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Results for “Health Behavior”

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PubMed2001

Prediction of health behaviors in pediatric cancer survivors.

BACKGROUND: It is important to understand the factors that motivate survivors of childhood cancer to engage in healthy behaviors. This is because of their susceptibility to adverse late effects from their malignancy and its treatment. We specifically examined sociodemographic and health perception variables as predictors of health-protective behaviors in pediatric cancer survivors. PROCEDURE: Forty-six patients, ages 10--18 years, who were previously treated for cancer and were 1--4 years off-therapy, were assessed using a battery of testing instruments. RESULTS: Preadolescent and adolescent cancer survivors reported moderately frequent practice of a variety of health-protective behaviors. The prevalence of risky health behaviors, as indicated by alcohol and tobacco use, was low. Regression analyses indicated that the practice of health-protective behaviors was best predicted by patient's age and socioeconomic status (SES); younger adolescents and patients from higher SES more frequently engaged in healthy behaviors. Health perception variables were not significantly related to health-protective behaviors. This was true despite findings that survivors perceived themselves to be vulnerable to health problems, identified a need to protect their health, and perceived their health outcomes to be largely determined by their own behaviors. CONCLUSIONS: Sociodemographic factors should be kept in mind when designing interventions to promote continuing good health for young cancer survivors. Also to be included is the assessment of specific health risks secondary to the cancer therapies given. Risk counseling that recognizes and builds on these variables will be most effective in helping this patient population observe sound health habits.

Adolescent↗

PubMed2004

Budapest Student Health Behavior Survey--Budapest, Hungary, 1999. Findings on unintentional and intentional injuries, alcohol use, and sexual activity.

OBJECTIVE: In Hungary, a large proportion of adult morbidity and mortality can be attributed to health risk behaviors that begin in early adolescence. To date, studies examining health risk behaviors among youth have rarely been undertaken in Hungary. In order to expand current research in this area, the Hungarian Metropolitan Institute of State Public Health and Public Health Officer Service and the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention developed and implemented the Budapest Student Health Behavior Survey. The objective of this study was to examine health behavior risk factors among secondary school students in Budapest in 1999. METHODS: The 1999 Budapest Student Health Behavior Survey is cross-sectional school-based survey A 2-stage cluster sampling design was used to produce a representative sample of secondary students in grades 9-12 in Budapest. Information was collected on unintentional and intentional injuries, alcohol use, and sexual activity. FINDINGS: During the 30 days preceding the survey, 28.7% of students had rarely or never worn a seatbelt and 68.1% drunk alcohol. During the 12 months preceding the survey, 14.5% had been threatened or injured with a weapon, 12.9% experienced dating violence, and 13.5% seriously considered suicide. Of the 44.7% of students who had had sexual intercourse, 29.5% had > or = 4 sex partners. Of sexually active students, 50.4% had not used a condom at last sexual intercourse. CONCLUSION: Many secondary school students in Budapest practice behaviors that place them at risk for serious health problems both in the short and long-term. Programs and policies that adequately address such behaviors among secondary school students are needed to reduce subsequent morbidity and mortality.

Adolescent↗

PubMed1989

Millon Behavioral Health Inventory norms for chronic pain patients.

The Millon Behavioral Health Inventory (MBHI) is being used more widely in pain treatment settings; however, normative data on a large sample of chronic pain patients have not been published. In the present study, norms were established for 247 chronic pain patients. The chronic pain patient norms then were compared statistically to norms for non-medical population. Overall, the results showed that the score distributions for chronic pain patients and normals were similar on most MBHI scales. The differences that were found are consistent with other research on pain patients and indicate that chronic pain patients are more likely to be depressed and anxious. Differences in scales between chronic pain patients and controls may be explained by state vs. trait factors. In evaluating chronic pain patients by personality tests, one needs to keep in mind state-trait problems and their potential influence on test results.

Adaptation, Psychological↗

PubMedDate not supplied

The impact of evidence-based guideline dissemination for the assessment and treatment of major depression in a managed behavioral health care organization.

This study tests whether a managed behavioral health care organization can influence adherence to practice guidelines for the treatment of major depression in a randomized trial of guideline dissemination. Guidelines were disseminated to mental health clinicians (N = 443) under one of three conditions: (1) a general mailing of guidelines to clinicians, (2) a mailing in which guidelines were targeted to a patient starting treatment with the clinician, and (3) no mailing of guidelines. The results showed no effects of guideline dissemination as measured by self-report of patients and clinicians and through episode characteristics derived from claims data, despite sentinel effects. Results also showed high rates of clinician-reported guideline adherence that were not detected in the claims data, indicating significant undertreatment of depression. Results suggest that mental health systems must look to other dissemination strategies to improve adherence to standards of care and raise the performance of independent practicing clinicians.

Benchmarking↗

PubMed2002

[The Child and Adolescent Health Survey: collection of health behavior data from parents and children].

The first German Health Survey for Children and Adolescents will start in 2003. During three years, a representative sample of children and adolescents between 0 and 18 years of age shall be examined and will, together with their parents, be interviewed on health-relevant issues. With this survey, health information on about 18,000 children will be gathered. The health behaviour of the parents as far as their children's health is concerned, as well as the personal health behaviour during adolescence will be assessed, since this will be highly relevant for future health. Questions on nutrition behaviour, eating disorders, alcohol consumption, smoking as well as leisure-time behaviour, with special emphasis on physical activity, will be asked. These questions were tested for feasibility in a one-year pilot study. With this survey, the occurrence of certain unhealthy behaviour characteristics may be documented and risk groups may be identified. This may help to conceptualize prevention measures.

Adolescent↗

PubMed2007

Cost shifting under managed behavioral health care.

OBJECTIVE: The study examined whether a managed behavioral health care organization (MBHO) shifted treatment costs. METHODS: Four years of claims data (1991-1995) from an insurer that introduced an MBHO in 1992 to control treatment costs were analyzed. Although the MBHO was not at direct financial risk for specialty mental health treatment, it faced incentives related to reputation and contract renewal to shift costs to primary care treatment or prescription drugs. It was hypothesized that if cost shifting occurred, an increase would be noted in the use of psychotropic medications without concurrent use of specialty mental health treatment. Simple t tests and a generalized estimating equations probit specification were used to test this hypothesis. Separate tests were performed for use of any psychotropic medication, any newer antidepressant, and any stimulant in a large employer group that simultaneously implemented parity coverage (75,360 enrollees) and a group of smaller employers that did not (9,228 enrollees). RESULTS: The use of any psychotropic medication rose 64% in relative terms (p<.001) over the four-year period among enrollees of the large employer group and by 87% in the smaller groups (p<.001). In general, there were downward secular trends in the use of psychotropic medications without specialty care. Introduction of the MBHO was not significantly associated with the use of psychotropic medication alone. For newer antidepressants, introduction of the MBHO was associated in the large group with a 2.4 (p=.003) absolute percentage point decrease in medication use alone. CONCLUSIONS: No evidence was found to suggest that the MBHO shifted treatment costs.

Adult↗

PubMed2000

The impact of prior authorization on outpatient utilization in managed behavioral health plans.

This study examines how preauthorization affects outpatient behavioral health utilization under managed care by comparing plans with similar benefits, but differing in the number of visits authorized. The authors compare plans primarily authorizing in increments of 5 visits to plans authorizing in increments of 10 visits. They analyze the likelihood of terminating outpatient service between the two groups using conditional logistic regression. Results suggest that patients whose treatment is authorized in increments of 5 sessions are nearly 3 times more likely to terminate treatment at exactly the fifth visit than if their treatment is authorized in increments of 10 sessions conditional on being in treatment until the 5th visit. The likelihood of termination peaks in both the 5- and 10-session authorization at the 10th visit, but the difference is not statistically significant. The authorization effect differs by provider type and is weaker among psychiatrists than among nonphysician providers.

Adult↗

PubMed1995

Health behaviors of military retirees: incidence of smoking and alcohol use.

Previous investigations of the health behaviors of active duty military members and their dependent spouses generally have found a higher rate of smoking and greater alcohol use in this group compared to their civilian counterparts. However, it is not known whether military retirees and their dependents also report higher smoking and alcohol use compared to the general senior population. Therefore, this study examined cigarette and alcohol use in a group of military retirees (n = 1,359) and dependents (n = 983). Contrary to studies surveying active duty members and their spouses, the present study found that smoking rates and alcohol use among military retirees and dependents were similar to those reported in surveys of the general senior population. In addition, the fact that the majority of retirees (68%) classified themselves as ex-smokers suggests that these individuals may adopt more healthy lifestyles over time. Factors associated with smoking and alcohol use are also presented, along with suggestions for future research.

Age Factors↗

PubMed1982

Self-administered programs for health behavior change: smoking cessation and weight reduction by mail.

Forty smokers and 47 overweight individuals were recruited for a home correspondence program for either smoking cessation or weight loss. Participants were assigned to one of four programs for changing their respective health behaviors: (1) a home correspondence program conducted entirely by mail, (2) the mail program with supplemental financial contigency contracts tied to completion of written homework, (3) the correspondence programs supplemented both by homework contracts and by regular calls to a telephone answering system, and (4) a standard behavioral group program which acted as a comparison condition. Results showed that all three correspondence approaches produced significant changes in health behaviors equal to the changes experienced by participants in the standard group program. The implication of these findings for development of low cost programs for disease prevention are discussed.

Adult↗

PubMed1991

Behavioral, health and psychosocial factors and risk for HIV infection among sexually active homosexual men: the Multicenter AIDS Cohort Study.

We examined whether 644 homosexual men who engaged in receptive anal intercourse were at particularly elevated risk for seroconversion if they also possessed specific behavioral, health or psychosocial vulnerability characteristics. Of 11 potential factors examined, heavy drinking, moderate to heavy drug use, and younger age were significantly related to seroconversion. These variables were also associated with an increased number of sexual partners, anonymous sex, and failure to use condoms.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Association of insulin-like growth factor-I with body composition, weight history, and past health behaviors in the very old: the Framingham Heart Study.

OBJECTIVES: We examined correlates of insulin-like growth factor-I (IGF-I), an indicator of growth hormone levels, to identify factors associated with higher levels of IGF-I in old age. DESIGN: Nested study of cross-sectional correlates and early-life predictors of IGF-I level. SETTING: A longitudinal cohort study, the Framingham Heart Study. PARTICIPANTS: A total of 790 men and women (mean age 78.5, range 72-94), who had weight, waist and hip circumferences measured at the time of IGF-I measurement. MEASUREMENTS: Association of IGF-I with weight, fat distribution, functional status, nutritional indicators, and past health behaviors was assessed. We also examined IGF-I in relation to body composition derived from dual energy X-ray absorptiometry. RESULTS: IGF-I levels declined with age in both men and women. However, low IGF-I did not show expected associations with low lean mass and increased body fat. Current functional status and grip strength were not associated with IGF-I Low IGF-I was associated with weight loss in men; the strongest associations were with indicators of poorer nutritional status in both men and women. Levels of IGF-I in old age did not vary by past health behaviors. CONCLUSION: Although IGF-I declined with age, these data from the Framingham Heart Study did not show expected cross-sectional associations of weight, body fat, and lean mass. The strongest associations were between IGF-I and nutritional indicators. These results suggest caution may be warranted with regard to use of IGF-I as an indicator of growth hormone.

Aged↗

PubMed1998

Lifestyle, gender and occupational status as determinants of dental health behavior.

The aim was to compare how general lifestyle, gender and occupational status determine dental health behavior. All the 1012 55-year-old citizens of Oulu (a medium-sized Finnish town) were invited to participate in this study. 780 of them did so. Information about frequency of toothbrushing, use of extra cleaning methods, use of sugar in coffee or tea, and time of the last dental visit, lifestyle, occupational status and gender was gathered from the 533 dentate subjects. Lifestyle was measured by means of questions about physical activity, tobacco smoking, alcohol consumption and dietary habits. Females and people with a healthy lifestyle brushed their teeth more often. Extra cleaning methods were used more often by people with a healthy lifestyle, whereas gender and occupational status had a weaker association. Males and people with a lower occupational status used sugar in coffee or tea more often. The time from the last dental visit was longer among workers and men; lifestyle had no significant association. At the population level oral cleaning habits are a matter of a health-oriented lifestyle and gender-related behavior. The dental visiting habit has a weaker association with general lifestyle.

Alcohol Drinking↗

PubMed2005

Overview of publicly funded managed behavioral health care.

Using MEDLINE and other Internet sources, the authors perform a systematic review of published literature. A total of 109 articles and reports are identified and reviewed that address the development, implementation, outcomes, and trends related to Managed behavioral health care (MBHC). MBHC remains a work in progress. States have implemented their MBHC programs in a number of ways, making interstate comparisons challenging. While managed behavioral health care can lower costs and increase access, ongoing concerns about MBHC include potential incentives to under-treat those with more severe conditions due to the nature of risk-based contracting, the tendency to focus on acute care, difficulties assuring quality and outcomes consistently across regions, and a potential cost-shift to other public agencies or systems. Success factors for MBHC programs appear to include stakeholder involvement in program and policy development, effective contract development and management, and rate adequacy.

Cost Savings↗

PubMed1988

Anxiety and aspects of health behavior among adolescents in Northern Ireland.

A sample of 238 15- to 16-year-old secondary school students from Northern Ireland answered a questionnaire in their schools about the level of anxiety and some aspects of their health behavior. Analysis of the findings showed that these teenagers had no higher anxiety than a Northern American sample of teenagers. In addition, anxiety was clearly correlated with a variety of health complaints and with use of the health service. The findings are discussed with reference to previous research on adolescent health and on stress in Northern Ireland.

Adolescent↗

PubMed1993

[Life conditions and health behavior of socially disadvantaged women: implications of an action-theoretic model of social structure for health research].

To operationalize social status epidemiology of social inequalities in health uses uncompounded indices, as school and job education, income and occupational status. Social epidemiology describes social inequalities from a more comprehensive perspective, including indicators of social status as well as subjective attitudes and behavior. Examples of a study on smoking in women indicate a broader framework of the relation between social indicators and healthy lifestyles. Action oriented theory of social inequalities substantiate restrictions of this epidemiological approach. Social analysis should focus on lifestyles and behavioral resources to reach overall life targets. An example of a qualitative study on health behavior in women prove the impact of this sociological theory for public health research. Health behavior of women from the lower SES is developed and improved in life history. It can be described as the capability to reach life targets regarding to health and social conditions.

Adult↗

PubMed1995

Oral health behavior, knowledge, and attitudes of children, mothers, and schoolteachers in Romania in 1993.

In Romania an increasing level of dental caries in children has been observed. The present study was undertaken to describe the oral health behavior of schoolchildren in the first grade, to assess the level of oral health knowledge and attitudes among the mothers, and to describe oral knowledge and attitudes to prevention among the schoolteachers. A total of 322 mothers of grade-1 children (response, 89%) and 97 schoolteachers (response, 86%) participated in the study. Data on mothers and children were collected through personal interviews, whereas the teachers responded to self-administered questionnaires. A significant proportion of the mothers knew about the causal factors in dental caries; however, relatively few were aware of the harmful effect of hidden sugar. Most of the mothers were aware of the importance of toothbrushing, but 33% also recommended the use of salt for prevention of periodontal disease. Of the children, 37% brushed their teeth at least twice a day; 26% had their teeth cleaned by their mothers every day. Sugar was mostly consumed in terms of milk with sugar, sugary breakfast cereals, biscuits, and sweets. The schoolteachers knew about the poor dental conditions in children and wanted to become involved in oral health education. Training of teachers should aim at improving their level of knowledge on oral health. The establishment of school-based oral health promotion programs in Romania is urgently needed.

Adult↗

PubMedDate not supplied

Knowledge, attitudes, treatment practices, and health behaviors of nurses regarding blood cholesterol.

BACKGROUND: This study, from a sample of west Texas RNs (n = 42), replicated a survey of New York City RNs' (n = 206) knowledge, attitudes, treatment practices, and health behaviors concerning cholesterol and cardiovascular disease. METHOD: A random sample of 42 RNs completed a 48-item questionnaire developed by the National Heart, Lung, and Blood Institute. Responses were analyzed by descriptive statistics. Differences between the present and previous study samples were analyzed by chi square. RESULTS: Nurses expressed enthusiasm for counseling clients regarding cholesterol management; yet, only approximately one eighth of respondents in either study agreed strongly they were prepared to counsel clients. Chi-square analyses showed no significant differences in most responses between the two samples. CONCLUSION: These findings suggest nurses could benefit from continuing education offerings targeted to client cholesterol management.

Adult↗

PubMed1997

Women's HIV risk reduction efforts and traditional models of health behavior: a review and critique.

This article reviews the empirical literature on women and HIV prevention and evaluates the predictive utility of prevailing models of health behavior change. The review focuses on three constructs that are central to the health belief model, protection motivation theory, and the theories of reasoned action and planned behavior: perceived vulnerability to HIV risk, outcome expectancies related to HIV preventive behaviors, and self-efficacy to reduce risk. The critical review pays particular attention to methodological and conceptual problems that may arise in applications of these models to the specific circumstances of HIV and AIDS and the specific experiences of women. Last, the ways in which these models should be adapted and expanded to adequately explain extra-individual influences on women's preventive behavior are discussed.

Female↗