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An essential characteristic of advanced practice nurses is the use of theory in practice. Clinical nurse specialists apply theory in providing or directing patient care, in their work as consultants to staff nurses, and as leaders influencing and facilitating system change. Knowledge of technology and pharmacology has far outpaced knowledge of how to facilitate healthbehavior change, and new theories are needed to better understand how practitioners can facilitate healthbehavior change. In this article, the Integrated Theory of HealthBehavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of HealthBehavior Change suggests that healthbehavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation. Engagement in self-management behaviors is seen as the proximal outcome influencing the long-term distal outcome of improved health status. Person-centered interventions are directed to increasing knowledge and beliefs, self-regulation skills and abilities, and social facilitation. Using a theoretical framework improves clinical nurse specialist practice by focusing assessments, directing the use of best-practice interventions, and improving patient outcomes. Using theory fosters improved communication with other disciplines and enhances the management of complex clinical conditions by providing holistic, comprehensive care.
This study explores the effects of social integration on behavioral change in the course of an intensive, community-based public health intervention. The intervention trained volunteers and mobilized local organizations to promote 16 key family health practices in rural San Luis, Honduras, during 2004 to 2006. A mixed methods approach is used.…
McQuestion, Michael J.; Calle, Ana Quijano; Drasbek, Christopher; Harkins, Thomas; Sagastume, Lourdes J.
Costs and effective management of health care in general, and behavioralhealth care in particular, have been of primary importance and concern to federal, state, and local governments. With the passage of Health Care Reform (HCR) these concerns will only escalate. Thus, the necessity for the development of innovative, successful, and integrated cost-effective treatments and procedures is evident. The behavioralhealth care model presented here is proposed to address these needs. The model centers on the composition of effective psychosocial treatment and provides a cost analysis of social work and its services. By defining the problems that need to be addressed in health care management and cost containment, and applying findings of evidence-based studies, this article provides an effective model for health care organizations. It also presents a profile of the behavioralhealth social worker, defining the requisite abilities for effectiveness in the role and looking at the key impact areas for a behavioralhealth model. This comprehensive guide will prepare new social workers entering health care organizations as well as provide a valuable reference for existing social workers, academics, and practitioners of behavioralhealth care. PMID:24871769
The article examines community dental health promotion for children in terms of factors impacting children's dental health (water fluoridation, dental health education, behavior change strategies, use of dental services, and dental phobias). Proposed is a large scale behavior change approach to public dental health which integrates applied…
To address the local health care needs of both patients and primary care providers in Montana, an integrated primary care and behavioralhealth 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…
This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioralhealth versus standard managed behavioralhealth care plans. A national managed behavioralhealth care organization's claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioralhealth services (OR 1.20, CI 1.17-1.24), and substance abuse services specifically (OR 1.23, CI 1.06-1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier. PMID:19690952
Levy Merrick, Elizabeth S; Hodgkin, Dominic; Horgan, Constance M; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G
Comments on the article "Joint principles: Integratingbehavioralhealth care into the patient-centered medical home" (see record 2014-24217-011). The American Association for Marriage and Family Therapy (AAMFT) represents a mental health profession with a long track record in integrated primary care, particularly with family medicine. The authors begin by affirming several core themes in the joint principles-behavioralhealth (JP-BH) statement. They then offer a systemic/relational perspective on the patient-centered medical home that goes beyond the focus of the JP-HP. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24955682
Doherty, William J; Hodgson, Jennifer L; Lamson, Angela L; Mendenhall, Tai J; Todd, Tracy
This article describes a process for integratinghealthbehavior 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 healthbehavior by offering…
Gillen, Emily M.; Hassmiller Lich, Kristen; Yeatts, Karin B.; Hernandez, Michelle L.; Smith, Timothy W.; Lewis, Megan A.
Integratedbehavioralhealth and primary care is emerging as a superior means by which to address the needs of the whole person, but we know neither the extent nor the distribution of integration. Using the Centers for Medicare and Medicaid Services' National Plan and Provider Enumeration System (NPPES) Downloadable File, this study reports where colocation exists for (a) primary care providers and any behavioralhealth provider and (b) primary care providers and psychologists specifically. The NPPES database offers new insights into where opportunities are limited for integration due to workforce shortages or nonproximity of providers and where possibilities exist for colocation, a prerequisite for integration. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24820692
Miller, Benjamin F; Petterson, Stephen; Burke, Bridget Teevan; Phillips, Robert L; Green, Larry A
The integration of behavioralhealth (BH) and primary care services has been the subject of considerable attention for almost a decade. Such work has been motivated by the prevalence of chronic health problems in persons with BH conditions and correspondingly high rates of early death. Service integration efforts typically included cross-referral or bidirectional efforts to add some features of primary care to specialty BH settings or the reverse. This article proposes a third approach based on full service and financial integration and shows how it differs substantially from the other 2 models. This new model has the potential to bring much-needed BH services to persons served in primary care settings who have these conditions, while fostering integrated services in specialty settings for those with the most severe mental or substance use conditions. The Patient Protection and Affordable Care Act could provide a valuable opportunity to implement this third model. PMID:24573665
Comments on the article "Joint principles: Integratingbehavioralhealth care into the patient-centered medical home" (see record 2014-24217-011). The American Psychiatric Association Workgroup on Integrated Care supports the recommendations made in these Joint Principles and recognizes the significant benefit of treating behavioral and general medical conditions concurrently. The workgroup offers comments on this effort as it pertains to health care in general and psychiatric practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24955687
Raney, Lori; Pollack, David; Parks, Joe; Katon, Wayne
We evaluated the Starting Early Starting Smart (SESS) national initiative to integratebehavioralhealth 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 behavioralhealth factors, with\\u000a infants less than 12 months of age
Connie E. Morrow; Elana Mansoor; K. Lori Hanson; April L. Vogel; Ruth Rose-Jacobs; Carolyn Seval Genatossio; Amy Windham; Emmalee S. Bandstra
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.
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
Mohr, David C; Schueller, Stephen M; Montague, Enid; Burns, Michelle Nicole; Rashidi, Parisa
Assertive community treatment (ACT) and integrated dual disorders treatment (IDDT) have individually proven effective for treatment of adults with complex behavioralhealth and housing needs. This study evaluated the effectiveness of an ACT team that delivered integrated care consistent with IDDT principles. Participants included 60 adults with a history of chronic homelessness and co-occurring mental health and substance use disorders. Measures assessing mental health, substance use, and residential stability were completed at intake to the program and then 6 months later. Participants reported statistically significant improvements in mental health symptomatology and residential stability over time, although there were no changes in substance use. Findings support the effectiveness of the intervention for improving mental health and housing stability among adults with complex behavioralhealth and housing needs. Fidelity data support the notion that multiple evidence-based interventions can be integrated while still maintaining adequate fidelity to individual components. PMID:24346225
Young, M Scott; Barrett, Blake; Engelhardt, Mark A; Moore, Kathleen A
The Collaborative Family Healthcare Association (CFHA) welcomes the opportunity to comment on the complementary set of Joint Principles underscoring the Integration of BehavioralHealth Care Into the Patient-Centered Medical Home (The Working Party Group on IntegratedBehavioral Healthcare et al., 2014). CFHA is an organization that promotes comprehensive and cost-effective models of health care delivery that integrate mind and body, individual and family, patients, providers, and communities. CFHA appreciates that the Joint Principles do not explicitly endorse any single model of collaboration between behavioralhealth and medical practice. Rather, they broadly emphasize integration, affirming the only way to have a whole person orientation is to adopt a biopsychosocial-spiritual perspective. This commentary will highlight areas of notable strength within the Joint Principles, as well as challenge the language, if not perspective, on a few critical elements. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24955686
Background: Adaptive healthbehavior changes following cancer diagnosis and treatment are associated with better psychological and physical\\u000a well-being. However, little is known about the roles that psychosocial factors play in facilitating or inhibiting these changes.\\u000a A better understanding of healthbehavior change will allow the development of more effective interventions.Purpose: Our goal was to conduct a systematic and exhaustive review
Research over the past 20 years suggests that the quality of the parent-adolescent relationship significantly affects the development of risk behaviors in adolescent health. The purpose of this paper is to present a review of studies published between 1996-2007 that address specific relationships between parenting styles and six priority adolescent risk behaviors. The review supports the substantial influence of parenting style on adolescent development. Adolescents raised in authoritative households consistently demonstrate higher protective and fewer risk behaviors than adolescents from non-authoritative families. There is also considerable evidence to show that parenting styles and behaviors related to warmth, communication and disciplinary practices predict important mediators, including academic achievement and psychosocial adjustment. Careful examination of parenting style patterns in diverse populations, particularly with respect to physical activity and unintentional injury, will be a critical next step in the development of efficacious, culturally tailored adolescent health promotion interventions. PMID:18392544
Newman, Kathy; Harrison, Lynda; Dashiff, Carol; Davies, Susan
Disparities in Latino utilization of mental health services have been documented for some years. Factors such as stigma, low rates of health insurance, paucity of culturally competent providers, and linguistic inaccessibility have contributed to this underutilization. The documented tendency of many Latinos to experience the mind and body as a unified whole, often referred to as "non-dualism"; provides a unique opportunity to address these disparities in utilization. This article advocates a specific model of engagement of Latinos into a continuum of needed behavioralhealth services via the primary care clinic, and suggests a variety of clinical and administrative outcome measures for evaluating the effectiveness of the model. The model centers on the inclusion of a behavioralhealth specialist who is "nested" within the primary care team. The preparation and perspectives of clinically trained social workers make them ideal for this role. PMID:19042495
\\u000a Optimizing the health and quality of life for people who have survived cancer requires a continuing focus on health promotion\\u000a and behavior change to reduce behavioralhealth risks. A focus on optimizing healthbehavior is critical for people surviving\\u000a cancer because they are at increased risk for the development of chronic health conditions. Some of these conditions may develop\\u000a from
Robyn Osborn; Tricia L. Psota; Jaesin Sa; Tracy Sbrocco
Recovery from mental illness is a process that involves personal decision-making in many areas. Nurses are in a unique position to assist individuals in assessing their personal health status and integratinghealthbehaviors into their recovery plans. The use of assessment tools, motivational interviewing techniques, and recovery planning can help individuals make decisions about their health, try out new behaviors, and integrate healthy living behaviors into a recovery plan and activities. This role of the nurse in this process is outlined, strategies are described, and outcome examples are provided. PMID:20624022
Objectives. We evaluated a quality improvement program with a pay-for-performance (P4P) incentive in a population-focused, integrated care program for safety-net patients in 29 community health clinics. Methods. We used a quasi-experimental design with 1673 depressed adults before and 6304 adults after the implementation of the P4P program. Survival analyses examined the time to improvement in depression before and after implementation of the P4P program, with adjustments for patient characteristics and clustering by health care organization. Results. Program participants had high levels of depression, other psychiatric and substance abuse problems, and social adversity. After implementation of the P4P incentive program, participants were more likely to experience timely follow-up, and the time to depression improvement was significantly reduced. The hazard ratio for achieving treatment response was 1.73 (95% confidence interval?=?1.39, 2.14) after the P4P program implementation compared with pre-program implementation. Conclusions. Although this quasi-experiment cannot prove that the P4P initiative directly caused improved patient outcomes, our analyses strongly suggest that when key quality indicators are tracked and a substantial portion of payment is tied to such quality indicators, the effectiveness of care for safety-net populations can be substantially improved.
Chan, Ya-Fen; Hafer, Erin; Knaster, Jessica; Shields, Anne; Powers, Diane; Veith, Richard C.
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, & Wohlford, 1997; E. Cohen
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, &…
The project goal is to develop behavioralhealth 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 behavioralhealth 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 behavioralhealth 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).
Special patient populations can present unique opportunities and challenges to integrating primary care and behavioralhealth services. This article focuses on four special populations: children with special needs, persons with severe and persistent mental illness, refugees, and deaf people who communicate via sign language. The current state of primary care and behavioralhealth collaboration regarding each of these four populations is examined via Doherty, McDaniel, and Baird's (1996) five-level collaboration model. The section on children with special needs offers contrasting case studies that highlight the consequences of effective versus ineffective service integration. The challenges and potential benefits of service integration for the severely mentally ill are examined via description of PRICARe (Promoting Resources for Integrated Care and Recovery), a model program in Colorado. The discussion regarding a refugee population focuses on service integration needs and emerging collaborative models as well as ways in which refugee mental health research can be improved. The section on deaf individuals examines how sign language users are typically marginalized in health care settings and offers suggestions for improving the health care experiences and outcomes of deaf persons. A well-integrated model program for deaf persons in Austria is described. All four of these special populations will benefit from further integration of primary care and mental health services. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24820687
Pollard, Robert Q; Betts, William R; Carroll, Jennifer K; Waxmonsky, Jeanette A; Barnett, Steven; Degruy, Frank V; Pickler, Laura L; Kellar-Guenther, Yvonne
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 behavioralintegrity to better understand the relationship between the leader's behavioralintegrity regarding safety and work-related injuries. In a time-lagged study of 658 nurses, we find that behavioralintegrity for high safety values is positively associated with greater reporting of fewer and less severe occupational injuries. The effects of behavioralintegrity 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
Halbesleben, Jonathon R B; Leroy, Hannes; Dierynck, Bart; Simons, Tony; Savage, Grant T; McCaughey, Deirdre; Leon, Matthew R
The Integrative Cardiac Health Project (ICHP) aims to lead the way in Cardiovascular Disease (CVD) Prevention by conducting novel research utilizing a Systems Biology / personalized medicine design to discover and develop practical, effective and preempti...
Environmental degradation seriously affects human health. Thus, a close relationship exists between the protection of ecosystem integrity and wilderness on one hand, and human health on the other. However, there is an overarching, holistic perspective in laws and regulations--as well as morality--to to maintain a healthy relationship between the two. Problem areas focused on in this paper are: (a) climate change and global warming; (b) food production; and (c) global equity. This paper argues for the principle of integrity, which provides an holistic perspective, suggested as a better approach than that of current regulations to mitigate against associated threats to human health. PMID:8693347
A review of theoretical and experimental literature on school health education indicates that most programs have focused on health knowledge despite conflicting information on the impact of knowledge based programs on healthbehaviors. Needed are interventions that include environmental engineering to support healthbehaviors and use of…
Borrowing insights from philosophical discussions on the concept of integrity, we propose a framework to understand religious behavior in consumption, production, and exchange. Whereas previous economic explanations of religious behavior have focused on preferences, opportunity sets, or social pressure, we emphasize the notion of integrity defined as identity-conferring commitments. We provide a framework that not only introduces commitment and identity
Health is best understood within an ecological context. Accordingly, health promotion involves processes that foster supportive environments and healthfulbehavior. 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…
People are inherently driven by the need to form and maintain relationships, and these affiliation goals can influence healthbehaviors in two ways: (a) indirectly, by increasing a person’s attention to others and subsequently leaving them more likely to emulate the healthbehaviors of others (social contagion); (b) directly, by leading people to be more likely to engage in healthbehaviors they perceive as helping them to form and maintain relationships with others (self-initiated behavioral engagement). In this review, we discuss the evidence for the catalyzing role of affiliation goals in these two processes for a variety of positive (e.g., exercising, smoking-cessation) and detrimental healthbehaviors (e.g., binge drinking and eating, needle sharing). Additionally, we discuss individual difference factors that may temporarily or chronically activate affiliation goals and ultimately impact healthbehaviors. Affiliation goals hold many implications for future work, and for improving interventions.
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
National survey data were used to assess whether child welfare agency ties to behavioralhealth care providers improved placement stability for adolescents served by both systems. Adolescents initially at home who were later removed tended to have fewer moves when child welfare and behavioralhealth were in the same larger agency. Joint training of child welfare and behavioralhealth staff was negatively associated with numbers of moves as well as numbers of days out of home.
The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in healthbehaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and healthbehaviors can do more to design studies that better test for the importance of the varied mechanisms.
Pampel, Fred C.; Krueger, Patrick M.; Denney, Justin T.
RESEARCH ABSTRACT Operating Engineers (heavy equipment operators in construction) may be at particular risk for heart disease and cancer related to their exposure to environmental dust and smoking, the sedentary nature of their job, and long hours of exposure to the sun. The aim of this study was to characterize the healthbehaviors of Operating Engineers. This cross-sectional survey from a convenience sample of Operating Engineers (N = 498) used validated instruments to measure smoking, drinking, diet, exercise, sleep, and sun exposure. Univariate and bivariate analyses to detect differences by age were conducted. The sample scored significantly worse on all five healthbehaviors compared to population norms. Those who were older were less likely to smoke and chew tobacco and more likely to eat fruits and vegetables. Many were interested in services to improve their healthbehaviors. Healthbehavior interventions are needed and wanted by Operating Engineers.
Duffy, Sonia A.; Missel, Amanda L.; Waltje, Andrea H.; Ronis, David L.; Fowler, Karen E.; Hong, OiSaeng
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.
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
Charles R. Farrar; Hoon Sohn; Michael L. Fugate; Jerry J. Czarnecki
Interdisciplinary integration of health professions education (e.g. pharmacy, medicine, dentistry, nursing, and podiatry) is examined in light of the pros (societal usefulness and cost effectiveness) and cons (justifiable professional boundaries and other concerns). Characteristics of an integrated cluster of individualized, cross-disciplinary…
Appropriate healthbehaviors are necessary to ensure health and well-being, thereby keeping military personnel ready to perform their jobs which may demand exceptional efforts at key times. An understanding of factors influencing healthbehaviors would be...
The National Air Space System-Wide Simulation (NAS Sim) program advances the development and implementation of a comprehensive, integratedhealth 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.
Bardina, Jorge; McDermott, William J.; Follen, Gregory J.; Blaser, Tammy M.; Pavlik, William R.; Zhang, Desheng; Liu, Xian-You
Social and behavioral history is increasingly recognized as integral for understanding important determinants of disease and critical for patient care, research, clinical guidelines, and public health policies. Social and behavioral history information in the public health domain, specifically large public health surveys, has not been well described. In this study, a content analysis was performed and information model constructed and contrasted with clinically-based models for each of three widely used public health surveys: BRFSS (Behavioral Risk Factor Surveillance System), NHANES (National Health and Nutrition Examination Survey), and NHIS (National Health Interview Survey). Survey items were predominantly related to alcohol use, drug use, occupation, and tobacco use. Although the clinical social history information model was similar, public health social history demonstrated additional complexity in coding temporality, degree of exposure, and certainty. Our results give insight into ongoing efforts to integrate clinical and public health information resources for improving and measuring health.
Melton, Genevieve B.; Manaktala, Sharad; Sarkar, Indra Neil; Chen, Elizabeth S.
Extant health literacy research is unclear about the contribution of health literacy to healthbehaviors and is limited regarding women's health issues. The primary purpose of this study is to investigate the association between health literacy and five healthbehaviors (Pap smear screening, annual physical checkup, smoking, checking food…
Lee, Shoou-Yih D.; Tsai, Tzu-I; Tsai, Yi-Wen; Kuo, Ken N.
This document presents papers, critiques, and comments from a symposium which assessed the current status of preventive dental behavior. The field was divided into the following three major areas: (a) mass media programs, (b) school health programs, and (c) effect of the private practitioner. Each author was asked to review the literature, provide…
Intelligent Integrated System Health Management (ISHM) is the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system (Management: storage, distribution, sharing, maintenance, processing, reasoning, and presentation). Presentation discusses: (1) ISHM Capability Development. (1a) ISHM Knowledge Model. (1b) Standards for ISHM Implementation. (1c) ISHM Domain Models (ISHM-DM's). (1d) Intelligent Sensors and Components. (2) ISHM in Systems Design, Engineering, and Integration. (3) Intelligent Control for ISHM-Enabled Systems
Two samples of working and college adults reported on their communication apprehension and healthbehaviors and communication. Specific communication apprehension as measured by a modified version of the Form State scale showed moderate to large negative effects on health communication (talking with physician, seeking health information) and almost no effects on healthbehaviors (tobacco use, exercise, health fairs) except diet.
... and Academic Achievement What is the relationship between health-risk behaviors and academic achievement? Data presented below from ... Percentage of high school students who engaged in health-risk behaviors, by type of grades earned (mostly A’s, ...
Objectives. We integrated and compared meta-analytic findings across diverse behavioral interventions to characterize how well they have achieved change in healthbehavior. Methods. Outcomes from 62 meta-analyses of interventions for change in healthbehavior were quantitatively synthesized, including 1011 primary-level investigations with 599 559 participants. Content coding suggested 6 behavioral domains: eating and physical activity, sexual behavior, addictive behaviors, stress management, female-specific screening and intervention behaviors, and behaviors involving use of health services. Results. Behavior change interventions were efficacious (mean effect sizes = 0.08–0.45). Behavior change was more evident in more recent meta-analyses; those that sampled older interventions and literatures or sampled more published articles; those that included studies that relied on self-report, used briefer interventions, or sampled fewer, older, or female participants; and in some domains (e.g., stress management) more than others (e.g., sexual behaviors). Conclusions. Interventions improved health-related behaviors; however, efficacy varied as a function of participant and intervention characteristics. This meta-synthesis provides information about the efficacy of behavioral change interventions across health domains and populations; this knowledge can inform the design and development of public health interventions and future meta-analyses of these studies.
Identifying correlates of healthbehavior is an important step both for understanding and modifying healthbehavior. 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…
The trend in school psychology services is a shift from an emphasis on an assessment-based paradigm to one of consultation problem-solving and behavioral intervention. A critical component of consultation-derived interventions and behavior change is "treatment integrity." Treatment integrity (or fidelity) refers to the extent to which an…
In a postal survey, 113 respondents completed the Rokeach (1967) Terminal Value Survey with an additional value, "health," and 15 questions about their preventive healthbehavior (PHB). Correlation and regression analyses showed that health and other values were related to overall PHB, suggesting that health researchers should also consider the role of values other than health. In consistency with Rokeach's theory, respondents who reported good PHB valued health more than did those who reported poor PHB. There were also significant differences in the general value orientation of extraversion versus introversion. Health educators might apply knowledge of such differences to a value confrontation program. As hypothesized, regression analyses for each of the 15 PHB items showed that health value was more likely to be predictive of behavior that involved a direct rather than indirect risk to health. For behaviorally consistent respondents, health value was correlated with both types of behavior, whereas for behaviorally inconsistent respondents, health value was only correlated with direct-risk behavior. This suggests that health researchers should ensure that subjects are aware of the relevance of a PHB to health before concluding that health value, or a related construct, cannot be predictive of PHB. Finally, the regression analyses suggest that it was possible to predict specific PHBs from the more general value ranks. This finding raised questions about the validity of Ajzen and Fishbein's (1977) notion of levels of specificity and provided further support to Rokeach's value theory. PMID:4045702
A study examined the use of sensory integration techniques to reduce the maladaptive behaviors that interfered with the learning of nine high school students with mental impairments attending a special school. Maladaptive behaviors identified included rocking, toe walking, echolalia, resistance to change, compulsive behaviors, aggression,…
There is a call across the country and in Texas to improve health care systems through integrated care. Integratedhealth care is the systematic coordination of physical and behavioralhealth services. The idea is that physical and behavioralhealth problems often occur at the same time and that integrating services will provide the best results…
To help health educators build upon the best of different healthbehavior change theories, this paper offers a unified set of instructional design strategies for health education interventions. This set draws upon the recommendations of Rosenstock (Health Belief Model), Bandura (Social Cognitive Theory), and Dearing (Diffusion Theory), and uses a modified Events of Instruction framework (adapted from Robert Gagne): gain
Finds that specific communication apprehension showed moderate to large negative effects on health communication (talking with physician, seeking health information) and almost no effects on healthbehaviors (tobacco use, exercise, health fairs) except diet; and that general-trait communication apprehension showed similar, though smaller, effects…
Integrated System Health Management (ISHM) describes a set of system capabilities that in aggregate perform: determination of condition for each system element, detection of anomalies, diagnosis of causes for anomalies, and prognostics for future anomalies and system behavior. The ISHM should also provide operators with situational awareness of the system by integrating contextual and timely data, information, and knowledge (DIaK) as needed. ISHM capabilities can be implemented using a variety of technologies and tools. This chapter provides an overview of ISHM contributing technologies and describes in further detail a novel implementation architecture along with associated taxonomy, ontology, and standards. The operational ISHM testbed is based on a subsystem of a rocket engine test stand. Such test stands contain many elements that are common to manufacturing systems, and thereby serve to illustrate the potential benefits and methodologies of the ISHM approach for intelligent manufacturing.
Discovers a high correlation between positive emotional states, supportive self talk, and specific healthy behaviors in college students. The correlated healthbehaviors 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)
Healthbehavior 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…
Health-related habits develop early in life. The period during junior high school is especially important for developing these habits. Because adolescent behaviors may be better predictors of adult disease than adult healthbehaviors, interventions with children and adolescents are important. Several theories and models for explaining how people…
The 1992 Washington State Survey of Adolescent HealthBehaviors (WSSAHB) was created to collect information regarding a variety of adolescent healthbehaviors among students in the state of Washington. It expands on two previous administrations of a student tobacco, alcohol, and other drug survey and includes questions about medical care, safety,…
Washington State Dept. of Social and Health Services, Olympia.
The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies sto...
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...
Education and mental healthintegration will be advanced when the goal of mental health includes effective schooling and the goal of effective schools includes the healthy functioning of students. To build a solid foundation for this reciprocal agenda, especially within the zeitgeist of recent educational reforms, a change in the fundamental framework within which school mental health is conceptualized is needed. This change involves acknowledging a new set of priorities, which include: the use of naturalistic resources within schools to implement and sustain effective supports for students' learning and emotional/behavioralhealth; inclusion of integrated models to enhance learning and promote health; attention to improving outcomes for all students, including those with serious emotional/ behavioral needs; and strengthening the active involvement of parents. A strong research agenda to support these new priorities is essential.
Hoagwood, Kimberly E.; Kutash, Krista; Seidman, Edward
The BehavioralHealth 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 behavioralhealth 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
Bryan, Craig J; Blount, Tabatha; Kanzler, Kathryn A; Morrow, Chad E; Corso, Kent A; Corso, Meghan A; Ray-Sannerud, Bobbie
The aim of this study was to determine the predictors of health risk behaviors of adolescents. A cross-sectional and descriptive design was used. A convenience sample of 436 undergraduate students was recruited from departments and faculties of Atatürk University. The researcher visited university departments 5 working days each week to conduct interviews with the students. The students were asked to complete a questionnaire in their classrooms. The data analysis used multivariate testing to identify predictors of health risk behaviors. The mean score on the health risk behavior scale indicated that the participants sometimes engaged in risky behaviors concerning diet, anger, stress, and disease prevention. The adolescents frequently engaged in risky behavior concerning medical compliance and beliefs about masculinity. Demographically, age, gender, income, and education level of demographic characteristics of the adolescents and, in terms of health status, healthbehaviors and the experience of a serious disease were significant predictors of adolescent health risk behaviors. In this study, some demographic characteristics were predictors for health risk behaviors, in general, of adolescents. PMID:24722616
PURPOSE We wanted to examine how coordinated care is implemented in primary care practices to address patients’ healthbehavior change needs. METHODS Site visit notes, documents, interviews, and online implementation diaries were collected from July 2005 to September 2007 from practice-based research networks (PBRNs) participating in Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks (P4H). An iterative group process was used to conduct a cross-case comparative analysis of 9 interventions. Published patient outcomes reports from P4H interventions were referenced to provide information on intervention effectiveness. RESULTS In-practice health risk assessment (HRA) and brief counseling, coupled with referral and outreach to a valued and known counseling resource, emerged as the best way to consistently coordinate and encourage follow-through for healthbehavior counseling. Findings from published P4H outcomes suggest that this approach led to improvement in healthbehaviors. Automated prompts and decision support tools for HRA, brief counseling and referral, training in brief counseling strategies, and co-location of referral with outreach facilitated implementation. Interventions that attempted to minimize practice or clinician burden through telephone and Web-based counseling systems or by expanding the medical assistant role in coordination of healthbehavior counseling experienced difficulties in implementation and require more study to determine how to optimize integration in practices. CONCLUSIONS Easy-to-use system-level solutions that have point-of-delivery reminders and decision support facilitate coordination of healthbehavior counseling for primary care patients. Infrastructure is needed if broader integration of healthbehavior counseling is to be achieved in primary care.
Cohen, Deborah J.; Balasubramanian, Bijal A.; Isaacson, Nicole F.; Clark, Elizabeth C.; Etz, Rebecca S.; Crabtree, Benjamin F.
To help health educators build upon the best of different healthbehavior change theories, this paper offers a unified set of instructional design strategies for health education interventions. This set draws upon the recommendations of Rosenstock (Health Belief Model), Bandura (Social Cognitive Theory), and Dearing (Diffusion Theory), and uses a modified Events of Instruction framework (adapted from Robert Gagne): gain attention (convey health threats and benefits), present stimulus material (tailor message to audience knowledge and values, demonstrate observable effectiveness, make behaviors easy-to-understand and do), provide guidance (use trustworthy models to demonstrate), elicit performance and provide feedback (to enhance trialability, develop proficiency and self-efficacy), enhance retention and transfer (provide social supports and deliver behavioral cues). Sample applications of these strategies are provided. A brief review of research on adolescent smoking prevention enables consideration of the frequency with which these strategies are used, and possible patterns between strategy use and behavioral outcomes. PMID:15590217
This poster reviews the working of the BehavioralHealth 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.
There is a substantial unmet need for mental health and substance abuse services in the USA. In 2009, the Institute of Medicine recommended increased early identification and intervention for young people with mental, emotional, and behavioral disorders. With the expansion of integrated models in primary care settings, we now have the chance to improve outcomes for young people with mental health conditions, just as we have by improving the early identification and treatment of other preventable and/or treatable conditions such as obesity, asthma, or HIV. This is a moment of great opportunity to fundamentally change how young people access mental health care in our country. Through strategic integration of care, we can increase access to care for those who would not seek out mental health services because of the stigma or inconvenience of reaching out to a mental health provider; we can identify those who need care earlier and reduce the impact of mental illness on individuals, family, and community through early identification and treatment; and we can purposefully embed integration into provider training programs for both primary care and mental health providers to ensure sustainability. PMID:24912970
Addresses the impact of patients' beliefs about health care on their decisions to follow medical advice and to undertake different actions to prevent illness. Concludes that among other things, doctors need to become more willing to modify their treatment plans according to patient needs. (VLC)
A Conference on Smoking and Behavior was held on September 27 and 28, 1979, at the National Academy of Science in Washington, D.C. The conference was organized by the Institute of Medicine, through its Division of Mental Health and Behavioral Medicine. Su...
Demographic analysis has been the primary form of analysis connected with health care coverage decisions. This paper reviews past demographic research and shows the need to use behavioral analyses for health care coverage policy decisions. A behavioral model based research study is presented and a case is made for integrated study into why consumers make health care coverage decisions. PMID:10106848
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.
In a postal survey, 113 respondents completed the Rokeach terminal value survey with the additional value, health, and questions regarding their preventive healthbehavior. Analyses showed that lighter nonsmokers displayed better preventive behavior than heavier smokers. Lighter nonsmokers also reported valuing health more than heavier smokers reported, and were oriented toward safety and inner-directedness compared with heavier smokers who were oriented toward satisfaction and outer-directedness. The preventive behavior of lighter nonsmokers increased with the value of social goals while the preventive behavior of heavier smokers was related to personal goals. These results are considered in the context of previous research which suggested that smokers and nonsmokers may have different value priorities. The implications of these findings for health education are discussed. PMID:4003136
Objective To examine the mechanisms linking health literacy to physical activity and self-reported health. Methods From 2005–2007, patients (N=330) with hypertension were recruited from safety net clinics. Path analytic models tested the pathways linking health literacy to physical activity and self-reported health. Results There were significant paths from health literacy to knowledge (r=0.22, P<0.001), knowledge to self-efficacy (r=0.13, P<0.01), self-efficacy to physical activity (r=0.17, P<0.01), and physical activity to health status (r=0.17, P<0.01). Conclusions Health education interventions should be literacy sensitive and aim to enhance patient health knowledge and self-efficacy to promote self-care behavior and desirable health outcomes.
Osborn, Chandra Y.; Paasche-Orlow, Michael K.; Bailey, Stacy Cooper; Wolf, Michael S.
This study was undertaken to examine the constellation of attitudes and beliefs felt to be related to healthbehavior. 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,…
A study of alternative definitions and interpretations of health education in public policy resulted in the identification of a typology of differing perspectives. The two perspectives, behavioral and structural, are described in this paper, along with the three levels of health education programs. The study found: (1) an over-emphasis of public health education policies on individual behavioral changes and (2) a lack of focus in health education programs at the federal level. An analysis was done of the National Consumer Health Information and Health Promotion Act of 1976 to demonstrate these findings. The paper concludes that a balance between the two perspectives is needed, and it offers policy direction to support this conclusion. PMID:10251081
The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integratedhealth-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, healthbehaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program.
George, Melissa W.; Trumpeter, Nevelyn N.; Wilson, Dawn K.; McDaniel, Heather L.; Schiele, Bryn; Prinz, Ron; Weist, Mark D.
Despite of an insignificant track record of quasi-market models in Sweden, new models of this kind have recently been introduced in health care; commonly referred to as "choice of care". This time citizens act as purchasers; choosing the primary care centre or family physician they want to be treated by, which, in turn, generates a capitation payment to the chosen unit. Policy makers believe that such systems will be self-remedial, that is, as a result of competition the strong providers survive while unprofitable ones will be eliminated. Because of negative consequences of the fragmented health care delivery, policy makers at the same time also promote different forms of integratedhealth care arrangements. One example is "local health care", which could be described as an upgraded community-oriented primary care, supported by adaptable hospital services, fitting the needs of a local population. This article reviews if it is possible to combine this kind of integrated care system with a competition driven model of governance, or if they are incompatible. The findings indicate that some choice of care schemes could hamper the development of integration in local health care. However, geographical monopolies like local health care, enclosed in a non-competitive context, lack the stimulus of competition that possibly improves performance. Thus, it could be argued that if choice of care and local health care should be combined, patients ought to choose between integratedhealth care arrangements and not among individual health professionals. PMID:20153910
Reviews research on relationship between cognitive schemas and vocational behavior following from Kelly's (1955) personal construct psychology. Focuses particular attention on traditional study of vocational differentiation and integration as well as more recent efforts to combine these two variables into a structural model of vocational…
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...
The Integrative Cardiac Health Program (ICHP) aims to understand the complex interactions of numerous molecular components that characterize individuals or populations at risk for cardiovascular disease (CVD). We are working to identify molecular networks...
Background: As members of interdisciplinary teams, school nurses provide behavioralhealth services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioralhealth and in the management of behavioralhealth emergencies, specifically. We conducted this study to describe the adolescent behavioralhealth…
Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy
The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a...
The purpose of this research was to investigate how university students' nutrition beliefs influence their healthbehavioral 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 healthbehavioral categories.
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.
Abstract In a sample of perinatally HIV-infected (PHIV+) and perinatally HIV-exposed, uninfected (PHEU) adolescents, we examined the co-occurrence of behavioralhealth risks including mental health problems, onset of sexual and drug use behaviors, and (in PHIV+ youth) nonadherence to antiretroviral therapy (ART). Participants, recruited from 2007 to 2010, included 349 youth, ages 10–16 years, enrolled in a cohort study examining the impact of HIV infection and ART. Measures of the above behavioralhealth risks were administered to participants and primary caregivers. Nearly half the participants met study criteria for at least one behavioralhealth risk, most frequently, mental health problems (28%), with the onset of sexual activity and substance use each reported by an average of 16%. Among the sexually active, 65% of PHIV+ and 50% of PHEU youth reported unprotected sex. For PHIV +youth, 34% reported recent ART nonadherence, of whom 45% had detectable HIV RNA levels. Between 16% (PHIV+) and 11% (PHEU) of youth reported at least two behavioralhealth risks. Older age, but not HIV status, was associated with having two or more behavioralhealth risks versus none. Among PHIV+ youth, living with a birth mother (versus other caregivers) and detectable viral load were associated with co-occurrence of behavioralhealth risks. In conclusion, this study suggests that for both PHIV+ and PHEU youth, there are multiple behavioralhealth risks, particularly mental health problems, which should be targeted by service systems that can integrate prevention and treatment efforts.
Tassiopoulos, Katherine; Malee, Kathleen; Moscicki, Anna-Barbara; Patton, Doyle; Smith, Renee; Usitalo, Ann; Allison, Susannah M.; Van Dyke, Russell; Seage, George R.
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.
Introduction. Systematic evaluation is an integral part of the organization and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. This study aimed to assess the knowledge and practice of primary health care (PHC) personnel regarding their duties toward oral health. Methods and Material. A cross-sectional study was carried out among three groups of PHC personnel in the city of Kerman (Iran). Volunteer personnel completed a piloted questionnaire which included demographic data, some question regarding their knowledge about oral health, their duties and also their practice regarding public oral health. All data were analyzed using chi-square and Pearson correlation test. Results. One hundred and fifty-seven out of 225 eligible personnel participated in the study. Sixty percent were auxiliary health workers (Behvarz). All personnel had a good level of knowledge regarding oral health. Despite significant differences among the knowledge of the personnel toward oral health, there was no significant difference between their knowledge related to their duties regarding oral health. The auxiliary health worker group had a higher rate (45.6%) for better public oral health practice. Conclusion. The study showed the personnel have good knowledge of their duties regarding oral health. However, their practice is not in line with their knowledge and needs more attention.
The behavioralhealth care needs of America's rural agricultural population are seriously underserved. Low farm prices, eight consecutive years of increases in farm debt, vagaries of weather, combined with ever more reliance on government payments by those who qualify for such payments, have created great stress for the majority of America's small and medium-sized food producers. The four-year down- ward
Integrated care entails the provision of behavioralhealth 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
Cristine E. Hine; Heather B. Howell; Kimberly A. Yonkers
Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of healthbehaviors with overweight and non-overweight adolescents and identify demographic and healthbehaviors related to exercise, hours of television viewing, and weight issues…
Choi, Won S.; Ellerbeck, Edward F.; Kaur, Harsohena; Nazir, Niaman; Ahluwalia, Jasjit S.
The paper describes the security concerns related to Electronic Health Records (EHR) both in registration of data and integration of systems. A description of the current state of EHR systems in Iceland is provided, along with the Ministry of Health's future vision and plans. New legislation provides the opportunity for increased integration of EHRs and further collaboration between institutions. Integration of systems, along with greater availability and access to EHR data, requires increased security awareness since additional risks are introduced. The paper describes the core principles of information security as it applies to EHR systems and data. The concepts of confidentiality, integrity, availability, accountability and traceability are introduced and described. The paper discusses the legal requirements and importance of performing risk assessment for EHR data. Risk assessment methodology according to the ISO/IEC 27001 information security standard is described with examples on how it is applied to EHR systems. PMID:20543313
Bjornsson, Bjarni Thor; Sigurdardottir, Gudlaug; Stefansson, Stefan Orri
Race, ethnicity, and cultural attitudes and practices are among the variables that influence healthbehaviors, including adaptive healthbehaviors. The following discussions highlight the important role of social conditions in shaping healthbehaviors and the central role of family in promoting health across the Asian, Hispanic, Native American, and African American ethnic groups. Factors that may lead to health-damaging behaviors are also discussed. The need for additional research that identifies correlations among physiological, social, and behavioral factors and healthbehaviors, as well as underlying mechanisms, is called for.
PURPOSE Our objective was to identify themes that emerged from the evaluation of 17 interventions funded by the Robert Wood Johnson Foundation’s Prescription for Health that aimed to enhance adherence to healthy behaviors in the primary care setting. METHODS We performed a content analysis of diary data from this 16-month initiative. Other data sources used to complement this analysis include funded grant applications and field notes from interviews with investigative teams and a limited number of site visits. Participants were 17 practice-based research networks (PBRNs) that had projects funded during Round 1 of Prescription for Health. RESULTS Five themes emerged regarding implementation of healthbehavior change: (1) healthbehavior change resources are enthusiastically received by practices and patients, and when given a choice, patients prefer methods of assistance that involve personal contact; (2) practice extenders require extensive training, as well as careful case management and support, in order to function fully and avoid burnout; (3) integratingbehavior change tools into the primary care setting requires time, effort, and often specialized expertise; (4) even simple interventions require practice change, and use of a practice change model to guide implementation efforts is crucial; and (5) research philosophy and project management approaches vary across PBRNs and have implications for the potential sustainability of an intervention. CONCLUSIONS A more versatile, multifaceted solution involving new tools, technologies, and multidisciplinary care teams is needed in order to integratehealthbehavior change into everyday primary care routines. Even the best interventions require a model to articulate how to integrate an innovation into practices.
Cohen, Deborah J.; Tallia, Alfred F.; Crabtree, Benjamin F.; Young, Denise M.
Background Individuals with posttraumatic stress disorder (PTSD) are more likely to undertake harmful healthbehaviors like substance use. Less is known about the association of PTSD with healthfulbehaviors such as healthy diet and exercise. The purpose of this study was to examine differences across physical health indicators and healthbehaviors in individuals with and without PTSD. Methods A cross-sectional, case–control study of health indicators and self-reported healthbehaviors in a community and military veteran sample was used. Results Based on a structured psychiatric interview, 25 participants had PTSD, and the remaining 55 without PTSD served as the comparison group. Participants were 40 years old on average and 45% were female. Multivariate analysis of variance analyses revealed that participants with PTSD had significantly higher body mass index (p = 0.004), had more alcohol use (p = 0.007), and reported fewer minutes of vigorous exercise (p = 0.020) than those without PTSD. Chi-square analysis of diet content and eating behavior constructs found that individuals with PTSD ate fewer fruits (p = 0.035) and had more guilt after overeating (p = 0.006). Conclusions These findings replicate prior research on the link between PTSD and negative health outcomes and engagement in harmful healthbehaviors and highlight the need for further examination of the association between PTSD and other healthbehaviors like diet content, eating behaviors, and exercise.
Objective: To model typical trajectories for improvement among patients treated in an integrated primary care behavioralhealth 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…
Bryan, Craig J.; Corso, Meghan L.; Corso, Kent A.; Morrow, Chad E.; Kanzler, Kathryn E.; Ray-Sannerud, Bobbie
Using a variety of data sets from two countries, we examine possible explanations for the relationship between education and healthbehaviors, 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.
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…
Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led healthbehavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1) facilitators that help mental health service users engage in better healthbehaviors and (2) the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1) factors of empowerment, self-value, and personal growth; (2) the need for social support; (3) pragmatic aspects of motivation and planning; and (4) access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to healthbehavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.
Graham, Candida; de Leeuw, Sarah; Griffiths, Brenda
The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.
Good health significantly improves a person's quality of life. However, people with intellectual disabilities disproportionately have more health problems than the general population. Further complicating the matter is that people with more severe disabilities often cannot verbalize health complications they are experiencing, which leads to health problems being undiagnosed and untreated. It is plausible these conditions can interact with reinforcement contingencies to maintain problem behavior because of the increased incidence of health problems among people with intellectual disabilities. This paper reviews common health problems influencing problem behavior and reinforcement processes. A clear implication of this review is the need for comprehensive functional assessments of problem behavior involving behavior analysts and health professionals.
Objective: To introduce item response theory (IRT) to healthbehavior researchers by contrasting it with classical test theory and providing an example of IRT in healthbehavior. 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…
Warne, Russell T.; McKyer, E. J. Lisako; Smith, Matthew L.
Objective: The investigators examined relations between mindfulness and healthbehaviors in college students, as well as the role of stress in mediating these effects. Participants: Participants were 553 undergraduates (385 females; mean age = 18.8 years, SD = 2.1) recruited from a university in the northeastern United States. Methods: Participants completed questionnaires assessing mindfulness, perceived health, healthbehaviors, health-related activity
Changes in health care have outpaced changes in the educational programs offered to the behavioralhealth workforce. The result is a training gap that leaves graduate students, working professionals, and other direct care providers inadequately prepared for practice in the current health care environment. This article is based on a keynote address delivered at the Annapolis Conference on BehavioralHealth
Objective: To reduce health disparities, behavioralhealth interventions must reach subcultural groups and demonstrate effectiveness in improving their healthbehaviors 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…
Barrera, Manuel, Jr.; Castro, Felipe G.; Strycker, Lisa A.; Toobert, Deborah J.
Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local HealthIntegration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care.
Tsasis, Peter; Evans, Jenna M; Forrest, David; Jones, Richard Keith
A high level of social support was a consistent predictor of preventive healthbehaviors among 936 elderly members of a health maintenance organization. Beliefs about the importance of preventive healthbehaviors contributed more toward predicting their performance than did other respondent characteristics. These results suggest that efforts to increase the practice of preventive healthbehaviors by the elderly might be
Maayn K. Potts; Margo-Lea Hurwicz; Michael S. Goldstein
PURPOSE The purpose of this analysis and commentary was to explore the rationale for an integrated approach, within and outside the office, to help patients pursue healthy behaviors. METHODS We examined the role of integration, building on (1) patterns observed in a limited qualitative evaluation of 17 Prescription for Health projects, (2) several national policy initiatives, and (3) selected research literature on behavior change. RESULTS The interventions evaluated in Prescription for Health not only identified unhealthy behaviors and advised change, but also enabled patients to access information at home, use self-help methods, obtain intensive counseling, and receive follow-up. Few practices can replicate such a model with the limited staff and resources available in their offices. Comprehensive assistance can be offered to patients, however, by integrating what is feasible in the office with additional services available through the community and information media. CONCLUSIONS Blending diverse clinical and community services into a cohesive system requires an infrastructure that fosters integration. Such a system provides the comprehensive model on which the quality of both health promotion and chronic illness care depend. Integrating clinical and community services is only the first step toward the ideal of a citizen-centered approach, in which diverse sectors within the community—health care among them—work together to help citizens sustain healthy behaviors. The integration required to fulfill this ideal faces logistical challenges but may be the best way for a fragmented health care system to fully serve its patients.
Woolf, Steven H.; Glasgow, Russell E.; Krist, Alex; Bartz, Claudia; Flocke, Susan A.; Holtrop, Jodi Summers; Rothemich, Stephen F.; Wald, Ellen R.
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.
Despite limited resources, emergency medical settings will be called upon to play many roles in the context of disasters and terrorist attacks that are related to preparedness, surveillance, mental health services delivery, and staff care. Such settings are a central capture site for those individuals likely to be at highest risk for developing mental health and functional problems. Because much of the potential harm to survivors of disaster or terrorism (and their families) will be related to their mental health and role functioning, preparedness requires the active integration of behavioralhealth into emergency medicine in every component of disaster response. There are many challenges of doing this including: (1) finding ways to integrate activities of the medical care, emergency response, and public health systems; (2) determining whether an incident has actually occurred; (3) making differential diagnoses and managing other aspects of initial medical needs; and (4) coping with the risks associated with system overload and failure. Delivery of direct mental health care must include: (1) survivor and family education; (2) identification and referral of those requiring immediate care and follow-up; (3) group education and support services; and (4) individual counseling. In order for effective response to occur, the integration of psychosocial care into disaster response must occur prior to the disaster itself, and will depend on effective collaboration between medical and mental health care providers. At workplaces, emergency medical care centers must ensure that staff and their families are properly trained and supported with regard to their disaster functions and encouraged to develop personal/family disaster plans. PMID:15453159
Ruzek, Josef I; Young, Bruce H; Cordova, Matthew J; Flynn, Brian W
Integrated Vehicle Health Management (IVHM) goals are to develop and integrate the technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce the costs of operations.
The authors examined the effects of supervisory guidance (providing instruction to employees) and behavioralintegrity (a pattern of word-deed alignment) on employee organizational citizenship behavior (OCB) and deviant behavior. Results revealed a pattern of Supervisory Guidance x BehavioralIntegrity interaction effects, such that relationships between guidance and outcome variables were dependent on the level of behavioralintegrity exhibited by supervisors. The interactions suggest a positive relationship between supervisory guidance and OCBs when behavioralintegrity is high but also a positive relationship between guidance and deviant behavior when behavioralintegrity is low. These results were consistent across 2 independent field samples: 1 assessing individual employee perceptions of supervisory behavior and the other assessing aggregate perceptions of supervisory behavior among employees in bank branches. PMID:16737359
Dineen, Brian R; Lewicki, Roy J; Tomlinson, Edward C
The biopsychosocial model describes interactions between psychosocial and biological factors in the etiology and progression of disease. How an individual interprets and responds to the environment determines responses to stress, influences healthbehaviors, contributes to the neuroendocrine and immune response, and may ultimately affect health outcomes. Health psychology interventions are designed to modulate the stress response and improve healthbehaviors
Background: Latinos experience disproportionate negative health status and health care access. Expanding understanding of factors impacting Latino immigrant health is imperative. Purpose: This study identified health-seeking behaviors among Latinas in a large Midwestern city with rapid immigrant population growth. Health-seeking behaviors like…
Rojas-Guyler, Liliana; King, Keith A.; Montieth, Brigid A.
Men who have sex with men (MSM) engage in several harmful healthbehaviors more frequently than do non-MSM. Meanwhile, evidence suggests that MSM experience barriers to accessing health care. To investigate health care disparities and healthbehaviors, we compared data from a diverse MSM sample (N = 871) to data from men from the National Health Interview Survey (N =
Lisa M. Alvy; David McKirnan; Steve N. Du Bois; Kyle Jones; Natalie Ritchie; David Fingerhut
Within a larger study, 181 female undergraduates completed the Rokeach instrumental value survey and a version of the terminal value survey which included the value 'health', as well as measures of general preventive healthbehavior and social desirability. Analyses showed that nonsmokers reported better healthbehavior, and particularly direct rather than indirect-risk behavior, than smokers. While there was no difference in the value of 'health', smokers gave more priority to being 'broadminded' than nonsmokers gave. Smokers were also more concerned with 'freedom', being 'independent' and not being 'obedient', suggesting that smokers were more concerned with being 'flexible' or 'unconstrained'. Further, the value of being 'broadminded' was inversely related to the general healthbehavior and direct-risk behavior of smokers. Together with other research, these findings suggest that decreasing the extent to which smokers value 'broadmindedness' might not only reduce their smoking behavior but also affect their general preventive healthbehavior. PMID:4083110
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.
The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. Management implies storage, distribution, sharing, maintenance, processing, reasoning, and presentation. ISHM is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this chapter, concepts, procedures, and approaches are presented as a foundation for implementing an ISHM capability relevant to intelligent systems. The capability stresses integration of DIaK from all elements of a system, emphasizing an advance toward an on-board, autonomous capability. Both ground-based and on-board ISHM capabilities are addressed. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.
This column describes an integratedbehavioralhealth initiative in primary care clinics in Louisiana parishes affected by the Deepwater Horizon oil spill. The Louisiana Mental and BehavioralHealth 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
Osofsky, Howard J; Osofsky, Joy D; Wells, John H; Weems, Carl
Two studies examined the relationship between preventive healthbehavior an aspect of patient preferences known as time preferences--the subjective value of future outcomes relative to immediate ones. Tow preventive healthbehavior, were examined: Accepta...
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.
Because a high percentage of primary care patients have behavioral problems, patient-centered medical homes (PCMHs) that wish to attain true comprehensive whole-person care will find ways to integratebehavioralhealth services into their structure. Yet in today's health care environment, the incorporation of behavioral services into primary care is exceptional rather than usual practice. In this article, we discuss the components considered necessary to provide sustainable, value-added integratedbehavioralhealth care in the PCMH. These components are to: (1) combine medical and behavioral benefits into one payment pool; (2) target complex patients for priority behavioralhealth care; (3) use proactive onsite behavioral "teams;" (4) match behavioral professional expertise to the need for treatment escalation inherent in stepped care; (5) define, measure, and systematically pursue desired outcomes; (6) apply evidence-based behavioral treatments; and (7) use cross-disciplinary care managers in assisting the most complicated and vulnerable. By adopting these 7 components, PCHMs will augment their ability to achieve improved health in their patients at lower cost in a setting that enhances ease of access to commonly needed services. PMID:24615314
This study assessed the association of lifestyle and clinical healthbehaviors 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 healthbehaviors…
Healthbehaviors of all students, including adolescents, have direct impact upon both personal well being and actualization of potential for maximum learning. This paper reviews examples of concrete healthbehaviors that both positively and negatively influence the two factors, and summarizes present objectives for the nation in the health…
Adolescents experience the onset and development of several health-related behaviors. The purpose of this study is to determine health risk and promotion behaviors of adolescents between the ages of 11 and 19 who were attending and to test the reliability and validity analysis of the Turkish version of Adolescent Health Promotion Scale (AHPS). The…
The Bamako Call for Action on Research for Health stresses the importance of inter-disciplinary, inter-ministerial and inter-sectoral working. This challenges much of our current research and postgraduate research training in health, which mostly seeks to produce narrowly focused content specialists. We now need to compliment this type of research and research training, by offering alternative pathways that seek to create expertise, not only in specific narrow content areas, but also in the process and context of research, as well as in the interaction of these different facets of knowledge. Such an approach, developing 'integrative expertise', could greatly facilitate better research utilisation, helping policy makers and practitioners work through more evidence-based practice and across traditional research boundaries.
Self-consciousness has been an important trait in personality research. It seems logical to investigate whether health consciousness, involving a similar self-focusing, might operate in a parallel manner. To this end, I developed the Health Consciousness Scale (HCS), primarily by modifying items of the Self-Consciousness Scale, and also tested it for reliability and validity. My study found the HCS to contain four first-order factors: (1) Health Self-Consciousness, (2) Health Alertness, (3) Health Self-Monitoring, and (4) Health Involvement. I found these four first-order factors, along with the overall HCS second-order factor, to relate to a number of self-reported, health-associated behavioral variables. The study also included comparisons with the Health Locus-of-Control Scale and other measures. PMID:2223170
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.
Peeples, Malinda M.; Iyer, Anand K.; Cohen, Joshua L.
Six measures of physiological dysregulation were derived from 11 clinically assessed biomarkers, and related to health outcomes and healthbehaviors for the Hawaii Personality and Health cohort (N = 470). Measures summing extreme scores at one tail of the biomarker distributions performed better than ones summing both tails, and continuous measures performed better than count scores. Healthbehaviors predicted men's dysregulation but not women's. Dysregulation and healthbehaviors predicted self-rated health for both men and women, and depressive symptoms predicted self-rated health only for women. These findings provide preliminary guidelines for constructing valid summary measures of global health status for use in health psychology. PMID:19237490
Hampson, Sarah E; Goldberg, Lewis R; Vogt, Thomas M; Hillier, Teresa A; Dubanoski, Joan P
The authors compared parents' perceptions of their college student children's health and health risk behaviors with the college students' own reports. One hundred sixty-four parent-college student child dyads completed questionnaires regarding the students' health, illness status, and health risk behaviors. Parents tended to be overoptimistic…
Bylund, Carma L.; Imes, Rebecca S.; Baxter, Leslie A.
Adolescent healthbehaviors, especially health risk behaviors, have previously been linked to distal (i.e., family economic pressure) and proximal (i.e., parental support) contributors. However, few studies have examined both types of contributors along with considering health promoting and health risk behaviors separately. The present study investigated the influences of family economic hardship, supportive parenting as conceptualized by self-determination theory, and individual psychosocial and behavioral characteristics (i.e., mastery and delinquency, respectively) on adolescents' health promoting and health risk behaviors. We used structural equation modeling to analyze longitudinal data from a sample of Caucasian adolescent children and their mothers and fathers (N = 407, 54 % female) to examine direct and indirect effects, as well as gender symmetry and asymmetry. Findings suggest that family economic pressure contributed to adolescent mastery and delinquency through supportive parenting. Further, supportive parenting indirectly affected adolescent health risk behaviors only through delinquency, whereas supportive parenting indirectly influenced health promoting behaviors only through mastery, suggesting different developmental pathways for adolescent health risk and health promoting behaviors. Testing for gender symmetry of the full model showed that maternal and paternal parenting contributed to females' health risk behaviors directly, while maternal and paternal parenting contributed to males' health risk behaviors through delinquency. Gender symmetry was largely unsupported. The study highlights key direct and indirect pathways to adolescent health risk and health promoting behaviors within a family stress model and self-determination theory framework, and also highlights important gender differences in these developmental pathways. PMID:24254978
This paper estimates whether marriage can improve health outcomes for African-Americans through changes in risky healthbehaviors\\u000a like smoking, drinking, and drug use. Using data from the National Longitudinal Study on Adolescent Health and propensity\\u000a score matching methodology to account for the potential selection bias, the results show that marriage does lead to a reduction\\u000a in risky healthbehaviors, specifically
Although online health information-seeking has been widely studied and findings suggest a variety of motivations behind an individual's health information-seeking behavior, little is known about how this information influences health utilization behaviors. Thus, the current study investigates the relationship between online health information seeking and health care utilization such as visiting a doctor. Additionally, this project expands the literature by examining the moderating role of health anxiety. Results suggest that an individual's level of health anxiety moderates the relationship between online health information seeking and health care utilization decisions. PMID:16901253
Most research about health promoting behaviors has focused on pre-old adults and men, despite clear evidence that the leading cause of death among postmenopausal women is related to healthbehaviors. This study applied social cognitive theory constructs to exercise, dietary, and stress management healthbehavior. The purpose of this study was to examine the ability of self-efficacy expectation and outcome expectancy to predict healthbehavior among older women. Community-dwelling women aged 65 to 92 years were interviewed with previously developed instruments and instruments designed specifically for this study (N = 225). Self-efficacy was the strongest predictor of each of the healthbehaviors (beta weights: dietary behavior .50; exercise, .39; stress management, .32). Outcome expectancy was not a significant predictor of exercise or dietary behavior. Outcome expectancy was a significant predictor of stress management behavior. The findings of this study, combined with the importance of health promotion behaviors among older women, justify the need for continued research about self-efficacy and healthbehavior among this vulnerable population. PMID:9501402
Integrating family nursing into a busy mental health urgent care setting is a challenge given the high acuity of patients and the demands of delivering service 7 days/week, 14 hours/day. In this article, the authors describe the development of a Mental Health Urgent Care Practice Framework that incorporates four elements: mental health/psychiatric assessment, physical health assessment, family nursing, and integratedbehavioralhealth care. Sample family nursing skills and ladders for mental health urgent care practice are highlighted.The framework and ladders have implications for recruitment and hiring, orientation, peer mentoring, performance appraisals, and continuing education and supervision. A clinical vignette illustrates sample conceptual/ perceptual and executive skills used to apply the framework and ladders in practice. Family nursing is conceptualized as an integral component of nursing care provided to individual and families in this unique setting. PMID:20407001
Many Korean Americans suffer from high levels of cancer incidence and have low cancer screening rates. A significant number of Korean Americans lack adequate information about cancer screening tests. However, little is known about their healthbehaviors. This article examines exposure to mass media and health information–seeking behaviors for Korean Americans, and their associations with demographic characteristics influencing variations in
Kyeung Mi Oh; Gary L. Kreps; Jungmi Jun; Elizabeth Chong; Lolita Ramsey
Increasing attention is being directed to the competency of those who deliver healthcare in the United States. In behavioralhealth, there is growing recognition of the need to define, teach, and assess essential competencies. Since attention to this issue in behavioralhealth is relatively recent, there is much to be gained by learning from the principles, definitions, and conceptual models
A survey of health risk behaviors was administered to a representative sample of 7,776 Idaho students in grades 8-12. Respondents were 86% White, 6% Hispanic, 4% American Indian, 3% Asian, and 2% Black. These rural adolescents reported that they had engaged in some health risk behaviors at rates comparable to those of other U.S. adolescents: 57%…
The 2011 Health Related Behaviors Survey of Active Duty Military Personnel (HRB) is the largest survey that anonymously gathers data on some of the most important behavioralhealth issues affecting the well-being of the U.S. military. The HRB provides an ...
F. M. Barlas J. C. Pflieger K. Diecker W. B. Higgins
This article discusses risk behaviors, seem- ingly voluntary actions of individuals that have adverse health consequences. The central theme is to examine these behaviors from two contrasting perspectives, that of the individual and that of the population as a whole. It is argued that distinguishing between individual and pop- ulation views is important for understanding and inter- preting health risk
Mobile health (mHealth) technologies and telecommunication have rapidly been integrated into the health care delivery system, particularly in developing countries. Resources have been allocated to developing mHealth interventions, including those that use mobile technology for behavior change communication (BCC). Although the majority of mobile phone users worldwide live in the developing world, most research evaluating BCC mHealth interventions has taken
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...
Prevalence of depression is associated inversely with some indicators of socioeconomic position, and the stress of social disadvantage is hypothesized to mediate this relation. Relative to whites, blacks have a higher burden of most physical health conditions but, unexpectedly, a lower burden of depression. This study evaluated an etiologic model that integrates mental and physical health to account for this counterintuitive patterning. The Baltimore Epidemiologic Catchment Area Study (Maryland, 1993–2004) was used to evaluate the interaction between stress and poor healthbehaviors (smoking, alcohol use, poor diet, and obesity) and risk of depression 12 years later for 341 blacks and 601 whites. At baseline, blacks engaged in more poor healthbehaviors and had a lower prevalence of depression compared with whites (5.9% vs. 9.2%). The interaction between healthbehaviors and stress was nonsignificant for whites (odds ratio (OR = 1.04, 95% confidence interval: 0.98, 1.11); for blacks, the interaction term was significant and negative (?: ?0.18, P < 0.014). For blacks, the association between median stress and depression was stronger for those who engaged in zero (OR = 1.34) relative to 1 (OR = 1.12) and ?2 (OR = 0.94) poor healthbehaviors. Findings are consistent with the proposed model of mental and physical health disparities.
Mezuk, Briana; Rafferty, Jane A.; Kershaw, Kiarri N.; Hudson, Darrell; Abdou, Cleopatra M.; Lee, Hedwig; Eaton, William W.; Jackson, James S.
Social capital and health research has emerged as a focus of contemporary behavioral epidemiology, while intervention research is seeking more effective measures to increase health protective behaviors and decrease health-risk behaviors. In this review we explored current literature on social capital and health outcomes at the micro-, mesa-, and macro-levels with a particular emphasis on research that incorporates a social capital framework, and adolescent and young adult engagement in risk behaviors. These data indicate that across a broad range of socio-cultural and economic contexts, social capital can affect individuals’ risk for negative health outcomes and their engagement in risk behaviors. Further research is needed which should focus on differentiating and measuring positive and negative social capital within both mainstream and alternative social networks, assessing how social constructions of gender, ethnicity, and race – within specific cultural contexts – mediate the relationship between social capital and risk and/or protective behaviors. This new research should integrate the existing research within historical socioeconomic and political conditions. In addition, social capital scales need to be developed to be both culturally and developmentally appropriate for use with adolescents living in a diversity of settings. Despite the proliferation of social capital research, the concept remains underutilized in both assessment and intervention development for adolescents’ and young adults’ engagement in risk behaviors and their associated short- and long-term poor health outcomes.
Historically, the behavioralhealth of the agricultural population has been affected by their economic well being. Sufficient research now exists to recognize the agricultural population as a health disparity group. A pattern of environmental, cultural, and economic factors unique to the agricultural community suggests a higher risk for health disparity among persons engaged in agriculture. This article traces the development
Undergraduate students increase their understanding of human geography and become aware of their community's health ecology by examining the degree and geographical pattern of dog-associated health hazards in Athens, Georgia, and by studying the behavioral patterns and attitudes of Athens's residents that might be causally related to these health…
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.
DeLoach, Kendra P.; Dvorsky, Melissa; Miller, Elaine; Paget, Michael
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…
Health damaging behaviors of young military personnel are reflections of health problems facing all young people in the U.S. Military life presents opportunities and challenges that may both protect and place young troops at risk for health damaging behav...
Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioralhealth care. Several…
This article provides a behavioral systems approach to improve operational performance in health and human service organizations. This article provides six performance truths that are relevant to any organization and a case study from a community mental health network of agencies. A comprehensive analysis, as described here, will help health and…
Most models exploring adolescent healthbehavior 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 healthbehavior. 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.
Aalsma, Matthew C.; Carpentier, Melissa; Azzouz, Faouzi; Fortenberry, Dennis
Background Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. Discussion To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work–related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. Summary An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace.
The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder. For each of the participants a functional assessment was conducted to identify the variables…
Devlin, Sarah; Healy, Olive; Leader, Geraldine; Hughes, Brian M.
...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...
Discussions of health care delivery and payment reforms have largely been silent about how behavioralhealth could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioralhealth conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioralhealth conditions: the Patient Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioralhealth into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools – accountability measures and payment designs – to improve access to and quality of care for patients with behavioralhealth needs.
Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan
Several major policy reports describe the central role of primary care in improving the delivery of behavioralhealth 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
George W. Bitar; Paul Springer; Robert Gee; Chad Graff; Manuel Schydlower
The application of behavioral economics to health and health care has captured the imagination of policymakers across the political spectrum. The idea is that many people are irrational in predictable ways, and that this both contributes to unhealthy behaviors like smoking and holds one of the keys to changing those behaviors. Because health care costs continue to increase, and a substantial portion of costs are incurred because of unhealthy behaviors, employers and insurers have great interest in using financial incentives to change behaviors. However, it is in the details that complexity and controversies emerge. Who should the targets be, and what outcomes should be rewarded? How should incentives be structured, to maximize their effectiveness and minimize unintended consequences? In what situations should we be intervening to affect decisions by people who may prefer to be obese or to smoke, and in what situations should we accept their preferences? To begin to answer these questions, the Penn-CMU Roybal P30 Center on Behavioral Economics and Health held its first annual Behavioral Economics and Health Symposium on March 24-25, 2011 with support from the Robert Wood Johnson Foundation. The symposium drew more than 50 researchers, scholars, and health professionals from a variety of disciplines, including medicine, public health, economics, law, management, marketing, and psychology. They heard perspectives on behavioral economics from public and private funders, the CEO of the University of Pennsylvania Health System, and the CEO of stickK.com, a start-up company that uses online, voluntary commitment contracts to help people achieve their goals. Participants formed eight working groups to review the current state-of-the-art in a variety of clinical contexts and to consider how behavioral economics could inform a research agenda to improve health. This Issue Brief summarizes the findings of these working groups and the symposium. PMID:21949955
...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...
...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...
Background For effective health promotion using health information technology (HIT), it is mandatory that health consumers have the behavioral intention to measure, store, and manage their own health data. Understanding health consumers’ intention and behavior is needed to develop and implement effective and efficient strategies. Objective To develop and verify the extended Technology Acceptance Model (TAM) in health care by describing health consumers’ behavioral intention of using HIT. Methods This study used a cross-sectional descriptive correlational design. We extended TAM by adding more antecedents and mediating variables to enhance the model’s explanatory power and to make it more applicable to health consumers’ behavioral intention. Additional antecedents and mediating variables were added to the hypothetical model, based on their theoretical relevance, from the Health Belief Model and theory of planned behavior, along with the TAM. We undertook structural equation analysis to examine the specific nature of the relationship involved in understanding consumers’ use of HIT. Study participants were 728 members recruited from three Internet health portals in Korea. Data were collected by a Web-based survey using a structured self-administered questionnaire. Results The overall fitness indices for the model developed in this study indicated an acceptable fit of the model. All path coefficients were statistically significant. This study showed that perceived threat, perceived usefulness, and perceived ease of use significantly affected health consumers’ attitude and behavioral intention. Health consumers’ health status, health belief and concerns, subjective norm, HIT characteristics, and HIT self-efficacy had a strong indirect impact on attitude and behavioral intention through the mediators of perceived threat, perceived usefulness, and perceived ease of use. Conclusions An extended TAM in the HIT arena was found to be valid to describe health consumers’ behavioral intention. We categorized the concepts in the extended TAM into 3 domains: health zone, information zone, and technology zone.
The health system is a complex system of systems - changes in agriculture, transportation, economics, family life, medical practices, and many other things can have a profound influence on health and health costs. Yet today, policy-level investment decisions are frequently made by modeling individual systems in isolation. We describe two sets of issues that we face in trying to develop a platform, method, and service for integrating expert models from different domains to support health policy and investment decisions. The first set of questions concerns how to develop accurate social and behavioralhealth models and integrate them with engineering models of transportation, clinic operations, and so forth. The second set of questions concerns the design of an environment that will encourage and facilitate collaboration between the health modelers themselves, who come from a wide variety of disciplines.
Maglio, Paul P.; Cefkin, Melissa; Haas, Peter J.; Selinger, Pat
The primary purpose of this study was to investigate whether the theory of planned behavior (TPB) mediated the relationship between dialectical thinking and healthbehaviors. A sample of 285 undergraduates was tested with a dialectical thinking styles scale, health promoting lifestyle profiles, and TPB questionnaires. Structural equation modeling was used for data analysis. Results indicated that all the three dimensions
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 behavioralhealth 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 behavioralhealth professionals are needed. Methods Using health center staffing data and behavioralhealth 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 behavioralhealth 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 behavioralhealth 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 behavioralhealth providers will be needed to serve 40 million medical patients, and grantees will need to increase behavioralhealth staff more than four-fold. Conclusions More behavioralhealth is seen in primary care than in any other setting, and health center clients have greater behavioralhealth needs than typical primary care patients. Most health centers needed additional behavioralhealth 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.
Objective To present common language for defining adherence of infrequent yet repeated healthbehaviors. Methods We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples. Results Adherence rates of infrequent, repeated behaviors varied widely depending on how adherence was defined and measured. We advocate use of 3 standard definitions of adherence: initiation of behavior (initiation), adherence to most recent opportunity (on-schedule), and timely adherence across multiple opportunities (maintenance or completion). Conclusions The proposed framework has cross-cutting implications for research and practice. Standardizing adherence metrics may facilitate comparisons across studies of healthbehaviors practiced at infrequent yet repeated intervals.
Gierisch, Jennifer M.; Reiter, Paul L.; Rimer, Barbara K.; Brewer, Noel T.
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
At the heart of PeaceHealth's IT infrastructure is the Community Health Record--a comprehensive medical record that links all patients served by any component of the integrated network to all PeaceHealth clinicians and staff. So far, satisfaction scores are soaring. PMID:14994458
...are the program requirements for behavioralhealth services? 36.91 Section 36.91 ...are the program requirements for behavioralhealth services? (a) The homeliving behavioralhealth program must make available the...
Uses ecological systems theory as a foundation for integratinghealth care and its public policy issues into family and consumer sciences classrooms. Offers teachers alternative perspectives on consumer behavior changes and needs in heath care systems and policies. Contains 24 references. (JOW)
Introduction: The Centre for Addiction and Mental Health (CAMH) is a 500 bed freestanding psychiatric hospital in Canada. We are in the process of preparing for an integrated commercial clinical information system, which will have computerized physician order entry (CPOE) functionality. Methods: As a preparation for CPOE, we developed inpatient order sets (OSs). Development teams from individual clinical programs created and sent their OSs to an OS Working Group for initial endorsement, and then to Pharmacy & Therapeutics and Medical Advisory committees subsequent approvals. Results: In twelve months we created and introduced 22 behavioralhealth OSs across eight clinical programs in our hybrid information system with an excellent adoption rate (>97%) by clinicians. Discussion: The development and implementation temporarily contributed to a multifactorial flow problem in the emergency department (ED), which was addressed by substantially simplifying the General Admission via the ED OS. Also, as the OSs were developed and sent for approval the project identified areas where local clinical practice can improve. Our electronic-paper hybrid set of clinical systems was a major factor impacting the effort.
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…
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…
Few existing studies have examined health and oral health needs and treatment-seeking behavior among the homeless and injection\\u000a drug users (IDUs). This paper describes the prevalence and correlates of health and oral health care needs and treatment-seeking\\u000a behaviors in homeless IDUs recruited in San Francisco, California, from 2003 to 2005 (N?=?340). We examined sociodemographic characteristics, drug use patterns, HIV status
Jonathan Leserman Robbins; Lynn Wenger; Jennifer Lorvick; Caroline Shiboski; Alex H. Kral
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.
Follette, William C.; Bach, Patricia A.; Follette, Victoria M.
c SYNOPSIS Objective. Relatively little is known about the intergenerational mechanisms that lead to social disparities in child health. We examined whether the association between low socioeconomic status (SES) and child behavior problems is mediated by maternal health conditions and behavior. Methods. Prospective cohort data (1979-1998) on 2,677 children and their mothers were obtained from the National Longitudinal Survey of
Background.?In the developing world, household surveys provide high-quality healthbehavior data integral to public health program management. The Expanded Program on Immunization Contact Method (EPI-CM) is a proposed, less resource-intensive method in which health center staff incorporate healthbehavior questions into routine vaccination activities. No systematic evaluation of EPI-CM validity has yet been conducted. Methods.?We used concurrent household survey and EPI-CM to collect data on 4 infant healthbehaviors in Mali at 2 time points (8 total comparisons). Studied healthbehaviors were bednet use, obtaining care for fever, obtaining care for a respiratory complaint, and using oral rehydration solution for diarrhea. Household survey and EPI-CM estimates were considered equivalent if a 95% confidence interval about the difference in estimated proportions fell within the interval (?.10, .10). Results.?EPI-CM estimates were higher than household survey estimates for 7 of 8 unadjusted paired estimates; estimates of bednet use in 2009 met a priori equivalence criteria in a setting of high bednet use (90.5%). When we restricted household survey data to infants up-to-date on vaccinations, estimates for behaviors other than bednet use remained substantially different. Conclusions.?We were unable to demonstrate that EPI-CM, as implemented, consistently produces data comparable with household survey data.
Wei, Stanley C.; Vanden Eng, Jodi L.; Patterson, Amy E.; Doumbia, Seydou; Kleinbaum, David G.; Ryman, Tove K.; Toure, Mahamoudou B.
Summary Studies of patient adherence to healthbehavior programs, such as physical exercise, smoking cessation, and diet, have resulted in the formulation and validation of the Transtheoretical Model (TTM) of behavior change. Although widely accepted as a guide for the development of healthbehavior interventions, this model has not been applied to vocal rehabilitation. Because resolution of vocal difficulties frequently depends on a patient’s ability to make changes in vocal and healthbehaviors, the TTM may be a useful way to conceptualize voice behavior change processes, including the patient’s readiness for change. The purpose of this paper is to apply the TTM to the voice therapy process to: (1) provide an organizing framework for understanding of behavior change in voice therapy, (2) explain how treatment adherence problems can arise, and (3) provide broad strategies to improve treatment adherence. Given the significant role of treatment adherence in treatment outcome, considering readiness for behavior change should be taken into account when planning treatment. Principles of healthbehavior change can aid speech pathologists in such understanding and estimating readiness for voice therapy.
Public health departments at the state and local levels are pursuing integration strategies to consolidate child health information systems to improve child health. Eighteen health departments were interviewed in this exploratory research study to gather information to describe their current activities related to integrating child health information systems. Results illustrate the common systems being brought together and the technical process for doing so, financing mechanisms, range of anticipated information-users and their method of access to the integrated system, and common internal and external challenges and strengths that the health departments face. The evidence suggests a trend towards more efficient and thoughtful use of the multiplicity of information systems within public health departments as programs consolidate and share data and expand electronic communication with their external partners in the health care delivery system to improve children's health. PMID:15643356
Fehrenbach, S Nicole; Kelly, Janet C R; Vu, Christie
Supervision plays a key role in the provision of health and human services. An extensive literature exists on supervision as an element of professional development in behavioralhealth care. However, much less attention has been given to the practice of supervision in publicly funded systems of care for persons with mental and substance use conditions. This article provides a comprehensive
Michael A. Hoge; Scott Migdole; Melanie S. Farkas; Allison N. Ponce; Christie Hunnicutt
Objective: Smoking is addictive and harmful, causing health problems and death; therefore, there is a need to understand which factors contribute to smoking. The prevalence rates of smoking are currently the highest among university students. The main objective of this cross-sectional study was to analyze the association of smoking status with depressive symptoms and personal healthbehaviors. Methods: A sample
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…
Objective: This study examines personal healthbehaviors and wellness, health-related lifestyles, and prevention screening practices among licensed physicians. Methods: An anonymous questionnaire was mailed to a random sample of 1,875 physicians practicing in California. Data from 763 returned questionnaires (41%) were analyzed. Results: Our data…
Bazargan, Mohsen; Makar, Marian; Bazargan-Hejazi, Shahrzad; Ani, Chizobam; Wolf, Kenneth E.
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
With the increasing differentiation of organisations involved in the pursuit of public health, there is also a growing need for inter-organisational integration. Starting from the concepts of differentiation and integration, this article is attempting a theoretical reconstruction based on published research on inter-organisational integration in public health and related welfare services. Different forms of integration are defined and related to each other in a conceptual framework, which is in itself an integration of different theoretical perspectives. According to this framework, integration in the field of public health requires inter-organisational collaboration across different sectors of the society. Such intersectoral collaboration can be organised mainly in the form of multidisciplinary teams across the boundaries of different organisations and sectors. Such an organisation is fragile and volatile, however, which means that it needs a lot of management support in order to survive. PMID:16604850
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.
Prosser, W. H.; Brown, T. L.; Woodard, S. E.; Fleming, G. A.; Cooper, E. G.
Objective: To examine the impact of prenatal cocaine exposure and maternal behavioralhealth (recent drug use and psychological functioning) on child behavior at age 5 years. Method: In this longitudinal investigation, maternal report of child behavior was assessed using the Achen- bach Child Behavior Checklist (CBCL) in 140 cocaine-exposed and 181 noncocaine-exposed (61 alcohol, to- bacco, and\\/or marijuana-exposed, and 120
Veronica H. Accornero; Connie E. Morrow; Emmalee S. Bandstra; Arnise L. Johnson; James C. Anthony
Purpose In a diverse group of early adolescents, this study explores the co-occurrence of a broad range of health risk behaviors: alcohol, cigarette, and marijuana use; physical inactivity; sedentary computing/gaming; and the consumption of low-nutrient energy-dense food. We tested differences in the associations of unhealthy behaviors over time, and by gender, race/ethnicity, and socioeconomic status. Methods Participants were 8360 students from 16 middle schools in California (50% female; 52% Hispanic, 17% Asian, 16% White, and 15% Black/multiethnic/other). Behaviors were measured with surveys in Spring 2010 and Spring 2011. Confirmatory factor analysis was used to assess if an underlying factor accounted for the covariance of multiple behaviors, and composite reliability methods were used to determine the degree to which behaviors were related. Results The measured behaviors were explained by two moderately correlated factors: a ‘substance use risk factor’ and an ‘unhealthy eating and sedentary factor’. Physical inactivity did not reflect the latent factors as expected. There were few differences in the associations among these behaviors over time or by demographic characteristics. Conclusions Two distinct, yet related groups of health compromising behaviors were identified that could be jointly targeted in multiple healthbehavior change interventions among early adolescents of diverse backgrounds.
de la Haye, Kayla; D'Amico, Elizabeth J.; Miles, Jeremy N. V.; Ewing, Brett; Tucker, Joan S.
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…
Barry, Adam E.; Chaney, Beth H.; Piazza-Gardner, Anna K.; Chavarria, Enmanuel A.
Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM (N = 871). The authors examined demographic differences in health care access and the relation between access and health-related attitudes, healthbehaviors, and HIV transmission risk. They operationalized health care access in terms of three indicators: perceived barriers, insurance status, and recent medical visit. Twenty-seven percent (n = 227) of MSM reported zero or one health care access indicator. African American and Latino race/ethnicity, lower income, and HIV-unknown status were associated with limited health care access. Limited health care access was related to health care attitudes (mistrust in the health care system and difficulty disclosing MSM status to providers), general healthbehaviors (smoking, never being HIV-tested, and drug abuse), and sexual risk-related variables (low self-efficacy for sexual safety, consistent drug use during sex, and HIV transmission risk). Overall, among MSM, less health care access relates to several adverse psychological constructs and healthbehaviors. Researchers and public health officials should address limited health care access, and its consequences, in this population. PMID:22505573
McKirnan, David J; Du Bois, Steve N; Alvy, Lisa M; Jones, Kyle
This study describes on-site behavioralhealth treatment capacity in health centers in 2007 and examines whether capacity was associated with health center characteristics, county-level behavioralhealth workforce, and same-day billing restrictions. Cross-sectional data from the 2007 Area Resource File and Uniform Data System were linked with data on Medicaid same-day billing restrictions. Mental health treatment capacity was common; almost four in five health centers provided on-site mental health services. Additional services such as crisis counseling (20 %), treatment from a psychiatrist (29 %), and substance abuse treatment were offered by fewer health centers (51 % provide on-site services and only 20 % employ substance abuse specialists). In multivariate analysis, larger health centers, health centers located in counties with a larger behavioralhealth workforce per capita, and those located in the West and Northeast were more likely to have behavioralhealth capacity. Same-day billing restrictions were associated with lower odds of substance use treatment capacity and providing 24 hr crisis counseling services. PMID:24114408
Jones, Emily; Ku, Leighton; Smith, Shelagh; Lardiere, Michael
Background A mental health advantage has been observed among adolescents in urban areas. This prospective study tests whether cultural integration measured by cross-cultural friendships explains a mental health advantage for adolescents. Methods A prospective cohort of adolescents was recruited from 51 secondary schools in 10 London boroughs. Cultural identity was assessed by friendship choices within and across ethnic groups. Cultural integration is one of four categories of cultural identity. Using gender-specific linear-mixed models we tested whether cultural integration explained a mental health advantage, and whether gender and age were influential. Demographic and other relevant factors, such as ethnic group, socio-economic status, family structure, parenting styles and perceived racism were also measured and entered into the models. Mental health was measured by the Strengths and Difficulties Questionnaire as a ‘total difficulties score’ and by classification as a ‘probable clinical case’. Results A total of 6643 pupils in first and second years of secondary school (ages 11–13 years) took part in the baseline survey (2003/04) and 4785 took part in the follow-up survey in 2005–06. Overall mental health improved with age, more so in male rather than female students. Cultural integration (friendships with own and other ethnic groups) was associated with the lowest levels of mental health problems especially among male students. This effect was sustained irrespective of age, ethnicity and other potential explanatory variables. There was a mental health advantage among specific ethnic groups: Black Caribbean and Black African male students (Nigerian/Ghanaian origin) and female Indian students. This was not fully explained by cultural integration, although cultural integration was independently associated with better mental health. Conclusions Cultural integration was associated with better mental health, independent of the mental health advantage found among specific ethnic groups: Black Caribbean and some Black African male students and female Indian students.
Bhui, Kamaldeep S; Lenguerrand, Erik; Maynard, Maria J; Stansfeld, Stephen A; Harding, Seeromanie
Objective: This study examined the relationship between social network characteristics and health promoting behaviors (having a routine medical check-up, consuming no alcohol, consuming no fast food, and meeting recommendations for leisure-time physical activity and sleep duration) among Latinos to identify potential targets for behavioral interventions. Method: Personal network characteristics and healthbehavior data were collected from a community sample of 393 adult Latinos (73% women) in San Diego County, California. Network characteristics consisted of size and composition. Network size was calculated by the number of alters listed on a name generator questionnaire eliciting people with whom respondents discussed personal issues. Network composition variables were the proportion of Latinos, Spanish-speakers, females, family, and friends listed in the name generator. Additional network composition variables included marital status and the number of adults or children in the household. Results: Network members were predominately Latinos (95%), Spanish-speakers (80%), females (64%), and family (55%). In multivariate logistic regression analyses, gender moderated the relationship between network composition, but not size, and a healthbehavior. Married women were more likely to have had a routine medical check-up than married men. For both men and women, having a larger network was associated with meeting the recommendation for leisure-time physical activity. Conclusion: Few social network characteristics were significantly associated with health promoting behaviors, suggesting a need to examine other aspects of social relationships that may influence healthbehaviors. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:24884908
Marquez, Becky; Elder, John P; Arredondo, Elva M; Madanat, Hala; Ji, Ming; Ayala, Guadalupe X
Background The prevalence and severity of obesity have increased among children and adolescents. While the medical and psychosocial consequences of youth obesity have been well-documented, less information exists on the association of overweight/obesity with health risk behaviors, which are considered to be a primary threat to adolescent health. Objectives This study examined the association of overweight and obesity with health-risk behaviors among U.S. youth. Methods Self-reported height and weight, substance use, violence and bullying were assessed in a nationally representative sample of students aged 11 to 17 years (N=7825) who participated in the 2005/6 HealthBehaviors in School-Aged Children survey. Data were analyzed in 2009. Results Significant gender and age differences in the relationship of overweight/obesity with risk behaviors were observed. Overweight and obesity were significantly associated with substance use among girls only: frequent smoking and drinking were associated with overweight and obesity among younger girls, whereas they were associated with obesity among older girls. Frequent smoking and cannabis use were associated with overweight among younger girls only. Relationships between violent behavior and overweight/obesity were mainly observed among boys: Younger obese boys were more likely to be victims of bullying, whereas older obese boys were more likely to carry weapons, compared to boys of normal weight. Conclusions Overweight and obese youth are at risk of developing health compromising behaviors which may compound medical and social problems associated with excess weight.
Farhat, Tilda; Iannotti, Ronald J.; Simons-Morton, Bruce
The purpose of the study was to test the psychometric properties of a culturally sensitive and theory-based instrument: the Breast HealthBehavior Questionnaire. This instrument was translated into Spanish and back-translated at a third- to fourth-grade reading level. The pilot group consisted of 70 Hispanic women who attended a class at a local church. Subsequent to pilot testing, another 40 Hispanic women who attended a class at the local health department comprised the study sample. The participants responded to the 15-item questionnaire, which is formatted as a Likert scale. Content validity of the Breast HealthBehavior Questionnaire was determined by a panel of experts. A factor analysis of this instrument showed five separate dimensions accounting for 71.82% of the instrument's variance. The three major components of self-regulation theory (schema, coping, and appraisal criteria) were found clustered within the first three dimensions after three items were discarded. The Breast HealthBehavior Questionnaire demonstrated an internal consistency reliability coefficient of .7172. The psychometric properties of the Spanish version of this questionnaire warrant further research. The instrument may support a better understanding of the Hispanic woman's practice of breast healthbehavior. Eventually, the Breast HealthBehavior Questionnaire may assist nurses in the formulation of culturally grounded interventions. PMID:11502042
Health care institutions and professionals are transforming the organizational structure of the nation's delivery system. Buyers and payers of health care are seeking more effective and efficient services for their dollars. Several new model organizational structures seek to put the providers who are aligning themselves with one another into a better position to deal with today's marketplace. PMID:8945275
As reported in last month's HEJ, the new Sustainable Development Strategy for the Health, Public Health and Social Care System for 2014-20 rightly emphasises the importance of the built environment to health and well-being. Chris Hall, the BRE's health sector lead, says this message 'stretches far beyond hospitals and healthcare buildings into the communities and homes that people live in'. Here he highlights some of the key elements relating to the current carbon efficiency of healthcare buildings, considers the impact of 'good' housing on health and preventing illness, and looks forward to a series of joint IHEEM and BRE 'Building Sustainable Development' mini-conference events planned in the run-up to October's Healthcare Estates 2014 event in response to the new Strategy, designed to share ideas and good practice on sustainable estates issues. The first takes place in London later this month (see panel below). PMID:24930185
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…
Background Finland has since 1972 had a primary health care system based on health centres run and funded by the local public authorities called ‘municipalities’. On the world map of primary health care systems, the Finnish solution claims to be the most health centre oriented and also the widest, both in terms of the numbers of staff and also of different professions employed. Offering integrated care through multi-professional health centres has been overshadowed by exceptional difficulties in guaranteeing a reasonable access to the population at times when they need primary medical or dental services. Solutions to the problems of access have been found, but they do not seem durable. Description of policy practice During the past 10 years, the health centres have become a ground of active development structural change, for which no end is in sight. Broader issues of municipal and public administration structures are being solved through rearranging primary health services. In these rearrangements, integration with specialist services and with social services together with mergers of health centres and municipalities are occurring at an accelerated pace. This leads into fundamental questions of the benefits of integration, especially if extensive integration leads into the threat of the loss of identity for primary health care. Discussion This article ends with some lessons to be learned from the situation in Finland for other countries.
Concepts from disciplines such as Biochemistry, Genetics, Cellular and Molecular Biology are essential to the understanding and treatment of an elevated number of illnesses, but often they are studied separately, with no integration between them. This article proposes a model for basic sciences integration based on problem-based learning (PBL) and…
Azzalis, L. A.; Giavarotti, L.; Sato, S. N.; Barros, N. M. T.; Junqueira, V. B. C.; Fonseca, F. L. A.
Background Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Methods Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Results Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. Conclusions The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual healthbehaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial and physical health. These findings have significant meaning for future public health programs, which should be more tailored with use of such knowledge on behavioral clustering via e.g. Transfer Learning.
Examine a social learning theory model as a framework to guide health system leaders as they consider the psychology of organizational design as it pertains to the successful integration. PMID:21675313
The United States Air Force is continually researching ways to reduce costs associated with aircraft maintenance and improve operational safety. This study focuses on creating a systems engineering process to develop an Integrated Structural Health Monito...
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...
This document describes a Concept of Operations (ConOps) for an Integrated Vehicle Health Assurance System (IVHAS). This ConOps is associated with the Maintain Vehicle Safety (MVS) between Major Inspections Technical Challenge in the Vehicle Systems Safet...
D. E. Berger, D. F. Perey, D. L. Simon, G. W. Hunter, J. D. Lekki, R. W. Mah, R. W. Ross, S. R. Schuet, S. W. Smith
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
Gerda G. Fillenbaum; Bruce M. Burchett; J. D. Dan; G. Blazer
Clustering behavior is studied in a model of integrate-and-fire oscillators with excitatory pulse coupling. When considering a population of identical oscillators, the main result is a proof of global convergence to a phase-locked clustered behavior. The robustness of this clustering behavior is then investigated in a population of nonidentical oscillators by studying the transition from total clustering to the absence of clustering as the group coherence decreases. A robust intermediate situation of partial clustering, characterized by few oscillators traveling among nearly phase-locked clusters, is of particular interest. The analysis complements earlier studies of synchronization in a closely related model.
Simulating physically realistic, complex dust behaviors is useful in interactive graphics applications, such as those used for education, entertainment, or training. Training in virtual environments is a major topic for research and applications, and generating dust behaviors in real time significantly increases the realism of the simulated training environment. We introduce a method for simulating the dust behaviors that a fast-traveling vehicle causes. Our method combines particle systems, rigid-body particle dynamics, computational fluid dynamics (CFD), rendering, and visualization techniques. Our work integrates physics-based computing and graphical visualization for applications in simulated virtual environments.
...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...
...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...
A socioculturally appropriate health risk behavior instrument, modeled after the U.S. Centers for Disease Control and Prevention's Youth Risk Behavior Survey (YRBS), was administered to 717 secondary school students in a rural area of Zimbabwe. Comparisons of risk behaviors by gender and school grade were made using univariate procedures and multiple logistic regression. Males were significantly more likely than females to have had sexual intercourse (odds ratio = 5.02, p < .0001) and to report drug use behaviors. Males also were significantly more likely to report early initiation (by age 13 years) of alcohol use, cigarette smoking, and marijuana use. School site violence and drug use behaviors also were prevalent in this sample. An interaction between gender and grade was evident for some behaviors. Additional research may further the understanding of these risk behaviors and facilitate development of effective, culturally relevant risk reduction programs. PMID:11575689
Gwede, C K; McDermott, R J; Westhoff, W W; Mushore, M; Mushore, T; Chitsika, E; Majange, C S; Chauke, P
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…
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.
Potvin, Louise; Gendron, Sylvie; Bilodeau, Angele; Chabot, Patrick
Maternal mental health research is a public health priority due to its impact on both maternal and child health. Despite the growing number of empirical studies in this area, particularly from developing countries, there is a paucity of synthetic review articles. Therefore, attempting to synthesize the existing literature in this area seems relevant to appraise the readers of the field's progress and to infer directions for future research. The present review aims to provide an overview of the literature on maternal mental health and its association with birth outcomes and child behavior. Specifically, the literature on mental health during pregnancy and in the postpartum period and its influence on birth outcomes and child behavior have been reviewed. Further, a conceptual and methodological evaluation of the existing literature has been provided to identify gaps in the literature and to suggest directions for future research.
Satyanarayana, Veena A.; Lukose, Ammu; Srinivasan, K.
...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...
A multidisciplinary team of researchers at the Center for the Promotion of Health in the New England Workplace (CPH-NEW) developed an evidence-based approach to address three recognized challenges to workplace programs designed to improve employee health: establishing employee ownership, integrating with work organization, and sustainability. The two main innovations being introduced in combination were (1) integrating traditional workplace health protection (e.g., ergonomics, industrial hygiene) with health promotion (e.g., assisting workers in improving healthbehaviors) and (2) introducing a bottom-up participatory model for engaging employees in innovative iterative design efforts to enhance both components of this integrated program. In the program, which was modeled after participatory ergonomics programs, teams of workers engage in the iterative design of workplace interventions to address their prioritized health concerns with the support of a multilevel steering committee. The integrated approach being tested can complement existing worksite safety and health initiatives and promote organizational learning, with expected synergistic effects. PMID:19618804
Henning, Robert; Warren, Nicholas; Robertson, Michelle; Faghri, Pouran; Cherniack, Martin
Substance use (SU) problems are common among adolescents, a serious health risk for them and a major public health problem, but are inadequately addressed in most pediatric health care settings. Primary care offers an excellent context for SU assessment and treatment for adolescents and their families, offering better access and a less stigmatized environment for receiving treatment than specialty programs. This paper examines the literature on the integration of substance use treatment with adolescent health care, focusing on 2 areas: Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Emergency Departments and Primary Care, and School- and College-Based Health Centers.
The fastest-growing prison subgroup is men age 50 years and older, of whom 85% have multiple chronic health conditions. This pilot study examined relationships between health status, self-efficacy beliefs, and behaviors through a convenience sample survey of 51 older male prisoners. Inmates with greater self-efficacy (i.e., confidence) in their health self-management abilities were significantly more likely to rate their health
Introduction: There are multiple ways to address the mental and behavioralhealth needs of people with intellectual and developmental disabilities (IDD). Method: In this paper, we do not argue for a particular approach or set of approaches, but instead review the benefits of integrating mental and behavioralhealth supports with primary healthcare based primarily on our experience in and understanding of healthcare systems in the United States. It is estimated that between 35 and 40% of people with IDD also live with psychiatric disorders. NADD, an association for persons with developmental disabilities and mental health needs in the US holds that coexisting IDD and a psychiatric disorder interferes with a person’s education and job readiness, and disrupts family and peer relationships. Historically, the presence of such disorders among people with IDD was not well understood or was discounted altogether. Conclusion: Over the past 15?years, however, greater attention is being paid to these comorbidities and their treatment, including the need to integrate mental and behavioralhealth treatments into primary care. Healthcare must account for multiple domains of quality of life, going beyond yearly physicals, and acute care visits, for example, to assess individuals’ healthcare goals and support them in achieving those goals. While integrated healthcare delivery systems can be difficult to find and access for people with IDD, such approaches are more responsive to the comprehensive needs and desires of people with IDD.
The purpose of this study was to examine the associations between God Locus of Health Control, healthbehaviors, and beliefs utilizing a cross-sectional online survey (N = 549). Results indicated that God Locus of Health Control was correlated with alcohol use, physical activity, perceived risk of chronic disease, and beliefs that poor healthbehaviors contribute to chronic disease (all p values < .05). Multiple regression analyses including covariates and other locus of control variables revealed that God Locus of Health Control was only an independent correlate of the belief that physical inactivity contributed to chronic disease. Insights from this study may be important for future faith-based healthbehavior change interventions. PMID:23431129
Describes an integrated instructional design approach that addresses cognitive, attitudinal, and behavioral aspects of learning and is based on three theoretical frameworks: instructional systems design, social learning theory, and the stages of change framework provided in the Transtheoretical Model of Change. (LRW)
I introduce a range of examples of different causal hypotheses about human mate selection. The hypotheses I focus on come from evolutionary psychology, fluctuating asymmetry research and chemical signaling research. I argue that a major obstacle facing an integrated biology of human behavior is the lack of a causal framework that shows how multiple proximate causal mechanisms can act together
We examined the effects of individualized video modeling on the accurate implementation of behavioral interventions using a multiple baseline design across 3 teachers. During video modeling, treatment integrity improved above baseline levels; however, teacher performance remained variable. The addition of verbal performance feedback increased…
DiGennaro-Reed, Florence D.; Codding, Robin; Catania, Cynthia N.; Maguire, Helena
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…
The precision of magnetic field calculation is crucial to predict the arc behavior using magnetohydrodynamic (MHD) model. A integrated calculation method is proposed to couple the calculation of magnetic field and fluid dynamics based on the commercial software ANSYS and FLUENT, which especially benefits to take into account the existence of the ferromagnetic parts. An example concerning air arc is presented using the method.
The authors argue that there is a clear link between mental and physical health issues. A wellness-based approach to integratedhealth care, such as the one described in this article, may allow older clients to be empowered to make lifestyle changes that can improve the quality of their lives and reduce physical illness.
This report is a comprehensive description of Minnesota's children's mental health system. It is designed to provide background and guidance to the Children's Integrated Fund Task Force, to assist local coordinating councils, and to serve policymakers outside of mental health who are increasingly asked to consider problems from an interagency…
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,…
It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1)
Lisa F. Berkman; Thomas Glass; Ian Brissette; Teresa E. Seeman
The references at home and abroad are summarized in this paper. This paper introduces the basic concept and the application significance of aerospace plane, the main differences between the aerospace plane and general aircraft, integratedhealth management system and its compositions of aerospace plane , the development status of health management for aerospace plane in domestic and foreign countries. Especially
This article discusses the benefits as well as the important considerations that should be taken into account in integrating popular films in health education classes. Use of popular films in the classroom, termed "cinema education," is becoming increasingly popular in teaching health education. As a matter of convenience, popular films are easy…
The public treatment of seriously mental ill patients continues to be frustrated by the lack of administrative and financial integration of state and community mental health services. Several states have initiated attempts to improve the costeffectiveness of public mental health services through mechanisms that create financial incentives fostering community-based alternatives to psychiatric hospitalization. Examples of such mechanisms include capitation financing
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…
Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra H.
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…
In this paper we develop a methodology for integrating the health effects from exposure to air pollution into the MIT Emissions Prediction and Policy Analysis (EPPA) model, a computable general equilibrium model of the economy that has been widely used to study climate change policy. The approach incorporates market and non-market effects of air pollution on human health, and is
This paper presents findings from a study designed to identify and describe models for integrating primary care and mental health services in rural communities. Data were obtained from telephone interviews with staff at rural primary care sites around the country. Findings are based on the responses of 53 primary care organizations in 22 states. The authors identify four integration models—diversification,
Donna C. Bird; David Lambert; David Hartley; Peter G. Beeson; Andrew F. Coburn
Education and mental healthintegration will be advanced when the goal of mental health includes effective schooling and the\\u000a goal of effective schools includes the healthy functioning of students. To build a solid foundation for this reciprocal agenda,\\u000a especially within the zeitgeist of recent educational reforms, a change in the fundamental framework within which school mental\\u000a health is conceptualized is
Marc S. AtkinsKimberly; Kimberly E. Hoagwood; Krista Kutash; Edward Seidman
Objective: The aim of the present paper was to analyze factors affecting distal and proximal healthbehavior within a biopsychosocial model for examining their interactions and associations with respect to health. Methods: Path analysis was based on the nationwide, cross-sectional German Health Interview and Examination Survey for Children and Adolescents (2003 to 2006). The data was collected from 4,529 participants with an average age of 9.45 years (SD = 4.01). Socio-demographic data, psychosocial factors and healthbehavior were assessed via questionnaire. Participants also underwent physical fitness tests and a medical examination. Results: Over the five levels of the model analyzed with socioeconomic status, immigration background, and rural-urban differences on the first level; physical activity of relatives and peers, intrinsic motivation, and quality of life on the second level; eating patterns, sedentary behavior, and physical activity on the third level; physical fitness and objective health on the fourth level; and health complaints and subjective health on the fifth level; direct, moderation, and mediation effects could be shown. Conclusions: Several distal and proximal factors are needed to take account of the multivariate complexity of health: e.g., immigration background affected healthbehaviors only indirectly and the effect of physical activity on objective health was mediated by physical fitness.
Lammle, Lena; Woll, Alexander; Mensink, Gert B. M.; Bos, Klaus
Most African countries consider family planning as a necessary policy instrument for the improvement of maternal and child health conditions. 68% of governments have set as a development objective the reduction of mortality, particularly the reduction of maternal and infant mortality. Additionally, 34% of these African governments have adopted an integrated approach of family planning programs with health services. Various reasons can justify the adoption of an integrated approach to the provision of family planning and maternal and child health services. From a political perspective, the integration approach is based on the political sensitivity and increasing the willingness of political authorities and motivating them to accept family planning as an instrument in the battle against maternal and infant mortality. From the organizational point of view, integration allows the establishment of a system of administration common to both programs of family planning and health, and consequently to develop the infrastructure in equipment and personnel that is necessary for the functioning of these programs. Births occurring to women in the 20-30 year age group are associated with low maternal mortality. Birth intervals of more than 1 year and preferably 2 years and more are associated with a low rate of maternal and infant mortality, prenatal mortality, and a low rate of prematurity. The high rate of abortion constitutes a danger against maternal health. A program of family planning integrated with health services will diminish the number of abortions. For integration to respond to its objectives, certain conditions should be met: the establishment of administrative services that allow the integrated functioning of family planning with maternal and infant health services; complete coverage in health services to pregnant women and women who just delivered; and the establishment and proper functioning of population education programs for pregnant and postpartum women and for young women and couples. PMID:12265378
Integratingbehavioralhealth into primary healthcare offers multiple advantages for patients and health professionals. This model requires a new skill set for all healthcare professionals that is not emphasized in current educational models. The new skills include interprofessional team-based care competencies and expanded patient care competencies. Health professionals must learn new ways to efficiently and effectively address healthbehavior change, and manage behavioralhealth issues such as depression and anxiety. Learning environments that co-train mental health and primary care professionals facilitate acquisition of both teamwork and patient care competencies for mental health and primary care professional trainees. Family Medicine Residency programs provide an excellent opportunity for co-training. This article serves as a "how to" guide for residency programs interested in developing a co-training program. Necessary steps to establish and maintain a program are reviewed, as well as goals and objectives for a co-training curriculum and strategies to overcome barriers and challenges in co-training models. PMID:24261270
Ruddy, Nancy Breen; Borresen, Dorothy; Myerholtz, Linda
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.
Background Healthbehaviors 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 healthbehaviors: 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 healthbehaviors and ultimately improve their health.
Objectives To examine associations of the US and community subjective social status (SSS) ladders with smoking status, at-risk drinking, fruit and vegetable intake, physical activity, and body mass index among 1467 church-going African American adults from a larger cohort study. Methods Regression analyses, adjusted for sociodemographics, examined associations between SSS ladders and healthbehaviors. Results The SSS-US ladder was significantly associated with fruit and vegetable consumption (p = .007) and physical activity (p = .005). The SSS-community ladder was not significantly associated with any healthbehaviors. Conclusions Among this sample of African Americans, the SSS-US ladder is more predictive of some healthbehaviors than is the SSS-community ladder.
Reitzel, Lorraine R.; Nguyen, Nga; Strong, Larkin L.; Wetter, David W.; McNeill, Lorna H.
Understanding and predicting positive healthbehaviors are a major concern to health promotion professionals. Consequently, research efforts have been aimed at examining the factors which underlie the practice of wellness behaviors. Although health value ...
The current use of Health Information Technology (HIT) within healthcare practice is limited. Clinical guidelines have been developed to bring research based evidence into practice. However, there is no defining step during the development process that explores the use of HIT and how it can benefit the patient, staff and delivery of care process. This paper presents a review of
...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'')....
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.
Background: Parents and teachers involvement reinforce health promotion programs for children's health. Objectives: The purpose of this study was to evaluate mothers’ lifestyle behavior and its association with children's oral health. Materials and Methods: The study was a cross sectional study on 383 children and their mothers who were selected from 6 primary schools in Tehran, Iran. Mothers and children who participated in this study were asked to complete a questionnaire containing demographic questions, knowledge of oral health, attitude towards the oral healthbehavior, and oral healthbehaviors. Furthermore, the Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI) were assessed by two calibrated dentists. Data were analyzed with multilevel mixed model analyses. Results: The average age of the children and their mothers were 11.6 and 38.4 years, respectively. Mothers’ higher knowledge, higher educational status, positive attitude, higher frequent oral healthbehaviors, lower DMFT and lower CPI were all associated significantly with children’s higher oral health status. Conclusions: The results suggest that to improve children’s oral health, educational interventions should focus on both children and mothers to obtain a more promising outcome.
Nourijelyani, Keramat; Yekaninejad, Mir Saeed; Eshraghian, Mohammad Reza; Mohammad, Kazem; Rahimi Foroushani, Abbas; Pakpour, Amir
Practicing physicians on the full-time academic and clinical (volunteer) faculty of an urban university department of medicine (N = 211) completed questionnaires that examined their coping behaviors, health habits, life satisfaction, job stress, conflict between work and home life, health status and moods. Attempts to organize and restructure work activities were more frequently practiced by physicians who were more satisfied with work. Socializing, exercising and discussing feelings with others were not associated with any measures of physician health status, job stress, conflict or satisfaction. Those with higher scores on a health habits index tended to be less anxious, experienced less job stress, less conflict between work and home life and were more satisfied with their lives in general. Full-time academic faculty engaged in fewer positive or negative coping behaviors than clinical faculty. There were few strong intercorrelations among the various positive and negative coping behaviors or health habits; physicians often simultaneously engaged in both positive and negative activities, indicating complex patterns of coping behaviors that were not dramatically associated with life or work satisfaction. PMID:3716413
We examined the association of muscular fitness with psychological positive health, health complaints, and health risk behaviors in 690 (n = 322 girls) Spanish children and adolescents (6-17.9 years old). Lower body muscular strength was assessed with the standing long jump test, and upper-body muscular strength was assessed with the throw basketball test. A muscular fitness index was computed by means of standardized measures of both tests. Psychosocial positive health, health complaints, and health risk behaviors were self-reported using the items of the HealthBehavior in School-aged Children questionnaire. Psychological positive health indicators included the following: perceived health status, life satisfaction, quality of family relationships, quality of peer relationships, and academic performance. We computed a health complaints index from 8 registered symptoms: headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, and feeling dizzy. The health risk behavior indicators studied included tobacco use, alcohol use, and getting drunk. Children and adolescents with low muscular fitness (below the mean) had a higher odds ratio (OR) of reporting fair (vs. excellent) perceived health status, low life satisfaction (vs. very happy), low quality of family relationships (vs. very good), and low academic performance (vs. very good). Likewise, children and adolescents having low muscular fitness had a significantly higher OR of reporting smoking tobacco sometimes (vs. never), drinking alcohol sometimes (vs. never), and getting drunk sometimes (vs. never). The results of this study suggest a link between muscular fitness and psychological positive health and health risk behavior indicators in children and adolescents. PMID:22158258
Padilla-Moledo, Carmen; Ruiz, Jonatan R; Ortega, Francisco B; Mora, Jesús; Castro-Piñero, José
The objective of the present study was to examine psychosocial correlates of diverse health-compromising behaviors among adoles- cents of different ages. The study population included 123 132 adolescents in sixth, ninth and 12th grades. Psychosocial correlates of sub- stance abuse, delinquency, suicide risk, sexual activity and unhealthy weight loss behaviors were examined. Risk-taking disposition was significantly associated with nearly every
Dianne Neumark-Sztainer; Mary Story; Simone A. French; Michael D. Resnick
Objective The Health Maintenance Consortium (HMC) is a multisite Grantee Consortium funded by the National Institutes of Health from 2004–2009. The goal of HMC is to enhance understanding of the long-term maintenance of behavior change, as well as effective strategies for achieving sustainable health promotion and disease prevention. Methods This introductory research synthesis prepared by the Resource Center gives context to this theme issue by providing an overview of the HMC and the articles in this journal. Results It explores the contributions to our conceptualization of behavior change processes and intervention strategies, the trajectory of effectiveness of behavioral and social interventions, and factors influencing the long-term maintenance of behavioral and social interventions. Conclusions Future directions for furthering the science of maintaining behavior change and reducing the gaps between research and practice are recommended.
Ory, Marcia G.; Smith, Matthew Lee; Mier, Nelda; Wernicke, Meghan M.
Numerous behavioralhealth and social service providers (primarily not-for-profit community mental health and chemical dependency treatment centers) have been joining forces on a local and regional basis to create their own managed care contracting entities, referred to as provider-sponsored networks. Even though these networks are emerging as an alternative managed care model, little is known about them. This descriptive survey
This article discusses the concepts and approaches underlying managed behavioralhealth care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioralhealth care. PMID:10183283
A framework of software components has been implemented to facilitate the development of ISHM systems according to a methodology based on Reliability Centered Maintenance (RCM). This framework is collectively referred to as the Toolkit and was developed using General Atomics' Health MAP (TM) technology. The toolkit is intended to provide assistance to software developers of mission-critical system health monitoring applications in the specification, implementation, configuration, and deployment of such applications. In addition to software tools designed to facilitate these objectives, the toolkit also provides direction to software developers in accordance with an ISHM specification and development methodology. The development tools are based on an RCM approach for the development of ISHM systems. This approach focuses on defining, detecting, and predicting the likelihood of system functional failures and their undesirable consequences.
Venkatesh, Meera; Kapadia, Ravi; Walker, Mark; Wilkins, Kim
Objectives The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. Data sources We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integratedhealth impact assessment (HIA)/EIA at both the state and federal level. Data synthesis We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. Conclusions The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.
Health coaching is an emerging behavioral intervention to improve outcomes in chronic disease management and prevention; however, no studies have investigated its utility in postpartum women who have gained excess weight during pregnancy. A 32-year-old primigravida woman who was overweight at conception and gained 23 lbs more than Institute of Medicine recommendations for her pre-pregnancy body mass index participated in a 6-month personalized health planning with integrativehealth coaching (PHPIHC) intervention. The intervention included a baseline health risk assessment review with a healthcare provider and eight biweekly, 30-minute telephonic health coaching sessions. The participant demonstrated improvement in physical activity, energy expenditure, knowledge, and confidence to engage in healthpromoting behaviors. Although the participant did not reach the target weight by completion of the health coaching sessions, follow up 8 months later indicated she achieved the target goal (within 5% of prepregnancy weight). This case report suggests that PHP-IHC can support postpartum women in returning to pre-pregnancy weight after gaining excess gestational weight. Future research and clinical trials are needed to determine the best timing, length, and medium (online, in-person, telephonic) of PHP-IHC for postpartum women. PMID:24278848
Health coaching is an emerging behavioral intervention to improve outcomes in chronic disease management and prevention; however, no studies have investigated its utility in postpartum women who have gained excess weight during pregnancy. A 32-year-old primigravida woman who was overweight at conception and gained 23 lbs more than Institute of Medicine recommendations for her pre-pregnancy body mass index participated in a 6-month personalized health planning with integrativehealth coaching (PHPIHC) intervention. The intervention included a baseline health risk assessment review with a healthcare provider and eight biweekly, 30-minute telephonic health coaching sessions. The participant demonstrated improvement in physical activity, energy expenditure, knowledge, and confidence to engage in healthpromoting behaviors. Although the participant did not reach the target weight by completion of the health coaching sessions, follow up 8 months later indicated she achieved the target goal (within 5% of prepregnancy weight). This case report suggests that PHP-IHC can support postpartum women in returning to pre-pregnancy weight after gaining excess gestational weight. Future research and clinical trials are needed to determine the best timing, length, and medium (online, in-person, telephonic) of PHP-IHC for postpartum women.
Compared with other developed countries, the United States has an inefficient and expensive health care system with poor outcomes and many citizens who are denied access. Inefficiency is increased by the lack of an integrated system that could promote an optimal mix of personal medical care and population health measures. We advocate a health trust system to provide core medical benefits to every American, while improving efficiency and reducing redundancy. The major innovation of this plan would be to incorporate existing private health insurance plans in a national system that rebalances health care spending between personal and population health services and directs spending to investments with the greatest long-run returns.
Drawing upon the results of research from over 4,500 businesses that are now re-inventing themselves through the application of current information technology, the author envisions the informational characteristics of the behavioral healthcare enterprise of the future. The new technology will be open for all stakeholders in the healthcare system to interoperate, integrated between providers and facilities nationwide, decentralized, immediately accessible and continuously updating clinically useful information. Although the new information system architecture may not be fully implemented for another 10 to 15 years, the transformation is already well underway. New computer technology makes such a reinvention of the behavioral healthcare enterprise both possible and inevitable. PMID:10142492
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 healthbehavior 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
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 healthbehavior 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.
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.
Baicker, Katherine; Congdon, William J; Mullainathan, Sendhil
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…
In the process of health transition, India is facing rapid pace of demographic aging. Rapid increase in older adult population posed serious concerns regarding health and health care utilization for them. However, very limited research documented resultant implications of demographic aging for health and health care use in the nexus of marital status and gender. With this perspective, the present study examined patterns in morbidity prevalence and health seeking behaviour among older widows in India. Multivariate logistic regression models were estimated to examine the effects of socio-demographic conditions on morbidity prevalence among older widows and their health care seeking behavior. Data from the latest 60th round of National Sample Survey (NSS), 2004 was used. Overall, morbidity prevalence was 13% greater among older widows compared to older widowers. Adjusted prevalence of communicable and non-communicable diseases was found 74 and 192 per 1000 older widows respectively. At the same time, likelihood of seeking health care services for reported morbidities was substantially lower among older widows. The findings of this study are important to support policy makers and health care providers in identifying individuals ‘at risk’ and could be integrated into the current programs of social, economic and health security for the older persons.
Integratedhealth systems are confronted with numerous dilemmas that must be managed. Many of these dilemmas are an inherent part of the system's structure, given that multiple competing hospitals, medical groups, and (sometimes) health plans are often under one organizational roof. This article presents an analysis of these dilemmas--referred to in the management literature as polarities--as they are found in six integratedhealth systems in Illinois. The nine polarities that must be managed include (1) hospital systems that want to be organizations of physicians; (2) system expansion by growing the physician component; (3) system centralization and physician decentralization; (4) centripetal and centrifugal forces involving physicians; (5) system objectives and physician interests; (6) system centralization and hospital decentralization; (7) primary care physicians and specialists; (8) physician autonomy via collectivization; and (9) vertical and virtual integration. The article identifies some of the solutions to the polarities that have been enacted by systems. In general, executives and physicians in integratedhealth systems must attend to the processes of integration as much as or more than the structures of integration. PMID:10345554
Objective: Prevalence and correlates of past-year acute behavioralhealth care use were examined. Methods: Data are from the 2008 National Survey on Drug Use and Health (N = 10,069 adults with behavioralhealth disorders). Associations between past-year acute behavioralhealth care use and factors related to health care use were examined through bivariate and logistic regression analyses per Andersen's behavioral
The perceived social, behavioral, and health effects of phencyclidine (PCP) use among a sample of 200 users were studied. Results suggest that chronic PCP use has a destructive impact upon developmental processes by disrupting education and employment, impairing close relationships, contributing to criminal status, and otherwise impairing mental…
Given the disease and cost burdens, Multiple HealthBehavior Research represents the future of preventive medicine. Growing evidence in this special issue and beyond indicates that simultaneous and sequential interventions can be effective. The challenge for the future is to make such interventions more effective, cost effective and less demanding. Co-variation represents one innovative approach in which effective change on
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…
de Groot, Esther; Jaarsma, Debbie; Endedijk, Maaike; Mainhard, Tim; Lam, Ineke; Simons, Robert-Jan; van Beukelen, Peter
Objective: The investigators examined relations between mindfulness and healthbehaviors in college students, as well as the role of stress in mediating these effects. Participants: Participants were 553 undergraduates (385 females; mean age = 18.8 years, SD = 2.1) recruited from a university in the northeastern United States. Methods:…
The power and performance model of sport stresses a sport ethic of doing "whatever it takes" to win (Coakley, 2004). Uncritical acceptance of this model may lead to various health-compromising behaviors. Employing achievement goal theory, we examine why female athletes may adopt the power and performance approach. An ego motivational climate and a…
This study examined the priority healthbehaviors 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…
This paper presents the results of two coordinated surveys of Massachusetts adolescents, the 2007 Massachusetts Youth Risk Behavior Survey (ESE) and the Massachusetts Youth Health Survey (DPH). These two surveys were supported by funding from the Centers for Disease Control and Prevention (CDC) and administered in a random selection of 124 public…
Massachusetts Department of Elementary and Secondary Education, 2008
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…
Duncan, Greg J.; Ziol-Guest, Kathleen M.; Kalil, Ariel
A 3-year study compared 52 undergraduate nursing students with 93 education majors and with the general population. No significant differences among students on 9 healthbehaviors appeared. Compared with the general population, nursing students had inadequate time for sleep, exercise, and eating breakfast. (Contains 77 references.) (SK)
Virtual health counseling agents on mobile devices need to be able to interrupt their users when it is time for them to engage in healthy behaviors, such as scheduled medication taking or exercise. However, these real-time reminders often represent task interruptions for individuals who are engaged in work activities. This paper presents the results of a study which compares four
Timothy W. Bickmore; Daniel Mauer; Francisco Crespo; Thomas Brown
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…
Copeland-Linder, Nikeea; Lambert, Sharon F.; Chen, Yi-Fu; Ialongo, Nicholas S.
This study examines whether offering sex education to young teenagers affects several measures of adolescent sexual behavior and health: virginity status, contraceptive use, frequency of intercourse, likelihood of pregnancy, and probability of contracting a sexually transmitted disease. Using data from the National Longitudinal Study of Adolescent…
Administered a questionnaire designed to measure consumer health knowledge and behavior to 200 randomly selected university students and 200 randomly selected high school students. Results demonstrated the consumer is hard pressed to stay informed and protected in the marketplace and needs guidance. (Author/BH)
The revolution in integrated circuits over the past 50 yr has produced inexpensive computing and communications systems that are powerful and portable. The technologies for these integrated chip-scale sensing systems, which will be miniature, lightweight, and portable, are emerging with the integration of sensors with electronics, optical systems, micromachines, microfluidics, and the integration of chemical and biological materials (soft/wet material integration with traditional dry/hard semiconductor materials). Hence, we stand at a threshold for health monitoring technology that promises to provide wearable biochemical sensing systems that are comfortable, inauspicious, wireless, and battery-operated, yet that continuously monitor health status, and can transmit compressed data signals at regular intervals, or alarm conditions immediately. In this paper, we explore recent results in chip-scale sensor integration technology for health monitoring. The development of inexpensive chip-scale biochemical optical sensors, such as microresonators, that are customizable for high sensitivity coupled with rapid prototyping will be discussed. Ground-breaking work in the integration of chip-scale optical systems to support these optical sensors will be highlighted, and the development of inexpensive Si complementary metal-oxide semiconductor circuitry (which makes up the vast majority of computational systems today) for signal processing and wireless communication with local receivers that lie directly on the chip-scale sensor head itself will be examined. PMID:18048897
Jokerst, Nan M; Brooke, Martin A; Cho, Sang-Yeon; Shang, Allan B
Girls’ early pubertal timing has been linked in many studies to behavioral problems such as delinquency and substance use.\\u000a The theoretical explanations for these links have often involved the girls’ peer relationships, but contexts have also been\\u000a considered important in some explanations. By integrating two theoretical models, the peer-socialization and the contextual-amplification hypotheses, we propose a contextual framework for explaining
Interacting services are at the center of attention in business- to-business (B2B) process integration scenarios. Global interaction mod- els specify the interaction behavior of each service and serve as con- tractual basis for the collaboration. Consequently, service implementa- tions have to be consistent with the specifications. Consistency checking ensures that an implemented service is compatible with other services, i.e. that
Objective: To assess the efficacy of a Web-based tailored behavioral weight management program compared with Web-based information-only weight management materials.Research Methods and Procedures: Participants, 2862 eligible overweight and obese (BMI = 27 to 40 kg\\/m2) members from four regions of Kaiser Permanente’s integratedhealth care delivery system, were randomized to receive either a tailored expert system or information-only Web-based weight
Kendra Rothert; Victor J. Strecher; Laurie A. Doyle; William M. Caplan; Jodi S. Joyce; Holly B. Jimison; Lya M. Karm; Adrienne D. Mims; Mark A. Roth
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.
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 healthbehaviors, and selective migration seems less likely to account for these differences. PMID:20811952
Hennessy-Burt, Tamara E; Stoecklin-Marois, Maria T; Meneses-González, Fernando; Schenker, Marc B
Health damaging behaviors of young military personnel are reflections of health problems facing all young people in the US. Military life presents opportunities and challenges that may both protect and place young troops at risk for health damaging behavi...
A triarchic organization of behavior, building on Skinner's description of respondents and operants, is proposed by introducing a third class of behavior called 'emergents.' Emergents are new responses, never specifically reinforced, that require operations more complex than association. Some of these operations occur naturally only in animals above a minimum level of brain complexity, and are developed in an interaction between treatment and organismic variables. (Here complexity is defined in terms of relative levels of hierarchical integration made possible both by the amount of brain, afforded both by brain-body allometric relationships and by encephalization, and, also, the elaboration of dendritic and synaptic connections within the cortex and connections between various parts/regions of the brain.) Examples of emergents are discussed to advance this triarchic view, of behavior. The prime example is language. This triarchic view reflects both the common goals and the cumulative nature of psychological science.
Rumbaugh, Daune M.; Washburn, David A.; Hillix, William A.
Context For three decades, experts have been stressing the importance of law to the effective operation of public health systems. Most recently, in a 2011 report, the Institute of Medicine recommended a review of state and local public health laws to ensure appropriate authority for public health agencies; adequate access to legal counsel for public health agencies; evaluations of the health effects and costs associated with legislation, regulations, and policies; and enhancement of research methods to assess the strength of evidence regarding the health effects of public policies. These recommendations, and the continued interest in law as a determinant of health system performance, speak to the need for integrating the emerging fields of Public Health Law Research (PHLR) and Public Health Systems and Services Research (PHSSR). Methods Expert commentary. Findings This article sets out a unified framework for the two fields and a shared research agenda built around three broad inquiries: (1) the structural role of law in shaping the organization, powers, prerogatives, duties, and limitations of public health agencies and thereby their functioning and ultimately their impact on public health (“infrastructure”); (2) the mechanisms through which public health system characteristics influence the implementation of interventional public health laws (“implementation”); and (3) the individual and system characteristics that influence the ability of public health systems and their community partners to develop and secure enactment of legal initiatives to advance public health (“innovation”). Research to date has laid a foundation of evidence, but progress requires better and more accessible data, a new generation of researchers comfortable in both law and health research, and more rigorous methods. Conclusions The routine integration of law as a salient factor in broader PHSSR studies of public health system functioning and health outcomes will enhance the usefulness of research in supporting practice and the long-term improvement of system performance.
Burris, Scott; Mays, Glen P; Douglas Scutchfield, F; Ibrahim, Jennifer K
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…
Smith, Theresa M. Enyeart; Skaggs, Gary E.; Redican, Kerry J.
The practice of mindfulness is increasingly being integrated into Western clinical practice within the context of psychotherapy and stress management. Although it is based in ancient Buddhist philosophy, there remains confusion about the definition, antecedents, processes, and outcomes of mindfulness practice. This article reviews the literature on mindfulness, with a focus upon a clearer definition and understanding of the processes and integration into psychiatric mental health nursing practice. PMID:19766927
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.
The Affordable Care Act, along with Medicaid expansions, offers the opportunity to redesign the nation's highly flawed mental health system. It promotes new programs and tools, such as health homes, interdisciplinary care teams, the broadening of the Medicaid Home and Community-Based Services option, co-location of physical health and behavioral services, and collaborative care. Provisions of the act offer extraordinary opportunities, for instance, to insure many more people, reimburse previously unreimbursed services, integrate care using new information technology tools and treatment teams, confront complex chronic comorbidities, and adopt underused evidence-based interventions. The Centers for Medicare and Medicaid Services and its Center for Medicare and Medicaid Innovation should work intensively with the states to implement these new programs and other arrangements and begin to fulfill the many unmet promises of community mental health care. PMID:22323168
OBJECTIVES: This study aims to comprehensively assess the association of subjective and objective oral health status and oral healthbehaviors with happiness, under consideration of demographic, socioeconomic, and general health-related factors. This study also aims to test whether subjective oral health outcomes are better predictors of happiness compared with objective oral health outcomes. METHODS: The data were collected from 479 community-dwelling elders aged 65 years or over selected by a cluster sampling method. A questionnaire and an oral examination were implemented. A multiple regression method was conducted to assess associations with happiness index (HI). RESULTS: The mean age of the elders was 74.6 years. Mean (standard deviation, SD) HI, EuroQol-visual analog scale (EQ-VAS) and 14-item oral health impact profile (OHIP-14) index were 5.7 (SD 2.3), 59.8 (SD 21.1), and 16.3 (SD 13.1). In the final model, a significant association with HI of the OHIP-14 index (P = 0.091) among all the participants and significant associations of oral symptoms (P = 0.038), wearing a removable denture (P = 0.039), and of the oral healthbehavior of daily toothbrushing (P = 0.007) among poorer oral health QoL group were confirmed under consideration of other related factors. While correlations of HI to subjective measures of health, EQ-VAS and OHIP-14 score were moderate to weak, those to objective measures of health were only weak or insignificant. CONCLUSIONS: Oral impacts which might persistently affect one's daily life need to be considered in designing and delivering public services aimed to promote people's happiness. With oral health impacts and behaviors accounting for 10% of happiness among elders, public and community services for the elderly that support oral health and daily toothbrushing for the dentate are critical for the well-being of our elders. PMID:23398395
Background. While HIV infection among men who have sex with men (MSM) in Vietnam has received increasing attention, most studies focus on HIV knowledge and established risk factors such as injection drug use. This paper proposes to address HIV risk among MSM from an integrated approach to preventive care that takes into account syndemic conditions such as substance use, mental health, and stigma, the latter of which prevents MSM from accessing health services. Method. Current studies related to MSM in Vietnam from 2000 onwards, gathered from peer-reviewed as well as non-peer-reviewed sources, were examined. Results. HIV and STI prevalence among MSM varied significantly by location, and yet HIV prevalence has increased significantly over the past few years. Most studies have focused on sexual risk behaviors, paying little attention to the broad spectrum of sexual health, including noninjecting drug use, heavy alcohol consumption, high rates of mental health distress and anxiety, and stigma. Conclusion. Future research and interventions targeting MSM in Vietnam should address their vulnerability to HIV from an integrated approach that pays attention to both sexual health and syndemic conditions.
Background. While HIV infection among men who have sex with men (MSM) in Vietnam has received increasing attention, most studies focus on HIV knowledge and established risk factors such as injection drug use. This paper proposes to address HIV risk among MSM from an integrated approach to preventive care that takes into account syndemic conditions such as substance use, mental health, and stigma, the latter of which prevents MSM from accessing health services. Method. Current studies related to MSM in Vietnam from 2000 onwards, gathered from peer-reviewed as well as non-peer-reviewed sources, were examined. Results. HIV and STI prevalence among MSM varied significantly by location, and yet HIV prevalence has increased significantly over the past few years. Most studies have focused on sexual risk behaviors, paying little attention to the broad spectrum of sexual health, including noninjecting drug use, heavy alcohol consumption, high rates of mental health distress and anxiety, and stigma. Conclusion. Future research and interventions targeting MSM in Vietnam should address their vulnerability to HIV from an integrated approach that pays attention to both sexual health and syndemic conditions. PMID:23119171
The 2002 Future of School Psychology Conference called for reform of current models of professional school psychology, including a paradigm shift toward a public health model of practice. This article explores the role of school psychologists in efforts to achieve an integrated public health and public education model for delivering comprehensive…
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 peer-socialization and the contextual-amplification hypotheses, we propose a contextual framework for explaining the link between early pubertal timing and external problem behavior in girls. We hypothesize that early developing girls engage in unhealthy, dangerous, and risky behavior under contextual conditions that promote access to older friends and opposite-sex relationships. Under other conditions it is less likely. We tested this integrated hypothesis in two studies conducted in Sweden. The first was a cross-sectional study with information about school and free-time friends in a community sample (N = 284). Early pubertal timing was linked to having older, more normbreaking friends outside of school, but not in school, thus suggesting that the school context interferes early-developing girls' selection of older peers. The second study involved both a longitudinal (N = 434) and a cross-sectional sample of girls (N = 634), where we examined a leisure setting that is known to attract delinquent youth. Results showed that early pubertal timing was most strongly linked to delinquency for girls who spent time in this context and were heavily involved with boys and peers. In sum, results from both studies supported our predictions that certain contexts would amplify the peer-socialization effect. Overall, we conclude that the integrated peer-socialization/contextual-amplification model satisfactorily explains the link between pubertal timing and external problem behavior. PMID:21769611
Objective Assessed the feasibility, acceptability, and sustainability of Planet Health, an interdisciplinary, integratedhealth education curriculum implemented in six public middle schools. Methods Workshops on Planet Health implementation were attended by 129 teachers (language arts, math, science, and social studies) over three school years (1999-2000, 2000-2001, and 2001-2002). Questionnaires were administered post-implementation and in the fall and spring of each
Jean L. Wiecha; Alison M. El Ayadi; Bernard F. Fuemmeler; Jill E. Carter; Shirley Handler; Nancy Strunk; Debra Korzec-Ramirez; Steven L. Gortmaker
There is a lack of information exchange for patients utilizing complementary and alternative therapies such as Traditional Chinese Medicine (TCM) combined with conventional western medicine. Siloed health information can lead to potential problems for safe, quality care and optimal health. The Continuity of Care Document (CCD) is intended to be a subset of health data to exchange between providers and foundational for personal health records (PHR). It is unknown, however, about the relevance of CCD to represent TCM data for information exchange across different health systems. Four clinical data elements and related standards in CCD were evaluated for relevance to TCM providers and adequacy to represent TCM data. Project results indicate that even though standardized TCM-specific terminology and coding are lacking, the CCD data elements and standards are relevant to TCM providers. Recommendations are made for an integrated PHR containing both conventional western medicine and TCM following the CCD standard. PMID:24199068
Background Various forms of community disorder are associated with health outcomes but little is known about how dynamic context where an adolescent spends time relates to her health-related behaviors. Objective Assess whether exposure to contexts associated with crime (as a marker of community disorder) correlates with self-reported health-related behaviors among adolescent girls. Methods Girls (N?=?52), aged 14–17, were recruited from a single geographic urban area and monitored for 1 week using a GPS-enabled cell phone. Adolescents completed an audio computer-assisted self-administered interview survey on substance use (cigarette, alcohol, or marijuana use) and sexual intercourse in the last 30 days. In addition to recorded home and school address, phones transmitted location data every 5 minutes (path points). Using ArcGIS, we defined community disorder as aggregated point-level Unified Crime Report data within a 200-meter Euclidian buffer from home, school and each path point. Using Stata, we analyzed how exposures to areas of higher crime prevalence differed among girls who reported each behavior or not. Results Participants lived and spent time in areas with variable crime prevalence within 200 meters of their home, school and path points. Significant differences in exposure occurred based on home location among girls who reported any substance use or not (p 0.04) and sexual intercourse or not (p 0.01). Differences in exposure by school and path points were only significant among girls reporting any substance use or not (p 0.03 and 0.02, respectively). Exposure also varied by school/non-school day as well as time of day. Conclusions Adolescent travel patterns are not random. Furthermore, the crime context where an adolescent spends time relates to her health-related behavior. These data may guide policy relating to crime control and inform time- and space-specific interventions to improve adolescent health.
Wiehe, Sarah E.; Kwan, Mei-Po; Wilson, Jeff; Fortenberry, J. Dennis
Integrity is interpreted as a holistic phenomenon that incorporates personal characteristics, cognition, interpersonal awareness, and practical enactment-ultimately relating to matters society deems worthwhile. This approach enables integrity to be understood as both a personal morality and a social (group) morality. Mental health nurses embedded in a hierarchical bureaucratic organisation may act according to their personal morality and display moral strength in many situations; however, if the social morality of the group is at variance with their convictions, as individuals their capacity to be courageous and enact integrity will be tested. A likely consequence will be that those with the most cherished positive patient care values, those with a stronger adherence to moral convictions about the public good, and those with a clearly developed understanding of integrity parameters will depart, and possibly leave the profession. In this article, we provide an overview of the structural and contextual realities of nursing work within organisations and discuss how these factors can compromise whole unit integrity and seriously challenge mental health nurses' commitment to enacting integrity. In the final section of this article, broad suggestions for strengthening individual and group integrity are provided. PMID:24004361
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
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.
Schnell, Bettina; Weir, Peter T.; Roth, Eatai; Fairhall, Adrienne L.
OBJECTIVES: This study assessed the effects of a 2-year integratedhealth promotion-health protection work-site intervention on changes in dietary habits and cigarette smoking. METHODS: A randomized, controlled intervention study used the work site as the unit of intervention and analysis; it included 24 predominantly manufacturing work sites in Massachusetts (250-2500 workers per site). Behaviors were assessed in self-administered surveys (n = 2386; completion rates = 61% at baseline, 62% at final). Three key intervention elements targeted healthbehavior change: (1) joint worker-management participation in program planning and implementation, (2) consultation with management on work-site environmental changes, and (3) health education programs. RESULTS: Significant differences between intervention and control work sites included reductions in the percentage of calories consumed as fat (2.3% vs 1.5% kcal) and increases in servings of fruit and vegetables (10% vs 4% increase). The intervention had a significant effect on fiber consumption among skilled and unskilled laborers. No significant effects were observed for smoking cessation. CONCLUSIONS: Although the size of the effects of this intervention are modest, on a populationwide basis effects of this size could have a large impact on cancer-related and coronary heart disease end points.
Sorensen, G; Stoddard, A; Hunt, M K; Hebert, J R; Ockene, J K; Avrunin, J S; Himmelstein, J; Hammond, S K
Research on health information has primarily focused on the needs of adults or parents of children with chronic illnesses or consumers. There is limited research on the health information needs of adolescents and in particular those from underserved communities. The primary objective of this qualitative study was to understand the health information needs of healthy, urban adolescents, and how they met those needs. Focus group methodology was used to gather information from a sample of ethnically diverse urban adolescents. Data was analyzed using Kriekelas' information seeking behavior framework to, examine the participants'' report of their immediate and deferred health information needs. Our sample of adolescents used several different sources to satisfy their health information needs depending on acuity and severity, which was congruent with Kriekelas' framework. Understanding how adolescents use technology to meet their health information needs, and in what order of preference, will be critical for the development of technology that adolescents find useful and has the potential to decrease health disparities. PMID:23512322
Okoniewski, Anastasia E; Lee, Young Ji; Rodriguez, Martha; Schnall, Rebecca; Low, Alexander F H
Successful integrated population health management models include: A leadership team that includes financial managers, physicians, and advisers. A plan that clearly connects tactics to measurable goals. Infrastructure that includes care coordinators and robust IT to avoid duplicative care and ensure care protocols are followed. PMID:24757876
Wireless integrated microsystems, merging micropower circuits, wireless interfaces, hermetic wafer-level packaging, and MEMS are poised to provide breakthroughs in health care. While cochlear microsystems have restored functional hearing to the deaf and deep brain stimulation is remarkably successful in suppressing Parkinson's tremor, retinal implants for the blind, cortical prostheses for paralysis, and other devices are also emerging, along with systems
This case study describes 1 international student's treatment experience with an integratedhealth 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.
Tucker, Cary; Sloan, Sarah K.; Vance, Mary; Brownson, Chris
Introduction Mental disorders occur as frequently in Russia as elsewhere, but the common mental disorders, especially depression, have gone largely unrecognised and undiagnosed by policlinic staff and area doctors. Methods This paper describes the impact and sustainability of a multi-component programme to facilitate the integration of mental health into primary care, by situation appraisal, policy dialogue, development of educational materials, provision of a training programme and the publication of standards and good practice guidelines to improve the primary care of mental disorders in the Sverdlovsk region of the Russian Federation. Results The multi-component programme has resulted in sustainable training about common mental disorders, not only of family doctors but also of other cadres and levels of professionals, and it has been well integrated with Sverdlovsk's overall programme of health sector reforms. Conclusion It is possible to facilitate the sustainable integration of mental health into primary care within the Russian context. While careful adaptation will be needed, the approach adopted here may also hold useful lessons for policy makers seeking to integrate mental health within primary care in other contexts and settings.
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
Expectancy theory has been criticized for its omission of normative, habitual, and other motivational elements. This paper describes the sources and features of an integrative motivational model from the field of preventive health care that combines expectancy/valence factors with habitual, normative, and conative motivational elements. The model is viewed as having implications for work motivation as well. PMID:10255417
Capitated managed care contracts for behavioralhealth 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 behavioralhealth care contract with a for-profit managed care company. The focus of the study was on the impact—at both the
In 2005, New Mexico implemented a unique reform in managed behavioralhealth services that seeks to ensure delivery of consumer-driven, recovery-oriented care to low-income individuals. Distinguishing features of the reform are the Local Collaboratives (LCs), regionally based community organizations designed by state government to represent behavioralhealth concerns of New Mexico's diverse cultural populations. We examine community response to the LCs, focusing on two broad sets of themes derived from 18 months of ethnographic fieldwork. The first set—structure and function—encompasses several issues: predominance of provider versus consumer voice; insufficient resources to support internal operations; imposition of state administrative demands; and perceived lack of state response to LC efforts. The second set—participation and collaboration—reveals how problems of information flow and other logistical factors impact involvement in LCs and how the construction of “community” introduced under this initiative exacerbates tensions across localities with varied histories and populations.
Kano, Miria; Willging, Cathleen E.; Rylko-Bauer, Barbara
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…
This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective\\u000a factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural\\u000a equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder,\\u000a and experiences with racial discrimination). Contextual stress in 8th grade was
Nikeea Copeland-Linder; Sharon F. Lambert; Yi-Fu Chen; Nicholas S. Ialongo
Using a multidimensional assessment of health literacy (the Cancer Message Literacy Test-Listening, the Cancer Message Literacy Test-Reading, and the Lipkus Numeracy Scale), the authors assessed a stratified random sample of 1013 insured adults (40–70 years of age). The authors explored whether low health literacy across all 3 domains (n = 111) was associated with sets of variables likely to affect engagement in cancer prevention and screening activities: (a) attitudes and behaviors relating to health care encounters and providers, (b) attitudes toward cancer and health, (c) knowledge of cancer screening tests, and (d) attitudes toward health related media and actual media use. Adults with low health literacy were more likely to report avoiding doctor's visits, to have more fatalistic attitudes toward cancer, to be less accurate in identifying the purpose of cancer screening tests, and more likely to avoid information about diseases they did not have. Compared with other participants, those with lower health literacy were more likely to say that they would seek information about cancer prevention or screening from a health care professional and less likely to turn to the Internet first for such information. Those with lower health literacy reported reading on fewer days and using the computer on fewer days than did other participants. The authors assessed the association of low health literacy with colorectal cancer screening in an age-appropriate subgroup for which colorectal cancer screening is recommended. In these insured subjects receiving care in integratedhealth care delivery systems, those with low health literacy were less likely to be up to date on screening for colorectal cancer, but the difference was not statistically significant.
Morris, Nancy S.; Field, Terry S.; Wagner, Joann L.; Cutrona, Sarah L.; Roblin, Douglas W.; Gaglio, Bridget; Williams, Andrew E.; Han, Paul J. K.; Costanza, Mary E.; Mazor, Kathleen M.
Previous studies have shown that adolescent religious participation is negatively associated with risky healthbehaviors such as cigarette smoking, alcohol consumption, and illicit drug use. One explanation for these findings is that religion directly reduces risky behaviors because churches provide youths with moral guidance or with strong social networks that reinforce social norms. An alternative explanation is that both religious participation and risky healthbehaviors are driven by some common unobserved individual trait. We use data from the National Longitudinal Study of Adolescent Health and implement an instrumental variables approach to identify the effect of religious participation on smoking, binge drinking, and marijuana use. Following Gruber (2005), we use a county-level measure of religious market density as an instrument. We find that religious market density has a strong positive association with adolescent religious participation, but not with secular measures of social capital. Upon accounting for unobserved heterogeneity, we find that religious participation continues to have a significant negative effect on illicit drug use. On the contrary, the estimated effects of attendance in instrumental variables models of binge drinking and smoking are statistically imprecise. PMID:20882576
Prior to the Columbia STS 107 disaster in 2003, the Johnson Space Center s BehavioralHealth and Performance Group (BHP) became involved in Space Shuttle Operations on an as needed basis, occasionally acting as a consultant and primarily addressing crew-crew personality conflicts. The BHP group also assisted with astronaut selection at every selection cycle beginning in 1991. Following STS 107, an event that spawned an increased need of behavioralhealth support to STS crew members and their dependents, BHP services to the Space Shuttle Program were enhanced beginning with the STS 114 Return to Flight mission in 2005. These services included the presence of BHP personnel at STS launches and landings for contingency support, a BHP briefing to the entire STS crew at L-11 months, a private preflight meeting with the STS Commander at L-9 months, and the presence of a BHP consultant at the L-1.5 month Family Support Office briefing to crew and family members. The later development of an annual behavioralhealth assessment of all active astronauts also augmented BHP s Space Shuttle Program specific services, allowing for private meetings with all STS crew members before and after each mission. The components of each facet of these BHP Space Shuttle Program support services will be presented, along with valuable lessons learned, and with recommendations for BHP involvement in future short duration space missions
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
Lawrence O. Gostin; Peter D. Jacobson; Katherine L. Record; Lorian E. Hardcastle
This study aimed to investigate health belief as a major motive for diet and lifestyle behaviors of 100 vegans in the United States; and to determine congruence with selected health and nutrition outcomes. Response data from an administered questionnaire was analyzed. Statistical analyses determined the most common factors influencing diet choice; the number of vegans practicing particular lifestyle behaviors; body mass index; and prevalence of self-reported chronic disease diagnoses. Nutrient intakes were analyzed and assessed against Dietary Reference Intakes. Health was the most reported reason for diet choice (47%). In the health belief, animal welfare, and religious/other motive categories, low percentages of chronic disease diagnoses were reported: 27%, 11%, and 15%, respectively. There were no significant differences in healthbehaviors and indices among vegan motive categories, except for product fat content choices. Within the entire study population, health-related vegan motive coincided with regular exercise; 71% normal BMI (mean=22.6); minimal alcohol and smoking practices; frequently consumed vegetables, nuts, and grains; healthy choices in meal types, cooking methods, and low-fat product consumption; and adequate intakes for most protective nutrients when compared to reference values. But incongruence was found with 0% intake adequacy for vitamin D; and observation of excessive sodium use. PMID:23583444
In two important health policy contexts - private plans in Medicare and the new state-run "Exchanges" created as part of the Affordable Care Act (ACA) - plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS). PMID:24308878
McGuire, Thomas G; Glazer, Jacob; Newhouse, Joseph P; Normand, Sharon-Lise; Shi, Julie; Sinaiko, Anna D; Zuvekas, Samuel H
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.
Schneiderman, Neil; Ironson, Gail; Siegel, Scott D.
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…
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…
Campbell, Thomas A.; Auerbach, Stephen M.; Kiesler, Donald J.
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 behavioralhealth expenditures were detected for non-VA sites, but the VA integrated arm had slightly higher ($38; p<0.05) behavioralhealth costs. Differences in other types of services use were detected.
A recent Population Council publication, Reproductive Health Approach to Family Planning, discusses integration of reproductive health into family planning programs in a series of edited presentations that Council staff and colleagues gave at a 1994 meeting of the US Agency for International Development (USAID) cooperating agencies. The presentations reflect the Council's view that family planning programs ought to help individuals achieve their own reproductive goals in a healthful manner. The report discusses four areas of reproductive health: reproductive tract infections (RTIs), including sexually transmitted diseases; prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. Christopher Elias (Senior Associate, Programs Division) argued that family planning programs ought to provide services that target RTIs, given that these illnesses afflict a significant proportion of reproductive-age women. The family planning community has an ethical responsibility to provide services to women who experience an unwanted pregnancy. They must have access to high-quality postabortion care, including family planning services. Professional midwives are ideally suited to serve as integrated reproductive health workers trained to combat the five major maternal killers: hemorrhage, sepsis, pregnancy-induced hypertension, obstructed labor, and unsafe abortion. This was demonstrated in a highly successful Life-Saving Skills for Midwives program undertaken in Ghana, Nigeria, and Uganda, and soon to start in Vietnam in conjunction with the Council's Safe Motherhood research program. Family planning services should be viewed as part of a comprehensive set of health services needed by postpartum women, which include appropriate contraception, maternal health checks, well-baby care, and information about breastfeeding, infant care, and nutrition. Family planning programs should incorporate breastfeeding counseling into their services. When programs aim to help individuals meet their own reproductive goals in a healthful manner, this implies that services will not increase clients' risk of morbidity. PMID:12319546
The social and physical environments have long since been recognized as important determinants of health. People in urban settings are exposed to a variety of health hazards that are interconnected with their health effects. The Millennium Development Goals (MDGs) have underlined the multidimensional nature of poverty and the connections between health and social conditions and present an opportunity to move beyond narrow sectoral interventions and to develop comprehensive social responses and participatory processes that address the root causes of health inequity. Considering the complexity and magnitude of health, poverty, and environmental issues in cities, it is clear that improvements in health and health equity demand not only changes in the physical and social environment of cities, but also an integrated approach that takes into account the wider socioeconomic and contextual factors affecting health. Integrated or multilevel approaches should address not only the immediate, but also the underlying and particularly the fundamental causes at societal level of related health issues. The political and legal organization of the policy-making process has been identified as a major determinant of urban and global health, as a result of the role it plays in creating possibilities for participation, empowerment, and its influence on the content of public policies and the distribution of scarce resources. This paper argues that it is essential to adopt a long-term multisectoral approach to address the social determinants of health in urban settings. For comprehensive approaches to address the social determinants of health effectively and at multiple levels, they need explicitly to tackle issues of participation, governance, and the politics of power, decision making, and empowerment.
Objective: To develop a youth form of the Motivators of and Barriers to Health-Smart Behaviors Inventory (MB-HSBI--Youth) for use in identifying self-reported motivators of and barriers to the following health-promoting behaviors (called "health-smart" behaviors): eating a healthy breakfast, eating healthy foods and snacks, drinking healthy…
Tucker, Carolyn M.; Rice, Kenneth G.; Desmond, Frederic F.; Hou, Wei; Kaye, Lillian B.; Smith, Tasia M.
Partnership between health care providers and patients is important for controlling illness. A limited number of studies show how to assess health professionals' communication and partnering behavior. The relationship between these aspects of professional behavior and enhanced management of disease by patients has received little empirical study. The research reported here developed a Health Care Providers' Teaching and Communication Behavior
Noreen M. Clark; Molly Gong; M. Anthony Schork; Lois A. Maiman; David Evans; Martin E. Hurwitz; Dietrich Roloff; Robert B. Mellins
Presents an overview of self-regulation models: theory of planned behavior, protection motivation theory, health belief model, action control theory, transtheoretical model of behavior change, health action process, and precaution adoption process. Applies models to healthbehavior change in older adults with cardiovascular disease or diabetes.…
The present study utilizes the National College Health Risk Behavior Survey to examine the relationship between health-risk behaviors and sexual victimization among a sample of college women. A prospective design is utilized to examine the relationship between health-risk behaviors as measured at baseline and sexual victimization during a 3-month…
Gidycz, Christine A.; Orchowski, Lindsay M.; King, Carrie R.; Rich, Cindy L.
Background Healthbehavior interventions using periodic prompts have utilized technology, such as the Internet, that allows messages to be sent to participants in cost-effective ways. To our knowledge, no comprehensive evidence review has been performed specifically to evaluate the effectiveness of communicating regular messages and to examine how characteristics of the prompts change the effectiveness of programs aimed at reminding people to adopt healthy behaviors, maintain those they already practice, and cease unhealthy behaviors. Objective A systematic literature review was performed to investigate the effectiveness of limited contact interventions targeting weight loss, physical activity, and/or diet that provided periodic prompts regarding behavior change for health promotion. The review sought to identify specific characteristics of these interventions that may be associated with superior results. Methods Electronic literature searches were performed between February and April, 2008. Articles were included if periodic prompts were used as an intervention or a component of an intervention, a behavioral or biological outcome measure was used, and an ongoing health promotion behavior was targeted. A rating system was applied to each study to provide a quantitative representation of the quality of the evidence provided by each article. Results There were 19 articles with a combined sample size of 15,655 that met the inclusion criteria, and 11 studies reported positive findings regarding the utility of periodic prompts. Several articles showed enhanced effectiveness when prompts were frequent and personal contact with a counselor was included. Long-term behavior change and health improvements were not examined by this review because of a lack of long-term follow-up in the literature. Conclusions In light of promising results of most studies, additional research on limited contact interventions targeting healthbehaviors including weight loss, physical activity, and/or diet is merited that utilizes rigorous methods including control groups; follow-up data collection; and testing of prompt frequencies, specific intervention components, or prompt characteristics. Future research would be especially valuable if it improves understanding of the most effective types of periodic prompts for fostering long-term behavior change in order to maximize use of this tool in limited contact health promotion programs. Specifically, various types of communication technology should be used and evaluated to expand and refine their use.
Summary Objectives We evaluated the design of three novel visualization techniques for integratedhealth information with health care providers in older adult care. Through focus groups, we identified generalizable themes related to the visualization and interpretation of health information. Using these themes we address challenges with visualizing integratedhealth information and provide recommendations for designers. Methods We recruited ten health care providers to participate in three focus groups. We applied a qualitative descriptive approach to code and extract themes related to the visualization of graphical displays. Results We identified a set of four common themes across focus groups related to: 1) Trust in data for decision-making; 2) Perceived level of detail for visualization (subthemes: holistic, individual components); 3) Cognitive issues (subthemes: training and experience; cognitive overload; contrast); and 4) Application of visual displays. Furthermore, recommendations are provided as part of the iterative design process for the visualizations. Conclusions Data visualization of health information is an important component of care, impacting both the accuracy and speed of decision making. There are both functional and cognitive elements to consider during the development of appropriate visualizations that integrate different components of health.
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.
Mychailyszyn, Matthew P.; Edmunds, Julie M.; Khanna, Muniya S.; Downey, Margaret Mary; Kendall, Philip C.
Health of college students is a national public health concern, however general health courses which cover topics of concern such as responsible sexual behaviors, alcoholism, drug abuse, tobacco use, nutrition, weight management, cardiovascular health, and mental health issues are rarely a required course for college students. University health…
Surveyed Japanese high school students' health risk behavior patterns, examining clustering and accumulation of health risk behaviors. Physical inactivity and alcohol use were the most common risk behaviors. Prevalence rates for most risk behaviors varied by demographic variables. Smoking, drinking, and sexual intercourse clustered among both…
This article discusses the concepts and approaches underlying managed behavioralhealth care and the need to assess quality of care. The author describes the Performance Measures for Managed Behavioral Healthcare Programs (PERMS) developed by the American Managed Behavioral Healthcare Association (AMBHA), which is offered as a first step toward enhanced quality of care assessment in managed behavioralhealth care.
Objectives The aim of the present study is to investigate the relationship between healthbehavior and general health status. Methods We used data from the 2011 Korea National Health and Nutrition Examination Survey. Mental health was measured by stress recognition and depression. Dietary habit was measured by mixed grain diet. Life pattern was measured by sleeping time and working pattern. Physical activity was measured by walking and exercise. We defined general health status as Euro Quality of Life-5 Dimension (EQ-5Dindex), Euro Quality of Life Visual Analogue Scale (EQ-5Dvas), number of people experienced lying in a sickbed for the last one month, number of days lying in a sickbed for the last one month, and activity limitations. Results Mental health, dietary habit, life pattern, and physical activity have seven factors. Most of the factors have a significant correlation with EQ-5Dindex, EQ-5Dvas, number of people experienced lying in a sickbed for the last one month, number of days lying in a sickbed for the last one month, and activity limitations. Conclusion Healthbehavior and general health status have a positive correlation.
Cheon, Chunhoo; Oh, So-Mi; Jang, Soobin; Park, Jeong-Su; Park, Sunju; Jang, Bo-Hyoung; Shin, Yong-Cheol; Ko, Seong-Gyu
This report describes the results of data collection efforts conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC) related to the behavioralhealth (mental health and s...
This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10-11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers' but not teachers' reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety. PMID:23748337
Leis, Julie A; Heron, Jon; Stuart, Elizabeth A; Mendelson, Tamar
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
Bezerra, Isabella Azevedo; Goes, Paulo Sávio Angeiras de
This Policy Brief examines behavioralhealth managed care contracting under separately administered State Children's Health Insurance Programs (SCHIP), i.e., programs that operate under the direct authority of Title XXI of the Social Security Act rather than as expansions of Medicaid. Most separate SCHIP programs buy managed care style health insurance for some or most of their enrolled children. Because Title XXI provides states with far greater administrative flexibility than Medicaid with respect to coverage and benefit design, provision of services, and administration of managed care arrangements,studying separate SCHIP managed care products sheds important light on how states might approach insurance and managed care design generally in the area of behavioralhealth were Medicaid modified through section 1115 demonstration or federal statutory authority to permit greater latitude. To conduct this analysis, two nationwide databases maintained by the George Washington University Center for Health Services Research and Policy (CHSRP) were used: a database consisting of all Medicaid MCO-style managed care contracts in use in Calendar Year 2000; and a nationwide database consisting of contracts used by separate SCHIP programs for the same calendar year. As of the point of collection in 2000 there were 33 such separate programs; according to CMS' latest website information, that total has now reached 35. Both sets of contracts were analyzed and separated into their components by lawyers experienced in managed care contract analysis and interpretation. The data were entered into working tables that organize the contents of the contracts into a series of searchable domains. PMID:12542079
Rosenbaum, Sara; Sonosky, Colleen; Shaw, Karen; Mauery, D Richard
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.
Postpartum depression is a prevalent mental disorder; however, scarce research has examined its association with prenatal healthbehaviors. This study investigated the associations of cigarette smoking, caffeine intake, and vitamin intake during pregnancy with postpartum depressive symptoms at 8 weeks after childbirth. Using a prospective cohort study design, participants were recruited from the postpartum floor at a hospital for women and newborns located in a northeastern city, from 2005 through 2008. Eligible women who were at least 18 years old and spoke English were interviewed in person while hospitalized for childbirth (N?=?662). A follow-up home interview was conducted at 8 weeks postpartum with a 79% response rate (N?=?526). Hierarchical regression analyses showed that smoking cigarettes anytime during pregnancy and not taking prenatal vitamins in the first trimester were significantly associated with worse depressive symptoms (Edinburgh Postnatal Depression Scale). Moreover, having a colicky infant, an infant that refuses feedings, being stressed out by parental responsibility, and having difficulty balancing responsibilities were stressors associated with worse depressive symptoms. Primary health care providers should consider evaluating women for risk of postpartum depression during their first prenatal visit, identifying prenatal healthbehaviors such as smoking and taking prenatal vitamins. PMID:22215286
The authors found the behavioral factors that influence the organization members' compliance with the information security policy in organizations on the basis of neutralization theory, Theory of planned behavior, and protection motivation theory. Depending on the theory of planned behavior, members' attitudes towards compliance, as well as normative belief and self-efficacy, were believed to determine the intention to comply with the information security policy. Neutralization theory, a prominent theory in criminology, could be expected to provide the explanation for information system security policy violations. Based on the protection motivation theory, it was inferred that the expected efficacy could have an impact on intentions of compliance. By the above logical reasoning, the integrativebehavioral model and eight hypotheses could be derived. Data were collected by conducting a survey; 194 out of 207 questionnaires were available. The test of the causal model was conducted by PLS. The reliability, validity, and model fit were found to be statistically significant. The results of the hypotheses tests showed that seven of the eight hypotheses were acceptable. The theoretical implications of this study are as follows: (1) the study is expected to play a role of the baseline for future research about organization members' compliance with the information security policy, (2) the study attempted an interdisciplinary approach by combining psychology and information system security research, and (3) the study suggested concrete operational definitions of influencing factors for information security policy compliance through a comprehensive theoretical review. Also, the study has some practical implications. First, it can provide the guideline to support the successful execution of the strategic establishment for the implement of information system security policies in organizations. Second, it proves that the need of education and training programs suppressing members' neutralization intention to violate information security policy should be emphasized.
Introduction Sri Lanka has one of the highest suicide rates in the world, with recent protracted conflict and the tsunami aggravating mental health needs. This paper describes a project to establish a systematic “train the trainers” programme to integrate mental health into primary care in Sri Lanka's public health system and private sector. Methods A 40 hour training programme was delivered to curriculum and teaching materials were adapted for Sri Lanka, and delivered to 45 psychiatrists, 110 medical officers of mental health and 95 registered medical practitioners, through five courses, each in a different region (Colombo, Kandy, Jaffna, Galle and Batticola). Participants were selected by the senior psychiatrist of each region, on the basis of ability to conduct subsequent roll out of the training. The course was very interactive, with discussions, role plays and small group work, as well as brief theory sessions. Results Qualitative participant feedback was encouraging about the value of the course in improving patient assessments and treatments, and in providing a valuable package for roll out to others. Systematic improvement was achieved between pre- and post-test scores of participants at all training sites. The participants had not had prior experience in such interactive teaching methods, but were able to learn these new techniques relatively quickly. Conclusions The programme has been conducted in collaboration with the Sri Lankan National Institute of Mental Health and the Ministry of Health, and this partnership has helped to ensure that the training is tailored to Sri Lanka and has the chance of long term sustainability.
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.
The current study investigates the comparative effects of sensory-integration therapy and behavioral interventions on rates of self-injurious behavior (SIB) in a 9-year-old boy with diagnosis of autism. A functional analysis was conducted to identify the variables maintaining the self-injurious behavior. This analysis demonstrated that SIB was…
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
Mona M. Shattell; Natasha Donnelly; Anna Scheyett; Gary S. Cuddeback
Amphibian water balance has been studied at many levels of biological order. Terrestrial species must react to environmental cues that relate to water availability while some arboreal species have cutaneous skin secretions that can reduce evaporative water loss. The Indian tree frog. Polypedates maculatus, uses cutaneous secretions and wiping behavior to lower evaporation but also relies on moist microclimates to endure prolonged survival away from water. The related species, P. leucomystax, inhabits wetter forest habitats. Preliminary studies with this species are unable to demonstrate the expression of wiping behavior, indicating that arid habitats may be a powerful selective force for this behavior. Laboratory experiments on rehydrating toads in the genus Bufo indicate that animals are able to detect changes in barometric pressure and humidity that might result in the availability of water under field situations. Experiments with Bufonid species and with spadefoot toads, Scaphiopus couchi, show that the peptide hormone, angiotensin II, stimulates cutaneous drinking in a similar manner seen for oral drinking by other vertebrate classes. Amphibian tissues have long been used as a model for the study of basic physiological principles of epithelial ion and water transport. Recent progress with tissue cultures has provided information on the molecular structure of ion and water channels that can be applied to obtain a better understanding, at the molecular level, of ion and water balance strategies used by the wide variety of amphibian species. Terrestrial amphibians are more tolerant of dehydration than are other vertebrates and are able to store dilute urine in their urinary bladder. Toads appear to be able to detect the presence of water in their bladders in addition to the availability of water in their environment. Dehydrated toads are able to rehydrate very rapidly by the coordination of behavioral and physiological mechanisms to enhance cutaneous water absorption. The integration of behavior with cutaneous water gain, renal handling of ions and water and the role of the lymphatic system in overall water balance involves complex interactions between neural and hormonal factors. Experiments are summarized that describe the contribution of individual factors however much more information is needed before the nature of these interactions are fully understood. PMID:10222590
Assertive Community Treatment (ACT) and the Comprehensive, Continuous, Integrated System of Care (CCISC) are two models for delivering services to homeless persons with complex behavioralhealth 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),
M. Scott Young; Colleen Clark; Kathleen Moore; Blake Barrett
Integrated Vehicle Health Management (IVHM) systems for aerospace vehicles, is the process of assessing, preserving, and restoring system functionality across flight and techniques with sensor and communication technologies for spacecraft that can generate responses through detection, diagnosis, reasoning, and adapt to system faults in support of Integrated Intelligent Vehicle Management (IIVM). These real-time responses allow the IIVM to modify the affected vehicle subsystem(s) prior to a catastrophic event. Furthermore, this framework integrates technologies which can provide a continuous, intelligent, and adaptive health state of a vehicle and use this information to improve safety and reduce costs of operations. Recent investments in avionics, health management, and controls have been directed towards IIVM. As this concept has matured, it has become clear that IIVM requires the same sensors and processing capabilities as the real-time avionics functions to support diagnosis of subsystem problems. New sensors have been proposed, in addition to augment the avionics sensors to support better system monitoring and diagnostics. As the designs have been considered, a synergy has been realized where the real-time avionics can utilize sensors proposed for diagnostics and prognostics to make better real-time decisions in response to detected failures. IIVM provides for a single system allowing modularity of functions and hardware across the vehicle. The framework that supports IIVM consists of 11 major on-board functions necessary to fully manage a space vehicle maintaining crew safety and mission objectives. These systems include the following: Guidance and Navigation; Communications and Tracking; Vehicle Monitoring; Information Transport and Integration; Vehicle Diagnostics; Vehicle Prognostics; Vehicle Mission Planning, Automated Repair and Replacement; Vehicle Control; Human Computer Interface; and Onboard Verification and Validation. Furthermore, the presented framework provides complete vehicle management which not only allows for increased crew safety and mission success through new intelligence capabilities, but also yields a mechanism for more efficient vehicle operations.
Paris, Deidre; Trevino, Luis C.; Watson, Michael D.
This study determined prevalence of health risk behaviors of 9th through 12th grade students attending dropout prevention/recovery alternative schools in Texas in 1997. Participants were 470 youth whose health risk behaviors were assessed using the Youth Risk Behavior Survey in an anonymous, self-administered format. Behaviors measured included frequency of weapon-carrying and fighting, suicide-related behaviors, substance use, and sexual behaviors. A substantial percentage of alternative school students reported participating in behaviors that placed them at acute or chronic health risk. Differences in the prevalence of risk behaviors were noted by gender, racial/ethnic, and age subgroups. In addition, alternative school students frequently engaged in multiple risk behaviors. These findings suggest a need for comprehensive school-based health education/intervention programs to reduce the prevalence of risk behaviors in populations of alternative school students. PMID:10098115
Weller, N F; Tortolero, S R; Kelder, S H; Grunbaum, J A; Carvajal, S C; Gingiss, P M
This study examined the effects of mental health service provider turnover rates on system integration. System integration was defined as appropriate referrals and the freeflow exchange of information among three components: mental health care, primary health care, and dedicated HIV care coordination services. From a sample of 17 mental health centres across a midwestern state, higher staff turnover rates did
...2013-10-01 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...
An intelligent integratedhealth 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
Smith, Harvey; Schmalzel, John; Figueroa, Fernando
The National College Health Risk Behavior Survey was administered to a convenience sample of students at 8 historically Black colleges and universities in 7 states. Analyses showed major differences in the men's and women's responses. The men were significantly more likely than the women to be current smokers. Also, they more frequently reported heavy drinking, drinking and driving in the past days 30 days, and carrying a weapon. The women were significantly more likely to view themselves as overweight, and more than one third reported they were trying to lose weight. More than one third of the students had not exercised or participated in sports activities for more than 20 minutes in the past 7 days. Because historically Black colleges and universities educate the majority of undergraduate Black college students, multidimensional programs to promote disease prevention and health promotion for Black college students must be expanded and evaluated. PMID:9394088
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 behavioralhealth, 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 behavioralhealth. 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.
Although the term “behavioral epidemiology” has been used in the literature since the late 1970s, it has not been clearly\\u000a defined. A behavioral epidemiology framework is proposed to specify a systematic sequence of studies on health-related behaviors,\\u000a leading to evidence-based interventions directed at populations. The phases are: 1—establish links between behaviors and health;\\u000a 2—develop measures of the behavior; 3—identify influences
James F. Sallis; Neville Owen; Michael J. Fotheringham
Objective This study examined ethnic differences in accessing treatment for depression and substance use disorders (SUDs) among men and women in a large integratedhealth plan, and explored factors potentially contributing to health care disparities. Methods Participants were 22,543 members ages 20 to 65 who responded to health surveys in 2002 and 2005. Survey questions were linked to provider-assigned diagnoses, electronic medication, psychiatry, and chemical dependency program records. Results Among women diagnosed with depression, Latinas (p < .01) and Asian-Americans (p < .001) were less likely than Whites to fill an antidepressant prescription. Among men diagnosed with depression, African Americans (p < .01) were less likely than Whites to do so. Among women diagnosed with an SUD, African Americans (p < .05) were less likely than Whites to have one or more chemical dependency program visits. Conclusions Results demonstrated ethnic differences in accessing depression and SUD treatment among patients diagnosed with these disorders, which persisted after controlling for education, income, having a regular health care provider and length of health plan enrollment. Findings highlight potential gender differences in ethnic disparities, lower antidepressant utilization among Asian Americans, and the effects of co-occurring disorders in accessing behavioralhealth care.
...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...
Background Many countries are facing the burden of accelerated population aging and a lack of institutional support to meet the needs of older individuals. In developing countries, adult children are primarily responsible for the care of their elderly parents. However, out-migration of adult children is common in these countries. This study aims to explore the impact of migration on the health of the elderly left behind and their health care-seeking behavior. Methods This paper uses data from a national survey of older persons in Thailand conducted in 2007. The analysis is confined to those who were aged 60 years or above and who had at least one child (biological or step/adopted) (n = 28,677). Logistic regression was used to assess the net effect of migration of adult children on the health of the elderly left behind and their health care-seeking behavior, after controlling for other socio-demographic and economic variables. Results More than two-thirds of the elderly (67%) had at least one migrant child. About three-fifths (58%) reported that they had at least one symptom of poor mental health. Almost three in five elderly (56%) rated their health as poor, and 44% had experienced at least one chronic disease. About two-thirds of the elderly (65%) got sick during the 5 years preceding the survey. An overwhelming majority of elderly (88%) who got sick during the five years preceding the survey had sought treatment for their last illness. After controlling for socio-demographic and economic variables, our study found that those elderly who had a migrant child were more likely (OR = 1.10; 95% CI 1.05-1.17) to have symptoms of poor mental health than those whose children had not migrated. However, no significant association was observed among physical health, such as experience of chronic disease, perceived poor health, and illness of the elderly left behind. Interestingly, however, out-migration of adult children was independently associated with higher utilization of health services. The elderly who had migrant children were more likely (odds ratio = 1.22, CI 1.11-1.33) than those whose children had not migrated to seek treatment for their most recent illness, after controlling for socio-demographic and economic variables. Conclusion Our study provides novel evidence on an issue of special importance to countries affected by heavy out-migration of adult children, an issue that has received little attention. Out-migration of adult children was highly associated with poor mental health but it was not associated with the physical health of the elderly left behind. Out-migration of children was also highly associated with higher utilization of health facilities by the elderly. Thus, in order to decrease morbidity among the elderly as well as to maintain and enhance the well-being of families, programs should focus on alleviating the symptoms of poor mental health among the elderly left behind and aim to reduce the differences in utilization of health care-seeking behavior among elderly with children present in the community and elderly left behind.
Many studies focus on healthbehavior within the context of intimate ties. However, this literature is limited by reliance on gender socialization theory and a focus on straight (i.e., heterosexual) marriage. We extend this work with an analysis of relationship dynamics around healthbehavior in 20 long-term straight marriages as well as 15 gay and 15 lesbian long-term cohabiting partnerships in the United States (N = 100 individual in-depth interviews). We develop the concept of "healthbehavior work" to align activities done to promote healthbehavior with theories on unpaid work in the home. Respondents in all couple types describe specialized healthbehavior work, wherein one partner works to shape the other partner's healthbehavior. In straight couples, women perform the bulk of specialized healthbehavior work. Most gay and lesbian respondents-but few straight respondents--also describe cooperative healthbehavior work, wherein partners mutually influence one another's healthbehaviors. Findings suggest that the gendered relational context of an intimate partnership shapes the dynamics of and explanations for healthbehavior work. PMID:22227238
Serious video games for health are designed to entertain players while attempting to modify some aspect of their healthbehavior. Behavior is a complex process influenced by multiple factors, often making it difficult to change. Behavioral science provides insight into factors that influence specific actions that can be used to guide key game…
The number of students accumulating credit card debt--and the amount of debt itself--on college campuses is increasing. If high-risk credit and healthbehavior are associated, healthbehavior interventions might apply to high-risk credit behavior. Objective: The authors' purpose was to examine these possible associations. Participants and Methods:…
Adolescents who abuse substances are more likely to engage in health-risking sexual behavior (HRSB) and are at particularly high risk for HIV/AIDS. Thus, substance abuse treatment presents a prime opportunity to target HIV-risk behaviors. The present study evaluated a one-session HIV-risk intervention embedded in a controlled clinical trial for drug-abusing adolescents. The trial was conducted in New Mexico and Oregon with Hispanic and Anglo adolescents. Youths were randomly assigned to individual cognitive behavior therapy (CBT) or to an integratedbehavioral and family therapy (IBFT) condition, involving individual and family sessions. The HIV-specific intervention was not associated with change. IBFT and CBT were both efficacious in reducing HIV-risk behaviors from intake to the 18-month follow-up for high-risk adolescents. For low-risk adolescents, CBT (versus IBFT) was more efficacious in suppressing HRSB. These data suggest that drug abuse treatments can have both preventative and intervention effects for adolescents, depending on their relative HIV-risk.
Ozechowski, Timothy J.; Waldron, Holly B.; Davis, Betsy; Turner, Charles W.; Brody, Janet L.; Barrera, Manuel
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)
Much of the behavioralhealth 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 behavioralhealth field. This paper explores the educational needs and
The importance of applied behavior analysis (ABA) in the etiology, control, and prevention of major types of morbidity and mortality is discussed in terms of the health promotion era in public health, the merging and extension of ABA and public health paradigms, and the development of effective interventions for maintaining healthy behavior.…
This report describes the methods and results of the 1999 Alaska Youth Risk Behavior Survey (YRBS) and the 1998 School Health Education Profile (SHEP). Each survey is intended to provide a better understanding of health and related programs within school settings. The YRBS asks students to report their behaviors in the six major areas of health…
Objective: The purpose of this study was to test a life span healthbehavior model in which educational attainment and healthbehaviors (eating habits, smoking, and physical activity) were hypothesized as mechanisms to account for relations between teacher ratings of childhood personality traits and self-reported health status at midlife. Design: The model was tested on 1,054 members of the Hawaii
Sarah E. Hampson; Lewis R. Goldberg; Thomas M. Vogt; Joan P. Dubanoski
Despite recent attention to health promotion and illness prevention, young people continue to engage in a variety of risk behaviors, which may negatively influence current and future health status. The purpose of this study was to create a comprehensive profile of health risk behaviors among undergraduate students at the University of Prince…
Taylor, Jennifer P.; McCarthy, Mary Jean; Herbert, Rosemary J.; Smith, Philip B.
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
Christine Jackson; Lisa Henriksen; Vangie A. Foshee
OBJECTIVE To quantify the magnitude of general medical and/or pharmacy claims expenditures for individuals who use behavioralhealth services and to assess future claims when behavioral service use persists. DESIGN Retrospective cost trends and 24-month cohort analyses. SETTING A Midwest health plan. PARTICIPANTS Over 250,000 health plan enrollees during 2000 and 2001. MEASUREMENTS Claims expenditures for behavioralhealth services, general medical services, and prescription medications. MAIN RESULTS Just over one tenth of enrollees (10.7%) in 2001 had at least 1 behavioralhealth claim and accounted for 21.4% of total general medical, behavioralhealth, and pharmacy claims expenditures. Costs for enrollees who used behavioralhealth services were double that for enrollees who did not use such services. Almost 80% of health care costs were for general medical services and medications, two thirds of which were not psychotropics. Total claims expenditures in enrollees with claims for both substance use and mental disorders in 2000 were 4 times that of those with general medical and/or pharmacy claims only. These expenditures returned to within 15% of nonbehavioral health service user levels in 2001 when clinical need for behavioralhealth services was no longer required but increased by another 37% between 2000 and 2001 when both chemical dependence and mental health service needs persisted. CONCLUSIONS The majority of total claims expenditures in patients who utilize behavioralhealth services are for medical, not behavioral, health benefits. Continued service use is associated with persistently elevated total general medical and pharmacy care costs. These findings call for studies that better delineate: 1) the interaction of general medical, pharmacy, and behavioralhealth service use and 2) clinical and/or administrative approaches that reverse the high use of general medical resources in behavioralhealth patients.
Kathol, Roger G; McAlpine, Donna; Kishi, Yasuhiro; Spies, Robert; Meller, William; Bernhardt, Terence; Eisenberg, Steven; Folkert, Keith; Gold, William
Introduction Sri Lanka has one of the highest suicide rates in the world, with recent protracted conflict and the tsunami aggravating mental health needs. This paper describes a project to establish a systematic "train the trainers" programme to integrate mental health into primary care in Sri Lanka's public health system and private sector.Methods A 40 hour training programme was delivered to curriculum and teaching materials were adapted for Sri Lanka, and delivered to 45 psychiatrists, 110 medical officers of mental health and 95 registered medical practitioners, through five courses, each in a different region (Colombo, Kandy, Jaffna, Galle and Batticola). Participants were selected by the senior psychiatrist of each region, on the basis of ability to conduct subsequent roll out of the training. The course was very interactive, with discussions, role plays and small group work, as well as brief theory sessions.Results Qualitative participant feedback was encouraging about the value of the course in improving patient assessments and treatments, and in providing a valuable package for roll out to others. Systematic improvement was achieved between pre- and post-test scores of participants at all training sites. The participants had not had prior experience in such interactive teaching methods, but were able to learn these new techniques relatively quickly.Conclusions The programme has been conducted in collaboration with the Sri Lankan National Institute of Mental Health and the Ministry of Health, and this partnership has helped to ensure that the training is tailored to Sri Lanka and has the chance of long term sustainability. PMID:23277794
Jenkins, Rachel; Mendis, Jayan; Cooray, Sherva; Cooray, Marius
Serious video games for health are designed to entertain players while attempting to modify some aspect of their healthbehavior. Behavior is a complex process influenced by multiple factors, often making it difficult to change. Behavioral science provides insight into factors that influence specific actions that can be used to guide key game design decisions. This article reports how behavioral science guided the design of a serious video game to prevent Type 2 diabetes and obesity among youth, two health problems increasing in prevalence. It demonstrates how video game designers and behavioral scientists can combine their unique talents to create a highly focused serious video game that entertains while promoting behavior change.
School-based health education can help young people develop the knowledge, skills, motivation, and support they need to choose health-enhancing behaviors and resist engaging in behaviors that put them at risk for health and social problems and school failure. The health of school-age youth is significantly associated with their school achievement. However, in the midst of today's increased emphasis on school accountability in the areas of reading, writing, and mathematics, subject areas such as health education tend to receive less prominence in the school curriculum. Recalling their own lackluster school experiences related to health topics, decision makers may not realize that today's skills-based school health curriculum involves a highly interactive and engaging approach to promoting good health and preventing the most serious health problems among youth. Health education is one important component of a coordinated school health program that includes health education, physical education, school health services, nutrition services, school counseling and psychological services, a healthy school environment, school promotion for faculty and staff, and involvement of family and community members. The purpose of this PowerPoint presentation--Healthy Keiki, Healthy Hawaii: Hawaii's "7 by 7" for School Health Education--is to educate health and education decision makers, teachers, parents, and community members on how Hawaii has integrated seven health education standards with seven priority health content areas to create an effective approach to school health education in grades kindergarten through 12. The goal of Hawaii's "7 by 7" curriculum focus is to ensure that all of Hawaii's keiki (children) have well-planned opportunities at school to become fit, healthy, and ready to learn. PMID:16539804
The launch site processing flow involves operations such as functional verification, preflight servicing and launch. These operations often include hazards that must be controlled to protect human life and critical space hardware assets. Existing command and control capabilities are limited to simple limit checking durig automated monitoring. Contingency actions are highly dependent on human recognition, decision making, and execution. Many opportunities for Integrated System Health Engineering and Management (ISHEM) exist throughout the processing flow. This paper will present the current human-centered approach to health management as performed today for the shuttle and space station programs. In addition, it will address some of the more critical ISHEM needs, and provide recommendations for future implementation of ISHEM at the launch site.
Waterman, Robert D.; Langwost, Patricia E.; Waterman, Susan J.
Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following functions: (1) detect anomalies, (2) diagnose causes, (3) predict future anomalies/failures, and (4) provide the user with an integrated awareness about the condition of every element in the system and guide user decisions.
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.
Over the last thirty years, children's behavioralhealth 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…
Caregiving and its consequences are major concerns for nurses. Many studies have examined health-promoting behaviors in general (Duffy, 1993; Walker, Volkan, Sechrist, & Pender, 1988), but few studies have explored health-promoting behaviors of caregivers. The purpose of this study was to examine the effects of age, gender, race, and length of caregiving on perceived health status and health-promoting behaviors of African-American and White informal caregivers of impaired elders. Data from a larger study was used to examine a conceptual model linking perceived health status and health-promoting behavior. A sample of 136 (n = 136) African-American and 257 (n = 257) White caregivers was recruited from northeastern Ohio through random digit dialing and interviewed face to face. English-speaking caregivers were selected for study who provided unpaid assistance or care for a minimum of five hours a week to an impaired person 60 years of age or older living in the community. The Health-Promoting Behavior Questionnaire, perceived health status, and a demographic profile were used to measure the study variables. Data were analyzed using hierarchical multiple regression. Findings from this study suggest that the overall fit of the conceptual model was significant, and that moreover, the relationship found between perceived health status and health-promoting behaviors supported Pender's model of health promotion (Pender, 1987). The relationship between perceived health status and health-promoting behaviors has not been documented in prior studies of caregivers, or in studies comparing the two racial groups of African-Americans and Whites. PMID:16255310
McDonald, Patricia E; Brennan, Patricia Flatley; Wykle, May L
Health damaging behaviors of young military personnel are reflections of health problems facing all young people in the U.S. Military life presents opportunities and challenges that may both protect and place young troops at risk for health damaging behav...
This research examined 1) the prevalence of substance use behaviors in college students, 2) gender and academic level as moderators of the associations between mental health problems and substance use, and 3) mental health service use among those with co-occurring frequent binge drinking and mental health problems. As part of the Healthy Minds Study, a probability sample of 2843 college
James A. Cranford; Daniel Eisenberg; Alisha M. Serras
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…
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 behavioralhealth, 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.
The Veterans Health Affairs is in the process of implementing a new model for the delivery of primary care: The Patient-Centered Medical Home (PCMH). One critical challenge of any PCMH model will be the integration of basic mental health treatment into primary care. Such a mental healthintegration program must be flexible enough to incorporate new evidence-based treatments as patient
Populations composed of racial/ethnic minorities, disabled persons, and people with low socioeconomic status have worse health than their counterparts. Implementing evidence-based behavioral interventions (EBIs) to prevent and manage chronic disease and disability in community settings could help ameliorate disparities. Although numerous models of implementation processes are available, they are broad in scope, few offer specific methodological guidance, and few address the special issues in reaching vulnerable populations. Drawing from 2 existing models, we describe 7 methodological phases in the process of translating and implementing EBIs in communities to reach these vulnerable groups: establish infrastructure for translation partnership, identify multiple inputs (information gathering), review and distill information (synthesis), adapt and integrate program components (translation), build general and specific capacity (support system), implement intervention (delivery system), and develop appropriate designs and measures (evaluation). For each phase, we describe specific methodological steps and resources and provide examples from research on racial/ethnic minorities, disabled persons, and those with low socioeconomic status. Our methods focus on how to incorporate adaptations so that programs fit new community contexts, meet the needs of individuals in health-disparity populations, capitalize on scientific evidence, and use and build community assets and resources. A key tenet of our approach is to integrate EBIs with community best practices to the extent possible while building local capacity. We discuss tradeoffs between maintaining fidelity to the EBIs while maximizing fit to the new context. These methods could advance our ability to implement potentially effective interventions to reduce health disparities. PMID:24262025
Nápoles, Anna Maria; Santoyo-Olsson, Jasmine; Stewart, Anita L
Obesity (and its related comorbidities) is one of the fastest-growing health concerns facing the United States and shows no sign of abating.(1) The Centers for Disease Control and Prevention calculated that nearly 36% of American adults were obese in 2010 and estimates that this number will reach 44% by 2018. The current standard of care for the management of patients with obesity in primary care is often a general recommendation by the physician to lose weight through improved nutrition and increased physical activity. Educational materials may be provided along with a referral to a dietician, nutritionist, or weight management program. Health coaching as an obesity intervention has yet to be fully integrated into primary care practice but has proven to be effective in corporate wellness and behavioral weight loss programs.(2) (-) (5.) PMID:24278845
Sherman, Ryan; Crocker, Ben; Dill, Diana; Judge, David
The biomedical model of health and disease dominates in current medical practice. The model attributes key role to biological determinants and explains disease as a condition caused by external pathogens or disorders in the functions of organs and body systems. Such an approach has its historic justification and has proved effective in the control of massive infectious diseases. However, now that chronic non-infectious diseases prevail, its efficacy has not only become questionable, but also the issue has been raised of its economic justification. The extension of biomedical approach and attribution of equal importance to psychosocial factors have become an imperative in the improvement of treatment efficacy and disease control, together with humanisation of relations between health staff and patients. A new biopsychosocial model has been suggested, that takes into account all relevant determinants of health and disease and that supports the integration of biological, psychological and social factors in the assessment, prevention and treatment of diseases. It does not diminish the significance of biological factors, but extends a rather narrow approach. The biopsychosocial model served as incentive for many studies of how psychological and social factors influence the development, course and outcome of a disease, giving rise to the development of interdisciplinary field--particularly the fields of health psychology and psychoneuroimmunology. Their contribution to better understanding of the impact of psychosocial factors on health stimulates greater interest of medical theory and practice in more holistic approach to a patient. However, the changes of the old, organ oriented approach are still too slow and too narrow. PMID:19408642
A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.
Influencing consumer behavior is a difficult and often resource-intensive undertaking, with success usually requiring identifying, describing, and understanding target audiences; solid product and/or service positioning relative to competitors; and significant media and communication resources. Integrated marketing communication (IMC) is a new way of organizing and managing persuasive communication tools and functions which involves realigning communications to consider the flow of information from an organization from the viewpoint of end consumers. Although the application of IMC to social marketing remains relatively unexplored, the IMC literature and recent efforts by the US Centers for Disease Prevention and Control suggest that integrated communication approaches have much to offer social marketing and health communication efforts. IMC, IMC and social marketing, and implications of IMC for public and private sector social marketing programs are discussed. PMID:12348831
Nowak, G; Cole, G; Kirby, S; Freimuth, V; Caywood, C
Objective: To examine adolescents' peer crowd affiliation and its linkages with health-risk behaviors, their friends' health-risk behaviors, the presence of close friends in the same peer crowd, and adolescents' social acceptance. Methods: We interviewed 250 high school students and identified six categories: popular, jocks, brains, burnouts, nonconformists, or average\\/other. Adolescents also reported on their health-risk behaviors (including use of cigarettes,
Annette M. La Greca; Mitchell J. Prinstein; Michael D. Fetter
Understanding the precise nature of the links among styles of behavior, emotional expression, and the development of heart disease is a major challenge in psychology and health. In the present research, 60 men at high risk for coronary heart disease were examined in terms of their expressive style, their specific nonverbal cues, their personality, and their health. As assessed by the self-report Jenkins Activity Survey (JAS; Jenkins, Zyzanski, & Rosenman, 1979), half the men were Type A and half were Type B. To provide a more refined grouping, the men were further classified on the basis of scores on the Affective Communication Test (ACT; H. S. Friedman, Prince, Riggio, & DiMatteo, 1980), a self-report measure of nonverbal expressiveness. In the framework of theory and research on nonverbal expressive style, videotapes of the men were extensively rated and coded in terms of their judged appearance, the actual audio and video nonverbal cues emitted, and the words said (transcript). Two groups of Type A individuals were found--one that was repressed, tense, and illness-prone, but another that was healthy, talkative, in control, and charismatic. Furthermore, in addition to the expected healthy Type B men, a subgroup of Type B men was found who were submissive, repressed, tense, have an external locus of control, and may be illness-prone. A refined conception of the Type A behavior pattern is deemed necessary in light of these findings. Implications for improving the validity of the Type A construct and understanding the link between psychosocial factors and disease are discussed. PMID:3998991
A description of self-report healthbehavior and attitudes of American youths based on questionnaire responses of a national probability sample of noninstitutionalized youths 12 through 17 years of age. Topics include behavior and attitudes relating to ge...
The Youth Risk Behavior Surveillance System (YRBSS), an epidemiologic surveillance system, was established by the Centers for Disease Control and Prevention (CDC) to monitor the prevalence of youth behaviors that most influence health. The 1995 National C...
Background: Well-Integrated Screening and Evaluation for Women Across the Nation (WISE WOMAN) provides low-income, underserved women ages 40-64 with risk factor screening and lifestyle intervention and referral services to prevent cardiovascular disease (CVD). In tegrating WISEWOMAN's services with the culturally appropriate medical care and support services offered by community health centers may improve the program's ability to reduce CVD burden
Glen P. Mays; Heather A. Hesketh; Alice S. Ammerman; Chris K. Stockmyer; Tamara Lewis Johnson; Marcia Bayne-Smith
Research on the association between health insurance coverage and sexual risk behavior among men who have sex with men (MSM) is sparse. We hypothesized that MSM with health insurance would be less likely to engage in risky sexual behavior based on previous research showing that insured persons increase contact with providers which can improve health knowledge, decrease tendency to engage in unhealthy behaviors, and raise awareness about health risks. As part of a study testing an online HIV prevention intervention, we collected information on health insurance and sexual behavior from MSM (n=650). Overall, men with health insurance had a 28% reduced prevalence of unprotected anal intercourse male partners (UAIMP) in the 90 days prior to the survey. Potential explanations include access to healthcare providers and awareness of sexual health. Additional research is needed to identify the mechanism through which health insurance is protective.
Brunsberg, Sarah A.; Rosser, B.R. Simon; Smolenski, Derek
Based on a case study of healthintegration in Canadian northern EA, this paper further demonstrates the lack of consistent integration of health in EA practice. A survey was administered to northern EA and health practitioners, administrators and special interest groups to assess current northern health assessment practices, the scope of health in EA, EA performance with regard to health assessment and the perceived barriers to healthintegration. Results suggest that health is currently recognized as an important component of northern EA and is addressed in the majority of cases; however, health is addressed primarily during the pre-decision stages of EA and less often during post-decision follow-up and monitoring. Moreover, when health is addressed, attention is limited to the physical components of health and health impacts due to physical environmental change, with considerably less attention given to the social aspects of health. Results also suggest dissent between EA practitioners, health practitioners and other interests concerning the overall state of health in EA; however, there is consensus on the key challenges to improved integration, namely differences in understanding of the scope of health and expectations of EA to assess health impacts; limited coordination between EA and health practitioners; limited scope and requirements of current EA legislation for health assessment; and the lack of supporting EA methods and frameworks.
Noble, Bram [Department of Geography, University of Saskatchewan, Saskatoon, Saskatchewan, S7N 5A5 (Canada)]. E-mail: firstname.lastname@example.org; Bronson, Jackie [Stantec Consulting Ltd., 100-75-24th Street East, Saskatoon, SK S7K 0K3 (Canada)]. E-mail: JBronson@stantec.com
This article describes an effective model for employing paraprofessionals to provide behavioral support for students in a general education setting. Behavioralhealth assistants (BHAs) worked under the supervision of school psychologists and counselors and provided behavioral interventions for students with behavioral goals on their individualized…
Adolphson, S. Lillian; Hawken, Leanne S.; Stein Carroll, Mishele
Oral infections and cardiovascular diseases share common biological and behavioral risk factors. Psychosocial determinants could act as a link between general healthbehavior and dental healthbehavior. Our objective was to study optimism and life satisfaction as determinants of general and dental healthbehavior and to evaluate whether these are connected with cardiovascular risk factors and dental diseases. The 1966
P. V. Ylöstalo; E. Ek; J. Laitinen; M. L. Knuuttila
An intelligent autonomous control capability has been developed and is currently being validated in ground cryogenic fluid management operations. The capability embodies a physical architecture consistent with typical launch infrastructure and control systems, augmented by a higher level autonomous control (AC) system enabled to make knowledge-based decisions. The AC system is supported by an integrated system health management (ISHM) capability that detects anomalies, diagnoses causes, determines effects, and could predict future anomalies. AC is implemented using the concept of programmed sequences that could be considered to be building blocks of more generic mission plans. A sequence is a series of steps, and each executes actions once conditions for the step are met (e.g. desired temperatures or fluid state are achieved). For autonomous capability, conditions must consider also health management outcomes, as they will determine whether or not an action is executed, or how an action may be executed, or if an alternative action is executed instead. Aside from health, higher level objectives can also drive how a mission is carried out. The capability was developed using the G2 software environment (www.gensym.com) augmented by a NASA Toolkit that significantly shortens time to deployment. G2 is a commercial product to develop intelligent applications. It is fully object oriented. The core of the capability is a Domain Model of the system where all elements of the system are represented as objects (sensors, instruments, components, pipes, etc.). Reasoning and decision making can be done with all elements in the domain model. The toolkit also enables implementation of failure modes and effects analysis (FMEA), which are represented as root cause trees. FMEA's are programmed graphically, they are reusable, as they address generic FMEA referring to classes of subsystems or objects and their functional relationships. User interfaces for integrated awareness by operators have been created.
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.
Although many previous studies have begun to address the reproductive health needs of women with intellectual disabilities; however, the supportive behaviors of caregivers to assist their reproductive health is not well understood. Data from a cross-sectional survey of ""2009 National Survey on Reproductive Health Care Needs and Health Education…
Lin, Lan-Ping; Lin, Pei-Ying; Chu, Cordia M.; Lin, Jin-Ding
BACKGROUND: In a literature-based discussion of research on the information behaviors of life and health scientists and health care practitioners, the problem of characterizing this complex literature is discussed. The issue of terminology for this interdisciplinary area is raised. The paucity of models for information seeking behavior that have been tested in a health care population is discussed, as are the frequently used methods of investigation and data collection methods. METHODS: By analyzing a large number of information behavior research studies, the questions of who does the research and where the research is published are answered. The characteristics of this research are discussed. Studies are cited that investigate the information behavior of physicians, multidisplinary groups of health professionals, medical students and faculty, nurses and other allied health personnel, life scientists, and basic science researchers. Two short case studies--on the diffusion of medical knowledge and on drug information and physician behavior--are used as examples of information behavior research. CONCLUSIONS: The importance of studying the information behavior of health and life scientists and health care providers is underscored by a discussion of the implications for further study.
Physiological studies have demonstrated that inputs from different sensory modalities converge on, and are integrated by, individual superior colliculus neurons and that this integration is governed by specific spatial rules. The present experiments were an attempt to relate these neural processes to overt behavior by determining if behaviors believed to involve the circuitry of the superior colliculus would show similar
Barry E. Stein; M. Alex Meredith; W. Scott Huneycutt; Lawrence McDade
While the majority of college and university campuses have discrete mental health and medical services, the integration of the two areas has been subject of increased discussion among student health and counseling professionals. The push to integrate counseling and health services is motivated by a variety of reasons: a philosophical desire to…
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
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 succeed or fail. The focus here is on services that cross disciplinary boundaries; that is, those that integratehealth services with social services, health services with mental health services, or one social service with a categorically different social service. PMID:22873935
Abstract Background: With the advancements in knowledge about health promotion, public health professionals have been seeking determinants of personal healthbehaviors. The purpose of this study was to assess the prevalence of health risk behaviors and its associated factors in a sample of Kyrgyz university students. Methods: In a cross-sectional survey, health risk behaviors among a sample of randomly selected university students were assessed. The sample included 837 university students from health sciences undergraduate courses of the State Medical Academy in Kyrgyzstan. The students were 358 (42.8%) males and 479 (57.2%) females in the age range of 18-29 years (Median age=21.3 years, SD=1.5). Results: On average, students engaged in 9.4 (SD=2.3) out of 23 health risk behavior practices (range, 3-18). Generally, there was a high rate of insufficient fruit and vegetable intake (86.4%), eating red meat at least once a day (62%), usually adding salt to meals (78.3%), skipping breakfast (50.5%), current tobacco use (49.7%) and two or more sexual partners in the past 12 months (46.1%) among men, and never using a condom with a primary partner in the past 3 months (90.9%) among women. Furthermore, 60.8% of the women were physically inactive. In bivariate analysis among men, the lack of perceived benefits was associated with health risk behavior. In multivariate analysis among women, poorer family background, being Russian, high personal constraints or stress, and better subjective health were associated with the health risk behavior index. Conclusions: Students had a high proportion of health risk behavior practices. Several high health risk practices were identified, including poor dietary behavior, physical inactivity, sexual risk behavior, and tobacco use. Gender specific predictors identified included sociodemographic characteristics and social and health variables, which can be utilized in health promotion programs. PMID:23807671
Pengpid, Supa; Peltzer, Karl; Mirrakhimov, Erkin M
This annotated bibliography of cooperative projects in mental health and behavioral sciences includes major projects, drug screening studies, physiological concomitants of psychiatric drug therapy, psychological studies, methodological studies, studies of...
During the climacteric, women experience multiple health problems. As their needs are not catered for in an integral fashion due to the lack of any specific programme or mechanism to provide for this, they show an increased use of the health services, and an increased rate of referrals to different specialists. This study, carried out in a Basic Health Zone
Amelia Rodríguez Martín; Ma MAR Fernández del Barrio; Teresa Fernández del Barrio; Pedro Arango Fernández; Juan Martín Tello
This article examined the usefulness of the Health Belief Model (HBM) and other confounding factors in determining healthbehavior of individuals involved in hospital waste management and tested four components of HBM in relation to demographic variables, knowledge, and occupational practices of the respondents. The study revealed that the waste pickers had a lower level of knowledge, attitude, and safe practices than nurses and sweepers. Perceived Susceptibility and Perceived Severity were moderately associated with safe occupational practices among the respondents (p < 0.05). In addition, respondents with higher levels of education and income were more likely to have higher levels of Perceived Susceptibility, Severity, and Benefits. The study findings indicate that individuals with greater economic vulnerability might be at greater risk for not using proper protective measures in handling or picking hospital wastes in Bangladesh. PMID:19959428
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
Gary E. Schwartz; Alvin P. Shapiro; Daniel P. Redmond; Donald C. E. Ferguson; David R. Ragland; Stephen M. Weiss
During the last decade, there has been a major effort in the aerospace industry to reduce the cost per pond of payload and become competitive in the international market. Competition from Europe, Japan, and China has reduced this cost to almost a third from 1990 to 2000. This cost has leveled in recent years to an average price of around $12,000/pound of payload. One of NASA's goals is to promote the development of technologies to reduce this cost by a factor of 10 or more Exploration of space, specially manned exploration missions, involves very complex launch and flight vehicles, associated ground support systems, and extensive human support during all phases of the mission. When considering the Space Shuttle Program, we can see that vehicle and ground support systems' processing, operation, and maintenance represent a large percentage of the program cost and time. Reducing operating, processing and maintenance costs will greatly reduce the cost of Exploration programs. The Integrated System Health Management (ISHM) concept is one of the technologies that will help reduce these operating, processing and maintenance costs. ISHM is an integratedhealth monitoring system applicable to both flight and ground systems. It automatically and autonomously acquires information from sensors and actuators and processes that information using the ISHM-embedded knowledge. As a result, it establishes the health of the system based on the acquired information and its prior knowledge. When this concept is fully implemented, ISHM systems shall be able to perform failure prediction and remediation before actual hard failures occurs, preventing its costly consequences. Data sources, sensors, and their associated data acquisition systems, constitute the foundation of the system. A smart sensing architecture is required to support the acquisition of reliable, high quality data, required by the ISHM. A thorough definition of the smart sensor architectures, their embedded diagnostic agents, and communication protocols need to be established and standardized to allow the embedding and exchange of health information among sensors and ISHM. This workshop is aimed to foster the exchange of ideas and lessons learned between government, industry and academia to aid in the establishment of ISHM (and smart sensors) standards and guidelines as well as to identify present technology gaps that will have to be overcome to successfully achieve this goal.
Background The integration of behavioralhealth services into primary care is increasingly popular, yet fidelity of implementation in this area has been infrequently assessed due to the few measurement tools available. A sentinel indicator of fidelity of implementation is provider adherence, or utilization of prescribed procedures and engagement in model-specific behaviors. This study aimed to develop the first self-report measure of behavioralhealth provider adherence for co-located, collaborative care, a commonly adopted model of behavioralhealth service delivery in primary care. Methods A preliminary 56-item measure was developed by the research team to represent critical components of adherence among behavioralhealth providers. To ensure the content validity of the measure, a modified Delphi study was conducted using a panel of co-located, collaborative care model experts. During three rounds of emailed surveys, panel members provided qualitative feedback regarding item content while rating each item’s relevance for behavioralhealth provider practice. Items with consensus ratings of 80% or greater were included in the final adherence measure. Results The panel consisted of 25 experts representing the Department of Veterans Affairs, the Department of Defense, and academic and community health centers (total study response rate of 76%). During the Delphi process, two new items were added to the measure, four items were eliminated, and a high level of consensus was achieved on the remaining 54 items. Experts identified 38 items essential for model adherence, six items compatible (although not essential) for model adherence, and 10 items that represented prohibited behaviors. Item content addressed several domains, but primarily focused on behaviors related to employing a time-limited, brief treatment model, the scope of patient concerns addressed, and interventions used by providers. Conclusions This study yielded the first content valid self-report measure of critical components of collaborative care adherence for use by behavioralhealth providers in primary care. Although additional psychometric evaluation is necessary, this measure may assist implementation researchers in clarifying how provider behaviors contribute to clinical outcomes. This measure may also assist clinical stakeholders in monitoring implementation and identifying ways to support frontline providers in delivering high quality services.
Background Having a significant other has been shown to be protective against physical and psychological health conditions for adults. Less is known about the period of emerging young adulthood and associations between significant others’ weight and weight-related healthbehaviors (e.g. healthy dietary intake, the frequency of physical activity, weight status). This study examined the association between significant others’ health attitudes and behaviors regarding eating and physical activity and young adults’ weight status, dietary intake, and physical activity. Methods This study uses data from Project EAT-III, a population-based cohort study with emerging young adults from diverse ethnic and socioeconomic backgrounds (n?=?1212). Logistic regression models examining cross-sectional associations, adjusted for sociodemographics and healthbehaviors five years earlier, were used to estimate predicted probabilities and calculate prevalence differences. Results Young adult women whose significant others had health promoting attitudes/behaviors were significantly less likely to be overweight/obese and were more likely to eat???5 fruits/vegetables per day and engage in???3.5 hours/week of physical activity, compared to women whose significant others did not have health promoting behaviors/attitudes. Young adult men whose significant other had health promoting behaviors/attitudes were more likely to engage in???3.5 hours/week of physical activity compared to men whose significant others did not have health promoting behaviors/attitudes. Conclusions Findings suggest the protective nature of the significant other with regard to weight-related healthbehaviors of young adults, particularly for young adult women. Obesity prevention efforts should consider the importance of including the significant other in intervention efforts with young adult women and potentially men.
The midwestern United States has a high number of recent Latino migrants, but little information is available regarding their sexual behaviors. A total of 75 behaviorally bisexual men (25 Latino, 25 Black and 25 White) participated in an exploratory study on sexual health. The data presented in this article are restricted to the 25 self-identified Latino men. Qualitative in-depth interviews
Omar Martinez; Brian Dodge; Gabriel Goncalves; Phillip W. Schnarrs; Miguel Muñoz-Laboy; Michael Reece; David Malebranche; Barbara Van Der Pol; Guadalupe Kelle; Ryan Nix; J. Dennis Fortenberry
Human lifespan is positively correlated with childhood intelligence, as measured by psychometric (IQ) tests. The strength of this correlation is similar to the negative effect that smoking has on the life course. This result suggests that people who perform well on psychometric tests in childhood may remain healthier and live longer. The correlation, however, is debated: is it caused exclusively by social-environmental factors or could it also have a biological component? Biological traits of systems integrity that might result in correlations between brain function and lifespan have been suggested but are not well-established, and it is questioned what useful knowledge can come from understanding such mechanisms. In a recent study, we found a positive correlation between brain function and longevity in honey bees. Honey bees are highly social, but relevant social-environmental factors that contribute to cognition-survival correlations in humans are largely absent from insect colonies. Our results, therefore, suggest a biological explanation for the correlation in the bee. Here, we argue that individual differences in stress handling (coping) mechanisms, which both affect the bees' performance in tests of brain function and their survival could be a trait of systems integrity. Individual differences in coping are much studied in vertebrates, and several species provide attractive models. Here, we discuss how pigs are an interesting model for studying behavioural, physiological and molecular mechanisms that are recruited during stress and that can drive correlations between health, cognition and longevity traits. By revealing biological factors that make individuals susceptible to stress, it might be possible to alleviate health and longevity disparities in people. PMID:24472488
Human lifespan is positively correlated with childhood intelligence, as measured by psychometric (IQ) tests. The strength of this correlation is similar to the negative effect that smoking has on the life course. This result suggests that people who perform well on psychometric tests in childhood may remain healthier and live longer. The correlation, however, is debated: is it caused exclusively by social-environmental factors or could it also have a biological component? Biological traits of systems integrity that might result in correlations between brain function and lifespan have been suggested but are not well-established, and it is questioned what useful knowledge can come from understanding such mechanisms. In a recent study, we found a positive correlation between brain function and longevity in honey bees. Honey bees are highly social, but relevant social-environmental factors that contribute to cognition-survival correlations in humans are largely absent from insect colonies. Our results, therefore, suggest a biological explanation for the correlation in the bee. Here, we argue that individual differences in stress handling (coping) mechanisms, which both affect the bees’ performance in tests of brain function and their survival could be a trait of systems integrity. Individual differences in coping are much studied in vertebrates, and several species provide attractive models. Here, we discuss how pigs are an interesting model for studying behavioural, physiological and molecular mechanisms that are recruited during stress and that can drive correlations between health, cognition and longevity traits. By revealing biological factors that make individuals susceptible to stress, it might be possible to alleviate health and longevity disparities in people.
Background: People's behaviors and intentions about healthy behaviors depend on their beliefs, values, and knowledge about the issue. Various models of health education are used in deter¬mining predictors of different healthy behaviors but their efficacy in cultural behaviors, such as water saving behaviors, are not studied. The study was conducted to explain water saving beha¬viors in Yazd, Iran on the basis of Health Belief Model and Reasoned Action Theory. Methods: The cross-sectional study used random cluster sampling to recruit 200 heads of households to collect the data. The survey questionnaire was tested for its content validity and reliability. Analysis of data included descriptive statistics, simple correlation, hierarchical multiple regression. Results: Simple correlations between water saving behaviors and Reasoned Action Theory and Health Belief Model constructs were statistically significant. Health Belief Model and Reasoned Action Theory constructs explained 20.80% and 8.40% of the variances in water saving beha-viors, respectively. Perceived barriers were the strongest Predictor. Additionally, there was a sta¬tistically positive correlation between water saving behaviors and intention. Conclusion: In designing interventions aimed at water waste prevention, barriers of water saving behaviors should be addressed first, followed by people's attitude towards water saving. Health Belief Model constructs, with the exception of perceived severity and benefits, is more powerful than is Reasoned Action Theory in predicting water saving behavior and may be used as a framework for educational interventions aimed at improving water saving behaviors. PMID:24688927
Morowatisharifabad, Mohammad Ali; Momayyezi, Mahdieh; Ghaneian, Mohammad Taghi
BACKGROUND: This report assessed the proportion of US 10th graders (average age, 16) who saw a physician in the past year and were asked and given advice about their drinking. We hypothesized that advice would vary by whether students were asked about drinking and their drinking, bingeing, and drunkenness frequency. METHODS: A nationally representative sample of 10th graders in 2010 (N = 2519) were asked their past 30-day frequency of drinking, bingeing, and intoxication and whether, during their last medical examination, their drinking was explored and they received advice about alcohol’s risks and reducing or stopping. RESULTS: In the past month, 36% reported drinking, 28% reported bingeing, and 23% reported drunkenness (11%, 5%, and 7%, respectively, 6 or more times). In the past year, 82% saw a doctor. Of that group, 54% were asked about drinking, 40% were advised about related harms, and 17% were advised to reduce or stop. Proportions seeing a doctor and asked about drinking were similar across drinking patterns. Respondents asked about drinking were more often advised to reduce or stop. Frequent drinkers, bingers, and those drunk were more often advised to reduce or stop. Nonetheless, only 25% of them received that advice from physicians. In comparison, 36% of frequent sm