Identifying the salient outcomes of exercise: application of marketing principles to preventive health behavior.
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PURPOSE: It is important to focus on various characteristics of people to promote measures for quitting-smoking. Using the Health Belief Model, we here investigated social and psychological factors related to willingness to cease smoking among factory-workers in the northern part of Kyoto Prefecture. METHOD: From October to November 2001, the 810 subjects were surveyed about their smoking behavior and related factors using an unsigned self-administered questionnaire. Among the 534 respondents, we performed logistic regression analysis, considering 7 factors ((1) age, (2) susceptibility, (3) seriousness, (4) benefits, (5) barriers, (6) mass-media and (7) advice from others) as independent variables and interest in smoking cessation as a dependent variable. Four comparisons ((1) "no interest" vs "precontemplation or contemplation", (2) "no interest" vs "precontemplation", (3) "no interest" vs "contemplation", (4) "precontemplation" vs "contemplation") were conducted for 239 males who were current smokers at the time of the survey. RESULTS: Acceptance of the benefits of smoking cessation showed a significant positive association with willingness to quit smoking, with Ors for comparisons of "no interest" vs "preconemplation or contemplation", "no interest" vs "precontemplation", and "no interest" vs "contemplation" (odds ratios (95%CI) of 3.06 (1.76-5.31), 2.78 (1.58-4.90), 4.41 (1.75-11.15), respectively). Acceptance of the seriousness of health hazards from smoking had a significant positive association with the willingness to quit (odds ratio (95%CI) was 1.88 (1.02-3.46)). CONCLUSION: It is can be concluded that it is useful to enhance subjective recognition of the benefits of not-smoking and the seriousness of the harm caused by smoking, to increase the level of willingness of quitting from "no interest" to "precontemplation" or "contemplation".
PURPOSE: To describe the baseline healthy lifestyle behaviors (dietary, calcium, vitamin D, caffeine and alcohol intake, smoking history, and physical activity) of postmenopausal breast cancer survivors (BCS); and to identify any relationship of healthy lifestyle behaviors with bone mineral density (BMD) at the forearm, total hip and spine, L1-L4. DATA SOURCES: Self-reported responses to a demographic and health status questionnaire, to a 3-day Diet Record, and to the 7-Day Physical Activity Questionnaire-Adapted provided data for the lifestyle behaviors. Baseline BMD (g/cm(2)) was determined with dual-energy x-ray absorptiometry (DEXA). Height, weight, and body mass index (BMI) were also measured in each of the 249 postmenopausal BCS. CONCLUSIONS: There was an imbalance between consumed kilocalories and expenditure of energy. The majority of BCS were overweight or obese. They consumed less fruit and vegetable servings than recommended by the new 2005 U.S. Department of Agriculture's dietary guidelines, less dairy products, below average recommended grains and fiber, less protein and carbohydrate intake, and a slightly higher fat gram intake. Approximately, 43% did not take any supplemental calcium, with 46% taking less than 1000 mg a day. Likewise, 52.59% consumed less than 400 IU of vitamin D with both supplemental and dietary intake. This group of BCS consumed below accepted levels of caffeine and alcohol. Only 18 BCS continued to smoke. This group spent an average of 10.36 h in light (sedentary) activities on a daily basis. There were significant negative relationships with bone mass (g/cm(2)) at the total hip and daily intake of caffeine/mg and daily grams of alcohol. Weight and BMI both demonstrated a significant relationship with bone mass (g/cm(2)) at the total hip, spine L1-L4, and the forearm. IMPLICATIONS FOR PRACTICE: The healthcare provider must incorporate appropriate teaching strategies, intensive counseling, and coaching, along with a support mechanism, to enable BCS to understand the importance of a healthy diet, calcium, and vitamin D supplement, and a regular strength/weight program that will be integrated into their daily lifestyle. Early DEXA screens should be part of the protocol with BCS, and there is a particular need for forearm DEXA screens to be included in the treatment protocol for BCS.
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The Robert Wood Johnson Foundation's national program, Depression in Primary Care: Linking Clinical and Systems Strategies, funds three related components to stimulate innovation in primary depression care. The incentives, value, and leadership components evaluate and implement strategies for financing and sustaining use of clinical best practices despite barriers created by economic and organizational structures that fragment behavioral and general health care. A challenge for policymakers is how to link depression care with the management of other chronic conditions, so that they are integrated into the quality improvement agenda of purchasers, payers, and providers without becoming submerged in health care's mainstream.
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