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PubMedDate not supplied

Hispanic chronic disease self-management: a randomized community-based outcome trial.

BACKGROUND: In light of health disparities and the growing prevalence of chronic disease, there is a need for community-based interventions that improve health behaviors and health status. These interventions should be based on existing theory. OBJECTIVE: This study aimed to evaluate the health and utilization outcomes of a 6-week community-based program for Spanish speakers with heart disease, lung disease, or type 2 diabetes. METHOD: The treatment participants in this study (n = 327) took a 6-week peer-led program. At 4 months, they were compared with randomized wait-list control subjects (n = 224) using analyses of covariance. The outcomes for all the treatment participants were assessed at 1 year, as compared with baseline scores (n = 271) using t-tests. RESULTS: At 4 months, the participants, as compared with usual-care control subjects, demonstrated improved health status, health behavior, and self-efficacy, as well as fewer emergency room visits (p <.05). At 1 year, the improvements were maintained and remained significantly different from baseline condition. CONCLUSIONS: This community-based program has the potential to improve the lives of Hispanics with chronic illness while reducing emergency room use.

California↗
PubMed2001

Cross-cultural surveys of adolescent health and behavior: progress and problems.

Adolescent health surveys administered in different countries or regions often are described as cross-cultural. Although most include youth of different ethnic and cultural groups, few attempt to define these constructs or to collect data that allow their characterization. This paper explores four challenges shared by large-scale surveys of adolescent health-related behaviors and beliefs. First, adolescent health investigators have used the terms culture and ethnicity loosely. The growing interest in contextual analysis demands standardization of the definitions as they apply to adolescents, followed by correct usage of the terms. Hypotheses regarding the associations between race, ethnicity, culture, health-related behaviors, and health outcomes should be clearly stated and incorporated into conceptual models. Second, cross-cultural analyses are interpretable only when the study designs and sampling methods provide adequate representation of cultural and ethnic minorities and when the survey items allow differentiation of factors related to race, ethnicity, culture, and socioeconomic factors. Third, cross-cultural research may expose traditions, beliefs, and behaviors that are supported by one population yet criticized by another. Investigators must recognize their own personal biases and must work collaboratively to analyze and interpret their data correctly. Fourth, generalizations about cultural/ethnic comparisons can evoke powerful emotional reactions. Interpretation and dissemination of research findings should be done sensitively and with the help of experts from the cultural/ethnic groups that have been studied.

Adolescent↗
PubMed2004

The relationship between alcohol and individual differences variables on attitudes and behavioral skills relevant to sexual health among heterosexual young adult men.

The purpose of this experiment was to investigate the effects of alcohol, alcohol sex expectancies, and sexual sensation seeking on determinants of sexual health behavior according to the Information-Motivation-Behavioral Skills (IMB) model. The participants were 48 heterosexual young adult males who attended 2 laboratory sessions. During Session 1, participants completed a set of screening and individual differences measures, and during Session 2 they were randomly assigned to 1 of 3 beverage conditions: control, alcohol (0.65 g alcohol/kg body weight), or placebo. Following the experimental manipulation, all participants completed measures regarding attitudes toward condom use, intention to engage in risky sex, and condom use negotiation skills. The results showed that participants who consumed alcohol had poorer negotiation skills and greater intention to engage in risky sex compared to participants who did not drink alcohol. Although alcohol did not affect any dimension of attitude regarding condom use, attitude about condoms' effects on sex, as well as sexual sensation seeking, were correlated with both intention ratings and skills. Multiple regression models, including both attitudes and sensation seeking, showed that attitudes accounted for 20-25% of variance independent of beverage condition in predicting intention ratings and skills. The findings were consistent with past research showing that alcohol consumption can have detrimental effects on determinants of sexual health behavior and that individual differences factors can enhance the power of models like the IMB to predict such behavior.

Adult↗
PubMedDate not supplied

The Women Physicians' Health Study: background, objectives, and methods.

A methodologically compelling reason to collect health-related data on physicians is that it is relatively reliable, easy, and cost effective data to collect. Physicians are capable of answering comparatively complex medical and nonmedical questions in a survey format, and most of these data are unavailable or difficult to obtain from other sources (eg, medical records). In addition, we will be able to recontact this cohort with relative ease, to determine, for example, the effect of time on health behaviors, counseling practices, and health status. This is the first large-scale study of the demographic and psychosocial characteristics as well as the health behaviors, health status, and counseling practices of women physicians. This study should help answer many important questions about women, physicians, and women physicians.

Adult↗
PubMed2006

The effect of a multicomponent professional development training on the beliefs and behaviors of community health educators concerning food irradiation.

Beliefs have a significant effect on the health behaviors of individuals and educators; however, they can be difficult to change. The purpose of this study was to determine if exposing community health educators, specifically family and consumer sciences county extension educators, to a multicomponent professional development training on food irradiation could change their beliefs and behaviors. This study compared the food irradiation beliefs and educational programming of educators who participated in a professional development training with those who did not. Results indicated that the training significantly improved the food irradiation beliefs of participants. In addition, the number of participants who provided food irradiation education significantly improved compared with educators who had not attended the training. These results suggest that this type of professional development training format can significantly affect beliefs and could increase the amount of food irradiation information available to consumers through community health educators.

Adult↗
PubMed2006

Clustering of health-related behaviors and their determinants: possible consequences for school health interventions.

Characterizing school health promotion is its category-by-category approach, in which each separate health-related behavior is addressed independently. Such an approach creates a risk that extra-curricular activities become overloaded, and that teaching staff are distracted by continuous innovations. Within the health promotion sector there are thus increasing calls for an integrative approach to health-related behaviors. However, a meaningful integrative approach to different lifestyles will be possible only if there is some clustering of individual health-related behaviors and if health-related behaviors have a minimum number of determinants in common. This systematic review aims to identify to what extent the four health-related behaviors smoking, alcohol abuse, safe sex and healthy nutrition cluster; and how their determinants are associated. Potentially modifiable determinants that offer clues for an integrative approach of school health-promotion programs are identified. Besides, the direction in which health educators should look for a more efficient instructional design is indicated.

Adolescent↗
PubMed1997

Health risk behaviors among California college students.

Health risk behaviors among students attending 4-year colleges in California were examined. The Youth Risk Behavior Survey for College Students was administered in a two-stage (29 universities, 5,652 students) random sample. All campuses and 3,810 (69%) students participated in the survey. In the 30 days preceding the survey, 36.7% of the students had binged at least once while drinking; 25.3% had driven after consuming alcohol; 32% had ridden in a car with someone who had been drinking; 17.6% had used marijuana; and 6% had carried a knife, gun, or club. More than half of the students who were sexually active and not married or living with a primary partner had not used a condom the last time they had sexual intercourse. Only 5% of regular bicycle riders always wore a helmet. Fewer than half (44%) reported aerobic physical activity on 3 or more of the preceding 7 days. The results of this study indicate a substantial amount of serious, risky health behaviors among California college students.

Adolescent↗
PubMed1993

Strategies for maintenance of health-promoting behaviors.

With our understanding of health expanding to include a dynamic of well-being, definitions of health vary, and activities associated with health promotion and disease prevention often overlap. Consequently, studies of health-promotion research include risk reduction. Most nursing studies are descriptive and cross-sectional, and although other disciplines report more intervention efforts, the same theoretic, definitional, and measurement issues exist in all studies. Women, older adults, and those better educated report a greater number of health-promoting behaviors and engage in a healthier lifestyle. An individual's view of health may affect his or her motivation to perform health-promoting behaviors. Removal of barriers, creation of supportive environments, and a strong sense of self-efficacy are important aspects of adoption and maintenance of health-promoting behaviors. Development of self-efficacy should be an integral part of health-promotion programs as increases in self-efficacy have been shown to precede the adoption and maintenance of health-promoting behaviors. Goal setting, contracting, and other behavioral techniques can help an individual develop competence in self-regulation of behavior. Outcomes of research must be congruent with the long-range view that promotion of health implies. Short-term outcomes may continue to be specific, but longer-term indicators will be more comprehensive. Measurement difficulties include evaluation of large-scale programs over extended periods, accounting for positive change in samples in which some persons already maintain health-promoting behaviors and proxy measures for future health. Future attention must be directed toward promoting healthy lifestyles and development of "wellness" thinking.

Attitude to Health↗
PubMed2002

The Behavior Change Consortium: setting the stage for a new century of health behavior-change research.

The Behavior Change Consortium (BCC), a collective of 15 National Institutes of Health-funded behavior-change projects, was conceived with the goal of evaluating the efficacy and effectiveness of novel ways of intervening in diverse populations to reduce tobacco dependence, and improve physical activity, nutrition and other health behaviors. The purpose of this article is to provide a general introduction and context to this theme issue by: (1) reviewing the promises and challenges of past efforts related to promoting change for three key health behaviors; (2) reviewing successful intervention strategies and principles of health behavior change; (3) discussing major theoretical approaches for obtaining successful behavior change; (4) setting BCC activities within the context of recent recommendations for the behavioral and social sciences; and (5) providing an organizational framework for describing each of the projects within this consortium. In addition to the rich database on behavioral outcomes for tobacco dependence, physical activity and diet, the BCC represents a unique opportunity to share data and address cross-cutting intervention research issues critical for strengthening the field of behavior change research.

Health Behavior↗
PubMed1999

Trends in safe driving behaviors and in relation to trends in health maintenance behaviors in the USA: 1985-1995.

Specific health and safe driving behaviors of the American adult population during the period 1985-1995, were examined for trends and for consistencies in observing them. The data base consisted of the results of annual surveys conducted on representative samples of 1250 people of the US adult population. Two indices were developed: a Health Index (HI) and a Safety Index (SI). The Health Index reflects the level of practice of six health and disease preventing behaviors (in order of decreasing importance: not smoking, frequent exercises, avoiding fat foods, having an annual blood pressure test, avoiding high-cholesterol foods, and having an annual dental exam). The Safety Index reflects the level of practice of three safe driving behaviors (in order of decreasing importance: wearing safety belts, avoiding drinking and driving, and observing the speed limit). Only a weak association was found among the individual safe driving behaviors, among the individual health maintenance behaviors, and between the two sets of behaviors. Over the 11-year study period the change in the Health Index has been practically and statistically insignificant, whereas the change in the Safety Index was both statistically and practically significant. The small improvement in the Safety Index actually masked a complex pattern of changes in safe driving habits. The three component Safety Index behaviors did not change in the same manner over the 11-year period. The greatest and most consistent increase was in the use of safety belts, with the reported percent who use it all the time increasing from 41.5% in 1985 to 74.1% in 1995 (an increase of 80%). There was also a consistent positive trend in refraining from drinking and driving, but the overall improvement was less dramatic than that reported for use of safety belts: from 71.6% reporting they never drink and drive in 1985 to 79.1% in 1995 (an increase of 10%). Still, it is noteworthy that by 1995 nearly 80% of the people reported they never drink and drive. Finally, obeying the speed limit did not improve over the 11-year period.

Accidents, Traffic↗
PubMed1982

Attitudes and health promoting behavior of medical and law students.

An entering class of medical students is compared with an entering class of law students on attitudes toward self-responsibility for health and reported health behaviors. Students' health behavior patterns are contrasted with those of practicing physicians and lawyers. Data were collected by self-administered questionnaires. Results indicated that medical students were stronger on self-responsibility and also reported more often engaging in health promoting behavior than law students. The same pattern of differences was reported for practicing physicians and lawyers.

Adult↗
PubMed2006

Evaluating the impact of a hypertension program for African Americans.

Although hypertension affects all racial and ethnic groups, its prevalence is highest in the African-American community. The goal of Healthy People 2010 is to reduce hypertension among African Americans from 40% to 16%. Although current levels remain high, culturally sensitive, community-based clinical projects might be helpful in addressing this problem. The goal of this study was to assess whether a community-based clinic's program was effective in improving blood pressure control among a sample of 134 African-American adults. The program design involved health education and physical fitness classes offered over a nine-month period, with blood pressure checks being conducted pre- and postphases to determine whether the program was effective in controlling high blood pressure. Health questionnaires were also administered pre- and posttest to assess whether health behaviors and perceived health status were influenced by the project. Two-thirds (70%) of the sample had high blood pressure at baseline and 43% at program conclusion. This was a statistically significant difference (p=0.003). Overall self-reported health survey results indicated improved health behaviors and health status changes. Findings suggest that culturally sensitive, community-based clinic programs that incorporate both health education and physical fitness might be effective in reducing hypertension among African Americans.

Adult↗
PubMed1996

Stress, social support and health-related behavior: a study of smoking, alcohol consumption and physical exercise.

The effects of academic examination stress on health behavior was assessed in university students. It was hypothesized that the anticipation of examinations would lead to increases in cigarette smoking and alcohol consumption, and to decreases in physical activity, and that effects would be particularly salient in students with low social supports. One hundred eighty students were divided into exam-stress (51 women, 64 men) and control (49 women, 16 men) groups, and were assessed at baseline and then within 2 weeks of exams, or an equivalent point for the control group. Perceived stress, emotional well-being and health behaviors were assessed by questionnaire and interview. The exam-stress group reported significant increases in perceived stress and emotional distress between baseline and exam sessions, but responses were not affected by social support availability. The controls showed no systematic changes in health behaviors. In the exam-stress group, smoking increased by an average of 54.7% between sessions in women with few social supports, but remained stable in men. There was a decrease in alcohol consumption of 17.5% in students with high social support between sessions, while those with low social supports showed an average increase of 18.5%. Physical activity decreased between baseline and exam sessions in the exam-stress group, but was not affected by social support. The results are discussed in relation to the effects of naturally occurring episodic stress on health behaviors, and the role of social support in moderating responses.

Adaptation, Psychological↗
PubMed2006

Spouses' provision of health-related support and control to patients participating in cardiac rehabilitation.

The authors examined spouses' provision of health-related support and control as predictors of health behavior and mental health among patients participating in cardiac rehabilitation (N = 94 couples). Cross-sectional analyses revealed that spouses' support was positively associated with patient health behavior. Prospective analyses of change over 6 months (N = 65 couples) revealed that spouses' support predicted increased patient mental health, whereas spouses' control predicted decreased patient health behavior and mental health. Findings suggest that spouses' efforts to facilitate patients' healthy lifestyle behaviors are associated with patients' health behavior and mental health, but not always as spouses might intend.

Female↗
PubMed1991

Using guiding-idea theories of the person to develop educational campaigns against drug abuse and other health-threatening behavior.

Educational campaigns against health-threatening behaviors such as drug abuse may lose effectiveness because they tend to be narrow, atheoretical and to stress negative effects. As a corrective, it is proposed that health campaigns take into account the broad range of human needs and consider how the health-threatening behavior may be gratifying to each need. This allows taking into consideration not just the bad effects (which tend to be obvious) of such behaviors as drug abuse, but also the gratifications they provide to a variety of human needs, by their associated lifestyles as well as by their pharmaceutical effects. In this way anti-drug campaigns can be made to cope more relevantly with the attractions of such health-threatening behaviors. We sketch 16 theorized human needs, widely contrasting in their assumption of what instigates human action and what terminates it, each of which theories has proven provocative in guiding basic research. From each of the 16 theories some implications are drawn regarding the attractions of drug abuse and regarding the design of educational campaigns against such health-threatening behaviors.

Behavior, Addictive↗
PubMed1998

Adolescents engaging in unhealthy weight control behaviors: are they at risk for other health-compromising behaviors?

OBJECTIVES: This study sought to determine whether adolescents engaging in weight control behaviors are at increased risk for tobacco, alcohol, and marijuana use; suicide ideation and attempts; and unprotected sexual activity. METHODS: Data were collected on a nationally representative sample of 16,296 adolescents taking part in the 1993 Youth Risk Behavior Survey. RESULTS: Adolescents using extreme weight control behaviors were at increased risk for health-compromising behaviors, while associations with other weight control behaviors were weak and inconsistent. CONCLUSIONS: The findings have relevance to clinical work with youth, provide a better understanding of disordered eating, and open up a number of opportunities for future research.

Adolescent↗
PubMed1991

Relationships between knowledge and belief variables and health maintenance behaviors in a Danish population over 45 years of age.

The growing body of evidence regarding the importance of self-care behavior for the maintenance of health and functional capacity has stimulated research interest in identifying the factors and processes that influence health-related behavior. This article examines relationships between health knowledge and belief variables and two types of health maintenance behavior: (a) routine habits that affect health and (b) deliberately undertaken health-protective behavior. The findings suggest that generalized health beliefs may have limited influence on behavior. Health locus of control beliefs may be related to behavioral change, but were not related to either current tobacco and alcohol consumption or to conscious health maintenance behaviors. It is concluded that more attention needs to be directed toward cultural influences on health beliefs and behavior.

Alcohol Drinking↗