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PubMedDate not supplied

Relationship between socioeconomic status, health status, and lifestyle practices of American Indians: evidence from a Plains reservation population.

This paper presents information on the prevalence of a variety of health behaviors and health conditions on an American Indian reservation in the Plains region of the western United States. In addition, data from two non-Indian comparison groups were used to examine the extent to which differences in health status and health behaviors between Indians and non-Indians could be explained by differences in socioeconomic status. The American Indian data were from a survey conducted in 1988 during an evaluation of a local community-based health promotion program, part of the Kaiser Family Foundation's Community Health Promotion Grants Program. The comparison groups were 12 communities in California surveyed in evaluating the Community Health Promotion Grants Program and three Plains States participating in the Behavioral Risk Factor Surveillance Survey. The results show that the higher prevalences of risk-taking behavior among Indians and their poorer self-reported health status remained after adjustment for socioeconomic status. Also, among Indians, higher levels of income and education were not associated with improved self-reported health status and lower prevalence of tobacco use, as was the case with the comparison groups. The higher prevalences of risk-taking behaviors and ill health among American Indians residing on one reservation, even among those with higher socioeconomic status, suggests a need for the investigation of other social and environmental influences.

Adolescent↗
PubMed2001

Self-rated health status: a new vital sign for primary care?

Self-reported health status ratings depend on whether one references health problems or health behaviors. Pessimistic health perceptions may indicate underlying emotional distress or predict mortality. This study explores the association between a single-item health status question and self-reported health problems or behaviors among women in a Wisconsin family medicine clinic. All women who present for health maintenance complete a health history form that includes a single item health status rating. Health status ratings from 251 randomly selected records were compared with certain reported demographics, health behaviors (e.g. smoking, exercise), health concerns, depression and anxiety symptoms, vital signs and body mass index. Health status ratings of fair or poor were found to be associated with race, marital and employment status, obesity, exercise, and depressive symptoms. Smokers were 4.22 times more likely to report a less favorable health category than non-smokers. Implications for future research are discussed.

Adolescent↗
PubMed1985

Physicians' beliefs about the importance of 25 health promoting behaviors.

A mail survey of 1,040 primary care physicians in Maryland examined their beliefs about the importance of 25 behaviors for promoting the health of the average person. Physician consensus existed across specialties in rating most health behaviors as very important and few as very unimportant. Eliminating smoking was most important and taking vitamin supplements least important.

Attitude of Health Personnel↗
PubMedDate not supplied

Ecological influences on health-promoting and health-compromising behaviors: a socially embedded approach to urban African American girls' health.

An ecological framework provides the underpinnings for the examination of factors associated with the health-promoting and health-compromising behaviors of African American adolescent females (N=137). Findings indicate that more positive family, peer, and neighborhood factors were associated with less engagement in health-compromising behaviors and increased engagement in health-promoting behaviors. Also, more positive family interactions buffered the relationship between neighborhood characteristics and adolescents' engagement in health-compromising behaviors. Overall, the findings suggest that the health-related behaviors of African American adolescent females are best understood in the context of their social relationships and environmental contexts.

Adolescent↗
PubMed1993

Health care behavior on Nicaragua's Atlantic Coast.

Survey methods are used to investigate health behavior in five communities on Nicaragua's Atlantic Coast. Eighteen health behaviors classified as 'biomedical' or 'traditional' are analyzed according to the ethnicity and educational level of the respondent. Household location (urban vs rural) and material wealth are also analyzed as predictors of health care behavior. Traditional behaviors are found to vary considerably among the six ethnic groups and among the various socioeconomic groupings. Biomedical behaviors are not found to be clearly related to ethnicity, wealth, or education.

Adult↗
PubMed1999

Interactive technology applications for behavioral counseling: issues and opportunities for health care settings.

CONTENT: This article discusses the rationale for, and the potential benefits and limitations of, computer-based interactive health communication (IHC) programs for health behavior counseling. We describe common barriers to health behavior counseling in medical settings and show how IHCs can address these issues. Following an overview of current and likely near-future IHCs, the potential impact of IHCs on the patient-provider relationship is considered. Results from evaluations of IHCs are summarized and important and unique issues in evaluating IHCs are discussed. We conclude with recommendations for clinical applications, including recommendations for consumers considering purchase or adoption of IHCs and recommendations for future research.

Computer Communication Networks↗
PubMed1998

Health-promoting behaviors of rural adolescent women.

A part of a larger study of the health behaviors of adolescent women, this investigation examined health-promoting behaviors and the influence of cognitive, social, and environmental factors on these health-promoting behaviors of rural adolescent women. The sample consisted of 128 rural African-American and white adolescent women. Forty-four percent of the variance in health-promoting behavior of this sample was explained by five variables: self-image, problem solving, mother's education, employment status, and family structure. Self-image was the most salient predictor of health-promoting behavior, explaining 33% of the variance.

Adolescent↗
PubMed2006

A chaotic view of behavior change: a quantum leap for health promotion.

BACKGROUND: The study of health behavior change, including nutrition and physical activity behaviors, has been rooted in a cognitive-rational paradigm. Change is conceptualized as a linear, deterministic process where individuals weigh pros and cons, and at the point at which the benefits outweigh the cost change occurs. Consistent with this paradigm, the associated statistical models have almost exclusively assumed a linear relationship between psychosocial predictors and behavior. Such a perspective however, fails to account for non-linear, quantum influences on human thought and action. Consider why after years of false starts and failed attempts, a person succeeds at increasing their physical activity, eating healthier or losing weight. Or, why after years of success a person relapses. This paper discusses a competing view of health behavior change that was presented at the 2006 annual ISBNPA meeting in Boston. DISCUSSION: Rather than viewing behavior change from a linear perspective it can be viewed as a quantum event that can be understood through the lens of Chaos Theory and Complex Dynamic Systems. Key principles of Chaos Theory and Complex Dynamic Systems relevant to understanding health behavior change include: 1) Chaotic systems can be mathematically modeled but are nearly impossible to predict; 2) Chaotic systems are sensitive to initial conditions; 3) Complex Systems involve multiple component parts that interact in a nonlinear fashion; and 4) The results of Complex Systems are often greater than the sum of their parts. Accordingly, small changes in knowledge, attitude, efficacy, etc may dramatically alter motivation and behavioral outcomes. And the interaction of such variables can yield almost infinite potential patterns of motivation and behavior change. In the linear paradigm unaccounted for variance is generally relegated to the catch all "error" term, when in fact such "error" may represent the chaotic component of the process. The linear and chaotic paradigms are however, not mutually exclusive, as behavior change may include both chaotic and cognitive processes. Studies of addiction suggest that many decisions to change are quantum rather than planned events; motivation arrives as opposed to being planned. Moreover, changes made through quantum processes appear more enduring than those that involve more rational, planned processes. How such processes may apply to nutrition and physical activity behavior and related interventions merits examination.

Journal Article↗
PubMedDate not supplied

Health-promoting behaviors of African American women.

Limited information exists concerning health behaviors of African American women. The purposes of this study were to describe health-promoting lifestyle behaviors among a sample of 187 African American women and to compare findings to other published reports on the Health-Promoting Lifestyle Profile (HPLP) instrument. Subscales with the highest means in this study were interpersonal support and self-actualization. However, when compared to reports of HPLP scores for other groups, total HPLP and subscale scores of women in this study were generally lower. Readability and applicability of the HPLP instrument may affect its validity and reliability in a diverse sample.

Adolescent↗
PubMed2000

From understanding health care provider behavior to improving health care: the QUERI framework for quality improvement. Quality Enhancement Research Initiative.

Basic science and health care research provide the evidence base for the scientific practice of medicine. Over the past 2 decades, as increasingly refined tools for improving health and health care have been developed, the health care community has attempted to bridge the gap between available tools and actual health care practices. This gap can be bridged only by influencing health care provider behavior. The VA Quality Enhancement Research Initiative (QUERI) is a program designed to systematically translate research findings into better health care practices, and thus better health outcomes for enrolled veterans. Integrating provider behavior research considerations and findings into each step of the QUERI process will enhance the effectiveness of the initiative. This article presents a provider behavior research framework for planning, implementing, and evaluating quality improvement interventions within QUERI.

Benchmarking↗
PubMed2000

Sports participation and health-related behaviors among US youth.

OBJECTIVE: To examine the relationship between sports participation and health-related behaviors among high school students. DESIGN: Cross-sectional design using data from the 1997 Centers for Disease Control and Prevention Youth Risk Behavior Survey. PARTICIPANTS: A nationally representative sample of 14,221 US high school students. MAIN OUTCOME MEASURES: Prevalence of sports participation among males and females from 3 ethnic groups and its associations with other health behaviors, including diet, tobacco use, alcohol and illegal drug use, sexual activity, violence, and weight loss practices. RESULTS: Approximately 70% of male students and 53% of female students reported participating on 1 or more sports teams in school and/or nonschool settings; rates varied substantially by age, sex, and ethnicity. Male sports participants were more likely than male nonparticipants to report fruit and vegetable consumption on the previous day and less likely to report cigarette smoking, cocaine and other illegal drug use, and trying to lose weight. Compared with female nonparticipants, female sports participants were more likely to report consumption of vegetables on the previous day and less likely to report having sexual intercourse in the past 3 months. Among white males and females, several other beneficial health behaviors were associated with sports participation. A few associations with negative health behaviors were observed in African American and Hispanic subgroups. CONCLUSION: Sports participation is highly prevalent among US high school students, and is associated with numerous positive health behaviors and few negative health behaviors.

Adolescent↗
PubMed2003

Insurance expenditures on bipolar disorder: clinical and parity implications.

OBJECTIVE: This study assessed treatment rates and expenditures for behavioral health care by employers and behavioral health care patients in a large national database of employer-sponsored health insurance claims. METHOD: Insurance claims from 1996 from approximately 1.66 million individuals were examined. Average annual charges per person and payments for behavioral health care were calculated along with patient out-of-pocket expenses and inpatient hospital admission rates. Behavioral health care expenditures for bipolar disorder were compared to expenditures for other behavioral health care diagnoses in these same insurance plans. RESULTS: A total of 7.5% of all covered individuals filed a behavioral health care claim. Of those, 3.0% were identified as having bipolar disorder, but they accounted for 12.4% of total plan expenditures. Patients with bipolar disorder incurred annual out-of-pocket expenses of $568, more than double the $232 out-of-pocket expenses incurred by all claimants. The inpatient hospital admission rate for patients with bipolar disorder was also higher (39.1%) compared to 4.5% for all other behavioral health care claimants. Furthermore, annual insurance payments were higher for covered medical services for individuals with bipolar disorder than for patients with other behavioral health care diagnoses. CONCLUSIONS: Bipolar disorder is the most expensive behavioral health care diagnosis, both for patients with bipolar disorder and for their insurance plans. For every behavioral health care dollar spent on outpatient care for patients with bipolar disorder, $1.80 is spent on inpatient care, suggesting that better prevention management could decrease the financial burden of bipolar disorder.

Adult↗
PubMed1998

Health-related behaviors and the benefits of marriage for elderly persons.

In this article, we investigate the relationship between health behaviors, marital status, and gender in the elderly population. We estimate logistic regression models to determine the factors that affect the likelihood of undertaking healthy behaviors. Using data from the 1987 National Medical Expenditure Survey, we find that marriage has positive impacts on health behaviors in the elderly population and that, when these effects differ by gender, they tend to be larger for elderly men than for elderly women. These results extend earlier findings showing that marriage encourages healthy behaviors for a younger population and demonstrate that these benefits continue later in life.

Aged↗
PubMed1996

Structure of health risk behavior among high school students.

The authors test the contention of R. Jessor's (1977) problem behavior theory that adolescent health risk behaviors comprise a single behavioral syndrome. Multidimensional scaling (MDS) and cluster analysis are used to analyze data from a statewide survey of high school students' (n = 5,537) health risk behaviors. A classical MDS analysis was calculated to test the dimensionality of the behaviors. All indicators supported a multidimensional model. An individual-differences MDS (INDSCAL) analysis revealed that a 4-dimensional solution best fit the data, with gender and racial-ethnic differences emerging in the relative salience of the dimensions. The INDSCAL dimensional coordinates for each health risk behavior were then submitted to a hierarchical cluster analysis technique. Five behavioral clusters were identified, 1 of which included many of the traditional "problem behaviors," such as smoking, unprotected sexual intercourse, and alcohol consumption. These findings support a multidimensional structure underlying adolescent health risk behavior. Implications for theory and prevention of health risk behaviors are discussed.

Adolescent↗
PubMed2005

Refugees' perceptions of healthy behaviors.

This descriptive study explored refugees' knowledge and perceptions of nutrition, physical activity and smoking behaviors using the Health Promotion and Transtheoretical Models. A one-time interview used both closed- and open-ended questions. The sample included 31 adults from Bosnia, Iran, and Cuba. Refugees had some knowledge of a healthy diet and physical activity, and were aware of both benefits and barriers for health behaviors. They had a realistic perception of their weight (55% overweight), and none thought obesity was a positive characteristic. Changes in diet, physical activity and smoking since arrival in the US have been positive for some and negative for others. For all categories discussed, refugees were in the pre-contemplation stage of change. There is a need to study refugees' health behaviors over time after arrival. Health behavior interventions must be specific to ethnicity in order to accurately document progress and to be culturally appropriate.

Acculturation↗
PubMed2003

A randomized clinical trial of a wellness intervention for women with multiple sclerosis.

OBJECTIVE: To examine the effects of a wellness intervention program for women with multiple sclerosis (MS) on health behaviors and quality of life (QOL). DESIGN: Randomized clinical trial. SETTING: Community setting in the southwestern United States. PARTICIPANTS: Convenience sample of 113 women with physician-confirmed MS (mean age, 45.79y). INTERVENTIONS: The 2-phase intervention program included lifestyle-change classes for 8 weeks, then telephone follow-up for 3 months. Participants were followed over an 8-month period. MAIN OUTCOME MEASURES: A series of self-report instruments to measure barriers, resources, self-efficacy for health behaviors, health promotion behaviors, and health-related QOL were completed at baseline, 2 months (after the classes), 5 months (after telephone follow-up), and at 8 months. Principal outcomes measures were health-promoting behaviors (scores on the Health Promoting Lifestyle Profile II) and QOL (scores on the Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] scales). RESULTS: Hierarchical linear modeling techniques revealed a statistically significant group by time effect for self-efficacy for health behaviors, health-promoting behaviors, and the mental health and pain scales of the SF-36. CONCLUSION: These data provide initial support for the positive effects of wellness interventions to improve health behaviors and selected dimensions of QOL for women with MS.

Adult↗
PubMed2002

[An evaluation of oral health promotion programs at the work site].

The purpose of this study was to evaluate oral health promotion activities at the work site, for three years. The subjects were 486 workers (men, 340; women, 146) and the mean age was 27.0. We examined the oral health status of the subjects once a year for three years from 1997 to 1999. We also asked them to complete questionnaires on oral health symptoms and health behavior. After oral health examinations, oral health education programs were provided at the work site. The following results were obtained. 1. During the three years, the oral health symptoms of the workers decreased, and the number of workers who practiced good oral health behavior increased. 2. No difference was observed on the status of teeth during the three years, but the oral hygiene and the periodontal status of the subjects improved significantly (p < 0.001). 3. The participant rate for oral health education programs was 15.8%. Workers who had better oral health status and health behavior had a higher participation rate in the education programs. 4. The workers who participated in dental education programs used interdental brushes more often than those without education programs. The difference was statistically significant (p < 0.05). Oral health promotion programs at the work site were usually provided using a group approach. But to enhance oral health awareness, combination with individual approaches might be necessary.

Adult↗