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PubMed2002

Dimensions of adolescent health behavior.

PURPOSE: To determine dimensions of healthy and unhealthy behaviors of young people aged 12 to 21 years to better inform measures of adolescent health behavior and assist in targeting appropriate strategies to promote health. METHODS: The study sample (N = 8730), derived from a U.S. national probability sample; 52.3% were female, 67% white, 15% African-American, 18% Hispanic, 22.2% aged 12-13 years, 38.4% aged 14-17 years, and 39.4% aged 18-21 years. Principal components analysis was done to examine the covariance structure of 42 healthy and unhealthy behaviors selected from the behavioral questions of the Youth Risk Behavior Survey (YRBS). RESULTS: A four-factor oblique rotation, comprised of 18 variables with factor loadings of.50 or greater, resulted in interpretable and meaningful health behavior factors. Sexual activity, substance use (e.g., alcohol, marijuana, and other drugs), smoking, and exercise factors accounted for 74% of the variance in the composite of healthy and unhealthy behaviors. These four factors were subsequently reproduced on random samples as well as on samples defined by age (12-13 years [excluding sexual activity variables], 14-17 years, 18-21 years), gender, and race (white, African-American, Hispanic). CONCLUSIONS: These results provide new information about the consistent structure of sexual activities and exercise behaviors across subgroups defined by age, gender, and racial/ethnic origins, and about differences in clusters of substance use behaviors across ethnic groups. Further study of diverse population-based samples and multiple health-promoting and health-negating behaviors should profile developmental variations and health protective factors in adolescents.

Adolescent↗

PubMed2002

Managed behavioral health care in the public sector: will it become the third shame of the States?

Managed behavioral health care is increasingly being used in public mental health systems. While supporters cite potential benefits, critics describe dire consequences for individuals with serious, long-term mental illness. The situation has parallels with the major changes resulting from deinstitutionalization some four decades ago. Believing that analyzing history may prevent repeating some of its mistakes, the authors compare the antecedents, benefits, and negative effects of deinstitutionalization with those of the public-sector managed behavioral health care systems being developed today. Lessons learned from the earlier era include the need for careful general and technical planning; for assignment of responsibility, including monitoring, to the public sector; and for a focus on clients and the special needs generated by severe mental illnesses.

Consumer Behavior↗

PubMed1999

The potential variances of tailoring in health behavior interventions.

The success of tailored print communications depends upon having a sufficiently diverse inventory of both content messages and delivery formats to respond to important differences among individuals. This article discusses means by which this diversity--the variances of tailoring--may be developed. One of the foundations of tailoring is the definition of a "focal point" for intervention. A focal point is characterized by a simultaneous combination of variables which specify a population group of interest, a target health behavior, and a setting in which the behavior occurs. All persons defined by the focal point may receive some intervention in common (i.e. targeted intervention). Tailored content responds to individuals within the focal point, based upon the antecedents of behavior within that focal point. This article elaborates on the focal point concept and then discusses factors that contribute to variations of tailoring. The psychosocial resources required by health behaviors are also reviewed, because tailoring must prepare the individual to make changes specific to the nature of a particular health behavior. This article does not specify what the variations of tailoring should be; the potential diversity of tailored messages is too great. Instead, the article presents basic elements that will go into the development of tailored interventions.

Health Education↗

PubMed1989

Depressive symptoms during pregnancy: relationship to poor health behaviors.

Although depression is well studied in women, little information is available regarding depression during pregnancy. The purpose of this study was to determine the correlates of depressive symptoms as measured by the Center for Epidemiological Studies-Depression Scale during pregnancy. Between 1984 and 1987, 1014 women, primarily poor and of minority status, who attended the prenatal clinic at Boston City Hospital were interviewed and were asked to furnish urine samples that were then assayed for marijuana and cocaine metabolites. Scores on the Center for Epidemiological Studies-Depression Scale ranged from 0 to 57, with a median score of 16. Depressive symptoms during pregnancy were associated with increased life stress (p less than 0.001), decreased social support (p less than 0.001), poor weight gain (p less than 0.01), and the use of cigarettes (p less than 0.001), alcohol (p less than 0.001), and cocaine (p less than 0.05). These findings are important because these health behaviors have been demonstrated to have an an adverse effect on infant outcome. Interventions to change health behaviors during pregnancy should consider a woman's affective state, social context, and mental health.

Cannabinoids↗

PubMedDate not supplied

Role of gender, insurance status and culture in attitudes and health behavior in a US Chinese student population.

INTRODUCTION: Asians are an understudied population in health research. Often their lower utilization of health care services and low participation in clinical trials has been attributed to socioeconomic factors and cultural beliefs. However, the role of gender and perceptions of health beliefs across generations in determining access have not been studied in this population. OBJECTIVE: This study seeks to examine the relationship of gender to the health beliefs and health utilization patterns of a group of undergraduate Chinese students in regard to their own use and what they perceived as their parents' use. DESIGN: Seventy-eight Chinese students responded to a health belief and utilization survey. They were asked to provide information on their perceptions and attitudes of health as well as what they perceived to be their parents' health attitudes and behavior. RESULTS: Findings indicated that female students were more proactive in their health beliefs towards preventive care and getting regular check-ups than male students. This difference between genders remained true in the students' perceptions of their mothers being more likely to seek preventive care and to get regular check-ups than their fathers. Cultural factors including privacy and modesty were important factors in determining use of health care by Chinese women. Insurance status played an important role in determining health behavior among Chinese men. Uninsured fathers were perceived as more likely to use complementary and alternative therapies (CAM) than mothers. Male students and fathers who had private insurance were perceived to access and utilize health services equally as the women. Gender differences are seemingly less apparent among parents who are using CAM. Language difficulty was identified most frequently as the major barrier to accessing care among this population. CONCLUSIONS: Considerations of socioeconomic factors, cultural and language barriers need to be made with particular focus on gender differences in attitudes and health behavior when making policy decisions for the Asian American population. Further studies are also needed on intergenerational attitudes and health behavior of older Asian Americans.

Adolescent↗

PubMed1995

Reading grade levels and health behaviors of parents at child clinics.

OBJECTIVES: Recent reports suggest alarmingly low levels of literacy among adults in the U.S., but these are not expressed in grade levels. Assessment of the epidemiology of reading grade levels is necessary for development of patient education materials written at appropriate levels. METHODS: We measured demographics, reading ability and self-described health behaviors of 646 parents at two private, two university, two indigent and six public child-related clinics in a midwestern city using a bilingual oral interview and the Wide Range Achievement Test. RESULTS: Parents were 59% white, 92% female, with mean age 28 years, mean years of school 12.1 and mean reading grade 8.7. Parents tended to read four to five grades below their highest completed school grade. Analysis of self-reported health behaviors showed that 69% had no private insurance, 31% smoked cigarettes, 35% had body mass index greater than 27, and 46% of parous mothers had never breast-fed. Prevalence odds ratios showed that all adverse health risks except obesity were associated with low reading ability. CONCLUSIONS: These findings have important implications for public health professionals working in clinical care, health education and agency policy. Persons with low literacy levels appear to be at particularly high risk for adverse health behaviors. Education materials and teaching vocabulary should be appropriate for client reading grade levels.

Adolescent↗

PubMed1997

Changes in health status and health behavior among Finnish adults 1978-1993.

The patterning of trends in self-assessed health, and in the "Holy Four" of health-related behaviors, that is, smoking, drinking, the use of high-fat milk and butter, and physical exercise, was examined in the Finnish general population aged 25-64 years. There were considerable differences in the health status and health behavior by study year, gender, and educational attainment. The longer the education, the better the health and the more favorable the health behavior, except for the use of alcohol. From the late 1970s to the early 1990s smoking increased slightly among women but decreased among men. The use of alcohol increased, whereas the use of butter and high-fat milk decreased dramatically. Physical exercise during leisure time increased, especially among women. Unemployed men and women were more often smokers than employed persons.

Adolescent↗

PubMed2000

Patients' and providers' perceptions of outpatient treatment termination in a managed behavioral health organization.

OBJECTIVE: A common complaint about managed care is that treatment decisions of patients and providers are frequently altered by concurrent review of ongoing outpatient treatment. The objective of this study was to examine this perception from the perspectives of patients and providers. METHODS: A total of 190 patients and their providers were surveyed about the reason that outpatient treatment was terminated. The sample was randomly drawn from completed outpatient treatment episodes of a large national managed behavioral health organization. RESULTS: In more than three-quarters of the cases, outpatient treatment ended because patients and providers agreed that treatment goals were partially or completely met. Only 5 percent of patients and 3 percent of providers said that treatment ended because the managed care organization denied ongoing treatment. Agreement between patient-provider pairs was generally poor regarding the perceived reason for termination, except when termination was attributed to concurrent review by the managed behavioral health organization. CONCLUSIONS: In this study of a single large managed behavioral health organization, outpatient treatment was most likely to end based on the decisions of patients and providers rather than utilization review decisions.

Adult↗

PubMed2004

Soil-transmitted helminthiases and health behaviors among schoolchildren and community members in a west-central border area of Thailand.

The prevalence of soil-transmitted helminthic infections and health behaviors related to infections in schoolchildren and villagers of a community (4 hamlets) was studied in Hauy Kayeng subdistrict, Thong Pha Phum district, in the north of Kanchanaburi Province. The intestinal helminth infection rate of the schoolchildren was 15.6%. Hookworm infection was the most prominent (9.8%), followed by Trichuris trichiura (6.2%), and Ascaris lumbricoides (2.2%). The community showed higher prevalence rates and was infected with more types of intestinal helminths than the schoolchildren. Thirty-five point two percent (35.2%) of the residents were infected with soil-transmitted helminths, 30.5% with hookworm, 3.4% with A. lumbricoides and 2.2% with T. trichiura. Almost all hookworm cases (94.3%) were light intensity infections, while only 1.3% were heavy infections. Moreover, the hookworm infection rate in the community was found to be much higher when a stool culture method was used (39.1%). With this technique, 2.3% Strongyloides stercoralis infections were detected in the community population. Examination of the health behavior of the study samples showed that approximately 75% always defecated in a toilet. Schoolchildren who always wore shoes comprised 67%, which was lower than the community, at 85%.

Adolescent↗

PubMedDate not supplied

The relationship between prayer, health behaviors, and protective resources in school-age children.

The purpose of this study was to examine (1) the relationship between children's use of prayer as a coping strategy and other protective resources, and (2) whether children who prayed frequently and those who never prayed exhibited different levels of perceived stress and health behaviors. Prayer was found to be positively related to the protective resources of social connectedness and sense of humor. In addition, children who prayed frequently reported significantly higher levels of positive health behaviors than children who never prayed. These two groups of children did not significantly differ in their levels of perceived stress.

Adaptation, Psychological↗

PubMedDate not supplied

Parents' health, health care utilization, and health behaviors following the violent deaths of their 12- to 28-year-old children: a prospective longitudinal analysis.

Health status, health care utilization, and health behaviors of parents bereaved by the violent deaths of their adolescent and young adult children were examined 4, 12, and 24 months later. Participants were 261 bereaved parents (171 mothers, 90 fathers). About 20% of the parents reported "poor" physical health during the early bereavement period compared with 16% of Americans the same age. Over time, mothers' health improved whereas fathers' health deteriorated. Fathers in poor health compared with fathers in good health are 15 times more likely to report emotional distress and 4.6 times more likely to report trauma symptoms. Mothers in poor health compared with mothers in good health are 11 times more likely to report emotional distress and 3 times more likely to report trauma symptoms. Mothers' reports of physician visits and medication use were higher than fathers', however, mothers' rates for both decreased significantly over time whereas fathers' rates remained constant. Over 70% of the mothers and nearly 60% of the fathers practiced 2 or more health protective behaviors over time--a finding significantly associated with fewer stress-related illnesses, days absent from work, and non-productivity at work. Implications for the findings are discussed.

Adolescent↗

PubMed1994

Attachment style and affect regulation: relationships with health behavior and family experiences of illness in a student sample.

Questionnaire measures of attachment style and health behavior were completed by 287 university students on 2 occasions, 10 weeks apart. At Time 1, Ss also provided reports of emotionality and early family experiences of illness. Reports of early family illness showed theoretically meaningful relationships with attachment style. Symptom reporting was predicted most strongly by anxious/ambivalent attachment and negative emotionality, with the link between anxious/ambivalent attachment and symptom reporting partially mediated by negative emotionality. Visits to health professionals at Time 2 were directly related to reports of chronic illness in the family but inversely related to paternal illness and avoidant attachment, controlling for symptom reporting. The results are discussed in terms of theories of attachment and affect regulation.

Adolescent↗

PubMed1987

Women's roles, interest in health and health behavior.

The purpose of this study is to assess the extent to which women's roles are associated with health interest and health concerns. In addition, the degree to which interest and concern with health are related to health behaviors is examined. The study population includes 1155 women between the ages of 18 and 64 from a random sample of members of a large health maintenance organization. The subjects were part of a large household interview survey. Medical record data covering seven years of outpatient services are linked with the survey data. The findings indicate that those roles which typically include responsibilities for caring for and protecting the health of family members are associated with a greater interest in health. For example, women who have the responsibility for younger and more dependent children have a greater interest in health than those women with older or no children in the household. Both health interest and health concerns are weakly related in the expected direction to both self-defined and medically-defined health behaviors.

Adolescent↗

PubMed2005

[Helping patients with risky health behaviors: some suggestions for motivational interviewing].

Helping patients modify risky health behaviors, including cigarette smoking, at-risk alcohol use, sedentary lifestyle and unhealthy diet, is a common and sometimes frustrating task. Motivational interviewing was developed from the notion that simple advice usually does not lead to behavioral change and may be even misperceived by patients. Based on active listening and an empathic attitude, some principles of motivational interviewing may be easily adapted to a primary care consultation. These principles facilitate positive, relaxed and constructive atmosphere for behavior change discussions and have been associated with promising results. This article presents key concepts of motivational interviewing such as ambivalence, resistance and stages of change, illustrated with practical examples.

Health Behavior↗

PubMed2005

Urban and rural differences in the prevalence of gender and age specific obesity and related health behaviors in Korea.

The objective of this study was to discuss the residential difference in gender and age specific prevalence of obesity by body mass index (BMI) and obesity related health behaviors in the Republic of Korea. A total of nationally representative 2,583 men and 3,087 women (age: 20-64 yr) was used as subjects from 1998 National Health and Nutrition Survey. All statistics were calculated using SUDAAN to consider a stratified multistage probability sampling design. The prevalence of obesity (BMI> or =25) was significantly different by age, gender and residential areas. Although younger men aged 20-49 yr did not show a residential difference in the prevalence of obesity, men aged 50-64 yr showed differences, highest in big cities and lowest in rural areas. However, in women, a higher prevalence was observed in rural areas compared to urban areas in the younger age group (20-49 yr), but not in the older age group. Residential differences of obesity related health behaviors existed mostly in the older population, but not in the younger population. The urban-rural differences demonstrate the various stages of behavioral transition that Korea is currently undergoing. Therefore, different strategies considering those factors are needed to manage obesity problems in Korea.

Adult↗

PubMed2004

Depressive symptoms and adolescent eating and health behaviors: a multifaceted view in a population-based sample.

BACKGROUND: Previous research has shown significant associations between depression and substance use and eating disordered behaviors. However, no research to date has described associations between depressive symptoms and nutritional intake or physical activity among adolescents in a nonclinical, population-based sample. METHODS: Classroom surveys were completed by 4,734 ethnically diverse, middle- and high school students. Based on their depressive symptom scores, males and females were categorized with low-, moderate-, or high-depressive symptom status. Linear models were used to examine eating and health behavior variables by depressive symptom groups. RESULTS: Depressive symptoms were positively associated with health-compromising attitudes such as perceived barriers to healthy eating and weight concerns, and health-compromising behaviors such as unhealthy weight-control behaviors and substance use, including caffeine. Depressive symptoms were negatively associated with health-promoting behaviors such as eating breakfast, lunch, and dinner. However, most associations between depressive symptoms and dietary micronutrients were not statistically significant. Health-promoting moderate-to-vigorous physical activity was negatively associated with depressive symptoms among males. CONCLUSIONS: Adolescents who report depressive symptoms are at risk for other health-compromising attitudes and behaviors and are also less likely to engage in health-promoting behaviors. Depressive symptoms may be an underlying trait in the expression of health behaviors among adolescents.

Adolescent↗

PubMed1998

Preventive oral health behaviors among African-Americans and whites in Detroit.

OBJECTIVE: This study compared the preventive oral health behaviors of African-Americans and whites. METHODS: Face-to-face interviews were conducted with a probability sample of 384 African-American and 358 white adults living in the greater Detroit area. Questions focused on brushing, flossing, and dental visits. RESULTS: More than 95 percent of both groups reported brushing daily; however, whites were more likely to brush all teeth, including parts that do not show. Frequency of flossing did not differ between groups. African-Americans, however, were less likely to floss all of their teeth. Whites were more likely than African-Americans to get dental check-ups at least once a year and much less likely to indicate they had never had a dental check-up. African-Americans tended to have less education and lower family income than whites and were more likely than whites to have Medicaid. Race differences in brushing thoroughness and annual check-ups were greatly reduced when income, education, and insurance were controlled statistically. CONCLUSIONS: African-Americans are less likely than whites to brush thoroughly, floss thoroughly, and get dental check-ups. These differences are partly traceable to differences in socioeconomic status and access to professional oral health care.

Adolescent↗

PubMed2006

The impact of two-dimensional versus three-dimensional ultrasound exposure on maternal-fetal attachment and maternal health behavior in pregnancy.

OBJECTIVE: To explore the impact of timing and type of ultrasound, particularly three-dimensional (3D), exposure on maternal-fetal attachment and maternal health behavior during pregnancy. METHODS: Subjects were 68 women aged 18 years or older expecting their first child who presented for a routine ultrasound scan at around either 12 or 18 weeks' gestation in Nepean Hospital, Western Sydney. Women completed questionnaires assessing maternal-fetal attachment and health behavior, and were then allocated arbitrarily to either two-dimensional (2D) or 3D ultrasound examination. Repeat questionnaires were completed 1 week later. RESULTS: Maternal-fetal attachment increased after both 2D and 3D ultrasound exposure, and the effect was moderated by the timing of exposure, with women receiving their first ultrasound examination at around 12 weeks showing the greatest change. Alcohol consumption was the only behavior to show significant change following ultrasound exposure, with a reduction in the reported average number of drinks per week. There was no significant difference in the pattern of change for 2D compared with 3D ultrasound exposure, and no effect of ultrasound exposure on maternal perception of the fetus. CONCLUSIONS: Ultrasound has a positive impact on maternal-fetal attachment, particularly in the first trimester. 3D ultrasound did not offer enhanced benefits. Associations between ultrasound exposure and alcohol consumption warrant further investigation. Larger samples are needed to clarify the moderating effects of gestational age and type of ultrasound exposure.

Adolescent↗