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At least 865 records · Page 48Linked to original sources
PubMed1999

A comparison of public and privatized approaches to managed behavioral health care for persons with serious mental illness.

This article compares public and privatized approaches to managed behavioral health care for persons with serious mental illness in Massachusetts. Data from the Department of Mental Health (DMH) for 247 patients receiving care managed by DMH and 312 in a Medicaid carve-out were compared. Repeated measures multivariate analysis of variance models were used to examine adjusted changes in number of admissions, bed days, and facilities used from a baseline year before program implementation in 1992 through two follow-up years. Results were comparable for the two programs with similar reductions in the number of people receiving inpatient care but increases in admissions and bed days. Possible problems with continuity of care, indicated by individuals using multiple facilities, were identified for both. Given the evidence of comparable results, the choice between the two approaches is likely to be dictated by various pragmatic and subjective factors other than their demonstrated effectiveness.

Adult↗
PubMed2000

Oral health behavior and attitudes of adults in Lithuania.

In Lithuania, the oral health system is currently in transition and systematic data are needed for public oral health care planning. The objectives of this study were (i) to describe the self-assessment of oral health status in Lithuanian adults, the oral hygiene practices, and dental visiting habits; (ii) to assess the attitudes towards teeth and oral health, dental care and oral health services; (iii) to determine whether oral health attitudes and behavior are affected by socio-economic factors; and (iv) to analyse the association between self-care practices and use of oral health services. The study comprised random samples of 35-44-year-olds (n = 381) and 65-74-year-olds (n = 302). Data were collected during 1997 98 by means of self-administered questionnaires and the response rate was 53%. Nearly all persons of ages 35-44 had natural teeth, whereas 14% of 65-74-year-olds were edentulous. Among the dentate persons, 45% of the young adults against 36% of the elderly claimed having poor teeth, and 66% and 55%, respectively, had experience of pain from teeth or mouth during the past year. At ages 35-44, 33% of participants reported toothbrushing at least twice a day and this was the case for 21% of 65-74-year-olds. Dental visits within the past year were indicated by 60% of young adults and 43% of the elderly; 83% of all participants reported that their last visit to the dentist was due to acute oral symptoms. In general, the participants had positive dental knowledge and attitudes; however, 56% were unaware of any effect of fluoride. The bivariate analyses showed that perceived oral health status and oral self-care practices were related to use of dental services. The multivariate analyses of dental visiting habits revealed the effects of gender, urbanization, presence of natural teeth, experience of dental problems, attitudes to dental care and dentists, and education. In conclusion, preventive dental services should be introduced and the establishment of community-based oral health promotion programs is urgently needed for Lithuania.

Adult↗
PubMed1995

Physical abuse among high school students. Prevalence and correlation with other health behaviors.

OBJECTIVE: To better understand the epidemiology of physical abuse among adolescents. DESIGN: School-based survey of students in grades 9 through 12. SETTING: Twenty-five schools throughout Oregon in 1993. MAIN OUTCOME MEASURES: Prevalence of ever being physically abused, prevalence of most recent occurrence of physical abuse, and correlation of physical abuse with high-risk health behaviors. RESULTS: Of the 1957 respondents, 31.5% reported having ever been physically abused, with female subjects (34.6%) more likely than male subjects (28.0%) to have ever been abused. Overall, 3.7% of students had been physically abused in the past week, 7.8% in the past month, and 16.3% in the past year. Based on multivariate models, students physically abused in the past year were more likely than students who had never been physically abused to engage in a variety of high-risk behaviors; these included weapon carrying (odds ratio, 1.9), suicidal ideation (odds ratio, 2.1), cigarette smoking (odds ratio, 1.8), cocaine use (odds ratio, 3.2), or multiple sexual partners (odds ratio, 1.9). CONCLUSIONS: Physical abuse, an important problem among high school students, is correlated with many high-risk behaviors. Using consistent definitions, periodic surveys of children about physical abuse and other types of violent behavior are needed to provide better estimates of the extent of these problems.

Adolescent↗
PubMed2004

The effect of a managed behavioral health carve-out on quality of care for medicaid patients diagnosed as having schizophrenia.

CONTEXT: Managed behavioral health carve-outs (MBHCOs) are a regular feature of public and private mental health care systems and have been successful in reducing costs. The evidence on quality impacts is limited and suggests comparable quality overall, except that people with severe psychiatric disorders may be those most disadvantaged by MBHCOs. OBJECTIVE: To explore the effect of implementing an MBHCO on the quality of outpatient care received by enrollees diagnosed as having schizophrenia. DESIGN AND PARTICIPANTS: Observational retrospective cohort study using a quasi-experimental design of state Medicaid enrollees diagnosed as having schizophrenia, aged 18 to 64 years between 1994 and 2000 in the carve-out and comparison regions (8082 person-years). SETTING: Ambulatory care. MAIN OUTCOME MEASURES: Quality indicators derived from the Schizophrenia Patient Outcomes Research Team recommendations. RESULTS: There was no statistical difference between the carve-out and integrated arrangements in the likelihood of receiving any antipsychotic medication (odds ratio [OR], 1.02; 95% confidence interval [CI], 0.81-1.29), second-generation antipsychotics (including clozapine: OR, 1.05; 95% CI, 0.86-1.28; not including clozapine: OR, 1.05; 95% CI, 0.85-1.29), or antiextrapyramidal medication (OR, 1.36; 95% CI, 0.84-2.19). The carve-out was negatively associated with receiving any individual therapy (OR, 0.27; 95% CI, 0.22-0.33), group therapy (OR, 0.19; 95% CI, 0.14-0.25), and psychosocial rehabilitation (OR, 0.31; 95% CI, 0.26-0.38). Family therapy occurred for less than 1% of this population in both carve-out and integrated regions. CONCLUSIONS: The MBHCO was not associated with changes in medication quality (for which it was not at financial risk). It was significantly associated with sharp decreases in the likelihood of receiving psychosocial treatments (for which it was financially at risk)-independent of whether a clinical evidence base supported them.

Adolescent↗
PubMed2005

Assessment of Medicaid managed behavioral health care for persons with serious mental illness.

OBJECTIVES: This five-site study compared Medicaid managed behavioral health programs and fee-for-service programs on use and quality of services, satisfaction, and symptoms and functioning of adults with serious mental illness. METHODS: Adults with serious mental illness in managed care programs (N=958) and fee-for-service programs (N=1,011) in five states were interviewed after the implementation of managed care and six months later. After a multiple regression to standardize the groups for case mix differences, a meta-analysis using a random-effects model was conducted, and bioequivalence methods were used to determine whether differences were significant for clinical or policy purposes. RESULTS: A significantly smaller proportion of the managed care group received inpatient care (5.7 percent compared with 11.5 percent). The managed care group received significantly more hours of primary care (4.9 compared with 4.5 hours) and was significantly less healthy. However, none of these differences exceed the bioequivalence criterion of 5 percent. Managed care and fee for service were "not different but not equivalent" on 20 of 34 dependent variables. Cochrane's Q statistic, which measured intersite consistency, was significant for 20 variables. CONCLUSIONS: Managed care and fee-for-service Medicaid programs did not differ on most measures; however, a lack of sufficient power was evident for many measures. Full endorsement of managed care for vulnerable populations will require further research that assumes low penetration rates and intersite variability.

Adult↗
PubMed1984

[Health behavior of pregnant teenagers in early pregnancy].

Considering the number of birth a special problem of "adolescent pregnants" is not presently valid in the GDR. Studying the health behavior however it becomes obvious that there are existing positive and negative differences, as well. On the contraceptive behaviour of adolescents must be set a careless value. The pregnancies therefore are planned more seldom. Adolescent pregnants smoke more frequent than older ones. This is valid before and during pregnancy, as well. Younger and also older pregnants pay only small attention to sporting activities. Younger ones however are more conscious with regard to nutrition, relaxation after work and body hygiene. Health educational tasks are outlined.

Abortion, Legal↗
PubMed2026

Experimental validation of an AI-driven digital healthcare platform for oral health behavior and plaque assessment among vietnamese children.

BACKGROUND: Oral health among children in developing countries, including Vietnam, remains a significant public health concern. Innovative approaches leveraging artificial intelligence AI-based digital health platforms may offer effective strategies for managing dental plaque and promoting better oral hygiene behaviors among school-aged children. This study aimed to evaluate the effectiveness of an AI-driven oral healthcare platform (Denti-i Vietnam) in improving oral hygiene and behavioral outcomes among Vietnamese primary school students. METHODS: A total of 204 primary school students aged 8-10&#xa0;years in Hanoi, Vietnam, participated in this experimental study. Participants were randomly assigned to an intervention group (n&#xa0;=&#xa0;107), which used the AI-driven oral healthcare platform, and a comparison group (n&#xa0;=&#xa0;97), which received traditional oral health education via pamphlets. Oral health behaviors, dental plaque levels (Simplified Oral Hygiene Index; OHI-S), and caries indices (dft/DMFT) were assessed at baseline and after the intervention period. RESULTS: The intervention group demonstrated a significant reduction in the OHI-S score compared to baseline (2.49&#xa0;&#xb1;&#xa0;0.60 to 1.70&#xa0;&#xb1;&#xa0;0.76, p&#xa0;<&#xa0;0.001), particularly in the debris component, indicating enhanced plaque control. Notable improvements were also observed in oral hygiene behaviors, including increased frequency of toothbrushing before and after breakfast (p&#xa0;<&#xa0;0.01) and more frequent parental assistance during brushing (p&#xa0;=&#xa0;0.03). Furthermore, parental awareness of dental caries significantly increased in the intervention group (p&#xa0;=&#xa0;0.001). CONCLUSIONS: The AI-driven oral healthcare platform significantly improved both oral hygiene behaviors and plaque control among Vietnamese primary school children. These findings suggest that AI-driven digital health tools can serve as practical and scalable solutions for promoting oral health in developing countries.

Humans↗
PubMedDate not supplied

Examining the role of acculturation in health behaviors of older Mexican Americans.

OBJECTIVES: To determine if acculturation is associated with smoking, alcohol use, and physical activity among older Mexican Americans. METHODS: Multivariate analyses of data from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE) were used. RESULTS: Those who were more proficient in English were more likely to be former or current smokers than nonsmokers and former or current drinkers than abstainers. In addition, those who had greater contact with Anglo-Americans were more likely to be former or current smokers than nonsmokers and former or current drinkers than abstainers. CONCLUSIONS: These results can assist health promotion programs in identifying those most at risk of engaging in negative health behaviors.

Acculturation↗
PubMed2000

The effect of cardiovascular health promotion on health behaviors in elementary school children: an integrative review.

This report provides on an integrative review of health promotion studies relevant to elementary school children published between 1986 and 1998. The 22 research articles represented several disciplines including public health and nursing. The studies varied in research design, sample characteristics, and approaches to health education. The most common interventions targeted behavioral risk factors for cardiovascular disease, but it also was evident from the literature that family and community involvement both played a significant role in health behaviors of children. Health promotion studies were under-represented in the nursing literature, a gap that creates an impetus to study children and families to identify the ways they learn primary preventive behaviors.

Cardiovascular Diseases↗
PubMed1976

[Normogram study: representative data on the state of health of male industrial workers in northern Switzerland. 1. Report: anamnesis and health behavior].

To obtain representative data about the health of industrial workers in nothern Switzerland, 1260 men from 44 plants have been examined. At the time of our study, 21% were under treatemnt by a doctor and 52% had so been 1-3 times during the previous year. 44% hat at some time in the past been patients in a surgical department, 13% in a department for internal medicine and 29% in a department for special diseases. During the previous year 39% reported loss of working days through illness. In 13%, working days had been lost through accidents. 48% were smokers, 38% had never smoked, and 14% had stopped smoking. Alcohol was consumed daily by 37%, three times a week by 30% and once a week by 18%; 11% drank rarely and 4% never, 16% took medicines often, 40% rarely and 44% never. The results of the study are classified by 5-year-age groups and compared.

Adult↗
PubMed1996

Health-related practices and priorities: the health behaviors and beliefs of community-living Black older women.

Black older women were found to have a high mean level of adherence to recommended health-protecting behaviors. Participants perceived that adherence to health-protecting behaviors played a highly important role in helping them to live a long and health life. Nurses must direct increased attention and intervention to the importance of practicing primary prevention behaviors as an assertion of control over the future health, well-being, and quality of life of Black older women.

Black or African American↗
PubMed1999

How to design and implement your children's services outcomes management program: a practical training institute for child welfare, behavioral health, and substance abuse services.

During the two-day conference, attendees met in groups to discuss the information provided and concerns or problems they were having regarding outcomes within their own organizations. Subjects addressed included current and future outcomes measurement requirements, determination of good outcomes measures for behavioral health care organizations, effective collection of outcomes data, and use of outcomes data to improve services. Throughout the conference sessions, attendees were reminded to use the outcomes measures and their results to manage and change; include all the pertinent (internal and external) players that will help with the measurement process; define a specific strategy to follow; and keep data collection simple (if people aren't able to collect the data, then collection won't occur).

Adolescent↗
PubMed2001

Age at earliest reported memory: associations with personality traits, behavioral health, and repression.

The present study examined relationships between the age at earliest memory and the personality traits and behavioral health of 107 undergraduates. Participants answered questions on their earliest memory and completed the Myers-Briggs Type Indicator (MBTI) and a medical history form. Analyses indicated that continuous scores on two MBTI scales (Sensing-Intuition and Judging-Perceiving) were inversely related to age at earliest memory as were participant's self-reported drug and alcohol problems, emotional and psychological symptoms, accident rates, physical symptoms, and satisfaction with health. Respondents who reported first memories at or after 7 years of age (i.e., approximately 1 SD above the mean age at recalled memory) were classified as repressors. Repressors scored in the Sensing and Judging directions on the MBTI and reported significantly fewer emotional symptoms, accidents, psychological symptoms, and less health satisfaction than nonrepressors. Results are consistent with the age at earliest memory and repression literature and support the use of earliest memory age as an index of repression.

Adult↗