Integrated behavioral health care or “integrated care” is a distinct service delivery model aimed at early identification and appropriate intervention with that portion of medical\\/surgical patients presenting with behavioral health issues. The clinical rationale for integrated care and the potential for medical cost offset savings have been clearly substantiated in available research (Cummings, 2007; O’Donohue, Ferguson & Cummings, 2002), but
Nissen, Stephanie W; Brotherton, Jeffery L; Cohn, James A
The North Carolina National Guard (NCNG) Integrated Behavioral Health System is designed to systematically bring the best internal and external military resources together to function collaboratively for the betterment of behavioral health assessment, crisis intervention, referral, and case management services available to NCNG service members and their families. PMID:21678689
Wennerstrom, Ashley; Hargrove, Leslie; Minor, Shontel; Kirkland, Angela L; Shelton, Steven R
Community health workers (CHWs) collaborating with health care teams improve health outcomes. The feasibility of employing CHWs to support behavioral health in primary care is unknown. We offered experienced CHWs a 48-hour behavioral health training and placed them at health centers. Supervisors received technical assistance to support integration. We interviewed team members to explore CHW interactions with patients and team members. There was evidence of CHW integration. Major CHW roles included care coordination, outreach, and screening. It may be feasible to integrate behavioral health-focused CHWs into primary care settings. Both CHWs and supervisors need ongoing training and support. PMID:26049656
and bathe the salivary glands. Saliva Adrenal Cortex Blood Unbound cortisol is lipid soluble and can moveIntegration of Salivary Bioscience into Behavioral, Health, and Sports Sciences: How Biomarkers in Saliva can Benefit Your Research Program Douglas A. Granger, Ph.D. Center for Interdisciplinary Salivary
Bridges, Ana J.; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.; Gomez, Debbie
Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos. PMID:25309845
Oakley, Claire; Moore, Douglas; Burford, Duncan; Fahrenwald, Roxanne; Woodward, Kathryn
To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioral health family practice clinic was developed. In this paper we describe our experience with integrating mental health and substance abuse services into a primary care setting (a community health center) while…
Fojt, Diane F; Cohen, Martin D; Wagner, Janet
The behavioral health aspects of disaster have not historically been addressed as a priority in emergency preparedness planning. The overwhelming evidence of significant to severe psychological consequences of disaster has remained in the shadows compared to the more widely televised dramatic physical destruction and trauma. However, the aftermath of September 11, as well as 2005's Hurricane Katrina and 2008's Hurricane Ike disasters reminded the country that the psychological footprint of disaster easily dwarfs the more visual physical footprint. Disaster behavioral health is now recognized as a major public health concern and a national issue that deserves a logical, systematic, proactive approach within the structure of the National Incident Management System (NIMS) and Incident Command Structure (ICS; Fojt, Cohen, Wagner 2008). With increased commitment, collaboration, and organization we can better utilize our qualified yet limited behavioral health resources, meeting the predictable needs of future disasters' survivors, communities, and responders. PMID:19112934
This article describes the development of the Joint Principles of The Patient-Centered Medical Home (PCMH) by the Working Party Group on Integrated Behavioral Healthcare. The Joint Principles establish the primacy of integrated behavioral health care as a core principle of the PCMH. PMID:24955690
Elizabeth S. Levy Merrick; Dominic Hodgkin; Deirdre Hiatt; Constance M. Horgan; Shelly F. Greenfield; Bernard McCann
New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP\\/MBHC product (N = 1,158). In 2004, 25.0% of clients
Pourat, Nadereh; Hadler, Max W; Dixon, Brittany; Brindis, Claire
More than 70 percent of behavioral health conditions are first diagnosed in the primary care setting. Yet physical and behavioral health care are typically provided separately, compelling many vulnerable patients to navigate the complexities of two separate systems of care. This policy brief examines five community health centers (CHCs) in California that have taken preliminary steps toward creating "one-stop shopping" for both physical and behavioral health care. The steps taken to increase integration by the CHCs include employing behavioral health providers, using a single electronic health record that includes both physical and behavioral health data, transforming the physical space, and developing mechanisms for effective transition of patients between providers. The findings emphasize the importance of changes to Medi-Cal reimbursement policies to promote same-day visits, as well as the importance of cultural changes to integrate behavioral health. They also highlight the need for comprehensive tools to assess and promote integration and to identify solutions for the most challenging activities required to achieve full integration. PMID:25924245
Christy, Shannon M.; Mosher, Catherine E.; Rawl, Susan M.
Colorectal cancer (CRC) is the third most common cause of cancer deaths among men in the United States. Although CRC screening has been found to reduce CRC incidence and mortality, current screening rates among men are suboptimal due to various practical and psychosocial barriers. One potential barrier to CRC screening identified in qualitative studies with men is the threat to masculinity that endoscopic screening methods pose. Indeed, beliefs about masculinity have been predictive of other preventive health behaviors among men. In this review paper, we propose a novel conceptual framework to explain men’s CRC screening behavior that integrates masculinity norms, gender role conflict, men’s health care experiences, behaviors, and beliefs, and social and background variables. This framework has the potential to guide future research on men’s CRC screening behaviors and other health behaviors and may inform gender-sensitive interventions which target masculinity beliefs to increase preventive health behaviors. PMID:23813927
Gillen, Emily M.; Hassmiller Lich, Kristen; Yeatts, Karin B.; Hernandez, Michelle L.; Smith, Timothy W.; Lewis, Megan A.
This article describes a process for integrating health behavior and social science theories with practice-based insights using participatory systems thinking and diagramming methods largely inspired by system dynamics methods. This integration can help close the gap between research and practice in health education and health behavior by offering…
David D. Luxton; Russell A. McCann; Nigel E. Bush; Matthew C. Mishkind; Greg M. Reger
The rapid growth in the use of smartphones has opened a new world of opportunities for use in behavioral health care. Mobile phone software applications (apps) are available for a variety of useful tasks to include symptom assessment, psychoeducation, resource location, and tracking of treatment progress. The latest two-way communication functionality of smartphones also brings new capabilities for telemental health.
Vogel, Mark E
Reviews the book, Integrated Behavioral Health in Primary Care: Evaluating the Evidence, Identifying the Essentials edited by Mary R. Talen and Aimee Burke Valeras (see record 2013-28686-000). The book provides a helpful context and understanding to current developments in the field. It is a useful summary of important findings and developments that have shaped practice, research, and policy. It provides critical review of clinical, operational, and finance realms-all three worlds critical for shaping change efforts. The integration of behavioral health into primary care holds tremendous potential for improving care that is comprehensive, timely, and effective. Talen and Valeras's book is designed for a wide range of readers, including administrators, payers, policymakers, clinicians, researchers, and other interested professionals. Readers will become more informed and knowledgeable of the field and equipped for the work that lies ahead. (PsycINFO Database Record PMID:26053583
Connie E. Morrow; Elana Mansoor; K. Lori Hanson; April L. Vogel; Ruth Rose-Jacobs; Carolyn Seval Genatossio; Amy Windham; Emmalee S. Bandstra
We evaluated the Starting Early Starting Smart (SESS) national initiative to integrate behavioral health services (parenting,\\u000a mental health, and drug treatment) into the pediatric health care setting for families with young children. Data are presented\\u000a from five pediatric care (PC) sites, drawing from families at risk due to demographic and behavioral health factors, with\\u000a infants less than 12 months of age
Schueller, Stephen M; Montague, Enid; Burns, Michelle Nicole; Rashidi, Parisa
A growing number of investigators have commented on the lack of models to inform the design of behavioral intervention technologies (BITs). BITs, which include a subset of mHealth and eHealth interventions, employ a broad range of technologies, such as mobile phones, the Web, and sensors, to support users in changing behaviors and cognitions related to health, mental health, and wellness. We propose a model that conceptually defines BITs, from the clinical aim to the technological delivery framework. The BIT model defines both the conceptual and technological architecture of a BIT. Conceptually, a BIT model should answer the questions why, what, how (conceptual and technical), and when. While BITs generally have a larger treatment goal, such goals generally consist of smaller intervention aims (the "why") such as promotion or reduction of specific behaviors, and behavior change strategies (the conceptual "how"), such as education, goal setting, and monitoring. Behavior change strategies are instantiated with specific intervention components or “elements” (the "what"). The characteristics of intervention elements may be further defined or modified (the technical "how") to meet the needs, capabilities, and preferences of a user. Finally, many BITs require specification of a workflow that defines when an intervention component will be delivered. The BIT model includes a technological framework (BIT-Tech) that can integrate and implement the intervention elements, characteristics, and workflow to deliver the entire BIT to users over time. This implementation may be either predefined or include adaptive systems that can tailor the intervention based on data from the user and the user’s environment. The BIT model provides a step towards formalizing the translation of developer aims into intervention components, larger treatments, and methods of delivery in a manner that supports research and communication between investigators on how to design, develop, and deploy BITs. PMID:24905070
Morrow, Connie E.; Mansoor, Elana; Hanson, K. Lori; Vogel, April L.; Rose-Jacobs, Ruth; Genatossio, Carolyn Seval; Windham, Amy; Bandstra, Emmalee S.
We evaluated the Starting Early Starting Smart (SESS) national initiative to integrate behavioral health services (parenting, mental health, and drug treatment) into the pediatric health care setting for families with young children. Data are presented from five pediatric care (PC) sites, drawing from families at risk due to demographic and…
Gillen, Emily M; Hassmiller Lich, Kristen; Yeatts, Karin B; Hernandez, Michelle L; Smith, Timothy W; Lewis, Megan A
This article describes a process for integrating health behavior and social science theories with practice-based insights using participatory systems thinking and diagramming methods largely inspired by system dynamics methods. This integration can help close the gap between research and practice in health education and health behavior by offering a systematic approach to bring together stakeholders across multiple domains. In this process we create a diagram using constructs from multiple health behavior theories at all levels of the social ecological framework as variables in causal loop diagrams. The goal of this process is to elucidate the reciprocal relationships between explanatory factors at various levels of the social ecological framework that render so many public health problems intractable. To illustrate, we detail a theory-based, replicable process for creating a qualitative diagram to enrich understanding of caregiver and provider behavior around adherence to pediatric asthma action plans. We describe how such diagramming can serve as the foundation for translating evidence into practice to address real-world challenges. Key insights gained include recognition of the complex, multilevel factors affecting whether, and how effectively, parents/caregivers and medical providers co-create an asthma action plan, and important "feedback" dynamics at play that can support or derail ongoing collaboration. Although this article applies this method to asthma action plan adherence in children, the method and resulting diagrams are applicable and adaptable to other health behaviors requiring continuous, daily action. PMID:23709516
Bonham, Caroline A.; Sommerfeld, David; Willging, Cathleen; Aarons, Gregory A.
Objective. In recent years, New Mexico has prioritized integrated treatment for cooccurring mental health and substance use disorders within its public behavioral health system. This report describes factors likely to be important when implementing evidence-based practices (EBPs) in community agencies. Methods. Our mixed-method research design consisted of observations, semistructured interviews, and surveys undertaken with employees at 14 agencies at baseline and after 18 months. We developed four-agency typologies based on iterative coding and analysis of observations and interviews. We then examined survey data from employees at the four exemplar agencies to validate qualitative findings. Results. Financial resources and strong leadership impacted agency capacity to train providers and implement EBPs. Quantitative analysis of service provider survey responses from these agencies (N = 38) supported qualitative findings and demonstrated significant mean score differences in leadership, organizational climate, and attitudes toward EBPs in anticipated directions. Conclusion. The availability of strong leadership and financial resources were key components to initial implementation success in this study of community agencies in New Mexico. Reliance only on external funding poses risks for sustainment when demoralizing work climates precipitate employee turnover. Strong agency leadership does not always compensate for deficient financial resources in vulnerable communities. PMID:24772411
Roshan Bastani; Beth A. Glenn; Vicky M. Taylor; Moon S. Chen Jr.; Tung T. Nguyen; Susan L. Stewart; Annette E. Maxwell
Mitigating the unequal burden of cancer often involves conducting community-based trials to develop effective intervention strategies to promote cancer-related health behaviors. However, this is challenging due to the simultaneous influence of numerous factors, at multiple levels in the socio-ecological context, on health behavior. A sound conceptual framework can bring order to this complex environment and provide a roadmap for systematically
Background Childhood obesity is a ‘wicked’ public health problem that is best tackled by an integrated approach, which is enabled by integrated public health policies. The development and implementation of such policies have in practice proven to be difficult, however, and studying why this is the case requires a tool that may assist local policy-makers and those assisting them. A comprehensive framework that can help to identify options for improvement and to systematically develop solutions may be used to support local policy-makers. Discussion We propose the ‘Behavior Change Ball’ as a tool to study the development and implementation of integrated public health policies within local government. Based on the tenets of the ‘Behavior Change Wheel’ by Michie and colleagues (2011), the proposed conceptual framework distinguishes organizational behaviors of local policy-makers at the strategic, tactical and operational levels, as well as the determinants (motivation, capability, opportunity) required for these behaviors, and interventions and policy categories that can influence them. To illustrate the difficulty of achieving sustained integrated approaches, we use the metaphor of a ball in our framework: the mountainous landscapes surrounding the ball reflect the system’s resistance to change (by making it difficult for the ball to roll). We apply this framework to the problem of childhood obesity prevention. The added value provided by the framework lies in its comprehensiveness, theoretical basis, diagnostic and heuristic nature and face validity. Summary Since integrated public health policies have not been widely developed and implemented in practice, organizational behaviors relevant to the development of these policies remain to be investigated. A conceptual framework that can assist in systematically studying the policy process may facilitate this. Our Behavior Change Ball adds significant value to existing public health policy frameworks by incorporating multiple theoretical perspectives, specifying a set of organizational behaviors and linking the analysis of these behaviors to interventions and policies. We would encourage examination by others of our framework as a tool to explain and guide the development of integrated policies for the prevention of wicked public health problems. PMID:23597122
Klontz, Bradley T; Bivens, Alex; Michels, Stanton; DeLeon, Patrick H; Tom, Lyndsey
As a result of difficulties with access to care and resulting low levels of service utilization, the mental health problems of children often go undiagnosed and untreated. One of the most promising approaches to increasing access to care is the delivery of mental health services in school settings, where almost all of the children in a community can be accessed. However, as a result of competing needs, cultures, and objectives, integrating mental health services into schools can be challenging. In the wake of a devastating hurricane in 1992 and efforts to identify and treat children with posttraumatic stress, many of these barriers were overcome on the island of Kauai, Hawaii and led to the development of the Mokihana Program, an integrated Department of Education and Hawaii Department of Health initiative for providing school-based behavioral health services. This study examined the effectiveness of the Mokihana Program in the treatment of 123 elementary age children and 56 adolescents by comparing teacher ratings of behavior problems and adaptive skills at intake and at 1-year follow-up. It was hypothesized that symptom severity would decrease from pretreatment to follow-up. Findings showed statistically significant improvements across a wide spectrum of behavioral problems and adaptive functioning. The authors explore the challenges and opportunities in sustaining and replicating this type of departmental integration in the service of children and youth. (PsycINFO Database Record PMID:25961646
Leveton, Lauren B.
The project goal is to develop behavioral health prevention and maintenance system for continued crew health, safety, and performance for exploration missions. The basic scope includes a) Operationally-relevant research related to clinical cognitive and behavioral health of crewmembers; b) Ground-based studies using analog environments (Antarctic, NEEMO, simulations, and other testbeds; c) ISS studies (ISSMP) focusing on operational issues related to behavioral health outcomes and standards; d) Technology development activities for monitoring and diagnostic tools; and e) Cross-disciplinary research (e.g., human factors and habitability research, skeletal muscle, radiation).
Frey, Andy; Young, Scott; Gold, Allene; Trevor, Earl
Although experts in early childhood mental health services make clear the need to infuse mental health services into all program components, many have suggested that the mental health services in the majority of Head Start programs are narrowly focused and that mental health consultants are often used in limited ways (see D. J. Cohen, Solnit, &…
Center for Technology and Behavioral Health Andrew Campbell, PhD, Professor of Computer Science with diabetes have 40-72% incidence of depression; 50% incidence anxiety Behavioral Health Disorders Typically. · e.g., when depression co-occurs with diabetes, health care costs increase by 50-75%. #12;Integration
Halbesleben, Jonathon R B; Leroy, Hannes; Dierynck, Bart; Simons, Tony; Savage, Grant T; McCaughey, Deirdre; Leon, Matthew R
While previous research has identified that leaders' safety expectations and safety actions are important in fostering occupational safety, research has yet to demonstrate the importance of leader alignment between safety expectations and actions for improving occupational safety. We build on safety climate literature and theory on behavioral integrity to better understand the relationship between the leader's behavioral integrity regarding safety and work-related injuries. In a time-lagged study of 658 nurses, we find that behavioral integrity for high safety values is positively associated with greater reporting of fewer and less severe occupational injuries. The effects of behavioral integrity regarding safety can be better understood through the mediating mechanisms of safety compliance and psychological safety toward one's supervisor. We discuss the implications of our findings for future research on safety climate. PMID:24099159
Graham, Lucy J
Retaining people living with HIV (PLWH) in care over the lifespan is critical to quality and longevity of life. Individual health behavior decisions that affect care retention are complicated and multifactorial. Current health behavior theories are inadequate in isolation to guide retention in care research. Two existing models, Cox's Interaction Model of Client Health Behavior, and Lazarus and Folkman's Transactional Model of Stress and Coping have both guided research with PLWH, although not related to retention in care. Integration of these models may more comprehensively inform care retention research and practice across the lifespan as it incorporates not only intra- and inter-personal characteristics and relationships but also the stress and coping experiences inevitable when living with a chronic illness such as HIV. PMID:25665883
Farrar, C. R. (Charles R.)
Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective structural health monitoring solution by integrating and extending technologies from various engineering and information technology disciplines. It is the authors opinion that all structural health monitoring systems must be application specific. Therefore, a specific application, monitoring welded moment resisting steel frame connections in structures subjected to seismic excitation, is described along with the motivation for choosing this application. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMS) technology, and statistical pattern recognition algorithms. The proposed system is based on an assessment of the deficiencies associated with many current structural health monitoring technologies including past efforts by the authors. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.
American Association for the Advancement of Science (American Association for the Advancement of Science; )
In this lesson, students become better aware of how their personal behavior and the environment can have a considerable impact on their health in general, particularly the health of their skin. In this exercise, students draw a model of a healthy and unhealthy person. This prompts a discussion on behavior and environmental behaviors that affect health. They also learn what good health is and the benefits of a healthy lifestyle. Finally, the students determine their skin types.
Rasch, Randolph F R; Davidson, Dawn; Seiters, John; MacMaster, Samuel A; Adams, Susie; Darby, Kathleen; Cooper, R Lyle
This paper provides outcomes from an evaluation of a federally funded program combining HIV prevention services with an integrated mental health and substance abuse treatment program to a population of primarily African American ex-offenders living with, or at high risk for contracting HIV in Memphis, Tennessee. During the 5-year evaluation, data were collected from 426 individuals during baseline and 6-month follow-up interviews. A subset of participants (n = 341) completed both interviews. Results suggest that the program was successful in reducing substance use and mental health symptoms but had mixed effects on HIV risk behaviors. These findings are important for refining efforts to use an integrated services approach to decrease (a) the effects of substance use and mental health disorders, (b) the disproportionate impact of criminal justice system involvement, and (c) the HIV infection rate in African American ex-offenders in treatment. PMID:23340238
Health is best understood within an ecological context. Accordingly, health promotion involves processes that foster supportive environments and healthful behavior. Thus, effective health promotion programs are typically multilevel, focusing not only on the population at risk but also on the environmental conditions that contribute so importantly…
Over a period of 10 years, a hospital in rural Africa slowly built an integrated primary and secondary health care program to the point where it has more than 40 elements. In its initial stage (1982-84), hospital staff and community participants were trained, the number of mobile clinics was increased, community participation was sought, and health education was emphasized. During 1985-86, 92 village health committees were organized with 70 trained Village Health Workers (VHWs). This led to a rapid increase in vaccination rates, the use of oral rehydration therapy, and training of traditional birth attendants. In 1987-88, 14 VHW were trained to use basic medical kits and distribute medicines. By 1990, 18,000 of the 72,000 outpatient treatments were administered by VHWs. In 1987, the hospital made a community diagnosis and increased the size of its advisory board (which became 60% female). Because the community identified food, water, and poverty as its priorities, the hospital took steps to improve the food supply, the water supply, and the financial position of the women. In 1989-90, the primary health care (PHC) project added the components of family planning, a weaning food production unit, food coupons, food for work, grain banks, a trust fund, literacy classes, health stamps, a mobile malnutrition clinic, subsidized fertilizer and seed, low-cost care for victims of AIDS, new malaria treatment schedules, and a housing association. The PHC program has resulted in a reduction in under-five deaths from the national average of 330/1000 to 145/1000 (other areas have reduced deaths to 270-300/1000. The program is also becoming increasingly cost-effective, costing about 6 pounds per capita over 10 years for a population of 50,000. Country-wide implementation of the PHC program would require only 30% of the present health budget. PMID:7778193
Ellen Burke Beckjord; Donna J Keyser; Dana Schultz; Susan L Lovejoy; Raymond Firth; Harold Alan Pincus
Depression among pregnant and postpartum women (i.e., perinatal depression) is the number one complication of childbirth.\\u000a The Allegheny County Maternal Depression Initiative aimed to bridge gaps between physical and behavioral health care and improve\\u000a the capacity of local systems of care for identifying and treating women at high risk for perinatal depression. To achieve\\u000a these goals, the collaborative adopted a
Barbara W. Posthuma
Lorna Jean King is interviewed concerning the present status of sensory integration as a treatment modality in the area of mental health. Topics covered are: use of sensory integration techniques with adults and adolescents in both chronic and acute mental health settings; goals and expected outcomes of using sensory integration techniques; cost-effectiveness of these techniques; differences between occupational therapy and
Helping You Choose Quality Behavioral Health Care Selecting quality behavioral health care services for yourself, a relative or friend requires special thought and attention. The Joint Commission on ...
Chin, Jean Lau; Yee, Barbara W K; Banks, Martha E
As health care reform promises to change the landscape of health care delivery, its potential impact on women's health looms large. Whereas health and mental health systems have historically been fragmented, the Affordable Care Act (ACA) mandates integrated health care as the strategy for reform. Current systems fragment women's health not only in their primary care, mental health, obstetrical, and gynecological needs, but also in their roles as the primary caregivers for parents, spouses, and children. Changes in reimbursement, and in restructuring financing and care coordination systems through accountable care organizations and medical homes, will potentially improve women's health care. PMID:24410361
Kathleen Mullan Harris
In this article, I make the case for using an integrative approach to health, broadly defined as social, emotional, mental,\\u000a and physical well-being; for studying health among the young as an important marker for future health and well-being across\\u000a the life course; and for understanding health disparities among the young as both causes and consequences of social stratification.\\u000a An integrative
This lesson, from Science NetLinks, provides students with a sound introduction and historical overview of the important figures and discoveries that have greatly advanced the study of human behavior since the early 1900s. This lesson is the first of three lessons on mental health and human behavior.
Snider, Barry B.
, families, and veterans Panel Sponsored by the Institute for Behavioral Health Mary Jo Larson, Ph for Behavioral Health SCHNEIDER INSTITUTES FOR HEALTH POLICY Veterans are Becoming More Diverse #12;Institute for Behavioral Health SCHNEIDER INSTITUTES FOR HEALTH POLICY Veterans are Becoming More Diverse #12;Institute
Jogging, running Jumping rope Swimming #12;Exercise: Benefits 1) Physical Health BenefitsHealth-Enhancing Behaviors Chapter Four Exercise Promotion Accident Prevention Cancer- Related Health Behaviors Weight Control #12;Exercise Promotion: Aerobic Sustained exercise that stimulates
Brady, Joseph V
Concern about the behavioral effects of spaceflight can be traced back a half century to the earliest preparatory bioastronautics experiments in the mid-1 950s. A central focus of the first primate suborbital flights, as well as the orbital chimpanzee pretest flights of Project Mercury, was the effects of such stressful ventures on the learned performances of these space behavioral health pioneers. The hiatus in spaceflight behavioral health experimental investments that followed these early initiatives began with the advent of the 'human astronaut' era of the mid-1960s, and has dominated the last several decades. Contemporary concerns in this regard have most recently been articulated by a turn-of-the-century Committee of the Institute of Medicine, National Academy of Sciences, providing a visionary view of space medicine during travel beyond Earth orbit. This 2-yr study focused on those most complex behavioral health interactions involving humans in extreme, isolated, and confined microsocieties-areas that have not received the necessary level of attention. The evident behavioral health issues raised by the prospect of long-duration exploratory missions beyond Earth orbit, including performance and general living conditions, recovery and support systems, and the screening, selection, and training of candidate participants are reviewed and discussed. PMID:15943190
Lee, Shoou-Yih D.; Tsai, Tzu-I; Tsai, Yi-Wen; Kuo, Ken N.
Extant health literacy research is unclear about the contribution of health literacy to health behaviors and is limited regarding women's health issues. The primary purpose of this study is to investigate the association between health literacy and five health behaviors (Pap smear screening, annual physical checkup, smoking, checking food…
Mackey, Dianne Dee; And Others
These four learning modules present text and exercises designed to help allied health students understand various elements of positive interaction with people. The first module, "Maslow's Hierarchy of Needs" by Dianne Mackey, defines human needs, presents Maslow's theories, and helps the learner identify behaviors that reflect the presence of…
Health-Compromising Behaviors characteristics substance abuse and dependence alcohol abuse at once" ! Substance abuse of all kinds are predicted by some of the same factors ! Interventions need to be matched to stage of vulnerability #12;Substance abuse: Links ! Conflict with parents and family problems
Agudelo, Carlos A
Despite their shared history, the Andean countries are socially and politically diverse, with heterogeneous health realities and complex integration processes. General developments such as the Latin American Free Trade Association and Latin American Integration Association have existed for decades, along with others of a regional scope, like the Andean Community of Nations, Caribbean Community, and Central American Common Market. The health field has a specific instrument in the Andean Region called the Hipólito Unánue Agreement, created in 1971. Integration processes have concentrated on economic aspects, based on preferential customs agreements that have led to an important long-term increase in trade. Less progress has been made in the field of health in terms of sharing national experiences, knowledge, and capabilities. Analysis of experiences in health has shown that integration depends on the countries' respective strengths and to a major extent on national political processes. PMID:17625652
Kyle L. Grazier
Although mental illness treatment protocols exist, the organization and financing of screening and treatment services inhibit access. These challenges are compounded for refugees, immigrants, and other groups vulnerable due to their ethnicity, race, or culture. By creating a system-wide, collaborative, integrated model that recognizes and addresses critical clinical and economic aspects in the delivery of services, high quality, evidence-based care
Samuel, Laura J.; Commodore-Mensah, Yvonne; Dennison Himmelfarb, Cheryl R.
Health behavior theories state that social environments influence health behaviors, but theories of how this occurs are relatively underdeveloped. This article systematically surveys community social capital concepts in health behavior literature and proposes a conceptual framework that integrates these concepts into existing behavioral theory.…
Hill, Wendell T.
1 SCHOOL OF PUBLIC HEALTH Department of Behavioral and Community Health MPH Internship Program;3 Table of Contents Internship Overview ........................................................................................................................................ 4 Goals of the Internship
Hill, Wendell T.
SCHOOL OF PUBLIC HEALTH Department of Behavioral and Community Health Undergraduate Internship Proverb #12;3 Table of Contents Undergraduate Internship Overview ......................................................................................................... 4 Internship Goals and Program Competencies
Bardina, Jorge; McDermott, William J.; Follen, Gregory J.; Blaser, Tammy M.; Pavlik, William R.; Zhang, Desheng; Liu, Xian-You
The National Air Space System-Wide Simulation (NAS Sim) program advances the development and implementation of a comprehensive, integrated health management system contributing to safety and modeling of the national aviation system. This program integrates different disciplines to develop an accurate and insightful method for real-time modeling of the local integrated airplane risk exposure and monitoring of operations of the global national air space.
Owen, Bonnie L.
The objective was to investigate the effects of health attitudes on behavior as well as the effects of a persuasive communication on health attitudes and behavior and the effects of attitudes and behavior on receptivity to health educational materials. Teenagers exposed to two persuasive communications about diabetes exhibited no effects on…
Materials Management in Health Services Organizations HMPD 318 Policy and Decision Making in Health Care HMPD 319 Strategic Management of Health Care Organizations HMPD 320 Governance in Health Care HMPD 325Master of Public Health Curriculum Health Behavior and Education Concentration HBED 310 Social
This Web site provides definitions of major theoretical constructs employed in health behavior research, and information about the best measures of these constructs. This resource is designed for health behavior researchers in public health, health communications, nursing, psychology, and related fields.
that fit your lifestyle and schedule #12;Exercise: Benefits 1) Physical Health Benefits: ! ! Increases.! 3) Economic Benefits: reduces absenteeism, health costs, increases job satisfaction.! #12;ExerciseHealth-Enhancing Behaviors Chapter Four Exercise Promotion Accident Prevention Cancer- Related
Wang, Catharine; Bowen, Deborah J.; Kardia, Sharon L. R.
Researchers and practitioners in health behavior and health education (HBHE) can play a pivotal leadership role in the integration of genomic advances to improve the public's health. The purpose of this article is to outline research and practice opportunities at the intersection of genomics and HBHE. We begin this article by briefly summarizing…
Faran, Michael E; Johnson, Patti L; Ban, Paul; Shue, Tracy; Weist, Mark D
The US Army has developed an innovative School Behavioral Health (SBH) program, part of the Child and Family Behavioral Health System, a collaborative, consultative behavioral health care model that includes SBH, standardized training of primary care providers in treatment of common behavioral health problems, use of tele-consultation/tele-behavioral health, optimizing community outreach services, and integration with other related behavioral health services. In this article, the needs of military children, adolescents, and families are reviewed, a history of this initiative is presented, key themes are discussed, and next steps in advancing this evolving, innovative system of health care featuring SBH are described. PMID:25773333
Richard H. Beinecke; Donald S. Shepard; Musetta Leung; Derek Sousa
The eight-year provider evaluation of the Massachusetts Behavioral Health Program showed positive assessments of care provision, continuing problems in integration of care, high assessments of the clinical review process, high evaluations for administration, and positive ratings compared with other managed care organizations. Changes in provider organizations continue. Substance abuse and mental health providers gave similar ratings, while inpatient providers were
Constance M. Horgan; Deborah W. Garnick; Elizabeth Levy Merrick; Dominic Hodgkin
Health plans appear to be moving toward less stringent management, but it is not known whether behavioral health care arrangements\\u000a mirror the overall trend. To improve access to and quality of behavioral health services, it is critical to track plans’ delivery\\u000a of these services. This study examined plans’ behavioral health care arrangements and changes over time using a nationally\\u000a representative
316 Marketing in Healthcare 2 HMPD 317 Materials Management in Health Services Organizations 2 HMPD Organizations 2 HMPD 320 Governance in Health Care 2 HMPD 325 Quality Management and Accreditation in HealthMaster of Public Health Curriculum Health Behavior and Education Concentration CR HBED 310 Social
David M. DeJoy
This paper provides a critical review of the applicability of theoretical models of health behavior to workplace self-protective behavior. Value-expectancy, environmental\\/contextual, and behavior change models are reviewed. On this basis, an integrative framework is proposed that conceptualizes self-protective behavior as consisting of four stages or phases: hazard appraisal, decision making, initiation, and adherence. In addition, five general constructs are identified
There is little question that social influence is an important determinant of health-related behaviors, including not only cigarette smoking and alcohol use but a range of other behaviors as well. Thus the basic question for new research on health behavior is not necessarily whether social influence should be studied, but what aspect should be measured.
Gary Mihalik; Michael Scherer
Making sense of managed behavioral health care organizations (MBHOs) is difficult as they rapidly evolve in response to payer, member, legislative, and market demands. This article describes the basic mechanisms involved in managed behavioral health care's evolution, including the nature of carve-out organizations, carved-in services, the array of payment mechanisms between payer and MBHO, and between MBHO and mental health
Carole Roan Gresenz; Roland Sturm
The growth of managed care and the possibility of biased enrollment and disenrollment rates have raised concerns about cost shifting. This article analyzes the duration of continuous enrollment in a managed behavioral health organization among members with and without behavioral health care utilization and among members with different mental health conditions. Eleven large employers with more than 250,000 members who
Meg Gerrard is a professor at Iowa State University who has published widely on health cognitions associated with adolescent risk behaviors such as unprotected sex, tanning, smoking, drinking and substance use. Her research has been designed to increase our understanding of the way people make decisions associated with health risk and health maintenance behaviors. Dr.
Conway, Terry L.; And Others
Identifying correlates of health behavior is an important step both for understanding and modifying health behavior. This study examined five personality factors (Neuroticism, Extraversion, Openness to Experience, Agreeableness, Conscientiousness) and three dimensions of health locus of control (Internal, Powerful Others, Chance) as correlates of…
Delaney, Kathleen R; Robinson, Karen M; Chafetz, Linda
In integrated care, a person will have his or her medical and behavioral health needs addressed within one health care system. Support for integrated models has grown with the increasing awareness of how the medical comorbidities of individuals with serious mental illness contribute to their morbidity and mortality, the prevalence of mental health problems in the general population, and the mental health issues among those with chronic medical problems. The enactment of effective integrated care will demand developing clinicians who are trained to work with mental health needs at various levels of intensity, who are capable of addressing complex comorbidities, and who operate from a person-centered approach to care. In this light we argue that given their unique skill set and clinical training, Psychiatric-Mental Health Advanced Practice Nurses could play a critical role in integrated care and present policy recommendations which support the development of the Psychiatric-Mental Health Advanced Practice Nurses role in such models. PMID:23702474
Louk WH Peters; Gerjo Kok; Geert TM Ten Dam; Goof J Buijs; Theo GWM Paulussen
BACKGROUND: Most school health education programs focus on a single behavioral domain. Integrative programs that address multiple behaviors may be more efficient, but only if the elements of change are similar for these behaviors. The objective of this study was to examine which effective elements of school health education are similar across three particular behavioral domains. METHODS: A systematic review
of Education, Health, and Human Services School of Health Sciences Catalog Year: 20122013 Page 1 of 3 | Last-BS-IHS-HLSV] College of Education, Health, and Human Services School of Health Sciences Catalog Year: 20122013 Page 2Roadmap: Integrated Health Studies Health Services Bachelor of Science [EH-BS-IHS-HLSV] College
of Education, Health, and Human Services School of Health Sciences Catalog Year: 20132014 Page 1 of 3 | Last Health Services Bachelor of Science [EH-BS-IHS-HLSV] College of Education, Health, and Human ServicesRoadmap: Integrated Health Studies Health Services Bachelor of Science [EH-BS-IHS-HLSV] College
The general definition of social influence is that health-related behavior is influenced by a person's social context. The behavioral social context can be represented by the behaviors of individual peers or family members (e.g., smoking) with whom the person interacts regularly, or by behaviors observed in a larger social environment such as the neighborhood in which a person lives.
Wood, Norma J.
The purpose of this study was to investigate the relationships among health status, personal definition of health, and health behavior choice in the elderly. Self-assessed health status was measured using a modified Cantril Ladder, personal definition of health was measured using the Laffrey Health Conception Scale (LHCS), and health behavior…
Dominic Hodgkin; Constance M. Horgan; Deborah W. Garnick; Elizabeth L. Merrick
Data from a nationally representative sample of private health plans reveal that special lifetime limits on behavioral health\\u000a care are rare (used by 16% of products). However, most plans have special annual limits on behavioral health utilization;\\u000a for example, 90% limit outpatient mental health and 93% limit outpatient substance abuse treatment. As a result, enrollees\\u000a in the average plan face
Birkimer, John C.; And Others
Discovers a high correlation between positive emotional states, supportive self talk, and specific healthy behaviors in college students. The correlated health behaviors were vigorous exercise, mild exercise, seat belts, and avoidance of alcohol and junk food. Considers the impact of negative self talk on the avoidance of negative behavior. (MJP)
Leventhal, Elaine A.; And Others
Health behavior may be influenced by age, beliefs, and symptomatology. To examine age-related health beliefs and behaviors with respect to six diseases (the common cold, colon-rectal cancer, lung cancer, heart attack, high blood pressure, and senility), 396 adults (196 males, 200 females) divided into three age groups completed a questionnaire…
Ransom, Mary Virginia
Perceptions adolescents formed of peers regarding modeled health behaviors were examined. Students viewed slides of adolescents with or without health behavior artifacts (apple, cigarette, beer can, or tennis racket), rating the models on 16 characteristics. Models were rated less mature, friendly, and intelligent when holding a beer can or…
Jeffrey S. Levin; C. David Jenkins; Robert M. Rose
In a study of air traffic controllers, religious differences are found in the way Type A behavior is associated with several health status indicators. Associations between the Jenkins Activity Survey (JAS) and physical illness incidence, health-promotive behavior, diastolic and systolic blood pressure, subjective distress and impulse control problems, and alcohol consumption are examined by religious attendance, religious affiliation, and change
Johnson, Pamela Jo; Blewett, Lynn A; Ruggles, Steven; Davern, Michael E; King, Miriam L
The National Health Interview Survey (NHIS) is a primary source of information on the changing health of the US population over the past 4 decades. The full potential of NHIS data for analyzing long-term change, however, has rarely been exploited. Time series analysis is complicated by several factors: large numbers of data files and voluminous documentation; complexity of file structures; and changing sample designs, questionnaires, and variable-coding schemes. We describe a major data integration project that will simplify cross-temporal analysis of population health data available in the NHIS. The Integrated Health Interview Series (IHIS) is a Web-based system that provides an integrated set of data and documentation based on the NHIS public use files from 1969 to the present. The Integrated Health Interview Series enhances the value of NHIS data for researchers by allowing them to make consistent comparisons across 4 decades of dramatic changes in health status, health behavior, and healthcare. PMID:18854709
Bryan, Craig J; Blount, Tabatha; Kanzler, Kathryn A; Morrow, Chad E; Corso, Kent A; Corso, Meghan A; Ray-Sannerud, Bobbie
The Behavioral Health Measure (BHM) is a brief self-report measure of general psychological distress and functioning developed for the tracking of mental health outcomes in outpatient psychotherapy settings (Kopta & Lowry, 2002). Although the BHM is used in integrated primary care behavioral health clinics, the scale's psychometric properties have not been evaluated in these settings. The current study investigated the BHM's psychometric properties, including its factor structure and reliability, and presents normative data from 3 large integrated primary care clinics. Mean scores for each of the BHM's 4 scales were significantly lower (i.e., more distress) for women than men, with scores being stable across the 3 primary care samples. Confirmatory factor analysis demonstrated adequate fit for the 3-factor and 1-factor models, with fit improving when 3 items were omitted. Internal consistency estimates for the BHM's 4 scales ranged from adequate to very good (? range: .72-.93). The 4 scales were highly intercorrelated, suggesting they measure similar constructs. Results suggest a revised, 17-item version of the BHM has adequate structure and reliability estimates, and is appropriate for use in primary care settings. PMID:24447151
van Geen, Alexander
Health Education & Behavior XX(X) 18 © 2012 Society for Public Health Education Reprints Health Orga- nization guideline for arsenic of 10 µg/L because of naturally occurring arsenic has been associated with cancers of the skin, bladder, and lung (Chen & Ahsan 2004; Marshall et al
Leveton, Lauren; Whitemire, Alexandra
This poster reviews the working of the Behavioral Health and Performance (BHP) group, which supports the research element which manages an integrated program for future space flight. The BHP operations group supports astronauts and their families in all phases of the International Space Station Mission, and post mission effects.
John C. Birkimer; Perri B. Druen; Jerry W. Holland; Margaret Zingman
The frequencies of American college students' positive self-talk, emotional reactions, and other positive thoughts for engaging in five health behaviors were assessed and found to be highly correlated; they then were combined into a composite measure. A similar composite resulted for negative self-talk, emotional reactions, and other negative thoughts for engaging in unhealthy alternative behaviors. Effortfulness and pleasantness of the
Dorian E. Traube; Ian W. Holloway; Lana Smith
In the presence of numerous health behavior theories, it is difficult to determine which of the many theories is most precise in explaining health-related behavior. New models continue to be introduced to the field, despite already existing disparity, overlap, and lack of unification among health promotion theories. This paper will provide an overview of current arguments and frameworks for testing
This research involves collaboration with other ORD Labs and Centers, as well as external collaborators, to foster integration of assessment approaches used to evaluate human health and ecological risks and to demonstrate integrated environmental socioeconomic approaches. Part...
Lyan, Dmitriy Eduard
The prevalence of Post Traumatic Stress Disorder (PTSD) and other related behavioral health conditions among active duty service members and their families has grown over 100% in the past six years and are now estimated ...
Measures of Perceived Control, Mastery, and Empowerment Mastery. Pearlin and Schooler (1978) xClose Pearlin, L.I., and Schooler, C., (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2-21.
Lyan, Dmitriy Eduard
The prevalence of Post Traumatic Stress Disorder (PTSD) and other related behavioral health conditions among active duty service members and their families has grown over 100% in the past six years and are estimated to ...
Although BI does have very good predictive validity, it is still the case that it doesn't explain 70% to 80% of the variance in health behavior, which raises the methodological question (with theoretical implications) of why?
Two important factors when deciding which measures to use in health research would be the type of behavior being examined and the age of the population being assessed. For health-promoting behaviors, such as those related to diet and nutrition, medical regimen, sun protection, exercise, etc., standard BI measures should work well, especially if accompanied by implementation intentions—where and when to exercise, which diet to follow, or which sunscreen to use.
Walker, Peter; Portnoy, Barry
This study sought to determine the effects of a high blood pressure education program for sixth graders on the preventive hypertension health attitudes and behaviors of their parents. Attention was focused on the role of students ("significant others") in affecting parental attitude and behavior changes relating to the three risk factors of…
Ohler, Frank D.
The author (1) presents data drawn from a fourteen-week program on oral health care involving second-grade students; (2) concludes that such a program is successful in promoting short-term behavioral change; and (3) stresses the need for periodic reinforcement and repetition to assure behavior maintenance over time. (MB)
Mehl, Garrett; Labrique, Alain
As countries strive toward universal health coverage, mobile wireless technologies-mHealth tools-in support of enumeration, registration, unique identification, and maintenance of health records will facilitate improved health system performance. Electronic forms and registry systems will enable routine monitoring of the coverage of essential interventions for individuals within relevant target populations. A cascading model is presented for prioritizing and operationalizing the role of integrated mHealth strategies. PMID:25214614
Bender, Bruce G
Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions. PMID:24152056
Owen, Bonnie L.
This study was undertaken to examine the constellation of attitudes and beliefs felt to be related to health behavior. Two types of health messages were delivered to a group of teenage camp counselors on the disease diabetes. Their attitudes toward the disease in terms of their perception of vulnerability to it, their perception of its severity,…
Using normative beliefs in the context of the theory of reasoned action Historically, there has been a strong tendency for health researchers to use normative beliefs in the context of the theory of reasoned action to predict and influence health behaviors. One strategy has been as follows.
Adler, Amy B; Saboe, Kristin N; Anderson, James; Sipos, Maurice L; Thomas, Jeffrey L
The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership. One emerging approach focuses on domain-specific leadership behaviors that may moderate the impact of combat deployment on mental health. In a recent study, US soldiers deployed to Afghanistan rated leaders on behaviors promoting management of combat operational stress. When soldiers rated their leaders high on these behaviors, soldiers also reported better mental health and feeling more comfortable with the idea of seeking mental health treatment. These associations held even after controlling for overall leadership ratings. Operational stress leader behaviors also moderated the relationship between combat exposure and soldier health. Domain-specific leadership offers an important step in identifying measures to moderate the impact of high-risk occupations on employee health. PMID:25160794
Lush, L.; Cleland, J.; Walt, G.; Mayhew, S.
Since 1994, integrating human immunodeficiency virus/sexually transmitted disease (HIV/STD) services with primary health care, as part of reproductive health, has been advocated to address two major public health problems: to control the spread of HIV; and to improve women's reproductive health. However, integration is unlikely to succeed because primary health care and the political context within which this approach is taking place are unsuited to the task. In this paper, a historical comparison is made between the health systems of Ghana, Kenya and Zambia and that of South Africa, to examine progress on integration of HIV/STD services since 1994. Our findings indicate that primary health care in Ghana, Kenya and Zambia has been used mainly by women and children and that integration has meant adding new activities to these services. For the vertical programmes which support these services, integration implies enhanced collaboration rather than merged responsibility. This compromise between comprehensive rhetoric and selective reality has resulted in little change to existing structures and processes; problems with integration have been exacerbated by the activities of external donors. By comparison, in South Africa integration has been achieved through political commitment to primary health care rather than expanding vertical programmes (top-down management systems). The rhetoric of integration has been widely used in reproductive health despite lack of evidence for its feasibility, as a result of the convergence of four agendas: improving family planning quality; the need to improve women's health; the rapid spread of HIV; and conceptual shifts in primary health care. International reproductive health actors, however, have taken little account of political, financial and managerial constraints to implementation in low-income countries. PMID:10534902
Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy
Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…
DeJoy, D M; Southern, D J
The present paper argues that health promotion efforts, particularly those directed to resistant and high-risk workers, should be integrated into a corporate health strategy in which equal concern is expressed for individual lifestyle modification and the provision of safe and healthful working conditions. The current popularity of work-site health promotion is discussed, and the health promotion and occupational safety and health movements are compared and contrasted. Following this, ecologic models of health promotion are examined as a vehicle for addressing environmental and organizational influences, and this line of thinking is expanded into an integrative model of worker health. The proposed model features three interactive systems: (1) job demands and worker characteristics, (2) work environment, and (3) extraorganizational influences, and assigns an expanded role to environmental factors in promoting and protecting worker health. The principal goal of integrative programming is to devise complementary behavioral and environmental interventions that will have mutually reinforcing effects on workplace health problems. The remainder of the paper outlines the three phases of implementing such a program. PMID:8113926
Kim, Hak-Seon; Ahn, Joo
The purpose of this research was to investigate how university students' nutrition beliefs influence their health behavioral intention. This study used an online survey engine (Qulatrics.com) to collect data from college students. Out of 253 questionnaires collected, 251 questionnaires (99.2%) were used for the statistical analysis. Confirmatory Factor Analysis (CFA) revealed that six dimensions, "Nutrition Confidence," "Susceptibility," "Severity," "Barrier," "Benefit," "Behavioral Intention to Eat Healthy Food," and "Behavioral Intention to do Physical Activity," had construct validity; Cronbach's alpha coefficient and composite reliabilities were tested for item reliability. The results validate that objective nutrition knowledge was a good predictor of college students' nutrition confidence. The results also clearly showed that two direct measures were significant predictors of behavioral intentions as hypothesized. Perceived benefit of eating healthy food and perceived barrier for eat healthy food to had significant effects on Behavioral Intentions and was a valid measurement to use to determine Behavioral Intentions. These findings can enhance the extant literature on the universal applicability of the model and serve as useful references for further investigations of the validity of the model within other health care or foodservice settings and for other health behavioral categories. PMID:23346306
Hansen, Jo-Ida C.; Conlon, Amy L.
The current intervention trend for many of the mental health and behavioral problems faced by today's youth is an integrative approach that involves the community, families, and schools. Clinical assessment for serious mental health and behavioral problems can be an important component in the development of school-based screening programs. The…
Health Link Alberta is a model of successful regional integration. Launched as a single-region service in 2000, Health Link Alberta was rolled out as a province-wide service in 2003, operating as one service from two sites (Calgary and Edmonton). Provincial integration of Health Link Alberta was successful because it took the time to establish collaborative governance structures, build relationships with regional and provincial stakeholders, recognize and accommodate regional and local needs, and develop the processes and tools that it needed to deliver a quality, consistent and accessible service for all Albertans. Within three years, Health Link Alberta achieved 63% awareness and 46% utilization among all Alberta households. PMID:20057251
Armitage, Gail D.; Suter, Esther; Oelke, Nelly D.; Adair, Carol E.
Introduction Integrated health systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. Methods A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Results Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Discussion and conclusion Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integrated health system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration. PMID:19590762
Background Today, people use the Internet to satisfy health-related information and communication needs. In Malaysia, Internet use for health management has become increasingly significant due to the increase in the incidence of chronic diseases, in particular among urban women and their desire to stay healthy. Past studies adopted the Technology Acceptance Model (TAM) and Health Belief Model (HBM) independently to explain Internet use for health-related purposes. Although both the TAM and HBM have their own merits, independently they lack the ability to explain the cognition and the related mechanism in which individuals use the Internet for health purposes. Objective This study aimed to examine the influence of perceived health risk and health consciousness on health-related Internet use based on the HBM. Drawing on the TAM, it also tested the mediating effects of perceived usefulness of the Internet for health information and attitude toward Internet use for health purposes for the relationship between health-related factors, namely perceived health risk and health consciousness on health-related Internet use. Methods Data obtained for the current study were collected using purposive sampling; the sample consisted of women in Malaysia who had Internet access. The partial least squares structural equation modeling method was used to test the research hypotheses developed. Results Perceived health risk (?=.135, t 1999=2.676) and health consciousness (?=.447, t 1999=9.168) had a positive influence on health-related Internet use. Moreover, perceived usefulness of the Internet and attitude toward Internet use for health-related purposes partially mediated the influence of health consciousness on health-related Internet use (?=.025, t 1999=3.234), whereas the effect of perceived health risk on health-related Internet use was fully mediated by perceived usefulness of the Internet and attitude (?=.029, t 1999=3.609). These results suggest the central role of perceived usefulness of the Internet and attitude toward Internet use for health purposes for women who were health conscious and who perceived their health to be at risk. Conclusions The integrated model proposed and tested in this study shows that the HBM, when combined with the TAM, is able to predict Internet use for health purposes. For women who subjectively evaluate their health as vulnerable to diseases and are concerned about their health, cognition beliefs in and positive affective feelings about the Internet come into play in determining the use of health-related Internet use. Furthermore, this study shows that engaging in health-related Internet use is a proactive behavior rather than a reactive behavior, suggesting that TAM dimensions have a significant mediating role in Internet health management. PMID:25700481
Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna
Introduction To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care. PMID:19956377
Jewgenij Botaschanjan; Benjamin Hummel; Thomas Hensel; Alexander Lindworsky
Despite the large amount of models for different aspects of factory automation systems, many of these models target at individual and in most cases static aspects of the system, such as the geometry or its electric parts. There is a lack of suitable description methods, which integrate these individual models to a behavior model including spatial aspects and the handling
Interconnections between Human Health and Ecological Integrity emanates from a June 2000 Pellston Workshop in Snowbird, Utah, USA. Jointly sponsored by the Society of Environmental Toxicology and Chemistry (SETAC) and the Society of Toxicology (SOT), the workshop was motivated by...
Kuhn, Wendy; Bellinger, Jillian; Stevens-Manser, Stacey; Kaufman, Laura
Peer specialists are people in recovery employed to share their experiences to promote the recovery of others affected by mental illness. Examining workplace integration indicators that predict the job satisfaction of peer specialists employed in a variety of behavioral health settings is critical to ensure the retention and effectiveness of this viable workforce. A survey of Texas Certified Peer Specialists (n = 86) examined workplace integration indicators. Results suggest that supervisor's understanding of the peer specialist job role has a significant impact on job satisfaction. Better workforce integration may be achieved through targeted efforts to educate supervisors about peer specialist job roles. PMID:25672842
Michael A. Hoge; Manuel Paris; Hoover Adger; Cherry V. Finn; Larry Fricks; Kenneth J. Gill; Judith Haber; Marsali Hansen; D. J. Ida; Linda Kaplan; William F. Northey; Maria J. O’Connell; Anita L. Rosen; Zebulon Taintor; Janis Tondora; Alexander S. Young
Competency-based training approaches are being used more in healthcare to guide curriculum content and ensure accountability and outcomes in the educational process. This article provides an overview of the state of competency development in the field of behavioral health. Specifically, it identifies the groups and organizations that have conducted and supported this work, summarizes their progress in defining and assessing
Given the limited scope of this review, I have focused on 1) barriers to cancer screening, 2) barriers to health behaviors related to cancer prevention and management-such as cigarette smoking cessation, exercise, and following a healthy eating pattern, and 3) a scale that uses response options not covered above.
Table of Contents 1 Description and Theoretical Background 2 Use in Health Behavior Theories 3 Measures and Measurement 4 Most Common Barriers 5 Measurement and Methodological Issues 6 Summary 7 References 8 Appendix 1 9 Appendix 2 10 Appendix 3 11 Appendix
Sara Wilcox; Kelly R. Evenson; Aaron Aragaki; Sylvia Wassertheil-Smoller; Charles P. Mouton; Barbara Lee Loevinger
This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N = 72,247) and prospective (N = 55,724) design in women aged 50–79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than
Kaplan, Robert M
The mission of the National Institutes of Health,"... is science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability". A wide range of factors contribute to longer life and to less illness. Although estimates vary, most analyses suggest that only about 10% of the variation in health outcome is attributable to medical care. Further, medical care is most effective in addressing and preventing infectious disease and acute illnesses. Recent large randomized clinical trials often fail to demonstrate that medical care lengthens life expectancy. International comparisons suggest that life expectancy in the United States is increasing, but the rate of increase is falling behind that of other wealthy countries. Strategies for improving health outcomes include better dissemination and implementation of proven evidence-based interventions. Further, reduction of services that use resources but do not offer health benefits must be considered. The final section of this paper reviews evidence relevant to factors outside the health care system that may enhance life expectancy and reduce illness and the disability. The relationship between educational attainment and life expectancy is used as a case example. The potential of behavioral and social interventions for increasing life expectancy may be orders of magnitude greater than traditional medial interventions. However, considerably more research is necessary in order to provide persuasive evidence for the benefits of these programs. PMID:24780526
Tay, Louis; Tan, Kenneth; Diener, Ed; Gonzalez, Elizabeth
The primary goal of this paper is to summarise current evidence on social relations and health, specifically how social integration and social support are related to health behaviors and health outcomes, using results from published reviews. Our analysis revealed that social relations are beneficial for health behaviors such as chronic illness self-management and decreased suicidal tendency. The salutary effects of general measures of social relations (e.g. being validated, being cared for, etc.) on health behaviors (e.g. healthy diet, physical activity, smoking, alcohol abuse) are weaker, but specific measures of social relations targeting corresponding health behaviors are more predictive. There is growing evidence that social relations are predictive of mortality and cardiovascular disease, and social relations play an equally protective role against both the incidence and progression of cardiovascular disease. On the other hand, evidence was mixed for the association between social relations and cancer. We discuss these findings and potential areas for future research such as other dimensions of social relations, support-receiver interactions, and observer ratings of social relations. PMID:23281315
Poole, Gary D.
It was hypothesized that a person's estimates of the preventability of health problems would be related to health behaviors such that a person who engages in healthful behavior should make higher estimates of preventability. A study was conducted to investigate the relationship between causal attribution of health problems and health-related…
He, David; Bechhoefer, Eric; Dempsey, Paula; Ma, Jinghua
In this paper, an integrated approach for gear health prognostics using particle filters is presented. The presented method effectively addresses the issues in applying particle filters to gear health prognostics by integrating several new components into a particle filter: (1) data mining based techniques to effectively define the degradation state transition and measurement functions using a one-dimensional health index obtained by whitening transform; (2) an unbiased l-step ahead RUL estimator updated with measurement errors. The feasibility of the presented prognostics method is validated using data from a spiral bevel gear case study.
Homoeopathy is a therapy which involves many components and three main agents: the patient, with his or her condition and personal characteristics; the medication used, with its composition and manufacturing procedure; and the physician, with his or her approach to treatment and concepts of health. The development of research and evaluation structures, combined with a critical education in the discipline, would help to improve practices and define homoeopathy's potential role in relation to the other therapies, both conventional and unconventional, used in Western health systems. PMID:10083716
Cristine E. Hine; Heather B. Howell; Kimberly A. Yonkers
Integrated care entails the provision of behavioral health services within the primary care setting and emphasizes a collaborative approach between mental health professionals and primary care providers (Kenkel, Deleon, Orabona Mantell, Steep, 2005). Research was collected to highlight the history, development, and implementation of integrated care within primary care facilities. The authors performed a comprehensive literature review of collaborative care
Integrated Systems Health Management (ISHM) is a system engineering discipline that addresses the design, development, operation, and lifecycle management of components, subsystems, vehicles, and other operational systems with the purpose of maintaining nominal system behavior and function and assuring mission safety and effectiveness under off-nominal conditions. NASA missions are often conducted in extreme, unfamiliar environments of space, using unique experimental spacecraft. In these environments, off-nominal conditions can develop with the potential to rapidly escalate into mission- or life-threatening situations. Further, the high visibility of NASA missions means they are always characterized by extraordinary attention to safety. ISHM is a critical element of risk mitigation, mission safety, and mission assurance for exploration. ISHM enables: In-space maintenance and repair; a) Autonomous (and automated) launch abort and crew escape capability; b) Efficient testing and checkout of ground and flight systems; c) Monitoring and trending of ground and flight system operations and performance; d) Enhanced situational awareness and control for ground personnel and crew; e) Vehicle autonomy (self-sufficiency) in responding to off-nominal conditions during long-duration and distant exploration missions; f) In-space maintenance and repair; and g) Efficient ground processing of reusable systems. ISHM concepts and technologies may be applied to any complex engineered system such as transportation systems, orbital or planetary habitats, observatories, command and control systems, life support systems, safety-critical software, and even the health of flight crews. As an overarching design and operational principle implemented at the system-of-systems level, ISHM holds substantial promise in terms of affordability, safety, reliability, and effectiveness of space exploration missions.
Centers for Disease Control and Prevention, 2011
The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…
Cutler, David M.; Lleras-Muney, Adriana
Using a variety of data sets from two countries, we examine possible explanations for the relationship between education and health behaviors, known as the education gradient. We show that income, health insurance, and family background can account for about 30 percent of the gradient. Knowledge and measures of cognitive ability explain an additional 30 percent. Social networks account for another 10 percent. Our proxies for discounting, risk aversion, or the value of future do not account for any of the education gradient, and neither do personality factors such as a sense of control of oneself or over one’s life. PMID:19963292
Pellmar, Terry C; Brandt, Edward N; Baird, Macaran A
An Institute of Medicine committee was convened to explore the links between biological, psychosocial, and behavioral factors and health and to review effective applications of behavioral interventions. Based on the evidence about interactions of the physiological responses to stress, behavioral choices, and social influences, the committee encouraged additional research efforts to explore the integration of these variables and to evaluate their mechanisms. An understanding of the social factors influencing behavior is growing and should be considered in programs and policies for public health, in addition to individual behavior and physiological status. Interventions to change behaviors have been directed toward individuals, communities, and society. Many intervention trials have documented the capacity of interventions to modify risk factors. However, more trials that include measures of morbidity and mortality to determine if the strategy has the desired health effects are needed. Behavior can be changed and new behaviors can be taught. Maintaining behavior changes is a greater challenge. Although short-term changes in behavior following interventions are encouraging, long-duration efforts are needed to improve health outcomes and to provide long-term assessments of effectiveness. Interventions aimed at any level can influence behavior change; however, existing research suggests that concurrent interventions at multiple levels are most likely to sustain behavior change and should be encouraged. PMID:11913326
Johnson, Pamela Jo; Blewett, Lynn A.; Ruggles, Steven; Davern, Michael E.; King, Miriam L.
The National Health Interview Survey (NHIS) is a primary source of information on the changing health of the U.S. population over the past four decades. The full potential of NHIS data for analyzing long-term change, however, has rarely been exploited. Time series analysis is complicated by several factors: large numbers of data files and voluminous documentation; complexity of file structures; and changing sample designs, questionnaires, and variable-coding schemes. We describe a major data integration project that will simplify cross-temporal analysis of population health data available in the NHIS. The Integrated Health Interview Series (IHIS) is a Web-based system that provides an integrated set of data and documentation based on the NHIS public use files from 1969 to the present. The Integrated Health Interview Series enhances the value of NHIS data for researchers by allowing them to make consistent comparisons across four decades of dramatic changes in health status, health behavior, and healthcare. PMID:18854709
Bryan, Craig J.; Corso, Meghan L.; Corso, Kent A.; Morrow, Chad E.; Kanzler, Kathryn E.; Ray-Sannerud, Bobbie
Objective: To model typical trajectories for improvement among patients treated in an integrated primary care behavioral health service, multilevel models were used to explore the relationship between baseline mental health impairment level and eventual mental health functioning across follow-up appointments. Method: Data from 495 primary care…
Douglas, Kathy A.; Collins, Janet L.; Warren, Charles; Kann, Laura; Gold, Robert; Clayton, Sonia; Ross, James G.; Kolbe, Lloyd J.
Results from the 1995 National College Health Risk Behavior Survey, which monitored health risk behaviors among U.S. college undergraduates via mailed surveys, indicate that many students' behaviors increase their likelihood of experiencing adverse health outcomes. Particularly high risks for college students include alcohol abuse, tobacco use,…
Warne, Russell T.; McKyer, E. J. Lisako; Smith, Matthew L.
Objective: To introduce item response theory (IRT) to health behavior researchers by contrasting it with classical test theory and providing an example of IRT in health behavior. Method: Demonstrate IRT by fitting the 2PL model to substance-use survey data from the Adolescent Health Risk Behavior questionnaire (n = 1343 adolescents). Results: An…
Becker, M H; Janz, N K
Health-promotion efforts often employ HRA as a device for providing an individual with quantitative information about the consequences of personal health-related behaviors and as an attempt to motivate the client to adopt recommendations directed at establishing a healthier lifestyle. From a behavioral science perspective, the HRA approach and process contain elements that (at least in retrospective analysis) appear to be founded in relevant bodies of theory. First, HRA seems to be a reasonably efficient mechanism for transmitting information relative to associations between personal health behaviors and mortality risks. Moreover, while general knowledge and advice about the untoward consequences of risk factors (such as smoking, obesity, high blood pressure, etc.) are currently widespread, HRA provides new and specific information: the client's own relative risks. Some individuals who voluntarily participate in HRA bring to the experience an already high level of readiness to take action; for them, the technique may constitute the final necessary stimulus or "cue to action" . Referring to a "borrowing from the future" phenomenon, Green points out that "some educational efforts are really only triggers to behavior that would have changed eventually anyway" [44, p. 159]. Thus, where motivation is sufficiently high, receipt of HRA feedback information may by itself be capable of inducing behavior change. Second, the focus on awareness and personalization of mortality risk fits well with most theoretical formulations concerning attitudes and beliefs involved in health-related decision making. Although the emphasis on mortality and often distant negative outcomes is problematic, increasing the client's perception of personal vulnerability is a psychologically defensible approach, and fear arousal can generate attitude change (although questions of appropriate level, duration of effects obtained, acceptability, etc. still need to be resolved). Third, HRA might be expected to enhance the client's perception of the benefits associated with lifestyle modifications and may even increase personal belief in his or her ability to undertake such changes in behavior. However, in light of the fact that the behaviors to be altered are complex, usually well-established and repetitive, and require different skills to extinguish, the provision of typical HRA feedback should not (on a theoretical basis) ordinarily be expected to accomplish much beyond information transmission, belief or attitude change, and the induction of some level of motivation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3679842
Barrera, Manuel, Jr.; Castro, Felipe G.; Strycker, Lisa A.; Toobert, Deborah J.
Objective: To reduce health disparities, behavioral health interventions must reach subcultural groups and demonstrate effectiveness in improving their health behaviors and outcomes. One approach to developing such health interventions is to culturally adapt original evidence-based interventions. The goals of the article are to (a) describe…
Goldenberg, Jamie L.; Arndt, Jamie
This article introduces a terror management health model (TMHM). The model integrates disparate health and social psychology literatures to elucidate how the conscious and nonconscious awareness of death can influence the motivational orientation that is most operative in the context of health decisions. Three formal propositions are presented.…
Van Wyk, Patrick
Reviews the book, The Implementer's Guide to Primary Care Behavioral Health edited by Neftali Serrano (2014). This is an edited book that, as stated in the title, is a guide to the world of primary care behavioral health. The tone of each chapter is at once didactic and conversational. Their book comprises 12 parts with up to 5 sections per part. Each part is titled and begins with a brief description of what will be covered. Each section begins with several numbered key points up front that are more than simply copy-and-paste versions of chapter subheadings and serve as a guide for what is to come. The topics covered are very thorough and would be appropriate for any level of behavioral health integration program from the most fledgling wondering where to start all of the way to the well established looking to fine tune operations. The book is targeted at a broad audience. This book is a great complement to other books on the same subject, and it offers a unique voice and perspective that will not feel redundant or repetitive if you are already familiar with these other texts. (PsycINFO Database Record PMID:26053582
Leveton, Lauren B.; Whitmire, Alexandra
BHP Program Element Goal: Identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration and return to terrestrial life. BHP Requirements: a) Characterize and assess risks (e.g., likelihood and consequences). b) Develop tools and technologies to prevent, monitor, and treat adverse outcomes. c) Inform standards. d) Develop technologies to: 1) reduce risks and human systems resource requirements (e.g., crew time, mass, volume, power) and 2) ensure effective human-system integration across exploration mission.
Lisa M. Alvy; David McKirnan; Steve N. Du Bois; Kyle Jones; Natalie Ritchie; David Fingerhut
Men who have sex with men (MSM) engage in several harmful health behaviors more frequently than do non-MSM. Meanwhile, evidence suggests that MSM experience barriers to accessing health care. To investigate health care disparities and health behaviors, we compared data from a diverse MSM sample (N = 871) to data from men from the National Health Interview Survey (N =
Godfrey, Erin B.
Integrating social psychological research with work in child development, this study explored relationships between system justification (Jost & Banaji, 1994), maternal mental health and child externalizing behavior among low-income immigrants and racial/ethnic minorities. Dominican, Mexican and African-American families (N = 239) were assessed when children were 14-, 24- and 36-months old. SEM was used to explore longitudinal relationships between maternal system justification and mental health and associations with child behavior. Earlier mental health was negatively related to later system justification and system justification was negatively related to children’s externalizing behavior. Implications for system justification theory, child development and immigration are discussed. PMID:25035527
Richman, Barak D
This Article employs a behavioral economic analysis to understand why Medicaid has failed to improve the health outcomes of its beneficiaries. It begins with a formal economic model of health care consumption and then systematically incorporates a survey of psychosocial variables to formulate explanations for persistent health disparities. This methodology suggests that consulting the literature in health psychology and intertemporal decision theory--empirical sources generally excluded from orthodox economic analysis--provides valuable material to explain certain findings in health econometrics. More significantly, the lessons from this behavioral economic approach generate useful policy considerations for Medicaid policymakers, who largely have neglected psychosocial variables in implementing a health insurance program that rests chiefly on orthodox economic assumptions. The Article's chief contributions include an expansion of the behavioral economic approach to include a host of variables in health psychology, a behavioral refinement of empirical health economics, a behavioral critique of Medicaid policy, and a menu of suggested Medicaid reforms. PMID:15868692
Norris, Cynthia; McFall, Stephanie
This study assessed the association of lifestyle and clinical health behaviors with prostate specific antigen (PSA) tests. The study used cross-sectional data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS). We used Stata 8.0 to take into account the complex sample design in analyses. Both lifestyle and clinical health behaviors…
Yang, Chi-Ta; Hung, Yu-Shiang; Deng, Guang-Feng
Health promotion must be emphasized to achieve the World Health Organization goal of health for all. Since the global population is aging rapidly, ComCare elder health-promoting service was developed by the Taiwan Institute for Information Industry in 2011. Based on the Pender health promotion model, ComCare service offers five categories of health-promoting functions to address the everyday needs of seniors: nutrition management, social support, exercise management, health responsibility, stress management. To assess the overall ComCare service and to improve understanding of the health-promoting behavior of elders, this study analyzed health-promoting behavioral data automatically collected by the ComCare monitoring system. In the 30638 session records collected for 249 elders from January, 2012 to March, 2013, behavior patterns were identified by fuzzy c-mean time series clustering algorithm combined with autocorrelation-based representation schemes. The analysis showed that time series data for elder health-promoting behavior can be classified into four different clusters. Each type reveals different health-promoting needs, frequencies, function numbers and behaviors. The data analysis result can assist policymakers, health-care providers, and experts in medicine, public health, nursing and psychology and has been provided to Taiwan National Health Insurance Administration to assess the elder health-promoting behavior.
Judith A. Klippel; David M. DeJoy
Counseling psychology can make a contribution to the newly emerging fields of health-related behavioral science, but the nature of that contribution will depend on counseling psychology's willingness to develop new perspectives and practices. The present authors compare 2 of these health orientations, behavioral medicine and health psychology, in an effort to establish counseling psychology's relationship with either of these approaches.
Rat Behavioral Thermoregulation Integrates With Nonshivering Thermogenesis During Postnatal University Bloomington Rat pups are capable of behavioral thermoregulation, both in the nest without shivering. The rat pup's primary source of nonshivering thermogenesis is the sympathetically
Malin, Jane T.; Oliver, Patrick J.
This paper identifies work needed by developers to make integrated system health management (ISHM) technology ready and by programs to make mission infrastructure ready for this technology. This paper examines perceptions of ISHM technologies and experience in legacy programs. Study methods included literature review and interviews with representatives of stakeholder groups. Recommendations address 1) development of ISHM technology, 2) development of ISHM engineering processes and methods, and 3) program organization and infrastructure for ISHM technology evolution, infusion and migration.
Osofsky, Howard J; Osofsky, Joy D; Wells, John H; Weems, Carl
This column describes an integrated behavioral health initiative in primary care clinics in Louisiana parishes affected by the Deepwater Horizon oil spill. The Louisiana Mental and Behavioral Health Capacity Project is an integral part of the Gulf Region Health Outreach Program and is funded from the Deepwater Horizon Medical Benefits Class Action Settlement. Using a public health approach, the Department of Psychiatry of the Louisiana State University Health Sciences Center developed an interprofessional collaboration model of care to provide culturally tailored and time-sensitive on-site and telemedicine services to adults and children affected by the disaster. Results indicate a high level of acceptance of the services and reductions in both mental health symptoms and general medical symptoms. Primary care clinic staff also report increased confidence and resilience to meet future disasters. The approach could be used by communities at risk of disasters and by rural communities with limited mental health resources. PMID:24584523
Daniel S. Bailis; Alexander Segall; Michael J. Mahon; Judith G. Chipperfield; Elaine M. Dunn
Perceived control is a personality characteristic that contributes to well-being, but few studies have attempted to integrate the functions of perceived control with those of other determinants of health. This research tested two hypotheses about the functions of perceived control: (a) individual differences in perceived control would account for socioeconomic differences in self-rated health status; (b) performance of health-related behaviors
BBC Science and Nature (British Broadcasting Corporation Broadcasting House)
A website from the BBC containing activities, tests, and review materials on life processes, cells, reproduction, health, disease, classification, food chains, and behavior for middle school students.
Dr. Jeffrey Fisher is a Board of Trustees Distinguished Professor of Psychology at the University of Connecticut and the founding Director of its Center for Health, Intervention, and Prevention. He has published extensively on factors associated with HIV risk behavior and has done conceptual and empirical work in the area of increasing HIV preventive behavior, as well as health behavior change in other domains. He has designed, implemented, and evaluated several effective HIV risk behavior change interventions in multiple populations.
John E. Donovan; Richard Jessor; Frances M. Costa
Examined the relation of psychosocial and behavioral conventionality-unconventionality to health-related behavior in cross-sectional data from 1,588 male and female 7th to 12th graders. Conventionalityunconventionality was represented by personality, perceived social environment, and behavior variables selected from the social-psychological framework of problem-behavior theory (R. Jessor & S. L. Jessor, 1977). Greater psychosocial conventionality correlates with more regular involvement in health-related behavior
Background Oral health behavior (OHB), one major factor contributing to proper oral health status, has been addressed insufficiently in addiction literature. The aim of our study was to investigate OHB and its determinants among drug addicts in withdrawal treatment. Methods Through a stratified cluster sampling method, we collected the data from 685 patients in withdrawal treatment in Tehran using self-administered questionnaires on OHB components and conducting interviews about patients’ characteristics and addiction history. The T-test, ANOVA, and a linear regression model served for statistical analysis. Results Of the patients, 48% reported brushing their teeth less than once a day, more than 90% used fluoride toothpaste almost or always, and 81% flossed their teeth rarely or never. Eating sugary products twice a day or more was reported by 57% of the patients and 85% of them were current smokers. Poor OHB was associated with male gender, lower education, being addicted mainly to crystalline heroin, starting drug abuse at a younger age, and having a longer history of addiction (p?.05). Conclusion Poor OHB was found among the participants in drug withdrawal treatment. Preventive strategies on oral health should be planned and be integrated into other health promotion programs for addicts along with their withdrawal treatment taking into account special groups at higher risk. PMID:23368406
Plaut, David C.
constraint satisfaction artificial neural network) and tested whether the model exhibited quantum404 T he quantum behavior change paradigm con- siders the possibility that health behavior may a novel analysis of the quantum behavior change para- digm that generated several implications for health
Fernández-Abascal, Enrique G.; Martín-Díaz, María Dolores
In this paper the relationship between emotional intelligence (EI) and health is examined. The current work investigated the dimensions of EI are sufficient to explain various components of physical and mental health, and various categories of health-related behaviors. A sample of 855 participants completed two measures of EI, the Trait Meta-Mood Scale and trait emotional intelligence questionnaire, a measure of health, the Health Survey SF-36 Questionnaire (SF-36); and a measure of health-related behaviors, the health behavior checklist. The results show that the EI dimensions analyzed are better predictors of mental health than of physical health. The EI dimensions that positively explain the Mental Health Component are Well-Being, Self-Control and Sociability, and negatively, Attention. Well-Being, Self-Control and Sociability positively explain the Physical Health Component. EI dimensions predict a lower percentage of health-related behaviors than they do health components. Emotionality and Repair predict the Preventive Health Behavior category, and only one dimension, Self-Control, predicts the Risk Taking Behavior category. Older people carry out more preventive behaviors for health. PMID:25859229
Michael A. Hoge; Janis Tondora; Anne F. Marrelli
Increasing attention is being directed to the competency of those who deliver healthcare in the United States. In behavioral health, there is growing recognition of the need to define, teach, and assess essential competencies. Since attention to this issue in behavioral health is relatively recent, there is much to be gained by learning from the principles, definitions, and conceptual models
Richard H. Beinecke; Renee Woliver
After a difficult transition from the previous vendor to the Massachusetts Behavioral Health Partnership (MBHP), Year 6 was a year of stability and incremental changes for the Massachusetts Behavioral Health Program. This assessment of Year 6 is based on interviews with key players, data provided by the MBHP, a survey of providers, as well as on the fifth year of
Holahan, Carole K.; Suzuki, Rie
This study investigated adulthood predictors of health-promoting behavior in later aging. The participants were 162 members of the Terman Study of the Gifted (Terman et al., 1925), who responded in 1999 at an average age of 86 to a mailout questionnaire which included questions concerning their positive health behavior. Adulthood variables were…
Wallander, Jan L., Ed.; Siegel, Lawrence J., Ed.
This book examines the relationship between adolescent risk-taking behaviors and health. The health-related problems of adolescents frequently are manifestations of social, economic, or behavioral factors. Following an overview (Siegal), the chapters in the first section of the book explore general and conceptual issues: (1) "Epidemiology of…
Redmond, Nicole; Baer, Heather J.; Clark, Cheryl R.; Lipsitz, Stuart; Hicks, LeRoi S.
Objective Current literature suggests that certain sources of information are used in varying degrees among different socioeconomic and demographic groups; therefore, it is important to determine if specific classes of health information sources are more effective than others in promoting health behaviors. Purpose To determine if interpersonal versus mass media sources of health information are associated with meeting recommendations for health behaviors (nonsmoking, fruit/vegetable intake, and exercise) and cancer screening. Methods Multivariable logistic regression models were used to examine the relationship of health information sources (mass media sources including print, TV, Internet; and interpersonal sources including friends and family, community organizations, and healthcare providers); with meeting recommendations for healthy behaviors and cancer screening in the 2005 and 2007 Health Information National Trends Surveys (HINTS). Analyses were conducted in 2009. Results In the 2005 HINTS, participants reporting use of print media and community organizations as sources of health information over the past year were mostly likely to meet recommendations for health behaviors. In the 2007 HINTS, utilization of healthcare providers for health information was associated with meeting recommendations for health behaviors, particularly cancer screening. Conclusions Use of print media and interpersonal sources of health information are most consistently associated with self-reported health behaviors. Additional research should explore the relationship of health information sources to clinical outcomes. Social network interventions to promote adoption of health behaviors should be further developed. PMID:20494238
Perceived behavioral control. Recognizing that perceived ability to perform a particular behavior, or achieve a certain goal may influence whether the behavior actually occurs, Ajzen (1991) xClose Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision processes, 50, 179-211. developed the TPB, which adds a self-efficacy component to the TRA, called perceived behavioral control (see Measures). When perceived and actual control are high, BI should relate directly to outcome.
Peeples, Malinda M.; Iyer, Anand K.; Cohen, Joshua L.
Background: Responses to the chronic disease epidemic have predominantly been standardized in their approach to date. Barriers to better health outcomes remain, and effective management requires patient-specific data and disease state knowledge be presented in methods that foster clinical decision-making and patient self-management. Mobile technology provides a new platform for data collection and patient–provider communication. The mobile device represents a personalized platform that is available to the patient on a 24/7 basis. Mobile-integrated therapy (MIT) is the convergence of mobile technology, clinical and behavioral science, and scientifically validated clinical outcomes. In this article, we highlight the lessons learned from functional integration of a Food and Drug Administration-cleared type 2 diabetes MIT into the electronic health record (EHR) of a multiphysician practice within a large, urban, academic medical center. Methods: In-depth interviews were conducted with integration stakeholder groups: mobile and EHR software and information technology teams, clinical end users, project managers, and business analysts. Interviews were summarized and categorized into lessons learned using the Architecture for Integrated Mobility® framework. Results: Findings from the diverse stakeholder group of a MIT–EHR integration project indicate that user workflow, software system persistence, environment configuration, device connectivity and security, organizational processes, and data exchange heuristics are key issues that must be addressed. Conclusions: Mobile-integrated therapy that integrates patient self-management data with medical record data provides the opportunity to understand the potential benefits of bidirectional data sharing and reporting that are most valuable in advancing better health and better care in a cost-effective way that is scalable for all chronic diseases. PMID:23759392
Meredith, Steven E; Jarvis, Brantley P; Raiff, Bethany R; Rojewski, Alana M; Kurti, Allison; Cassidy, Rachel N; Erb, Philip; Sy, Jolene R; Dallery, Jesse
Behavior plays an important role in health promotion. Exercise, smoking cessation, medication adherence, and other healthy behavior can help prevent, or even treat, some diseases. Consequently, interventions that promote healthy behavior have become increasingly common in health care settings. Many of these interventions award incentives contingent upon preventive health-related behavior. Incentive-based interventions vary considerably along several dimensions, including who is targeted in the intervention, which behavior is targeted, and what type of incentive is used. More research on the quantitative and qualitative features of many of these variables is still needed to inform treatment. However, extensive literature on basic and applied behavior analytic research is currently available to help guide the study and practice of incentive-based treatment in health care. In this integrated review, we discuss how behavior analytic research and theory can help treatment providers design and implement incentive-based interventions that promote healthy behavior. PMID:24672264
Chassin, L; Presson, C C; Sherman, S J
Previous literature suggests that the adolescent at risk to engage in substance use and other negative health-related behaviors is deviant in a negative sense (i.e., rebellious, antisocial, and alienated from traditional institutions). However, some researchers have distinguished between two types of deviance-a true autonomy and independence that is more positive and constructive, and a reactant "anticonformity" that is more negative and destructive. The current study assessed the roles of both constructive and destructive deviance in adolescent cigarette smoking and positive health-related behaviors. Adolescents who were constructively deviant engaged in higher levels of health-protective behaviors. Moreover, constructive deviance was an independent predictor of both cigarette smoking and positive health behaviors over and above the effects of traditional negative deviance indicators. These data suggest that constructive deviance is not a competing model to more traditional notions, but that it is an additional possible pathway into adolescent positive and negative health behaviors. PMID:24271783
To measure normative beliefs in a way that maximizes their ability to predict subjective norms (and behavioral intentions and behaviors), it is necessary to conform to the principle of correspondence. According to this principle, behaviors have four components. These are action, target, time, and context. For example, consider the behavior of attending a cervical cancer screening.
Alias, Siti Noormi; Ismail, Maimunah
Purpose: This paper aims to propose a conceptual model of philanthropic behavior of volunteers in the health care sector. Design/methodology/approach: This study is based on an extensive review of past research on philanthropic behavior. To conduct the literature review, keywords such as philanthropy, philanthropic behavior, giving, donating,…
Mark T. Harvey; James K. Luiselli; Stephen E. Wong
The theoretical and conceptual basis for behavior analysis emerged from the fields of experimental psychology, physiology, and philosophy, effectively melding theory with scientific rigor. Behavior analysis has since expanded from controlled laboratories into applied settings, including hospitals, clinics, schools, family homes, and communities. Much of the early research in applied behavior analysis (ABA) included participants with mental health disorders and
Laugesen, Miriam J; France, George
Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations. PMID:24759287
Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp
Objective: To explore the sexual and reproductive health behaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…
Richard M. Scheffler
Background: Within the past decade, the mental health care system in the United States has undergone a significant transformation in terms of delivery, financing and work force configuration. Con- tracting between managed care organizations (MCOs) and providers has become increasingly prevalent, paralleling the trend in health care in general. These managed care carve-outs in behavioral health depend on networks of
Petosa, R. L.; Smith, Laureen H.
Background: Peer mentoring can be a powerful complement to health instruction. Mentoring has been used to change health behaviors and promote sustainable lifestyle patterns in adults and, more recently, among adolescents. Purpose: This article reviews the use of peer mentoring to promote health practices and describes how this approach can be used…
Russell, Elizabeth B.
This article explores the impact of practitioners' attitudes and knowledge of sexual health on clinical behaviors. Sexual health topics are often areas of concern for clients of any age in counseling. Thus, counselors must be trained and equipped to address sexual health across the life span. This study explored whether child and adolescent…
HBS Department of Health and Behavior Studies Teachers College Columbia University Annual End Teachers College (TC) founded programs of advanced study in the fields of Health, Nursing, and Nutrition population-wide health status cannot be achieved without learning and literacy skills. Thus, the mission
DeLoach, Kendra P.; Dvorsky, Melissa; Miller, Elaine; Paget, Michael
Students with emotional and behavioral challenges are significantly impacted by mental health issues. Teachers and other school staff need mental health knowledge to work more effectively with these students. Collaboration with mental health professionals and sharing of information is essential. [For complete volume, see ED539318.
Aalsma, Matthew C; Carpentier, Melissa Y; Azzouz, Faouzi; Fortenberry, J Dennis
Most models exploring adolescent health behavior have focused on individual influences to understand behavior change. The goal of the current study was to assess the role of adolescent romantic partners on the expression of health behavior. Our sample utilized two waves of data from the U.S. National Longitudinal Study of Adolescent Health, which included 80 romantic dyads (160 individuals). A longitudinal multilevel analysis was conducted. We assessed individual and romantic partner health-harming behaviors (i.e., delinquency, alcohol use, smoking, and marijuana use), health-protective behaviors (i.e., physical activity, physical inactivity, sleep patterns, seatbelt use, and contraception motivations), as well as the role of gender and age. Participants average age was 16 years at baseline. We found evidence for partner similarity and partner influence with the majority of health-harming behaviors. Specifically, partner influence was evident for smoking and alcohol use with partner influence approaching significance for marijuana use. We found limited evidence for partner similarity and partner influence for health-protective behaviors. The importance of assessing romantic dyads was evident in these data. Interventions focusing on health-harming behavior for adolescent populations are important public health goals. It is recommended that future intervention efforts with adolescent health-harming behaviors should target not only peers, but also consider the role of romantic partners. PMID:22424832
Aalsma, Matthew C.; Carpentier, Melissa; Azzouz, Faouzi; Fortenberry, Dennis
Most models exploring adolescent health behavior have focused on individual influences to understand behavior change. The goal of the current study was to assess the role of adolescent romantic partners on the expression of health behavior. Our sample utilized two waves of data from the US National Longitudinal Study of Adolescent Health (1994, 1996), which included 80 romantic dyads (160 individuals). A longitudinal multilevel analysis was conducted. We assessed individual and romantic partner health-harming behaviors (i.e., delinquency, alcohol use, smoking, and marijuana use), health-protective behaviors (i.e., physical activity, physical inactivity, sleep patterns, seatbelt use, and contraception motivations), as well as the role of gender and age. Participants average age was 16 years at baseline. We found evidence for partner similarity and partner influence with the majority of health-harming behaviors. Specifically, partner influence was evident for smoking and alcohol use with partner influence approaching significance for marijuana use. We found limited evidence for partner similarity and partner influence for health-protective behaviors. The importance of assessing romantic dyads was evident in these data. Interventions focusing on health-harming behavior for adolescent populations are important public health goals. It is recommended that future intervention efforts with adolescent health-harming behaviors should target not only peers, but also consider the role of romantic partners. PMID:22424832
in commercializing our basic research to produce a successful new product. Keywords: Systems integration, Electronic simplifies building such integration infrastructure. Our system allows health systems integrators to specify message exchange system is used to communicate between the data source and data target health information
Bradstock, K; Forman, M R; Binkin, N J; Gentry, E M; Hogelin, G C; Williamson, D F; Trowbridge, F L
Alcohol use is a complex behavior, occurring in the context of an overall health lifestyle. We used data from a nationally representative telephone survey (N = 12,467 women) to examine associations between binge drinking, chronic drinking, and other health behaviors. Certain health-risk behaviors (e.g., smoking, drunk driving, and seatbelt nonuse) tend to cluster with alcohol misuse. These may act synergistically, thus augmenting the negative health effects of alcohol misuse. Conversely, some health behaviors (e.g., eating or exercising, particularly in response to stress) are negatively associated with alcohol misuse and may serve similar functions for some women. Finally, binge drinking occurs more frequently among women who may have relatively restrictive eating behaviors and higher levels of interpersonal stress. Our findings suggest that alcohol prevention and treatment programs should address sociodemographic and health lifestyle factors that initially predispose an individual to engage in health-risk behaviors and should recognize the interdependent patterns of behaviors associated with alcohol misuse. This approach will help prevent substitutions, recurrence, or induction of detrimental behaviors and will identify potentially negative interactions between existing concurrent health-risk behaviors. PMID:3364225
Reisi, Mahnoush; Javadzade, Seyed Homamodin; Heydarabadi, Akbar Babaei; Mostafavi, Firouzeh; Tavassoli, Elahe; Sharifirad, Gholamreza
Background: Health literacy is a measure of individual's ability to read, comprehend, and act on medical instructions. Older adults are one of the most important at risk groups affected by the impact of inadequate health literacy. Health promoting behaviors in older adults have potential impact on their health and quality of life and reduce the costs incurred to health care. Given the paucity of information health literacy and health promoting behavior, the purpose of this study was to examine health literacy level in older adults and the relationship between health literacy and health promoting behaviors. Materials and Method: A cross-sectional survey of 354 older adults was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data were collected via home interviewing. Health promoting behaviors were measured based on self-reported smoking status, exercise, and consumption of fruit and vegetables. The collected data were analyzed using descriptive statistics and one-way ANOVA and ?2 tests under SPSS 18 software. Results: The sample group averaged 67 ± 6.97 years in age. Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, have fewer years of schooling, lower household income, and being female Individuals with inadequate health literacy were more likely to report limitations in activity and lower consumption of fruit and vegetables (P < 0.001). No significant association was found between health literacy and smoking status. Conclusion: Considering high prevalence of inadequate health literacy among older adults, and its inverse relationship with some health promoting behaviors. Simple educational materials and effective interventions for low health literacy people can improve health promotion in society and mitigate the adverse health effects of low health literacy. PMID:25540792
Dowdell, Elizabeth Burgess
Health risk behaviors undertaken in adolescence, such as smoking, can have a lasting impact on both short-term and long-term health developments. To better describe the health risk behaviors of an adolescent urban population, a study was conducted at two parochial middle schools in the southwest section of Philadelphia. The study purpose was to describe (1) the types of health risk behaviors being undertaken by a seventh grade student population, (2) the frequency of health risk behaviors, and (3) the age of initiation of the health risk behavior, e.g., age when they first began smoking. A descriptive, correlational study was undertaken with 106 urban seventh graders (ages of 11-13 years) from two seventh grade classes. Using the Youth Risk Behaviors Surveillance System Questionnaire, information was collected about health risk behaviors. Correlational statistics indicated significant correlations between students who smoke and alcohol use, dieting, and not feeling safe in their neighborhood. Interestingly, girls were more likely to use smoking as their primary method of weight control and dieting. Because the long-term impact of smoking is known to be negative, nurses should provide support to this at-risk population and also should be prepared to educate adolescents who come under their care. PMID:12542884
George W. Bitar; Paul Springer; Robert Gee; Chad Graff; Manuel Schydlower
Several major policy reports describe the central role of primary care in improving the delivery of behavioral health care services to children and adolescents. Although primary care providers are uniquely positioned to provide these services, numerous obstacles hinder the integration of these services, including time, clinic management and organization issues, training, and resources. Although many of these obstacles have been
Grace Chang; Marsha Wilcox
The purpose of this case study is to assess a Medicaid health maintenance organization quality initiative designed to screen new members for behavioral health treatment needs on enrollment. New members were screened by the health maintenance organization, which then informed the for-profit managed care organization responsible for the management of the mental health and substance abuse benefit of its findings.
Investigates the relationship of depression to health risk behaviors and health perceptions in Korean college students. The level of students' depression predicted alcohol consumption, symptom pattern, and physical health. Students who were more depressed reported more symptoms and perceived their health as worse than those who were less…
...requirements for behavioral health services? 36...OF THE INTERIOR EDUCATION MINIMUM ACADEMIC...STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN...requirements for behavioral health services? ...student's Individual Education Plan). (b...homeliving behavioral health program must...
...requirements for behavioral health services? 36...OF THE INTERIOR EDUCATION MINIMUM ACADEMIC...STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN...requirements for behavioral health services? ...student's Individual Education Plan). (b...homeliving behavioral health program must...
...requirements for behavioral health services? 36...OF THE INTERIOR EDUCATION MINIMUM ACADEMIC...STANDARDS FOR THE BASIC EDUCATION OF INDIAN CHILDREN...requirements for behavioral health services? ...student's Individual Education Plan). (b...homeliving behavioral health program must...
...EDUCATION OF INDIAN CHILDREN AND NATIONAL CRITERIA...requirements for behavioral health services? (a...non-emergency behavioral health services by submitting...consulted before a child is prescribed behavioral health. (e)...
Mather, Patrick T.
SAMHSA's support of behavioral health systems serving service members, veterans, and their families Page 1 SAMHSA's support of behavioral health systems serving service members, veterans Aligata, SAMHSA's support of behavioral health systems serving service members, veterans
Isman, Robert E.
Primary oral health care, and the scope of services it includes, are defined. The proposed scope of services is a set of basic dental services used by the Indian Health Service. Policy recommendations for improving the integration of primary oral health services with primary health care and delivery are offered. (Author/MSE)
The relationship between health and nutrition is well known. A similar relationship exists between child development and health and between child development and nutrition. Actions favoring child development should be combined with health and nutrition actions that promote child growth. There is accumulating evidence showing the important interplay between nutrition and activities that strengthen a child's environment and the child's interaction with the caregiver. This research suggests that: children's physical growth and development can be improved both by nutrition and by nonnutritional interventions. The interaction between a child's nutritional status and psychosocial development suggests that child feeding should be viewed as a social, developmental, and nutritional process. Opportunities exist within nutrition programs for linkages with child development activities. In the first 4-6 months of life, much of the mother-infant interaction is focused on breastfeeding. During feeding, the child's relationship with the mother grows; the mother can also observe the development of her child's capacities. Other nutrition programs that could be combined with psychosocial components include weaning, center-based supplementary feeding, nutritional recuperation, growth monitoring, and nutrition education. The first 6 years are critical in the formation of intelligence, personality and social behavior and the negative effects of early child deprivation are cumulative. There are many options available for complementary programming that will promote children's development, beginning from early childhood, including: providing direct attention to children through support to child care and development centers, training and supporting parents and other child caregivers, promoting change in community conditions that adversely affect child development, supporting strategies to strengthen national resources and capacities, e.g., strengthening institutions devoted to improving early childhood development, influencing policy and planning through direct advocacy with policy makers, and providing information to the public to create demand and awareness. PMID:12346416
Background Federally Qualified Health Centers are expanding to increase access for millions of more Americans with a goal of doubling capacity to serve 40 million people. Health centers provide a lot of behavioral health services but many have difficulty accessing mental health and substance use professionals for their patients. To meet the needs of the underserved and newly insured it is important to better estimate how many behavioral health professionals are needed. Methods Using health center staffing data and behavioral health service patterns from the 2010 Uniform Data System and the 2010 National Survey on Drug Use and Health, we estimated the number of patients likely to need behavioral health care by insurance type, the number of visits likely needed by health center patients annually, and the number of full time equivalent providers needed to serve them. Results More than 2.5 million patients, 12 or older, with mild or moderate mental illness, and more than 357,000 with substance abuse disorders, may have gone without needed behavioral health services in 2010. This level of need would have required more than 11,600 full time providers. This translates to approximately 0.9 licensed mental health provider FTE, 0.1 FTE psychiatrist, 0.4 FTE other mental health staff, and 0.3 FTE substance abuse provider per 2,500 patients. These estimates suggest that 90% of current centers could not access mental health services or provide substance abuse services to fully meet patients’ needs in 2010. If needs are similar after health center expansion, more than 27,000 full time behavioral health providers will be needed to serve 40 million medical patients, and grantees will need to increase behavioral health staff more than four-fold. Conclusions More behavioral health is seen in primary care than in any other setting, and health center clients have greater behavioral health needs than typical primary care patients. Most health centers needed additional behavioral health services in 2010, and this need will be magnified to serve 40 million patients. Further testing of these workforce models are needed, but the degree of current underservice suggests that we cannot wait to move on closing the gap. PMID:23816353
The integrity and health of society's life-supporting ecosystems establishes a fundamental constraint on economic growth and development. Energy Systems Theory provides a theoretical basis for defining, measuring and interpreting the concepts of ecological integrity and ecosystem...
Sipos, Maurice L; Foran, Heather M; Crane, Maria L; Wood, Michael D; Wright, Kathleen M
Virtual behavioral health (VBH) services are used frequently to address the high demand for behavioral health (BH) services in the military. Few studies have investigated the relationship between the use of VBH services and BH outcomes or preferences for the use of VBH technologies. In this article, we evaluated BH interviews conducted via video teleconferencing (VTC) or face-to-face in terms of BH symptoms, satisfaction rates, stigma, barriers to care, and preferences for future use of BH care. Soldiers (n = 307) from the headquarters element of an operational unit were surveyed 4 months following a 12-month deployment to Iraq. There were no significant differences in satisfaction rates based on interview modality, but significantly more soldiers preferred face-to-face interviews over VTC interviews in the future. Soldiers who preferred face-to-face interviews also reported higher levels of anxiety and depression symptoms than those who preferred VTC interviews. No significant age differences were found in terms of interview modality satisfaction or preference. Soldiers with greater deployment experience were more likely to report that they would not like using VTC if seeking BH care in the future than soldiers with less deployment experience. These findings highlight the importance of promoting choice in type of BH interview modality. PMID:22645878
Carole C. Upshur
This paper describes the views of primary care providers about treating depression among adult Medicaid patients and their experiences with managed behavioral health care. It also shows the outcomes of an intervention project that provides a care manager to facilitate connections among PCPs, patients, and behavioral health providers. Despite widespread initiatives to improve depression management in primary care and to
Di Giacomo, P; Ricci, Fabrizio L; Bocchi, Leonardo
Computer systems and communication technologies are making a strong and influential presence in the different fields of medicine. The cornerstone of a functional medical information system represents the electronic health records management system. Due to a very sensitive nature of medical information, such systems are faced with a number of stringent requirements, like security and confidentiality of patients' related data, different media type's management, diversity of medical data that need to be processed etc. At present most clinical software systems are closed with little or no operability between them, and the medical information are locked in a variety of different incompatible databases. As the result of these facts, it is very hard for the developers to provide the solution for an integrated health computing environment, which would considerably improve the quality of medical care in general. This paper presents the framework for a functional EHR management system that meets these demands, but also follows the initiative taken by the Next Generation Network (NGN) approach, which includes user mobility, service transparency and common communication platform for transferring and serving different types of information, services and media. PMID:17095822
Lybeck, Nancy; Coble, Jamie B.; Tawfik, Magdy; Bond, Leonard J.
In order to meet the ever increasing demand for energy, the United States nuclear industry is turning to life extension of existing nuclear power plants (NPPs). Economically ensuring the safe, secure, and reliable operation of aging NPPs presents many challenges. The 2009 Light Water Reactor Sustainability Workshop identified online monitoring of active and structural components as essential to better understanding and management of the challenges posed by aging NPPs. Additionally, there is increasing adoption of condition-based maintenance (CBM) for active components in NPPs. These techniques provide a foundation upon which a variety of advanced online surveillance, diagnostic, and prognostic techniques can be deployed to continuously monitor and assess the health of NPP systems and components. The next step in the development of advanced online monitoring is to move beyond CBM to estimating the remaining useful life of active components using prognostic tools. Deployment of prognostic health management (PHM) on the scale of an NPP requires the use of an integrated health management (IHM) framework - a software product (or suite of products) used to manage the necessary elements needed for a complete implementation of online monitoring and prognostics. This paper provides a thoughtful look at the desirable functions and features of IHM architectures. A full PHM system involves several modules, including data acquisition, system modeling, fault detection, fault diagnostics, system prognostics, and advisory generation (operations and maintenance planning). The standards applicable to PHM applications are indentified and summarized. A list of evaluation criteria for PHM software products, developed to ensure scalability of the toolset to an environment with the complexity of an NPP, is presented. Fourteen commercially available PHM software products are identified and classified into four groups: research tools, PHM system development tools, deployable architectures, and peripheral tools.
Paris-Sud XI, Université de
Effectiveness of Health Education on Toxoplasma-Related Knowledge, Behavior, and Risk Appendix Key Words: congenital toxoplasmosis, prenatal care, health education, health promotion Word count the effectiveness of health education on toxoplasma-related knowledge, behavior, and risk of seroconversion
...Promotion, and Integrative and Public Health AGENCY: Office of the Assistant...Promotion, and Integrative and Public Health. FOR FURTHER INFORMATION CONTACT...Promotion, and Integrative and Public Health (the ``Advisory...
Amaral, Gorette; Geierstanger, Sara; Soleimanpour, Samira; Brindis, Claire
Background: The purpose of this study is to compare the mental health risk profile and health utilization behaviors of adolescent school-based health center (SBHC) users and nonusers and discuss the role that SBHCs can play in addressing adolescent health needs. Methods: The sample included 4640 students in grades 9 and 11 who completed the…
Abood, Doris A.; Conway, Terry L.
Study examined relationships between self-esteem, health values, specific health behaviors, and general practice of wellness behaviors in Navy personnel. Lifestyle surveys indicated health values predicted specific health behaviors and general practice of wellness behaviors. After controlling for health values, self-esteem predicted general…
Klippel, Judith A.; DeJoy, David M.
Compares behavioral medicine and health psychology to establish counseling psychology's relationship with these approaches. Surveys three areas of training and application that the current research suggests will offer opportunities for meaningful participation by counseling psychologists. (JAC)
General Information Course Overview Schedule Application Frequently Asked Questions 6th Annual Advanced Training Institute on Health Behavior Theory July 14–July 21, 2012 Application The application for the 2012 ATI can now be accessed. Please follow
Matarazzo, Joseph D.
Asserts that psychologists can contribute to a reduction in national health expenditures by focusing on such illness- and accident-causing behaviors as smoking, alcohol use, improper diet, and speeding and the nonuse of seat belts in cars. (GC)
Palinkas, Lawrence A
Along with other manmade and natural disasters, oil spills produce profound and long-term impacts on the behavioral health of their survivors. Although previous and ongoing research has focused on producing evidence of the breadth and depth of these impacts, future efforts must begin to translate this evidence into developing and implementing policies, programs, and practices that effectively contribute to their prevention and mitigation. Drawing upon a conceptual framework of the behavioral health impacts of oil spills developed from data collected in the aftermath of the Exxon Valdez oil spill in 1989, this paper examines potential interventions designed to prevent or mitigate biopsychosocial, interpersonal, and intrapersonal impacts on behavioral health. Future efforts to translate behavioral health research into effective practice will require the formation and maintenance of academic-community partnerships for the purpose of building resilience to these impacts and providing targeted services to those most vulnerable to their long-term consequences. PMID:24443145
Page 1 of 4 Applied Health Behavior Research Student Application for Enrollment Disability Do you have a disability? Yes No Intentionally withheld If yes, which of the following categories best describes your disability? (Select
Providing health care services to Native women has become a challenge owing to the severity of illness—in particular, diabetes, alcoholism, and arthritis—in this group today. If comprehensive health care is to be offered, coordination of services between health and mental health practitioners is needed. Gathering together to support each other has been a traditional custom for Native women. An integrated health care model is discussed that offers Native women an opportunity to deal with the challenge of mental health and health issues through traditional activities, enhancing their physical and spiritual health and receiving education while creating an atmosphere of empowerment and mutual support. PMID:12356594
Follette, William C.; Bach, Patricia A.; Follette, Victoria M.
This paper argues that a behavioral analysis of psychological health is useful and appropriate. Such an analysis will allow us to better evaluate intervention outcomes without resorting only to the assessment of pathological behavior, thus providing an alternative to the Diagnostic and Statistical Manual system of conceptualizing behavior. The goals of such an analysis are to distinguish between people and outcomes using each term of the three-term contingency as a dimension to consider. A brief review of other efforts to define psychological health is provided. Laboratory approaches to a behavioral analysis of healthy behavior are presented along with shortcomings in our science that impede our analysis. Finally, we present some of the functional characteristics of psychological health that we value. PMID:22478160
Walsh, Jennifer L; Senn, Theresa E; Carey, Michael P
Although there are established relationships between physical and mental health, few studies have explored the relationship between health behaviors and mental health over time. To explore rates of health-compromising behaviors (HCBs) and the longitudinal relationship between HCBs and depression, anxiety, and stress, five waves of data were collected over 1 year from 482 patients at an urban public health clinic (47 % female, 68 % African-American, M age?=?28). Smoking (61 %), binge drinking (52 %), illegal drug use (53 %), unprotected sex with non-primary partners (55 %), and fast food consumption (71 %) were common, while consumption of fruits or vegetables (30 %) and breakfast (17 %) were rare. Cross-lagged models identified within-time associations between HCBs and depression/anxiety and stress. Additionally, depression/anxiety and stress predicted later HCBs, but HCBs did not predict later mental health. Results suggest that targeting mental health may be important to promoting improvements across multiple health behaviors. PMID:23997836
...Promotion, and Integrative and Public Health AGENCY: Department of Health...Surgeon General of the United States Public Health Service. ACTION: Notice...Promotion, and Integrative and Public Health (the ``Advisory...
...Promotion, and Integrative and Public Health AGENCY: Department of Health...Surgeon General of the United States Public Health Service. ACTION: Notice...Promotion, and Integrative and Public Health (the ``Advisory...
...Promotion, and Integrative and Public Health AGENCY: Department of Health...Surgeon General of the United States Public Health Service. ACTION: Notice...Promotion, and Integrative and Public Health (the ``Advisory...
Since 1996, the Massachusetts Behavioral Health Partnership (the Partnership\\/MBHP) has been the behavioral health carve-out vendor for the Commonwealth of Massachusetts Primary Care Clinician (PCC) Plan. Its use of performance standards and incentives has become one of the central organizing activities for both the Commonwealth and the vendor, and one of the program’s hallmarks. Each year, the Commonwealth uses a
Perceived vulnerability, also called perceived susceptibility, perceived likelihood, and perceived probability, reflects an individual's belief about the likelihood of a health threat's occurrence or the likelihood of developing a health problem. Perceptions of event likelihood are central to both expectancy-value theory in social psychology and to subjective-expected utility theory in economics. The earliest work using the construct of perceived susceptibility in the health domain sought to determine why people use health services and included research by Hochbaum (1958)x Close Hochbaum, G.M. (1958).
Brian Yamauchi; Randall Beer
This paper explores the use of dynamical neural networks to control autonomous agents in tasks requiring reactive, sequential, and learning behavior. We use a genetic algorithm to evolve networks that can integrate these different types of behavior in a smooth, continuous manner. We apply this approach to three different task domains: landmark recognition using sonar on a real mobile robot,
Ron Loeppke; Sean Nicholson; Michael Taitel; Matthew Sweeney; Vince Haufle; Ronald C. Kessler
This study evaluated the impact of an integrated population health enhancement program on employee health risks, health conditions, and productivity. Specifically, we analyzed changes in these measures among a cohort of 543 employees who completed a health risk assessment in both 2003 and 2005. We compared these findings with 2 different sets of employees who were not offered health enhancement
Paris-Sud XI, Université de
ON THE BEHAVIOR AT INFINITY OF AN INTEGRABLE FUNCTION EMMANUEL LESIGNE We denote by x a real. It is well known that the fact that a function tends to zero at infinity is a condition neither necessary nor. Thus for a continuous integrable function f which does not tend to zero at infinity, property (1
Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.
Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among…
Elliott, Timothy R.; And Others
Examines the relationship of social problem solving to health behaviors as reported by 126 undergraduate students. Findings revealed significant relationships between elements of social problem solving and wellness and accident prevention behaviors, and traffic and substance risk taking. However, correlations revealed differences between men and…
Christopher Tompkins; Jennifer Perloff
This evaluation of substance abuse and mental health treatment services in Arizona discusses and illustrates the use of data already collected by the State to manage and monitor the public behavioral health sector. The authors utilize a framework that focuses on rate-setting and financial incentives; provider profiling and education; and monitoring of data quality and system-wide performance. Information and analysis
McLeod, Jane D.; Uemura, Ryotaro; Rohrman, Shawna
Prior research on the association of mental health and behavior problems with academic achievement is limited because it does not consider multiple problems simultaneously, take co-occurring problems into account, and control for academic aptitude. We addressed these limitations using data from the National Longitudinal Study of Adolescent Health…
Bausell, R. Barker; Soeken, Karen L.
Beginning in 1983, a national poll has been conducted annually to assess the extent to which the American public engaged in a core of 21 recommended health seeking behaviors. For the third consecutive year a national sample of approximately 1250 adults were interviewed concerning their self-reported compliance with a basic core of 21 health…
Bakke, Sandra I.
A description is provided of a course, "Behavior of Man in Health and Illness," designed to introduce first-year undergraduate nursing students to the theories and concepts related to the health-illness continuum, the stress of illness, and coping theory. The description begins with an overview of course content, followed by information on the…
Barry, Adam E.; Chaney, Beth H.; Piazza-Gardner, Anna K.; Chavarria, Enmanuel A.
Health education and behavior researchers and practitioners often develop, adapt, or adopt surveys/scales to quantify and measure cognitive, behavioral, emotional, and psychosocial characteristics. To ensure the integrity of data collected from these scales, it is vital that psychometric properties (i.e., validity and reliability) be assessed. The…
Teresa E. Seeman
This article explores the relationship between level of social integration and various aspects of health. A search of the literature published since the mid-1970s (under the MEDLINE key words, “social ties”, “social network”, “social isolation”, “social environment”) presented strong evidence that social integration leads to reduced mortality risks, and to a better state of mental health. The evidence on physical
Fraser, Michael; Elgamal, Ahmed; Conte, Joel P.; Masri, Sami; Fountain, Tony; Gupta, Amarnath; Trivedi, Mohan; El Zarki, Magda
Internet technologies are increasingly facilitating real-time monitoring of Bridges and Highways. The advances in wireless communications for instance, are allowing practical deployments for large extended systems. Sensor data, including video signals, can be used for long-term condition assessment, traffic-load regulation, emergency response, and seismic safety applications. Computer-based automated signal-analysis algorithms routinely process the incoming data and determine anomalies based on pre-defined response thresholds and more involved signal analysis techniques. Upon authentication, appropriate action may be authorized for maintenance, early warning, and/or emergency response. In such a strategy, data from thousands of sensors can be analyzed with near real-time and long-term assessment and decision-making implications. Addressing the above, a flexible and scalable (e.g., for an entire Highway system, or portfolio of Networked Civil Infrastructure) software architecture/framework is being developed and implemented. This framework will network and integrate real-time heterogeneous sensor data, database and archiving systems, computer vision, data analysis and interpretation, physics-based numerical simulation of complex structural systems, visualization, reliability & risk analysis, and rational statistical decision-making procedures. Thus, within this framework, data is converted into information, information into knowledge, and knowledge into decision at the end of the pipeline. Such a decision-support system contributes to the vitality of our economy, as rehabilitation, renewal, replacement, and/or maintenance of this infrastructure are estimated to require expenditures in the Trillion-dollar range nationwide, including issues of Homeland security and natural disaster mitigation. A pilot website (http://bridge.ucsd.edu/compositedeck.html) currently depicts some basic elements of the envisioned integrated health monitoring analysis framework.
Doornwaard, Suzan M.; ter Bogt, Tom F. M.; Reitz, Ellen; van den Eijnden, Regina J. J. M.
Research on the role of sex-related Internet use in adolescents’ sexual development has often isolated the Internet and online behaviors from other, offline influencing factors in adolescents’ lives, such as processes in the peer domain. The aim of this study was to test an integrative model explaining how receptive (i.e., use of sexually explicit Internet material [SEIM]) and interactive (i.e., use of social networking sites [SNS]) sex-related online behaviors interrelate with perceived peer norms in predicting adolescents’ experience with sexual behavior. Structural equation modeling on longitudinal data from 1,132 Dutch adolescents (Mage T1 = 13.95; range 11-17; 52.7% boys) demonstrated concurrent, direct, and indirect effects between sex-related online behaviors, perceived peer norms, and experience with sexual behavior. SEIM use (among boys) and SNS use (among boys and girls) predicted increases in adolescents’ perceptions of peer approval of sexual behavior and/or in their estimates of the numbers of sexually active peers. These perceptions, in turn, predicted increases in adolescents’ level of experience with sexual behavior at the end of the study. Boys’ SNS use also directly predicted increased levels of experience with sexual behavior. These findings highlight the need for multisystemic research and intervention development to promote adolescents’ sexual health. PMID:26086606
Bozorgmehr, Elham; Hajizamani, Abolghasem; Malek Mohammadi, Tayebeh
Introduction. It is widely acknowledged that the behavior of parents affects their children's health. This study aimed to evaluate the relationship between oral health behavior of parents and oral health status and behavior of their children in a sample of preschool children in Iran. Method and Material. A random sample of over-five-year-old preschool children and their parents were enrolled in the study. Selection of schools was by clustering method. Parents were asked to fill a piloted questionnaire which included demographic characteristics, socioeconomic status, oral health behaviors of children and their parents. Oral health status of children was examined. The parent and their children oral health relationship were tested using regression and correlation analysis. Results. About 222 parents and children participated in the study. There was a significant relationship between history of having dental problems in parents and dmft index in their children (P = 0.01). There was a significant relationship between parental frequency of tooth brushing and child frequency of tooth brushing (P = 0.05); however, there was no significant relationship between parental frequency of dental visits and those of their children (P = 0.1). Conclusion. The study concluded that some important health behaviors in parents, such as tooth brushing habits are important determinants of these behaviors in their young children. So promoting parent knowledge and attitude could affect their children oral health behavior and status. PMID:23738088
Champion, V., Skinner, C. S., Hui, S., Monahan, P., Juliar, B., Daggy, J. et al. (2007). The effect of telephone versus print tailoring for mammography adherence. Patient Education and Counseling, 65, 416-423.). For lifestyle behaviors such as healthy eating, exercising regularly, and smoking cessation, key barriers appear to be social-environmental-peer pressure, negative emotions or mood, stress, and habitual patterns associated with undesired behaviors (Glasgow et al., 2001 xClose Glasgow, R.
Davis, Matthew A; West, Alan N; Weeks, William B; Sirovich, Brenda E
Objective To compare the characteristics, health behaviors, and health services utilization of U.S. adults who use complementary and alternative medicine (CAM) to treat illness to those who use CAM for health promotion. Data Source The 2007 National Health Interview Survey (NHIS). Study Design We compared adult (age ?18 years) NHIS respondents based on whether they used CAM in the prior year to treat an illness (n = 973), for health promotion (n = 3,281), or for both purposes (n = 3,031). We used complex survey design methods to make national estimates and examine respondents' self-reported health status, health behaviors, and conventional health services utilization. Principal Findings Adults who used CAM for health promotion reported significantly better health status and healthier behaviors overall (higher rates of physical activity and lower rates of obesity) than those who used CAM as treatment. While CAM Users in general had higher rates of conventional health services utilization than those who did not use CAM; adults who used CAM as treatment consumed considerably more conventional health services than those who used it for health promotion. Conclusion This study suggests that there are two distinct types of CAM User that must be considered in future health services research and policy decisions. PMID:21554272
The widespread adoption of electronic health records (EHRs) is a public policy strategy to improve healthcare quality and reduce accelerating health care costs. Much research has focused on medical providers' perceptions of EHRs, but little is known about those of behavioral health providers. This research was informed by the theory of reasoned…
Calvert, Wilma J.; Isaac,, E. Paulette; Johnson, Sharon
This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (greater than…
Hou, Su-I; Charlery, Su-Anne Robyn; Roberson, Kiersten
Purpose: This review examines Internet interventions aiming to change health behaviors in the general population. Methods: Internet health interventions in the USA published between January 2005 and December 2013 were identified through Medline and CINAHL. Keywords used were (Internet or e-health or social media or web) paired with (intervention or program*). A total of 38 articles met all criteria and were reviewed. Results: Studies were analyzed by targeted health behavior interventions: tobacco (5), alcohol (4), weight loss (7), physical activity (PA) (7), nutrition (2), PA and nutrition combined (5), HIV or sexual health (4), and chronic diseases (4). Interventions ranged from one session to 24? weeks (average 6–12 weeks). Common strategies used, including web-based information, tailored feedback, weekly e-mails, goal setting, and self-assessment. Social cognitive theory and the transtheoretical models were the most commonly used frameworks. Recruitment strategies were typically media based varied by settings and populations. Except for the tobacco interventions, the majority studies yielded significant outcomes. Conclusion: This review provides updates and synthesized knowledge on the design and consistent effectiveness of Internet interventions across health behaviors. Results have implications for public health and healthcare professionals, as they play a key role in developing and delivering health promotion interventions as well as in assisting the communities and clients serviced obtaining evidence-based health information. PMID:25750795
Illness representations are one class of illness cognitions which in a general sense might also include other cognitive constructs related to health threats, including perceived vulnerability, optimism and self-efficacy beliefs, as well as perceptions of social norms.
Risk. Worry about a health event is likely to be related to one's appraisal of risk concerning that event. Indeed, Slovic (1987) xClose Slovic, P. (1987). The perception of risk. Science, 236, 280-285.
Kenton L. Burns
Health costs in the US have risen at astronomic rates, rising from 4.6% of the GNP in 1950 to 8.3% in 1975. Yet, despite the compounding costs of medical care, the health of the population has not improved significantly since 1950, when viewed from the standpoint of increased longevity or decrease in the incidence of the major causes of death
Feather, Martin S.; Uckun, Serdar; Hicks, Kenneth A.
Despite two decades of significant investments in R&D of Integrated System Health Management (ISHM), mission-critical applications of it in aerospace are few and far between. ISHM is subject to the general difficulty of transitioning technologies out of R&D labs and into practical applications. New and unproven methods such as ISHM introduce multiple mission risks (technology, schedule, cost), and may require a transition to unconventional and as-yet-unproven operations concepts in order to be effective. Laboratory and flight demonstrations are necessary but insufficient to adequately reduce those risks. What is needed is a solid business case before a new technology can be considered for fleetwide deployment. To address these problems, we recently applied a technology maturation assessment process developed at NASA's Jet Propulsion Laboratory to study the challenges of ISHM technology maturation. This application resulted in identification of the technologies (and technology maturation activities) that would result in the greatest risk reduction per investment dollar. Our approach and its results are described herein.
Kelly, Ursula A
Persisting health disparities have lead to calls for an increase in health research to address them. Biomedical scientists call for research that stratifies individual indicators associated with health disparities, for example, ethnicity. Feminist social scientists recommend feminist intersectionality research. Intersectionality is the multiplicative effect of inequalities experienced by nondominant marginalized groups, for example, ethnic minorities, women, and the poor. The elimination of health disparities necessitates integration of both paradigms in health research. This study provides a practical application of the integration of biomedical and feminist intersectionality paradigms in nursing research, using a psychiatric intervention study with battered Latino women as an example. PMID:19461221
Iain Cameron; Billy Hare
Approaches to planning for health and safety in the UK construction industry have been criticised for being bureaucratic and irrelevant, especially if done by individuals in isolation. This paper reports on the findings of a research project, commissioned by the UK Health and Safety Executive, which investigated the integration of health and safety with construction project planning. A combination of
Davis, Jeffrey R.
Dr. Davis' presentation includes a brief overview of space flight and the lessons learned for health care in microgravity. He will describe the development of policy for health care for international crews. He will conclude his remarks with a discussion of an integrated health care system.
HSDM Presents: "Integrating Oral Health and Primary Care" A3 Advancement · Achievement and Primary Care" R. Bruce Donoff, DMD, MD Dean and Walter C. Guralnick Distinguished Professor of Oral Health, Mental Health, and Primary Care for the Elderly" Lisa Thompson, DMD Clinical Instructor in Oral
Centers for Disease Control and Prevention, 2011
The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…
Shaw, Benjamin A.; McGeever, Kelly; Grubert, Elizabeth; Agahi, Neda; Fors, Stefan
Recent studies indicate that socioeconomic inequalities in health extend into the elderly population, even within the most highly developed welfare states. One potential explanation for socioeconomic inequalities in health focuses on the role of health behaviors, but little is known about the degree to which health behaviors account for health inequalities among older adults, in particular. Using data from the Health and Retirement Study (N=19,245), this study examined the degree to which four behavioral risk factors – smoking, obesity, physical inactivity, and heavy drinking – are associated with socioeconomic position among adults aged 51 and older, and whether these behaviors mediate socioeconomic differences in mortality, and the onset of disability among those who were disability-free at baseline, over a 10-year period from 1998–2008. Results indicate that the odds of both smoking and physical inactivity are higher among persons with lower wealth, with similar stratification in obesity, but primarily among women. The odds of heavy drinking decrease at lower levels of wealth. Significant socioeconomic inequalities in mortality and disability onset are apparent among older men and women; however, the role that health behaviors play in accounting for these inequalities differs by age and gender. For example, these health behaviors account for between 23–45% of the mortality disparities among men and middle aged women, but only about 5% of the disparities found among women over 65 years. Meanwhile, these health behaviors appear to account for about 33% of the disparities in disability onset found among women survivors, and about 9–14% among men survivors. These findings suggest that within the U.S. elderly population, behavioral risks such as smoking and physical inactivity contribute moderately to maintaining socioeconomic inequalities in health. As such, promoting healthier lifestyles among the socioeconomically disadvantaged older adults should help to reduce later life health inequalities. PMID:24560224
Robert D. Friedberg; Angela A. Gorman
There has been a recent focus on the processes that underlie intervention delivery for children and adolescents throughout\\u000a the Cognitive-Behavioral Therapy (CBT) literature. Certain process variables have been associated with treatment outcome among\\u000a youth receiving CBT. Data for these process variables including: the therapeutic alliance or therapeutic relationship, child\\u000a and parent involvement, other child and therapist variables, and issues of
Sturm, Lynne A.; Perry, Deborah F.
This article describes innovative service delivery models and clinical strategies that support the social-emotional development of young children and their families in the pediatric primary care setting. By understanding the trends affecting well-child care, early childhood providers will be better equipped to partner with their pediatric…
Carole Alcock; Lois Burgess; Khin Than Win; Joan Cooper
The ability to provide accurate, timely information to authorised health providers will unquestionably improve health care delivery. Essential to this is the development of Electronic Health Record Systems. Such systems will be dependent on accurate linking of data from disparate healthcare databases. Correct identification of Electronic Health Records(EHRs) through Universal Patient Identifiers(UPIs) and guaranteed integrity of content are two elements
Davern, Mike; Blewett, Lynn A; Lee, Brian; Boudreaux, Michel; King, Miriam L
The Integrated Health Interview Series (IHIS) is a public data repository that harmonizes four decades of the National Health Interview Survey (NHIS). The NHIS is the premier source of information on the health of the U.S. population. Since 1957 the survey has collected information on health behaviors, health conditions, and health care access. The long running time series of the NHIS is a powerful tool for health research. However, efforts to fully utilize its time span are obstructed by difficult documentation, unstable variable and coding definitions, and non-ignorable sample re-designs. To overcome these hurdles the IHIS, a freely available and web-accessible resource, provides harmonized NHIS data from 1969-2010. This paper describes the challenges of working with the NHIS and how the IHIS reduces such burdens. To demonstrate one potential use of the IHIS we examine utilization patterns in the U.S. from 1972-2008. PMID:22463071
The Integrated Health Interview Series (IHIS) is a public data repository that harmonizes four decades of the National Health Interview Survey (NHIS). The NHIS is the premier source of information on the health of the U.S. population. Since 1957 the survey has collected information on health behaviors, health conditions, and health care access. The long running time series of the NHIS is a powerful tool for health research. However, efforts to fully utilize its time span are obstructed by difficult documentation, unstable variable and coding definitions, and non-ignorable sample re-designs. To overcome these hurdles the IHIS, a freely available and web-accessible resource, provides harmonized NHIS data from 1969-2010. This paper describes the challenges of working with the NHIS and how the IHIS reduces such burdens. To demonstrate one potential use of the IHIS we examine utilization patterns in the U.S. from 1972-2008. PMID:22463071
Hutchinson, Jayne; Prady, Stephanie L.; Smith, Michaela A.; White, Piran C. L.; Graham, Hilary M.
Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling) and physical activity (92 studies) or sedentary behaviors (19 studies). Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14), including organic food, locally-sourced food and plate waste) and other health behaviors ((n = 20) smoking, dietary intake, alcohol). These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain. PMID:25950651
Williams, Roy Jerome, III
The Patient Protection and Affordable Care Act (PPACA) has set the tone for a radically revised health landscape in America that focuses on community-based care. Our health care system, however, has neither the infrastructure ...
Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...
Ribisl, Kurt M.; Leeman, Jennifer; Glasser, Allison M.
The relatively high cost of delivering many public health interventions limits their potential for broad public impact by reducing their likelihood of adoption and maintenance over time. Practitioners identify cost as the primary factor for which interventions they select to implement, but researchers rarely disseminate cost information or consider its importance when developing new interventions. A new approach is proposed, whereby intervention developers assess what individuals and agencies adopting their interventions are willing to pay and then design interventions that are responsive to this price range. The ultimate goal is to develop effective and affordable interventions, called lean interventions, which are widely adopted and have greater public health impact. PMID:24842743
David B. Abrams; C. Tracy Orleans; Raymond S. Niaura; Michael G. Goldstein; James O. Prochaska; Wayne Velicer
There is an increasing momentum to integrate prevention into mainstream health care. Three decades of research on tobacco\\u000a dependence can provide insights into the conceptual, clinical, economic, and service delivery challenges to such an integration.\\u000a Biological sciences, cognitive-behavioral, clinical treatment outcome, and public health arenas are selectively reviewed.\\u000a The key conceptual issues are explored relevant to the optimal delivery of
Outcome expectancy is the expectation that a behavior will produce a set of outcomes, i.e., the belief that a given action will lead to a defined result, whether beneficial or not (Bandura, 1982,x Close Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37(2), 122-147. 1997x Close Bandura, A. (1997).
Table of Contents 1 Introduction 2 Self-Report of Cancer Behaviors 3 Self-Reports of Family History 4 Self-Reported Psychosocial Risk Factors among Cancer Patients 5 Application of Self-Report Measures in Cancer 6 Suggestions for Use of Self-Report for
Summary Background Persons with an optimistic attitude do not give up despite obstacles and failures. Optimistic athletes compete more out of hope for success than out of fear of defeat. The purpose of my research was to determine if optimism also promotes good health behavior in athletes. Material/Methods In order to measure the role of optimism in shaping the health behavior of athletes, I examined a group of women (N=147) and men (N=385) who were currently in training for athletic competition. The control group consisted of women (N=262) and men (N=435) who were not and had never been competitive athletes. The “O-P” Attitude Questionnaire was used to measure optimism, while health behavior was measured with the Juczynski Health Behavior Inventory, which measures proper nutrition habits, preventive behavior, positive attitude, and healthy practices. Results The level of pessimism in these athletes was average. The female athletes were less pessimistic than the female controls. A similar, highly significant difference occurred between the male athletes and non-athletes. Gender did not differentiate the level of optimism in either group. Among the women, optimism correlated with healthy practices, such as daily sleep and recreation habits, or physical activity. The greater the pessimism increased, positive attitudes declined in the female controls, the female athletes, and the male controls. Conclusions The athletes displayed greater optimism than the controls. Among the women, optimism correlated with good health practices. PMID:22207118
Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings. PMID:22276600
Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries. PMID:14744719
, and acute respiratory infections are a larger share of the global burden than are noncommunicable chronic respiratory infections, stove, toilets, bed nets, fuel Abstract We consider health and environmental quality Words policy interventions, water quality, arsenic, indoor air pollution, diarrhea, malaria, acute
Whenbehavioral healthpatientswhohave been hospitalized are cared for in their home, hospital readmissions drop. PyscHealth's Home Intervention Project won a gold award from URAC. Program's goal is to increase compliance with post-hospital outpatient follow-up therapy and reduce rehospitalizations. PMID:19186491
Secondary and tertiary prevention research often assesses and intervenes on processes that affect the cancer experience. These include health-related quality of life and medical adherence and, because there are often no reliable biomedical markers for these factors, self-report is the primary assessment method.
With regard to diet, health-promoting environments are those which facilitate healthy food choices. Put simply, in a healthy nutrition environment, the healthy choice is the easy choice. The number of reports of various dimensions of nutrition environments is increasing, however, there is no guidance in the literature on how best to measure these environments in a comprehensive manner.
Price, L. N.; Reider, E. E.; Robertson, E. B.
The National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA) have a long history of supporting investigator-initiated research and research training to enhance the scientific understanding of and effective interventions for a range of problems associated with youth violence. New technologies are emerging and basic…
Gao, X-L; Hsu, C-Y S; Xu, Y C; Loh, T; Koh, D; Hwarng, H B
Policymakers' understanding of and ability to reduce health disparities are pivotal for health promotion worldwide. This study aimed to verify the behavioral pathways leading to oral health disparities. Oral examinations were conducted for 1782 randomly selected preschoolers (3-6 yrs), and 1576 (88.4%) participants were followed up after 12 months. Parents were surveyed on their knowledge (K), attitude (A), and practices (P) regarding their children's oral health homecare (infant feeding, diet, and oral hygiene) and dental attendance. Structural equation modeling substantiated the links between specific KAs and corresponding practices, while generic KA did not affect practices. KAP pathways partly explained the ethnic and socio-economic disparities in oral health. Deprivation had a direct effect (not mediated by KA) on dental attendance, but not on oral health homecare. Ethnicity directly influenced oral health homecare practices, but not dental attendance. These behavioral pathways, furthering our understanding of health disparity, may have practical implications for health promotion and policy-making. PMID:20554887
Prosser, W. H.; Brown, T. L.; Woodard, S. E.; Fleming, G. A.; Cooper, E. G.
NASA is focusing considerable efforts on technology development for Integrated Vehicle Health Management systems. The research in this area is targeted toward increasing aerospace vehicle safety and reliability, while reducing vehicle operating and maintenance costs. Onboard, real-time sensing technologies that can provide detailed information on structural integrity are central to such a health management system. This paper describes a number of sensor technologies currently under development for integrated vehicle health management. The capabilities, current limitations, and future research needs of these technologies are addressed.
Self-report data are essential to behavioral research and clinical practice. Self-report is one of the primary means of obtaining information about a person, placing it at the heart of the research history that underlies much of cancer diagnosis and care. There are numerous benefits of retrospective self-reports, such as the expeditious development and modification of measures that are easy to administer and complete.
Background Health behaviors are a key determinant of health and well-being that are influenced by the nature of the social environment. This study examined associations between social relationships and health-related behaviors among a nationally representative sample of older people. Methods We analyzed data from three waves (1999–2004) of the US National Health and Nutrition Examination Survey (NHANES). Participants were 4,014 older Americans aged 60 and over. Log-binomial regression models estimated prevalence ratios (PR) for the associations between social relationships and each of the following health behaviors: alcohol use, smoking, physical activity and dental attendance. Results Health-compromising behaviors (smoking, heavy drinking and less frequent dental visits) were related to marital status, while physical activity, a health-promoting behavior, was associated with the size of friendship networks. Smoking was more common among divorced/separated (PR?=?2.1; 95% CI: 1.6, 2.7) and widowed (PR?=?1.7; 95% CI: 1.3, 2.3) respondents than among those married or cohabiting, after adjusting for socio-demographic background. Heavy drinking was 2.6 times more common among divorced/separated and 1.7 times more common among widowed men compared to married/cohabiting men, while there was no such association among women. For women, heavy drinking was associated with being single (PR?=?1.7; 95% CI: 1.0, 2.9). Being widowed was related to a lower prevalence of having visited a dentist compared to being married or living with a partner (PR?=?0.92; 95% CI 0.86, 0.99). Those with a larger circle of friends were more likely to be physically active (PR?=?1.17; 95% CI:1.06, 1.28 for 5–8 versus less than 5 friends). Conclusions Social relationships of older Americans were independently associated with different health-related behaviors, even after adjusting for demographic and socioeconomic determinants. Availability of emotional support did not however mediate these associations. More research is needed to assess if strengthening social relationships would have a significant impact on older people’s health behaviors and ultimately improve their health. PMID:24885507
Self-reported cancer screening. Cancer screening is a commonly reported clinical assessment designed to facilitate early detection, and regular screening is important for reducing morbidity and mortality across an array of cancer types. Although more objective alternatives exist for determining screening practices in the population (e.g., health insurance or medical records), self-report of screening is nonetheless the measure of choice in the majority of studies.
Most research has investigated optimistic biases at the group level, which has been sufficient given the predominant focus on which types of events, comparative targets, and other factors elicit the most bias. However, in order to establish the utility of this construct in the domain of health, it is necessary to measure optimistic bias at the level of the individual. Given the difficulties of doing so, research taking this approach is in its infancy.
Webb, Barbara H.; Harrison, Reid R.
The mechanisms by which animals manage sensorimotor integration and coordination of different behaviors can be investigated in robot models. In previous work the first author has build a robot that localizes sound based on close modeling of the auditory and neural system in the cricket. It is known that the cricket combines its response to sound with other sensorimotor activities such as an optomotor reflex and reactions to mechanical stimulation for the antennae and cerci. Behavioral evidence suggests some ways these behaviors may be integrated. We have tested the addition of an optomotor response, using an analog VLSI circuit developed by the second author, to the sound localizing behavior and have shown that it can, as in the cricket, improve the directness of the robot's path to sound. In particular it substantially improves behavior when the robot is subject to a motor disturbance. Our aim is to better understand how the insect brain functions in controlling complex combinations of behavior, with the hope that this will also suggest novel mechanisms for sensory integration on robots.
...Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant...Promotion, and Integrative and Public Health (the ``Advisory...
...Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant...Promotion, and Integrative and Public Health (the ``Advisory...
...Promotion, and Integrative and Public Health; Notice of Meeting AGENCY: Office...Surgeon General of the United States Public Health Service, Office of the Assistant...Promotion, and Integrative and Public Health (the ``Advisory...
...Promotion, and Integrative and Public Health AGENCY: Office of the Surgeon General of the United States Public Health Service, Office of the Assistant...Promotion, and Integrative and Public Health (the ``Advisory...
Smith, Matthew L.
the validity and reliability of data collected from 1,992 Indiana middle and high school students with the Adolescent Health Risk Behavior Survey (AHRBS) instrument. The AHRBS instrument was created using the Biopsychosocial Model (BPSM) theoretical framework...
Gerda G. Fillenbaum; Bruce M. Burchett; J. D. Dan; G. Blazer
We examined the effects of use of low charge, integrated and comprehensive health care services (Veterans Administration (VA) health care system) on health care service use and health-related outcomes. Data came from the 10-year (1986\\/87–1996\\/97) Duke Established Populations for Epidemiologic Studies of the Elderly, with 159 men aged 65–85 who primarily used VA health services compared with 1,100 men aged
McLeod, Jane D; Uemura, Ryotaro; Rohrman, Shawna
Prior research on the association of mental health and behavior problems with academic achievement is limited because it does not consider multiple problems simultaneously, take co-occurring problems into account, and control for academic aptitude. We addressed these limitations using data from the National Longitudinal Study of Adolescent Health (N = 6,315). We estimated the associations of depression, attention problems, delinquency, and substance use with two indicators of academic achievement (high school GPA and highest degree received) with controls for academic aptitude. Attention problems, delinquency, and substance use were significantly associated with diminished achievement, but depression was not. Combinations of problems involving substance use were especially consequential. Our results demonstrate that the social consequences of mental health problems are not the inevitable result of diminished functional ability but, rather, reflect negative social responses. These results also encourage a broader perspective on mental health by demonstrating that behavior problems heighten the negative consequences of more traditional forms of distress. PMID:23197485
Joan-Carles Suris; Christina Akre; Susan M. Sawyer
OBJECTIVE.The objective of this study was to compare the frequency of risk behaviors and to measure the extent of co-occurrence of these behaviors in chronically ill and healthy adolescents. METHODS.Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health database, a nationally representative survey of 7548 adolescents in postman- datory school aged 16 to 20 years. There were
...Promotion, and Integrative and Public Health AGENCY: Department of Health...Office of the Secretary, Office of Public Health and Science. ACTION: Notice...Promotion, and Integrative and Public Health will be governed by...
Specificity is critical to the assessment of perceived benefits. For example, development of a scale to measure perceived benefits of sun protection must take into account the specific action being considered (e.g., use of sunscreen vs. wearing a hat), and the specific benefits being considered (e.g., decreasing likelihood of skin cancer vs. delaying the appearance of age spots and wrinkles). Thus, developing appropriate operational definitions of benefits will continue to challenge researchers as the construct is used with new behaviors.
Anat A. Shemesh; Iris Rasooly; Pamela Horowitz; John Lemberger; Yosefa Ben-Moshe; Josefa Kachal; Josepha Danziger; A. Mark Clarfield; Elliot Rosenberg
To assess factors that affect the adoption of healthy lifestyles among a variety of active Israeli seniors, a survey was conducted in 2002 at the Peiluyada, a physical activity-oriented health fair for seniors held annually in Israel from 1995 to 2002. A multi-language, self-administered questionnaire, assessing predisposing factors, barriers and health-protective behaviors, was fielded to potential participants. Response rate at
The World Health Organization's International Programme on Chemical Safety (IPCS), the Organization for Economic Cooperation and Development (OECD), and the U.S. Environmental Protection Agency have developed a collaborative partnership to foster integration; of assessment approa...
Thumbi, S. M.; Njenga, M. Kariuki; Marsh, Thomas L.; Noh, Susan; Otiang, Elkanah; Munyua, Peninah; Ochieng, Linus; Ogola, Eric; Yoder, Jonathan; Audi, Allan; Montgomery, Joel M.; Bigogo, Godfrey; Breiman, Robert F.; Palmer, Guy H.; McElwain, Terry F.
Background For most rural households in sub-Saharan Africa, healthy livestock play a key role in averting the burden associated with zoonotic diseases, and in meeting household nutritional and socio-economic needs. However, there is limited understanding of the complex nutritional, socio-economic, and zoonotic pathways that link livestock health to human health and welfare. Here we describe a platform for integrated human health, animal health and economic welfare analysis designed to address this challenge. We provide baseline epidemiological data on disease syndromes in humans and the animals they keep, and provide examples of relationships between human health, animal health and household socio-economic status. Method We designed a study to obtain syndromic disease data in animals along with economic and behavioral information for 1500 rural households in Western Kenya already participating in a human syndromic disease surveillance study. Data collection started in February 2013, and each household is visited bi-weekly and data on four human syndromes (fever, jaundice, diarrhea and respiratory illness) and nine animal syndromes (death, respiratory, reproductive, musculoskeletal, nervous, urogenital, digestive, udder disorders, and skin disorders in cattle, sheep, goats and chickens) are collected. Additionally, data from a comprehensive socio-economic survey is collected every 3 months in each of the study households. Findings Data from the first year of study showed 93% of the households owned at least one form of livestock (55%, 19%, 41% and 88% own cattle, sheep, goats and chickens respectively). Digestive disorders, mainly diarrhea episodes, were the most common syndromes observed in cattle, goats and sheep, accounting for 56% of all livestock syndromes, followed by respiratory illnesses (18%). In humans, respiratory illnesses accounted for 54% of all illnesses reported, followed by acute febrile illnesses (40%) and diarrhea illnesses (5%). While controlling for household size, the incidence of human illness increased 1.31-fold for every 10 cases of animal illness or death observed (95% CI 1.16–1.49). Access and utilization of animal source foods such as milk and eggs were positively associated with the number of cattle and chickens owned by the household. Additionally, health care seeking was correlated with household incomes and wealth, which were in turn correlated with livestock herd size. Conclusion This study platform provides a unique longitudinal dataset that allows for the determination and quantification of linkages between human and animal health, including the impact of healthy animals on human disease averted, malnutrition, household educational attainment, and income levels. PMID:25798951
Baicker, Katherine; Congdon, William J; Mullainathan, Sendhil
Context Millions of uninsured Americans ostensibly have insurance available to them—many at very low cost—but do not take it up. Traditional economic analysis is based on the premise that these are rational decisions, but it is hard to reconcile observed enrollment patterns with this view. The policy prescriptions that the traditional model generates may thus fail to achieve their goals. Behavioral economics, which integrates insights from psychology into economic analysis, identifies important deviations from the traditional assumptions of rationality and can thus improve our understanding of what drives health insurance take-up and improved policy design. Methods Rather than a systematic review of the coverage literature, this article is a primer for considering issues in health insurance coverage from a behavioral economics perspective, supplementing the standard model. We present relevant evidence on decision making and insurance take-up and use it to develop a behavioral approach to both the policy problem posed by the lack of health insurance coverage and possible policy solutions to that problem. Findings We found that evidence from behavioral economics can shed light on both the sources of low take-up and the efficacy of different policy levers intended to expand coverage. We then applied these insights to policy design questions for public and private insurance coverage and to the implementation of the recently enacted health reform, focusing on the use of behavioral insights to maximize the value of spending on coverage. Conclusions We concluded that the success of health insurance coverage reform depends crucially on understanding the behavioral barriers to take-up. The take-up process is likely governed by psychology as much as economics, and public resources can likely be used much more effectively with behaviorally informed policy design. PMID:22428694
Eselius, Laura L; Cleary, Paul D; Zaslavsky, Alan M; Huskamp, Haiden A; Busch, Susan H
Objective To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO™) survey to allow for fair comparisons across health plans. Data Source Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate=48 percent). Study Design Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified. Principal Findings The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings. Conclusions Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information. PMID:18783456
Ford, Denyce S.; Goode, Carolyn R.
A study of African American college students compared students' health-related behaviors with their perceptions of corresponding health issues. Students had low smoking rates but higher alcohol consumption. Most students did not practice good nutrition or daily physical activity. Over half managed stress well, and three-quarters were sexually…
G. Reza Najem; Marian Rose Catherine Passannante; James D. Foster
The assumption of this study is: the preventive care beliefs and practices of health science students stand-out among the general public. To test this assumption, a survey of beliefs, behaviors and disease prevention practices of medical, dental, undergraduate and graduate nursing students in three health science schools was carried out in New Jersey. All students in these three schools were
Koh, Seong A.
The purpose of this study was to examine the similarity of outcomes from three different treatment integrity (TI) methods, and to identify the method which best corresponded to the assessment of a child's behavior. Six raters were recruited through individual contact via snowball sampling. A modified intervention component list and 19 video clips…
Stattin, Hakan; Kerr, Margaret; Skoog, Therese
Girls' early pubertal timing has been linked in many studies to behavioral problems such as delinquency and substance use. The theoretical explanations for these links have often involved the girls' peer relationships, but contexts have also been considered important in some explanations. By integrating two theoretical models, the…
Potvin, Louise; Gendron, Sylvie; Bilodeau, Angèle; Chabot, Patrick
The innovative practice that resulted from the Ottawa Charter challenges public health knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors’ mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of public health programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges. PMID:15798114
Patterson, Sheila M.; Graf, Helen M.
Reviews the popularity of complementary and alternative medicine (CAM) approaches in health education, suggesting a proposed CAM course for health education professional preparation and offering a course outline which can be used as a self- standing course or integrated into existing courses. It includes a proposed course description and goals,…
Hall, Bob; Mageean, Pauline
This guide is designed to help technical and further education (TAFE) curriculum writers in Australia integrate safety education into vocational education courses. It provides a general overview of occupational health and safety from the perspective of TAFE trade training and a brief summary of the major health and safety issues that might be…
Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra H.
The influence of family, school, and religious social contexts on the mental health of Black adolescents has been understudied. This study used Durkheim's social integration theory to examine these associations in a nationally representative sample of 1,170 Black adolescents, ages 13-17. Mental health was represented by positive and negative…
Janie Canty-Mitchell; Joan K Austin; Kim Jaffee; Rong Amy Qi; Nancy Swigonski
This study examined caregiver perceptions of mental health problems and counseling needs in low-income children with special health care needs (CSHCN). Interviewers collected data from 257 caregivers of CSHCN (61% males; 60% African American; Mean age = 8.4 years) attending six Midwestern inner-city health clinics. Measures included the Child Behavior Checklist (CBCL) and an investigator-designed questionnaire. CBCL T-scores indicated that
Punnett, Laura; Cherniack, Martin; Henning, Robert; Morse, Tim; Faghri, Pouran
Musculoskeletal, cardiovascular, and mental health are all associated with the physical and psychosocial conditions of work, as well as with individual health behaviors. An integrated approach to workplace health-promotion programs should include attention to the work environment, especially in light of recent findings that work organization influences so-called lifestyle or health behaviors. Macroergonomics provides a framework to improve both physical and organizational features of work and, in the process, to empower individual workers. The Center for the Promotion of Health in the New England Workplace (CPH-NEW) is a research-to-practice effort examining the effectiveness of worksite programs that combine occupational safety and health--especially ergonomics--with health promotion, emphasizing the contribution of work organization to both. Two intervention studies are underway in three different sectors: health care, corrections, and manufacturing. Each study features participatory structures to facilitate employee input into health goal-setting, program design and development, and evaluation, with the goal of enhanced effectiveness and longer-term sustainability. PMID:19618803
Diverse safety and health operation data collected and stored in different departments have not been fully integrated and\\u000a utilized by managers due to poor design of safety and health information system. The safety and health management system can\\u000a be depicted, conceptually, as an organic system with circulation of information flow which carries required data and information\\u000a to specified workers and
... zinc. Pain Find health information, seminars, and research. Research Results Highlights of recently published studies funded by NCCIH. ... Filter Out Distractions ( February 4, 2015 ) See more research results Connect with Us Subscribe to our e-newsletters ...
Rew, Lynn; Arheart, Kristopher L.; Horner, Sharon D.; Thompson, Sanna; Johnson, Karen E.
Although much is known about health-risk behaviors of adolescents, less is known about their health-promoting behaviors. The purpose of this analysis was to compare health-promoting behaviors in adolescents in Grades 9-12 by gender and ethnicity and explore how these behaviors changed over time. Data were collected from 878 rural adolescents…
Nigg, Claudio Renato; Lee, Hye-ryeon; Hubbard, Amy E.; Min-Sun, Kim
Objective: There is a dearth of studies on the mechanisms of multiple risk behaviors, even though these behaviors are significant public health issues. The authors investigated whether health behavior interventions have transfer or compensatory effects on other health behaviors. Participants and Methods: The authors looked at transfer and…
...Promotion, and Integrative and Public Health; Notice of Meeting AGENCY: Department...Surgeon General of the United States Public Health Service. ACTION: Notice...Prevention, Health Promotion and Public Health (the ``Council'')....
Gore, Brian F.; Jarvis, Peter A.
The Man-machine Integration Design and Analysis System (MIDAS) is an integrated human performance modeling software tool that is based on mechanisms that underlie and cause human behavior. A PC-Windows version of MIDAS has been created that integrates the anthropometric character "Jack (TM)" with MIDAS' validated perceptual and attention mechanisms. MIDAS now models multiple simulated humans engaging in goal-related behaviors. New capabilities include the ability to predict situations in which errors and/or performance decrements are likely due to a variety of factors including concurrent workload and performance influencing factors (PIFs). This paper describes a new model that predicts the effects of microgravity on a mission specialist's performance, and its first application to simulating the task of conducting a Life Sciences experiment in space according to a sequential or parallel schedule of performance.
Mabary-Olsen, Elizabeth A.; Litchfield, Ruth E.; Foster, Randal; Lanningham-Foster, Lorraine; Campbell, Christina
Summer 4-H camps present an untapped opportunity for advancement of mission mandates. The project reported here immersed campers in healthy living experiential learning. The goal was to improve self-efficacy and health behaviors related to nutrition and physical activity. Data was collected from enrolled campers through multiple survey tools. A…
KATHLEEN A. MARTIN GINIS; MARK R. LEARY
Self-presentation has been shown to play a role in the performance of a variety of potentially health-damaging behaviors such as substance abuse, exercise avoidance, failing to wear protective sports equipment, and failing to seek medical treatment (Leary, Tchividjian, & Kraxberger, 1994; Martin, Leary, & Rejeski, 2000). Using the two component model of impression management (Leary & Kowalski, 1990) as an
Richard Gist; Vickie Harris Taylor
Recent advances in research and understanding of the behavioral health impacts of an emergency medical service (EMS) career have necessitated reconceptualization of previous approaches to prevention, mitigation, and intervention. Approaches modeled on critical incident stress debriefing have fallen into disfavor due to a growing body of research indicating little if any efficacy for these techniques while suggesting the potential for
Mardia A. Coleman; William Schnapp; Debra Hurwitz; Sabine Hedberg; Linda M. Cabral; Aniko Laszlo; Jay S. Himmelstein
Using MEDLINE and other Internet sources, the authors perform a systematic review of published literature. A total of 109 articles and reports are identified and reviewed that address the development, implementation, outcomes, and trends related to Managed behavioral health care (MBHC). MBHC remains a work in progress. States have implemented their MBHC programs in a number of ways, making interstate
Sallie Anne Newell; Rob William Sanson-Fisher; Afaf Girgis; Heather Maree Davey
Background: Despite the widespread use of written health education materials as interventions, relatively few studies have adequately evaluated the effectiveness of such materials on changing healthcare behaviors in the general population.Setting\\/ Participants: The study consisted of ten matched pairs of small rural towns in New South Wales, Australia, with a total combined population of approximately 25,000 in both the intervention
Johnson, Ping H.
This study examined the priority health behaviors among Chinese youth by administering a questionnaire to 1,917 undergraduates enrolled in three universities in China. The response rate was 89.7%. This survey found that 75.2% of the participants tried cigarettes at least once during their lifetime, over half had their first cigarette and alcoholic…
Kristjansson, Alfgeir Logi; Sigfusdottir, Inga Dora; Allegrante, John P.; Helgason, Asgeir R.
Objectives: To examine the association between health behavior indicators, school contentment, and academic achievement. Methods: Structural equation modeling with 5810 adolescents. Results: Our model explained 36% of the variance in academic achievement and 24% in school contentment. BMI and sedentary lifestyle were negatively related to school…
Porter, Kandice; Johnson, Ping Hu; Petrillo, Jane
This study examined the priority health behaviors of South African youth by administering a questionnaire to 635 undergraduate students enrolled in a large metropolitan university in South Africa. Results indicate that 65.5% of the participants tried cigarettes at least once during their lifetime, over 15.2% had their first cigarette and 31.2% had…
Copeland-Linder, Nikeea; Lambert, Sharon F.; Chen, Yi-Fu; Ialongo, Nicholas S.
This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress…
This response to five excellent commentaries is intended to clarify some issues in research on health behavior change that appear to be ambiguous or con- troversial, such as the debate about stage models versus continuum models or the search for moderators and mediators. The assumption of stages can be useful, but the quest for truly existing stages is considered fruitless
Wiley, David C.; And Others
Using telephone surveys, researchers examined the health behaviors of 1,408 Texas college students. Results indicated that most had consumed alcohol at least once, and nearly one-third were regular smokers. Most were sexually active but did not use condoms. Over half had never received HIV/AIDS education in college. (SM)
Many investigators are considering developing video games for health (video-G4Hs) but have questions about how to get started. This report provides guidance for investigators considering a G4H as a behavioral intervention procedure from a team of experienced G4H developers. Thirteen commonly asked q...
de Groot, Esther; Jaarsma, Debbie; Endedijk, Maaike; Mainhard, Tim; Lam, Ineke; Simons, Robert-Jan; van Beukelen, Peter
Introduction: Better understanding of critically reflective work behavior (CRWB), an approach for work-related informal learning, is important in order to gain more profound insight in the continuing development of health care professionals. Methods: A survey, developed to measure CRWB and its predictors, was distributed to veterinary…
Brouskeli, Vasiliki; Loumakou, Maria
In this study we investigated materialism among future educators and its relationship with stress and a number of health behaviors. Participants were 228 students (Mean = 20.64 years of age, S.D = 2.571) of the Department of Education Sciences in Early Childhood of the University of Thrace, Greece. The instrument consisted of a short form of the…
Eaton, Danice K.; Kann, Laura; Okoro, Catherine A.; Collins, Janet
This study examined the prevalence of selected clinical preventive health services, health status indicators, health risk behaviors, and health-promoting behaviors among adults aged 18 to 24 years in the general U.S. population. The study analyzed data from the 2003 Behavioral Risk Factor Surveillance System. Nearly 30% of young adults lacked…
Smith, Theresa M. Enyeart; Skaggs, Gary E.; Redican, Kerry J.
Research on whether health education, specifically personal health classes affects behavior change is inconclusive. In this study, a sample of students from two large southeastern universities enrolled in a required personal health course and an elective personal health course were administered the National College Health Risk Behavior Survey…
Holden, Kisha; McGregor, Brian; Thandi, Poonam; Fresh, Edith; Sheats, Kameron; Belton, Allyson; Mattox, Gail; Satcher, David
Despite decades of research, recognition and treatment of mental illness and its comorbidities still remain a significant public health problem in the United States. Ethnic minorities are identified as a population that is vulnerable to mental health disparities and face unique challenges pertaining to mental health care. Psychiatric illness is associated with great physical, emotional, functional, and societal burden. The primary health care setting may be a promising venue for screening, assessment, and treatment of mental illnesses for ethnic minority populations. We propose a comprehensive, innovative, culturally centered integrated care model to address the complexities within the health care system, from the individual level, which includes provider and patient factors, to the system level, which includes practice culture and system functionality issues. Our multidisciplinary investigative team acknowledges the importance of providing culturally tailored integrative health care to holistically concentrate on physical, mental, emotional, and behavioral problems among ethnic minorities in a primary care setting. It is our intention that the proposed model will be useful for health practitioners, contribute to the reduction of mental health disparities, and promote better mental health and well-being for ethnic minority individuals, families, and communities. PMID:25383991
Leveton, Lauren B.
This slide presentation reviews the research into the Behavioral Health and Performance (BHP) of the Human Research Program. The program element goal is to identify, characterize and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. To accomplish this goal the program focuses on applied research that is designed to yield deliverables that reduce risk. There are several different elements that are of particular interest: Behavioral Medicine, Sleep, and team composition, and team work. In order to assure success for NASA missions the Human Research Program develops and validate the standards for each of the areas of interest. There is discussion of the impact on BHP while astronauts are on Long Duration Missions. The effort in this research is to create tools to meet the BHP concerns, these prospective tools are reviewed.
Hennessy-Burt, Tamara E; Stoecklin-Marois, Maria T; Meneses-González, Fernando; Schenker, Marc B
In the US, Mexican immigrant women often have better health outcomes than non-Hispanic white women despite a greater health risk profile. This cross-sectional pilot study compared women living in Chavinda, Michoacán (n = 102) to women who had migrated from Mexico to Madera, California (n = 93). The interview gathered information on acculturation and risk behaviors including smoking, alcohol use and number of sexual partners. The results suggest that more acculturated women living in the US are more likely to consume alcohol. US residence and higher acculturation level was marginally associated with having more than one sexual partner. There were no differences between odds of smoking among Chavinda and Madera women. While results with acculturation are not consistently significant due to small sample sizes, the results are suggestive that acculturation among immigrant Hispanic women in the US may be associated with adverse health behaviors, and selective migration seems less likely to account for these differences. PMID:20811952
Seng, Julia S.; Sperlich, Mickey; Low, Lisa Kane
Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed. PMID:18984507
Mainuddin, AKM; Ara Begum, Housne; Rawal, Lal B.; Islam, Anwar; Shariful Islam, SM
Objective: Over the last few decades, Bangladesh has made significant progress towards achieving targets for the Millennium Development Goals (MDGs) and women empowerment. This study is aimed at identifying the levels and patterns of women empowerment in relation to health seeking behavior in Bangladesh. Materials and methods: We conducted a cross-sectional study among 200 rural married women in Cox’s Bazar district in Bangladesh using multi stage sampling technique and face-to-face interview. Data was collected on socio-economic characteristics, proxy indicators for women empowerment in mobility and health seeking behavior related decision making. Bivariate and multivariate regression analyses were performed to identify associations between women empowerment in relation to health seeking behavior on mobility and decision making, controlling the effect of other independent variables. Results: The results showed that only 12% women were empowered to decide on their own about seeking healthcare and 8.5% in healthcare seeking for their children. In multivariate analysis women empowerment in health seeking behavior was higher among age group 25-34 years (OR 1.76, [CI = 0.82-3.21]), women’s education, husband’s education, age at marriage > 18 years (OR 6.38, [CI = 0.98-4.21]) and women’s working status (OR 16.44, [CI = 0.79-2.71]). Conclusion: Women empowerment enhances their decision-making authority regarding health seeking behavior. Acknowledging and adopting the implications of these findings are essential for an integrated health and development strategy for Bangladesh and achieving the MDGs. PMID:26175761
Mas, Francisco Soto; Mein, Erika; Fuentes, Brenda; Thatcher, Barry; Balcázar, Héctor
Adult Hispanic immigrants are at a greater risk of experiencing the negative outcomes related to low health literacy, as they confront cultural and language barriers to the complex and predominately monolingual English-based U.S. health system. One approach that has the potential for simultaneously addressing the health, literacy, and language needs of Hispanics is the combination of health literacy and English as a second language (ESL) instruction. The purpose of the project was to evaluate the feasibility of using ESL instruction as a medium for improving health literacy among Hispanic immigrants. Objectives included the development, implementation, and evaluation of an interdisciplinary health literacy/ESL curriculum that integrates theories of health literacy and health behavior research and practice, sociocultural theories of literacy and communication, and adult learning principles. This article describes the curriculum development process and provides preliminary qualitative data on learners’ experiences with the curriculum. Results indicate that the curriculum was attractive to participants and that they were highly satisfied with both the format and content. The curriculum described here represents one example of an audience-centered approach designed to meet the specific health and literacy needs of the Hispanic population on the U.S.–Mexico border. The combination of ESL and health literacy contributed to a perceived positive learning experience among participants. Interdisciplinary approaches to health literacy are recommended. PMID:22982707
Chou, Chiu-Fang; Johnson, Pamela Jo
Objective To examine whether health status and obesity prevalence differ by race or ethnicity and health care workforce category. Methods Data representing US health care workers aged 20 to 64 between 1982 and 2004 were retrieved from the Integrated Health Interview Series. Trends, as well as disparities, in health status and obesity are examined by workforce category using logistic regression. Results Self-reported health status of health care workers has declined over time and the prevalence of obesity is rising. Moreover, there is a clear social gradient across workforce categories, which is widening over time. Within workforce categories, there are significant racial disparities in health status and prevalence of obesity. Conclusions Health of health care workers needs to be taken into account when setting policies intended to increase access to health care and create a healthy diverse workforce. PMID:18545097
Berk, Justin; Mills, Brooke; Varma, Surendra
The goal of this article is to assess the need for health maintenance intervention programs directed at physicians and patients. We compared the health maintenance behavior compliance of physicians (as patients) to a control patient population. An online survey was sent to the Texas Tech University Health Sciences Center (TTUHSC) medical school clinical and nonclinical basic science faculties and to the non-TTUHSC clinicians of the local county medical society. The survey included questions regarding basic demographics and recent participation in regular health maintenance strategies including annual checkup, influenza vaccination, colonoscopy, Pap smear, and mammogram. Logistic regressions were conducted to determine if being a physician had a significant association with the likelihood of participating in the health maintenance behavior outcomes listed above. This article shows that physicians are less likely than the general population to adhere to specific health maintenance guidelines: namely, annual checkups, colonoscopies, and mammograms. Pap smear rates did not differ between physicians and a control population, but physicians showed an increased likelihood of receiving an influenza vaccine. PMID:25504354
de Rezende, Leandro Fornias Machado; Rodrigues Lopes, Maurício; Rey-López, Juan Pablo; Matsudo, Victor Keihan Rodrigues; Luiz, Olinda do Carmo
Objective 1) To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2) To assess the methodological quality of the systematic reviews found. Methodology/Principal Findings Medline; Excerpta Medica (Embase); PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers. Conclusions This overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted. PMID:25144686
White-Traut, Rosemary; Rankin, Kristin M; Pham, Thao; Li, Zhuoying; Liu, Li
Preterm infants are challenged by immature infant behavioral organization which may negatively influence their ability to oral feed. The purpose of this study was to determine whether the integrated H-HOPE (Hospital to Home: Optimizing the Infant's Environment) intervention would improve infant behavioral organization by increasing the frequency of orally directed behaviors and the proportion of time spent in an alert behavioral state when offered prior to oral feeding. Mother-infant dyads (n=198) were randomly assigned to the H-HOPE intervention or the Attention Control groups. Infants were born at 29-34 weeks gestation and were clinically stable. Mothers had at least two social environmental risk factors such as minority status or less than high school education. H-HOPE is an integrated intervention that included (1) twice-daily infant directed stimulation using the ATVV intervention (auditory, tactile, visual, and vestibular stimuli) and (2) maternal participatory guidance sessions by a nurse-community advocate team. Orally directed behaviors and behavioral states were assessed weekly prior to feeding during hospitalization when infants were able to feed orally. There were no differences between the groups at baseline (Day 0, prior to the initiation of the integrated H-HOPE intervention). We observed a pattern of increased frequency of orally directed behaviors in the H-HOPE intervention group when compared to the Attention Control group, however, the proportion of time spent in an alert behavioral state remained stable in both groups over the course of the study. On Day 7, the H-HOPE intervention group exhibited a significantly higher mean frequency of orally directed behaviors than the Attention Control group (12.6 vs. 7.1 pre-intervention, 51.8 vs. 33.2 during intervention, 4.3 vs. 3.2 immediately after intervention, and 8.9 vs. 5.3 immediately prior to feeding). On Day 7, the H-HOPE intervention group exhibited a significantly higher proportion of time spent in an alert behavioral state only during intervention (0.26 vs. 0.11) and immediately after intervention (0.28 vs. 0.06). These findings are suggestive that the integrated H-HOPE intervention facilitated infant behavioral organization for clinically stable infants born between 29 and 34 weeks gestation. The orally directed behaviors appear to be an important indicator of the infant's preparation for feeding, and when used in conjunction with assessment of behavioral states, are especially valuable to the clinician. Use of this combined assessment approach in practice would strengthen clinician assessment for initiation of (beginning the first oral feeding) and daily preparation for oral feeding in preterm infants. PMID:25189523
Gibbons, Frederick X.; Kingsbury, John H.; Weng, Chih-Yuan; Gerrard, Meg; Cutrona, Carolyn; Wills, Thomas A.; Stock, Michelle
Objective Prospective data tested a “differential mediation” hypothesis: The relations (found in previous research) between perceived racial discrimination and physical health status versus health-impairing behavior (problematic substance use) are mediated by two different types of affective reactions, internalizing and externalizing. Methods The sample included 680 African American women from the Family and Community Health Study (M age = 37 at Time 1; 45 at Time 4). Four waves of data were analyzed. Perceived discrimination was assessed, along with anxiety and depression (internalizing) and hostility / anger (externalizing) as mediators, and physical health status and problematic substance use (drinking) as outcomes. Results Structural equation modeling indicated that discrimination predicted increases in both externalizing and internalizing reactions. These affective responses, in turn, predicted subsequent problematic substance use and physical health status, respectively, also controlling for earlier reports. In each case, the indirect effects from discrimination through the affective mediator to the specific health outcome were significant and consistent with the differential mediation hypothesis. Conclusion Perceived racial discrimination is associated with increases in internalizing and externalizing reactions among Black women, but these reactions are related to different health outcomes. Changes in internalizing are associated with self-reported changes in physical health status, whereas changes in externalizing are associated with changes in substance use problems. Discussion focuses on the processes whereby discrimination affects health behavior and physical health status. PMID:24417690
Pronk, Nicolaas P.
Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747
Morgan, Richard K., E-mail: email@example.com
Health has always had a place in wider impact assessment activities, from the earliest days of the National Environmental Policy Act in the United States. However, early thinking tended to focus on health protection and environmental health issues, especially in relation to the effects of pollution. The adoption of wider models of health was reflected in impact assessment circles from the early 1990s, with particular emphasis on an integrated approach to impact assessment, especially at the project level, which would see health impact assessment benefiting from working with other forms of impact assessment, such as social and ecological. Yet twenty years later, integration still seems a distant prospect in many countries. In this paper I examine the case for integrating health considerations within the wider IA process, discuss some of the problems that have historically restricted progress towards this end, and explore the degree to which impact assessment practitioners have been successful in seeking to improve the consideration of health in IA. In New Zealand, project-level impact assessment is based on an integrated model under the Resource Management Act. In addition, HIA was recognised in the early 1990s as a valuable addition to the toolkit for project assessment. Since then policy-level HIA has grown supported by extensive capacity building. If health is being integrated into wider impact assessment, it should be happening in New Zealand where so many enabling conditions are met. Three major project proposals from New Zealand are examined, to characterise the broad trends in HIA development in New Zealand in the last ten years and to assess the degree to which health concerns are being reflected in wider impact assessments. The findings are discussed in the context of the issues outlined in the early part of the paper.
of civil aviation safety authority require- ments. Typical composites damage mechanisms, which make and PWAS-tuning effects. The paper presents a number of experimental results for damage detection in simple to impact damage, due to the relatively thin composite skins and the generally brittle behavior of carbon
Lovallo, William R.
Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor health behaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes. PMID:23085387
Factors Modeling Methods to Ambulatory Care Sventlana Z. Lowry Mala Ramaiah Emily S. Patterson David Brick Modeling Methods to Ambulatory Care Svetlana Z. Lowry Mala Ramaiah Information Access Division Information Care IT, Center for Health IT American Academy of Family Physicians Jason M. Mitchell, M.D., Medical
Robinson, Thomas N.; Walters, Paul A.
Computer-based health education has been employed in many settings. However, data on resultant behavior change are lacking. A randomized, controlled, prospective study was performed to test the efficacy of Stanford Health-Net in changing community health behaviors. Graduate and undergraduate students (N=1003) were randomly assigned to treatment and control conditions. The treatment group received access to Health-Net, a health promotion computer network emphasizing specific self-care and preventive strategies. Over a four month intervention period, 26% of the treatment group used Health-Net an average of 6.4 times each (range 1 to 97). Users rated Health-Net favorably. The mean number of ambulatory medical visits decreesed 22.5% more in the treatment group than in the control group (P<.05), while hospitalizations did not differ significantly between groups. In addition, perceived self-efficacy for preventing the acquisition of a STD and herpes increased 577% (P<.05) and 261% (P<.01) more, respectively, in the treatment group than in the control group. These findings suggest that access to Stanford Health-Net can result in significant health behavior change. The advantages of the network approach make it a potential model for other communities.
M. G. Ory; P. J. Jordan; T. Bazzarre
The Behavior Change Consortium (BCC), a col- lective 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 popula- tions to reduce tobacco dependence, and improve physical activity, nutrition and other health behaviors. The purpose of this article is to provide a general introduction
Albert J. Bellg; Belinda Borrelli; Barbara Resnick; Jacki Hecht; Daryl Sharp Minicucci; Marcia Ory; Gbenga Ogedegbe; Denise Orwig; Denise Ernst; Susan Czajkowski
Treatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. This article describes a multisite effort by the Treatment Fidelity Workgroup of the National Institutes of Health Behavior Change Consortium (BCC) to identify treatment fidelity concepts and strategies in health behavior intervention research. The work group reviewed treatment fidelity practices in
Cooper, Shauna M; Guthrie, Barbara
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. PMID:17149030
Knowles, David William
) System July 2013 Revision 8 Lawrence Berkeley National Laboratory #12;Work performed under the auspices of the U.S. Department of Energy by the University of California, Lawrence Berkeley National Laboratory, under Contract DE-AC02-05CH11231 #12;Lawrence Berkeley National Laboratory PUB-3140 Integrated Safety
David, H P
Surveying experience with incentives, disincentives, and integrated community development approaches in selected Asian countries, this overview defines concepts, notes policy trends, and discusses ethical and legal constraints, psychosocial and socioeconomic aspects, and cultural-environmental influences on reproductive behavior. Major emphasis is on experience reported from China, India, Indonesia, Korea, Philippines, Singapore, and Thailand. Findings to date suggest that, to be successful, programs using incentives, disincentives, and integrated community development approaches will have to be formulated as consistent, clearly defined, and well-communicated policies, responsive to development needs and sensitive to local autonomy and values, with dynamic leadership to obtain and nurture continued policy backing. PMID:7101362
England, Elizabeth; Lester, Helen
Abstract Purpose The purpose of this paper is to examine the effects of health care policy on the development of integrated mental health services in England. Data sources Drawing largely from a narrative review of the literature on adult mental health services published between January 1997 and February 2003 undertaken by the authors, we discuss three case studies of integrated care within primary care, secondary care and across the primary/secondary interface for people with serious mental illness. Conclusion We suggest that while the central thrust of a raft of recent Government policies in England has been towards integration of different parts of the health care system, policy waterfalls and implementation failures, the adoption of ideas before they have been thoroughly tried and tested, a lack of clarity over roles and responsibilities and poor communication have led to an integration rhetoric/reality gap in practice. This has particular implications for people with serious mental health problems. Discussion We conclude with suggestions for strategies that may facilitate more integrated working. PMID:16773165
Craig Anne Heflinger; Denine A. Northrup
Capitated managed care contracts for behavioral health services are becoming more prevalent across the country in both public and private sectors. This study followed the transition from a demonstration project for child mental health services to a capitated managed behavioral health care contract with a for-profit managed care company. The focus of the study was on the impact—at both the
Alegría, Margarita; Cook, Benjamin; Loder, Stephen; Doonan, Michael
Massachusetts is in the midst of a demographic shift that will leave the state with unprecedented ethnic, racial and cultural diversity. In light of this change, health care services in the Commonwealth need to respond to and serve an increasingly multicultural population. The time is now for bold initiatives to reduce behavioral health and health service disparities by building collaborations between policymakers, insurers/payers, provider organizations, training institutions, and community groups. In the same way collaboration among diverse stakeholders enabled the Commonwealth to lead the nation in achieving near universal access to health insurance, a new collaboration can pave the way for the elimination of behavioral health and health care disparities. This brief compiles current information on racial and ethnic disparities in mental health and substance use disorders and treatment disparities in Massachusetts. It concludes with state level policy recommendations. The Brief does not recommend policies already in motion, such as moving to universal insurance coverage, enforcement of parity laws, policies to expand coverage of drug treatment services or greater inclusion of consumers in the development and configuration of behavioral health services. Recommendations offered are based on best practices and evidence-based research. Most research, however, studies incremental changes. To transform rather than reform the system, we integrate consideration of experience and research from other policy areas. The ultimate goal is to generate an action plan that motivates policymakers to address persistent racial and ethnic disparities in the availability and quality of behavioral health services in the Commonwealth. PMID:25911768
McConnell, K John; Wallace, Neal T; Gallia, Charles A; Smith, Jeanene A
Objective To determine the extent to which the elimination of behavioral health benefits for selected beneficiaries of Oregon's Medicaid program affected general medical expenditures among enrollees using outpatient mental health and substance abuse treatment services. Data Source/Study Setting Twelve months of claims before and 12 months following a 2003 policy change, which included the elimination of the behavioral health benefit for selected Oregon Medicaid enrollees. Study Design We use a difference-in-differences approach to estimate the change in general medical expenditures following the 2003 policy change. We compare two methodological approaches: regression with propensity score weighting; and one-to-one covariate matching. Principal Findings Enrollees who had accessed the substance abuse treatment benefit demonstrated substantial and statistically significant increases in expenditures. Individuals who accessed the outpatient mental health benefit demonstrated a decrease or no change in expenditures, depending on model specification. Conclusions Elimination of the substance abuse benefit led to increased medical expenditures, although this offset was still smaller than the total cost of the benefit. In contrast, individuals who accessed the outpatient mental health benefit did not exhibit a similar increase, although these individuals did not include a portion of the Medicaid population with severe mental illnesses. PMID:18384360
Zismer, Daniel K; Werner, Mark J
The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles presented here are necessary as a complete recipe. Leaders of health systems moving toward integration are cautioned to apply the recipe in full. This article ends with two questions. First, if not an integrated model of health care, what's the alternative? Since it seems clear that many of the existing community-based models are excessively fragmented and inefficient, especially in a reforming U.S. health care marketplace, is there a new model that is superior to the integrated models and, if so, what is it and what are its functional principles? The second question: Is there more than one functional form of integration? This article argues for the most integrated form. Others would argue that clinical integration is sufficient,'s and full integration isn't required. The stability, durability and adaptability of the fully integrated models have, arguably, been tested. The lesser integrated models remain to be proven in an unstable health care marketplace seeking higher levels of economic efficiency. PMID:23888674
Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration. PMID:25636041
King, Miriam L
The U.S. National Health Interview Survey (NHIS) is the world's longest survey time series of health data and a rich source of information on health conditions, behaviors, and care from the 1960s to the present. NHIS public-use files are difficult to use for long-term analysis, due to complex file structure, changes in questionnaire content, and evolving variable names and coding schemes. Researchers at the Minnesota Population Center have created the Integrated Health Interview Series (IHIS) to overcome these problems. IHIS provides access to thousands of consistently coded and well-documented NHIS variables on the Internet and makes it easy to analyze health trends and differentials. IHIS multiplies the value of NHIS data by allowing researchers to make consistent comparisons over half a century and thus to study U.S. health status as a dynamic process. This article describes the main features of IHIS and suggests fruitful avenues for historical research using these invaluable health data. PMID:21935261
Zin, Thi Thi; Tin, Pyke; Hama, Hiromitsu; Toriu, Takashi
In this paper, we propose an integrated framework for detecting suspicious behaviors in video surveillance systems which are established in public places such as railway stations, airports, shopping malls and etc. Especially, people loitering in suspicion, unattended objects left behind and exchanging suspicious objects between persons are common security concerns in airports and other transit scenarios. These involve understanding scene/event, analyzing human movements, recognizing controllable objects, and observing the effect of the human movement on those objects. In the proposed framework, multiple background modeling technique, high level motion feature extraction method and embedded Markov chain models are integrated for detecting suspicious behaviors in real time video surveillance systems. Specifically, the proposed framework employs probability based multiple backgrounds modeling technique to detect moving objects. Then the velocity and distance measures are computed as the high level motion features of the interests. By using an integration of the computed features and the first passage time probabilities of the embedded Markov chain, the suspicious behaviors in video surveillance are analyzed for detecting loitering persons, objects left behind and human interactions such as fighting. The proposed framework has been tested by using standard public datasets and our own video surveillance scenarios.
Ahn, H G
This study attempted to identify the factors related to health behavior and the degree of health practice among the employee of security investment companies in Pusan. The survey data used in the study were collected from 203 white collar employee in 21 companies. The factors considered in the health behavior and the degree of health practice were selected from Pender's model of health promoting behavior and Backer's model of health preventive behavior model. The major findings of the study could be summarized as followings: 1. The most closely associated factors with health behavior were identified as perceived control of disease (r = .393), importance of health (r = .350), pattern of family health care (r = .302), and options of health promotion (r = .215). 2. The study explored that the most closely related factors to the degree of health care practice were annual physical examination and the control of illegal and habitual drug in order. Other behaviors such as hand washing at each return to home, avoidance of indirect smoking, no exchange of glasses, regular exercise, stop or reduction of drinking and smoking, control of high cholesterol food were identified as less effective in the health promotion. 3. The most important factors associated with the less effective behaviors for health promotion were identified as their laziness in continuous practice and the limited time for their habituation. 4. The most important agent contributing to the knowledge and practice of health was identified as mass media. PMID:7953878
Garfield, Rachel L; Beardslee, William R; Greenfield, Shelly F; Meara, Ellen
The Children's Health Insurance Program (CHIP) plays a vital role in financing behavioral health services for low-income children. This study examines behavioral health benefit design and management in separate CHIP programs on the eve of federal requirements for behavioral health parity. Even before parity implementation, many state CHIP programs did not impose service limits or cost sharing for behavioral health benefits. However, a substantial share of states imposed limits or cost sharing that might hinder access to care. The majority of states use managed care to administer behavioral health benefits. It is important to monitor how states adapt their programs to comply with parity. PMID:21461975
Jacobs, Angeline Marchese; And Others
Part of a three-volume document, this volume is concerned with providing source data about the activities of mental health nursing personnel as these activities relate to patient care, and contains abstracts of more than 4,000 critical behaviors of psychiatric nurses in 50 psychiatric hospitals, general hospitals with psychiatric units, and…
Jacobs, Angeline Marchese; And Others
Part of a three-volume document, this volume is concerned with providing source data about the activities of mental health nursing personnel as the activities relate to patient care and contains abstracts of more than 4,000 critical behaviors of psychiatric attendants in 50 psychiatric hospitals, general hospitals with psychiatric units, and…
Heo, Seulkee; Lee, Jong-Tae
We have investigated the usefulness of environmental health indicators for the evaluation of environmental health in Korea. We also assessed the association between environmental contamination and health outcomes by integrating indicators into a composite measure. We selected health-related environmental indicators and environment-related health status indicators. The data were obtained from published statistical data from the period 2008–2009. Both synthesized measures of environmental indicators and health status indicators were calculated using Strahll’s taxonometric methods. The range of values determined by this method is 0–1, with higher values representing a better situation in the given area. The study area consisted of 16 large administrative areas within Korea. The arithmetic mean of the synthesized measure of environmental indicators was 0.348 (SD = 0.151), and that of the synthesized measure of health status indicators was 0.708 (SD = 0.107). The correlation coefficient between the synthesized measures of environmental indicators and health status indicators was 0.69 (95% CI: 0.28–0.88). Comparisons between local communities based on integrated indicators may provide useful information for decision-makers, allowing them to identify priorities in pollutant mitigation policies or in improvement actions for public health. Integrated indicators are also useful to describe the relationships between environmental contamination and health effects. PMID:23892549
Poltavski, Dmitri; Holm, Jeffrey; Vogeltanz-Holm, Nancy; McDonald, Leander
Associations of behavioral health risks and healthy behaviors with self-reported health-related quality of life measures were investigated in a Northern Plains American Indian sample. Participants were surveyed in person using the Behavioral Risk Factor Surveillance Survey. The results showed that regular physical activity was significantly…
Teresa J. Sakraida; Jessica D'Amico; Erica Thibault
This article describes considerations in health and behavioral sciences small grant management and describes lessons learned during post-award implementation. Using the components by W. Sahlman [Sahlman, W. (1997). How to write a great business plan. Harvard Business Review, 75(4), 98–108] as a business framework, a plan was developed that included (a) building relationships with people in the research program and
Buday, Richard; Thompson, Debbe; Lyons, Elizabeth J.; Lu, Amy Shirong; Baranowski, Janice
Abstract Many investigators are considering developing videogames for health (video-G4Hs) but have questions about how to get started. This report provides guidance for investigators considering a G4H as a behavioral intervention procedure from a team of experienced G4H developers. Thirteen commonly asked questions are answered, including defining a G4H, considerations in developing a team, considerations in G4H design, and anticipating unintended consequences. PMID:24443708
The health medical costs of colorectal cancer are increasingly higher in Taiwan. The National Health Insurance Administration (NHI) and The Health Promotion Administration of the Ministry of Health and Welfare (MOHW) in Taiwan encourage individuals to adopt an earnest approach to healthy behavior through advocacy advertising. However, the number of colorectal cancer patients continues to increase annually. Our study explored the effects of health-related advertisements (ads) on healthy behavior intentions as influenced by regulatory focus theory (RFT) and construal level theory (CLT). We conducted an experiment with different public health advocacy ads. A 2 (regulatory focus: promotion vs. prevention) × 2 (temporal distance: one month vs. one year) × 2 (graphics-text ratio: more pictures and less text vs. fewer pictures and more text) three-factor experiment was adopted. The multiple analysis of variance (MANOVA) results revealed that ads with higher construal levels (i.e., more text) had greater effects with a promotion-oriented regulatory focus. However, no significant differences were found in either attitude toward the ads or behavior intention when the regulatory focus was prevention. In addition, according to the young testers and those who were psychologically distant from colorectal cancer, different temporal distances and different construal levels had no statistically significantly effects on attitudes toward advertising or on behavior intentions. The results revealed that viewers found the information easier to understand when the ads triggered the regulatory focuses of the viewers and applied an appropriate graphics-text ratio, which resulted in favorable health-related advertising effectiveness. Thus, we provide two suggestions regarding the use of health-related advertising for MOHW in the future. PMID:25826394
Foti, Kathryn; Balaji, Alexandra; Shanklin, Shari
Background: To monitor priority health risk behaviors and school health policies and practices, respectively, the Centers for Disease Control and Prevention (CDC) developed the Youth Risk Behavior Surveillance System (YRBSS) and the School Health Profiles (Profiles). CDC is often asked about the use and application of these survey data to improve…
Campbell, Thomas A.; Auerbach, Stephen M.; Kiesler, Donald J.
Objective: The authors' aim was to evaluate patient-provider relationships in a college health center. Participants: Eighty student patients and their health-care providers. Methods: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before…
Meredith B. Rosenthal; Sarah Minden; Ronald Manderscheid; Marilyn Henderson
The evolution of behavioral health care financing and delivery has led to a wide variety of arrangements connecting consumers to behavioral health services. In this paper, we present a typology based on three distinguishing features of behavioral health arrangements along which there is a high degree of variability and this variability has been shown to affect the cost and quality
Costakis, Catherine E.; Dunnagan, Tim; Haynes, George
Examined whether stages of exercise adoption were associated with the practice of other health behaviors. Surveys of university employees examined demographics, health behavior, and stages of change. Results indicated that stage of exercise adoption was predictive of three out of five health behaviors. Encouraging individuals to think about…
Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of o...
Krist, Alex H.; Phillips, Siobhan M.; Sabo, Roy T.; Balasubramanian, Bijal A.; Heurtin-Roberts, Suzanne; Ory, Marcia G.; Johnson, Sallie Beth; Sheinfeld-Gorin, Sherri N.; Estabrooks, Paul A.; Ritzwoller, Debra P.; Glasgow, Russell E.
PURPOSE Guidelines recommend screening patients for unhealthy behaviors and mental health concerns. Health risk assessments can systematically identify patient needs and trigger care. This study seeks to evaluate whether primary care practices can routinely implement such assessments into routine care. METHODS As part of a cluster-randomized pragmatic trial, 9 diverse primary care practices implemented My Own Health Report (MOHR)—an electronic or paper-based health behavior and mental health assessment and feedback system paired with counseling and goal setting. We observed how practices integrated MOHR into their workflows, what additional practice staff time it required, and what percentage of patients completed a MOHR assessment (Reach). RESULTS Most practices approached (60%) agreed to adopt MOHR. How they implemented MOHR depended on practice resources, informatics capacity, and patient characteristics. Three practices mailed patients invitations to complete MOHR on the Web, 1 called patients and completed MOHR over the telephone, 1 had patients complete MOHR on paper in the office, and 4 had staff help patients complete MOHR on the Web in the office. Overall, 3,591 patients were approached and 1,782 completed MOHR (Reach = 49.6%). Reach varied by implementation strategy with higher reach when MOHR was completed by staff than by patients (71.2% vs 30.2%, P <.001). No practices were able to sustain the complete MOHR assessment without adaptations after study completion. Fielding MOHR increased staff and clinician time an average of 28 minutes per visit. CONCLUSIONS Primary care practices can implement health behavior and mental health assessments, but counseling patients effectively requires effort. Practices will need more support to implement and sustain assessments. PMID:25384814
Ting, Laura; Jacobson, Jodi M.; Sanders, Sara
Research indicates that mental health social workers risk being confronted with fatal and nonfatal client suicidal behaviors during professional practice. Although reactions to client suicidal behavior have been documented, there is little empirical evidence about coping behaviors and available supports following client suicidal behavior. This…
Kerber, Cindy H; Hickey, Kari L; Astroth, Kim M; Kim, MyoungJin
The proliferation of lotteries and casinos has led to increased participation in gambling. Older adults who have opportunities to gamble may be vulnerable to gambling problems, and incarcerated older adults may be the most vulnerable. Furthermore, research has linked decreased health to gambling problems. This study compared perceived health and gambling problems among 43 incarcerated older adults from two county jails in the midwestern United States. Results from the South Oaks Gambling Screen indicated 48.83% of the sample scored in the problem or pathological range. Short Form-36 results were compared with U.S. norms for ages 55 to 64 and showed significantly lower perceived health scores on Role-Physical, Bodily Pain, Mental Health, Social Functioning, and Role-Emotional subscales. The problem and pathological gamblers showed significantly lower social functioning than the recreational gamblers. Assessment of health conditions and gambling behaviors is important for quantifying current and anticipated burdens of these conditions on correctional health care systems and the community. PMID:22801820
Merrill, Ray M; Aldana, Steven G; Pope, James E; Anderson, David R; Coberley, Carter R; Whitmer, R William
The objective of this study is to identify the contribution that selected demographic characteristics, health behaviors, physical health outcomes, and workplace environmental factors have on presenteeism (on-the-job productivity loss attributed to poor health and other personal issues). Analyses are based on a cross-sectional survey administered to 3 geographically diverse US companies in 2010. Work-related factors had the greatest influence on presenteeism (eg, too much to do but not enough time to do it, insufficient technological support/resources). Personal problems and financial stress/concerns also contributed substantially to presenteeism. Factors with less contribution to presenteeism included physical limitations, depression or anxiety, inadequate job training, and problems with supervisors and coworkers. Presenteeism was greatest for those ages 30-49, women, separated/divorced/widowed employees, and those with a high school degree or some college. Clerical/office workers and service workers had higher presenteeism. Managers and professionals had the highest level of presenteeism related to having too much to do but too little time to do it, and transportation workers had the greatest presenteeism because of physical health limitations. Lowering presenteeism will require that employers have realistic expectations of workers, help workers prioritize, and provide sufficient technological support. Financial stress and concerns may warrant financial planning services. Health promotion interventions aimed at improving nutrition and physical and mental health also may contribute to reducing presenteeism. PMID:22856386
Park, Grace; Miller, Diane; Tien, George; Sheppard, Irene; Bernard, Michael
Background A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased). Conclusion Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients. PMID:24648834
Objective. Although the impact of widowhood on the surviving spouse’s health has been widely documented, there is little empirical research examining whether certain spousal choice decisions and marital sorting patterns predispose individuals to be more vulnerable to the adverse consequences of widowhood for health. Design and Method. We use data from the Wisconsin Longitudinal Study and employ ordinary least squares models to (a) document variations in mental and physical health between married and widowed persons, (b) determine whether widowed persons in age heterogamous unions are especially vulnerable to the adverse consequences of widowhood, and (c) investigate to what extent differential selection, marital quality, and health practices account for health disparities by marital status and the spousal age gap. Results. Widowed persons, especially those in age heterogamous unions, have worse mental health than married persons, but they do not seem to be more disadvantaged in terms of physical health. Differential selection, marital quality, and health behaviors partly account for some of the health disparities by marital status and spousal age gap. Discussion. Our findings suggest that marrying a spouse who is very dissimilar in age may enhance one’s vulnerability to the adverse consequences of widowhood for health. PMID:24128991
Schneiderman, Neil; Ironson, Gail; Siegel, Scott D.
Stressors have a major influence upon mood, our sense of well-being, behavior, and health. Acute stress responses in young, healthy individuals may be adaptive and typically do not impose a health burden. However, if the threat is unremitting, particularly in older or unhealthy individuals, the long-term effects of stressors can damage health. The relationship between psychosocial stressors and disease is affected by the nature, number, and persistence of the stressors as well as by the individual’s biological vulnerability (i.e., genetics, constitutional factors), psychosocial resources, and learned patterns of coping. Psychosocial interventions have proven useful for treating stress-related disorders and may influence the course of chronic diseases. PMID:17716101
The Two-Day CERC-BEE Forum on Building Integrated Design and Occupant Behavior: Presentations and discussions at the two-day CERC-BEE Forum on Building Integrated Design and Occupant Behavior for High employer. #12;2013 CERC-BEE Forum on Human Behavior and Integrated Design for High Performance Buildings
transistors, statistical i-nodeling techniques for integrated circuits, statistical behavioral modeling of analog functional blocks, and finally statistical behavioral system level modeling and simulation. A full statistical model for the behavioral parameters...
Leistikow, Bruce N.
1 Syllabus SPH 222: Social and Behavioral Aspects of Public Health Winter Quarter, 2011 Instructor: Diana Cassady, DrPH Associate Professor Department of Public Health Sciences Class time and location is Behavioral Sciences? MPH Competencies for Behavioral Sciences The social and behavioral sciences in public
Soe, Minn M; Swanson, Mark E; Bolen, Julie C; Thibadeau, Judy K; Johnson, Natalie
AIM Persons with spina bifida who adopt unhealthy lifestyles could be at increased risk of adverse health outcomes because the presence of spina bifida may magnify this risk. We estimated overall and age-specific prevalence of selected health risk behaviors (HRBs) in young people with spina bifida and examined the association between HRBs and depression. METHOD We performed analyses on data obtained from individuals with spina bifida (n=130; mean age 23y SD 4y 5mo; 64 males, 66 females; 64% lumbosacral lesion; 77% with shunt) who participated in a population-based survey conducted by the Arkansas Spinal Cord Commission in 2005. RESULTS Compared with national estimates, young people with spina bifida tend to eat less healthy diets, do less exercise, and engage inmore sedentary activities. Respondents were less likely to use substances (alcohol, tobacco, illegal drugs), which peaked among 25 to 31 year olds. About 90% saw a doctor in the previous year. Nearly one half reported mild or major depressive symptoms. In the logistic regression analysis after controlling for potential confounders (age, sex, ethnic group, education, employment, marital status, living arrangement, level of lesion, presence of shunt, mobility, self-rated health and healthcare utilization), major depressive symptoms were associated with current alcohol drinking (adjusted odds ratio: 4.74; 95% CI 1.18–19.04). INTERPRETATION Young adults with spina bifida exhibit unhealthy behaviors that continue into their late 20s. The findings highlight the need to increase awareness of their health risk profiles in the spina bifida community and show opportunities for mental health and health risk screening and counseling by healthcare providers. PMID:22937873
Cartland, Jenifer; Ruch-Ross, Holly S.
Relatively little is known about risk behaviors of elementary school children. A recent evaluation of a comprehensive school health education curriculum provided an opportunity to survey elementary school children about their perceived health status, knowledge, attitudes, health self-efficacy, and health and risk behaviors. For the evaluation, a…
Domino, ME; Maxwell, J; Cody, M; Cheal, K; Busch, A; Stone, WW Van; Cooley, SG; Zubtritsky, C; Estes, CL; Shen, Y; Lynch, M; Grantham, S; Wohlford, P; Aoyama, MC; Fitzpatrick, J; Zaman, S; Dodson, J; Levkoff, SE
We compared the healthcare costs associated with an integrated care model to an enhanced referral model for the treatment of depression, anxiety, and at-risk drinking from the randomized Primary Care Research in Substance Abuse and Mental Health for the Elderly study. We examined total healthcare costs and cost components, separately for Veteran’s Affairs and non-VA participants. No differences in total health expenditures were detected between study arms. No differences in behavioral health expenditures were detected for non-VA sites, but the VA integrated arm had slightly higher ($38; p<0.05) behavioral health costs. Differences in other types of services use were detected. PMID:19777089
Schnell, Bettina; Weir, Peter T; Roth, Eatai; Fairhall, Adrienne L; Dickinson, Michael H
Sensory feedback is a ubiquitous feature of guidance systems in both animals and engineered vehicles. For example, a common strategy for moving along a straight path is to turn such that the measured rate of rotation is zero. This task can be accomplished by using a feedback signal that is proportional to the instantaneous value of the measured sensory signal. In such a system, the addition of an integral term depending on past values of the sensory input is needed to eliminate steady-state error [proportional-integral (PI) control]. However, the means by which nervous systems implement such a computation are poorly understood. Here, we show that the optomotor responses of flying Drosophila follow a time course consistent with temporal integration of horizontal motion input. To investigate the cellular basis of this effect, we performed whole-cell patch-clamp recordings from the set of identified visual interneurons [horizontal system (HS) cells] thought to control this reflex during tethered flight. At high stimulus speeds, HS cells exhibit steady-state responses during flight that are absent during quiescence, a state-dependent difference in physiology that is explained by changes in their presynaptic inputs. However, even during flight, the membrane potential of the large-field interneurons exhibits no evidence for integration that could explain the behavioral responses. However, using a genetically encoded indicator, we found that calcium accumulates in the terminals of the interneurons along a time course consistent with the behavior and propose that this accumulation provides a mechanism for temporal integration of sensory feedback consistent with PI control. PMID:24706794
Park, Byung-Ha; Lee, Moo-Sik; Hong, Jee-Young; Bae, Seok-Hwan; Kim, Eun-Young; Kim, Kwang-Kee; Kim, Dae-Kyoung
This research aims to verify whether it is possible to explain the health-promoting behaviors based on sociodemographic characteristics by integrating the theory of planned behavior (TPB) proposed by Ajzen in 1988 and the transtheoretical model (TTM) proposed by Prochaska and DiClemente in 1983. In particular, the aim was to verify whether the variables of the TPB can properly distinguish the stages of change in exercise in the proposed integrated model and to figure out how attitude, subjective norm, perceived behavior control, influence, and intention-can explain the stages of change in exercise. Investigators who have taken previous training for the survey visited and interviewed 3658 people older than 30 years in the chosen town by multistage sampling method from July 27 to July 31, 2003. After the exclusion of inappropriate data out of 760 participants, only data from 584 participants were used for this research. chi2 test, t test, and 1-way analysis of variance were used to identify the difference between the distribution of the stages of change in exercise and the variables of the means. A discriminant analysis to verify the accuracy of the stages of change in exercise by means of the variables of the TPB and a path analysis to verify the fit of the integrated model were also used. The variables of the TPB were useful to satisfactorily distinguish and predict the stages of change in exercise. But to clarify the validity of this model, more diversified research should be conducted in the future, and the results must be accumulated. PMID:19124338
Patricia A Cirone; P Bruce Duncan
The interconnections between ecosystems, human health and welfare have been increasingly recognized by the US government, academia, and the public. This paper continues this theme by addressing the use of risk assessment to integrate people into a single assessment. In a broad overview of the risk assessment process we stress the need to build a conceptual model of the whole
Flagle, C D
This paper presents a personal view of the development of integrated, comprehensive health-care systems in the United States. The influence of Federal legislation is described, beginning with the 1950-60s policy objective of Hill-Burton Program administrators to create a number of community-based regional medical centers, each consisting of a range of health services organized by and around community hospitals. Later variations of the concept appeared in such programs as Medicare-Medicaid, Comprehensive Health Planning, the Regional Medical Programs, and the new Agency for Health Care Policy and Research. Based on the cumulative experience of the past, the economic, professional and social climate of the present, with its increasing involvement of the patient/payer/consumer in decisions, and the enhanced inter-organizational coordination emerging from technologies of computers and communication science, the goal of creating comprehensive integrated systems as conceived in the 1950s and 60s may finally be achieved in the 1990s, but in a different form from that envisioned earlier. By judicious exploitation of computer and communication capabilities and the massive knowledge bases evolving from research, the way is eased for patient-centered integration and coordination of services without demanding integration in the sense of ownership or formal control of all the providers within a central organization. PMID:1288669
Donald Nickles; David Rauth; John Schmalzel
Using the IEEE 1451 Smart Sensor Standard helps reconcile issues of proliferation and interoperability of systems and sensors. Integrated System Health Management (ISHM) uses IEEE 1451 to provide homogeneity and expandability to increasingly complex sensor networks. Sensor conformance allows a large part of system commissioning, data processing, and network upgrades to be handled automatically. While IEEE 1451 supports this end,
Tucker, Cary; Sloan, Sarah K.; Vance, Mary; Brownson, Chris
This case study describes 1 international student's treatment experience with an integrated health program on a college campus. This program uses a multidisciplinary, mind-body approach, which incorporates individual counseling, primary care, psychiatric consultation, a mindfulness-based cognitive therapy class, and a meditation group.
Bezerra, Isabella Azevedo; Goes, Paulo Sávio Angeiras de
The theory of social capital seeks to explain social inequality in health through the interaction of social, economic and environmental factors and has been associated with many health problems, though there is still little research in the area of oral health. The scope of this study was to evaluate the association between social capital and socio-demographic and behavioral factors related to oral health among schoolchildren aged from 15 to 19. A random sample of 1,417 adolescents filled out a self-administered survey and the data were descriptively analyzed (simple frequencies, central tendency and variability measurement) and inferential statistics (Pearson's chi-square test). The results showed that the social capital which is more prevalent among adolescents was intermediate level, as well as between each of its dimensions, except for social action where the majority were classified as lower-leveled. Among the variables analyzed, social capital was statistically associated only with sex, with women being more likely to be classified under the 'low social capital' label. This area still needs considerable research to increase theoretical-conceptual and methodological maturity in order to better understand the social contexts that are essential for formulating effective public health policies. PMID:24897493
VanEenwyk, Juliet; Siegel, Paul; Njai, Rashid
Few studies of associations between housing and health have focused on housing insecurity and health risk behaviors and outcomes. We measured the association between housing insecurity and selected health risk behaviors and outcomes, adjusted for socioeconomic measures, among 8,415 respondents to the 2011 Washington State Behavioral Risk Factor Surveillance System. Housing insecure respondents were about twice as likely as those who were not housing insecure to report poor or fair health status or delay doctor visits because of costs. This analysis supports a call to action among public health practitioners who address disparities to focus on social determinants of health risk behaviors and outcomes. PMID:26160295
Chisholm, Rex L.
behavioral intervention technologies (BITs) that promote physical and mental health. Behavioral Intervention Technologies (BITs) use mobile phone, web-based, and sensor of health and mental health outcomes. Proposed projects may include a range of BIT
Salter, Amber; Tyry, Tuula; Fox, Robert J; Cutter, Gary R
Background Low health literacy is generally associated with poor health outcomes; however, health literacy has received little attention in multiple sclerosis (MS). Objective The aim of this study was to investigate the health literacy of persons with MS using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Methods In 2012, we conducted a cross-sectional study of health literacy among NARCOMS participants. Respondents completed the Medical Term Recognition Test (METER) which assesses the ability to distinguish medical and nonmedical words, and the Newest Vital Sign (NVS) instrument which evaluates reading, interpretation, and numeracy skills. Respondents reported their sociodemographic characteristics, health behaviors, comorbidities, visits to the emergency room (ER), and hospitalizations in the last 6 months. We used logistic regression to evaluate the characteristics associated with functional literacy, and the association between functional literacy and health care utilization. Results Of 13,020 eligible participants, 8934 (68.6%) completed the questionnaire and were US residents. Most of them performed well on the instruments with 81.04% (7066/8719) having functional literacy on the METER and 74.62% (6666/8933) having adequate literacy on the NVS. Low literacy on the METER or the NVS was associated with smoking, being overweight or obese (all P<.001). After adjustment, low literacy on the METER was associated with ER visits (OR 1.28, 95% CI 1.10-1.48) and hospitalizations (OR 1.19, 95% CI 0.98-1.44). Findings were similar for the NVS. Conclusions In the NARCOMS cohort, functional health literacy is high. However, lower levels of health literacy are associated with adverse health behaviors and greater health care utilization. PMID:24513479
Testa, Marcia A.; Spackman, Thomas J.
The transfer of information within the academic health center is complicated by the complex nature of the institution's multi-dimensional role. The diverse functions of patient care, administration, education and research result in a complex web of information exchange which requires an integrated approach to system management. System integration involves a thorough assessment of “end user” needs in terms of hardware and software as well as specification of the communications network architecture. The network will consist of a series of end user nodes which capture, process, archive and display information. This paper will consider some requirements of these nodes, also called intelligent workstations, relating to their management and integration into a total health care network.
Goddard, Maria; Weatherly, Helen; Chalkley, Martin
Objectives Integrated funds for health and social care are one possible way of improving care for people with complex care requirements. If integrated funds facilitate coordinated care, this could support improvements in patient experience, and health and social care outcomes, reduce avoidable hospital admissions and delayed discharges, and so reduce costs. In this article, we examine whether this potential has been realized in practice. Methods We propose a framework based on agency theory for understanding the role that integrated funding can play in promoting coordinated care, and review the evidence to see whether the expected effects are realized in practice. We searched eight electronic databases and relevant websites, and checked reference lists of reviews and empirical studies. We extracted data on the types of funding integration used by schemes, their benefits and costs (including unintended effects), and the barriers to implementation. We interpreted our findings with reference to our framework. Results The review included 38 schemes from eight countries. Most of the randomized evidence came from Australia, with nonrandomized comparative evidence available from Australia, Canada, England, Sweden and the US. None of the comparative evidence isolated the effect of integrated funding; instead, studies assessed the effects of ‘integrated financing plus integrated care’ (i.e. ‘integration’) relative to usual care. Most schemes (24/38) assessed health outcomes, of which over half found no significant impact on health. The impact of integration on secondary care costs or use was assessed in 34 schemes. In 11 schemes, integration had no significant effect on secondary care costs or utilisation. Only three schemes reported significantly lower secondary care use compared with usual care. In the remaining 19 schemes, the evidence was mixed or unclear. Some schemes achieved short-term reductions in delayed discharges, but there was anecdotal evidence of unintended consequences such as premature hospital discharge and heightened risk of readmission. No scheme achieved a sustained reduction in hospital use. The primary barrier was the difficulty of implementing financial integration, despite the existence of statutory and regulatory support. Even where funds were successfully pooled, budget holders’ control over access to services remained limited. Barriers in the form of differences in performance frameworks, priorities and governance were prominent amongst the UK schemes, whereas difficulties in linking different information systems were more widespread. Despite these barriers, many schemes – including those that failed to improve health or reduce costs – reported that access to care had improved. Some of these schemes revealed substantial levels of unmet need and so total costs increased. Conclusions It is often assumed in policy that integrating funding will promote integrated care, and lead to better health outcomes and lower costs. Both our agency theory-based framework and the evidence indicate that the link is likely to be weak. Integrated care may uncover unmet need. Resolving this can benefit both individuals and society, but total care costs are likely to rise. Provided that integration delivers improvements in quality of life, even with additional costs, it may, nonetheless, offer value for money. PMID:25595287
Rask, Kimberly J; Brigham, Kenneth L; Johns, Michael M E
The growing burden of chronic disease, an aging population, and rising health care costs threaten the sustainability of our current model for health care delivery. At the same time, innovations in predictive health offer a pathway to reduce disease burden by preventing and mitigating the development of disease. Academic health centers are uniquely positioned to evaluate the comparative effectiveness of predictive and personalized health interventions, given institutional core competencies in innovative knowledge development. The authors describe Emory University's commitment to integrating comparative effectiveness research (CER) into predictive health programs through the creation and concurrent evaluation of its Center for Health Discovery and Well Being (hereafter, "the Center"). Established in 2008, the Center is a clinical laboratory for testing the validity and utility of a health-focused rather than disease-focused care setting. The Center provides preventive health services based on the current evidence base, evaluates the effectiveness of its care delivery model, involves trainees in both the delivery and evaluation of its services, and collects structured physical, social, and emotional health data on all participants over time. Concurrent evaluation allows the prospective exploration of the complex interactions among health determinants as well as the comparative effectiveness of novel biomarkers in predicting health. Central to the Center is a cohort study of randomly selected university employees. The authors describe how the Center has fostered a foundation for CER through the structured recruitment of study cohorts, standardized interventions, and scheduled data collection strategies that support pilot studies by faculty and trainees. PMID:21512361
Lawrence O. Gostin; Peter D. Jacobson; Katherine L. Record; Lorian E. Hardcastle
The Patient Protection and Affordable Care Act is a major achievement in improving access to health care services. However, evidence indicates that the nation could achieve greater improvements in health outcomes, at a lower cost, by shifting its focus to public health. By focusing nearly exclusively on health care, policy makers have chronically starved public health of adequate and stable
O'Neill, Suzanne C.; McBride, Colleen M.; Alford, Sharon Hensley; Kaphingst, Kimberly A.
Background Increased availability of genetic risk information may lead the public to give precedence to genetic causation over behavioral/environmental factors, decreasing behavior change motivation. Few population-based data inform these concerns. Purpose We assess the association of family history, behavioral risks, and causal attributions for diseases and the perceived value of pursuing information emphasizing health habits or genes. Method 1959 healthy adults completed a survey that assessed behavioral risk factors, family history, causal attributions of eight diseases, and health information preferences. Results Participants’ causal beliefs favored health behaviors over genetics. Interest in behavioral information was higher than in genetic information. As behavioral risk factors increased, inclination toward genetic explanations increased; interest in how health habits affect disease risk decreased. Conclusions Those at greatest need for behavior change may hold attributions that diminish interest in behavior change information. Enhancing understanding of gene-environment influences could be explored to increase engagement with health information. PMID:20532842
O'Neill, Suzanne C; McBride, Colleen M; Alford, Sharon Hensley; Kaphingst, Kimberly A
Increased availability of genetic risk information may lead the public to give precedence to genetic causation over behavioral/environmental factors, decreasing motivation for behavior change. Few population-based data inform these concerns. We assess the association of family history, behavioral risks, and causal attributions for diseases and the perceived value of pursuing information emphasizing health habits or genes. 1,959 healthy adults completed a survey that assessed behavioral risk factors, family history, causal attributions of eight diseases, and health information preferences. Participants' causal beliefs favored health behaviors over genetics. Interest in behavioral information was higher than in genetic information. As behavioral risk factors increased, inclination toward genetic explanations increased; interest in how health habits affect disease risk decreased. Those at greatest need for behavior change may hold attributions that diminish interest in information for behavior change. Enhancing understanding of gene-environment influences could be explored to increase engagement with health information. PMID:20532842
Jung-won Lim; Patricia Gonzalez; Ming F. Wang-Letzkus; Kimlin T. Ashing-Giwa
Purpose The purpose of this study was to (1) describe health behaviors and health-related quality of life (HRQOL) of Latina and Asian-American\\u000a breast cancer survivors (BCS), (2) estimate possible culturally driven predictors of health behaviors and HRQOL, and (3) compare\\u000a pathways for predicting health behaviors and HRQOL between the two groups.\\u000a \\u000a \\u000a \\u000a Materials and methods Secondary data were used to investigate health behaviors
Andrew S. Pomerantz; John A. Corson; Mark J. Detzer
A growing body of research has demonstrated the effectiveness of integrating mental\\/behavioral healthcare with primary care\\u000a in improving health outcomes. Despite this rich literature, such demonstration programs have proven difficult to maintain\\u000a once research funding ends. Much of the discussion regarding maintenance of integrated care has been focused on lack of reimbursement.\\u000a However, provider factors may be just as important,
M. Scott Young; Colleen Clark; Kathleen Moore; Blake Barrett
Assertive Community Treatment (ACT) and the Comprehensive, Continuous, Integrated System of Care (CCISC) are two models for delivering services to homeless persons with complex behavioral health needs. This quasi-experimental study presents preliminary data comparing these two programs. The first program was based out of a community mental health center and utilized the ACT model of care with supported housing (ACT-SH),
Duncan, Greg J; Ziol-Guest, Kathleen M; Kalil, Ariel
This article assesses the consequences of poverty between a child's prenatal year and 5th birthday for several adult achievement, health, and behavior outcomes, measured as late as age 37. Using data from the Panel Study of Income Dynamics (1,589) and controlling for economic conditions in middle childhood and adolescence, as well as demographic conditions at the time of the birth, findings indicate statistically significant and, in some cases, quantitatively large detrimental effects of early poverty on a number of attainment-related outcomes (adult earnings and work hours). Early-childhood poverty was not associated with such behavioral measures as out-of-wedlock childbearing and arrests. Most of the adult earnings effects appear to operate through early poverty's association with adult work hours. PMID:20331669
Valleley, Rachel J; Romer, Natalie; Kupzyk, Sara; Evans, Joseph H; Allen, Keith D
This pilot study investigated the effect of the Pediatric Symptom Checklist (PSC) on identification of and physician response to behavioral health (BH) concerns. Researchers reviewed 1211 charts of youth aged 4 to 16 years. Records were compared during baseline and an intervention consisting of implementation of the PSC to determine the rate of BH identification and pediatrician response. Access to PSC data resulted in a trivial difference in BH concerns identified by physicians and did not affect physician responses. This case study demonstrates that simply implementing BH screening in primary care may not result in improved outcomes for these children. PMID:25504936
Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as ‘a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain’. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions. PMID:23171406
Petty, Brian E
Understanding health information-seeking behaviors (HISBs) within a particular patient demographic group is an important part of effective clinical outreach and education efforts. Although the community of classically trained singers has long been recognized by specialized health care providers, no studies have yet addressed the processes by which they search for voice-related health information, and little is known about how they use and access medical care. An electronic questionnaire focusing on HISB and voice-related health care issues was administered to 151 self-identified classically trained singers and 49 nonsinger controls. Outcomes of interest were tested for association with groups of singers and controls, followed by tests of association between demographic variables (age, gender, insurance status) with each outcome of interest. Results showed significant differences in specialty care access including point of first contact (P=0.0085), gender-associated delay of treatment initiation (P=0.0324), and use of home remedies for vocal problems (P?0.0001). Significant differences in HISB were noted as well, including history of having undertaken an information search (P?0.0001), likelihood of having concerns about information quality (P?0.0001), and difficulty knowing where to find information (P?0.0001). Differences were influenced by singing status, age, and gender. The insights provided by these data may inform decision-making processes regarding patient care, patient education, and clinical outreach to the target population. PMID:21865009
Munir, Samina K.; Kay, Stephen
This paper illustrates the importance of organisational culture for Clinical Information Systems (CIS) integration. The study is based on data collected in intensive care units in the UK and Denmark. Data were collected using qualitative methods, i.e., observations, interviews and shadowing of health care providers, together with a questionnaire at each site. The data are analysed to extract salient variables for CIS integration, and it is shown that these variables can be separated into two categories that describe the ‘Actual Usefulness’ of the system and the ‘Organisational Culture’. This model is then extended to show that CIS integration directly affects the work processes of the organisation, forming an iterative process of change as a CIS is introduced and integrated. PMID:14728220
David Korotkov; Mihailo Perunovic; Marvin Claybourn; Ian Fraser; Michael Houlihan; Melissa Macdonald; Kimberly Ann Korotkov
To test the hypotheses that Type B individuals would engage in more preventive and less risk-related behaviors under high stress than Type As, 155 students were administered questionnaires pertaining to the TABP, daily hassles, and health behavior. As predicted, in six out of seven regression analyses, Type Bs engaged in more preventive, and fewer risk-related behaviors under high stress, than
Grant Title: TRANSLATING BASIC BEHAVIORAL AND SOCIAL SCIENCE DISCOVERIES INTO INTERVENTIONS of Research: Support interdisciplinary teams of basic and applied biological, behavioral and/or social science, or adherence to medical regimens) and/or prevent and reduce problem health behaviors (e.g., smoking, tanning
Silveira, Elaine Rosner
This article is an offshoot of my doctoral thesis defended at the Federal University of Rio Grande do Sul. It seeks to approach the historical dissociation between mental health and broader public health as well as practices that work towards the integration of the two. It examines the scientific background that fosters this dissociation and also national and international health-related documents that stress the need for integration. Based on Rose, I analyzed the documents and interviews with health professionals on the practices of Matricial Support and Interconsultation formulated by the Ministry of Health and by the Porto Alegre/ Rio Grande do Sul Municipal Health Department, which seek to relate mental health with Primary Healthcare. These documents and health practices propose new subjectivations to the professionals. They emphasize the interdisciplinarity and the non-hierarchization of services and knowledge, and are in line with the form of contemporary social organization, which suggests taking horizontal and democratic decisions, rather than decisions imposed by a vertical authority typical of the patriarchal and biomedical model. PMID:22996888
Sprigg, W. A.
Experiments in real-time prediction of desert dust emissions and downstream plume concentrations (~ 3.5 km near-surface spatial resolution) succeed to the point of challenging public safety and public health services to beta test a dust storm warning and advisory system in lowering risks of highway and airline accidents and illnesses such as asthma and valley fever. Key beta test components are: high-resolution models of dust emission, entrainment and diffusion, integrated with synoptic weather observations and forecasts; satellite-based detection and monitoring of soil properties on the ground and elevated above; high space and time resolution for health surveillance and transportation advisories.
Background Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005. Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes. Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership. The partnership is guided by the belief that HSS interventions should be comprehensive, integrated, responsive to local conditions, and address health care access, cost, and quality. The PHIT Partnership represents a collaboration between the MOH and PIH, with support from the National University of Rwanda School of Public Health, the National Institute of Statistics, Harvard Medical School, and Brigham and Women’s Hospital. Description of intervention The PHIT Partnership’s health systems support aligns with the World Health Organization’s six health systems building blocks. HSS activities focus across all levels of the health system — community, health center, hospital, and district leadership — to improve health care access, quality, delivery, and health outcomes. Interventions are concentrated on three main areas: targeted support for health facilities, quality improvement initiatives, and a strengthened network of community health workers. Evaluation design The impact of activities will be assessed using population-level outcomes data collected through oversampling of the demographic and health survey (DHS) in the intervention districts. The overall impact evaluation is complemented by an analysis of trends in facility health care utilization. A comprehensive costing project captures the total expenditures and financial inputs of the health care system to determine the cost of systems improvement. Targeted evaluations and operational research pieces focus on specific programmatic components, supported by partnership-supported work to build in-country research capacity. Discussion Building on early successes, the work of the Rwanda PHIT Partnership approach to HSS has already seen noticeable increases in facility capacity and quality of care. The rigorous planned evaluation of the Partnership’s HSS activities will contribute to global knowledge about intervention methodology, cost, and population health impact. PMID:23819573
Mona M. Shattell; Natasha Donnelly; Anna Scheyett; Gary S. Cuddeback
BACKGROUND: Assertive community treatment (ACT) is characterized as a service delivery platform and represents an ideal setting in which mental health and physical health care can be integrated. OBJECTIVE: Little is known about the extent to which ACT integrates physical health care with mental health care or the challenges ACT teams experience. To address this gap, focus groups were conducted
Baiocchi-Wagner, Elizabeth A; Talley, Amelia E
This study explored associations among family communication patterns (conversation and conformity orientations), health-specific communication variables, health attitudes, and health behaviors in a sample of 433 family dyads (N?=?866). As expected, results of multilevel models revealed that individuals' health attitudes were strongly associated with their self-reported health behaviors. Findings also suggested that perceived confirmation from a family member during health-specific conversations (a) directly influenced health attitudes, (b) partially accounted for the positive relationship between family conversation orientation and health attitudes, and (c) partially accounted for the inverse relationship between family conformity orientation and health attitudes. Similarly, frequency of health-specific communication (a) directly influenced health attitudes, (b) partially accounted for the positive relationship between family conversation orientation and health attitudes, and (c) directly associated with health behaviors. Results from an actor-partner interdependence model (APIM) supported the aforementioned within-person association between a person's own health attitudes and health behaviors, as well as a positive relationship between young adults' health attitudes and their influential family member's health behaviors. Implications of these findings are discussed as they relate to theory and obesity prevention. PMID:22582714
Guimarães, Luisa; Giovanella, Lígia
This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions. PMID:16917576
Determined current health risk behaviors of rural college freshmen using elements of the National College Health Risk Behavior Survey (NCHRBS). Student surveys indicated that for some behaviors, the incidence among these rural students was higher than the incidence among freshmen from the NCHRBS (e.g., binge drinking, ever smoking marijuana, and…
Serious video games for health are designed to entertain players while attempting to modify some aspect of their health behavior. Behavior is a complex process influenced by multiple factors, often making it difficult to change. Behavioral science provides insight into factors that influence specifi...
Harrison, Albert A.
Space architecture is the theory and practice of designing and building environments for humans in outer space. In our present century professional astronauts and cosmonauts will remain a focus for space architects, but new designs must better accommodate passengers (tourists and industrial workers) and settlers who set forth to establish off-world societies. Psychologists and architects can work together to assure good spaceflight behavioral health, defined by a lack of neuropsychiatric dysfunction, and the presence of high levels of personal adjustment, cordial interpersonal relations, and positive interactions with the physical and social environments. By designing and constructing facilities that are occupant centered and activity oriented, architects increase habitability thereby decreasing environmental challenges to behavioral health. Simulators and spaceflight-analogous environments make it possible to test design solutions prior to their deployment in space. This paper concludes with suggestions for increasing collaboration between architects and psychologists. These include increased sharing of hypotheses and data, articulating complementary research styles, and mutual advocacy for early, potent, and sustained involvement in mission planning and execution.
Richard H. Beinecke; Donald S. Shepard; Jill Tetreault; Dominic Hodgkin; Jennifer Marckres
Substance abuse providers surveyed after Year 6 of the Massachusetts Behavioral Health Plan reported better treatment outcomes and access than in previous years. The Massachusetts Behavioral Health Partnership's clinical practices helped to improve quality of care. Its review process was highly rated. Coordination of substance abuse and mental health services was favorable, but was unfavorable with primary care. Staffing and
John A. Morris; Gail W. Stuart
Much of the behavioral health care delivered to people with serious mental illnesses and chronic addictive disorders is provided by front-line or direct service mental health workers. Issues related to the qualifications, training, and ongoing evaluation of the competencies of this important provider group have received scant attention in the behavioral health field. This paper explores the educational needs and
Christine Jackson; Lisa Henriksen; Vangie A. Foshee
Public health research demonstrates increasing interest in mobilizing parental influence to prevent health risk behaviors among children and adolescents. This research focuses on authoritative parenting, which previous studies suggest can prevent health risk behaviors among youth. To evaluate the reliability and validity of a new survey measure of authoritative parenting, data from studies of (1) substance use in a sample
Calderon, Susana J.; Mallory, Caroline
Despite improvements in prevention, oral diseases are a problem among adolescents, linked to poor health outcomes and poor school performance. Little is known about adolescent oral health behavior. This systematic review describes factors that influence oral health behavior in adolescents. Inclusion criteria for the literature search were American…
Hui Bian; Michele J. Moore; Steve Ames; Carlo C. DiClemente; Robert M. Weiler
PurposeThis study examined the effects of brief image-based interventions, including a multiple behavior health contract, a one-on-one tailored consultation, and a combined consultation plus contract intervention, for impacting multiple health behaviors of students in a university health clinic.
Center for Disease Control (DHHS/PHS), Atlanta, GA.
Noting that health-risk behaviors among youth may result in immediate health problems or extend into adulthood and increase risk for chronic diseases, this report examines the prevalence of health-risk behaviors among a nationally representative sample of persons aged 12 to 21 years and presents age group comparisons of the most important…
Shirley Taylor; Peter Todd
This study examines the antecedents of recycling and composting intentions in the context of an integrated waste management behavior model. This model incorporates a wide variety of important factors from previous research on environmental behavior. The theory of planned behavior provides a theoretical framework to integrate these factors. The model was tested using both recycling and composting data from a
Kevin M. Jones; Katherine F. Wickstrom; Patrick C. Friman
This study evaluated the effects of performance feedback on levels of treatment integrity in school-based behavioral consultation. Three teachers employed in a residential treatment community were responsible for treatment implementation. Treatment integrity was defined as the percentage of 2 minute intervals during which contingent teacher reinforcement for student on-task behavior was directly observed. Teacher and child behavior were monitored across
Lambrew, J M; Ricketts, T C; Morrissey, J P
As rural communities struggle to sustain health services locally, innovative alternatives to traditional programs are being developed. A significant adaptation is the rural health network or alliance that links local health departments and community health centers. The authors describe how a rural local health department and community health center, the core organizations in publicly sponsored primary care, came to share a building and administrative and service activities. Both the details of this alliance and its development are examined. The case history reveals that circumstance and State involvement were the catalysts for service integration, more so than the need for or the benefits of the arrangement. The closure of a county-owned hospital created a situation in which State officials were able to broker a cooperative agreement between the two agencies. This case study suggests two hypotheses: that need for integrated services alone may not be sufficient to catalyze the development of primary care alliances and that strong policy support may override any local and internal resistance to integration. PMID:8434093
...Draft Integrated Science Assessment for Nitrogen Oxides--Health Criteria AGENCY: Environmental...Draft Integrated Science Assessment for Nitrogen Oxides--Health Criteria'' (EPA...ambient air quality standards (NAAQS) for nitrogen dioxide (NO 2 ). The...
Ozmen, Ozgur [ORNL; Nutaro, James J [ORNL
Discrete Event Systems Specification (DEVS) is a widely used formalism for modeling and simulation of discrete and continuous systems. While DEVS provides a sound mathematical representation of discrete systems, its practical use can suffer when models become complex. Five main functions, which construct the core of atomic modules in DEVS, can realize the behaviors that modelers want to represent. The integration of these functions is handled by the simulation routine, however modelers can implement each function in various ways. Therefore, there is a need for graphical representations of complex models to simplify their implementation and facilitate their reproduction. In this work, we illustrate the use of activity diagrams for this purpose in the context of a health care behavior model, which is developed with an agent-based modeling paradigm.
Joanne M. Spahn; Rebecca S. Reeves; Kathryn S. Keim; Ida Laquatra; Molly Kellogg; Bonnie Jortberg; Nicole A. Clark
Behavior change theories and models, validated within the field of dietetics, offer systematic explanations for nutrition-related behavior change. They are integral to the nutrition care process, guiding nutrition assessment, intervention, and outcome evaluation. The American Dietetic Association Evidence Analysis Library Nutrition Counseling Workgroup conducted a systematic review of peer-reviewed literature related to behavior change theories and strategies used in nutrition
Godfrey, Kathryn M; Lindamer, Laurie A; Mostoufi, Sheeva; Afari, Niloofar
physical health indica- tors, such as waist-hip ratio, blood pressure, or heart rate,physical health indicators: BMI, waist-hip ratio, systolic blood pressure, diastolic blood pressure, and resting heart rate.physical activity differences between the PTSD and con- trol group, but the difference on resting heart rate
Kishore, Mallika; Panat, Sunil R; Choudhary, Ananda; Aggarwal, Ashish; Upadhyay, Nitin; Agarwal, Nupur; Alok, Abhijeet
Aging is inevitable, every day we live we age. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. Oral health reflects overall well being for the elderly population. Compromised oral health may be a risk factor for systemic diseases commonly occurring in age. Diagnosis and proper treatment is essential for healthy aging. Timely diagnosis, appropriate treatment and regular follow-up of both oral and systemic diseases are a prerequisite for active aging. Oral diagnostics is a revolutionary development with high potential to replace other investigative modalities. Changing demographics, including the increase in life expectancy and the growing numbers of elderly, has focused attention on the need for dental research activities to be expanded for geriatric dentistry. This paper is aimed to shed light on the growing elderly population and their ailments. It also aims to create awareness among health care providers about oral diagnostics and their application in geriatrics. PMID:23617577
LaValley, J W; Verhoef, M J
Complementary medicine and health care services constitute a significant proportion of the use of health care services in Canada, despite a history of limited acceptance of these therapies by the medical profession. However, physician attitudes appear to be changing. A survey of a random sample of general practitioners in Quebec (see page 29 of this issue) shows that four out of five general practitioners perceive at least one of three complementary health care services to be useful. Similar surveys of samples in Alberta and Ontario suggest that physicians there, although somewhat less enthusiastic than their counterparts in Quebec, have also begun to be more open-minded about these types of therapies. However, physicians have reported little understanding of complementary health care services, which suggests the need for more research on and education about these services. The Medical Society of Nova Scotia has responded to this need by establishing a Section of Complementary Medicine. The authors believe that fair, accountable, scientific and rigorous research on complementary therapies will benefit physicians and patients. The problems inherent in applying reductionist analysis to a holistic approach to care can be largely circumvented by focusing on outcomes research. In light of the popularity of these therapies, inquiry into patient use of complementary health care services should become a part of a complete patient history. This measure would promote greater patient-physician communication and integration of complementary health care services into patient care. PMID:7796375
Rose, R. I.
Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strategies for mosquito control. PMID:11266290
K. Reichard; E. Crow; T. Bair
Integrated system health management (ISHM) technologies have been developed to address safety, replace time-based maintenance with condition-based maintenance, and to reduce life cycle costs. Traditional space system designs have focused on safety to minimize the risk to crew and to protect the public, astronauts and pilots, the NASA workforce, and high-value equipment and property. Systems have relied on high reliability
Starkly unequal built and social environments among urban neighborhoods are part of the explanation for health disparities in the United States. This study is a qualitative investigation of the ways that residents of a low-income neighborhood in Madison, WI, use and interpret nearby neighborhood places. Specifically, I ask how and why certain places may facilitate beneficial behavioral and social mechanisms that impact health. I develop the organizing concept of “vital places”: nearby destinations that are important to and frequently-used by neighborhood residents, and that have theoretical relevance to health. I argue that conceiving of certain places as vital integrates our understanding of the essential components of places that are beneficial to health, while also allowing policy-makers to be creative about the ways they intervene to improve the life chances of residents in disadvantaged neighborhoods. I synthesize the findings into the characteristics of three types of vital places. First, I find that a convenient, comprehensive, and affordable food source can facilitate a healthy diet. An attractive, accessible, and safe recreational facility can support greater physical and social activity. Finally, shared, casual, focused social spaces provide opportunities to create and sustain supportive social ties. This study adds depth and complexity to the ways we conceptualize health-relevant community assets and provides insight into revitalization strategies for distressed low-income housing. PMID:25313992
Selby, R; Weinstein, H M; Bird, T S
This study examined several aspects of the health of university athletes. Five areas of concern were targeted for investigation: general health background, use of drugs and alcohol, weight and eating behaviors, stress, and use of helping resources. The authors developed a questionnaire and used it to survey 27 varsity athletic teams at a major private university. The incidence of injuries was high; one third of the 247 student athletes surveyed reported sport-related injuries. Alcohol was much more frequently used than other drugs, and use tended to decrease during the competitive season. Significant differences between men and women athletes were found in off-season alcohol and marijuana use. Anabolic steroid abuse did not appear to be a major problem for this athlete population. Issues of diet, weight, and body image were found to be significantly different for women than for men. Although the incidence of bulimia and anorexia was low for both female and male athletes, it was clear that female athletes brought to their sport heightened concern for body image. The authors discuss the psychological and interpersonal implications that these findings have for the adjustment of female athletes. Injury and academics were perceived as the most stressful factors for both men and women, whereas weight and diet issues were a major stress factor for one third of the women. Given these data, specific recommendations are made for health professionals who work with college athletes. PMID:2365926
Cautilli, Joseph; Harrington, Nadine; Gillam, Emma Vila; Denning, Jamie; Helwig, Ileana; Ettingoff, Andrea; Valdes, Antonio; Angert, Ashley
Over the last thirty years, children's behavioral health services in the school have witnessed drastic progress. Over this time, medications for mental health problems have improved. In addition, empirically validated treatments, most of which have come from behavioral psychology, have made their way into Best Practice guidelines for the treatment…
Eagar, Kathy; Pirkis, Jane E; Owen, Alan; Burgess, Philip M; Posner, Natasha; Perkins, David A
Three projects were funded under the national Mental Health Integration Program (MHIP) in 1999, each of which employed a different model aimed at improving linkages between disparate parts of the mental health system. A national evaluation framework guided local evaluations of these projects, and this paper presents a synthesis of the findings. For providers, the projects improved working relationships, created learning opportunities and increased referral and shared care opportunities. For consumers and carers, the projects resulted in a greater range of options and increased continuity of care. For the wider system, the projects achieved significant structural and cultural change. Cost-wise, there were no increases in expenditure, and even some reductions. Many of the lessons from the projects (and their evaluations) may be generalised to other mental health settings and beyond. PMID:15865570
Oniki, Thomas A.; Rodrigues, Drayton; Rahman, Noman; Patur, Saritha; Briot, Pascal; Taylor, David P.; Wilcox, Adam B.; Reiss-Brennan, Brenda; Cannon, Wayne H.
Intermountain Healthcare’s Mental Health Integration (MHI) Care Process Model (CPM) contains formal scoring criteria for assessing a patient’s mental health complexity as “mild,” “medium,” or “high” based on patient data. The complexity score attempts to assist Primary Care Physicians in assessing the mental health needs of their patients and what resources will need to be brought to bear. We describe an effort to computerize the scoring. Informatics and MHI personnel collaboratively and iteratively refined the criteria to make them adequately explicit and reflective of MHI objectives. When tested on retrospective data of 540 patients, the clinician agreed with the computer’s conclusion in 52.8% of the cases (285/540). We considered the analysis sufficiently successful to begin piloting the computerized score in prospective clinical care. So far in the pilot, clinicians have agreed with the computer in 70.6% of the cases (24/34). PMID:25954401
Carmel, Adam; Fruzzetti, Alan E; Rose, Monica L
There is a risk of experiencing clinical burnout among therapists providing treatment to clients with borderline personality disorder (BPD), a complex, costly and difficult-to-treat psychiatric disorder. Dialectical behavior therapy (DBT) is an evidence-based treatment of BPD that has been widely disseminated. There is only one published study that has examined pre and post scores of burnout among clinicians who receive training in DBT, and none that have taken place within a public behavioral health system in the United States where resources for community-based agencies are limited and demands are high. The current study examined the rates of burnout among therapists treating clients with BPD within a large, urban public behavioral health system. The study included a sample of nine clinicians and showed significantly decreased scores of burnout after participants attended a series of DBT trainings over a period of 13 months. There were several key limitations to internal validity including the lack of a control group. Similar evaluations of training outcomes are needed to address the widespread occurrence of burnout among community-based clinicians providing treatment to clients with BPD in order to enhance the quality of patient care. PMID:24346223
Zarini, Gustavo G.; Vaccaro, Joan A.; Canossa Terris, Maria A.; Exebio, Joel C.; Ajabshir, Sahar; Cheema, Amanpreet; Huffman, Fatma G.
Background. Lack of adherence to dietary and physical activity guidelines has been linked to an increase in chronic diseases in the United States (US). The aim of this study was to assess the association of lifestyle behaviors with self-rated health (SRH). Methods. This cross-sectional study used self-reported data from Living for Health Program (N = 1,701) which was conducted from 2008 to 2012 in 190 health fair events in South Florida, US. Results. Significantly higher percent of females as compared to males were classified as obese (35.4% versus 27.0%), reported poor/fair SRH (23.4% versus 15.0%), and were less physically active (33.9% versus 25.4%). Adjusted logistic regression models indicated that both females and males were more likely to report poor/fair SRH if they consumed ?2 servings of fruits and vegetables per day (OR = 2.14, 95% CI 1.30–3.54; OR = 2.86, 95% CI 1.12–7.35, resp.) and consumed mostly high fat foods (OR = 1.58, 95% CI 1.03–2.43; OR = 3.37, 95% CI 1.67–2.43, resp.). The association of SRH with less physical activity was only significant in females (OR = 1.66, 95% CI 1.17–2.35). Conclusion. Gender differences in health behaviors should be considered in designing and monitoring lifestyle interventions to prevent cardiovascular diseases. PMID:25530764
Ng, Chee; Chauhan, Ajay P.; Chavan, Bir Singh; Ramasubramanian, Chellamuthu; Singh, Amool R.; Sagar, Rajesh; Fraser, Julia; Ryan, Brigid; Prasad, Jagdish; Singh, Sujeet; Das, Jayanta; Isaac, Mohan
The Ministry of Health and Family Welfare and its public health institutes are collaborating with Asia Australia Mental Health on an innovative community mental health development project designed to enhance initiatives under the District Mental Health Program and increase accessibility of essential community mental health services. The project is an exciting opportunity to create positive change in meeting the challenges of community mental health care in India. It recognizes that no one single model of care can be applied to all the community in the country and that locally appropriate models working in close partnership with local communities is required. Targeted and skill-based training programs are useful to build local leadership capacity in implementing quality and culturally appropriate community mental health services. PMID:25316931
Lipschitz, Jessica M; Paiva, Andrea L; Redding, Colleen A; Butterworth, Susan; Prochaska, James O
This study provides a preliminary investigation of the role of stress management in multiple behavior change. Risk status on stress management and five health behaviors (healthy eating, exercise, alcohol, smoking, and depression management) was assessed before and after a multiple behavior change intervention. Findings suggested a link between stress management and a worse health risk behavior profile at baseline. Results also showed relationships between improved stress management over 6 months and heightened odds of improving on specific behaviors as well as improving one's overall behavioral risk profile. Particularly strong links between stress management and energy balance and other affective behaviors were observed. PMID:24165862
Kennedy, Cassondra Jeanne
A survey returned by 300 homeowners (50 percent) in a community at risk for high home radon concentrations found that, although 64 percent were concerned, only 7 percent tested their homes. Findings indicate the need for more education about radon and its health effects. (JOW)
Yoo, Joan; Slack, Kristen S.; Holl, Jane L.
This study's objective was to examine whether five child health-promoting behaviors by caregivers would be associated with caregivers' assessments of their children's health as "excellent," controlling for an array of risk factors for adverse health outcomes. The study used the third and fourth waves of the Illinois Families Study-Child Well-being…
Rico, Florentino; Yalcin, Ali; Eikman, Edward A
This study assesses the impact of an automated infusion system (AIS) integration at a positron emission tomography (PET) center based on "lean thinking" principles. The authors propose a systematic measurement system that evaluates improvement in terms of the "8 wastes." This adaptation to the health care context consisted of performance measurement before and after integration of AIS in terms of time, utilization of resources, amount of materials wasted/saved, system variability, distances traveled, and worker strain. The authors' observations indicate that AIS stands to be very effective in a busy PET department, such as the one in Moffitt Cancer Center, owing to its accuracy, pace, and reliability, especially after the necessary adjustments are made to reduce or eliminate the source of errors. This integration must be accompanied by a process reengineering exercise to realize the full potential of AIS in reducing waste and improving patient care and worker satisfaction. PMID:24878516
...2011-10-01 false Integration of environment, safety, and health into work planning...Contracts 970.5223-1 Integration of environment, safety, and health into work planning...following clause: Integration of Environment, Safety, and Health Into Work...
...2010-10-01 false Integration of environment, safety, and health into work planning...Contracts 970.5223-1 Integration of environment, safety, and health into work planning...following clause: Integration of Environment, Safety, and Health Into Work...
Eksuzian, Daniel J.
It will be the responsibility of the long-duration space flight crew to take the actions necessary to maintain their health and well-being and to cope with medical emergencies without direct assistance from support personnel, including maintaining mental health and managing physiological and psychological changes that may impair decision making and performance. The Behavior and Performance Integrated Product Team at Johnson Space Center, working, within the Space Medicine, Monitoring, and Countermeasures Program, has identified critical questions pertaining to long-duration space crew behavioral health, psychological adaptation, human factors and habitability, and sleep and circadian rhythms. Among the projects addressing these questions are: the development of tools to assess cognitive functions during space missions; the development of a model of psychological adaptation in isolated and confined environments; tools and methods for selecting individuals and teams well-suited for long-duration missions; identification of mission-critical tasks and performance evaluation; and measures of sleep quality and correlation to mission performance.
Caren M. Stalburg; Tamara A. Stein
Traditionally, undergraduate medical education is divided into preclinical and clinical years, with basic sciences taught during the first years and clinical sciences taught during the latter years. In an effort to better integrate the basic and clinical sciences in undergraduate medical education, and focus on women's health, we have developed a new interdisciplinary fourth-year elective at the University of Michigan
Boiarsky, Greg; Rouner, Donna; Long, Marilee
This study investigated the effect of message attributes on responses to health messages. The authors examined 3 variables--responsibility attribution (individual vs. social), source (personal blog vs. online magazine), and illness (stigmatized vs. nonstigmatized)--for effects on young adults' health-related attitudes and behaviors. Responsibility attributions influenced attitudes about individual responsibility for health but did not alter participants' behavioral intentions. Further, individuals exposed to a story from a health magazine exhibited stronger intentions to communicate about health than individuals exposed to a personal health blog. Although women's attitudes regarding social responsibility for health did not differ by illness type or responsibility attribution, men's attitudes did. PMID:23557181
Hansson, Helena; Lagerkvist, Carl Johan
This study integrated risk-benefit analysis with prospect theory with the overall objective of identifying the type of management behavior represented by farmers' choices of mastitis control options (MCOs). Two exploratory factor analyses, based on 163 and 175 Swedish farmers, respectively, highlighted attitudes to MCOs related to: (1) grouping cows and applying milking order to prevent spread of existing infection and (2) working in a precautionary way to prevent mastitis occurring. This was interpreted as being based on (1) reactive management behavior on detection of udder-health problems in individual cows and (2) proactive management behavior to prevent mastitis developing. Farmers' assessments of these MCOs were found to be based on asymmetrical evaluations of risks and benefits, suggesting that farmers' management behavior depends on their individual reference point. In particular, attitudes to MCOs related to grouping cows and applying milking order to prevent the spread of mastitis once infected cows were detected were stronger in the risk domain than in the benefit domain, in accordance with loss aversion. In contrast, attitudes to MCOs related to working in a precautionary way to prevent cows from becoming infected in the first place were stronger in the benefit domain than in the risk domain, in accordance with reverse loss aversion. These findings are of practical importance for farmers and agribusiness and in public health protection work to reduce the current extensive use of antibiotics in dairy herds. PMID:24372180
Solomon, Laura; And Others
Businesses with limited resources to invest can successfully carry out programs that promote healthful behavior in their employees. The design and implementation of such a program, which encourages exercise, healthful eating, weight management, nonsmoking, and stress management, is described. (PP)
...Promotion, and Integrative and Public Health AGENCY: Office of the Assistant...Promotion, and Integrative and Public Health (hereafter referred to as...Prevention, Health Promotion, and Public Health Council (hereafter referred...
Pearce, Michelle J; Koenig, Harold G; Robins, Clive J; Nelson, Bruce; Shaw, Sally F; Cohen, Harvey J; King, Michael B
Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients' spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive-behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155
Pearce, Michelle J.; Koenig, Harold G.; Robins, Clive J.; Nelson, Bruce; Shaw, Sally F.; Cohen, Harvey J.; King, Michael B.
Intervention studies have found that psychotherapeutic interventions that explicitly integrate clients’ spiritual and religious beliefs in therapy are as effective, if not more so, in reducing depression than those that do not for religious clients. However, few empirical studies have examined the effectiveness of religiously (vs. spiritually) integrated psychotherapy, and no manualized mental health intervention had been developed for the medically ill with religious beliefs. To address this gap, we developed and implemented a novel religiously integrated adaptation of cognitive–behavioral therapy (CBT) for the treatment of depression in individuals with chronic medical illness. This article describes the development and implementation of the intervention. First, we provide a brief overview of CBT. Next, we describe how religious beliefs and behaviors can be integrated into a CBT framework. Finally, we describe Religiously Integrated Cognitive Behavioral Therapy (RCBT), a manualized therapeutic approach designed to assist depressed individuals to develop depression-reducing thoughts and behaviors informed by their own religious beliefs, practices, and resources. This treatment approach has been developed for 5 major world religions (Christianity, Judaism, Islam, Buddhism, and Hinduism), increasing its potential to aid the depressed medically ill from a variety of religious backgrounds. PMID:25365155
Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.
This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to develop a socio-physical model of systemic seismic vulnerability that enhances the further understanding of societal seismic risk by taking into account social vulnerability impacts for health and health-care system, shelter, and transportation.
This editorial provides a behavioral science view on gamification and health behavior change, describes its principles and mechanisms, and reviews some of the evidence for its efficacy. Furthermore, this editorial explores the relation between gamification and behavior change frameworks used in the health sciences and shows how gamification principles are closely related to principles that have been proven to work in health behavior change technology. Finally, this editorial provides criteria that can be used to assess when gamification provides a potentially promising framework for digital health interventions. PMID:25658754
Hassan, Siti Hasnah
Religion has become more prominent in shaping attitudes and behavior, but little empirical information is available on the impact of religious behavior in shaping individual Muslims' health-related lifestyle behaviors in developing countries. The present study explores the relationship between religious behavior and the health-related practices of Malaysian Muslims. A convenience sample of 176 Malaysian Muslims was collected through a self-administered questionnaire. Structural equation modeling was used to develop the model. Result shows that health-related actions are strongly influenced, both directly and indirectly, by the health-related lifestyle choices consumers engaging in on a daily basis in accordance with Islamic teachings. PMID:24729099
Dowdell, Elizabeth Burgess; Santucci, Mary Ellen
Health attitudes and behaviors develop in childhood and progress through adolescence into adulthood. To better understand the health risk behaviors being undertaken by a seventh-grade urban population, a study was conducted to identify what health risk behaviors a group of adolescents were participating in. The purpose of this study was to describe (1) the types of health risk behaviors being undertaken, (2) the frequency of their taking health risk behaviors, and (3) the age of initiation of the health risk behavior. The findings from this study indicate that this sample of 54, urban seventh graders suffers from multidimensional health needs. These students participated in a variety of health risk behaviors, as measured by the Youth Risk Behaviors Surveillance System Questionnaire. These students have begun to smoke regularly, which correlated with the use of alcohol. They rate their health as being good or excellent but rarely met the daily requirements for intake of fruits and vegetables. And, although they rate their weight as being acceptable, most are trying to lose weight. Additionally, differences between the boys and girls were noted in weight perception, with girls more likely than boys to use smoking as the primary method of weight control. Nursing is in an ideal position to provide effective primary care interventions and community health outreach to this adolescent population. PMID:14987212
Brunero, Scott; Jeon, Yun-Hee; Foster, Kim
Mainstreaming of mental health services has led to an increase in the presentation and care of mental health patients in generalist health settings. The lack of adequate mental health educational preparation of general health professionals (GHP) has been identified as a major barrier to meeting the health-care needs of mental health patients. This study aimed to review and synthesize research evidence on mental health education programmes (MHEP) that have been designed to develop the knowledge, skills, and attitudes of GHP. An integrative literature review was conducted following a search of key electronic databases and hand searching of references of relevant papers, and 25 papers met the study inclusion criteria. Knowledge, skill, and attitudinal improvements in GHP post MHEP were shown in most studies. MHEP that included supervised clinical experience, role play, and case scenarios were reported as being more effective. Issues such as patient participation in education, interprofessional education models, and the willingness, interest and, motivation for GHP to be involved in MHEP warrant further research. PMID:22500589
School of Public Health, University of Memphis Doctoral Degree in Social and Behavioral Sciences PREFIX COURSE DESCRIPTION (15 hours) LEVEL HOURS TERM GRADE PUBH 8014 Public Health Comm/PUBH 8012 Public GRADE PUBH 8900 Advanced Readings in Public Health 3 PUBH 8901 Professional Development in Public Health
Yi, Yong Jeong
Previous studies indicated inadequate health literacy of American adults as one of the biggest challenges for consumer health information services provided in public libraries. Little attention, however, has been paid to public users' health literacy and health information behaviors. In order to bridge the research gap, the study aims to…
Jones, Kevin M.; Wickstrom, Katherine F.; Friman, Patrick C.
The addition of performance feedback increased treatment integrity for three teachers who implemented interventions in a residential treatment community. Findings support the need for direct assessment of treatment integrity in school-based behavioral consultation research and practice. (EMK)
Smith, Harvey; Schmalzel, John; Figueroa, Fernando
An intelligent integrated health management system (IIHMS) incorporates major improvements over prior such systems. The particular IIHMS is implemented for any system defined as a hierarchical distributed network of intelligent elements (HDNIE), comprising primarily: (1) an architecture (Figure 1), (2) intelligent elements, (3) a conceptual framework and taxonomy (Figure 2), and (4) and ontology that defines standards and protocols. Some definitions of terms are prerequisite to a further brief description of this innovation: A system-of-systems (SoS) is an engineering system that comprises multiple subsystems (e.g., a system of multiple possibly interacting flow subsystems that include pumps, valves, tanks, ducts, sensors, and the like); 'Intelligent' is used here in the sense of artificial intelligence. An intelligent element may be physical or virtual, it is network enabled, and it is able to manage data, information, and knowledge (DIaK) focused on determining its condition in the context of the entire SoS; As used here, 'health' signifies the functionality and/or structural integrity of an engineering system, subsystem, or process (leading to determination of the health of components); 'Process' can signify either a physical process in the usual sense of the word or an element into which functionally related sensors are grouped; 'Element' can signify a component (e.g., an actuator, a valve), a process, a controller, an actuator, a subsystem, or a system; The term Integrated System Health Management (ISHM) is used to describe a capability that focuses on determining the condition (health) of every element in a complex system (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK) not just data to control systems for safe and effective operation. A major novel aspect of the present development is the concept of intelligent integration. The purpose of intelligent integration, as defined and implemented in the present IIHMS, is to enable automated analysis of physical phenomena in imitation of human reasoning, including the use of qualitative methods. Intelligent integration is said to occur in a system in which all elements are intelligent and can acquire, maintain, and share knowledge and information. In the HDNIE of the present IIHMS, an SoS is represented as being operationally organized in a hierarchical-distributed format. The elements of the SoS are considered to be intelligent in that they determine their own conditions within an integrated scheme that involves consideration of data, information, knowledge bases, and methods that reside in all elements of the system. The conceptual framework of the HDNIE and the methodologies of implementing it enable the flow of information and knowledge among the elements so as to make possible the determination of the condition of each element. The necessary information and knowledge is made available to each affected element at the desired time, satisfying a need to prevent information overload while providing context-sensitive information at the proper level of detail. Provision of high-quality data is a central goal in designing this or any IIHMS. In pursuit of this goal, functionally related sensors are logically assigned to groups denoted processes. An aggregate of processes is considered to form a system. Alternatively or in addition to what has been said thus far, the HDNIE of this IIHMS can be regarded as consisting of a framework containing object models that encapsulate all elements of the system, their individual and relational knowledge bases, generic methods and procedures based on models of the applicable physics, and communication processes (Figure 2). The framework enables implementation of a paradigm inspired by how expert operators monitor the health of systems with the help of (1) DIaK from various sources, (2) software tools that assist in rapid visualization of the condition of the system, (3) analical software tools that assist in reasoning about the condition, (4) sharing of information via
Health care technology has witnessed incredible advances and increasingly effective treatments for physical and psychological disorders, but the spiritual component of care is an intervention resource that often goes unseen, unaddressed, and underused for patients facing multiple challenges. State-of-the-art services must take a perspective that expands beyond a focus on the biological and psychological needs of patients to also integrate practice skills to address spiritual needs. Spirituality can provide valuable interventions to help maintain hope and stability in times of turbulence. If health care providers are to offer holistic care to patients, we must create an environment in which spirituality is competently explored and addressed. What do health care providers have to lose by integrating the spiritual, dimension into care delivery and accessing a powerful intervention that can make a positive difference to patients? How might patients benefit and what might we learn by asking a few simple, but profound, spiritual questions? What gives your life meaning? What is your greatest hope? What do you fear? What comforts or encourages you most? As you consider how spirituality fits into and benefits your practice you might find meaning in Viktor Frankl's words, "No cure that fails to engage our spirit can make us well". PMID:16499171
Baiocchi-Wagner, Elizabeth A
Although numerous fields continue to advance research toward various areas of health prevention, communication researchers have yet to examine fully the link between communication and health improvement. This is particularly true of those studying the intersections of family and health communication-unfortunate, given that family members serve as primary socialization agents in health attitudes and behaviors. Using the example of obesity-related health behaviors, the following essay advances the argument that continued research aimed at understanding the intersection of health and families' communicative influence may help to illuminate the nature, causes, and redress to health issues that are correlated with individual health practices. This is accomplished by (a) reviewing contributions and limitations of pioneering studies in (family) health literature and (b) offering three key research areas for health communication exploration that will move scholars toward communication-based solutions (e.g., family-level communication health interventions). PMID:24837245
Earickson, R J
This paper expands on Jonathan Mann's third wave of the AIDS pandemic: the epidemic of economic, social, political, and cultural reaction and response to the HIV infection and to AIDS. This worldwide epidemic is a major economic challenge, especially in Third World countries, which can ill afford additional health care costs. AIDS is also a harbinger of political and cultural conflicts between and among nations, states, institutions, and people everywhere. It may ultimately transform law as radically as it has health care practices. In terms of management, it is possible to approach AIDS much as we do natural and technological hazards. The biology and epidemiology of AIDS require a coordinated attack, involving research on vaccines and drugs, modification of human behavior and education of populations to arrest the disease. All of these require money, of which the United States was the major contributor before the Reagan years. Funding to the United Nations and WHO has since languished, jeopardizing the AIDS efforts of those two organizations. PMID:2255967
Polanco, Nuria Toro; Zabalegui, Iñaki Berraondo; Irazusta, Itziar Pérez; Solinís, Roberto Nuño; Del Río Cámara, Mario
Introduction This paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions. Methods This organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i) readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii) collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii) overall impact of integration through several indicators based on the Triple Aim Framework. Results The measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure. Conclusion There is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.
Two areas of focus for optimizing behavioral health and human performance during International Space Station missions are 1) sleep and circadian assessment and 2) behavioral medicine. The Mir experience provided the opportunity to examine the use and potential effectiveness of tools and procedures to support the behavioral health of the crew. The experience of NASA has shown that on-orbit performance can be better maintained if behavioral health, sleep, and circadian issues are effectively monitored and properly addressed. For example, schedules can be tailored based upon fatigue level of crews and other behavioral and cognitive indicators to maximize performance. Previous research and experience with long duration missions has resulted in the development and upgrade of tools used to monitor fatigue, stress, cognitive function, and behavioral health. Self-assessment and objective tools such as the Spaceflight Cognitive Assessment Tool have been developed and refined to effectively address behavioral medicine countermeasures in space.
Chao, Jianqian; Yang, Liang; Xu, Hui; Yu, Qing; Jiang, Lili; Zong, Mengmeng
The objective of this study was to evaluate the effect of integrated health management model on the health of older adults with diabetes. The 100 older adults with diabetes who gave informed consent were randomly allocated 1:1 into management and control groups. The integrated health management model was applied in the former while the latter was only given usual care. This model included the following components: health record establishment, health evaluation and health management (such as: diet advice, psychological aspects of health, education/skills training on health self-management, regular blood glucose monitoring, long-term diabetes drug monitoring, etc.). After 18 months, differences in three categories of variables (subjective grading items, objective measurement health indices and health service utilization) between the two groups before and after the intervention were assessed with t-test, ?(2)-test and mixed model analysis. The management group demonstrated improvement on the following variables: health knowledge score, self-evaluated psychological conditions, overall self-evaluated health conditions, diet score, physical activity duration per week, regular blood sugar monitoring, waist-to-hip ratio, diastolic blood pressure and fasting blood sugar, the days of hospital admissions in the preceding 6 months. Mixed model analysis showed that gender, age, self-evaluated health status, self-evaluated psychological status, education level and resident status were important factors affecting health indices. This study demonstrated that integrated health management model was effectiveness in improving the health of older adults with diabetes. PMID:25456892
Vamos, Cheryl A; Walsh, Margaret L; Thompson, Erika; Daley, Ellen M; Detman, Linda; DeBate, Rita
Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse. PMID:25366104
Background Following a situation appraisal in 2001, a six year mental health reform programme (Egymen) 2002-7 was initiated by an Egyptian-Finnish bilateral aid project at the request of a former Egyptian minister of health, and the work was incorporated directly into the Ministry of Health and Population from 2007 onwards. This paper describes the aims, methodology and implementation of the mental health reforms and mental health policy in Egypt 2002-2009. Methods A multi-faceted and comprehensive programme which combined situation appraisal to inform planning; establishment of a health sector system for coordination, supervision and training of each level (national, governorate, district and primary care); development workshops; production of toolkits, development of guidelines and standards; encouragement of intersectoral liaison at each level; integration of mental health into health management systems; and dedicated efforts to improve forensic services, rehabilitation services, and child psychiatry services. Results The project has achieved detailed situation appraisal, epidemiological needs assessment, inclusion of mental health into the health sector reform plans, and into the National Package of Essential Health Interventions, mental health masterplan (policy guidelines) to accompany the general health policy, updated Egyptian mental health legislation, Code of Practice, adaptation of the WHO primary care guidelines, primary care training, construction of a quality system of roles and responsibilities, availability of medicines at primary care level, public education about mental health, and a research programme to inform future developments. Intersectoral liaison with education, social welfare, police and prisons at national level is underway, but has not yet been established for governorate and district levels, nor mental health training for police, prison staff and teachers. Conclusions The bilateral collaboration programme initiated a reform programme which has been sustained beyond the end of the funding. The project has demonstrated the importance of using a multi-faceted and comprehensive programme to promote sustainable system change, key elements of which include a focus on the use of rapid appropriate treatment at primary care level, strengthening the referral system, interministerial and intersectoral liaison, rehabilitation, and media work to mobilize community engagement. PMID:20576104
Walter, Phillip B.; Edwards, Robert M.
An integrated control and health monitoring architecture that is being developed for the Pratt & Whitney XNR2000 nuclear rocket concept is presented. Control system requirements such as temperature regulation, fault accommodation, and autonomous operation are discussed. The proposed architecture will meet these requirements using proven control, information processing, and intelligent decision technologies, and will be integrated into a modular system to allow easier development and implementation in a distributed manner. The development of a simulation system for modeling the dynamic behavior of nuclear rockets and to allow control system testing is described. Development work on the intelligent decision (supervisory) control module and the module interfaces continues. The development of a higher level coordinating controller will be necessary for the interface of the multiple nuclear rocket propulsion subsystem with the rest of the spacecraft systems.
Ryan, Terence J
The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice. PMID:23716803
Global Action, Center for Effective
reward and regulates behavior and emotion. This could help2000). Emotions in economic theory and economic behavior.behavior (Camerer, Lowenstein & Rabin, 2011). The change in preferences resulting from emotions
Fleary, Sasha A.
incorporates these three sources of risk-taking, however it lacks explanatory power. For this reason, this thesis focused on explaining risk perception of health risk behaviors (smoking cigarette, alcohol and marijuana use), and health risk behaviors...
Gipson, Polly; King, Cheryl
Treatment linkage and adherence to psychotherapeutic interventions can be challenging with suicidal individuals. Health behavior theories, specifically the Health Belief Model, Stages of Change, and Theory of Planned Behavior, focus on individuals' beliefs, their readiness to change, their perceptions of illness severity and "threat," their…
Johnson, Karen E.; Eisenberg, Marla E.; Bearinger, Linda H.; Fulkerson, Jayne A.; Sieving, Renee E.
Background: Evidence suggests that sports team participation differentially relates to health-risk behaviors. Few studies have explored relationships among high-risk youth. Purpose: To examine associations between weekly sports team participation and health-risk behaviors (substance use, sexual risk-taking, violence involvement) among alternative…
Philip G. Bashook
The need for mechanisms to assess the competence and performance of the behavioral health workforce has received increasing attention. This article reviews strategies used in general medicine and other disciplines for assessing trainees and practitioners. The possibilities and limitations of various approaches are reviewed, and the implications for behavioral health are addressed. A conceptual model of competence is presented, and
Becker, Marion; Jordan, Neil; Larsen, Rebecca
This article compares behavioral health service use and cost for foster care versus nonfoster care children; children before, during, and after foster care placement; and successfully reunified versus nonsuccessfully reunified foster care children. Behavioral health service costs for children in foster care were higher than for children not in…
Francisca Azocar; Loren M. McCarter; Brian J. Cuffel; Thomas W. Croghan
Medical and pharmacy utilization patterns were examined among 782 depressed patients seen by independent clinicians through a Managed Behavioral Health Organization using behavioral, medical and pharmacy claims spanning 2 years. Two-thirds received psychiatric care in the medical and mental health sector concurrently, 43% had comorbid medical disorders, 61% received psychotropic medications, and 54% were on antidepressants. Fewer depressed medically comorbid
Max Molinaro; Phyllis Solomon; Edie Mannion; Kathleen Cantwell; Arthur C. Evans Jr
The support and understanding of families, relatives, friends, and others can be of great importance in the treatment and recovery of people with mental illness (known hereafter as “service participants.”). However, behavioral health provider programs vary widely in the extent to which they contact, engage, and utilize these “significant people” (SPs) of behavioral health service participants in productive ways that
Craig Anne Heflinger; Celeste G. Simpkins; Sarah H. Scholle; Kelly J. Kelleher
The experiences of children in FFS and MC managed care plans (n = 715) were examined through satisfaction ratings by their parents\\/caregivers about their behavioral health provider and their Medicaid behavioral health plan. Multivariate regression analyses compared satisfaction ratings among children enrolled in FFS versus MC while controlling for other known predictors of satisfaction including child and parent\\/caregiver demographic characteristics,
Rutman, Irvin D.; Baron, Richard C.; Hadley, Trevor R.
This monograph examines issues in the field of psychosocial/psychiatric rehabilitation (PSR) services for people with serious mental illness, placed in the context of a debate within the field about trends toward managed behavioral health care companies. Four main issues are addressed: (1) the degree to which managed behavioral health care…
Saingam, Darika; Assanangkornchai, Sawitri; Geater, Alan F.
Drinking, smoking, and health risk behaviors are significant problems for Thai adolescents. However, little is known about the association and magnitude among alcohol, tobacco, or co-using and health risk behaviors. Data of the National School Survey of 2007 were analyzed. The sample consisted of 50,033 high school and vocational college students.…
John G. Bruhn; Guy S. Parcel
Twenty-five researchers involved in work related to the health behavior of young children attended an invitational conference to achieve consensus regarding: (a) the definitions, research methods, instru ments, and variables that should guide future research into the health behavior of young children, and (b) the nature of the knowledge deficits that should be addressed by future research. The researchers examined
Rosemarie Kobau; Marc A Safran; Matthew M Zack; David G Moriarty; Daniel Chapman
BACKGROUND: Mood disorders are a major public health problem in the United States as well as globally. Less information exists however, about the health burden resulting from subsyndromal levels of depressive symptomatology, such as feeling sad, blue or depressed, among the general U.S. population. METHODS: As part of an optional Quality of Life survey module added to the U.S. Behavioral
Pipkin, Claire St. Peter; Vollmer, Timothy R.; Sloman, Kimberly N.
Differential reinforcement of alternative behavior (DRA) is used frequently as a treatment for problem behavior. Previous studies on treatment integrity failures during DRA suggest that the intervention is robust, but research has not yet investigated the effects of different types of integrity failures. We examined the effects of two types of…
Integrating a behavior-based approach to active stereo vision with an intelligent control. In this chapter we describe our behavior- based active stereo vision system and how we integrated this system uses a stereo-based active vision system to accomplish several di erent tasks, including pursuing other
Hashemian, H. M.; Shumaker, B. D.; McCulley, J. R.; Morton, G. W.
Based on such criteria as safety and mission success, programmatic risk, affordability, and extensibility/flexibility, the National Aeronautics and Space Administration (NASA) has chosen fission surface power (FSP) as the primary energy source for building a sustained human presence on the Moon, exploring Mars, and extremely long-duration space missions. The current benchmark FSP system has a mission life of at least 8 years during which time there is no opportunity for repair, sensor calibrations, or periodic maintenance tasks that are normally performed on terrestrial-based nuclear power plants during scheduled outages. Current technology relies heavily on real-time human interaction, monitoring and control. However; due to the long communication times between the Earth and Moon, or Mars, real-time human control is not possible, resulting in a critical need to develop autonomous health monitoring technology for FSP systems.This paper describes the design and development of an autonomous health monitoring system that will (1) provide on-line calibration monitoring, (2) reduce uncertainties in sensor measurements, and (3) provide sensor validation and fault detection capabilities for the control systems of various FSP subsystems. The health monitoring system design integrates a number of signal processing algorithms and techniques such as cross-calibration, empirical modeling using neural networks, and physical modeling under a modular signal processing platform that will enable robust sensor and system monitoring without the need for human interaction. Prototypes of the health monitoring system have been tested and validated on data acquired from preliminary subsystem testing of NASA's FSP Technology Demonstration Unit (TDU) as well as simulated laboratory data. Results from this testing have demonstrated the utility and benefits that such autonomous health monitoring systems can provide to FSP subsystems and other potential applications within NASA such as launch vehicle systems, other nuclear power systems, and ground operations.
Peker, Kadriye; Bermek, Gülçin
The aim of this cross-sectional study was to determine the predictors of health-promoting behaviors among freshman dental students at Istanbul University. Data were collected from a convenience sample of 111 students using questionnaires including a sociodemographic section, the Health-Promoting Lifestyle Profile II, the Health Value Scale, the Generalized Self-Efficacy Scale, the Perceived Stress Scale, and the Multidimensional Scale of Perceived Social Support. Data were analyzed using descriptive statistics, t-test, Pearson's correlation, and stepwise multiple linear regression. The overall health-promoting lifestyle behaviors among these students were at a moderate level, indicating that they engaged in health-promoting behaviors sometimes to often. They scored highest on the spiritual growth but lower on the health responsibility subscales. Females reported having engaged more in health responsibility behaviors and lower in physical activity than did males. Students from high-income families reported more physical activity. Significant correlations were found between overall health-promoting lifestyle behaviors, self-efficacy, health value, stress, and social support. Among all the related factors, self-efficacy was the most strongly predictive factor: it explained 61 percent of the variance in overall health-promoting behaviors. Thus, self-efficacy as a cognitive-perceptual factor should be considered by dental educators when planning educational interventions to promote students' healthy lifestyle. PMID:21368265
Satre, Derek; Gordon, Nancy P.; Weisner, Constance
ethnicity (African-American) and worse self-reported health.African-American vs others) Lower education Diabetes Worse self-reported healthAfrican-American vs. White), lower education, diabetes, and worse self-reported health.
Jordan, Stephen J; Benson, William H
Sustainable management of aquatic ecosystems is a worldwide priority; the integrity of these systems depends, in turn, on the integrity of the watersheds (catchments) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health, and socioeconomic values in the context of water quality, water quantity, landscapes, the condition of watersheds, and the connectivity of waters, from headwaters to estuaries and the coastal ocean. These assessments will be a foundation for what we have termed "watershed epidemiology," through which the connections between ecosystems and human health can be explored over broad spatial and temporal scales. Understanding and communicating these relationships should lead to greater awareness of the roles watersheds play in human well-being, and hence to better management and stewardship of water resources. The U.S. Environmental Protection Agency is developing the research, models, and planning tools to support operational national assessments of watershed sustainability, building upon ongoing assessments of aquatic resources in streams, rivers, lakes, wetlands and estuaries. PMID:25987844
Jordan, Stephen J; Benson, William H
Sustainable management of aquatic ecosystems is a worldwide priority; the integrity of these systems depends, in turn, on the integrity of the watersheds (catchments) in which they are embedded. In this article, we present the concepts, background, and scientific foundations for assessing, both nationally and at finer scales, the relationships between ecosystem services, human health, and socioeconomic values in the context of water quality, water quantity, landscapes, the condition of watersheds, and the connectivity of waters, from headwaters to estuaries and the coastal ocean. These assessments will be a foundation for what we have termed “watershed epidemiology,” through which the connections between ecosystems and human health can be explored over broad spatial and temporal scales. Understanding and communicating these relationships should lead to greater awareness of the roles watersheds play in human well-being, and hence to better management and stewardship of water resources. The U.S. Environmental Protection Agency is developing the research, models, and planning tools to support operational national assessments of watershed sustainability, building upon ongoing assessments of aquatic resources in streams, rivers, lakes, wetlands and estuaries. PMID:25987844
Cash-Gibson, Lucinda; Rosenmoller, Magdalene
Background The use of case studies in health services research has proven to be an excellent methodology for gaining in-depth understanding of the organisation and delivery of health care. This is particularly relevant when looking at the complexity of integrated healthcare programmes, where multifaceted interactions occur at the different levels of care and often without a clear link between the interventions (new and/or existing) and their impact on outcomes (in terms of patients health, both patient and professional satisfaction and cost-effectiveness). Still, integrated care is seen as a core strategy in the sustainability of health and care provision in most societies in Europe and beyond. More specifically, at present, there is neither clear evidence on transferable factors of integrated care success nor a method for determining how to establish these specific success factors. The drawback of case methodology in this case, however, is that the in-depth results or lessons generated are usually highly context-specific and thus brings the challenge of transferability of findings to other settings, as different health care systems and different indications are often not comparable. Project INTEGRATE, a European Commission-funded project, has been designed to overcome these problems; it looks into four chronic conditions in different European settings, under a common methodology framework (taking a mixed-methods approach) to try to overcome the issue of context specificity and limited transferability. The common methodological framework described in this paper seeks to bring together the different case study findings in a way that key lessons may be derived and transferred between countries, contexts and patient-groups, where integrated care is delivered in order to provide insight into generalisability and build on existing evidence in this field. Methodology To compare the different integrated care experiences, a mixed-methods approach has been adopted with the creation of a common methodological framework (including data collection tools and case study template report) to be used by the case studies for their analyses. Methods of analysis The four case studies attempt to compare health care services before and after the ‘integration’ of care, while triangulating the findings using quantitative and qualitative data, and provide an in-depth description of the organisation and delivery of care, and the impact on outcomes. The common framework aims to allow for the extraction of key transferable learning from the cases, taking into account context-dependency. Conclusion The application and evaluation of the common methodological approach aim to distill and identify important elements for successful integrated care, in order to strengthen the evidence base for integrated care (by facilitating cross-context comparisons), increase the transferability of findings from highly context-specific to other settings and lead to concrete and practical policy and operational recommendations. PMID:25550690
Ahgren, Bengt; Axelsson, Runo
Introduction The recent history of integrated health care in Sweden is explored in this article, focusing on the first decade of the 2000s. In addition, there are some reflections about successes and setbacks in this development and challenges for the next decade. Description of policy and practice The first efforts to integrate health care in Sweden appeared in the beginning of the 1990s. The focus was on integration of intra-organisational processes, aiming at a more cost-effective health care provision. Partly as a reaction to the increasing economism at that time, there was also a growing interest in quality improvement. Out of this work emerged the ‘chains of care’, integrating all health care providers involved in the care of specific patient groups. During the 2000s, many county councils have also introduced inter-organisational systems of ‘local health care’. There has also been increasing collaboration between health professionals and other professional groups in different health and welfare services. Discussion and conclusion Local health care meant that the chains of care and other forms of integration and collaboration became embedded in a more integrative context. At the same time, however, policy makers have promoted free patient choice in primary health care and also mergers of hospitals and clinical departments. These policies tend to fragment the provision of health care and have an adverse effect on the development of integrated care. As a counterbalance, more efforts should be put into evaluation of integrated health care, in order to replace political convictions with evidence concerning the benefits of such health care provision. PMID:21677844
Schonfeld, Lawrence; Braue, Lawrence A; Stire, Sheryl; Gum, Amber M; Cross, Brittany L; Brown, Lisa M
Abstract Increasing numbers of student service members/veterans (SSM/Vs) are enrolling in college. However, little is known about how their previous military experience affects their adjustment to this new role. The present study tested the hypothesis that SSM/Vs who report adjustment problems in college have a higher incidence of posttraumatic stress disorder (PTSD), depression, and other behavioral health problems compared to those who do not report adjustment problems. SSM/Vs (n = 173) at a large, Southeastern, public university completed online surveys that included well-validated screens measuring substance use, depression, PTSD, and other mental disorders. Those reporting difficulties adjusting to university life (28%) reported significantly higher frequencies of behavioral and health problems while in the military, and significantly higher levels of PTSD, depression, and mental health disorders, but no difference in substance use. Implications for improved behavioral health screening and coordination of university behavioral health services with veterans' health systems are discussed. PMID:25257623
Dahl, D H; McFarlan, T K
Technology management has assumed a role of vital importance in today's health care environment. Capital reserves and operating income have been stretched by pervasive and expensive technologies, while overall reimbursement has been reduced. It is imperative for hospitals to develop and consistently use technology management processes that begin prior to a technology's introduction in the hospital and continue throughout its life cycle. At Samaritan Health System (SHS), an integrated health care delivery system based in Phoenix, technology management provides tools to improve decision making and assist in the system's integration strategy as well as control expenses. SHS uses a systemwide technology-specific plan to guide acquisition and/or funding decisions. This plan describes how particular technologies can help achieve SHS' organizational goals such as promoting system integration and/or improving patient outcomes while providing good economic value. After technologies are targeted in this systemwide plan they are prioritized using a two-stage capital prioritization process. The first stage of the capital prioritization process considers the quantitative and qualitative factors critical for equitable capital distribution across the system. The second stage develops a sense of ownership among the parties that affect and are affected by the allocation at a facility level. This process promotes an efficient, effective, equitable, and defensible approach to resource allocation and technology decision making. Minimizing equipment maintenance expenditures is also an integral part of technology management at SHS. The keys to reducing maintenance expenditures are having a process in place that supports a routine fiscal evaluation of maintenance coverage options and ensuring that manufacturers are obligated to provide critical maintenance resources at the time of equipment purchase. Maintenance service options under consideration in this report include full-service contracts with the manufacturer, insurance coverage, time and materials, and independent service vendors/in-house support. Careful consideration of all the ramifications of each option is warranted because there are substantial cost differences among these methods. At SHS, technology management efforts resulted in equipment purchases and maintenance negotiations representing savings of more than $1.5 million in a single year. SHS undertakes an intensive review of purchases and maintenance expenditures, using the techniques described in this report, with the objective of reducing expenses by 10% per year. This report describes the technology management methods that SHS uses to achieve these results. PMID:10139509
The role and position of chiropractic care in the health care system must be transformed from being alternative and separate to alternative and mainstream. This transformation requires that chiropractic services become integrated in the many health care delivery organizations that collectively constitute the health care system. There is solid and impressive economic and related justification for the desired integration. Chiropractic
Michael P. Fisher; Christine Elnitsky
Health and social services integration is particularly relevant for populations whose needs span physical health, mental health, housing, and disability services, along with others. Veterans, homeless, chronically ill, and aging are among those populations. This review examines recent peer-reviewed literature about different approaches to services integration, rationales behind those approaches, and successes of those approaches, including factors that make them
McGovern, Thomas V.; Miller, Samantha Leigh
We describe a model for new and senior faculty members, integrating a behavioral approach to enhancing teaching skills with research from the field of positive psychology on virtues and character strengths. The Teacher Behaviors Checklist (Keeley, Smith, & Buskist, 2006) identifies target behaviors amenable to modification, derived from…
Analyzing bank databases for customer behavior management is difficult since bank databases are multi-dimensional, comprised of monthly account records and daily transaction records. This study proposes an integrated data mining and behavioral scoring model to manage existing credit card customers in a bank. A self-organizing map neural network was used to identify groups of customers based on repayment behavior and
Gary E. Schwartz; Alvin P. Shapiro; Daniel P. Redmond; Donald C. E. Ferguson; David R. Ragland; Stephen M. Weiss
This article compares behavioral and biological approaches to hypertension, highlights some of the practical, semantic, and theoretical issues involved, and attempts a constructive, behavioral medicine integration of these approaches. The major behavioral approaches to hypertension are described, with a focus on their conceptual limitations as stimulants to research into psychobiological mechanisms. A biobehavioral systems analysis of hypertension is outlined, emphasizing
Integrating Theories of Message Effects and Health Behavior Change to Improve Cancer Control In recognition of cancer communication as an "Extraordinary Opportunity," the National Cancer Institute's Behavioral Research Program (part of DCCPS) supports the Theories Project to examine the role of theory in health behavior and to promote the use of theory in health behavior research.
ACCLIMATION OF HOLSTEIN CALVES TO TRANSIT STRESS: THE INTEGRATION OF ENDOCRINE, IMMUNE, AND BEHAVIOR SYSTEMS A Dissertation by AMBER LYNN ADAMS Submitted to the Office of Graduate Studies of Texas A&M University in partial..., and Behavior Systems Copyright 2012 Amber Lynn Adams ACCLIMATION OF HOLSTEIN CALVES TO TRANSIT STRESS: THE INTEGRATION OF ENDOCRINE, IMMUNE, AND BEHAVIOR SYSTEMS A Dissertation by AMBER LYNN ADAMS Submitted to the Office of Graduate Studies...
Sun, Ru-Jiao; Sun, Zhi; Dan, Dan-Hui; Sun, Li-Min
Thanking to its distinguishing advantages including wavelength multiplexing capability, miniature size, high sensitivity, immunity from electro-magnetic interference and etc, the fiber Bragg grating (FBG) sensing technologies are regarded as a competent candidate for the bridge long-term health monitoring. According to the shifted Bragg wavelength of the light reflected by a fiber grating, the FBG sensors can accurately measure various physical properties such as strain, temperature, displacement, acceleration and corrosion. One special advantage of the FBG sensing technology is that only one demodulation device is required to acquire various physical properties simultaneously. Compared with the bridge health monitoring system using conventional sensors, this advantage makes the quasi-distributed sensing possible and data transmission more convenient because many FBG sensors can be connected in series by a single fiber. In this paper, an integrated FBG sensing system is presented for monitoring the physical state of a real bridge, the main-navigation channel cable-stayed bridge of the Donghai Bridge. The strain variation of two selected sections in the construction stage and during the load trial test are continuously monitored. The results of this study will supply a good guidance for the use of FBG sensors on the health monitoring of real bridges. Finally, the paper present the design and fabrication of an accelerometer based on the FBG technology for structure vibration monitoring.
Hospitals throughout the country are increasingly sharing health services, jointly purchasing supplies, and merging. The Veterans Administration (VA)-Department of Defense (DoD) Health Resources Sharing Law of 1982 (PL 97-174) has encouraged much closer relationships between hospitals of these agencies than had existed previously. All VA hospitals within 50 miles of a military treatment facility now have multiservice agreements. Before passage of the law, only a handful of facilities were involved in limited sharing. Closer relationships have led to expanded care for federal beneficiaries at considerable cost savings. In Albuquerque, New Mexico, for example, the VA Medical Center houses the VA and Air Force hospital operations, obviating the need for a separate freestanding hospital. The lack of VA authority to receive reimbursement from the Civilian Health and Medical Program for the Uniformed Services and a lack of a reimbursement incentive for military hospitals to share are identified as factors preventing greater coordination. Even greater local integration of services is likely to occur in the future. PMID:10291807
Current changes in health care professions requiring practitioners to have more and better communications skills are necessitating the integration of writing into the health curricula of higher education programs. At Ferris State University, a number of models (in Optometry, Dental Hygiene, Health Systems Management, Nursing, Pharmacy, Medical…
Paula M. Lantz; John W. Lynch; James S. House; James M. Lepkowski; Richard P. Mero; Marc A. Musick; David R. Williams
This study investigated the hypothesis that socioeconomic differences in health status change can largely be explained by the higher prevalence of individual health-risk behaviors among those of lower socioeconomic position. Data were from the Americans’ Changing Lives study, a longitudinal survey of 3617 adults representative of the US non-institutionalized population in 1986. The authors examined associations between income and education
Murphy, Caitlin C.; Vernon, Sally W.; Diamond, Pamela M.; Tiro, Jasmin A.
Background Competitive hypothesis testing may explain differences in predictive power across multiple health behavior theories. Purpose We tested competing hypotheses of the Health Belief Model (HBM) and Theory of Reasoned Action (TRA) to quantify pathways linking subjective norm, benefits, barriers, intention, and mammography behavior. Methods We analyzed longitudinal surveys of women veterans randomized to the control group of a mammography intervention trial (n=704). We compared direct, partial mediation, and full mediation models with Satorra-Bentler ?2 difference testing. Results Barriers had a direct and indirect negative effect on mammography behavior; intention only partially mediated barriers. Benefits had little to no effect on behavior and intention; however, it was negatively correlated with barriers. Subjective norm directly affected behavior and indirectly affected intention through barriers. Conclusions Our results provide empiric support for different assertions of HBM and TRA. Future interventions should test whether building subjective norm and reducing negative attitudes increases regular mammography. PMID:23868613
Campo, John; Kilbourne, Amy M.; Hart, Jonathan; Sakolsky, Dara; Wisniewski, Stephen
OBJECTIVE: To assess the efficacy of collaborative care for behavior problems, attention-deficit/hyperactivity disorder (ADHD), and anxiety in pediatric primary care (Doctor Office Collaborative Care; DOCC). METHODS: Children and their caregivers participated from 8 pediatric practices that were cluster randomized to DOCC (n = 160) or enhanced usual care (EUC; n = 161). In DOCC, a care manager delivered a personalized, evidence-based intervention. EUC patients received psychoeducation and a facilitated specialty care referral. Care processes measures were collected after the 6-month intervention period. Family outcome measures included the Vanderbilt ADHD Diagnostic Parent Rating Scale, Parenting Stress Index-Short Form, Individualized Goal Attainment Ratings, and Clinical Global Impression-Improvement Scale. Most measures were collected at baseline, and 6-, 12-, and 18-month assessments. Provider outcome measures examined perceived treatment change, efficacy, and obstacles, and practice climate. RESULTS: DOCC (versus EUC) was associated with higher rates of treatment initiation (99.4% vs 54.2%; P < .001) and completion (76.6% vs 11.6%, P < .001), improvement in behavior problems, hyperactivity, and internalizing problems (P < .05 to .01), and parental stress (P < .05–.001), remission in behavior and internalizing problems (P < .01, .05), goal improvement (P < .05 to .001), treatment response (P < .05), and consumer satisfaction (P < .05). DOCC pediatricians reported greater perceived practice change, efficacy, and skill use to treat ADHD (P < .05 to .01). CONCLUSIONS: Implementing a collaborative care intervention for behavior problems in community pediatric practices is feasible and broadly effective, supporting the utility of integrated behavioral health care services. PMID:24664093
Suedfeld, Peter; Bootzin, Richard; Harvey, Allison; Leon, Gloria; Musson, David; Oltmanns, Thomas; Paulus, Martin
The first meeting of the Behavioral Health and Performance (BHP) Standing Review Panel (SRP) was held in Houston, TX on November 1-3, 2009. Our task was to assess the Integrated Research Plan (IRP) related to the fields covered in the SRP charge (see section VIII). Having considered and discussed the extensive materials distributed prior to the meeting, and the highly informative briefings by the NASA BHP Human Research Program (HRP) personnel during the site visit, the SRP agreed that the IRP is comprehensive and was developed carefully. Question and answer periods with the presenters were particularly productive and helpful to the SRP. The presenters' willingness to share information and positive responses to the SRP's suggestions were greatly appreciated. Although the IRP and related documents are impressive, the SRP does have a number of recommendations regarding both the overall plan and its component parts.
Mychailyszyn, Matthew P.; Edmunds, Julie M.; Khanna, Muniya S.; Downey, Margaret Mary; Kendall, Philip C.
Anxiety disorders are among the most prevalent mental health difficulties experienced by youth. A well-established literature has identified cognitive-behavior therapy (CBT) as the gold-standard psychosocial treatment for youth anxiety disorders. Access to CBT in community clinics is limited, but a potential venue for the provision of CBT for child anxiety disorders is the school setting. The present study examined a subset of data from a larger study in which therapists from a variety of settings, including schools, were trained in CBT for child anxiety (N = 17). The study investigated the relationship between provider- and organizational-level variables associated with training and implementation among school mental health providers. The present findings indicate a positive relationship between provider attitudes and adherence to CBT. Self-reported barriers to implementation were also identified. Integrating CBT into school mental health providers’ repertoires through training and consultation is a critical step for dissemination and implementation of empirically supported psychosocial treatments. PMID:24817916
Behavioral Health Affordable Care Act Initiative (BHACA)," a collaborative initiative designed by the Network health providers so that they are agency-ready for the full roll out of the Affordable Care Act mandates of the Affordable Care Act and its impact on health providers. Experience in presenting to professional and academic