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PubMed2005

Operational behavioral health and performance resources for international space station crews and families.

The Behavioral Health and Performance Section (BHP) at NASA Johnson Space Center provides direct and indirect psychological services to the International Space Station (ISS) astronauts and their families. Beginning with the NASA-Mir Program, services available to the crews and families have gradually expanded as experience is gained in long-duration flight. Enhancements to the overall BHP program have been shaped by crewmembers' personal preferences, family requests, specific events during the missions, programmatic requirements, and other lessons learned. The BHP program focuses its work on four areas: operational psychology, behavioral medicine, human-to-system interface, and sleep and circadian. Within these areas of focus are psychological and psychiatric screening for astronaut selection as well as many resources that are available to the crewmembers, families, and other groups such as crew surgeon and various levels of management within NASA. Services include: preflight, in flight, and postflight preparation; training and support; resources from a Family Support Office; in-flight monitoring; clinical care for astronauts and their families; and expertise in the workload and work/rest scheduling of crews on the ISS. Each of the four operational areas is summarized, as are future directions for the BHP program.

Adaptation, Psychological↗
PubMed2006

Ten-year changes in cancer-related health behaviors and screening practices among Latino women and men in California.

OBJECTIVE: This study examines changes in cancer-related health behaviors and risk factors (overweight/obesity, unhealthy diet, high alcohol use, and smoking), and screening practices related to cervical, breast, and colorectal cancer among Latinos of predominantly Mexican origin in Monterey County, California. DESIGN: Data is from two cross-sectional surveys, conducted in 1990 and 2000, that included 919 women and 774 men from a community sample, and 276 men from an agricultural labor camp sample (ages 18-64). RESULTS: Over the 10-year period, the prevalence of obesity increased by 48% among community women, 47% among community men, and 91% among labor camp men. Although consumption of fruits and vegetables remained low and consumption of fried foods remained high, other diet-related behaviors showed significant improvements (e.g. milk consumption shifted from whole-fat to lower-fat among women from the community and men from the labor camps, use of lard or meat fat when cooking decreased among women and men from the community). In addition, alcohol intake decreased among men from both samples, as did smoking among labor camp men. There were large improvements for annual pap and mammography screening (increases from 53 to 71% for pap testing, and from 15 to 53% for mammography screening) but annual blood stool testing remained infrequent and unchanged. CONCLUSION: These findings highlight the need for interventions and policies that improve knowledge, preventive care, and social environments to sustain improvements and address areas of special need in cancer prevention for Latinos, especially related to obesity and colorectal screening.

Adolescent↗
PubMed1979

Participation of senior citizens in the swine flu inoculation program: an analysis of Health Belief Model variables in preventive health behavior.

Evidence is presented of statistically significant and strong relationships between Swine Flu Inoculation status and nine variables in the reformulated Health Belief Model with 122 randomly selected subjects, primarily Black and Portuguese-American, who are active members of two Providence, Rhode Island senior centers. No statistically significant relationship was discovered between inoculation status and previously having had the flu. The variables which were found related are: Efficacy, Safety, Knowledge of Side Effects, Prior Flu Shot Status, Proportion of Friends and Relatives Who Got the Shot, Sex, Race, Future Plans for Flu Shots, and Future Plans for Other Inoculations. The data were obtained through personal interviews in the Spring of 1977. It is suggested that the results provide some basis for optimism for successful intervention designed to change the future preventive health behaviors of nonparticipants in the Swine Flu Inoculation Program. Many nonparticipants had fears and doubts about the effectiveness and safety of the shot and are amendable to suggestions from physicians about future inoculation participation. Full information should be provided to high-risk groups such as senior citizens about the relative risks of suffering serious side effects, the effectiveness and safety of the procedure for persons their age with the typical health problems of senior citizens, and the relative risks and dangers to them of contracting the illness against which the shot is designed to protect them.

Aged↗
PubMed2000

Health behavior changes after a cancer diagnosis: what do we know and where do we go from here?

Survival rates for certain types of cancer have improved over the past few decades. Changing unhealthy behaviors such as smoking, poor diet, and sedentary life-style among individuals who have been diagnosed with cancer may help to reduce cancer treatment sequelae, possibly reduce risk of recurrence for specific types of cancer, and reduce risk for other common diseases such as cardiovascular disease, obesity, and hypertension. This article reports the prevalence of each of these behaviors among those diagnosed with cancer and reviews interventions that have targeted these risk behaviors. There is considerable variation in the type of research questions asked, the methodologic quality of the research, sample sizes, and the outcomes observed across studies focusing on changing the three health risk behaviors. In the final section, we provide guidelines for researchers in developing health behavior interventions for individuals diagnosed with cancer and highlight challenges that should be addressed.

Clinical Trials as Topic↗
PubMed1998

Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults.

CONTEXT: A prominent hypothesis regarding social inequalities in mortality is that the elevated risk among the socioeconomically disadvantaged is largely due to the higher prevalence of health risk behaviors among those with lower levels of education and income. OBJECTIVE: To investigate the degree to which 4 behavioral risk factors (cigarette smoking, alcohol drinking, sedentary lifestyle, and relative body weight) explain the observed association between socioeconomic characteristics and all-cause mortality. DESIGN: Longitudinal survey study investigating the impact of education, income, and health behaviors on the risk of dying within the next 7.5 years. PARTICIPANTS: A nationally representative sample of 3617 adult women and men participating in the Americans' Changing Lives survey. MAIN OUTCOME MEASURE: All-cause mortality verified through the National Death Index and death certificate reviews. RESULTS: Educational differences in mortality were explained in full by the strong association between education and income. Controlling for age, sex, race, urbanicity, and education, the hazard rate ratio of mortality was 3.22 (95% confidence interval [CI], 2.01-5.16) for those in the lowest-income group and 2.34 (95% CI, 1.49-3.67) for those in the middle-income group. When health risk behaviors were considered, the risk of dying was still significantly elevated for the lowest-income group (hazard rate ratio, 2.77; 95% CI, 1.74-4.42) and the middle-income group (hazard rate ratio, 2.14; 95% CI, 1.38-3.25). CONCLUSION: Although reducing the prevalence of health risk behaviors in low-income populations is an important public health goal, socioeconomic differences in mortality are due to a wider array of factors and, therefore, would persist even with improved health behaviors among the disadvantaged.

Adult↗
PubMed2001

ADHD treatment in a behavioral health care carve-out: medications, providers, and service utilization.

Children's mental health services are increasingly being managed by managed behavioral health organizations (MBHOs) through carve-outs. Little information is available, however, about services and interventions being received by children whose mental health benefits are carved out. Using claims data, this study explores the treatment of children with a common child psychiatric disorder, attention deficit hyperactivity disorder (ADHD). Children being treated for ADHD see a variety of provider combinations. Children diagnosed with comorbid mood or anxiety disorders are more likely to see a psychiatrist than a primary care physician or therapist, and they are more likely to be in treatment with both a psychiatrist and a therapist than with just one mental health professional. After controlling for severity indicators, costs were significantly lower for patients being treated by just a psychiatrist than for patients seeing both a psychiatrist and therapist. This finding raises the possibility that attempts to save money by "splitting treatment" may not be cost-effective.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

Akrasia, health behavior, relapse, and reversal theory.

Philosophical explanations of the phenomenon of akrasia have been used in this article to characterize some of the difficulties involved in successful behavior change. The theory of psychological reversals provides a framework for understanding various types of akratic behavior. In addition, empirical research on the temptations of persons trying to quit smoking has supported hypotheses generated by the theory. The theory suggests that resisting the temptation to engage in akratic behavior is a complex phenomenon. Different strategies are needed in different types of metamotivational states. Reversal theory provides a coherent system for understanding and predicting akratic behavior. It suggests possible interventions that would improve the probability of circumventing akrasia and that would improve behavior change efforts of nurses engaged in health-promotion and disease-prevention activities.

Adaptation, Psychological↗
PubMed2006

Adolescent girls' and boys' weight-related health behaviors and cognitions: associations with reputation- and preference-based peer status.

In this study, the authors examined associations between preference- and reputation-based peer status and weight-related behaviors and cognitions for both adolescent boys and girls. Sociometric measures of peer like-ability and peer-perceived popularity, as well as self-reported measures of body size, dieting behavior, and weight-related cognitions were collected from a sample of 441 adolescents in Grades 11 and 12. Results revealed weight-related cognitions for girls (concerning obesity) and boys (concerning musculature/fitness). Peer-perceived popularity, but not like-ability, was significantly associated with both boys' and girls' body size and dieting. Lower levels of popularity were associated with heavier body shapes for girls and with both thin and heavier body shapes for boys. Findings suggest that peer status is an important source of social reinforcement associated with weight-related behaviors and cognitions.

Adolescent↗
PubMedDate not supplied

Behavioral health benefits in employer-sponsored health plans, 1997.

Data for 1997 show that three-quarters or more of employer-sponsored health plans continue to place greater restrictions on behavioral health coverage than on general medical coverage. The nature of these restrictions varies by plan type. Some improvement in the treatment of mental health/substance abuse (MH/SA) benefits in employer plans may be occurring, however. Comparisons with data from 1996 show that the proportion of plans with benefits for "alternative" types of MH/SA services, such as nonhospital residential care, has increased. Further, the proportion with special limitations on these benefits shows a modest decrease.

Data Collection↗
PubMed1993

Health behavior changes through television: the roles of de facto and motivated selection processes.

We assess the role played by two types of self-selection in accounting for the influence of a television series on smoking cessation. De facto selection is based on respondents' regular channel viewing habits that can expose them to the series. Motivated self-selection takes place when viewers deliberately select to watch television programming because it meets their desire to quit smoking. Self-selection also can be viewed as a methodological artifact, spuriously accounting for the association between the airing of the series and smoking cessation among the target audience. Subjects were a probability sample of Chicago smokers who regularly watch the evening news on one of the network channels. The intervention was a televised self-help smoking cessation program broadcast on one of the network channels over 20 days. Using nested covariance structure models for the analysis, we conclude that 1) de facto selection had no influence on exposure to the program; 2) motivated selection had no influence on exposure to the program; 3) the program reduced smoking; and 4) this effect cannot be attributed solely to the methodological artifact of self-selection, although motivation to quit smoking did have the strongest influence on attempts to quit.

Adolescent↗
PubMed2016

Implications of Personal Genomic Testing for Health Behaviors: The Case of Smoking.

INTRODUCTION: Direct-to-consumer personal genomic testing has the potential to influence health behaviors, including smoking. Critics of this testing highlight limited evidence to support positive behavioral benefits and caution that genomic results may provide false reassurance, leading to unhealthy behaviors. This study investigates interest in genetic risks of smoking-related diseases and changes in smoking behaviors among genomic testing consumers. METHODS: From 2012 to 2013, a longitudinal series of web surveys was conducted. A total of 1464 customers of 23andMe and Pathway Genomics completed a survey prior to viewing genomic test results, of which 1002 participants provided data on smoking behaviors 6 months after receiving results. RESULTS: At baseline, 64% of participants were never smokers, 29% were former smokers, and 7% were current smokers. Most baseline current smokers were very interested in genetic risk results for lung cancer (65%) and heart disease (72%). For lung cancer, this interest was significantly greater than former (50% very interested) and never smokers (37% very interested) (p < .0001). Even though participants were interested in smoking-related disease genetic risks, 96% reported the same smoking status at baseline and 6-month follow-up. Importantly, only 1% (n = 13/916) of former and never smokers became current smokers at 6 months and 22% (n = 14/64) of current smokers reported quitting. CONCLUSIONS: Overall, smokers show a high level of interest in genetic risks of smoking-related illnesses. The experience of receiving direct-to-consumer genomic health risks does not appear to have obvious harms related to smoking behaviors, with some potential benefits. IMPLICATIONS: In the setting of ongoing controversy surrounding direct-to-consumer genomic testing, this study provides evidence that consumers are interested in genetic risk results of smoking-related diseases. Receiving genomic testing results does not lead to smoking initiation among never smokers or reinitiation among former smokers and may be associated with a higher quit rate among current smokers at 6-month follow-up than the general population. These findings ease concerns that direct-to-consumer genomic testing could lead to false reassurance and unhealthy behaviors related to smoking.

Adolescent↗
PubMed2001

Gender-specific health behaviors of German university students predict the interest in campus health promotion.

This cross-sectional study aimed to provide an assessment of the needs for health promotion in university freshmen, based on lifestyle variables and the interest in health-promoting activities. A questionnaire survey was performed using a sample of 288 male and 362 female university freshmen from 19 to 33 years of age. Male students were significantly more likely to engage in drug-taking behaviors, referring to alcohol and cannabis use, and had a higher body mass index. No gender difference was noted in the numbers of regular smokers. Preventive behaviors with respect to healthy nutrition and dental hygiene were reported more often in females, whereas the duration of physical activity per week and the use of condoms with a new sexual partner showed no gender difference. There was a strong demand for group health-oriented programs (79.5% of respondents). Substantial proportions of students had a high interest in individual counseling aiming at stress management (24.5%), healthy nutrition (19.3%) and prevention of sexually transmitted diseases (18.2%). Women expressed a greater interest in most programs than men. Multivariate regression analyses showed that a disposition for alcohol abuse was the strongest predictor of interest in health counseling in male students (p < 0.001), while psychosocial stress was the most important predictor in female students (p < 0.001). From the prevalence of health risks and the students' interest in health promotion programs it was concluded that there is a strong need for health promotion in the university setting in Germany. Results suggested that individuals at risk would probably benefit most from an individual counseling program.

Adult↗
PubMed1993

Process variables as predictors of risk factor changes in a family health behavior change program.

The purpose of the present study was to determine the extent to which intervention process measures are useful in predicting changes in cardiovascular disease (CVD) risk factors among subjects exposed to interventions. Subjects were 99 adult and 105 children who participated in an 18 session, family-based diet and exercise change program. During the intervention, each participant self-monitored diet and exercise for 12 weeks. Additionally, attendance, session evaluation, confidence to achieve goals and goal achievement data were collected each week. The intervention was successful in changing diet, blood pressure and cholesterol levels, but did not produce significant changes in exercise or body mass index. Stepwise multiple regression analyses were conducted for each outcome variable at the 1 and 2 year follow-ups. Ethnicity and sex were first forced into each regression. None of the process measures consistently predicted multiple outcomes in adults and children. The pattern of results provides limited support for the hypothesis that intervention process variables such as attendance, adherence to self-monitoring, achievement of goals and attitude toward sessions partially mediate intervention effects. It is concluded that process measures should be collected in health behavior change programs so that process-outcome relationships can be further explored.

Adolescent↗