviors (e.g., exercise) for decreasing the risk of cardiovascular disease. Changes in health behavior over two years were consistently more likely in the United States for weight loss, decreased alcohol consumption, decreased red meat and egg consumption, and increased exercise. Americans were also much more likely to have changed at least three health behaviors in the previous two years (United States 41.5%, United Kingdom 25.5%, France 13.8%, p < 0.002). A multivariate linear model confirmed the high likelihood of health behavior changes in the United States compared with the United Kingdom or France. CONCLUSIONS: The findings confirm that changes in health behaviors are continuing to occur in the United States, but remain comparatively modest in the United Kingdom and France. These international variations in health behaviors parallel differential declines in mortality rates in ischemic heart disease.

Adolescent↗

PubMed1991

Socioeconomic status differences in health behaviors related to obesity: the Healthy Worker Project.

Obesity and health behaviors that influence energy balance (diet, exercise, and dieting to lose weight) were examined in a population of 2108 and 2539 working men and women in relation to socioeconomic status (SES). The hypothesis investigated was that the inverse relationship between SES and obesity observed in a number of studies is due to the fact that the distribution of obesity relevant health behaviors differs by social class. Body mass index (BMI), as expected, was found to be inversely related to SES. Higher SES was also associated with several behaviors that contribute importantly to energy balance. High SES respondents reported a lower fat diet, more exercise, and a higher prevalence of dieting to control weight. However, lower smoking rates were observed in upper SES men and women and higher alcohol consumption was reported in upper SES women. Both of these associations appear to be inconsistent with the hypothesis that the inverse association between SES and obesity is caused by differences in health behaviors. In multiple regression analyses, SES remained a significant predictor of BMI after controlling for all measured health behaviors. Weaknesses in the methodologies for measuring health behaviors and possible effects of obesity itself on social mobility are suggested as possible explanations for the residual association between obesity and SES.

Adult↗

PubMedDate not supplied

Correlates of expected success at health habit change and its role as a predictor in health behavior research.

Perceived ability to change health habits successfully is undoubtedly an important factor underlying personal health behavior. This report examines expected success in changing future habits, using a sample of community-resident adults 18-65 years of age (n = 1,367). One set of analyses used expected success as a dependent variable, whereas another set used it as an independent variable for health behavior and knowledge indices. In the dependent variable analysis, results showed that reported past success at health habit change was the strongest predictor of success expected in the future. Optimism about future success was also associated with variables that already placed individuals at an advantage to change behavior (e.g., not smoking, regular exercise, lower Body Mass Index, support in the family). When used as a predictor variable, expected future success was not associated with five health-related, self-report indices of behavior, knowledge, and perceived risk. Further examination showed, however, that in three instances the association between expected success and the outcome indices seemed to plateau in the most optimistic group. Extreme optimism (that admits no chance of failure) may be a belief characteristic that deserves further investigation, one that will present a challenge to research and practice. Men tended to report greater expected future success than women, although women had more favorable reports on three of the five health-related behavior/knowledge indices.

Adolescent↗

PubMed1991

A health education program for inner city high school youths: promoting positive health behaviors through intervention.

This descriptive study examined the influence of a 7-week Health Education Program (HEP) on the reported health behaviors of inner city high school youths. A convenience sample of 83 youths between the ages of 14 and 17 years was selected from a moderate size, metropolitan, midwestern high school. A 32-item Health Behaviors Survey (HBS), developed by the researcher, was administered to the youths before and after the completion of the HEP. Participants were classified by their health behaviors into high-, moderate-, or low-risk categories. In addition, the subjects completed a health diary that was discussed before the weekly presentations. Findings of the study revealed a positive shift in several reported health behaviors from high-risk to low-risk following completion of the HEP. The professional nurse is in an excellent position to develop nursing interventions and creative innovations including preventive measures to positively influence the health behaviors of young people.

Adolescent↗

PubMed1990

Foreign-born and US-born black women: differences in health behaviors and birth outcomes.

We studied health behaviors and birth outcome among 201 foreign-born and 616 US-born Black women receiving prenatal care at Boston City Hospital. Foreign-born women had better pre-pregnancy nutritional status and prenatal health behaviors, and their infants had greater intrauterine growth. Black women are not a homogeneous group; culture and ethnicity, in addition to other variables, must be considered in the study of their birth outcomes.

Adolescent↗

PubMedDate not supplied

Health consciousness and health behavior: the application of a new health consciousness scale.

Self-consciousness has been an important trait in personality research. It seems logical to investigate whether health consciousness, involving a similar self-focusing, might operate in a parallel manner. To this end, I developed the Health Consciousness Scale (HCS), primarily by modifying items of the Self-Consciousness Scale, and also tested it for reliability and validity. My study found the HCS to contain four first-order factors: (1) Health Self-Consciousness, (2) Health Alertness, (3) Health Self-Monitoring, and (4) Health Involvement. I found these four first-order factors, along with the overall HCS second-order factor, to relate to a number of self-reported, health-associated behavioral variables. The study also included comparisons with the Health Locus-of-Control Scale and other measures.

Adult↗

PubMed1985

Health behaviors and beliefs of four allied health professions regarding health promotion and disease prevention.

Certified nurse midwives, certified physician assistants, registered dental hygienists, and registered dietitians were surveyed to determine to what extent important health promotion and disease prevention behaviors are a part of their lifestyle. Also assessed were beliefs about health promotion and disease prevention practices. The study found that the respondents perceive themselves as important providers of health promotion and preventive services. Although most of the respondents are good health role models, many should consider changes in their own behaviors. Additionally, continued learning by many of these professionals appears warranted, particularly in recognizing the significance of certain health behaviors as they relate to preventing disease and promoting health.

Allied Health Personnel↗

PubMed1992

Peer perceptions of adolescent health behaviors.

Perceptions adolescents form of peers in relation to modeled health behaviors were examined. Five hundred ten adolescents, ages 12-15, from eight midwest schools were shown a slide of a male or female adolescent displaying a health behavior artifact (apple, tennis racket, cigarette, beer can), or without an artifact and asked to rate the model on 16 characteristics using a semantic differential scale. Data were factor analyzed using principle components analysis and a 2x2x5 MANOVA. Results indicated that models appeared less mature when holding a beer can or cigarette. In addition, the female model was rated more popular than the male in the control and beer can depictions. The influence of modeled behaviors on traits adolescents want to develop must be understood to present effective health education programs. Educational efforts should include consideration of the perceptions adolescents hold of their peers' health behaviors.

Adolescent↗

PubMed1991

Distribution of dental health behaviors in Nordic schoolchildren.

The present study was part of the project "Health Behavior in Schoolchildren. A WHO Cross National Survey". The distribution of eight dental health behaviors among Finnish, Norwegian, and Swedish schoolchildren aged 11, 13, and 15 yr was studied separately for boys and girls. The sample size approximated 3000 individuals for each country, and the samples are considered to be representative for whole countries. The distinction between individual and collective behavior was empirically supported in this study. Thus collective behaviors (supervised fluoride rinsing and distribution of fluoride tablets) did not vary according to sex but declined with increasing age. On the other hand, individual behaviors varied according to sex and tended to increase in frequency with increasing age. The levels of the studied dental health behaviors were different among the three countries. This may be related to country-specific preventive policies as well as social and cultural norms.

Adolescent↗

PubMed1992

A longitudinal assessment of the impact of health/fitness status and health behavior on perceived quality of life.

This study extended cross-sectional research associating quality of life with health and fitness factors. Longitudinal analyses were performed on data collected from 519 U.S. Navy personnel to assess changes in quality of life with changes in health/fitness status and health behavior dimensions at 1-yr. and 2-yr. intervals. Multiple regression results showed that such changes were positively associated with changes in health/fitness status and behaviors related to accident control and wellness maintenance, with these predictors accounting for 8% of the variance in change in quality of life at the 1-yr. interval. At the 2-yr. interval, such change was associated with health/fitness status and accident control behaviors, accounting for 11% of the variance. Health behavior change made a unique contribution to change in quality of life after controlling for changes in health/fitness status at both intervals. Findings affirm modest yet consistent associations between changes in fitness and health variables and quality of life and suggest that improvements in health behavior influence quality of life independently of one's health/fitness status.

Adult↗

PubMed1990

Dental health behaviors and periodontal disease indicators in Danish youths. A 10-year epidemiological follow-up.

The purpose of the present study was to analyse the epidemiologic relationship between dental health behaviors and periodontal disease. Indicators of periodontal disease in terms of bleeding and calculus were measured dichotomously (absence/presence). Periodontal pockets were as follows: normal pockets (0-3 mm), shallow pockets (4-5 mm), and deep pockets (6+ mm). The indicators were measured on 4 surfaces on 6 index teeth (16, 11, 26, 36, 31, 46) in 1984-85. The highest value for each tooth of bleeding (0/1), calculus (0/1) and pockets (0/1/2) was used for calculation of the bleeding index, the calculus index and the pocket index. The participation rate in 1984-85 was 86%, and the study population involved 368 males and 388 females. Information concerning dental health behavior was obtained both in childhood (1974) when the individuals were 9-10 years of age, and in adulthood (1984-85) when the individuals were 20-21 years of age. Information concerning dental health behaviors in adulthood, i.e., regularity of dental visits, frequency of tooth brushing, and regular use of interdental aids, was obtained through a self-administered questionnaire (1984-85). Dental health behaviors in childhood (1974) was operationalized as level of plaque, gingivitis, and dmfs. The results showed that dental health behaviors in childhood and in adulthood were together responsible for 9.4-13.8% of the variance in level of periodontal disease indicators. Determinants of early dental health behaviors in terms of plaque and dmfs at age 9-10 years were significant predictors in pocket index at age 20-21.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Relationships between health protective behaviors.

Health protective behaviors are receiving increasing attention for maintaining health and preventing disease. Most research has examined specific health behaviors individually, with relatively few studies of the relationships between many health protective behaviors. This investigation examined how health protective behaviors were related with each other using data from the American Family Report, a survey of a national sample of 1,247 adults in U.S. families. Eighteen health protective behaviors were not all consistently intercorrelated with each other, with only 39% of the correlations significant at p less than .001. Factor analysis using oblique rotation revealed six underlying dimensions of health protective behaviors: not smoking, planned exercise, routine exercise, moderate drinking, absence of sedative use, and general health behaviors. These dimensions were associated with sociodemographic variables, particularly with higher education being associated with healthier behavior. The multidimensional nature of health protective behaviors needs to be considered in programs for enhancing prevention and health promotion.

Adult↗

PubMedDate not supplied

Perceived susceptibility to heart disease and preventive health behavior among Type A and Type B individuals.

Although the Type A behavior pattern has been the subject of extensive research, surprisingly little information is available about the preventive health behavior of this population. Measures of perceived susceptibility, preventive health behavior, current stress, and risk for cardiovascular disease were obtained from 37 Type A and 37 Type B college students. Results indicated that the Type A students generated susceptibility judgments that covaried significantly with perceived stress. Susceptibility judgments for the Type B group, however, covaried significantly with nonbehavioral cardiovascular risk-factor status. Correlations between perceived susceptibility and preventive health behavior also differed between the two groups. For the Type A group, increments in perceived susceptibility were associated with decrements in preventive behavior. For the Type B group, however, increments in perceived susceptibility were associated with increments in preventive behavior. Between-group comparisons of preventive health behavior indicated that Type A participants were less likely to use relaxation and avoidance of overwork but were more likely than those who were Type B to regulate their diets.

Adult↗

PubMed1989

Smoking alcohol consumption and dental health behavior among 25-44-year-old Danes.

The purpose of this investigation was to describe smoking and alcohol habits of an adult Danish population and to study whether these habits are influenced by living conditions. Moreover, the purpose was to test the hypothesis of unidimensionality of health behavior. The study comprised 749 persons in the age group 25-44 yr (82% of original sample) and data on smoking, alcohol consumption, diet, and dental health behavior were collected by interviews. Fifty-one percent of the interviewed persons were current smokers, 58% among men and 44% among women. One-fifth of the males and about one-tenth of the females were classified as heavy smokers consuming more than 15 cigarettes per day. Fifty-eight percent reported to have alcoholic drinks weekly 71% of men and 47% of women. All in all, 65% of the study group had a weekly consumption of larger beer, 6% of strong beer, 52% of red or white wine, 12% of dessert wine, and 27% of spirits. Alcohol consumption as well as smoking was more frequent among workers than officials. Multivariate regression analyses showed that smoking and alcohol habits varied according to sex, urbanization, education, shift work, and number of children in family. Correlations between alcohol habits, smoking, and perceived dental health were observed. Furthermore, smoking and dental health behavior were negatively associated. In factor analysis of variables on diet, smoking, alcohol, and dental health behavior, two factors were isolated: 1) alcohol consumption, and 2) active dental care. Only a small proportion of the total variance was explained and, thus, the hypothesis of unidimensionality of health behavior was not confirmed. Because of the multidimensionality different strategies and methods in health education may be needed to modify or change the various types of negative health behavior.

Adult↗

PubMed1992

Patient attitudes concerning health behaviors during pregnancy: initial development of a questionnaire.

The major determinant of infant mortality in the United States is low birthweight (LBW). Health behaviors related to LBW are inadequate prenatal care, poor nutrition, smoking, and moderate to heavy alcohol use. Before interventions can be designed to assist women in modifying these health behaviors, more must be understood about their causes. The Health Belief Model (HBM) is a framework for analyzing beliefs that motivate health behaviors and is well established as a model for understanding health behavior decisions. The chief aim of this study was to develop an instrument to assess women's health beliefs during pregnancy. Questions for the instrument were generated around the four major constructs of the HBM: perceived susceptibility, seriousness, benefits, and barriers. Four focus group interviews, a literature review, and consultation with an HBM expert provided content for questions. The questionnaire was administered to a convenience sample of 127 women. The measurement models were tested using confirmatory factor analysis. Parsimony was achieved by reducing the original 106-item scale to 64 items. The final instrument provides support for the HBM but not for all of its discrete constructs.

Adolescent↗

PubMed1989

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↗

PubMed1991

Determinants of dental health behaviors in Nordic schoolchildren.

As part of the comprehensive study "Health Behavior in Schoolchildren. A WHO Cross National Survey", this paper set out to identify determinants of four dental health behavioral dimensions in Finnish, Norwegian, and Swedish schoolchildren aged 11, 13, and 15. The data were collected by means of self-administered questionnaires, and the results are considered to be representative of each country. The total sample size approximated 3000 pupils in each country. The four dependent variables, fluoride, interdental cleaning, sugar, and brushing behavior, were all based upon sum-scores of several questions, and were subsequently regressed upon five predictors: school achievement, sex, time spent with friends, educational plans, and family meal pattern. This model provided a far better fit to the data on sugar and brushing behavior than to fluoride and interdental cleaning behavior. However, brushing seems to be different from sugar behavior, being influenced by different factors. While brushing is closely linked to the prevailing sex-role pattern, sugar behavior is stronger related to peer group norms. Thus, the symbolic function of sweet consumption of the youth culture should have implications for the design of intervention strategies. For example, the provision of alternative behaviors will only be successful if the behaviors serve the same function as sugar consumption.

Adolescent↗

PubMed1987

Motivation in health behavior: measurement, antecedents, and correlates.

Additional reliability, validity, and information on health behavior correlates for a recently developed measure of intrinsic motivation in health behavior are reported. A randomly selected sample of 379 elders responded to a structured interview containing the Health Self-determinism Index (HSDI) and other relevant variables. The overall reliability of the HSDI was supported with an alpha coefficient of 0.78. The multidimensionality of the instrument was reconfirmed through principal components analysis, and factor invariance across study samples was established. The total HSDI and subscale scores were associated with the practice of selected life-style behaviors. The homogeneity of the sample raises significant considerations relative to contextual item sensitivity and sample-induced response tendencies.

Aged↗