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At least 379 records · Page 21Linked to original sources

PubMed1999

Who leaves managed behavioral health care?

The growth of managed care and the possibility of biased enrollment and dis-enrollment rates have raised concerns about cost shifting. This article analyzes the duration of continuous enrollment in a managed behavioral health organization among members with and without behavioral health care utilization and among members with different mental health conditions. Eleven large employers with more than 250,000 members who are enrolled in managed behavioral health plans are studied. Compared to managed care 10 years ago, the rate of dis-enrollment among patients with depression appears to have dropped. Moreover, there appear few differences in dis-enrollment among users and nonusers of behavioral health services, except for employees for whom coverage is linked to job performance. However, patients with substance abuse problems or severe types of disorders are significantly more likely to dis-enroll than patients with less severe problems.

Adolescent↗

PubMed1994

[Health behavior model based analysis of factors affecting alcohol behavior of company employees].

Factors affecting alcohol behavior were studied using, as a conceptual framework, a Health Behavior Model on Alcohol (Alcohol Behavior Model), adapted from Munakata's Health Behavior Model. Under this model alcohol behavior is restricted or promoted by the levels of self-initiative ability, which influences both health promotion factors and health hindrance factors. How these factors influence alcoholic behavior in company employees was studied. Employees were asked to complete questionnaires when they came to health centers for their regular health examination between August to September 1990. Two hundred and ninety-two of the three hundred subjects answered the questionnaire. Results indicate that the major factor for restricting alcoholic behavior was self-efficacy regarding drinking alcohol. The self-efficacy level was increased by the persons' perceived vulnerability to alcohol and was decreased when alcohol functioned as an aid to recover from fatigue or to lower stress. As a conclusion, empowering clients to enhance self-efficacy appears to be effective as a health objective for coping with alcoholic behavior.

Adult↗

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↗

PubMed1986

The hale elderly: health behavior and its correlates.

The purposes of this study were to describe health behavior of the elderly and to explore the determinants and health consequences of that behavior, using survey data from 386 respondents (138 men, 248 women), 55 years of age and older. These elderly persons engaged in a wide variety of activities to protect their health, the most important of which were eating properly, obtaining adequate rest, and exercising. By multiple regression analysis, age, sex, socioeconomic status, and marital status explained only 7.2% of the variance in health protective behavior. Of those variables, sex had the greatest association with health protective behavior and age the least. Married men, but not married women, practiced more health behaviors than their unmarried counterparts. Health protective behavior was not related to overall health status, but was weakly related to perceived health. The lack of association between health protective behavior and health status is interpreted in terms of the nature of the population examined.

Age Factors↗

PubMed1998

Oversight of managed care for behavioral health services.

Contract specifications for behavioral health services can be used to ensure that services are accessible, efficient, and effective. Staff-per-population ratios and service utilization rates derived from the health services research literature, are proposed as a practical set of performance indicators. Structural, process, and outcome indicators are included. Examples include therapist full-time equivalents per 1000 cases (structural), number of crisis calls per 1000 enrollees (process), and number of emergency department visits per 1000 (outcome). The need for occasional clinical audits and further research in other areas is discussed.

Behavioral Medicine↗

PubMed1999

Dairy-product intake and hip fracture among older women: issues for health behavior.

The purpose of this study was to examine the association between dairy-product intake and hip fracture among a national sample of women aged 50 years and older. Univariate analyses using SAS procedures showed dairy-product intake was significantly associated with hip fracture. Women who had suffered hip fracture reported higher dairy use than women who had not experienced these fractures, a finding that is dramatically inconsistent with the literature. This finding may reflect positive behavioral changes resulting from the hip fracture event. Further research must focus on changes in health behavior after fracture, which may assist in understanding the roles of specific theories of health behavior. Application of principles of health behavior could improve the effectiveness of preventive treatment programs for osteoporosis.

Aged↗

PubMed1999

Symptom reporting in cancer patients II: relations to social desirability, negative affect, and self-reported health behaviors.

BACKGROUND: Patients' appraisal of somatic symptoms is correlated with their negative affect. The authors have investigated whether social desirability is associated with patients' symptom and health behavior reporting. METHODS: One hundred fourteen surgical cancer patients who participated in either an outpatient or an inpatient follow-up care program filled out the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, the New Social Desirability Scale, and a health behavior checklist. RESULTS: Patients' reports of somatic symptoms were correlated inversely with social desirability (r = -0.50) and positively with negative affect (r = 0.72). When objective health and demographic variables (e.g., prognosis, adjuvant therapy prior to follow-up, and gender) were entered first in hierarchical multiple regression analyses, social desirability and negative affect accounted for an additional 16% and 36% of the symptom variance, respectively. Similar results were found when global quality of life was the dependent variable. Self-reported health behaviors were explained only through the set of health and demographic variables (14%), and social desirability and negative affect did not account for additional variance. On the average, patients reported that they had a median of 4.7 (out of a list of 21) self-initiated health behaviors, and 11% of the patients admitted to having used unproven therapies. CONCLUSIONS: Symptom reports do not give a pure picture of patients' health status, but they are strongly correlated with social desirability and negative affect. Detection of such psychologic variables is essential to understanding the dynamics of quality of life. In applied settings, quality-of-life measures should be used together with conventional criteria. As practical experience and scientific understanding grow, the relative positioning of these patient-oriented versus clinic-oriented endpoints will become clear.

Adaptation, Psychological↗

PubMed1998

Stage theories of health behavior: conceptual and methodological issues.

Despite growing interest in stage theories of health behavior, there is considerable confusion in the literature concerning the essential characteristics of stage theories and the manner in which such theories should be tested. In this article, the 4 key characteristics of a stage theory-a category system, an ordering of categories, similar barriers to change within categories, and different barriers to change between categories--are discussed in detail. Examples of stage models of health behavior also are described. Four major types of research designs that might be used for testing stage theories are examined, including examples from the empirical literature. The most commonly used design, which involves cross-sectional comparisons of people believed to be in different stages, is shown to have only limited value for testing whether behavior change follows a stage process.

Attitude to Health↗

PubMed2004

Behavioral health care of isolated military personnel by videoconference.

The changing role of the military presents a unique challenge for military behavioral health organizations in dealing with the geographic isolation of personnel. Telemedical solutions should help to meet this challenge. In the behavioral health arena, there are many uses for videoconferencing and other communications technology in maintaining continuity when patients or clinicians travel or deploy; assisting isolated behavioral health-care providers and general practitioners; evaluating and treating isolated military personnel; and addressing family issues. Family interventions by videoconference and other communications technology may be particularly useful in treating military personnel and in promoting morale of the fighting force. Although much remains to be researched and proven empirically, anecdotal experience supports the utility of using communications technology to enhance behavioral health interventions. This article describes the clinical videoconference experience within the Department of Psychiatry at Tripler Army Medical Center (TAMC), during a Multinational force deployment to the Sinai, and during training at the Joint Readiness Training Center, Fort Polk, Louisiana. A brief discussion of potential legal issues involving videoconferencing in behavioral health is also included.

Communication↗

PubMedDate not supplied

Best practices for assessing competence and performance of the behavioral health workforce.

The need for mechanisms to assess the competence and performance of the behavioral health workforce has received increasing attention. This article reviews strategies used in general medicine and other disciplines for assessing trainees and practitioners. The possibilities and limitations of various approaches are reviewed, and the implications for behavioral health are addressed. A conceptual model of competence is presented, and practical applications of this model are reviewed. Finally, guidelines are proposed for building competency assessment protocols for behavioral health.

Behavioral Medicine↗

PubMed1988

Health and health behavior of persons with chronic cardiovascular disease.

Health conceptions, perceived health status and health behaviors were compared for 58 adults; 29 with cardiovascular disease and 29 who were healthy. Data were collected by interview. Results indicated similarities in health conceptions and behaviors for the two groups. The cardiovascular patients perceived themselves less healthy overall but when health status was subdivided into dimensions, they perceived themselves less healthy on the clinical dimension only. They were equally healthy on the functional, adaptive, and eudaimonistic (self-actualization) dimensions. These findings underscore the necessity of viewing health within a broader context when providing health care to individuals with chronic disease.

Adult↗

PubMed1990

[Changing health behavior].

This paper describes the process of changing health behavior or lifestyle experienced by individuals who already have succeeded in changing smoking habits, nutrition habits and/or exercise habits. Eighteen persons were interviewed about their experiences. The process starts with an awareness of a concrete threat to health or with a dissatisfaction with the self. Social support, physical and psychological feed-back are the most important helping factors and loneliness, bad models and conflict in given information are threatening factors. The conclusion is that health care professionals play an important part in the process of change if the life situation and the needs of the individual are understood and if right kind of help is offered.

Adult↗

PubMedDate not supplied

Behavioral outcome of preschoolers exposed prenatally to cocaine: role of maternal behavioral health.

OBJECTIVE: To examine the impact of prenatal cocaine exposure and maternal behavioral health (recent drug use and psychological functioning) on child behavior at age 5 years. METHOD: In this longitudinal investigation, maternal report of child behavior was assessed using the Achenbach Child Behavior Checklist (CBCL) in 140 cocaine-exposed and 181 noncocaine-exposed (61 alcohol, tobacco, and/or marijuana-exposed, and 120 nondrug-exposed) low-income, African American children. Structural equation modeling was used to estimate suspected causal relationships between indicators of maternal behavioral health at 5-year follow-up, according to self-report on a modified Addiction Severity Index (ASI) and CBCL scores. RESULTS: Prenatal cocaine exposure was not related to child behavior at age 5. Recent maternal drug use and psychological functioning had relationships with CBCL Internalizing and Externalizing scores. However, when considered within a combined model, only maternal psychological functioning remained significant. CONCLUSIONS: Findings highlight the importance of maternal functioning in the behavioral outcome of children exposed prenatally to cocaine.

Black or African American↗

PubMed2006

A longitudinal study of the relationship between health behavior risk factors and dependence in activities of daily living.

OBJECTIVES: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. METHODS: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non-Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. RESULTS: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. CONCLUSIONS: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.

Activities of Daily Living↗

PubMed1999

Social control in personal relationships: impact on health behaviors and psychological distress.

This study examines associations among social control, health behavior change, and psychological distress. Social control refers to interactions between social network members that entail regulation, influence, and constraint. Social control is predicted to have dual effects leading to better health practices while also arousing psychological distress. A random sample of 242 individuals answered questions about health practices, overall exposure to social control in their networks, and social control attempts made by a specific network member. Analyses yielded mixed support for the hypotheses, but analyses of responses to the social control attempts of a specific network member did reveal that social control predicted less health-compromising behavior and more health-enhancing behavior as well as more distress. The results suggest that social control warrants greater attention in efforts to understand how personal relationships influence health.

Adult↗

PubMed1992

Changes in personal health behaviors of medical students.

Physicians, including medical students, seem to lead healthier lives than the general public. Whether their favorable health behavior is learned through medical education is not known. This study uses a standardized health risk assessment to compare the personal health behaviors of a single class of medical students before and after completing their clinical rotations. Our findings confirm that medical students exhibit healthier lifestyle behaviors than that of the general population, and that changes in health behaviors may evolve with training.

Adult↗

PubMed1999

Tracking changes in behavioral health services: how have carve-outs changed care?

This special issue of the Journal of Behavioral Health Services & Research on mental health carve-outs brings together some of the latest research on recent policy and market changes affecting behavioral health services. This introductory article provides background information about carve-outs and the managed behavioral health care industry. This article also reviews prior research in the mental health carve-out field.

Behavior Therapy↗

PubMed2005

The lack of social gradient of health behaviors and psychosocial factors in Northern Italy.

OBJECTIVES: To examine inequalities in health behaviors and psychosocial factors in Northern Italy. METHODS: The study was based on a computer-assisted telephone interview (CATI) of 4 002 non-institutionalized adults living in the Veneto region of Italy. RESULTS: Cigarette smoking, binge drinking, fruit and vegetables consumption and stress failed to show a social gradient. Only physical activity was significantly associated with social class. Stress was a significant predictor of physical inactivity, smoking and low fruit and vegetable intake. Lack of emotional support was associated with smoking and physical inactivity among males, and low fruit and vegetable intake for both genders. CONCLUSIONS: Three proposed explanations may account for the lack of consistent social gradient of health behaviors in Northern Italy: a) socio-economic context; b) uncompleted epidemiological transition of behavioral risk factors across social classes; c) lack of systematic health promotion efforts. Future research is needed to examine the plausibility of such explanations.

Adolescent↗