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PubMed1999

Community-based Spanish language arthritis education program: a randomized trial.

OBJECTIVES: To determine 4-month and 1-year health-related outcomes of a 6-week, lay-led, and community-based arthritis self-management program for Spanish-speaking participants and to determine the role of self-efficacy in predicting health status for this population. METHODS: Three hundred and thirty one subjects were randomized to the program or to a 4-month wait list control group. One hundred ninety eight subjects continued in a 1-year longitudinal study. Data were collected via mailed questionnaires with telephone follow up. RESULTS: At 4 months, treatment subjects, compared with controls, demonstrated positive changes in exercise, disability, pain, and self-efficacy (P < 0.05). At 1 year, compared with baseline, treatment subjects demonstrated improvements in exercise, general health, disability, pain, self-efficacy, and depression (P < 0.05). Baseline and 4-month changes in self-efficacy predicted health status at 1 year. CONCLUSIONS: Spanish-speaking participants of an arthritis self-management program demonstrate short- and long-term benefits (improved health behaviors, health status, and self-efficacy).

Adult↗

PubMed2005

Physical and mental health status of older long-term cancer survivors.

OBJECTIVES: To assess the physical and mental health status of older long-term cancer survivors. DESIGN: Cohort study using propensity score methods to control for baseline differences between cancer survivors and controls. SETTING: General community population in the United States. PARTICIPANTS: Nine hundred sixty-four cancer patients who had survived for more than 4 years and 14,333 control patients who had never had cancer from a population-based sample of Americans aged 55 and older responding to the 2002 Health and Retirement Study. MEASUREMENTS: Medical conditions, symptoms, health behaviors, health status, mobility, activities of daily living, mental health diagnoses, self-rated memory, depressive symptoms, cognitive function, and self-reported life expectancy. RESULTS: Cancer survivors reported higher rates of lung disease (13.9% vs 9.6%; P=.001), heart condition (29.3% vs 22.9%; P<.001), arthritis (69.4% vs 59.4%; P<.001), incontinence (26.6% vs 19.7%; P=.001), frequent pain (36.4% vs 29.4%; P=.005), and obesity (27.0% vs 24.2%; P=.001) than individuals without cancer but lower rates of smoking (12.0% vs 14.8%; P=.03). Cancer survivors were less likely than persons without cancer to report excellent or very good health status (37.2% vs 44.6%; P<.001) and had more mobility (P<.001) and activity of daily living (P=.01) limitations. Cancer survivors did not differ from persons without cancer in rates of depression or cognitive function (both P>.2) but were less optimistic about their life expectancy (P=.004). CONCLUSION: The physical health status of older long-term cancer survivors is somewhat worse than that of comparable persons who have never had cancer, but they have surprisingly similar mental health status. Future research is needed to understand factors contributing to poorer health status and identify patients at highest risk of long-term cancer-related problems.

Aged↗

PubMedDate not supplied

Outcomes of border health Spanish/English chronic disease self-management programs.

PURPOSE: The purpose of this study was to evaluate the community-based Chronic Disease Self-management Program (CDSMP) and the Spanish-language version (Tomando Control de Su Salud) programs as delivered in settings along the Texas/New Mexico/Mexico border. The programs had proven effective in randomized trials, and the authors wished to determine if they would be as effective when administered by others to different populations. METHODS: The El Paso Diabetes Association administered the CDSMP and Tomando to 445 persons with chronic illness (two thirds with diabetes) in Texas, New Mexico, and Mexico. Four-month and 1-year outcomes were compared to baseline using t tests of change scores. Regression models were used to test whether baseline demographics and self-efficacy were associated with positive outcomes of the programs. RESULTS: Participants showed improvements in health behaviors, health status, and self-efficacy at both 4 month and 1 year. Baseline self-efficacy and 4-month change in self-efficacy were significantly associated with improved 1-year outcomes. CONCLUSIONS: The CDSMP and Tomando are effective when used in settings other than that of the original study for populations other than those for which they were initially developed.

Attitude to Health↗

PubMed2004

[Prevention of osteoporosis in childhood and adolescence].

Osteoporosis prevention starts in childhood and adolescence. These periods are important to achieve adult peak bone mass and establish health behaviors. Health behaviors influence the development of osteoporosis later in life, so we should aim osteoporosis prevention efforts toward children and adolescents by encouraging habits that promote bone growth and development.

Adolescent↗

PubMed1998

Sudanese refugees in a Minnesota family practice clinic.

BACKGROUND AND OBJECTIVES: During the 1990s, African refugees from the southern Sudan were resettled in Minnesota. This research characterizes the health care utilization of a small sample of these recently arrived refugees and describes their health histories. METHODS: Data were abstracted from the medical charts of all identified Sudanese patients in an urban, Midwestern family practice residency unit. RESULTS: A small sample of Sudanese refugees were found to have high rates of prior infectious illness and experienced communication difficulties in accessing health care. CONCLUSIONS: Information about this sample's demographic variables, health behavior, health histories, and communication difficulties are documented. Some descriptors of the Nuer ethnic group are provided, and issues are raised that may help health care workers provide more culturally competent care to this Sudanese refugee population.

Adult↗

PubMed1994

Using feminist and social structural analysis to focus on the health of poor women.

Poverty results in both personal and structural deprivation for women. Health status and health care are intimately affected by this deprivation. As a result, the increasing rates of poverty among women have serious immediate and long-term consequences for their overall health status. Feminist and social structural analyses are crucial to a comprehensive understanding of poor women's health. Critical to these perspectives is the premise that the underlying structure of American society has produced a social stratification system that has grossly unequalized life chances for poor women. This inequity deleteriously affects poor women's health behaviors, health outcomes, and the health care delivery services that are accessible to them. An adequate understanding of poor women's health calls for an in-depth examination of health and behavior and the social contextual framework within which they occur, taking into account poor women's position in society, the communities in which they live, and the stressful life events they experience.

Continuity of Patient Care↗

PubMed2002

Multi-component behavioral intervention to promote health protective behaviors in childhood cancer survivors: the protect study.

BACKGROUND: Improved cure rates for childhood cancer have produced a growing population of survivors at risk for late toxicities of chemotherapy and radiation therapy. Healthy behaviors can modify these risks. We initiated a controlled prospective trial to determine if a multi-component behavioral intervention could induce change in childhood cancer survivors' health knowledge, health perceptions, and practice of health-protective behaviors. PROCEDURE: Adolescent cancer survivors attending a long-term follow-up clinic were randomized to receive standard follow-up care or standard care plus the educational intervention. Baseline measures were obtained at randomization (T(0)) and repeated 1 year (T(1)) later during the survivors' annual check-up. RESULTS: Of 272 patients enrolled and randomized, 251 are evaluable at both time points. Treatment and control groups were similar in regards to diagnosis, gender, race, and age. The change in outcome measures over the year (T(1)-T(0)) was not significantly different between the two groups as assessed by a two-sample pooled t test. However, additional exploratory analyses indicated a significant gender difference in knowledge with female survivors in the intervention group having higher scores. In addition, patients who choose certain individual health goals, such as breast/testicular self-examination, showed improved practice of the health behavior. In addition, in a very exploratory analysis, a gender difference in response to the intervention was noted, with females exhibiting a greater improvement in knowledge scores than did males. CONCLUSIONS: Although the multi-behavioral educational intervention did not induce change in health knowledge, perceptions, and behaviors of childhood cancer survivors for the treatment group as a whole, gender differences and specific health goal differences were found. These findings suggest that future interventions should be tailored to reflect gender differences and the nature of the health goal under assessment.

Adaptation, Psychological↗

PubMed2005

Qualitative evaluation of Chronic Disease Self Management Program (CDSMP) in Shanghai.

OBJECTIVES: To explore the impact of Chronic Disease Self-Management Program (CDSMP) on participants' perception of their behavior, health status and quality of life and how the program achieve its benefits, and to collect suggestions for future improvement and dissemination. METHODS: Qualitative data were obtained from 57 participants attending all sessions of the CDSMP course using semi-structured interviews and analyzed using content analysis. RESULTS: The interviewees perceived that CDSMP improved their knowledge, self-management skills, positive health behavior, increased self-confidence, health status and quality of life. Behavior change and self-efficacy were the two main transmitters of the effectiveness of CDSMP in Shanghai. The identified deficiencies focused on language, size and style of helpbook and the lack of Chinese relaxing exercises. CONCLUSION: CDSMP was perceived to be effective to participants mainly through behavior change and self-efficacy development, though it had a few deficiencies to be modified. PRACTICE IMPLICATIONS: CDSMP in Shanghai needs further work and research on the content and delivery modification for future improvement and dissemination.

Aged↗

PubMed1997

Youth Risk Behavior Surveillance: National College Health Risk Behavior Survey--United States, 1995.

PROBLEM/CONDITION: Colleges and universities are important settings for delivering health promotion education and services to many young adults. However, before this national college-based survey was conducted in 1995, the prevalences of health-risk behaviors among college students nationwide had not been well characterized. REPORTING PERIOD: January through June 1995. DESCRIPTION OF THE SYSTEM: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: behaviors that contribute to unintentional and intentional injuries, tobacco use, alcohol and other drug use, sexual behaviors, unhealthy dietary behaviors, and physical inactivity. The YRBSS includes a) national, state, and local school-based surveys of high school students conducted biennially since 1991, b) a household-based survey conducted in 1992 among a national sample of youth aged 12-21 years, whether enrolled in school, and c) the national college-based survey conducted in 1995. This report summarizes results from the national college-based survey-the National College Health Risk Behavior Survey (NCHRBS)-and describes priority health-risk behaviors among college students nationwide and health promotion programs on college campuses. RESULTS AND INTERPRETATION: Data from the 1995 survey indicated that many college students throughout the United States engage in behaviors that place them at risk for serious health problems. Almost one third (29.0%) of college students were current cigarette smokers. One third (34.5%) of college students reported episodic heavy drinking during the 30 days preceding the survey, 27.4% reported drinking alcohol and driving during the 30 days preceding the survey, and 30.5% of students who had gone boating or swimming during the 12 months preceding the survey had drunk alcohol while boating or swimming. One in five (20.4%) female college students had been forced to have sexual intercourse during her lifetime. Only 29.6% of students who had had sexual intercourse during the 3 months preceding the survey had used a condom at last sexual intercourse, and 34.5% had used birth control pills. Approximately one in five (20.5%) college students was overweight. Survey results indicated that three fourths (73.7%) of students had failed to eat five or more servings of fruits and vegetables on the day preceding the survey, 21.8% had eaten three or more high-fat foods on the day preceding the survey, and few students had engaged in vigorous (37.6%) or moderate (19.5%) physical activity at recommended levels. ACTIONS TAKEN: The NCHRBS data will be used to measure progress toward achieving 28 national health objectives related to the health-risk behaviors of college students and two national health objectives related to the availability and characteristics of health promotion programs for college students. These data also will be used nationwide by college health and education officials to improve health policies and programs designed to reduce risks associated with the leading causes of mortality and morbidity among college students.

Adolescent↗

PubMed2005

The role of health education and behavior in public health genetics.

This article highlights the important role of health behavior and health education (HBHE) research in public health genetics. Broadly defined, public health genetics is the integration of genetic advancements and technologies in the study and practice of public health. The potential role of HBHE within this area is presented across two intersecting continua--namely, the continuum between research and practice and the continuum between individual/personalized medicine and population health. The authors begin this article with an overview of current issues arising from the use of genetic information to improve the public's health and provide a framework for understanding the multidimensional role of HBHE research in translating genetic research into medical and public health practice. An introduction to the nine articles and two practice notes included in this special issue is also provided to draw attention to the crosscutting themes and issues presented.

Genetic Research↗

PubMed1992

[A study of the relationship between job type and/or position to life style and health of male white-collar workers].

The relationship between the type of job and/or position of male white-collar workers to their working life, life style, health behavior, and health condition was examined based on data obtained from a survey of 1129 male workers in a major computer manufacturing company in 1988. The results were as follows: 1. Work, life style, health behavior, and health condition of male white-collar workers are strongly affected by type of job and position when adjusted for education, income, and age. 2. Workers in the sales department and engineering department appeared to have the most problems associated with working life, life style, health behavior, and health condition. Workers in sales, especially, displayed Type A behavior and their job was characterized by a lot of business transactions in a working environment that requires them to work until late at night. This leads to an irregular diet, late bed time, and makes their family relationships worse. Workers in the engineering department had work loads that were heavy because they have the longest working hours, and the content of their jobs is a mixture of both research and sales. Consequently their health is not good. On the other hands, workers in the laboratory had the best situation, and with general workers about average in terms of working life, life style, health behavior, and the state of health. 3. The department heads have the best conditions of life and health over all, except for their diet. The chiefs of sections are generally in the middle between the department heads and ordinary workers in terms of life and health. They drink and smoke heavily and show Type A behavior characteristics. Ordinary workers appear to have the most problems in working life, life style, health behavior, and health condition. From these results it may be concluded that this is associated with the difference in work type and position of these workers compared to managerial class and also with a low level of morale.

Adult↗

PubMed2003

Oral health knowledge and behavior among male health sciences college students in Kuwait.

BACKGROUND: Health auxiliary personnel have an important role in oral health promotion when they graduate and start working in the health care system. This study aims to find out oral health knowledge and oral health behavior of male Health Sciences College students. METHODS: A questionnaire was distributed to all students at the male Health Sciences College in Kuwait (N = 153) during the academic year 2001/2002. The students filled the anonymous questionnaire in the class after the lecture. The response rate was 84% (n = 128). The questions consisted information on the general background, oral health behavior and oral health knowledge. RESULTS: Oral health knowledge seemed to be limited and very few background factors were associated with it. More than half of the students had visited a dentist during the previous 12 months, but only one third of students were brushing twice a day or more often. CONCLUSIONS: It may be concluded that the male Health Sciences College students seemed to have appropriate knowledge on some oral health topics, but limited knowledge on the others. Their toothbrushing practices are still far behind the international recommendation (twice a day) and also the knowledge, why it should be done so frequently also very limited.

Journal Article↗

PubMed2003

Effect of obesity on health-related quality of life among Appalachian elderly.

BACKGROUND: There is a paucity of research on health behaviors, health status, and overall health-related quality of life among Appalachian elderly. Identifying factors among older adults that place them at risk for low health-related quality of life is important for targeting unmet health needs and guiding community efforts to help improve population health. METHODS: For this study, we examined the relationship between obesity and health-related quality of life among Appalachians aged 65 years or older using the 2000 Behavioral Risk Factor Surveillance Survey data. RESULTS: Our results showed that obese elderly Appalachians report poorer self-rated health and more days of poor physical health compared with their nonobese counterparts. CONCLUSION: The goals put forward in Healthy People 2010 include the reduction of obesity and enhancement of quality of life. If such health disparities are to be eliminated and quality of life enhanced, a sustained effort to identify their determinants among Appalachian elderly is needed.

Age Factors↗

PubMedDate not supplied

Characteristics of adults who use prayer as an alternative therapy.

PURPOSE: To describe the demographics, health-related and preventive-health behaviors, health status, and health care charges of adults who do and do not pray for health. DESIGN: Cross-sectional survey with 1-year follow-up. SETTING: A Minnesota health plan. SUBJECTS: A stratified random sample of 5107 members age 40 and over with analysis based on 4404 survey respondents (86%). MEASURES: Survey data included health risks, health practices, use of preventive health services, satisfaction with care, and use of alternative therapies. Health care charges were obtained from administrative data. RESULTS: Overall, 47.2% of study subjects reported that they pray for health, and 90.3% of these believed prayer improved their health. After adjustment for demographics, those who pray had significantly less smoking and alcohol use and more preventive care visits, influenza immunizations, vegetable intake, satisfaction with care, and social support and were more likely to have a regular primary care provider. Rates of functional impairment, depressive symptoms, chronic diseases, and total health care charges were not related to prayer CONCLUSIONS: Those who pray had more favorable health-related behaviors, preventive service use, and satisfaction with care. Discussion of prayer could help guide customization of clinical care. Research that examines the effect of prayer on health status should adjust for variables related both to use of prayer and to health status.

Adult↗

PubMed2003

Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life.

The effect of a grateful outlook on psychological and physical well-being was examined. In Studies 1 and 2, participants were randomly assigned to 1 of 3 experimental conditions (hassles, gratitude listing, and either neutral life events or social comparison); they then kept weekly (Study 1) or daily (Study 2) records of their moods, coping behaviors, health behaviors, physical symptoms, and overall life appraisals. In a 3rd study, persons with neuromuscular disease were randomly assigned to either the gratitude condition or to a control condition. The gratitude-outlook groups exhibited heightened well-being across several, though not all, of the outcome measures across the 3 studies, relative to the comparison groups. The effect on positive affect appeared to be the most robust finding. Results suggest that a conscious focus on blessings may have emotional and interpersonal benefits.

Adaptation, Psychological↗

PubMed2004

[Health seeking behavior and access to health care among patients with chronic cough diagnosed by county general hospitals in northern parts of Jiangsu province].

OBJECTIVE: To analyze the impact of socioeconomic and demographic factors on health-seeking behavior among patients with long-term chronic cough. METHODS: 310 patients with chronic cough, identified in two county general hospitals from the study sites were involved in a cross-sectional study. Questionnaire and personal interview were used for data collection. Binary logistic regression, Kaplan-Meier method and Cox analysis were applied in multivariate analysis to identify and quantify the impact of individual factors regarding the delay of reaching primary health care provider and the choice of health facility selection. RESULTS: Delay caused by patients themselves showed a difference between the counties with or without the programes. Occupation and medical insurance were associated with patients' health-seeking behavior. Patients under 18 years old had an earlier chance to access the health facility (RR = 1.90, 95% CI: 1.27 - 2.84), and choosing the general hospital as their first preference when seeking healthcare (RR = 2.06, 95% CI: 1.12 - 3.80). Patients with medical insurance were more likely to seek health care service in the general hospitals (RR = 1.64, 95% CI: 1.35 - 2.10). Only 2.5% of the patients with cough longer than two weeks had received sputum smear tests in the general hospitals. CONCLUSION: Occupation, medical insurance had great importance to the health seeking behaviors of patients with chronic cough which had not been viewed as an 'on-the-alert' symptom to be included in the tuberculosis control programs at the general hospitals either in the Programmed or Non-programmed counties in Jiangsu province.

Adolescent↗

PubMed1985

Preventing coronary heart disease in high-risk families.

A preventive nursing intervention to reduce coronary heart disease (CHD) risk was tested. The sample was 19 families composed of 58 first-degreed relatives of young (age 30-55 years) victims of sudden cardiac death. Families were randomly assigned to control and experimental groups. The intervention at 3-5 months postdeath focused on assessment of health history, health behaviors, health beliefs, informing and educating about CHD risk factors, and methods for detecting and reducing these factors. The control group received mailed questionnaires and no intervention. The subject's reduction of CHD risk was measured at 7 months by changes in high risk CHD behaviors, changes in health beliefs, and adherence to screening for serum cholesterol and blood pressure determination. Analysis of covariance (covarying age and pretest scores) demonstrated no differences between groups for health beliefs; however, significant differences for health beliefs existed between the sibling subgroups. The intervention was correlated with a significant reduction in alcohol intake. Reductions in high fat meat consumption were in the desired direction. Greater percentages of subjects in the intervention group obtained blood pressure and cholesterol screening.

Adult↗

PubMed1999

When asked, patients tell: disclosure of sensitive health-risk behaviors.

OBJECTIVES: National health care organizations recommend routinely screening patients for behavioral health risks, the effectiveness of which depends on patients' willingness to disclose risky behaviors. This study aimed to determine if primary care patients' disclosures of potentially stigmatizing behaviors would be affected by (1) their expectation about whether or not their physician would see their disclosures and (2) the assessment method. METHODS: One thousand nine hundred fifty-two primary care patients completed a questionnaire assessing human immunodeficiency virus (HIV), alcohol, drug, domestic violence, tobacco, oral health, and seat belt risks; half were told their responses would be seen by the researcher and their physician and half were told that their responses would be seen by the researcher only. Patients were randomly assigned to one of five assessment methods: written, face-to-face, audio-based, computer-based, or video-based. RESULTS: Across all risk areas, patients did not disclose differently whether or not they believed their physician would see their disclosures. Technologically advanced assessment methods (audio, computer, and video) produced greater risk disclosure (4%-8% greater) than traditional methods in three of seven risk areas. CONCLUSIONS: These findings suggest patients are not less willing to disclose health risks to a research assistant knowing that this information would be shared with their physician and that a number of assessment methods can effectively elicit patient disclosure. Potentially small increases in risk disclosure must be weighed against other factors, such as cost and convenience, in determining which method(s) to use in different health care settings.

Adult↗