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Health habits and coping behaviors among practicing physicians.

Practicing physicians on the full-time academic and clinical (volunteer) faculty of an urban university department of medicine (N = 211) completed questionnaires that examined their coping behaviors, health habits, life satisfaction, job stress, conflict between work and home life, health status and moods. Attempts to organize and restructure work activities were more frequently practiced by physicians who were more satisfied with work. Socializing, exercising and discussing feelings with others were not associated with any measures of physician health status, job stress, conflict or satisfaction. Those with higher scores on a health habits index tended to be less anxious, experienced less job stress, less conflict between work and home life and were more satisfied with their lives in general. Full-time academic faculty engaged in fewer positive or negative coping behaviors than clinical faculty. There were few strong intercorrelations among the various positive and negative coping behaviors or health habits; physicians often simultaneously engaged in both positive and negative activities, indicating complex patterns of coping behaviors that were not dramatically associated with life or work satisfaction.

Activities of Daily Living↗

Health risk factors and health-seeking behavior in lesbians.

Lesbians may engage in behavior that places their health at risk and may delay health care and screening more than do their heterosexual counterparts. This article examines influences on lesbians' health risk factors and health-seeking behaviors. A statewide, self-administered survey of members of a lesbian community organization was performed. Univariate and bivariate analyses were calculated, and linear regression was used to examine models of health risks and health-seeking behavior. Of 324 respondents, 90% had disclosed sexual orientation to at least one provider, 22% reported seeking care without symptoms (preventive care), and 23% reported waiting until symptoms are at their worst or never seeking care. Young age, belief in the importance of lung cancer, difficulty of getting health care when needed, reliance on the partner for health support, and fewer male partners were all associated with greater health risk for lesbians. Difficulty obtaining health care, difficulty communicating with the primary care provider, discomfort in discussing depression, and degree of comfort in discussing menopause were all associated with a delay in seeking health care. Sensitive communication with lesbians and further identification of lesbians' specific barriers to care may improve health-seeking behavior and provide more opportunities for screening and risk factor counseling in this population.

Adolescent↗

The association between health care behavior and attitudes.

A study was conducted to document the extent to which persons engage in health promotion and disease prevention behaviors, and to examine demographic and attitudinal variables associated with those behaviors. Health promotion behaviors are those undertaken by a person to stay healthy that do not require the assistance of a health professional (eg, exercising). Disease prevention behaviors are those undertaken to stay healthy that do require the assistance of a professional (eg, physical exam). The study design was descriptive. Data were collected from a convenience sample of 104 emergency room (ER) patients using an interview guide developed by the authors. Two major findings were that: a) individuals were more apt to go to the doctor than do health promotion behaviors in order to be healthy; and b) individuals who expressed belief in health promotion behaviors were more likely to practice them than were those who did not express such a belief. Two demographic variables were related.

Analysis of Variance↗

Person-environment congruence as a predictor of adolescent health and behavioral problems.

Most research on health and behavioral outcomes of stressors has focused on adults. One stressor identified in this literature is lack of "fit," or congruence, between individual needs and environmental opportunities. This study examines relations between person-environment congruence in three settings (home, school, and peer group) and several indices of health and behavioral disorder among adolescents. We also examine whether person-environment congruence contributes to the prediction of health and behavioral disorder once the effects of stressful life events have been taken into account. Using self-report data from 531 high school students, we find (a) person-environment congruence has relatively little impact on youngsters' health and well-being; and (b) although the contribution of congruence is small it is independent of the contribution of life events. Problems in the measurement of congruence are noted.

Adolescent↗

Alcohol use, smoking, and feeling unsafe: health risk behaviors of two urban seventh grade classes.

Health risk behaviors undertaken in adolescence, such as drinking alcohol and smoking, can have a lasting consequence on both short-term and long-term health. To better describe the health risk behaviors being undertaken by an urban adolescent population, a study was conducted at two parochial, middle schools in the Southwest section of Philadelphia, Pennsylvania, USA. The study purpose was to describe the types of health risk behaviors being undertaken by a seventh grade student population, the frequency of health risk behaviors, and the age of initiation of the health risk behavior.A descriptive, correlational study was undertaken with 105 seventh graders (ages of 11 to 13 years) from two middle schools using the Youth Risk Behaviors Surveillance System (YRBSS) Questionnaire. Information was collected about health risk behaviors such as alcohol use and tobacco use and feeling safe. Findings indicated that these adolescent students reported increased incidence of health risk behaviors including alcohol use, smoking, and carrying weapons to combat their feeling unsafe in their neighborhoods. Interestingly, there were differences between schools in the type of health risk behaviors in which the students participated. Nurses are often in an ideal position to assess the health and behaviors of adolescents and to offer education, health promotion, and support to this at-risk population.

Adolescent↗

Comprehensive health status assessment of centenarians: results from the 1999 large health survey of veteran enrollees.

BACKGROUND: Information on the health status of centenarians provides a means for understanding the health care needs of this growing population. Therefore, we examined the health status of a national cohort of centenarian veteran enrollees. METHODS: Ninety-three centenarian veteran enrollees returned a complete health history questionnaire, which included questions about sociodemographic information, age-associated conditions, health behaviors, health-related quality of life as measured by the Veterans SF-36, and change in health status. RESULTS: Centenarian veteran enrollees are a group with major impairment across multiple dimensions of health-related quality of life despite having a relatively low prevalence of diseases. They had considerable physical limitations as reflected by their physical health summary scores (26.2 +/- 8.3). However, their mental health was comparatively good (mental health summary score 44.1 +/- 12.5). Compared to younger elderly veterans (ages 85-99), centenarians had a lower prevalence of hypertension, angina or myocardial infarction, diabetes, and chronic low back pain (p <.05). Centenarians had significantly worse physical functioning, role physical, vitality, and social functioning scores than did younger elderly veterans. The two groups did not differ in their general health, bodily pain, role emotional, and mental health scores. Centenarians did not perceive much decline in their physical or mental health during the preceding year. CONCLUSIONS: Centenarian veteran enrollees are a group with a low number of age-associated diseases and good mental health despite substantial physical limitations. These results support future studies of services directed toward improvement of function as opposed to those focused solely on the treatment of diseases.

Activities of Daily Living↗

Cognition and all-cause mortality across the entire adult age range: health and lifestyle survey.

OBJECTIVE: To investigate the association of reaction time and brief measures of memory and spatial ability with all-cause mortality. METHODS: Participants were from the UK Health and Lifestyle Survey (HALS), a national sample survey of adults in England, Scotland, and Wales. In 1984/1985, data on lifestyle factors, socioeconomic status, and health were collected for 9,003 people. Cognitive data were collected for 7,414 individuals. All-cause mortality was investigated over 19 years of follow-up in relation to simple and choice reaction time, performance on a short-term verbal declarative memory test, and on a test of visual-spatial reasoning. RESULTS: Slower and more variable simple and choice reaction times were significantly related to increased risk of all-cause mortality over 19 years of follow-up. The increased risk of all-cause mortality was partly attenuated after adjustments for socioeconomic status, health behaviors, and health status. A novel finding was the existence of an effect of reaction time on all-cause mortality in young adults. Poorer verbal memory ability was also significantly related to an increased risk of dying in young adults independently of reaction time score. CONCLUSION: Slower and more variable reaction time was related to higher mortality risk in younger as well as older participants. Among younger adults, higher memory ability was also associated with lower risk of dying. The cognition-mortality relationship may be explained in part by the brain's efficiency of information processing and memory performance.

Adolescent↗

Staying healthy: the salience and meaning of health maintenance behaviors among rural older adults in North Carolina.

Beliefs about what constitutes health promoting behaviors vary by culture and class, and knowing how an older adult interprets a specific health behavior can improve health education and medical compliance. Ethnomedical approaches have investigated how people define disease and the therapies used to return to a state of health. However, little research has addressed how individuals define health, or the behaviors they use to maintain health. We analyze the behaviors elders state are needed to stay healthy, and their meanings for these behaviors. Narratives collected through in-depth interviews with 145 male and female rural North Carolina residents aged 70 and older, including African Americans, Native Americans and European Americans are analyzed using systematic text analysis. The participants' narratives include seven salient health maintenance domains: (1) Eating Right, (2) Drinking Water, (3) "Taking" Exercise, (4) Staying Busy, (5) Being with People, (6) Trusting in God and Participating in Church, and (7) Taking Care of Yourself. Several of these domains are multi-dimensional in the meanings the elders ascribe to them. There is also overlap in the content of some of the domains; they are not discrete in the minds of the elders and a specific health behavior can reflect more than one domain. Four themes cross-cut the domains: "balance and moderation", "the holistic view of health", "social integration", and "personal responsibility". Elders in these rural communities hold a definition of health that overlaps with, but is not synonymous with a biomedical model. These elders' concept of health seamlessly integrates physical, mental, spiritual, and social aspects of health, reflecting how health is embedded in the everyday experience of these elders. Staying healthy is maintaining the ability to function in a community. These results indicate that providers cannot assume that older patients will share their interpretation of general health promotion advice.

Black or African American↗

Results from the 1995 National College Health Risk Behavior Survey.

Results from the 1995 National College Health Risk Behavior Survey, which monitored health risk behaviors among US college and university undergraduates, suggest that many students' behaviors increase their likelihood of adverse health outcomes. During the 30 days preceding the survey, 34% of the participants had consumed five or more alcoholic drinks on at least one occasion, and 27% had drunk alcohol and driven a car. Thirty-one percent had smoked cigarettes regularly during their lifetimes, 49% had ever used marijuana, 30% had used a condom during their last sexual intercourse, 21% were overweight, and 38% had participated in vigorous physical activity on 3 or more of the 7 days preceding the survey. These data were analyzed by gender, age group, race and ethnicity, and institution type. They can be used by those responsible for the health and education of college students to reduce risks associated with the leading causes of mortality and morbidity.

Adolescent↗

Health-related behaviors, social support, and community morale.

The relation among health behaviors, social support, and community morale--attitudes toward one's community, such as attachment and social participation--was examined in 597 adults living in a Japanese community. Logistic models revealed that strong spousal support was related to reduced alcohol drinking and enhanced family support was related to a reduction in smoking. The support of friends was positively associated with the frequency of alcohol drinking by men. Among women, family support was positively related to the frequency of consuming Japanese-style food. Community morale was positively associated with consuming Japanese-style side dishes and negatively associated with alcohol consumption. The results indicate that there are varied associations between social relationships and health-related behavior and that these associations are gender-related. Knowing the specific associations between an individual's social relationships and his or her health-related behavior will he helpful for community-based intervention.

Journal Article↗

Youth Resilience Framework for reducing health-risk behaviors in adolescents.

Adolescents engage in risky behaviors that compromise their health. Leading causes of morbidity and mortality are associated with a few preventable health-risk behaviors initiated in childhood and early adolescence. Interventions that enhance protective factors in childhood are needed to offset these vulnerabilities and thus promote the health of adolescents. The Youth Resilience Framework is presented that addresses individual and sociocultural risk factors and protective resources that can influence health outcomes throughout adolescence. This framework incorporates a developmental approach to address precursors and health-risk behaviors that may be amenable to early health-promoting interventions.

Adaptation, Psychological↗

Stages of change across ten health risk behaviors for older adults.

Owing to the recent success of the Transtheoretical Model of behavior change and the possible relationships between health behaviors, this study investigated the stage distribution of 10 healthy behaviors (seatbelt use, avoidance of high fat food, eating a high-fiber diet, attempting to lose weight, exercising regularly, avoiding sun exposure, sunscreen use, attempting to reduce stress, stopping smoking, and conducting cancer self-exams) and their interrelationships in a representative sample of health maintenance organization (HMO) members. The majority of older adults were found to be in either precontemplation or maintenance, illustrating the need to target interventions to precontemplation. Most older individuals were in precontemplation for losing weight and/ or sunscreen use and exercise, making these behaviors a priority for intervention research. Possible gateway behaviors to general health could be identified; however, these results are preliminary and require longitudinal follow-up.

Aged↗

Is one theory better than another in nutrition education? A viewpoint: more is better.

Health behavior theories describe the relations among variables influencing a behavior and specify targets for facilitating behavior change. Nutrition education does not have a dominant theory specific to the discipline. Instead, constructs from multiple theories have been borrowed, primarily from the social sciences, and have been applied to describe or predict nutrition-related behaviors. However, current theories do not fully predict behavior or behavior change. A more effective approach may be to integrate distinct constructs from competing theories into one or more polytheoretical models that can be empirically tested and refined into a more comprehensive, tailored theory or set of theories specific to food and nutrition behavior changes. In our view, more than one will be needed to address the complex array of people, issues, and contexts that we routinely address in nutrition education and behavioral interventions.

Behavior Therapy↗

The meaning of health for women with physical disabilities: a qualitative analysis.

UNLABELLED: Researchers used qualitative research methods to explore determinants of and barriers to the health of women with physical disabilities. Semistructured, open-ended interviews were conducted with one focus group (n=9) and 9 individual women with various physical disabilities. PARTICIPANTS: (1) defined physical health as a correlate of functional capacity; (2) noted the importance of a positive mental state; (3) recognized the effect of having or lacking social support; (4) described the role of health behaviors in health promotion, as adapted to their functional limitations; and (5) described problems with their medical practitioners' lack of knowledge. Barriers included certain disability characteristics, stress, inadequate social support, societal attitudes, and lack of resources.

Adolescent↗

The prevalence and health burden of self-reported diabetes in older Mexican Americans: findings from the Hispanic established populations for epidemiologic studies of the elderly.

OBJECTIVES: The prevalence and health burden of self-reported adult-onset diabetes mellitus were examined in older Mexican Americans. METHODS: Data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly were used to assess the prevalence of self-reported diabetes and its association with other chronic conditions, disability, sensory impairments, health behaviors, and health service use in 3050 community-dwelling Mexican Americans 65 years and older. RESULTS: The prevalence of self-reported diabetes in this sample was 22%, and there were high rates of obesity, diabetes-related complications, and diabetic medication use. Myocardial infarction, stroke, hypertension, angina, and cancer were significantly more common in diabetics than in nondiabetics, as were high levels of depressive symptoms, low perceived health status, disability, incontinence, vision impairment, and health service use. Many of the rate differences found in this sample of older Mexican Americans were higher than those reported among other groups of older adults. CONCLUSIONS: Our findings indicate that the prevalence and health burden of diabetes are greater in older Mexican Americans than in older non-Hispanic Whites and African Americans, particularly among elderly men.

Aged↗

Health impacts of AT&T's Total Life Concept (TLC) program after five years.

For study group participants who returned for measurement in 1988, the health promotion program appeared to have a limited effect on health risk indicators and a positive effect on health-related attitudes. The data suggest that decreases in smoking and alcohol consumption may be attributed to the program. The combined evidence after 5 years of improved health behaviors, better health attitudes, and self-reports of lifestyle improvements suggests that the program has a positive impact on habit and attitude changes.

Adult↗

Experiences of racist events are associated with negative health consequences for African American women.

This study investigated whether experiences of racist events were related to psychological distress, negative health behaviors, and health problems. Participants were 71 African American women (mean age 44.4) who were recruited from an urban cancer-screening clinic as part of a larger longitudinal study on familial risk of breast cancer. Participants completed three study assessments, approximately one month apart, and data were collected via self-report. Correlational analyses revealed that past year and lifetime racism were both related to psychological distress. Among smokers and drinkers, past year racism was positively correlated with number of cigarettes and drinks consumed. Lifetime racism was negatively related to perceived health, and positively related to lifetime history of physical disease and frequency of recent common colds. Analyses using a general linear model revealed that these relationships were largely unaccounted for by other variables. In addition, demographic variables such as income and education were not related to experiences of racism. The results suggest that racism can be detrimental to African American's well being and should be investigated in health disparities research.

Adaptation, Psychological↗