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PubMedDate not supplied

Student assistance program: a new approach for student success in addressing behavioral health and life events.

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.

Counseling↗
PubMed2006

Behavioral health insurance parity for federal employees.

BACKGROUND: To improve insurance coverage of mental health and substance-abuse services, the Federal Employees Health Benefits (FEHB) Program offered mental health and substance-abuse benefits on a par with general medical benefits beginning in January 2001. The plans were encouraged to manage care. METHODS: We compared seven FEHB plans from 1999 through 2002 with a matched set of health plans that did not have benefits on a par with mental health and substance-abuse benefits (parity of mental health and substance-abuse benefits). Using a difference-in-differences analysis, we compared the claims patterns of matched pairs of FEHB and control plans by examining the rate of use, total spending, and out-of-pocket spending among users of mental health and substance-abuse services. RESULTS: The difference-in-differences analysis indicated that the observed increase in the rate of use of mental health and substance-abuse services after the implementation of the parity policy was due almost entirely to a general trend in increased use that was observed in comparison health plans as well as FEHB plans. The implementation of parity was associated with a statistically significant increase in use in one plan (+0.78 percent, P<0.05) a significant decrease in use in one plan (-0.96 percent, P<0.05), and no significant difference in use in the other five plans (range, -0.38 percent to +0.23 percent; P>0.05 for each comparison). For beneficiaries who used mental health and substance-abuse services, spending attributable to the implementation of parity decreased significantly for three plans (range, -201.99 dollars to -68.97 dollars; P<0.05 for each comparison) and did not change significantly for four plans (range, -42.13 dollars to +27.11 dollars; P>0.05 for each comparison). The implementation of parity was associated with significant reductions in out-of-pocket spending in five of seven plans. CONCLUSIONS: When coupled with management of care, implementation of parity in insurance benefits for behavioral health care can improve insurance protection without increasing total costs.

Cost Sharing↗
PubMed1990

Knowledge, attitudes, treatment practices, and health behaviors of nurses regarding blood cholesterol and cardiovascular disease.

Knowledge, attitudes, and practice patterns concerning cholesterol and heart disease were evaluated in a stratified, random sample of 206 registered nurses at a major academic medical center in New York City. Virtually all nurses were convinced of the importance of diet in reducing heart disease risk, and most (78%) agreed that nutrition counseling should be their responsibility. Although only 19% reported that they were currently counseling, many more felt prepared to counsel about diet or drug therapy (43%). Nurses who were likely to counsel were those working in general medicine, those who were certified nurse practitioners, those who knew their own blood cholesterol level, and those with higher knowledge scores. Level of overall knowledge was associated with the practice of counseling, an attitude that counseling should be a nurse's responsibility, and personal health behavior (knew own level), regardless of age or occupational or degree status. Despite their enthusiasm for heart disease prevention through diet modification, many nurses had substantial knowledge gaps, suggesting that nurses are currently not adequately prepared to counsel about diet and/or drug treatment for high blood cholesterol. Educational strategies and considerations in integrating an expanded role for nurses with those of physicians and dietitians are discussed.

Academic Medical Centers↗
PubMed2001

Implementing medication algorithms. Role of behavioral health nurses.

1. Clinical practice guidelines, also called algorithms, practice standards, protocols, and policies, are systematically refined parameters that guide decision making related to specific clinical disorders. 2. Algorithms and clinical practice guidelines were developed to provide a sequential framework for clinical decision making, improve quality of care, increase patient safety, control costs, and provide standardization of care. 3. While each format used to develop algorithms and clinical practice guidelines has advantages and disadvantages, the evidence-based format, in which an expert panel reviews evidence and designs the guidelines, which are then reviewed by practitioners and organizations in that clinical area, provides the most up-to-date and accurate guidelines. 4. As frontline caregivers in the behavioral health care system, nurses are in an ideal position to monitor patients' adherence and responses to clinical guidelines, including medication algorithms.

Algorithms↗
PubMed2026

Effectiveness of peer recovery support services for substance use disorders: A systematic review of healthcare utilization, behavioral health, and engagement outcomes.

BACKGROUND: Peer recovery support services (PRS) delivered by individuals with lived experience of substance use, are increasingly incorporated into substance use disorder (SUD) care systems to improve care engagement, reduce acute care use, and support recovery. However, existing systematic reviews have focused on substance use outcomes, with limited attention to healthcare utilization, psychosocial functioning, and outcomes across settings, and populations. METHODS: This systematic review, registered in PROSPERO (CRD42023469279), synthesized peer-reviewed studies from 2003 to 2026 evaluating PRS for individuals with alcohol or drug-related SUD. Using MEDLINE, Embase, PsycINFO, and CINAHL, the review included 53 studies primarily conducted in high-income countries that reported quantitative outcomes across substance use, healthcare utilization, behavioral health, and treatment engagement. Risk of bias was assessed using Cochrane RoB 2, ROBINS-I, and ROBINS-E tools. RESULTS: Overall, evidence was most favorable for selected treatment-linkage and engagement outcomes, whereas findings for substance use, emergency department use, hospitalization, overdose, and mortality were inconsistent. Uncontrolled longitudinal studies frequently reported improvements in depression and anxiety, but no randomized trials evaluated these outcomes, limiting causal inference. Exploratory cross-study patterns suggested that sustained navigation, practical assistance, and repeated peer contact were more often present in programs reporting favorable outcomes; however, these components were not independently evaluated. Substantial heterogeneity, frequent multicomponent interventions, high risk of bias in many nonrandomized studies, and limited long-term and economic data constrain conclusions. CONCLUSIONS: Findings support the promise of PRS while underscoring the need for more rigorous comparative studies, cost-effectiveness data, and further research in low- and middle-income countries.

Humans↗
PubMed2001

Health behavior changes after colon cancer: a comparison of findings from face-to-face and on-line focus groups.

This qualitative study assessed the feasibility and comparability of findings from face-to-face versus on-line chat focus groups including 12 individuals affected by colon cancer. Discussion questions focused on issues of lifestyle (nutrition and exercise), cancer screening, and treatment. Despite demographic differences, the themes that emerged from the two types of groups were similar. On-line participants generally talked more about cancer treatment and advocacy issues and used support groups more frequently. The anonymity of on-line chat groups appeared to provide a more comfortable forum for some people to discuss sensitive personal health issues. As both methods provided similar results, researchers may wish to consider circumstances in which using chat-based focus groups may provide a feasible alternative to traditional face-to-face groups.

Colonic Neoplasms↗
PubMed2005

Behavioral health problems, ex-offender reentry policies, and the "Second Chance Act".

The federal "Second Chance Act of 2005" calls for expanding reentry services for people leaving prison, yet existing policies restrict access to needed services for those with criminal records. We examined the interaction between individual-level characteristics and policy-level restrictions related to criminal conviction, and the likely effects on access to resources upon reentry, using a sample of prisoners with Axis I mental disorders (n=3073). We identified multiple challenges related to convictions, including restricted access to housing, public assistance, and other resources. Invisible punishments embedded within existing policies were inconsistent with the call for second chances. Without modification of federal and state policies, the ability of reentry services to foster behavioral health and community reintegration is limited.

Adolescent↗
PubMed2005

NCQA behavioral health measurement efforts.

OBJECTIVE: To review the role of the National Committee for Quality Assurance (NCQA) in ensuring the quality of care in the managed care setting and identify novel strategies to improve performance rates for Health Plan Employer Data and Information Set (HEDIS) measures, particularly in the area of depression. SUMMARY: NCQA, by regulating HEDIS measures, sets the standards by which managed care organizations evaluate their performance in providing care for their enrollees. The medication management measure for depression evaluates practitioner contacts and acute and continuation phase treatments for persons treated with an antidepressant. Despite increased detection and management of patients with depression, there is still room for improvement in HEDIS performance rates for this chronic disease. CONCLUSION: NCQA hopes to improve collaboration among managed care organizations and managed behavioral health organizations In addition, NCQA regularly reevaluates the HEDIS measures using input from panels of experts. Incentive p r o grams for providers who deliver quality care may also help to improve HEDIS performance rates for depression. Research is under way to evaluate the feasibility and re t u rn on investment for pay-for-performance programs in depression.

Antidepressive Agents↗
PubMed1999

Stage distributions for five health behaviors in the United States and Australia.

BACKGROUND: A key variable for the design of individual and public health interventions is the Stage of Change. The five stages of readiness to change are Precontemplation, Contemplation, Preparation, Action, and Maintenance. The distribution of individuals across the stages of change can provide a valuable tool for designing health interventions. METHODS: The pattern of distribution across the stages of change for five behavioral risk factors is presented from five independent surveys, two from the United States and three from Australia. The five risk factors are smoking, low fat diet, regular exercise, reducing stress, and losing weight. Identical single-item questionnaire items for staging health behaviors were used in all surveys. RESULTS: The stage distributions for the five risk factors were similar across the five independent samples. In general, the pattern of stage distributions was stable across health risk factors, gender, country, and sample. CONCLUSIONS: Single-item survey measures of stage of change that are readily applicable to population studies appear to provide important information about the population characteristics of readiness to change behavioral risk factors. The stability of these distributions suggests that interventions matched by stage may have broad applicability.

Adolescent↗
PubMed2005

Establishing the computer-patient working alliance in automated health behavior change interventions.

Current user interfaces for automated patient and consumer health care systems can be improved by leveraging the results of several decades of research into effective patient-provider communication skills. A research project is presented in which several such "relational" skills - including empathy, social dialogue, nonverbal immediacy behaviors, and other behaviors to build and maintain good working relationships over multiple interactions - are explicitly designed into a computer interface within the context of a longitudinal health behavior change intervention for physical activity adoption. Results of a comparison among 33 subjects interacting near-daily with the relational system and 27 interacting near-daily with an identical system with the relational behaviors ablated, each for 30 days indicate, that the use of relational behaviors by the system significantly increases working alliance and desire to continue working with the system. Comparison of the above groups to another group of 31 subjects interacting with a control system near-daily for 30 days also indicated a significant increase in proactive viewing of health information.

Adult↗
PubMed1991

Dental health behavior and attitudes--an application of correspondence analysis.

Differences in dental behavior and dental attitudes between people with (almost) all natural teeth, people with a full denture in both jaws and people with a full denture in only the maxilla are visualized by means of correspondence analysis in one overall picture. In this picture the three distinguished subgroups of dental patients and their characteristics are indicated as points in a two-dimensional space. The distances between the points in this picture show to what extent these points are connected. The findings obtained in this study can lead to the conclusion that: a. differences in dental status are related to differences in dental behavior and dental attitudes; b. people with all natural teeth and people with a full denture in both jaws obviously are opposite of each other in many respects, whereas people with a full denture in only one jaw can be characterized as a dental in-between group.

Adult↗
PubMed2006

Improving measurement in health education and health behavior research using item response modeling: introducing item response modeling.

This paper is the first of several papers designed to demonstrate how the application of item response models in the behavioral sciences can be used to enhance the conceptual and technical toolkit of researchers and developers and to understand better the psychometric properties of psychosocial measures. The papers all use baseline data from the Behavior Change Consortium data archive. This paper begins with an introduction to item response models, including both dichotomous and polytomous versions. The concepts of respondent and item location, model interpretation, standard errors and testing model fit are introduced and described. A sample analysis based on data from the self-efficacy scale is used to illustrate the concepts and techniques.

Data Interpretation, Statistical↗
PubMed2005

The effects of perceived stress on reactions to messages designed to increase health behaviors.

This study examined the impact of perceived stress on responses to messages that encouraged the performance of health promotion and disease detection behaviors. It was hypothesized that increases in perceived stress would be associated with decreased processing of messages encouraging disease detection behaviors, and that increases in perceived stress would not effect the processing of messages encouraging health promotion behaviors. To test these hypotheses participants completed a perceived stress measure and then read a message that encouraged the performance of either a health promotion or a disease detection behavior. Then the participants were asked to indicate their agreement with the message and to attempt to recall the message. The results indicated that participants experiencing higher levels of perceived stress spent less time reading and recalled less of the messages about detection behaviors than of the messages about promotion behaviors. When participants were experiencing lower levels of perceived stress these differences disappeared.

Adolescent↗
PubMedDate not supplied

Optimism: a determinant of health behavior.

Nurses intuitively recognize an optimistic outlook as a personality component that has a positive impact on clients' health-related behavior. Optimism, however, has not been studied from the perspective of nursing. The author did a concept analysis of optimism (the first step in grounding the study of optimism in nursing practice); identified attributes, antecedents, and consequences; and developed a definition of optimism. A case study contrasts examples of a model, borderline, and contrary positions and illustrates their differences.

Adaptation, Psychological↗
PubMed2005

Health status, health behaviors, and acculturation factors associated with overweight and obesity in Latinos from a community and agricultural labor camp survey.

BACKGROUND: U.S. Latino adults have experienced an 80% increase in obesity in the last decade. METHODS: A cross-sectional survey of 18-64-year-old Latino women (N = 380) and men (N = 335) from a community sample, and men (N = 186) from an agricultural labor camp sample in Monterey County, California, provided data on correlates of obesity. RESULTS: In the community and labor camp samples, prevalences of chronic disease risk factors (high blood pressure and cholesterol, diabetes) were 1.5-7 times higher in the heaviest compared with the leanest weight groups. Higher acculturation (generational status, years lived in the United States) was the strongest correlate of obesity (measured by BMI) in the community sample (P < 0.001), followed by less exercise and poorer diet (P values < 0.05). Women who exercised <2.5 h/week, watched TV regularly, ate chips/fried snacks, and ate no fruit the previous day were 45 lbs heavier than women with healthier habits. Men who did not exercise, rarely trimmed fat from meat, and ate fried foods the previous day were 16 lbs heavier than men with healthier habits. Discussions with health care providers about diet/exercise were associated with more accurate weight perception and more weight loss attempts in obese participants in both samples. CONCLUSIONS: The associations of acculturation, exercise, and diet to BMI implicate societal as well as individual contributors to obesity among U.S. Latinos.

Acculturation↗
PubMed1985

Methodologic issues in self-report of health behavior.

Self-reports of behavior are the most commonly used method for collecting outcome data in health education programs, but they are subject to a variety of sources of measurement error. Problems of measurement in some recently reported education program evaluations are identified, and a model is proposed to identify systematically the major influences for accuracy of self-reported measures of behavior. Several methodologic studies on the skill aspect of self-report form completion are briefly described, and eight steps to promote more accurate self-report of health behaviors are proposed.

Attitude to Health↗
PubMed2006

Application of theory-based health behavior change techniques to the prevention of obesity in children.

Few studies that apply behavior change constructs such as goal setting, self-efficacy, and readiness for change to childhood obesity interventions exist. The purpose of this study was to adapt these constructs for use within a community-based obesity prevention program designed for fifth and sixth graders and their families. Games, worksheets, and a helpful acronym made the constructs developmentally appropriate and comprehensible to 11- and 12-year-olds. The age-adapted techniques have the potential to enhance obesity programs in a population for whom the obesity issue is critical.

Abbreviations as Topic↗