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PubMed2000

[Subjective health and health behavior of children and adolescents--a survey of Hamburg students within the scope of school medical examination].

The subjectively perceived health of children and adolescents has received little attention in Public Health research so far. In co-operation with school physicians of Hamburg, Eimsbuettel, 1,501 children and adolescents (grades 4 and 8, as well as their parents) were questioned with regard to health-related quality of life and health behaviour, using among others the short form of the KINDL Quality of Life Questionnaire and established psychosocial instruments. High values in the KINDL scale were found in 75% of the students, the mean value of the 0-100 transformed KINDL total scale was around 80. Adolescents--and in this group specifically the girls--reported significantly lower quality of life scores. Psychosocial strain, presence of disease and school absenteeism were negatively associated with quality of life ratings. Health-related behaviours in terms of resources in the area of food intake and risk behaviours in terms of addiction, obesity and stressors correlated with subjective health as expected. In multiple regressions these factors explained 20% of the KINDL-score variance in the total group. Taking into account indicators of functional status and life satisfaction, the percentage of explained variance increased to over 50%; here these predictors yielded a correct classification of high vs. low self-reported quality of life in 90% of the cases. The study shows that subjective health is a methodologically adequate and scientifically interesting indicator which in the public health area can be used in epidemiological research, in health reporting and in school physicians' practice to identify young persons with quality of life impairments in order to provide early and in-focus support to this group.

Adolescent↗
PubMed1998

Advantages and disadvantages of collaborative research: a university and behavioral health care provider's experience.

This article describes the issues involved in a collaborative research effort between a university and a behavioral health care provider. We describe the collaborative process and highlight advantages and disadvantages of such collaboration. Specific examples are used to show how the collaborative process between a university team and clinical team can integrate theory, research, and clinical practice.

Behavior Therapy↗
PubMedDate not supplied

A conceptual application of health behavior theory in the design and implementation of a successful surgical weight loss program.

Obesity (BMI > or =30 kg/m(2)) is recognized as a primary risk factor in the pathogenesis of several leading causes of morbidity and mortality, most notably hypertension, diabetes, and coronary artery disease. Despite numerous preventive approaches, the number of Americans who are overweight and obese has reached pandemic proportions and continues to increase. Moreover, the "fat are becoming fatter" as evidenced by the increasing prevalence of morbidly obese individuals (BMI > or =40 kg/m(2)). For the morbidly obese individual with potentially life-threatening comorbidities, the support for and use of surgical treatment options as a corrective mechanism is growing. Weight reduction results for bariatric surgery average 30-80% of excess body weight, depending on the length of the follow-up and the surgical technique. The demonstrated effectiveness of surgical treatment as a weight-reduction method coupled with the increasing prevalence of severe obesity is certain to increase the popularity of surgical treatment options. With this increased popularity, comes a responsibility for health-care professionals to guard against patients' perception of surgical treatment as a panacea. To counter this possibility, three recommendations are presented as components of a treatment paradigm by a multidisciplinary team of health professionals, which incorporate surgical and non-surgical treatment components, increase patient responsibility, promote lifelong health behavior change and effect permanent weight loss.

Health Behavior↗
PubMed2006

The relationship between education and health behavior: some empirical evidence.

Although researchers agree that more educated people typically engage in healthier behaviors, they have not uncovered the reason why. This paper considers several explanations, including future opportunity costs. Future opportunity costs represent any utility-improving future outcome that is affected by currently engaging in health-related behavior. This paper also examines whether there are degree effects in the health behaviors of binge drinking and smoking. Results suggest that future opportunity costs may affect smoking, although other interpretations cannot be ruled out. The results also find degree effects with regard to binge drinking.

Adolescent↗
PubMed2003

Sociostructural factors influencing health behaviors of urban African-American men.

African-American men are suffering disproportionately from most illnesses. Seemingly, action is needed if health disparities that disproportionately affect African-American men as compared to their White and female counterparts are to be reduced or eliminated. An important step in decreasing common health disparities evidenced among African-American men is to understand social factors that act as motivators and barriers to seeking care for most of this vulnerable population. Following a constructionist epistemology, this study used ethnography to explore social structure factors that motivate urban African-American men to seek care. Leininger's Culture Care Diversity and Universality Theory guided this study. Qualitative interviews were conducted with urban African-American men and other individuals in the community to explore understanding, attitudes, and beliefs about health. Critical issues examined included social factors associated with health seeking behaviors. Themes that emerged from these data indicated that critical social factors include: 1) Kinship/significant others; 2) accessibility of resources; 3) ethnohealth belief; and 4) accepting caring environment. The data also indicated a relationship between these social factors and health seeking behaviors of urban African-American men.

Adult↗
PubMedDate not supplied

The Millon Behavioral Health Inventory Life Threat Reactivity Scale as a predictor of mortality in patients awaiting heart transplantation.

This study examined the Millon Behavioral Health Inventory Life Threat Reactivity Scale (LTRS) as a predictor of mortality in patients awaiting heart transplantation. The one-year mortality while awaiting cardiac transplantation was more than double for the high-risk group based on the LTRS scores. The high-risk group had a 42% mortality rate versus an 18% mortality rate in the low-risk group. Mortality for those patients that received transplants was similar for both groups. A review of the medical literature regarding the role of personality traits in cardiac mortality and the findings of this study are discussed.

Adult↗
PubMed1995

Toward the behavioral health report card.

In this article, the authors review current organized efforts, strategies, and partnerships involved in attempts to design a behavioral health care report card that offers a comprehensive approach to obtaining performance measurements in the fields of psychiatry and chemical dependence treatment.

Data Collection↗
PubMed2001

Effects of future writing and optimism on health behaviors in HIV-infected women.

Optimists (people who have positive expectations about the future) have been shown to perform more health-promoting behaviors than pessimists. This study attempts to alter individuals' levels of optimism, and thereby their health behaviors, by having them write about a positive future. HIV-infected women (N = 40) on combination therapies were randomly assigned to write about a positive future or assigned to a no-writing control group. Among participants who were low in optimism, the writing intervention led to increased optimism, a trend toward increased self-reported adherence to medications, and decreased distress from medication side effects, compared to controls who did not write. Participants who were high in optimism showed the opposite effects after writing about the future. Results suggest that a future-oriented writing intervention may be apromising technique to increase medication adherence and decrease symptom distress in pessimistic individuals.

Adolescent↗
PubMed1999

Psychological and behavioral health issues of long-duration space missions.

It will be the responsibility of the long-duration space flight crew to take the actions necessary to maintain their health and well-being and to cope with medical emergencies without direct assistance from support personnel, including maintaining mental health and managing physiological and psychological changes that may impair decision making and performance. The Behavior and Performance Integrated Product Team at Johnson Space Center, working within the Space Medicine, Monitoring, and Countermeasures Program, has identified critical questions pertaining to long-duration space crew behavioral health, psychological adaptation, human factors and habitability, and sleep and circadian rhythms. Among the projects addressing these questions are: the development of tools to assess cognitive functions during space missions; the development of a model of psychological adaptation in isolated and confined environments; tools and methods for selecting individuals and teams well-suited for long-duration missions; identification of mission-critical tasks and performance evaluation; and measures of sleep quality and correlation to mission performance.

Adaptation, Psychological↗
PubMed2004

Differences in self-reported oral health behavior between dental students and dental technology/dental hygiene students in Jordan.

The aim of this study was to compare differences in oral health behavior between dental students and dental technology/dental hygiene students in Jordan. One hundred and five dental students and seventy-eight dental technology/dental hygiene students were recruited into this study. All subjects were recruited from the students who were receiving training at the clinics and laboratories that belong to the Faculty of Dentistry, Jordan University of Science and Technology. The Hiroshima University-Dental Behavioral Inventory (HU-DBI) was used to assess the oral heath behavior of the subjects. Significant differences were found between students from different disciplines. Dental students were found to worry more about visiting their dentist, to be less aware of bleeding gums when brushing and were less bothered by the color of their gums compared with dental technology and dental hygiene (DT/DH) students (P < 0.05, P < 0.001 and P < 0.05, respectively). Dental students tended to be more professionally educated about brushing and to have a belief that they cannot clean their teeth well without using toothpaste (P < 0.01 and P < 0.001, respectively). Most of them did not feel they have brushed well unless they brush with strong strokes (P < 0.05). A logistic regression model showed that it might be possible to distinguish dental students from DT/DH students by using three items of the HU-DBI and the level of dental education. The difference in the HU-DBI scores was not a major feature. There were significant differences in oral health attitudes/behavior between dental students and DT/DH students. The findings might reflect differences in students' training experience and education between different specialties.

Attitude to Health↗
PubMed2004

The relationships of social participation and community ratings to health and health behaviors in areas with high and low population density.

Previous studies have linked social participation and community levels of trust with improved health status. We examined the associations between levels of community participation, self-reported community ratings (trust), and health within a public health surveillance survey conducted in Kansas (N=4601). Independent variables were individual ratings of their communities (excellent, very good, good/ fair, poor), and their involvement in community groups or organizations in the last 5 years (yes/no). Dependent variables were self-rated health status, depressive symptoms, physical activity, smoking, obesity, and binge drinking. After controlling for age, gender, race/ethnicity, education, and having a medical doctor, self-rated health status (p<0.001) and physical activity (PA) (p<0.001) were positively, and smoking (p<0.001) and depressive symptoms (p<0.001) were negatively associated with community ratings. Only PA (p<0.001) remained associated with community involvement in a multivariate analyses. Multilevel analysis using county-level data showed no significant interactions between population density and dependent variables. Individuals from rural areas had the highest community involvement but relatively low levels of community ratings. Our findings suggest that individuals in rural areas, especially in densely settled rural areas, may face increased risks of poor health.

Adolescent↗
PubMed2005

A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research.

A. Bellg, B. Borrelli, et al. (2004) previously developed a framework that consisted of strategies to enhance treatment fidelity of health behavior interventions. The present study used this framework to (a) develop a measure of treatment fidelity and (b) use the measure to evaluate treatment fidelity in articles published in 5 journals over 10 years. Three hundred forty-two articles met inclusion criteria; 22% reported strategies to maintain provider skills, 27% reported checking adherence to protocol, 35% reported using a treatment manual, 54% reported using none of these strategies, and 12% reported using all 3 strategies. The mean proportion adherence to treatment fidelity strategies was .55; 15.5% of articles achieved greater than or equal to .80. This tool may be useful for researchers, grant reviewers, and editors planning and evaluating trials.

Behavioral Research↗
PubMed2004

American Association of Community Psychiatrists' principles for managing transitions in behavioral health services.

Continuous engagement in treatment and recovery services is one of the most important aspects of addressing acute episodes of severe behavioral health problems and the ongoing disabilities associated with them. Traditionally, fragmentation in systems of care has been common, and the transition from one provider, location, or intensity of service to another has not been prioritized in treatment planning. The authors describe a set of guidelines for maintaining continuity of care that was developed by the American Association of Community Psychiatrists. These guidelines embrace a progressive conceptualization of an integrated service system. For each element of the guidelines, a sample outcome indicator is presented that could be used to measure implementation. These guidelines can be used to help form transition plans, quality improvement initiatives, and program evaluations.

Community Psychiatry↗
PubMedDate not supplied

Selected health behaviors and perceptions among U.S. adults in 1990.

Risk factors for cardiovascular disease among Americans were analyzed using data from the 1990 Health Promotion and Disease Prevention supplemental survey to the annual National Health Interview Survey. Adult Americans were found to be quite heart-health conscious. More than half reported having had their cholesterol levels checked; of those with admitted hypertension, more than 85 percent said it was "under control" or "cured," and 44 percent of men and 37 percent of women exercised or played sports regularly. Just over 60 percent of men and 68 percent of women acknowledged "a lot" or "a moderate" amount of stress in their lives, and significantly more women than men considered themselves to be overweight. Variations in these perceptions and risk factors by age, sex, race, region and other socioeconomic variables are presented. The vast majority of the respondents reported "very good" to "excellent" general health, with proportionately more men than women in each age group reporting "excellent" health.

Adult↗
PubMed2001

Children who return home from foster care: a 6-year prospective study of behavioral health outcomes in adolescence.

OBJECTIVE: Returning children to their biological families after placement in foster care (ie, reunification) has been prioritized with legislation. Comprehensive studies of child behavioral health functioning after reunification, however, have not been conducted. This study examined outcomes for youth who were reunified after placement in foster care as compared with youth who did not reunify. DESIGN: Prospective cohort. SETTING: Children who entered foster care in San Diego, California, and who remained in foster care for at least 5 months. Participants. A cohort of 149 ethnically diverse youth, 7 to 12 years old, who entered foster care between May 1990, and October 1991. Seventy-five percent of those interviewed at Time 1 were interviewed at Time 2 (6 years later). OUTCOME MEASURES: 1) Risk behaviors: delinquent, sexual, self-destructive, substance use, and total risk behaviors; 2) Life-course outcomes: pregnancy, tickets/arrests, suspensions, dropping out of school, and grades; 3) Current symptomatology: externalizing, internalizing, total behavior problems, and total competence. RESULTS: Compared with youth who were not reunified, reunified youth showed more self-destructive behavior (0.15 vs -0.11), substance use (0.16 vs -0.11), and total risk behavior problem standardized scores (0.12 vs -0.09). Reunified youth were more likely to have received a ticket or have been arrested (49.2% vs 30.2%), to have dropped out of school (20.6% vs 9.4%), and to have received lower grades (6.5 vs 7.4). Reunified youth reported more current problems in internalizing behaviors (56.6 vs 53.0), and total behavior problems (59.5 vs 55.7), and lower total competence (41.1 vs 45.0). There were no statistically significant differences between the groups on delinquency, sexual behaviors, pregnancy, suspensions, or externalizing behaviors. Reunification status was a significant predictor of negative outcomes in 8 of the 9 regression equations after controlling for Time 1 behavior problems, age, and gender. CONCLUSIONS: These findings suggest that youth who reunify with their biological families after placement in foster care have more negative outcomes than youth who do not reunify. The implications of these findings for policy and practice are discussed.

Child↗