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Rethinking perceived risk and health behavior: a critical review of HIV prevention research.

Perceived risk of infection, one factor influencing HIV-related behavior decisions, has been the focus of expanding research efforts. A body of research now exists examining factors related to risk perceptions and the relationship between risk perceptions and behavioral decision making. This article examines 60 quantitative studies of HIV-related risk perceptions, identifies methodological and theoretical limitations or gaps in current knowledge, and suggests ways future research might better assess the role of risk perceptions and facilitate the adoption and maintenance of HIV-related health protective behaviors. The authors argue that mixed findings in the quantitative literature are due to (1) cross-sectional study designs that constrain or confound the interpretation of findings, (2) construct confusion and measurement inconsistencies. (3) insufficient consideration of specific subgroup or behavioral differences, and (4) inattention to situational norms and other contextual factors that influence risk perceptions and behavior.

Acquired Immunodeficiency Syndrome↗

Cynical hostility: developmental factors, psychosocial correlates, and health behaviors.

Examined potential differences between individuals with high and low Cook and Medley (1954) Hostility (Ho) scale scores in regard to (a) self-esteem and particular developmental experiences; (b) utilization of social support, experience of anger, and the manner in which anger is managed; and (c) potentially health-damaging behaviors. Individuals with high Ho scale scores were found to be low in covert self-esteem and reported behavior on the part of their parents that reflected (a) less genuine acceptance, (b) more interference in the person's desires as a child, and (c) more punitiveness. In addition, the results indicated that high Ho score individuals avoid seeking or accepting social support, experience anger that is excessive and that occurs in a wide variety of situations, and suppress expression of anger. Finally, it was found that hostile individuals tended to drink more alcohol and drive a car more frequently after drinking and to have greater relative weight.

Adult↗

Dental prophylaxis for youths in their late teens. II. Knowledge about dental health and diseases and the relation to dental health behavior.

A study of the knowledge about dental health and diseases of youths in their late teens has been conducted. A 10-class questionnaire relating to dental caries and gingivitis/periodontitis was answered by three test groups (A, B, C) totalling seventy-eight 19-year-olds who, during a 3-year period, had undergone professional prophylaxis at different intervals. Nineteen young people of the same age without organized preventive measures since their last attendance at the public dental service constituted a control group (D). The test groups were found to have a significantly better knowledge of factors relating to gingivitis/periodontitis than the control group. In questions relating to caries there were no differences among the groups. Higher points were scored in knowledge of therapy and prevention than of the causes and symptoms of the dental diseases. Several regularly repeated sessions for professional prophylaxis did not lead to better knowledge than only a few. No consistent correlation was found for any of the groups between knowledge and both quantitative tooth cleaning, i.e. type and frequency of use of oral hygiene aids, and qualitative tooth cleaning, expressed as the occurrence of plaque and gingivitis. Nor were significant differences found in these respects between individuals with and without a caries increment during the observation period regardless of grouping.

Adolescent↗

Predictors of dietary change in Mexican American families participating in a health behavior change program.

Previous research indicates that Mexican Americans have dietary patterns related to cardiovascular disease risk factors. Research on health beliefs in this ethnic group suggests that Mexican Americans may be less amenable to interventions based on cognitive-behavioral change models. Our study derives from the experience in a community trial, the San Diego Family Health Project, in which Mexican American families were recruited for a structured heart health intervention program. We examined correlations between one-year dietary change scores (three-day sodium, three-day fat, 24-hour sodium, 24-hour fat) and a set of predictor variables derived from social learning theory. Both adults and children had lower intake scores after the intervention, except for children's 24-hour sodium scores. Our correlational analysis found only weak and somewhat inconsistent relationships between theoretically based predictor and outcome variables for adults. The children's results showed statistically significant correlations between two theoretical variables (self-efficacy and supporting others' dietary change) and three-day fat and 24-hour sodium intake. We discuss the implications for cardiovascular disease risk reduction interventions with Mexican Americans.

Adult↗

Increasing the screening and counseling of adolescents for risky health behaviors: a primary care intervention.

OBJECTIVE: To determine whether a systems intervention for primary care providers resulted in increased preventive screening and counseling of adolescent patients, compared with the usual standard of care. METHODS: The intervention was conducted in 2 outpatient pediatric clinics; 2 other pediatric clinics in the same health maintenance organization served as comparison sites. The intervention was implemented in 2 phases: first, pediatric primary care providers attended a training workshop (N = 37) to increase screening and counseling of adolescents in the areas of tobacco, alcohol, drugs, sexual behavior, and safety (seatbelt and helmet use). Second, screening and charting tools were integrated into the intervention clinics. Providers in the comparison sites (N = 39) continued to provide the usual standard of care to their adolescent patients. Adolescent reports were used to assess changes in provider behavior. After a well visit, 13- to 17-year olds (N = 2628) completed surveys reporting on whether their provider screened and counseled them for risky behavior. RESULTS: Screening and counseling rates increased significantly in each of the 6 areas in the intervention sites, compared with rates of delivery using the usual standard of care. Across the 6 areas combined, the average screening rate increased from 58% to 83%; counseling rates increased from 52% to 78%. There were no significant increases in the comparison sites during the same period. The training component seems to account for most of this increase, with the tools sustaining the effects of the training. CONCLUSIONS: The study offers strong support for an intervention to increase clinicians' delivery of preventive services to a wide age range of adolescent patients.

Adolescent↗

Comparing three theories in predicting reproductive health behavioral intention in adolescent women with diabetes.

BACKGROUND: Understanding factors that affect decision-making in using preconception planning is important to reduce the rate of unplanned pregnancies and pregnancy-related complications in all women with diabetes. Previously, there were no studies of reproductive health-related beliefs, attitudes, or behaviors of adolescent women with diabetes. Constructs from social cognitive models, such as, the health belief model (HBM), theory of reasoned action, and social cognitive theory, are factors that can influence these behavioral outcomes. OBJECTIVE: To compare the predictive powers of these three theories in regard to decision-making with reproductive health behaviors in teens with diabetes and to identify a composite model of the strongest predictors across all three theories. METHOD: Data were collected from a telephone interview by same-gender research assistants on a sample of 87 female adolescents with type 1 diabetes (T1D) from four medical centers using the reproductive health attitudes and behavior (RHAB) questionnaire. Measures represent demographic variables, constructs of the three theories, and behavioral outcomes. Standard multiple regression analyses were used to examine the prediction of the three theories in the outcome variable [intention for using birth control (BC)]. RESULTS: Among the three theories considered, the HBM explained the highest percent of variance (24.4%) in intention to using BC. The best composite model consisted of perceived barriers, cues to action, and self-efficacy (explaining 26.1% of the variance). These three variables were also the strongest predictors among all constructs considered. CONCLUSION: In this sample of adolescent females with T1D, the strongest predictors from the three theories for intention to using BC appeared to be perceived barriers, cues to action, and self-efficacy. Intervention studies to decrease future unplanned pregnancies in this high-risk population could focus on strategies to target these factors that are amenable to change.

Adolescent↗

[Health behavior of school children without parental care].

INTRODUCTION: Life style (behavior) is one of the most significant factors affecting health. Although a number of factors participate in creating behavior, family is one the most important. The goal was to analyze the life style of children without parental care. MATERIAL AND METHODS: The research was done using cross-sectional data from "Children village" in Sremska Kamenica (N=127), and a questionnaire was especially created for this purpose. RESULTS AND DISCUSSION: It was established that 75% of elementary school children and 43% of high school children are physically active. The greatest health risk is smoking (only 50% of students reported never to smoke cigarettes, while 17.5% were daily smokers). The problem is greatest in high school children (43% polled are daily smokers). Alcohol consumption is less common than in the general population of the same age (10% polled drink beer and wine several times a month, while 5% drink spirits--brandy, whisky etc.). Attitudes to sports, smoking and alcohol are mainly positive, but at older age there is an increased number of children with negative attitudes. Knowledge regarding healthy diet is on a lower level comparing with general population, meals are more regular, but with less desirable food. CONCLUSION: From the aspect of health, life style of children without parental care is characterized by risky behavior, particularly in high school children.

Adolescent↗