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At least 847 records · Page 47Linked to original sources
PubMed1992

Contract management behavioral health programs: are hospitals satisfied with their performance?

Many hospitals have opted to develop and operate inpatient behavioral health programs utilizing contract management providers. This article identifies key performance characteristics for such programs and summarizes the degree of performance satisfaction reported by 48 hospitals. Performance characteristics include bed occupancy, net income, contract management fees, marketing support, staffing ratios, and staff turnover. The survey data also compares bottom-line performance characteristics for groups of contract management programs rated most and least satisfactory in overall performance. The survey findings are used to develop contract negotiation strategy designed to shift greater accountability for program performance to contract management providers in order for hospitals to achieve maximum return from these programs.

Bed Occupancy↗
PubMed1986

[Determinants of preventive health behavior of the Swiss population. Results of the SOMIPOPS study].

In the context of the first Swiss National Health Survey preventive health behaviour was tested in 3419 Swiss citizens aged over 20 years. A health behaviour index including favourable health attitudes and good utilization of preventive health services was correlated with different social indicators. Age, sex and a good self-rated health were the most important factors associated with a high preventive health behaviour score. Education showed a less strong but also significant influence on positive health behaviour. Overall utilization of health services decreased with high preventive health behavior index.

Adult↗
PubMedDate not supplied

Uncertainty, posttraumatic stress, and health behavior in young adult childhood cancer survivors.

BACKGROUND: Young adult survivors of childhood cancer are at risk for medical late effects, some of which can be managed through health promotion behaviors. However, chronic uncertainty about the future can lead to the development of posttraumatic stress symptoms (PTSS) that can interfere with health promotion behaviors. OBJECTIVES: To test a mediating model for the relationships among uncertainty, PTSS, and health promotion behaviors in young adult survivors of childhood cancer. METHODS: The design was cross-sectional correlational. A convenience sample was used, and the data were collected using a mailed survey. Study measures included the Mishel Uncertainty in Illness Scale-Community Form, the Posttraumatic Stress Disorder Index, and the Health Promoting Lifestyle Profile II. RESULTS: Forty-six (51.1%) of the eligible survivors responded to the invitation to participate in the study. The analysis was based on data from 45 survivors. The results show that the relationship between PTSS and health promotion behaviors was mediated by uncertainty. DISCUSSION: Uncertainty is a suitable target for theory-based nursing interventions used to boost health promotion behaviors in young adult survivors of childhood cancer.

Adult↗
PubMed2000

MOMMA. Multi-centered On-going Mothers Monitoring Algorithm for perinatal behavioral health.

Depression during pregnancy and after delivery is a problem for the mother and poses a threat to the health of the fetus, the infant, and the family members. Low birth-weight babies have an increased risk for impaired cognitive function, cardiac disease, vascular disease, and diabetes. The incidence of depression during pregnancy and after delivery transforms an individual psychological problem into a problem of public health. The Multi-centered Ongoing Mothers Monitoring Algorithm for Perinatal Behavioral Health offers a structured approach to diagnosis and treatment of depression during pregnancy and after delivery. MOMMA serves as a model of care which can be offered to other hospitals.

Algorithms↗
PubMed1996

A model for evaluating intensive outpatient behavioral health care programs.

OBJECTIVE: This study proposes a model with five criteria for evaluating the effectiveness of intensive outpatient behavioral health care programs and applies this model to a brief partial hospital-crisis stabilization program. The five criteria are client selection, program attendance, service utilization and focus of treatment, client improvement, and cost-effectiveness. METHODS: The program evaluation model was tested with a sample of 285 adults with severe mental illness who were admitted for or were receiving outpatient treatment at a state-funded community mental health center. Evaluation data included pre- and postprogram ratings by clinical staff of clients' symptoms, level of functioning, and treatment readiness; current and retrospective reports of clients' symptoms based on interviews with clients; and clients' service and financial records. Clients and clinicians also provided data about the problems addressed during treatment sessions. RESULTS: Program dropouts used significant facility resources before dropping out. Clients who participated in the partial hospital-crisis stabilization program showed reduced symptoms, improved daily functioning, and improved treatment readiness. Clients who showed more improvement cost less to treat. CONCLUSIONS: The evaluation model produced the information necessary for demonstrating program effectiveness. The results support the belief that clinical effectiveness and cost-effectiveness are positively related.

Adult↗
PubMedDate not supplied

Promoting health behavior change using appreciative inquiry: moving from deficit models to affirmation models of care.

This article describes a new theoretical approach to health promotion and behavior change that may be especially suited to underserved women. Appreciative inquiry (AI), an organizational development process that focuses on the positive and creative as a force for an improved future, is described and adapted for use as an intervention to achieve health behavior change at the individual level. Guiding principles for its use with clients are provided, and an example of its application is illustrated in a hypothetical case study of an African American woman of low-socioeconomic resources who is attempting to increase lifestyle exercise following a cardiac event. AI is contrasted with the more traditional problem-solving approaches to the provision of care. The advantages, challenges, and issues associated with the use of AI as a health behavior change strategy are discussed.

Black or African American↗
PubMed2002

The association of health literacy with cervical cancer prevention knowledge and health behaviors in a multiethnic cohort of women.

OBJECTIVE: Our purpose was to describe the relationship between health literacy, ethnicity, and cervical cancer screening practices and to evaluate physician recognition of low literacy. STUDY DESIGN: We studied a prospective cohort of English-speaking patients > or =18 years (n = 529) in ambulatory women's clinics. Univariate and multivariate analyses were used to evaluate demographics, health practices and beliefs, and knowledge regarding cervical cancer screening and prevention. Physicians' assessments of patient reading skills were obtained. RESULTS: Low health literacy (<9th grade) was found among 40% of participants. Minority women were half as likely to know the purpose of the Papanicolaou test (9% vs 21%; P <.03) and were significantly more likely to have low literacy levels compared with white women (46% vs 15%; P <.05). Literacy was the only factor independently associated with knowledge related to cervical cancer screening (adjusted odds ratio, 2.25; 95% CI, 1.05-4.80). Physicians detected only 20% of the lowest readers. CONCLUSION: Poor health literacy was a better predictor of cervical cancer screening knowledge than ethnicity or education, yet physicians infrequently recognized low literacy. Improved physician awareness and development of low literacy interventions may improve cervical cancer screening, particularly for the most vulnerable women.

Adult↗
PubMed1988

Differentiating the etiology of male erectile dysfunction using the Millon Behavioral Health Inventory and self-report measures.

This study examines the effectiveness of using the Millon Behavioral Health Inventory in conjunction with self-report measures of erectile dysfunction to classify the etiology of erectile dysfunction in males. Subjects were 70 males with erectile dysfunction. The results indicate that 47% of the subjects with psychogenic etiology, 65% with mixed etiology, and 71% of the subjects with organic etiology were correctly classified. These and previous findings indicate that the MBHI is an effective method of assessing the etiology of erectile dysfunction.

Adult↗
PubMed1991

[The Heart for Life action in 1987. Effects on health behavior related factors].

A comprehensive short-term campaign aimed of raising money to benefit a health charity organization also contained a considerable amount of information on prevention of heart disease. The campaign ended up with a six-hour TV-show broadcast by the only Norwegian TV channel covering the whole country. The 1987 fund-raising, which was extensively announced in TV and other media and involved large groups of the population, has been evaluated as a nationwide mass media-based health education campaign through a stratified random sample of 976 persons aged 15 years or more. 96% of the population were aware of the campaign, 72% had watched TV in addition to the news reports, 47% reported having acquired new knowledge and 22% reported having changed one or more habits as a result of the campaign. The factors most clearly associated with self-reported change of behaviour were a change of health behaviour by family/friends, new information and worry created by the campaign. The paper discusses the magnitude of the effects in relation to the weak design of the study, and elaborates upon the importance for impact on social environment, knowledge and arousal of fear for health behaviour.

Attitude to Health↗
PubMed1991

High-risk health behaviors associated with various dietary patterns.

We have previously identified dietary patterns among 1,475 male and 780 female normal healthy control subjects in a case-control study of cancer at various sites. In this paper we examine the presence, among persons exhibiting these dietary patterns, of individual health behaviors that may contribute to risks for cancer. Specifically we examine trimming of separable fat from meats, fats used in cooking and as additions to foods, alcohol consumption, and smoking. Results indicate that men and women differ in possession of these high-risk behaviors. Women are more likely to trim fat from meat, consume less alcohol, and have lower exposures to smoking. Their dietary patterns are more independent of the fats used. Several eating patterns are positively associated with total fat intake but differ in their associations with high-risk behaviors. These data suggest that assessing risk associated with dietary patterns sheds more light on disease relationships than studies of single nutrients.

Aged↗
PubMed2002

Assessing behavioral health using OASIS: Part 1: Depression and suicidality.

This article is the first of a two-part series on assessing behavioral health in adult and elderly patients using OASIS. Direct questioning about emotional and behavioral symptoms in addition to observation, reports from family members, and input from other team members are used. This approach improves assessment information and increases nurse confidence and accuracy when making referrals for further psychiatric evaluation and treatment.

Adult↗
PubMed1999

Cost and quality trends under managed care: is there a learning curve in behavioral health carve-out plans?

The paper studies the performance of network plans over time using data from 52 managed behavioral health plans. Costs exhibit a 'learning curve' with additional cost declines of 10-15% with every doubling of experience, which are independent from time trends and scale economies. Process-of-care measures show increased appropriateness of follow-up care and reduced 30-day rehospitalization, but the relationship to experience or time is not statistically significant. Possible causes of organizational 'learning' could be faster referrals to network clinicians, increased acceptance of network providers by patients, selection of more efficient providers, improved care management procedures, or better monitoring techniques.

Behavioral Medicine↗
PubMedDate not supplied

Setting rates for Medicaid managed behavioral health care: lessons learned.

This paper reviews Tennessee's experience setting, monitoring, and updating capitation rates for Medicaid managed behavioral health care, and draws lessons from those experiences for other states. Our review of assumptions about four components of Tennessee's rate-setting process--data, benefit design, savings expectations, and processes for monitoring and updating rates--suggests that the initial rate established by Tennessee was inadequate, and its inadequacy resulted primarily from the way available information was used to set the rate, rather than from the method of rate setting selected. Tennessee's experiences illustrate how difficult rate setting is and illuminate several key lessons about the rate-setting process.

Behavioral Medicine↗
PubMedDate not supplied

Structural equation modeling: a primer for health behavior researchers.

OBJECTIVE: To introduce the state of the art of structural equation modeling (SEM). METHOD: This primer is organized in a manner allowing readers to review any one of 5 freestanding sections. RESULTS: SEM maintains several advantages over regression and other multivariate techniques. Through a 2-step modeling process, SEM strengthens research by allowing for the specification of complex, theory-driven models that can be tested with empirical data. Although use of SEM alone is not a magic solution, new software developments provide users with unparalleled flexibility for improving research. CONCLUSION: SEM must be thrust into the daily vocabulary and routine practice of health behavior researchers.

Health Behavior↗