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PubMed2006

Social influences, social context, and health behaviors among working-class, multi-ethnic adults.

Little research has explored the relationship between social influences (e.g., social networks, social support, social norms) and health as related to modifying factors that may contribute to health disparities. This is a cross-sectional analysis of fruit and vegetable intake and physical activity, using baseline data from two cancer prevention studies with working-class, multi-ethnic adults. Several social influence and social contextual variables were associated with fruit and vegetable intake and physical activity in both samples. Fruit and vegetable consumption was associated with social norms and social networks, although different contextual variables also were related to intake across the two samples. Physical activity was associated with social networks, social norms, and competing demands. By examining how key social influence and contextual mediating variables relate to health behaviors, we can learn more about the types of interventions that might be needed to promote sustained health behavior change in this population.

Adult↗

PubMed1991

Adolescent health behavior and conventionality-unconventionality: an extension of problem-behavior theory.

Examined the relation of psychosocial and behavioral conventionality-unconventionality to health-related behavior in cross-sectional data from 1,588 male and female 7th to 12th graders. Conventionality-unconventionality was represented by personality, perceived social environment, and behavior variables selected from the social-psychological framework of problem-behavior theory (R. Jessor & S. L. Jessor, 1977). Greater psychosocial conventionality correlates with more regular involvement in health-related behavior (regular physical activity, adequate sleep, safety belt use, attention to healthy diet). Greater behavioral conventionality (less involvement in problem behaviors such as marijuana use, problem drinking, delinquent-type behavior, and greater involvement in conventional behaviors such as church attendance) was also associated with greater involvement in health-maintaining behavior. The overall findings provide support for the extension of problem-behavior theory to the domain of adolescent health behavior and for the relevance of the dimension of conventionality-unconventionality.

Adolescent↗

PubMed2005

Associations of frequent sleep insufficiency with health-related quality of life and health behaviors.

BACKGROUND AND PURPOSE: Sleep-related problems, which affect 50-70 million Americans, involve all areas of life, including cognitive performance, emotional well-being, work and leisure-time activities, and general physical and mental well-being. We examined the association of insufficient sleep with health-related quality of life (HRQOL) and health behaviors. PATIENTS AND METHODS: Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing, state-based, random-digit telephone survey of the non-institutionalized US population aged >or =18 years. In 2002, HRQOL measures were administered in 18 states and the District of Columbia, yielding complete responses to questions regarding sleep and demographic characteristics from 98% of study participants (n=79,625). RESULTS: An estimated 26% of adults reported frequent (> or =14 days in the past 30 days) sleep insufficiency. They were significantly more likely than those without frequent sleep insufficiency to report fair/poor general health, frequent physical distress, frequent mental distress, activity limitations, depressive symptoms, anxiety, and pain. In addition, they were significantly more likely to smoke, to be physically inactive, to be obese, and, among men, to drink heavily. CONCLUSION: Insufficient sleep is associated with a variety of adverse health behaviors and impairment in all HRQOL domains investigated. Accordingly, assessment of sleep appears to be an important component of general medical care. Moreover, expanded assessment of sleep in the general population may provide a better understanding of prevalence of impaired sleep and its many implications.

Adult↗

PubMed1985

Value correlates of preventive health behavior.

In a postal survey, 113 respondents completed the Rokeach (1967) Terminal Value Survey with an additional value, "health," and 15 questions about their preventive health behavior (PHB). Correlation and regression analyses showed that health and other values were related to overall PHB, suggesting that health researchers should also consider the role of values other than health. In consistency with Rokeach's theory, respondents who reported good PHB valued health more than did those who reported poor PHB. There were also significant differences in the general value orientation of extraversion versus introversion. Health educators might apply knowledge of such differences to a value confrontation program. As hypothesized, regression analyses for each of the 15 PHB items showed that health value was more likely to be predictive of behavior that involved a direct rather than indirect risk to health. For behaviorally consistent respondents, health value was correlated with both types of behavior, whereas for behaviorally inconsistent respondents, health value was only correlated with direct-risk behavior. This suggests that health researchers should ensure that subjects are aware of the relevance of a PHB to health before concluding that health value, or a related construct, cannot be predictive of PHB. Finally, the regression analyses suggest that it was possible to predict specific PHBs from the more general value ranks. This finding raised questions about the validity of Ajzen and Fishbein's (1977) notion of levels of specificity and provided further support to Rokeach's value theory.

Adult↗

PubMed2003

The news on health behavior: coverage of diet, activity, and tobacco in local newspapers.

News media are an important and influential part of the social environment, calling attention to certain issues by the amount and nature of their coverage. To better understand how health behaviors are covered, we examined more than 80,000 stories in 1,354 newspaper issues from four midsize Missouri communities. Health behavior stories were rare. Of 1,373 stories (1.7%) that addressed diet, physical activity, or tobacco, few were prominently located in the paper, and only half had a primary prevention focus. A large majority had no local angle, local quotes, or call to action for individuals or the community, and only 10% were generated by local reporters. Because the local newspaper can be especially influential in smaller communities, strategies are needed to help reporters and editors in these settings provide more and better coverage of health behavior-related stories.

Chi-Square Distribution↗

PubMed1984

Doctor-patient interaction, patients' health behavior and effects of treatment.

Studies of doctor-patient communication and its consequences are usually limited to factors that may determine patients' compliance with doctors' instructions. But many patients besides or instead of following doctors' advice undertake additional activity in order to get well. The purpose of this study was to explore the whole range of patients' health behavior, its connection with the process of doctor-patient interaction (as an independent variable) and with the treatment results (as a dependent variable). The direct effect of doctor-patient relationship on the outcome of treatment was also examined. The subjects were 62 out-patients. Two visits of every patient to his physician were tape-recorded and analyzed. To obtain the data concerning patients' health behavior, interviews were performed twice in every case. Treatment results were evaluated by physicians. It was found that some characteristics of the doctor-patient interaction; doctors' directiveness, doctors' emotional attitude towards the patient, patients' activity, patients' partnership status had an effect on patients' health behavior (compliance with doctors' orders and patients' spontaneous health activity). Even stronger was the connection between these with the degree of patients' compliance with doctors' instructions but were positively connected with the amount of patients' spontaneous health activity. Authors analyzed these findings in the light of psychosomatic medicine.

Behavior↗

PubMed1995

Changes in psychological variables and health behaviors by dieting status over a three-year period in a cohort of adolescent females.

PURPOSE: Psychologic and behavioral changes associated with frequent dieting were examined. Compared to nondieters, frequent dieters were hypothesized to show more adverse psychologic changes and increased use of unhealthy weight control behaviors, but possibly healthier eating and exercise behavior changes, over the three-year period of observation. METHODS: A prospective study of female students, in grades 7-10 at baseline completed a health behavior survey in school once a year for a total of three years. RESULTS: Restrained eating, body dissatisfaction and drive for thinness, self-induced vomiting, laxative use, diet pill use, and alcohol use, significantly increased, and physical appearance and self-concept significantly decreased among frequent dieters, compared to non-dieters. Changes in scores on five EDI subscales, eight self-esteem subscales, weight fluctuations, dietary intake, and physical activity patterns did not significantly differ over time by dieting status. CONCLUSION: Dieting may reflect a general pattern of unhealthy behaviors adopted in adolescence, rather than act as a causal factor in promoting psychologic distress.

Adolescent↗

PubMed2003

Oral health and health behavior in patients referred for open-heart surgery.

OBJECTIVE: Little is known about the dental health and health behavior of patients referred for open-heart surgery because of severe heart disease. Yet, coronary atherosclerosis has been suggested to be an inflammatory disease in which chronic dental infections may trigger pathogenic mechanisms in the walls of arteries. In epidemiological studies periodontal disease in particular has been linked with coronary heart disease (CHD). STUDY DESIGN: We set out to investigate by means of clinical examination, x-ray, and questionnaire the oral health status, health-related behavior, and conceptions of 256 CHD patients referred for open-heart surgery in the Kuopio University Hospital. The patients' heart disease was New York Heart Association grades II-IV. For comparison, 250 age- and sex-matched non-CHD patients were also studied. Differences between groups were analyzed conventionally and with the Total Dental Index (TDI), which uses linear modeling and logistic regression analyses to summarize periodontal factors and other signs of oral infections. We expected to find neglected dental care and worse oral health situation among the CHD patients. RESULTS: Edentulousness was seen in 35% of the CHD group and in 15% of the non-CHD group (P < .001). The CHD group had significantly lower number of teeth (8.8 +/- 9.1) than the non-CHD group (17 +/- 10.5; P < .001). No dental appointment in the past 10 years was reported in 66% of the CHD patients and 35% of the non-CHD patients. Forty-nine percent of the CHD group and 69% of the non-CHD group had had a dental visit within the past 2 years (P < .001). Daily tooth brushing was reported by 46% of the CHD group and 56% of the non-CHD group (P < .05). Only 2% of the CHD group and 8% of the non-CHD group flossed daily (P < .001). TDI scores were significantly higher in the edentulous than in the dentate study groups (P < .001), but no difference was observed between CHD and non-CHD patients of the same dentate or edentulous status. Mean TDI score was 3.2 +/- 0.8 in edentulous CHD patients and 3.1 +/- 0.4 in edentulous non-CHD patients; the scores in the dentate patients were 2.5 +/- 0.9 in the CHD group and 2.4 +/- 2.0 in the non-CHD group. The TDI score appeared almost significant a predictor of CHD when used as a dependent variable in logistic regression analysis (P = .08). CONCLUSION: Worse oral health status and less satisfactory oral health behavior were observed in the CHD patients than among the cardiologically healthy.

Adult↗

PubMed2004

Innovation in behavioral health workforce education.

This article describes an effort to promote improvement in the quality and relevance of behavioral health workforce education by identifying and disseminating information on innovative training efforts. A national call for nominations was issued, seeking innovations in the education of behavioral health providers, consumers, and family members. A review committee evaluated each nomination on four dimensions: novelty, significance, transferability, and effectiveness. Nineteen innovations were selected for recognition, all of which are briefly described.

Adult↗

PubMed2001

Colorectal cancer-screening tests and associated health behaviors.

BACKGROUND: Studies have shown that screening reduces colorectal cancer mortality. We analyzed national survey data to determine rates of use of fecal occult blood testing (FOBT) and sigmoidoscopy, and to determine if these rates differ by demographic factors and other health behaviors. METHODS: A total of 52,754 respondents aged >or=50 years were questioned in the 1997 Behavioral Risk Factor Surveillance System (BRFSS) survey (a random-digit-dialing telephone survey of the non-institutionalized U.S. population) about their use of FOBT and sigmoidoscopy. RESULTS: The age-adjusted proportion of respondents who reported having had a colorectal cancer screening test during the recommended time interval (past year for FOBT and past 5 years for sigmoidoscopy) was 19.8% for FOBT, 30.5% for sigmoidoscopy, and 41.1% for either FOBT or sigmoidoscopy. Rates of use of colorectal cancer screening tests were higher for those who had other screening tests (mammography, Papanicolaou smear, and cholesterol check). There were also differences in rates of use of colorectal cancer screening tests according to other health behaviors (smoking, seat belt use, fruit and vegetable intake, and physical activity) and several demographic factors. However, none of the subgroups that we examined reported a rate of FOBT use above 29% within the past year or a rate of sigmoidoscopy use above 41% within the past 5 years. CONCLUSIONS: While rates of use of FOBT and sigmoidoscopy were higher among people who practiced other healthy behaviors, rates of use were still quite low in all subgroups. There is a need for increased awareness of the importance of colorectal cancer screening.

Aged↗

PubMed1997

Does geriatric evaluation and management improve the health behavior of older veterans in psychological distress?

A randomized, controlled trial compared prospective 16-month health service use among 160 frail, elderly veterans receiving outpatient geriatric evaluation and management (GEM) or usual primary care (UPC). In this secondary analysis, multivariable regression was used to determine if the psychosocial assessment and support provided by the GEM team moderated the use of medical services by patients in psychological distress. The results indicate that GEM reduced outpatient use among patients who scored higher on a measure of somatization (p less than or equal to .05), but GEM increased outpatient use among patients with higher manifest anxiety (p less than or equal to .05) Psychological distress was not a factor in the use of inpatient services. GEM had a modest beneficial effect on the health behavior of frail older persons manifesting some symptoms of psychological distress.

Aged↗

PubMed2001

Health behavior in a kibbutz population: correlations among different modalities of healthcare utilization.

BACKGROUND: Alternative medicine use is increasing worldwide and the associated expenditures are significant. In Israel 19% of patients who consulted their family physician had also sought treatment by an alternative medicine practitioner. OBJECTIVES: To explore the correlation between different modalities of healthcare utilization, health behavior, and health belief among adult members of a kibbutz (rural communal settlement). This unique study population enabled the use of a simplified quantitative model due to the minimal individual differences in cost and access. METHODS: Healthcare utilization data were obtained for 220 kibbutz members aged 15-70 years from patient medical files and self-administered questionnaires over a 45 month period. Patient visits to the family practitioner and other specialist physicians were tallied, and individuals reported alternative medicine consultations during the previous year. Multiple regression analysis was used to control for age, chronic disease, and other background characteristics. RESULTS: The mean number of patient FP visits was 3.6 per patient per year. Women and chronic disease sufferers visited the doctor more frequently. A patient's number of FP visits and other specialist physician visits were closely correlated, with each specialist physician consult resulting in an additional 0.64 FP visit for a given individual (P = 0.007). Our analysis indicated that self-reported alternative therapy utilization was positively associated with the number of FP visits; patients reporting alternative therapy use visited their primary care physician once additionally per year (P = 0.03). Low self-rated health status was correlated with increased likelihood of alternative therapy use (borderline significance). CONCLUSION: These results suggest that a patient who seeks treatment from one type of healthcare practitioner will seek out other practitioners as well. This study supports the notion that unconventional therapies are used in conjunction with, rather than instead of, mainstream medical care.

Adolescent↗

PubMed2003

Association of health behavior and social role with total mortality among Japanese elders in Okinawa, Japan.

BACKGROUND AND AIMS: Longitudinal studies on the relationship of life-style factors and social networking with mortality have been only slightly conducted in a comprehensive manner among the Japanese elderly. This study aims at examining associations of health behavior and social role with total mortality among Japanese elders in Okinawa. METHODS: All residents aged 65 years or older were recruited in 1987 from the village of Ohgimi, and 724 subjects were followed for 12 years. A comprehensive health assessment questionnaire was used, and the resulting data were analyzed by the Cox proportional hazards model. RESULTS: The number of deaths during the study period was 139 (55.4%) for men and 166 (35.1%) for women. The standardized mortality rates of malignancy, cerebrovascular disease, heart disease and pneumonia were higher for men. In the final model of multivariate analysis for women, less than 6 hours of sleep [Hazard ratio (HR)=2.62] and lower social role (HR=1.88) significantly increased the risk of mortality. As for men, neither health behavioral items nor social role showed a significant association with mortality. CONCLUSIONS: Our study results suggest that having sufficient hours of sleep and enhancing social role could greatly help elderly women in Okinawa to maintain good health. Moreover, our study provides direction for future research to explore the difference in adequate health promotion measures between women and men.

Aged↗

PubMed2005

[Self-efficacy and health behaviors associated with osteoporosis of middle-aged and elderly subjects: a community-based study].

OBJECTIVE: To understand the self-efficacy and health behaviors with respect to osteoporosis of middle-aged and elderly subjects living in the communities. METHOD: A questionnaire-based survey was conducted using the Osteoporosis Self-Efficacy Scale (designed by Horan M et al ) and osteoporosis health behaviors questionnaire designed by the authors among 290 middle-aged and elderly community dwellers. RESULTS: The mean score of the self-efficacy was 64.75+/-21.93 among the involved subjects without statistically significant difference in terms of gender and intensity of daily exercises. The score differed significantly, however, in terms of age, education background, occupation and calcium intake (P<0.01), and the older group had lower scores than the younger one. Subjects with higher education scored higher, and those with occupations of physical labor scored lower than those with intellectual work. Higher calcium intake also resulted in higher score. It was found in this survey that the preventive behaviors of osteoporosis was insufficient among the subjects, and only 36.1% of the subjects drank milk everyday with 29.2% often having bean products and 49.8% taking calcium supplements. A percentage of 58.1% of these subjects regularly took part in exercises more than 3 times a week for over 30 minutes each time, but they seldom took weight bearing exercise. CONCLUSION: Osteoporosis self-efficacy should enhanced to promote osteoporosis- preventing behaviors in osteoporosis education program for the middle-aged and elderly people in the communities.

Aged↗

PubMed2006

Patterns of health care utilization and health behaviors among street sex workers in Hong Kong.

OBJECTIVE: To describe the current use of health services by the street-based female sex workers (FSWs) and to explore beliefs behind these health behaviors. STUDY SETTING: Community outreach approach in a few red-light districts in Hong Kong. STUDY DESIGN: A 30 min face-to-face interview was carried out in 89 women by direct approach and snowballing, followed by a focus group discussion drawn from the participants of the questionnaire. RESULTS: While these FSWs' perception of personal health was good, a considerable proportion suffered from illnesses but the consultation rate was a third of the mean rate of the general population in Hong Kong. Many street workers experienced difficulty in utilizing health service in Hong Kong and even when they did, it was mainly for acute problems. Affordable access to health public services was excluded and many found private services unaffordable due to the high price charged by the practitioners. It was common for these women to self-medicate, delay in seeking medical help, or travel back to China for treatment. CONCLUSION: The current empirical understanding of the health and health service utilization by sex workers is unbalanced. In order to reduce sexually transmitted infections (STIs) and HIV among the street sex workers, it is essential to address the fundamental issue of health care access.

Adult↗

PubMedDate not supplied

Living kidney donors' long-term psychological status and health behavior after nephrectomy - a retrospective study.

BACKGROUND: The aim of the study was a comprehensive psychological evaluation of living kidney donors. Existing studies indicate a high donor satisfaction with the decision to donate and good donor quality of life in short-term, as well as in long-term follow-up periods. In many studies, questionnaires with only a few items have been used to assess psychological health or well-being; however, most studies exclusively measured quality of life. Therefore, our retrospective single center study applied a broad assessment of psychological variables. We evaluated whether standardized, differentiated and specific psychological research instruments confirmed the positive, long-term condition of kidney donors as reported in the scientific literature, albeit based on a limited set of variables. METHODS: From 1973 to 2001, 152 nephrectomies were performed in Frankfurt. In the context of a detailed medical follow-up examination, a psychological study was implemented using a semi-structured interview and a set of four standardized, well-established questionnaires. Overall, data from 145 donors was included in the medical follow-up and 112 donors participated in the psychological investigation. RESULTS: The mean age of donors was 55.9 (+/- 10.7) yrs at follow-up, and the time-since-donation was 11.2 (+/- 7.5) yrs. Donors scored better on a wide range of the psychological scales such as psychological symptoms, health behavior and health consciousness that was to be expected in comparison with data from representative German population samples. Nearly all donors (97%) would choose to donate again, and 91% remain entirely satisfied with their decision. CONCLUSION: The study demonstrates that existing results, reporting positive long-term psychological donor well-being, could be confirmed by a set of comprehensive, standardized and multi-methodological psychological instruments.

Adult↗

PubMed2005

Preventive services and health behaviors among people with spinal cord injury.

BACKGROUND/OBJECTIVE: To document receipt of certain understudied preventive services and health behaviors in spinal cord injury (SCI) and to compare them to the general adult population. METHODS: Cross-sectional survey. PARTICIPANTS: One hundred ninety-nine community-living adults with SCI residing in New Jersey. MAIN OUTCOME MEASURES: Receipt of recommended general preventive health services, such as screening for colorectal and prostate cancer and dental examinations, and health-related behaviors, including injury prevention, obesity, and tobacco use, as assessed by survey items in the Behavioral Risk Factors Surveillance System. RESULTS: Deficiencies in provision of needed preventive services were evident but were similar to those noted in the general adult population. Among participants 50 years of age or older, 47% had not had either a stool test for occult blood in the last year or a sigmoidoscopy/colonoscopy in the last 5 years. While 43.9% of participants were overweight or obese and 46.3% of these were trying to lose weight, only 1 3.8% had been counseled to lose weight. Twenty-two percent smoked on at least some days. Safety problems were evident: 15.5% did not use seatbelts consistently; 44% had not discussed a fire escape plan at home; and smoke detectors were often not checked adequately. Twelve and a half percent of participants reported having injuries during the last year, and fully 75% of these were related to SCI. Emergency room use and hospitalization were frequent. Participants had a median of 3 to 5 current doctors. CONCLUSIONS: Persons with SCI need the general screening and safety services recommended for all persons. Enhanced efforts will be needed to meet national goals in Healthy People 2010 in SCI.

Adult↗

PubMed2000

Associations between exercise and health behaviors in a community sample of working adults.

BACKGROUND: The present study examined the associations between leisure-time exercise and a range of health behaviors and reports of illness and injury in a sample of community working adults. METHODS: The study population included 4907 women and 4136 men who completed surveys in 24 worksites in the Minneapolis-St. Paul metropolitan area. RESULTS: Participants in the study were ranked by gender according to their exercise score and grouped into quartiles. Women and men in the highest activity quartiles were more highly educated and were younger. High-activity men were more likely to be unmarried. Higher levels of leisure-time exercise were positively associated with seat belt use and inversely related to smoking, dietary fat intake, reported stress, and obesity. In men only, leisure-time exercise was related to greater reports of injuries resulting in restriction of usual activities. In women only, leisure-time exercise was positively associated with daily alcohol use. Most of the significant associations were seen in the two highest quartiles of exercise. CONCLUSIONS: These findings suggest that associations between leisure-time exercise and health behaviors occur at the higher levels of exercise and interventions may need to promote this higher level of leisure-time exercise to impact overall public health.

Adult↗