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At least 829 records · Page 46Linked to original sources
PubMed1984

Empirical test of the interaction model of client health behavior.

The general concepts, variables, and relationships described by the Interaction Model of Client Health Behavior (IMCHB) were used to guide a secondary data analysis of 203 women's decisions to request an amniocentesis. Step-wise multiple regression explained 58% of the variance in these decisions by jointly examining the factors which define the client as unique in her responses to an at-risk pregnancy, as well as factors describing the client-provider interaction. The women could be correctly classified as users or nonusers of prenatal diagnosis with 87% accuracy in a discriminant analysis based on the variables derived from the conceptual model. Finally, structural equation modeling was used to estimate the causal paths described by the general model. While the relationships proposed in the model need further empirical evaluation, this first application serves to demonstrate the testability of the IMCHB and its potential to direct nursing inquiries.

Adult↗
PubMed1993

Comparison of selected health behavior variables in elderly women with osteoarthritis in different environments.

Hardiness, social support, perceived health, functional independence, and use of health care facilities were compared in this descriptive study of 45 elderly women with osteoarthritis living in three different environments--urban, rural, and frontier. All participants were between the ages of 65 and 75 years and were residing in their own homes. Statistical differences were found between groups in overall perceived health and functional independence; the frontier sample perceived their health as better and themselves as more functionally independent than the urban or the rural sample. No statistical differences were found in levels of hardiness or perceived social support between the three groups. Use of health care facilities varied among participant groups by environmental context; the urban group made more use of facilities than the rural or frontier group, and the rural group used more facilities than the frontier group.

Activities of Daily Living↗
PubMedDate not supplied

The Nebraska Medicaid managed behavioral health care initiative: impacts on utilization, expenditures, and quality of care for mental health.

This study evaluates the impact of Nebraska's Medicaid managed care program for behavioral health services on mental health service utilization, expenditures, and quality of care. Implementation of the program is correlated with progressive reductions in both total (about 13% over 3 years) and per eligible per month (20%) expenditures and a rapid, extensive decline in inpatient utilization and admissions. The percentage of enrollees receiving any type of treatment for a mental disorder actually increased modestly. Most important, several indicators of quality of care (e.g., timely receipt of ambulatory care following discharge from inpatient care and readmission to inpatient care shortly following discharge) suggest that quality of care did not materially change under the carve-out. Although a thorough assessment of quality of care impacts is warranted, this study suggests implementation of a managed care program may allow states to reduce Medicaid expenditures without compromising quality of care.

Data Collection↗
PubMed2005

Managed behavioral health care: lessons from Massachusetts.

Since implementing the first statewide carve-out for behavioral health care in 1992, Massachusetts has achieved sustained reductions in cost, increases in access, and improvements in major quality measures. This introduction to a special issue describes the context, linkages with primary care, consumer satisfaction, unmet need, performance incentives (a key component of the success), stakeholder perspectives, and impacts on special populations.

Managed Care Programs↗
PubMedDate not supplied

[Health behaviors in Portugal. Epidemiological studies].

It is necessary to evaluate habitudes and behaviours in health in Portugal. The purpose of this review is to analyse some portuguese epidemiological studies. CINDI-Portugal, ERICA-Portugal and the National Health Inquiry were national studies regarding multiple health data. Nutritional attitudes and practices have been evaluated since 1940. The National Food Study and the Study of Prevalence of Obesity in Portugal studied Portuguese nutritional attitudes. There are studies of the prevalence of eating disorders i school populations. Some research about the association between food and disease is reported. The Portuguese Food Balance is reviewed. Some methodological problems are pointed out and the results discussed. The results of Portuguese studies suggest that our country is in danger of errors in the course of consumption attitudes.

Adult↗
PubMed1998

[Effects of a health-education approach on health behavior, consultation satisfaction and psychological well being].

78 patients were recruited from a local occupational health clinic service and from general practices. They were allocated randomly to either an intervention group (40 patients) for a patient-centred approach to health care, or to a control group (38 patients) for conventional care. The patients were free to express their attitudes to health-related behaviour and to suggest behaviour changes. Emphasis was placed on the doctor being an active listener, with an understanding and sympathetic approach to the patient. 27 of the 40 patients in the intervention group suggested initiating change. After six weeks 24 patients reported having accomplished changes. There was a more significant reduction in the use of tobacco in the intervention group (p = 0.05) than in the control group. The patients' evaluation of the two approaches was the same, except for four patients in the intervention group, who felt provoked. Psychological well-being was measured using the Goldberg General Health Questionnaire, 28 item version (GHQ-28). In the control group there was a significant improvement in the GHQ-28 score (p = 0.022) after six weeks; the intervention group showed a near-significant improvement (p = 0.068) after 12 weeks. There was no significant difference in the change in GHQ-28 score between the groups. A patient-centred approach to health care may have potential for changing attitudes to health-related behaviour and bringing about actual behaviour changes. Further research with more extensive material is needed to confirm both this, and the effects on psychological well-being.

Attitude to Health↗
PubMed1996

Usefulness of multiple equations for predicting preventive oral health behaviors.

Canonical correlation analyses of a previous dental survey suggested that dental checkups, flossing, and tooth brushing could all be predicted from a single equation. Most theories and research about the influence of beliefs on behavior, however, suggest different behaviors will be best predicted by different behavior-specific measures. The current survey investigated influences on brushing, flossing, and dental checkups in a probability sample of adults in the Detroit tri-county area. Both behavior-specific variables, such as perceived benefits and costs of flossing, and general variables, such as gender, were included as predictors. Canonical correlation analysis indicated three equations were needed to predict the three oral health behaviors. Flossing frequency, for example, was best predicted by confidence in flossing ability and beliefs about the benefits of and barriers to flossing. The results suggest that even these closely related behaviors are best predicted using separate equations that include mostly behavior-specific predictors.

Adolescent↗
PubMed2004

Enhancing adolescent health behaviors through strengthening non-resident father-son relationships: a model for intervention with African-American families.

This paper provides a description of and rationale for components of a theoretically based conceptual model that guided the development and implementation of the Fathers and Sons Intervention Program. Using a community-based participatory research process, this intervention was designed to prevent risky health behaviors through strengthening father-son relationships among non-resident African-American fathers and their pre-adolescent sons. The implications of the conceptual model for future interventions with African-American fathers and sons are discussed.

Adolescent↗
PubMed2006

Influence of personality and health behaviors on fatigue in late and very late life.

There is limited understanding about variables associated with fatigue in late and very late life. The purpose of this study was to explore the longitudinal influences of personality and health behaviors on changes in fatigue. One hundred and seventy-eight participants of the Georgia Centenarian Study were part of this study. Multiple regression analyses were computed to assess the influence of personality, physical activity, stress management, and nutritional risk on fatigue after initial fatigue, self-reported health, and psychosocial variables were controlled for. Anxiety, physical activity, and nutritional risk had significant longitudinal effects on fatigue. Older adults who were anxious, less engaged in physical activity, and who had higher levels of nutritional risk were more likely to show increased fatigue levels. The results suggest that more clinical and research attention should be paid to changes of fatigue in older populations.

Activities of Daily Living↗
PubMed2006

Running out of time: physician management of behavioral health concerns in rural pediatric primary care.

OBJECTIVE: The purpose of this work was to examine pediatricians' responses to behavioral health concerns raised in the context of rural primary care visits with particular focus on time spent. METHODS: Research assistants directly observed 302 patient visits in 2 rural pediatric primary care offices. The length of the visit, concerns raised, and physicians' responses were recorded. Interrater reliability, scored for 25% of observed visits, was strong. RESULTS: Behavioral, emotional, or developmental concerns were raised by either the parent or physician in 23.6% of all primary care visits observed. Approximately 9% of all visits were identified as a psychological consultation before the visit and lasted approximately 7 minutes longer than visits for other reasons. Behavioral concerns were raised during approximately 18% of visits not originally identified as a psychological consultation. In these cases, visit length increased by >5 minutes on average, a statistically significant difference. In addition, during these visits, discussion of behavioral concerns often consumed more than half of the visit. Data suggested that physicians were responsive to behavioral, developmental, or emotional concerns, engaging in further assessment, supportive statements, treatment, or referral in approximately 97% of the visits when such concerns were raised. CONCLUSIONS: Findings converge with previous research, showing that approximately one quarter of all primary care visits involve a discussion of behavioral, developmental, or emotional concerns. Moreover, this study is the first to document the specific impact of such concerns on pediatricians' time, often sited as a key reason why they struggle to effectively identify and treat behavioral concerns presenting in primary care. These data provide a starting point for controlled studies, including comparisons of rural versus urban samples and the impact of various collaborative models of care.

Adult↗
PubMed2006

Value for the future and breast cancer-preventive health behavior.

BACKGROUND: Time preference, or the extent to which people discount future benefits in favor of immediate benefits, might represent an important determinant of preventive health behavior, but the little research thus far on this association has yielded mixed results. This study examined the association between future time preference and use of genetic counseling for BRCA1/2 testing and how this association may differ from the relationship between future time preference and mammography screening and self-breast examination. EXPERIMENTAL DESIGN: A health system-based case-control study with a nested cross-sectional survey. Eight hundred women who saw a primary care physician in the University of Pennsylvania Health System in the 3 years before the study, of whom 234 had undergone BRCA1/2 counseling (cases) and of whom 566 had not (controls). RESULTS: Placing a relatively greater value on future benefits than present benefits was strongly associated with use of BRCA1/2 counseling [odds ratio (OR), 3.0 for one-point increase in future time preference; 95% confidence intervals (CI), 1.9-4.9]. Future time preference was weakly associated with adherence to annual mammography (OR, 1.3; 95% CI, 0.81-2.2), and was not associated with monthly self-breast examination (OR, 1.03; 95% CI, 0.75-1.4). A stronger future orientation was seen in women who had higher levels of education (P = 0.0021) or income (P = 0.0011). CONCLUSION: Time preference is strongly associated with use of BRCA1/2 counseling. Time preference is more weakly associated with mammography adherence and is not associated with breast self-examination. This variation may reflect the degree to which the behavior is seen as related to future risk.

Adolescent↗
PubMedDate not supplied

Smoking, diet, and health behaviors among lead-exposed blue-collar workers.

The objectives of the study were to compare dietary intake by smoking levels in blue-collar Israeli workers occupationally exposed to lead and thus identify additional areas for health-enhancing intervention in addition to smoking cessation. One hundred and eighty-seven male industrial employees who were exposed to lead through their work were screened at the worksite to evaluate health status and dietary intake. Smokers had higher intakes of fat, cholesterol, calcium, riboflavin, and vitamin E per day. They were consuming more meat and high-fat dairy products. Dose-response relationships were shown for fat and energy intake by smoking level. Thus, smoking is associated with other adverse health behaviors. When conducting epidemiologic or occupational studies, analyses should include adjustment for the fact that the lifestyles of smokers may also be unhealthy in other ways.

Adult↗
PubMed2004

Primary sources of health information: comparisons in the domain of health attitudes, health cognitions, and health behaviors.

The recent growth in consumer autonomy in health care accompanied by the surge in the use of new media for health information gathering has led to an increasing scholarly interest in understanding the consumer health information search construct. This article explores consumer health information seeking in the realm of the primary sources of health information used by consumers. Based on an analysis of the 1999 HealthStyles data, the paper demonstrates that active communication channels such as interpersonal communication, print readership, and Internet communication serve as primary health information sources for health-conscious, health-information oriented individuals with strong health beliefs, and commitment to healthy activities. On the other hand, passive consumption channels such as television and radio serve as primary health information resources for individuals who are not health-oriented. Media planning implications are drawn from the results, suggesting that broadcast outlets with an entertainment orientation are better suited for prevention campaigns. Such channels provide suitable sites for entertainment-education. On the other hand, print media, interpersonal networks, and the Internet are better suited for communicating about health issues to the health-active consumer segment.

Adult↗
PubMedDate not supplied

[Oral health behavior in students in north Lebanon].

We conducted a study of the state of oral health among 600 twelve-year-old schoolchildren in North Lebanon. We assessed the range of behaviours linked to dental health: dental hygiene, eating habits, use of fluoride and use of dental health services. Half of the students brushed their teeth at least once a day. For 74% of the children, it was mainly their mothers who taught them how to brush their teeth. Toothbrushes and toothpaste were used by 75% of the children. About 82% had heard of fluoride but only 58% understood its usefulness. Four out of five children drank sugared drinks on a daily basis and 83% said that they had never been to the dentist. The information can serve as a basis for the development and implementation of health promotion and education programmes for oral health within schools.

Child↗
PubMedDate not supplied

Health behavior surveys for youth.

In recent years, many health-related risk behavior surveys have been developed for youth. Three of these inventories - the Wellness Check Teen Health Risk Appraisal, the Adolescent Health Survey, and the Youth Risk Behavior Survey - are used widely, and pediatric nurses need to be familiar with them to enhance health promotion activities.

Adolescent↗
PubMed2006

School connectedness in the health behavior in school-aged children study: the role of student, school, and school neighborhood characteristics.

School connectedness includes liking school and positive relations with teachers and peers. School connectedness is associated with a variety of positive health outcomes. The goal of this study was to identify characteristics of students, schools, and school neighborhoods that are related to school connectedness. In the Health Behavior in School-Aged Children (HBSC) Study, school connectedness was reported by 13,207 students (grades 6-10) in 340 schools. HBSC measured a variety of student characteristics. Characteristics of schools were culled from data maintained by Quality Education Data, and school neighborhood characteristics were derived from the 2000 decennial census. Associations between connectedness and student, school, and school neighborhood characteristics were estimated using hierarchical linear models. Characteristics of students, schools, and school neighborhoods were associated with school connectedness. Connectedness was greater among younger students, females, students with better academic performance and greater extracurricular involvement, students with greater self-rated physical attractiveness, students with more friends, students from 2-parent families, and students whose parents were more involved with school. Connectedness was greater in smaller schools, more racially homogeneous schools, and schools with more students from relatively wealthy households. School connectedness was higher in neighborhoods with a greater percentage of non-US citizens. As the percent of renters in the neighborhood increased beyond 20%, school connectedness tended to decrease. The findings point to possible strategies for fostering school connectedness.

Adolescent↗