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PubMed1983

A continuing education program for rural communities: evaluating cognitive and behavioral change.

A total of 133 laboratory workers from 60 institutions participated in a unique continuing education project in North Dakota. Cognitive and behavioral changes of the participants were measured in an attempt to evaluate the effectiveness of the Laboratory Education for North Dakota (LEND) program, which included self-instructional programs (SIPs), telelectures, and workshops. The effects of variables such as institutional size, educational level of participants, topic presented, and type of participation were studied. Institutional size had no significant effect on cognitive change (P greater than .05) but had some effect on behavioral change. Educational level was found to significantly affect pretest scores (P less than .05), but was not a major factor in post-test scores. Certain topics presented (i.e., quality assurance and microbiology) resulted in significantly more behavioral changes than other categories. Behavioral changes and degree of cognitive change did not always correspond. Significant correlation was shown between attendance at wet workshops and the number of behavioral changes.

Behavior↗
PubMedDate not supplied

Knowledge of AIDS and related behavior change among unmarried adults in a low-prevalence city.

Interviews regarding AIDS knowledge and related behavior change were conducted with a random sample of 409 unmarried individuals 18-39 years of age in Richmond, Virginia, between March 18 and April 3, 1987. Eight percent of the sample described themselves as "gay" or "bisexual," 92% as "heterosexual" (or "straight"). Key variables were knowledge of AIDS and HIV testing, level of concern for self, and changes in sexual behavior. Sixty-five percent of sexually active nonmonogamous individuals reported changing their behavior because of concern about AIDS; an additional 8% reported that they were already being careful. Fifty-two percent of those who changed their behavior reported having fewer sexual partners, and 51% were learning more about potential partners than before the AIDS crisis. Thirty-seven percent were using condoms to minimize risk. The level of concern for self was strongly associated with behavior change; of sexually active nonmonogamous individuals who were "very concerned" for themselves, 80% reported changes in sexual behavior. A multiple linear regression analysis indicated that three independent variables with significant F scores explained 17% of the variance in behavior change; the amount of knowledge about AIDS did not distinguish between those who had changed and those who had not. The level of concern was the most influential independent variable, explaining 12% of the variance.

Acquired Immunodeficiency Syndrome↗
PubMed2006

A chaotic view of behavior change: a quantum leap for health promotion.

BACKGROUND: The study of health behavior change, including nutrition and physical activity behaviors, has been rooted in a cognitive-rational paradigm. Change is conceptualized as a linear, deterministic process where individuals weigh pros and cons, and at the point at which the benefits outweigh the cost change occurs. Consistent with this paradigm, the associated statistical models have almost exclusively assumed a linear relationship between psychosocial predictors and behavior. Such a perspective however, fails to account for non-linear, quantum influences on human thought and action. Consider why after years of false starts and failed attempts, a person succeeds at increasing their physical activity, eating healthier or losing weight. Or, why after years of success a person relapses. This paper discusses a competing view of health behavior change that was presented at the 2006 annual ISBNPA meeting in Boston. DISCUSSION: Rather than viewing behavior change from a linear perspective it can be viewed as a quantum event that can be understood through the lens of Chaos Theory and Complex Dynamic Systems. Key principles of Chaos Theory and Complex Dynamic Systems relevant to understanding health behavior change include: 1) Chaotic systems can be mathematically modeled but are nearly impossible to predict; 2) Chaotic systems are sensitive to initial conditions; 3) Complex Systems involve multiple component parts that interact in a nonlinear fashion; and 4) The results of Complex Systems are often greater than the sum of their parts. Accordingly, small changes in knowledge, attitude, efficacy, etc may dramatically alter motivation and behavioral outcomes. And the interaction of such variables can yield almost infinite potential patterns of motivation and behavior change. In the linear paradigm unaccounted for variance is generally relegated to the catch all "error" term, when in fact such "error" may represent the chaotic component of the process. The linear and chaotic paradigms are however, not mutually exclusive, as behavior change may include both chaotic and cognitive processes. Studies of addiction suggest that many decisions to change are quantum rather than planned events; motivation arrives as opposed to being planned. Moreover, changes made through quantum processes appear more enduring than those that involve more rational, planned processes. How such processes may apply to nutrition and physical activity behavior and related interventions merits examination.

Journal Article↗
PubMed2004

"Is there nothing more practical than a good theory?": Why innovations and advances in health behavior change will arise if interventions are used to test and refine theory.

Theoretical and practical innovations are needed if we are to advance efforts to persuade and enable people to make healthy changes in their behavior. In this paper, I propose that progress in our understanding of and ability to promote health behavior change depends upon greater interdependence in the research activities undertaken by basic and applied behavioral scientists. In particular, both theorists and interventionists need to treat a theory as a dynamic entity whose form and value rests upon it being rigorously applied, tested and refined in both the laboratory and the field. To this end, greater advantage needs to be taken of the opportunities that interventions afford for theory-testing and, moreover, the data generated by these activities need to stimulate and inform efforts to revise, refine, or reject theoretical principles.

Journal Article↗
PubMed2005

Bandwidth constraints to using video and other rich media in behavior change websites.

BACKGROUND: Web-based behavior change interventions often include rich media (eg, video, audio, and large graphics). The rationale for using rich media includes the need to reach users who are not inclined or able to use text-based website content, encouragement of program engagement, and following the precedent set by news and sports websites. OBJECTIVES: We describe the development of a bandwidth usage index, which seeks to provide a practical method to gauge the extent to which websites can successfully be used within different Internet access scenarios (eg, dial-up and broadband). METHODS: We conducted three studies to measure bandwidth consumption. In Study 1, we measured the bandwidth usage index for three video-rich websites (for smoking cessation, for caregivers, and for improving eldercare by family members). We then estimated the number of concurrent users that could be accommodated by each website under various Internet access scenarios. In Study 2, we sought to validate our estimated threshold number of concurrent users by testing the video-rich smoking cessation website with different numbers of concurrent users. In Study 3, we calculated the bandwidth usage index and threshold number of concurrent users for three versions of the smoking cessation website: the video-rich version (tested in Study 1), an audio-rich version, and a Web-enabled CD-ROM version in which all media-rich content was placed on a CD-ROM on the client computer. RESULTS: In Study 1, we found that the bandwidth usage index of the video-rich websites ranged from 144 Kbps to 93 Kbps. These results indicated that dial-up modem users would not achieve a "good user experience" with any of the three rich media websites. Results for Study 2 confirmed that usability was compromised when the estimated threshold number of concurrent users was exceeded. Results for Study 3 indicated that changing a website from video- to audio-rich content reduced the bandwidth requirement by almost 50%, but it remained too large to allow satisfactory use in dial-up modem scenarios. The Web-enabled CD-ROM reduced bandwidth requirements such that even a dial-up modem user could have a good user experience with the rich media content. CONCLUSIONS: We conclude that the bandwidth usage index represents a practical tool that can help developers and researchers to measure the bandwidth requirements of their websites as well as to evaluate the feasibility of certain website designs in terms of specific use cases. These findings are discussed in terms of reaching different groups of users as well accommodating the intended number of concurrent users. We also discuss the promising option of using Web-enabled CD-ROMs to deliver rich media content to users with dial-up Internet access. We introduce a number of researchable themes for improving our ability to develop Web-based behavior change interventions that can better deliver what they promise.

Attitude to Health↗
PubMed2005

Role of NMDA receptors in the syndrome of behavioral changes produced by predator stress.

Effects on behavioral response to predator stress of competitive block of NMDA receptors with doses of .1, 1.0 and 10 mg/kg of CPP (3-(2-carboxypiperazin4-yl)propyl-l-phosphonic acid) were studied. An affect test battery assessed behavioral response to stress and employed hole board, elevated plus maze, light/dark box, social interaction, social avoidance and response to acoustic startle tests. Doses of 1-10 mg/kg of CPP administered ip 30 min prior to predator stress blocked the effects of predator stress on some but not all behaviors measured 8-9 days later. Predator stress normally reduces open arm exploration and risk assessment in the plus maze, decreases entries into the lighted arm of the light dark box and delays habituation of the acoustic startle response. CPP blocked all of these effects of predator stress. A dose of 10 mg/kg of CPP was required for all behaviors except habituation to startle. Block of effects on habituation to startle occurred at 1 and 10 mg/kg. Behaviors in which effects of predator stress were not blocked by CPP included reduction in unprotected head dips in the elevated plus maze and reduced social interaction. In addition, predator stress was without effect on social avoidance measured with the Haller test. These findings extend previous work showing NMDA receptor dependence of effects of predator stress on behavior in the elevated plus maze and on amplitude of acoustic startle response. Novel findings include NMDA receptor dependence of predator stress effects on light dark box behavior and startle habituation. Taken together, the findings add to a body of evidence showing that a syndrome of behavioral changes follows predator stress. Components of this syndrome of behavioral changes likely depend on changes in separable neural substrates initiated in part by NMDA receptors as well as by other neurochemical means.

Analysis of Variance↗
PubMed1994

The association between health beliefs and health behavior change in older adults.

BACKGROUND: Previous studies have reported weak relationships between health beliefs and behavior change; few studied elderly populations. METHODS: We examined the relation between self-reported behavior change and health-related beliefs among an educated, upper-middle-class population age 50 to 89 years. RESULTS: More women reported decreasing dietary salt and fat, changing diet, and reading self-help materials than men. Younger respondents (age 50 to 69 years) reported more positive health behavior changes in diet and exercise than did older respondents (age 70 to 89 years). Respondents who agreed that diet and exercise were important for optimal health and/or spent money on healthful items reported more positive behavior change than those who disagreed. Those who reported confusion about how to stay healthy or a lack of motivation to engage in healthful behaviors were less likely to make positive lifestyle changes. Older respondents reported a higher rate of confusion regarding which foods to eat (53% vs 39%) and how to stay healthy (29% vs 19%) than younger respondents, while younger respondents were more likely to report a problem with motivation (40% vs 34%). CONCLUSIONS: These results suggest that increasing age does not diminish the relation between health beliefs and health behaviors. Health promotion campaigns aimed at older adults should strive to reduce confusion to improve health behavior.

Age Factors↗
PubMed2001

Prevalence of behavioral changes associated with age-related cognitive impairment in dogs.

OBJECTIVE: To determine the prevalence of age-related behavioral changes, namely impairment, in a randomly chosen population of dogs. DESIGN: Age-stratified cohort study. ANIMALS: 97 spayed female and 83 castrated male dogs that were 11 to 16 years old. PROCEDURE: Data on possible impairment in 4 behavioral categories (ie, orientation in the home and yard, social interaction, house training, and sleep-wake cycle) linked to cognitive dysfunction were obtained from dog owners, using a structured telephone interview. Hospital records of dogs had been screened to exclude dogs with dysfunction in organ systems that may cause behavioral changes. Dogs with behavioral impairment were those with > or = 2 signs of dysfunction within a category. Dogs with impairment in 1 category were considered mildly impaired and those with impairment in > or =2 categories were considered severely impaired. RESULTS: Age by sex interactions for dogs with impairment in any category were not significant, and, therefore, data on castrated males and spayed females were pooled for analyses across ages. The prevalence of age-related progressive impairment was significant in all categories. The percentage of 11- to 12-year-old dogs with impairment in > or = 1 category was 28% (22/80), of which 10% (8/80) had impairment in > or = 2 behavioral categories. Of 15- to 16-year-old dogs, 68% (23/34) had impairment in > or =1 category, of which 35% (12/34) had impairments in > or = 2 categories. There were no significant effects of body weight on the prevalence of signs of dysfunction in the behavioral categories. CONCLUSIONS AND CLINICAL RELEVANCE: Data collected provide estimates of the prevalence of various degrees of age-related behavioral changes associated with cognitive dysfunction in dogs. Age-related behavioral changes may be useful indicators for medical intervention for dogs with signs of cognitive impairment.

Age Factors↗
PubMed1995

HIV/AIDS-related behavior change among injecting drug users in different national settings.

OBJECTIVES: To identify factors associated with effective AIDS behavior change among injecting drug users (IDU) in different national settings. DESIGN: Cross-sectional surveys of IDU, with determination of HIV status. Trends in city HIV seroprevalence among IDU also used to validate effectiveness of behavior change. SETTING AND PARTICIPANTS: Subjects recruited from drug-use treatment programs and outreach efforts in Bangkok, Thailand (n = 601), Glasgow, Scotland (n = 919), New York City, USA (n = 2539), and Rio de Janeiro, Brazil (n = 466). RESULTS: Evidence for the effectiveness of self-reported risk reduction was available for all cities. Univariate followed by multiple logistic regression analyses were used to identify factors associated with self-reported AIDS behavior change. Separate analyses were conducted for each city. Talking about AIDS with drug-using friends was significantly associated with behavior change in all four cities. Talking with sex partners about AIDS, educational level, knowing that someone can be HIV-infected and still look healthy, and having been tested previously for HIV were each significantly associated with behavior change in three of the four cities. CONCLUSIONS: Despite the substantial differences in these national settings, there were common factors associated with effective risk reduction. In particular, risk reduction appears to occur through social processes rather than through individual attitude change. HIV prevention programs need to explicitly incorporate social processes into their work.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Systematic comparison of apomorphine-induced behavioral changes in two mouse strains with inherited differences in brain dopamine receptors.

Dosage and time dependencies of apomorphine-induced changes in stereotyped behaviors (climbing, gnawing and sniffing), locomotor activity and rearing activity were compared in young adult male mice of two inbred strains, DBA/2 and C57BL/6. These two strains are known to differ in their genetically specified brain dopamine receptor number. Apomorphine administered intraperitoneally at dosages of 0.5-20 mg/kg failed to induced stereotyped climbing in DBA/2 at any of the doses tested but markedly increased climbing in C57BL/6 at higher dosages. Apomorphine-induced stereotyped gnawing occurred in both strains at higher dosages although the latency was shorter and maximal effect greater in C57BL/6. Stereotyped sniffing was induced in both strains to a comparable degree at doses greater than or equal to 2.0 mg/kg, and the duration of this stereotypy was indistinguishable between strains. Locomotor activity was inhibited maximally in DBA/2 at an apomorphine dosage of 2 mg/kg and was inhibited to a greater extent than was C57BL/6. Rearing was inhibited in both strains by doses of apomorphine greater than or equal to 0.5 mg/kg; however the duration of the effect was considerably greater in DBA/2 than in C57BL/6. These data suggest that genetically determined differences in central dopamine receptors may have profound and selective effects on behaviors mediated by dopamine pathways; that complex behavioral patterns, e.g., apomorphine-induced stereotypy, may be dissected in to individual components by identifying neuropharmaco genetic differences between strains; that marked strain-specific, inherited differences in dopamine agonist-induced behavioral changes do occur among inbred, non-mutant mouse strains and that their occurrence in other mammalian species including man should be considered.

Animals↗
PubMedDate not supplied

Implementing health behavior change in primary care: lessons from prescription for health.

PURPOSE: Our objective was to identify themes that emerged from the evaluation of 17 interventions funded by the Robert Wood Johnson Foundation's Prescription for Health that aimed to enhance adherence to healthy behaviors in the primary care setting. METHODS: We performed a content analysis of diary data from this 16-month initiative. Other data sources used to complement this analysis include funded grant applications and field notes from interviews with investigative teams and a limited number of site visits. Participants were 17 practice-based research networks (PBRNs) that had projects funded during Round 1 of Prescription for Health. RESULTS: Five themes emerged regarding implementation of health behavior change: (1) health behavior change resources are enthusiastically received by practices and patients, and when given a choice, patients prefer methods of assistance that involve personal contact; (2) practice extenders require extensive training, as well as careful case management and support, in order to function fully and avoid burnout; (3) integrating behavior change tools into the primary care setting requires time, effort, and often specialized expertise; (4) even simple interventions require practice change, and use of a practice change model to guide implementation efforts is crucial; and (5) research philosophy and project management approaches vary across PBRNs and have implications for the potential sustainability of an intervention. CONCLUSIONS: A more versatile, multifaceted solution involving new tools, technologies, and multidisciplinary care teams is needed in order to integrate health behavior change into everyday primary care routines. Even the best interventions require a model to articulate how to integrate an innovation into practices.

Health Behavior↗
PubMed1982

Sucrose-induced behavior changes of persons with Prader-Willi syndrome.

The relationship between changed or erratic behavior of nine Prader-Willi males and their ingestion of excess kcalories from sucrose was examined. The study was a double-blind design, with objective measures of behavioral change following ingestion of either a sucrose solution or a control preparation containing starch or saccharin. On each of the 3 test days, one of the three test solutions was given, along with a standard 210 kcalorie starch-based breakfast. Blood glucose values at 0.30, 60, 120, and 180 minutes after feeding were compared to the percentage of errors made on paired-associate learning tasks (given eight times daily) and the gross-motor "movement" scores from a wrist monitor and a chair attached to an electrical counter. Results showed that out of 162 test correlations performed, only 8 were significant, exactly the number expected by chance. Possible reasons were suggested as to why no significant differences were found.

Adolescent↗
PubMed1990

Behavioral changes induced by stressful situations: effects of enkephalins, dynorphin, and their interactions.

Effects of opioid peptides on behavioral changes induced by stressful situations were investigated. [D-Ala2,Met5]-enkephalinamide and [D-Ala2,D-Leu5]-enkephalin, degrading-enzyme-resistant derivatives of methionine-enkephalin and leucine-enkephalin, respectively, significantly attenuated both environment-induced conditioned suppression of motility and forced swimming-induced immobility in a dose-dependent manner. The [D-Ala2,Met5]-enkephalinamide- and [D-Ala2,D-Leu5]-enkephalin-induced attenuations were antagonized by naloxone at different doses. In contrast, dynorphin A(1-17) and [N-methyl-Tyr1,N-methyl-Arg7,D-Leu8]-dynorphin A(1-8) ethylamide (E 2078), a degrading-enzyme-resistant derivative of dynorphin, significantly potentiated both behavioral changes. The dynorphin- and E 2078-induced potentiations were inhibited by Mr 2266. [D-Ala2,Met5]-enkephalinamide-induced attenuation of environment-induced conditioned suppression of motility and forced swimming-induced immobility was prevented by treatment with dynorphin and E 2078 at the doses that did not affect the behavioral changes. This antagonism by both dynorphin and E 2078 was inhibited by Mr 2266. However, [D-Ala2,D-Leu5]-enkephalin-induced attenuation of both behavioral changes was not affected by either dynorphin or E 2078. These results indicated that activation of the methionine- or leucine-enkephalinergic system attenuates behavioral changes induced by stress, whereas activation of the dynorphinergic system potentiates those changes. Furthermore, the dynorphinergic system may interact with the methionine-enkephalinergic system, but not with the leucine-enkephalinergic system.

Animals↗
PubMed2001

The therapeutic challenge: behavioral changes for long-term weight maintenance.

OBJECTIVES: Long-term results of dietary and behavioral treatment of obesity fail to match the obese patients' expectations, as well as the professionals' requirements. The therapeutic challenge remains to induce behavioral changes during treatment which are maintained over a long period of time, thus enabling long-term weight maintenance. The paper develops a framework to improve lasting behavioral changes. RESULTS AND CONCLUSIONS: Four elements may enhance long-term success. First, patients' unrealistic expectations about the weight loss have to be modified and patients have to be supported in accepting moderate and modest weight losses as success. Second, behavioral change can only be achieved if treatment involves a long-lasting training process, which for most patients needs to continue more than a year. Third, behavioral and attitudinal change should be governed by the principle of flexible control of eating behavior, and rigid control should be discouraged. Forth, long-term success appears to be more likely, the more behavioral dimensions are involved in the process of behavioral change.

Assertiveness↗
PubMed1998

Changing behaviors to optimize women's health: a multidisciplinary seminar.

The purpose of this article is to summarize the multidisciplinary seminar, "Changing Behaviors to Optimize Women's Health," which was offered in June 1997. We describe each of the 5 seminar presentations and present a synopsis of their conclusions and implications for dietetics practice. The seminar presented evidence that women's health is a national issue of increasing economic, political, and medical importance; the treatment and prevention of many diseases common to women have special and unique nutritional considerations; and optimizing women's health will require more effective strategies for transforming information into health practices. We discuss salient points from the seminar regarding the leadership roles of dietitians as educators, advocates, and agents for behavior change in optimizing women's health and explore strategies that could help dietetics professionals enhance their effectiveness among women, including building partnerships with patients, developing an understanding of the patient's experience, starting where the patient is, and concentrating on small changes for success.

Dietetics↗
PubMedDate not supplied

Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature.

OBJECTIVE: Estimate effectiveness of goal setting for nutrition and physical activity behavior change, review the effect of goal-setting characteristics on behavior change, and investigate effectiveness of interventions containing goal setting. DATA SOURCE: For this review, a literature search was conducted for the period January 1977 through December 2003 that included a Current Contents, Biosis Previews, Medline, PubMed, PsycINFO, and ERIC search of databases and a reference list search. Key words were goal, goal setting, nutrition, diet, dietary, physical activity, exercise, behavior change, interventions, and fitness. STUDY INCLUSION AND EXCLUSION CRITERIA: The search identified 144 studies, of which 28 met inclusion criteria for being published in a peer reviewed journal and using goal setting in an intervention to modify dietary or physical activity behaviors. Excluded from this review were those studies that (1) evaluated goal setting cross-sectionally without an intervention; (2) used goal setting for behavioral disorders, to improve academic achievement, or in sports performance; (3) were reviews. DATA EXTRACTION AND SYNTHESIS: The articles were categorized by target audience and secondarily by research focus. Data extracted included outcome measure, research rating, purpose, sample, sample description, assignment, findings, and goal-setting support. RESULTS: Thirteen of the 23 adult studies used a goal-setting effectiveness study design and eight produced positive results supporting goal setting. No adolescent or child studies used this design. The results were inconclusive for the studies investigating goal-setting characteristics (n = 7). Four adult and four child intervention evaluation studies showed positive outcomes. No studies reported power calculations, and only 32% of the studies were rated as fully supporting goal setting. CONCLUSIONS: Goal setting has shown some promise in promoting dietary and physical activity behavior change among adults, but methodological issues still need to be resolved. The literature with adolescents and children is limited, and the authors are not aware of any published studies with this audience investigating the independent effect of goal setting on dietary or physical activity behavior. Although, goal setting is widely used with children and adolescents in nutrition interventions, its effectiveness has yet to be reported.

Diet↗
PubMed2000

Teacher training as a behavior change process: principles and results from a longitudinal study.

For students to realize the benefits of behavior change curricula for disease prevention, programs must be implemented effectively. However, implementation failure is a common problem documented in the literature. In this article, teacher training is conceptualized as a behavior change process with explicit teacher motivation components included to help effect the intended behavior (i.e., implementation). Using this method, the Hutchinson Smoking Prevention Project, a randomized controlled trial in school-based smoking prevention, conducted 65 in-service programs, training nearly 500 teachers (Grades 3-10) from 72 schools. Implementation was monitored by teacher self-report and classroom observations by project staff. The results were favorable. All eligible teachers received training, virtually all trained teachers implemented the research curriculum, and 89% of observed lessons worked as intended. It is concluded that teacher training conceptualized as a behavior change process and including explicit teacher motivation components can promote effective implementation of behavior change curricula in public school classrooms.

Adolescent↗