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PubMed1996

[Education for responsible health behavior].

34 nursery school teachers, 40 primary school teachers, and 40 parents of primary school children were interviewed. Based on the results of these interviews, standardized questionnaires were developed and answered by 100 mothers of primary school children. Main results are as follows. Most of the nursery school teachers, primary school teachers, and mothers don't show great interest in health-related information, despite the fact that they lack knowledge in this area. Health risks which children could be educated to know, like unhealthy nutrition, are underestimated, whereas ecological risks which cannot be affected are overrated. Nursery and primary school teachers hold that parents are responsible for the health education of their children. Consequently, health-related behaviour in kindergarten and health-related teaching in school are unsatisfactory. Mothers, however, expect schools to teach health-related topics concerning dependencies of all sorts--nicotine, alcohol, illegal drugs, and medication. Nursery school teachers as well as mothers demonstrate little systematic control and few sanctions when it comes to teaching children hygienic behaviour. Therefore, most children show satisfactory preventive behaviour only with regard to brushing their teeth. There are clear deficits in other areas. The mothers act only partly as good role models--for example, many mothers smoke when their children are around. Additionally, mothers don't regularly talk to their children about health-related topics.

Adult↗
PubMed1992

Does the Millon Behavioral Health Inventory (MBHI) predict lumbar laminectomy outcome? A comparison with the Minnesota Multiphasic Personality Inventory (MMPI).

Response to surgery for low-back pain is influenced by psychosocial as well as physical factors. However, no psychosocial measure has yet been found to be highly accurate in predicting surgical outcome for individual patients. The purpose of this prospective study was to assess the usefulness of the Millon Behavioral Health Inventory (MBHI) in predicting outcome of laminectomy for lumbar disc herniation or spinal stenosis. Its use was compared with that of the Minnesota Multiphasic Personality Inventory. The influence of several demographic, clinical, and radiographic variables was also investigated. One hundred twenty-seven patients were assessed at an average of 24 months postsurgery. Ninety-three patients had a good outcome, 20 had a fair outcome, and 14 had a poor outcome. The MBHI scales as a group were not associated with surgical outcome.

Evaluation Studies as Topic↗
PubMed1999

[The pattern of health behavior and its determinants--results of the Bern-Munich Life Style Panel].

Results from a study on health-related lifestyles of Munich citizens aged between 55 and 65 were compared with an independent data set from Bern. Cluster analysis identified eight health-related behavior patterns in the Munich sample which were also found in the Bern sample. Predictors of health-relevant behavior patterns were analysed via multiple logistic regressions. Most results showed different effects on cluster membership between the two samples. Gender, professional status, social support from friends, and paying attention to regular meals were identified as predictor variables in both samples. Other variables identified as predictors occurred either in only one of the two samples or differed in the direction of their effect.

Female↗
PubMed1999

[Adoption and maintenance of health behavior: the challenge of treatment compliance].

The aim of this article is to give an overview of the different concepts related to the phenomenon of regularity so as to better outline it in the context of a medical treatment. The attitudes, the beliefs, the perception of the personal control as well as the motivation are presented as the different factors influencing the adoption and upholding of a health behaviour. The recent conception of the learning process and the active role given to the learner have led to the recognition of the fact that, in order to have an effective learning process, the learner must become involved in the self management and self control of his own learning process. Whatever the chosen strategy, an educative intervention focused on the knowledge can only be efficient if it enables the person to increase his (her) control.

Health Behavior↗
PubMed1995

Human behavior, health education and schistosomiasis control: a review.

This paper examines the role of human behavior in schistosomiasis transmission and control in relation to health education. The literature is reviewed to identify relevant behaviors and to examine progress and constraints in health education, using the primary health care approach. The behavior model by Dunn and the PRECEDE health education model by Green and coworkers are adapted for health education in schistosomiasis control. Because of its focus on the role of individual and community vs outside factors, deliberate vs non-deliberate behavior and health-enhancing and health-maintaining vs health-lowering behavior, Dunn's model can evaluate social, economic, cultural and political factors in schistosomiasis transmission and control that must be considered in health education. The PRECEDE model represents a suitable diagnostic tool for health education planning, intervention and evaluation.

Health Behavior↗
PubMed2001

[Cervical cancer prevention - awareness and health behavior changes of women in 1976, 1986, 1990 and 1998].

AIM: To find the changes in the proportion of women who declared knowledge about cytological tests and underwent that test in the years 1976, 1986, 1990 and 1998, as well as in the proportion of those who declared showing up at the gynaecologist during the last year. To assess the number of women taking part in the secondary prevention of cervical cancer. To correct health education intervention targeted at women. METHODS: The results of four cervical prevention surveys on representative samples of Polish women aged over 18 years were compared. RESULTS: The substantial (58%) increase in the proportion of women who declared awareness of cytological tests was shown. As expected, smaller favourable changes were found in the field of women's health related to secondary prevention. The percent of women who declared yearly visits at the gynaecologists increased by 12% and those who declared having cytological tests done during last three years by 7%. The lowest level of awareness and the lowest frequency of using prevention services were declared among women aged over 60, represented the lowest education level and resided in rural areas. CONCLUSIONS: It is important to continue educational work and intervention measures concerning cervical cancer prevention, with special attention to the most neglected groups of women.

Adult↗
PubMed1998

A profile of sexual health behaviors among college women.

This study examined the risk taking and preventive behaviors related to sexually transmitted diseases among sexually active college women. Self-report questionnaires were distributed at two mid-Atlantic universities yielding a final sample of 556 students. Data were collected regarding frequencies of pelvic examinations, numbers of vaginal, oral, and anal sex partners, and number of partners who had forced sex against their will. Also, frequencies of tests for sexually transmitted disease and HIV before having sex with new partners, methods of protection and birth control, and types of relationships were assessed. Finally, subjects reported the types of questions asked before having sex with a new partner and diagnoses of sexually transmitted diseases. Because most college-aged women are sexually active and vulnerable to a host of short- and long-term complications from sexually transmitted infections, educational interventions, in addition to promoting condom use, must focus on the need for regular pelvic examinations, screenings for sexually transmitted disease/HIV (self and partner), and lower risk sexual activity.

Adolescent↗
PubMed2005

[Relationship between parents' attitude and children's oral health behavior].

PURPOSE: The purpose of this investigation was to study the relationship between parents' attitude toward caries risk factor and children's behavior, such as brushing behavior and sugar-intake behavior, to provide foundation in carrying out oral health education. METHODS: A case-control study was performed to analyze parents' attitude of caries and their relationship with children's behavior. The groups were as follows: control group(dmft=0) and case group(dmft> or =3). Data was processed with Logistic regression of SPSS10.0. RESULTS: It was found that parents' attitude toward children's brushing teeth and sugar-intake had strong correlation with children's behavior in daily life. CONCLUSIONS: The results support the concept that parents' attitude toward children's tooth brushing and sugar-intake can predict their children's behavior. Caries can be reduced through oral health education in parents.

Attitude to Health↗
PubMed2000

Why carve out? Determinants of behavioral health contracting choice among large U.S. employers.

Many U.S. employers have carved substance abuse and mental health services out of their medical plans, changing the way millions of people access care. Employers that take this approach contract directly with specialized vendors, bypassing their general health plans. Since carving out may alter access and treatment, there is a need to understand why employers take this approach. This article reviews various hypotheses about why purchasers carve out and tests them using data from a survey of America's largest employers, the Fortune 500 firms. Size is the strongest predictor of an employer's decision to carve out behavioral health once other characteristics are controlled for. Employers that report they value coordination are less likely to carve out, while those that value special expertise are more likely to carve out. Employers are less likely to carve out enrollees in health maintenance organizations (HMOs) than those in other types of plans.

Employer Health Costs↗
PubMed2001

Monitoring and enforcing cultural competence in Medicaid managed behavioral health care.

In recent years cultural competence has expanded beyond language provisions to include understanding and factoring into services provision the cultural perspectives clients may have that are different from the majority culture. The federal government requires state Medicaid programs to offer culturally competent services, but little is known about how states implement such mandates and monitor and enforce them. We reviewed the origins and implications of cultural competence mandates and conducted a brief case study of 5 states to learn about the implementation of cultural competence provisions in behavioral managed care contracts. We found that states and managed behavioral health organizations (MBHOs) vary in their definitions and implementation of standards to ensure mental health care access for vulnerable populations. Although states had a variety of oversight mechanisms, varying contractual requirements ranging from optional to required, vague contract language, no existing standardized indicators or definitions, and scant data on the cultural characteristics of the populations enrolled in Medicaid managed care hamper monitoring and enforcement of cultural competence by states. Implications for MBHOs, states, and the federal government, as well as services researchers, follow.

Clinical Competence↗
PubMed1997

Interpreting profiling data in behavioral health care for a continuous quality improvement cycle.

OUTCOME MEASUREMENT SYSTEM: PsychSentinel, a symptom reduction measure, uses 20 diagnostically defined symptom checklists derived from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Symptoms are enumerated and are assigned weights on the basis of clinical significance, providing an overall assessment of symptom intensity. The availability of multisite benchmark norms makes possible the computation of observed-to-expected ratios. EXAMPLES OF THE CONTINUOUS QUALITY IMPROVEMENT CYCLE: Six examples, drawn from the experience of a number of behavioral health care programs since 1994, illustrate how outcome data can be used to guide and test changes that will effect improvements over current practices. Example 1: Problem identification is one of the most obvious and immediate applications of outcome data relative to a quality improvement process. Data were presented at a meeting of the hospital medical staff; the data showed that one clinician had significantly poorer outcomes in treating bipolar patients. A review of the medical records for bipolar patients treated by this clinician indicated that this clinician was changing medications too rapidly, a problem that was quickly and easily corrected-with improved outcomes. Example 6: Data revealed that patients who were treated in accordance with the critical pathway showed a greater degree of improvement, even though these patients entered treatment with a 10% greater level of symptom intensity. SUMMARY AND CONCLUSIONS: Each example provides a sample of variability in outcomes and therefore an opportunity to study the reasons for the variability and institute changes.

Bipolar Disorder↗
PubMed2003

Identity shifts as turning points in health behavior change.

The authors used a grounded formal theory approach to synthesize the findings of 14 studies, with the goal of identifying common elements in qualitative studies of individuals' efforts to change a variety of unhealthy behaviors. The combined sample of 399 participants had experiences of weight loss, smoking cessation, and alcohol and drug-abuse recovery. Data were extracted from published reports and analyzed using grounded-theory techniques. In the provisional model, a value conflict in response to distressing accumulated evidence prompts a small step toward behavior change. If successful, an identity shift begins. Increased self-awareness and self-confidence fuel continued change. Numerous constraints to success are noted at each step. The links to previous conceptions of identity shift are discussed.

Health Behavior↗
PubMed1988

Orthodontic treatment, dental health, and oral health behavior in young Norwegian adults.

Information about previous orthodontic treatment and oral health is evaluated for 525 17 yr-olds and 175 21 yr-olds. Of these, 24.6% of the 17 yr-olds and 14.3% of the 21 yr-olds had received orthodontic treatment. Orthodontic treatment did not appear to have had any adverse effect on the level of periodontal disease, and caries prevalence in the orthodontically treated 17 yr-olds was less than in the untreated subjects.

Adolescent↗
PubMedDate not supplied

Using social norms theory to explain perceptions and sexual health behaviors of undergraduate college students: an exploratory study.

The authors and associates conducted a social norms-based intervention targeting high-risk sexual behaviors among undergraduate students at 4 college campuses. Social norms theory predicts that widely held misperceptions may encourage risky behavior in a misguided attempt to conform to perceived norms and that information correcting these misperceptions will lead to a decrease in such behaviors. Students overestimated their peers' levels of sexual activity, numbers of partners, incidence of sexually transmitted infections, and rates of unintended pregnancies, but underestimated rates of condom use. Rates of HIV test taking, however, were accurately estimated. Although some components of sexual risk behaviors lend themselves well to social norms-based interventions, others, specifically inconsistent condom use and avoiding HIV tests, do not. Although no changes in reported beliefs or practices were apparent at the end of a 9-month intervention period, longer or modified interventions may be needed to make a fair assessment of the efficacy of this approach.

Adult↗
PubMed2006

Health behaviors among American Indian/Alaska Native women, 1998-2000 BRFSS.

BACKGROUND AND OBJECTIVE: Minority populations, including American Indians and Alaska Natives (AI/AN), in the United States generally experience a disproportionate share of adverse health outcomes compared with whites. The prevalence of risk behaviors associated with these adverse health outcomes among AI/AN women is not well documented, especially for those who live outside areas serviced by Indian Health Service. We sought to describe the prevalence of selected health risk behaviors among AI/AN women, document the disparities between AI/AN women and all U.S. women, and demonstrate the efforts needed for AI/AN women to reach Healthy People 2010 goals. METHODS: Age-adjusted prevalence estimates for selected sociodemographic characteristics, current smoking, obesity, lack of leisure time physical activity, and binge drinking were calculated using Behavioral Risk Factor Surveillance System (BRFSS) data from 1998 to 2000, combined. Comparisons were made between prevalence estimates for AI/AN women and all women who participated in the BRFSS and Healthy People 2010 goals. RESULTS: The prevalences of current smoking (27.8%) and obesity (26.8%) were significantly higher among AI/AN women than among all U.S. women. AI/AN women did not meet Healthy People 2010 goals for current smoking, obesity, leisure time physical activity, or binge drinking. CONCLUSIONS: These data highlight both disparities in health risk behaviors between AI/AN women and all U.S. women and improvements needed for AI/AN women to meet Healthy People 2010 goals. This project demonstrates the overwhelming need for culturally appropriate and accessible prevention programs to address health risk behaviors associated with the leading causes of death among urbanized AI/AN women.

Alcohol Drinking↗