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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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PubMed1979

Associative learning, habit, and health behavior.

Habit is defined as a firmly established behavior pattern marked by increasing automaticity, decreasing awareness, and partial independence from reinforcement. Reinforcement is viewed as of primary importance in the acquisition of behavior, whereas principles of associative learning enter to complement reinforcement in the maintenance of behavior. Habit is seen as a mechanism for short-circuiting the reinforcement process to avoid its overload and for providing the organism with speed and stability of response instead of the variability offered by reinforcement. The implications of this definition of habit for acquisition and alteration of health behavior are discussed; examples include smoking, obesity, alcoholism, and coronary-prone (type A) behavior.

Alcoholism↗
PubMed2004

A collaborative approach to the development of psychiatric rehabilitation services in a public behavioral health managed care environment.

This article summarizes the collaborative effort that took place between providers, managed care administrators, and state and county officials in Pennsylvania to create a fluid system in the development of psychiatric rehabilitation services. The stakeholders involved solved the numerous logistical problems that are inherent in the start-up of new services and were able to cooperatively create procedures for service delivery, service coordination, and reimbursement across systems and funding mechanisms. The article reviews that process and highlights the services of Welcome House, a psychiatric rehabilitation program exemplifying the products of their collaboration.

Community Mental Health Centers↗
PubMed2000

Self-reported health and prior health behaviors of newly admitted correctional inmates.

OBJECTIVES: This study obtained comprehensive health information from newly admitted correctional inmates. METHODS: Interviews were conducted with 1198 inmates on day 3 of their incarceration. RESULTS: Interviewers found a high prevalence of chronic medical and mental health issues, limited access to health care, high rates of infections and sexually transmitted diseases, substantial substance abuse, other unhealthy behaviors and violence, and a strong desire for help with health-related problems. CONCLUSIONS: The data document the need to apply the public health approach to correctional health care, including detection and early treatment of disease, education and prevention to facilitate health and behavior change, and continuity of care into the community.

Adult↗
PubMed1998

The roles of the behavioral health professional in integrated systems.

It is surprising that integration has only recently re-emerged as a major issue in healthcare. It has taken the economic pressures of managed care and the demands from employers for accountability to place integration in the spotlight. Without these pressures, we would most likely continue to focus our attention in behavioral health on the preservation of traditional professional roles and boundaries, instead of focusing on prevention and developing processes that produce the best outcome for the patient at the lowest possible cost. Integration challenges traditional roles and processes, forcing institutions in our field to change. Role change, as sociologists know, can be profoundly disorienting to individuals and is often vehemently resisted by groups and institutions who have an investment in the status quo. That is where we are now in this field despite our current enthusiasm for this rather innocent-looking concept called integration. We should be confident that the innovators in healthcare will succeed. The economy and quality-of-care concerns demand it. I hope they receive something more than a lukewarm reception.

Behavioral Medicine↗
PubMedDate not supplied

Risk sharing in managed behavioral health care.

While policymakers have expressed concern over the impact of risk sharing with providers on treatment patterns, the literature lacks decisive evidence on which to base policy. This paper evaluates the impact of a contracting change within a managed behavioral health organization from a fee-for-service system to a case-rate system with utilization management delegated to providers. The contracting change resulted in a 25 percent reduction in mental health visits per episode. This effect varies with the dollar amount of the case rate and is more pronounced for providers with a larger share of revenue from risk contracts and with intensive utilization management programs.

Adult↗
PubMed2000

Behavioral health care dot-com and beyond: computer-mediated communications in mental health and substance abuse treatment.

Computer-mediated communications (CMC) such as e-mail, websites, and CD-ROM and DVD programs, both on and off the Internet, will play an ever larger role in the future of behavioral health care. This address describes the current rapid expansion of CMC and some profound changes that are likely in the future. The reasons for using such CMC programs are addressed, and an example of a new multimedia version of the Addiction Severity Index is described. Issues and concerns about future uses of CMC are raised, as are possible implications for psychology.

Behavior Therapy↗
PubMed1999

A model for multidisciplinary peer review and supervision of behavioral health clinicians.

The authors describe a semi-annual program for multidisciplinary peer review and supervision that is in use at two rural adult and child mental health and drug and alcohol service agencies. The program incorporates semiannual chart reviews and face-to-face discussions held with each clinician by a multidisciplinary supervisory group. Several quality improvement issues addressed by this program are described, including improved communication, improved clinical diagnosis, the establishment of service parameters, more appropriate referrals for psychiatric and other medical care, and improved clinician skills. The program represents an inexpensive approach to peer review and supervision that can incorporate university-based consultants, improve quality of care, improve clinicians' skills, and be readily applied by clinical supervisors to most behavioral health settings.

Adult↗
PubMedDate not supplied

Preventive health behaviors and mammography use among urban older women.

A cross-sectional survey of 610 low income women between the ages of 60 and 84 who attended community meal sites in Los Angeles was conducted to determine health behaviors associated with mammography use among urban community dwellers. Preventive practices that require women to take an active role and recurrent participation were positively associated with a current mammography, while services that are clinician-initiated were associated with ever having a mammography.

Aged↗
PubMed1996

[The "healthy community" project--morbidity, risk factors, health behavior and psychiatric symptoms in Steiermark].

27,344 persons in Styria participated in a study of the "Steirische Gesellschaft für Gesundheitsschutz" in Graz, within the framework of the project "Healthy communities" and were asked about diseases and health attitudes. All analyses were made separately for men and women and were adjusted for age and education. The goal of this study was a regional comparison of chronic diseases, risk factors, health consciousness and psychiatric complaints. Thus it should be possible to define the problematic regions with regard to health, in order to take the necessary political action to improve the situation. Men and women show a relative lack of health consciousness in the Weinbauregion and East Styria. Psychiatric complaints of women are more frequent in the Weinbauregion than the other areas. It appears that the healthier people live in the regions Mur/Mürztal and the Ennstal. Women have less risk factors than men, but have more psychiatric complaints. Men live less healthy lives in relation to their nutrition, risk avoidance and dental hygiene, except with respect to sports. Of the interviewed people from the surroundings of Graz 63% suffer from chronic disease, whilst in the Mur/Mürz- and Ennstal the respective figure is 56%. In the wine growing regions 54% of men drink alcohol daily, whereas in the Mur/Mürz- and Ennstal 42% of men drink alcohol daily. In the wine-growing regions 35% of the women and 50% of the men are overweight; in the Ennstal only 28% of the women are overweight but 45% of the men. Regular sports activities are undertaken by 35% of the women and 38% of the men in the Ennstal, as compared with 22% of the women and 27% of the men in East Styria. Insomnia was recorded in 29% of the women in East Styria, but in only 22% of the women in the Mur/Mürztal.

Adolescent↗
PubMed1981

Heart healthy eating and exercise: introducing and maintaining changes in health behaviors.

The Heart Program is a health education project developed for elementary school students. It was designed to 1) increase their consumption of complex carbohydrates, and decrease their consumption of saturated fat, cholesterol, sodium, and sugar; 2) increase their level of habitual physical activity; and 3) generalize these changes to other family members. The overall program and 12 class lessons were designed using informative instruction, participatory classroom activities, personal goal setting, parent handouts, feedback, and reinforcement. The program was evaluated using a time-series experimental design with all students in three 4th grade classes at School 1 and three 5th grade classes at School 2. Evaluation was conducted using direct observations of eating and activity, as well as paper-and-pencil assessments of knowledge and attitude. Results indicated substantial changes in eating behavior at school, knowledge about heart health, food preferences, and family eating patterns are reported by parents. Observed changes in exercise were minimal during treatment, and were related to seasonal sports activities at follow-up. Eating which spanned summer vacation. These outcomes suggest that school programs developed using specific techniques can be effective in facilitating important behavior changes at school and at home.

Child↗
PubMed2004

Effects of a tailored follow-up intervention on health behaviors, beliefs, and attitudes.

BACKGROUND: The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers. METHODS: Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled in the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program at local North Carolina health departments. During the year after the behavior change program, intervention participants were mailed six sets of computer-tailored health messages and received two computer-tailored telephone counseling sessions. Main outcomes of dietary and physical activity behaviors, beliefs, and attitudes were measured. RESULTS: Intervention participants were more likely to move forward into more advanced stages of physical activity change (p = 0.02); control participants were more likely to increase their level of dietary social support at follow-up (p = 0.05). Both groups maintained low levels of reported saturated fat and cholesterol intake at follow-up. No changes were seen in physical activity in either group. CONCLUSIONS: Mailed computer-tailored health messages and telephone counseling calls favorably modified forward physical activity stage movement but did not appreciably affect any other psychosocial or behavioral outcomes.

Attitude to Health↗
PubMed1982

Overcoming design problems in evaluating health behavior programs.

The increasing importance of high-quality evaluative research on health lifestyle change programs is established. Failure to ask the right evaluative research questions and problems of research design are identified as two major reasons for the dearth of well-controlled, interpretable evaluations in this area. Thirteen issues of research design that need to be considered if interpretable answers to evaluative research questions are to be obtained are identified and discussed. Solutions to these problems and design recommendations are offered.

Attitude to Health↗
PubMed2003

Elevated risk of arrest for Veteran's Administration behavioral health service recipients in four Florida counties.

This paper examines the relative contribution of mental and substance abuse disorders to criminal justice involvement by examining the relative risk of arrest for three groups of adult male recipients of VA behavioral health care services. These groups include men served for both substance abuse and mental health, for only substance abuse, and for only mental health. The relative risk of multiple offences is compared to relative risk of a single offense for each group. Results indicated that relative risk of multiple arrests for the dual diagnosis group is substantially greater than for either of the single diagnosis groups, and greater than the relative risk for recipients of nonbehavioral health services. Relative risk of arrest for recipients of only mental health services is no different than the relative risk for other veterans living in the region under examination.

Adult↗
PubMed2000

Mapping the road to quality collaborative patient care in a behavioral health community treatment center. Avoiding the detours of managed care.

At this writing, the system and tools described have improved the author's organization's ability to meet managed care requirements better and support a collaborative care and case management model. Refer to the boxed information for the key functions and outcomes of the system. The Behavioral Health Multiaxial Protocol CareMapping System offers one approach to addressing the dilemma of health environmental change, managed care requirements, and financial constraints that have the potential to endanger the quality of clinical practice and to have a negative effect on patient and family outcomes. The tools illustrated in this article are in a constant cycle of revision and improvement and requires adequate clerical support to accommodate revision and tool improvement. Many more improvement initiatives are needed to improve the patient care process and organizational performance continuously. Because quality is a journey, the author hopes that her institution is on the right road and carries the correct map.

Behavior Therapy↗
PubMed2004

Best practices in behavioral health workforce education and training.

Dramatic changes have occurred in the delivery of mental health and substance abuse services over the past decade and a half. There is growing concern that education programs have not kept pace with these changes and that reforms are needed to improve the quality and relevance of training efforts. Drawing on the published works of experts and a national initiative to develop a consensus among stakeholders about the nature of needed reforms, this article outlines 16 recommended "best practices" that should guide efforts to improve workforce education and training in the field of behavioral health.

Behavioral Medicine↗