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PubMedDate not supplied

Motivating drinking behavior change depressive symptoms may not be noxious.

Depression often hinders behavior change among people who abuse alcohol; it adversely affects self-efficacy and is associated with poor outcomes. However, the Transtheoretical Stages of Change Model suggests that personal discomfort, namely if the costs of drinking outweigh the benefits, may lead to behavior change. Often such alcohol-related consequences are associated with depression. Seventy-five alcohol-abusing participants, ages 18-50, completed the Beck Depression Inventory (BDI), Losses Of Significance Self-report Questionnaire-Revised (LOSS-QR), Situational Confidence Questionnaire-42 (SCQ-42), the Brief Readiness to Change Questionnaire (RTC), and the Steady Pattern Chart (SP) at baseline and again 3 months later. BDI scores were significantly associated with all three RTC stage scores. LOSS-QR scores significantly predicted BDI scores but SCQ-42 scores did not. Interestingly, BDI scores did not predict changes in drinking rates over time. Greater levels of depressive symptoms, perhaps associated with awareness of negative drinking consequences, may promote rather than hinder motivation to change drinking behavior among people.

Adolescent↗

PubMed2004

Where are the gaps? The effects of HIV-prevention interventions on behavioral change.

As more funding becomes available for HIV/AIDS programs in developing countries, an understanding of how prevention interventions lead to behavioral change and how behavioral change leads to reductions in HIV prevalence is crucial. This study presents the results of an extensive effort to develop a matrix to relate coverage of key HIV/AIDS-prevention services to changes in behavior among different risk groups and to describe the gaps that exist in the literature. Many studies could not be included in the matrix because they did not meet the necessary criteria. Evaluation of interventions targeting abstinence programs, workplace programs, and certain groups at high risk of infection would prove invaluable.

Condoms↗

PubMedDate not supplied

A criterion measurement model for health behavior change.

Researchers in the field of health behavior change have traditionally relied on a univariate criterion measure to evaluate the efficacy of an intervention. Such measures have superficial face validity but suffer from a number of problems: (a) lack of precise definitions; (b) poor statistical power; and (c) a lack of meaningfulness for some aspects of the problem. As an alternative, a theoretical model is developed that attempts to define more appropriate multivariate sets of dependent variables for the study of health behavior change. The model involves three separate constructs: Positive Evaluation Strength, Negative Evaluation Strength, and Habit Strength. The pattern of change for each construct is described across four stages of change: Precontemplation, Contemplation, Action, and Maintenance. For each construct, two thresholds are proposed representing the ability of the environment to modify the construct. Four tests of the model are provided from existing data sets. First, a structural model analysis was used to test if the proposed measurement model adequately fits the data. Second, a dynamic typology approach produced profiles of change that are consistent with the model. Third, a time series analysis provided support for the assumed model. Fourth, longitudinal, five-wave panel design was employed to test if the relation between the two cognitive variables (Pros and Cons) and the behavioral measure (Habit Strength) was consistent with the model. Implications for alternative intervention strategies are discussed.

Behavior, Addictive↗

PubMed1985

A systems model of health behavior change.

The modeling in this paper is at the level of the individual, in relation to the subsystem of health behavior. It integrates social, environmental, psychological, and physiological factors to describe the health behavior change process. It is not intended to be quantitatively predictive of behavior change, since further development of this model is needed to determine the mathematical form of the relationships between variables. The model is innovative in several ways. First, it includes health-related variables and a rich feedback structure. In contrast, attitude behavior change models often cannot explain health behavior adequately, because they do not incorporate physiological variables. Second, the model can be easily used by educators to help identify important variables for developing health education curricula. Consequently, program developers are helped in determining program intents, teaching strategies, and learning activities, and evaluative strategies which are congruent with the attitude behavior change process.

Attitude to Health↗

PubMed1986

The role of self-efficacy in achieving health behavior change.

The concept of self-efficacy is receiving increasing recognition as a predictor of health behavior change and maintenance. The purpose of this article is to facilitate a clearer understanding of both the concept and its relevance for health education research and practice. Self-efficacy is first defined and distinguished from other related concepts. Next, studies of the self-efficacy concept as it relates to health practices are examined. This review focuses on cigarette smoking, weight control, contraception, alcohol abuse and exercise behaviors. The studies reviewed suggest strong relationships between self-efficacy and health behavior change and maintenance. Experimental manipulations of self-efficacy suggest that efficacy can be enhanced and that this enhancement is related to subsequent health behavior change. The findings from these studies also suggest methods for modifying health practices. These methods diverge from many of the current, traditional methods for changing health practices. Recommendations for incorporating the enhancement of self-efficacy into health behavior change programs are made in light of the reviewed findings.

Alcohol Drinking↗

PubMed1997

Behavioral changes following participation in a home health promotional program in King County, Washington.

This study examined behavioral changes in households after participation in a home environmental assessment. Home assessment visits by a trained coach, which involved a walk-through in the home with the home residents, were conducted in 36 homes. The walk-through included a list of recommended behavioral changes that the residents could make to reduce their exposures to home pollutants in areas such as dust control, moisture problems, indoor air, hazardous household products, and hobbies. Recruited households were surveyed 3 months after the home assessment to evaluate their implementation of the recommendations. Following the home visits, 31 of 36 households reported making at least one behavioral change, and 41% of the recommendations made by the volunteer coaches were implemented. In conclusion, this study found that the majority of the households who participated in the home assessment reported implementing at least one recommendation. This home health promotional method was effective in influencing behavioral changes.

Feedback↗

PubMed1996

Effects of mail-mediated, stage-matched exercise behavior change strategies on female adults' leisure-time exercise behavior.

This study compared three forms of mail-mediated exercise behavior change strategies on the weekly leisure time exercise behavior of individuals at different stages of exercise (SOE). Subjects were 113 healthy females, 22 to 50 years old (M = 36.9). After being classified by SOE, subjects were randomly assigned to receive one of three treatments: lifestyle exercise packet (LEP); structured exercise packet (SEP); or control packet. Packets were mailed to subjects at their worksite. After 31-days, 108 (95%) subjects responded to a query about their previous week's leisure-time exercise behavior. A 3 (SOE) x3 (Exercise group) x2 (Time) REANOVA revealed main effects for SOE (p < 0.0001), exercise group (p < 0.05), and time (p < 0.0001). No significant interactions were observed. Post-hoc testing showed that those in the action/maintenance stages differed from those in the preparation and precontemplation/contemplation stages (p < 0.01), and that LEP subjects reported significantly more weekly leisure-time exercise post-intervention compared to controls (p < 0.01). These findings suggest the LEP was the most effective strategy for encouraging weekly leisure-time exercise. Future research should be directed at corroborating these findings and determining the potential long-term value of this strategy in comparison to more traditional strategies.

Adult↗

PubMed2000

Health behavior changes after a cancer diagnosis: what do we know and where do we go from here?

Survival rates for certain types of cancer have improved over the past few decades. Changing unhealthy behaviors such as smoking, poor diet, and sedentary life-style among individuals who have been diagnosed with cancer may help to reduce cancer treatment sequelae, possibly reduce risk of recurrence for specific types of cancer, and reduce risk for other common diseases such as cardiovascular disease, obesity, and hypertension. This article reports the prevalence of each of these behaviors among those diagnosed with cancer and reviews interventions that have targeted these risk behaviors. There is considerable variation in the type of research questions asked, the methodologic quality of the research, sample sizes, and the outcomes observed across studies focusing on changing the three health risk behaviors. In the final section, we provide guidelines for researchers in developing health behavior interventions for individuals diagnosed with cancer and highlight challenges that should be addressed.

Clinical Trials as Topic↗

PubMed2006

Facilitating behavioral change in voice therapy: the relevance of motivational interviewing.

PURPOSE: The purpose of this article is to present an exploration of some of the issues surrounding adherence to vocal behavioral change in voice therapy within the context of Motivational Interviewing (MI) and to explore MI's potential for integration into voice therapy (MI-adapted voice therapy). MI is a style of interpersonal communication in which resistance is minimized through the use of skillful listening in a directive, constructive discussion about behavior change. The goal of MI-adapted voice therapy is to enhance patient adherence to vocal behavioral change. METHOD: A narrative review of the literature is presented, together with the experiences of the author with 10 adult patients with voice disorders who participated in MI-adapted voice therapy. RESULTS: It is shown that the principles of MI can be applied throughout the therapy program. Points of resistance to vocal behavioral change that were common across many patients appeared to be addressed appropriately by specific MI dialogue strategies. CONCLUSIONS: It is concluded that MI-adapted voice therapy holds promise as an approach to address patient adherence to vocal behavioral change. However, research is necessary to define the efficacy of this approach and the factors associated with its efficacy.

Adult↗

PubMed2006

Adherence, behavior change, and visualization: a qualitative study of the experiences of taking an obesity medication.

OBJECTIVE: Our objective was to examine patients' experiences of taking orlistat as a means to explore adherence and behavior change. METHOD: We performed qualitative interviews with 12 participants who had taken orlistat in the past 2 years. RESULTS: Their experiences were described in terms of beliefs about the causes of their obesity, their motivations for taking orlistat, and highly visual side effects. These themes have implications for understanding adherence and behavior change. For some, the side effects led to nonadherence and absence of behavior change. These individuals seemed to be motivated by routine effects of being overweight, such as lowered self-esteem. In contrast, those who were motivated by a life crisis seemed to tolerate the side effects of the drug, leading to adherence. In turn, these highly visual side effects enabled them to make an explicit link between food consumed and weight, creating a shift in their beliefs about the causes of obesity and making behavior change more likely. CONCLUSION: Orlistat use illustrates how treatment and illness beliefs interact to create both adherence and behavior change, particularly in the context of a life crisis and particularly when symptoms can be visualized.

Adult↗

PubMed2005

Protective and harmful effects of neighborhood-level deprivation on individual-level health knowledge, behavior changes, and risk of coronary heart disease.

The authors examined associations between neighborhood-level deprivation and cardiovascular disease-related health knowledge and behavior changes, as well as the estimated 12-year probability of experiencing a coronary heart disease event. Primary analyses included multilevel regression models among 8,197 women and men living in 82 neighborhoods in four northern California cities who were interviewed in one of five surveys conducted between 1979 and 1990. After controlling for age, gender, marital status, race/ethnicity, city, and time, the authors found that adults living in high-deprivation neighborhoods had significantly lower health knowledge and a higher probability of no positive behavior changes than did adults in moderately deprived neighborhoods (i.e., harmful effects). Conversely, those living in low-deprivation neighborhoods had significantly higher health knowledge and lower probabilities of no positive behavior changes and estimated risk of coronary heart disease (i.e., protective effects). The association between high neighborhood deprivation and no positive behavior changes remained statistically significant after additional adjustment for a composite measure of individual-level socioeconomic status. Associations with neighborhood deprivation did not vary by individual-level socioeconomic status. These results suggest that focusing exclusively on changing individuals' behaviors will have a limited effect unless contextual influences at the neighborhood level are also addressed.

Adult↗

PubMed2000

An examination of theory and behavior change in randomized clinical trials.

This paper underscores the important role played by theory-based mediating variables in randomized clinical trials. Indeed, it is essential that we know what mediating variables are relevant for particular outcomes in randomized clinical trials and that we design interventions to optimize change in the mediators of interest. Yet, knowledge of the pivotal mediating variables in behavior change does not imply that we know how to intervene effectively. This gap may be due to the fact that existing research typically has been designed to garner support for theory, as opposed to testing support for behavior change strategies that are based on theory. In addition, we argue that there are important mediating variables in behavior change that have not been given systematic attention in theory development. For example, behavior change must be viewed as a collaborative process, and participants' perceptions concerning the feasibility of change is important to motivational processes in randomized clinical trials. Control Clin Trials 2000;21:164S-170S

Aged↗

PubMedDate not supplied

Use of health behavior change theories to guide urinary incontinence research.

BACKGROUND: Urinary incontinence in adults has been the focus of researchers for over 40 years. Health behavior change theories, predominantly operant conditioning, have guided much of the intervention research. In recent years cognitive theories have been used to guide behavioral interventions for urinary incontinence. Most research has focused on individual rather than group or community behavior. Few, if any, health behavior change theories have been tested on population-based interventions. OBJECTIVES: To explore urinary incontinence research guided by health behavior change theories. METHODS: Existing literature on health behavior change theories was analyzed to generate a plan for future research. RESULTS: Gaps in knowledge are identified and discussed and recommendations for future research are made. CONCLUSIONS: The development and testing of new theories will guide the next generation of incontinence researchers and ultimately lead to reducing the incidence and prevalence of incontinence.

Attitude to Health↗

PubMedDate not supplied

[Information centers as an instrument for behavioral change in order to prevent HIV infection].

The importance of information and behavioral changes in preventing HIV infection in three different groups of people is shown. The content of one of such strategies, the Prochaska-DiClemente model of behavior changing, which proved to be good in popular programs realized in many countries, including Russia, is demonstrated. In this model the change of behavior is presented as a process consisting of 5 stages of making definite decisions. The realization of the program has started by such organizations as "Médecins sans Frontières" (Holland) and "SPID-infosvyaz" (Russia) in the prevention of HIV infection, sexually transmitted diseases (including hepatitides) and drug dependence in 6 regions of Russia. The prospect lying before these activities is the creation in Russia of a network of organizations working in the above-mentioned field.

Behavior, Addictive↗

PubMed1996

The protective effect of AIDS-related behavioral change among injection drug users: a cross-national study. WHO Multi-Centre Study of AIDS and Injecting Drug Use.

OBJECTIVE: This study assessed the relationship between self-reported acquired immunodeficiency syndrome (AIDS) behavioral change and human immunodeficiency virus (HIV) serostatus among injection drug users. METHODS: The study sample involved 4419 injection drug users recruited from drug abuse treatment and nontreatment settings in 11 cities in North America, South America, Europe, Asia, and Australia. The World Health Organization multisite risk behavior questionnaire was used, and either blood or saliva samples for HIV testing were obtained. Subjects were asked, "Since you first heard about AIDS, have you done anything to avoid getting AIDS?" RESULTS: The protective odds ratio for behavioral change against being infected with HIV was 0.50 (95% confidence interval = 0.42, 0.59). While there was important variation across sites, the relationship remained consistent across both demographic and drug use history subgroups. CONCLUSIONS: Injection drug users are capable of modifying their HIV risk behaviors and reporting accurately on behavioral changes. These behavioral changes are associated with their avoidance of HIV infection.

Acquired Immunodeficiency Syndrome↗

PubMed2000

Cross-cutting themes in maintenance of behavior change.

This article reviews the cross-cutting themes and research recommendations that emerged from the National Heart, Lung, and Blood Institute "Maintenance of Behavior Change in Cardiorespiratory Risk Reduction" conference. Throughout the conference participants emphasized that maintenance should be conceptualized as a process rather than merely as the last step in the behavior change process. Researchers should focus on understanding how those who are successful at long-term maintenance complete this process and on developing new approaches that can be used to help those who are not successful. Further attention to the following topics was encouraged: observational studies of the natural history of successful long-term behavior change, development of new technologies for measuring health behaviors, better theoretical understanding of the differences between initial behavior change and maintenance, development of strategies to increase participation rates and long-term effectiveness of formal treatment programs, new approaches to increase the effectiveness of self-help interventions, and better understanding of the development of behavioral patterns in children and adolescents.

Adolescent↗

PubMed1998

A trial to detect behavioral changes by swimming stress.

We investigated behavioral changes in mice in a light/dark test after forced swimming stress in a streaming pool. Locomotion and rearing behavior in mice in a light/dark test was suppressed immediately after the swimming and gradually regained. Shuttle crossing between light and dark zones was also suppressed but time spent in a light zone was not. The suppression of locomotor activity by the swimming was not observed 20 min after it. Naloxone (10 mg/kg, i.p.) suppressed recovery of locomotor activity after the swimming while it did not affect a light/dark test in nonswimming mice. These results suggest that this model is useful for the study of behavioral and psychological changes after exercise, and that opioidergic systems may be involved in regaining spontaneous locomotor activity.

Animals↗

PubMed2004

Health behavior change among office workers: an exploratory study to prevent repetitive strain injuries.

The purpose of this evidence-based study is to investigate the impact of a multi-component intervention on health behavior change among office/computer workers in preventing repetitive strain injuries. Forty office workers employed in an administrative office in Michigan participated in this project. The subjects completed a comprehensive questionnaire at three different times in 1994 and 1995. The intervention took place between time 2 and time 3 and included posters, e-mail tips, mini-workshops, and activities of a Wellness Ergonomic Team. A theoretical model was tested to identify factors influencing healthy behaviors. Study findings revealed positive behavior change for 62% of the participants. The factors most strongly related to health behavior change appear to be self-efficacy, the intention to change one's behavior, and perceived health status. Better understanding of health behavior change coupled with ergonomic modifications is a significant step toward the prevention of repetitive strain injuries resulting from computer use.

Administrative Personnel↗