Adolescent perceptions of family health behavior: a tenth grade educational activity to increase family awareness of a community cardiovascular risk reduction program.
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Adolescent↗
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Results for “Health Behavior”
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Design and sample characteristics of the PRISM-E multisite randomized trial to improve behavioral health care for the elderly.
OBJECTIVE: To describe the design of the Primary Care Research in Substance Abuse and Mental Health for Elderly (PRISM-E) study and baseline characteristics of the randomized primary care patients with mental health problems and at-risk alcohol use. METHOD: Adults aged 65 and older were screened at primary care clinics from 10 study sites throughout the United States. Those diagnosed for depression, anxiety, and/or at-risk alcohol consumption were randomized to either integrated or enhanced referral care. RESULTS: Of the 23,828 participants, 14% had a positive assessment for depressive and/or anxiety disorders, and 6% had at-risk alcohol consumption diagnoses. Among patients with mental health diagnoses, there was a higher preponderance of younger ages, women, and ethnic minorities. Among patients with at-risk drinking, there was a higher preponderance of younger ages, Whites, and men. DISCUSSION: These findings indicate the need for screening in primary care and for engaging older adults in treatment.
Age Factors↗
Cholesterol-related health behaviors in rural elderly persons.
1. Hypercholesterolemia in the elderly is a major risk factor for cardiovascular disease. 2. Elderly subjects were found to be concerned about their cholesterol, but awareness of beneficial cholesterol reduction strategies and desirable cholesterol levels were low. 3. Major concerns for the rural elder are accessibility to cholesterol screening, explanation of the results of screening, and education about dietary interventions. 4. Nurses developing health promotion programs for rural elders need to incorporate methods which promote accessibility to screening and follow-up, understandable written information, and family support.
Aged↗
Impact of HIV-related stigma on health behaviors and psychological adjustment among HIV-positive men and women.
HIV-related stigmatization remains a potent stressor for HIV-positive people. This study examined the relationships among stigma-related experiences and depression, medication adherence, serostatus disclosure, and sexual risk among 221 HIV-positive men and women. In bivariate analyses that controlled for background characteristics, stigma was associated with depressive symptoms, receiving recent psychiatric care, and greater HIV-related symptoms. Stigma was also associated with poorer adherence and more frequent serostatus disclosure to people other than sexual partners, but showed no association to sexual risk behavior. In a multivariate analysis that controlled for all correlates, depression, poor adherence, and serostatus disclosure remained as independent correlates of stigma-related experiences. Findings confirm that stigma is associated with psychological adjustment and adherence difficulties and is experienced more commonly among people who disclose their HIV status to a broad range of social contacts. Stigma should be addressed in stress management, health promotion, and medication adherence interventions for HIV-positive people.
Adult↗
Managed care and children's behavioral health services in Massachusetts.
OBJECTIVE: The authors investigated changes in treatment patterns and costs of care for children after the implementation of the Massachusetts Medicaid carve-out managed care plan. METHODS: The authors hypothesized that after the introduction of managed care, per-child expenditures would be reduced, continuity of care would not improve, and per-child mental health expenditures would undergo larger reductions for disabled children, compared with children enrolled in the Aid to Families With Dependent Children program. Using data from Medicaid and the Massachusetts Department of Mental Health, the authors studied 16,664 Massachusetts Medicaid beneficiaries aged one to 17 years for whom reimbursement claims were submitted for psychiatric or substance use disorder treatment at least once during the two years before the introduction of managed care (1991 to 1992) or during the two years afterward (1994 to 1995). Multivariate analysis was used to estimate changes in probability of admission, and, among patients admitted, to identify factors accounting for variation in length of stay. To assess the variation in expenditures, we regressed the same variables, using the natural logarithm function to transform total mental health expenditures data and inpatient expenditures data to reduce skewness. RESULTS: After the introduction of managed care, per-child expenditures were lower, especially for disabled children, and the Department of Mental Health was used as a safety net for the most seriously ill children without increasing state expenditures. Continuity of care appeared to decline for disabled children. CONCLUSIONS: It is likely that a combination of factors related to the reported changes in patterns of care and expenditures were responsible for the overall per-child expenditures.
Adolescent↗
Sociocultural influences upon preventive health behavior and attitudes towards dentistry.
One hundred eighty adults who presented for general dental care at an urban dental school clinic were interviewed and given epidemiological screening examinations. The findings presented include a profile of a clinic population with respect to ethnic identity, family income, education, nuclear family structure, and residence. The two major racial groups (black and white) are found to have highly significant differences in their perception of dental services and their experiences with dental disease and treatment. An assessment of dental health status indicates that whites were more likely to have filled teeth, and blacks, decayed or unfilled teeth. This relates to different patterns in seeking recent preventive dental services and a marked disparity in utilization early in life. Fear and anxiety about dental care, degree of orientation towards prevention and differences in exposure to preventive information varied with race. Consumerist orientation is examined in terms of willingness to criticize services, be cared for by auxiliary health workers and accept professional fees. The identification of diversity in perception and values with respect to dental health care is characterized as an element in developing understanding between providers and consumers.
Adult↗
Health Behavior of International Travelers to Calcutta: Identifying the Need for a Travelers' Clinic.
With the growing rates of travel and, potentially therefore, of travel-related illness in India, this study was conducted to establish both the need of a travelers' clinic in Calcutta and a profile of the group or groups at risk of illness best served by such facilities. A total of 452 visitors, half business and package holiday travelers (group A) and half younger, low-budget tourists with less pretravel advice (group B), were compared. Through a questionnaire, their health, pretravel advice and prophylaxis, use of first aid, safe water use, posttravel treatment, and opinion concerning the need for a travelers' clinic were determined. Group A travelers stayed in deluxe hotels with more pretravel advice (90% compared to 72% in group B), were taking antimalarial agents (82% compared to 61% in group B), remained healthy (72% compared to 58% in group B), consumed safe water (87% compared to 47% in group B), and were more likely to seek posttravel treatment (75% compared to 60% in group B). The group B travelers, consequently, felt an increasing need for a travelers' clinic (92% compared to 82% in group A). Given the complexities of travel in India, there is a palpable need for appropriate medical attention to travelers, especially among the young, budget tourists, which is best provided at a travelers' clinic.
Journal Article↗
A multisite study of Air Force outpatient behavioral health treatment-seeking patterns and career impact.
This study examined 1,068 cases of active duty Air Force service members seen in eight Air Force outpatient mental health clinics during a 1-year period. Age, gender, rank, marital status, special duty status, diagnostic category, treatment completion, and recommendations to the member's unit were examined across referral sources (i.e., self-referred, supervisor-referred, or commander-directed). Results showed significant differences across all variables, with self-referred members being more likely to be older, single, higher ranking, and without special duty status, as well as to have a less significant axis I diagnosis. Self-referred members were less likely to have confidentiality broken and to have career-affecting recommendations made. The implications of these findings, in terms of targeting interventions to increase self-initiated help-seeking behavior, and recommendations for future research are discussed.
Adolescent↗
Illness and health behavior in septuagenarians.
A random sample of septuagenarians was obtained by taking 400 consecutive names from a city birth register. Information regarding survival and present residence was acquired. The investigation comprised those septuagenarians who were still alive and had not moved abroad. The results showed that one-third reported no physical disease. Only half of those with physical disease considered themselves ill. Hypochondria was observed only in 3.9%, which contrasting with the high proportion of hypochondria in studies based on voluntary subjects. Active interest in physical exercise and a restrictive attitude to smoking and drinking correlated with health.
Aged↗
Health behavior, treatment-seeking patterns, and cost of treatment for patients visiting malaria clinics in western Thailand.
A clinic-based case-control study was conducted at two malaria clinics in western Thailand in order to investigate social and behavioral factors believed to be associated with malaria occurrence. The finding was that the malaria cases were predominantly male, under age 25 and single. The results showed a significant association for use of mosquito nets, conformance with DDT spraying and residing in forested areas two weeks before occurrence of illness with malaria. Analysis of symptoms revealed fever, headache and chills to be the major noticeable symptoms initiating treatment. Three basic treatment-seeking patterns were observed. The results of this study suggest that particular attention should be given to malaria health education for younger age groups and forest-related people. In addition, attention should also be given to ways of increasing awareness of symptoms, and motivation of people to use malaria clinics for malaria screening and treatment at onset of first symptoms in order to eliminate treatment-seeking at ineffective first sources. Malaria Voluntary Collaborators, Village Health Volunteers and Village Health Communicators have an important role in convincing people in malarious areas to use malaria clinics for malaria screening and treatment when the villagers develop malaria-like symptoms. This would reduce disease transmission and severity by reducing the delay for efficacious treatment and would also reduce the cost of malaria treatment.
Adult↗
Self-reported health behavior and dental knowledge of a migrant worker population.
In conjunction with operation of a summer school-based dental program in Michigan, 101 children from migrant families, primarily Mexican-American, completed questionnaires relating demographic background, past dental experience, and knowledge of caries preventive methods. A smaller number of available mothers were asked these questions plus others relating to family dental problems, diet and knowledge of periodontal disease. Adults and children reported similar demographic backgrounds. Most children (68.7%) listed brushing as the best way to prevent cavities as did 60% of the mothers. Less than 2% of the children considered use of fluoride in any form as the best way to prevent cavities and only two of 20 mothers mentioned fluoride in this context. Members of this selected population were weak in their knowledge of the relation between a sweet diet and caries, the relation between oral hygiene and periodontal health, and the role of fluorides in caries prevention.
Adult↗
Understanding managed behavioral health care.
Managed care can be understood from an historical perspective as a reaction to perceived abuses by providers or an extension of earlier efforts to manage care in the public sector. It can be viewed as a young and emerging force--a fourth party to the health care transaction--that is rapidly progressing through a series of generations that redefine the approach to organizing and delivering services. And finally, because managed care emerges with so many faces, consumers and providers can perhaps best understand its implementation in a specific state or community by examining the multiple dimensions, such as those outlined herein, on which these initiatives vary. Until the forms and functions are more uniform, no simple definition of managed care will exist.
Behavior Therapy↗
Mass media based health behavior change: televised smoking cessation program.
This report describes the 1-year follow-up assessment of a television-based smoking cessation program shown as a part of local news in the Los Angeles area. The post-broadcast experiences of two distinct samples was considered: individuals who wrote in for additional materials (Registrants) and a cross section sample (CS) contacted by a random survey method. Results showed significant between-group differences in demographic characteristics and smoking behavior outcomes. Compared to the CS sample, registrants displayed more quitting attempts during the 1-year follow-up period (70.7% and 49.8%) and more abstinence (6.2% and 2.4%, respectively). When compared to results from a comparison survey, both registrant and CS subjects made significantly more quitting attempts in the three week period following broadcast. In terms of abstinence, only registrant results significantly differed from the comparison survey (6.2% vs. 2.9%). Few correlates of outcome were identified. Overall, analyses suggest that the televised quit smoking program encouraged viewers to initiate more numerous attempts to quit smoking than otherwise would have been expected. In terms of maintaining nonsmoking over time, however, only registrants experienced significantly greater success than might have been observed in the general population. Implications for research and policy recommendations of televised health promotion programs are proposed.
Adult↗
Assessment of the Massachusetts Medicaid managed Behavioral Health Program: year three.
This evaluation of the third year of the Massachusetts Medicaid managed Mental Health/Substance Abuse Program showed that overall utilization increased slightly and expenditures were nearly the same in FY1994 compared to FY1993; however, they were lower for disabled members. Providers believed that access to care, utilization, and quality of care were the same or better than a year earlier and that the clinical review process was improved. Client severity was higher. Aftercare planning improved but gaps in services persisted. Integration of care improved. Administrative and management problems continued. Lessons for similar, more recent initiatives are discussed.
Adult↗
Breast cancer screening and health behaviors among African American and Caribbean Women in New York City.
A telephone-based survey regarding breast cancer screening practices among 300 African American and Caribbean women age 40 and over in New York City revealed that while U.S.-born women had significantly different sociodemographic profiles (in terms of insurance status, marital status, educational attainment), they were no more likely to have had a mammogram than the foreign-born women. Adjusting for insurance status and source of care, women with a provider recommendation were 8 times more likely ever to have had a mammogram (AOR 8.01, 95%CI: 3.74-17.14). Among foreign-born Caribbean women in the U.S. for less than half their lives, only 52% ever had a provider recommend a mammogram, compared with 77% of U.S.-born women. The findings confirm previous reports of the importance of physician recommendation in increasing mammography screening among urban Black women, and suggest that efforts to reach Caribbean-born women with breast cancer screening messages should emphasize the important role of providers.
Adult↗
EAP/managed behavioral health care providers: how to get what you pay for.
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Contract Services↗
Thought Field Therapy clinical applications: utilization in an HMO in behavioral medicine and behavioral health services.
Thought Field Therapy (TFT) is a self-administered treatment developed by psychologist Roger Callahan. TFT uses energy meridian treatment points and bilateral optical-cortical stimulation while focusing on the targeted symptoms or problem being addressed. The clinical applications of TFT summarized included anxiety, adjustment disorder with anxiety and depression, anxiety due to medical condition, anger, acute stress, bereavement, chronic pain, cravings, depression, fatigue, nausea, neurodermatitis, obsessive traits, panic disorder without agoraphobia, parent-child stress, phobia, posttraumatic stress disorder, relationship stress, trichotillomania, tremor, and work stress. This uncontrolled study reports on changes in self-reported Subjective Units of Distress (SUD; Wolpe, 1969) in 1,594 applications of TFT, treating 714 patients. Paired t-tests of pre- and posttreatment SUD were statistically significant in 31 categories reviewed. These within-session decreases of SUD are preliminary data that call for controlled studies to examine validity, reliability, and maintenance of effects over time. Illustrative case and heart rate variability data are presented.
Adult↗
An overview of managed behavioral health care.
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Humans↗