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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.
The need, benefit, and desirability of behavioralhealthintegration in primary care is generally accepted and has acquired widespread positive regard. However, in many health care settings the economics, business aspects, and financial sustainability of practice in integrated care settings remains an unsolved puzzle. Organizational administrators may be reluctant to expand behavioralhealth services without evidence that such programs offer
Samantha Pelican Monson; J. Christopher Sheldon; Laurie C. Ivey; Carissa R. Kinman; Abbie O. Beacham
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…
|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…
Mental and behavioralhealth needs are more common in patients with other chronic medical illnesses. These mental and behavioralhealth problems are often associated with poor adherence to treatment, adverse healthbehaviors that complicate physical health problems, and excess health care costs. With the increased discussion of why integratingbehavioralhealth and primary care is important, we must understand the
This column describes recent policy and program initiatives implemented by the New York State Office of Mental Health to enhance integration of general medical and behavioralhealth services throughout the state public mental health system. Recent initiatives were implemented to improve access to health and wellness-oriented services, redesign managed care programs to improve engagement and retention of high-need individuals, and raise the bar on quality while lowering costs. Taken as a whole, these initiatives represent a 21st-century transformation of a state mental health authority into an accountable and more fully integrated public health delivery system. PMID:24026832
Smith, Thomas E; Erlich, Matthew D; Sederer, Lloyd I
This report provides on an integrative review of health promotion studies relevant to elementary school children published between 1986 and 1998. The 22 research articles represented several disciplines including public health and nursing. The studies varied in research design, sample characteristics, and approaches to health education. The most common interventions targeted behavioral risk factors for cardiovascular disease, but it also
The close interplay between mental health and physical health makes it critical to integrate mental and behavioralhealth considerations into all aspects of public health and medical disaster management. Therefore, the National Biodefense Science Board (NBSB) convened the Disaster Mental Health Subcommittee to assess the progress of the US Department of Health and Human Services (HHS) in integrating mental and behavioralhealth into disaster and emergency preparedness and response activities. One vital opportunity to improve integration is the development of clear and directive national policy to firmly establish the role of mental and behavioralhealth as part of a unified public health and medical response to disasters. Integration of mental and behavioralhealth into disaster preparedness, response, and recovery requires it to be incorporated in assessments and services, addressed in education and training, and founded on and advanced through research. Integration must be supported in underlying policies and administration with clear lines of responsibility for formulating and implementing policy and practice. PMID:22490938
Pfefferbaum, Betty; Flynn, Brian W; Schonfeld, David; Brown, Lisa M; Jacobs, Gerard A; Dodgen, Daniel; Donato, Darrin; Kaul, Rachel E; Stone, Brook; Norwood, Ann E; Reissman, Dori B; Herrmann, Jack; Hobfoll, Stevan E; Jones, Russell T; Ruzek, Josef I; Ursano, Robert J; Taylor, Robert J; Lindley, David
Extensive research supports the biopsychosocial model, but the current health care system generally operates according to a model of mind-body dualism. Integrated primary behavioralhealth care offers an alternative to this dualism. This paper describes the University of Louisville Graduate Psychology Education (GPE) program, a pre-doctoral integrated primary behavioralhealth care training program. This program emphasizes four shared psychosocial determinants
Tamara L. Newton; Janet Woodruff-Borden; Barbara A. Stetson
|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 article describes a model for integrating psychiatric rehabilitation services in a managed behavioralhealth care structure. Psychiatric rehabilitation and managed care are two distinct developments in the provision of mental health services that have proceeded independently though they can have compatible methods and outcomes. Descriptive detail is provided about a state initiative in Iowa to provide psychiatric rehabilitation services
Marsha Langer Ellison; William A. Anthony; John L. Sheets; William Dodds; William J. Barker; Joseph Massaro; Nancy J. Wewiorski
The Affordable Care Act has led to a widespread movement to integratebehavioralhealth services into primary care settings. Integratedbehavioralhealth (IBH) holds promise for treating mild to moderate psychiatric disorders in a manner that more fully addresses the biopsychosocial spectrum of needs of individuals and families in primary care, and for reducing disparities in accessing behavioralhealth care. For behavioralhealth practitioners, IBH requires a shift to a brief, outcome-driven, and team-based model of care. Despite the fact that social workers comprise the majority of behavioralhealth providers in IBH settings, little research has been done to assess the extent to which social workers are prepared for effective practice in fast-paced primary care. We conducted a survey of social workers (N = 84) in IBH settings to assess the following: (1) Key competency areas for social work practice in IBH settings and (2) Self-rated preparedness for effective practice in IBH settings. Online snowball sampling methods were used over a period of 1 month. Results indicate that social workers feel prepared for general practice in IBH settings, but would benefit from additional training in IBH-specific competency areas identified in the survey. Findings can help guide social work training to improve workforce preparedness for practice in IBH settings in the wake of health care reform. PMID:24028739
The rapid growth in the use of smartphones has opened a new world of opportunities for use in behavioralhealth care. Mobile phone software applications (apps) are available for a variety of useful tasks to include symptom assessment, psychoeducation, resource location, and tracking of treatment progress. The latest two-way communication functionality of smartphones also brings new capabilities for telemental health.
David D. Luxton; Russell A. McCann; Nigel E. Bush; Matthew C. Mishkind; Greg M. Reger
Individuals with co-occurring serious mental illness and substance use disorders experience a highly fragmented system of care, contributing to poor health outcomes and elevated levels of unmet treatment needs. Several elements in the health care reform law may address these issues by enhancing the integration of physical and behavioralhealth care systems. The purpose of this paper is to analyze these elements, which fall into three domains: increasing access, restructuring financing and reimbursement mechanisms, and enhancing infrastructure. We conclude with a consideration of the implementation challenges that lie ahead. PMID:22371190
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 simultaneously teaching family practice physicians to take the lead in providing these services. The Deering Community Health Center in Billings, Montana, is a Federally Qualified Health Center serving a largely low-income patient population. The medical care at the clinic is provided primarily by the faculty and residents of the Montana Family Medicine Residency. The teaching model was founded on the belief that improved care will result when physicians have increased comfort with, and are able to enjoy the challenges of, patients with mental illnesses. The enhanced longitudinal curriculum incorporates mental health across the 3 years of the family practice residency. Unique characteristics of this model include staffing and the concurrent delivery of a high volume mental health service while teaching family practice resident physicians and the faculty to integrate this competency into their primary care practices. PMID:16294659
The fundamental aim of healthcare reform is twofold: to provide health insurance coverage for most of the citizens currently uninsured, thereby granting them access to healthcare; and to redesign the overall healthcare system to provide better care and achieve the triple aim (better health for the population, better healthcare for individuals, and at less cost). The foundation for this improved system will rest on a redesigned (i.e., sufficiently comprehensive and integrated) system of primary care, with which all other providers, services, and sites of care are associated. The Patient-Centered Medical Home (PCMH) and its congeners are the best current examples of the kind of primary care that can achieve the triple aim, if they can become sufficiently comprehensive and can adequately integrate services. This means fully integratingbehavioral healthcare into the PCMH, a difficult task under the most favorable circumstances. Creating functioning accountable care organizations is an even more daunting task: this requires new principles of collaborating and financing and the current prototypes have generally failed to incorporate behavioral healthcare sufficient to meet even the basic needs of the target population. This paper will discuss (1) the case for and the difficulties associated with integratingbehavioral healthcare into primary care at three levels: the practice, the state, and the nation; and (2) how this looks clinically, operationally, and financially. PMID:24073136
Levey, Shandra M Brown; Miller, Benjamin F; Degruy, Frank Verloin
New federal parity and health reform legislation, promising increased behavioralhealth care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioralhealth care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes.
Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard
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
|Presents theoretical perspectives on children's health attitudes. Considers the influence of socialization agents, including families, schools, peers, and the media, on children's acquisition of health attitudes and behaviors. Examines implications of research for social policy, research, and modeling of child health attitudes and behavior. (BC)|
In substantial numbers of affected populations, disasters adversely affect well-being and influence the development of emotional problems and dysfunctional behaviors. Nowhere is the integration of mental and behavioralhealth into broader public health and medical preparedness and response activities more crucial than in disasters such as the 2009-2010 H1N1 influenza pandemic. The National Biodefense Science Board, recognizing that the mental and behavioralhealth responses to H1N1 were vital to preserving safety and health for the country, requested that the Disaster Mental Health Subcommittee recommend actions for public health officials to prevent and mitigate adverse behavioralhealth outcomes during the H1N1 pandemic. The subcommittee's recommendations emphasized vulnerable populations and concentrated on interventions, education and training, and communication and messaging. The subcommittee's H1N1 activities and recommendations provide an approach and template for identifying and addressing future efforts related to newly emerging public health and medical emergencies. The many emotional and behavioralhealth implications of the crisis and the importance of psychological factors in determining the behavior of members of the public argue for a programmatic integration of behavioralhealth and science expertise in a comprehensive public health response. PMID:22490939
Pfefferbaum, Betty; Schonfeld, David; Flynn, Brian W; Norwood, Ann E; Dodgen, Daniel; Kaul, Rachel E; Donato, Darrin; Stone, Brook; Brown, Lisa M; Reissman, Dori B; Jacobs, Gerard A; Hobfoll, Stevan E; Jones, Russell T; Herrmann, Jack; Ursano, Robert J; Ruzek, Josef I
Provision of integrated community case management (iCCM) for common childhood illnesses by community health workers (CHWs) represents an increasingly common strategy for reducing childhood morbidity and mortality. We sought to assess how iCCM availability influenced care-seeking behavior. In areas where two different iCCM approaches were implemented, we conducted baseline and post-study household surveys on healthcare-seeking practices among women who were caring for children ? 5 years in their homes. For children presenting with fever, there was an increase in care sought from CHWs and a decrease in care sought at formal health centers between baseline and post-study periods. For children with fast/difficulty breathing, an increase in care sought from CHWs was only noted in areas where CHWs were trained and supplied with amoxicillin to treat non-severe pneumonia. These findings suggest that iCCM access influences local care-seeking practices and reduces workload at primary health centers. PMID:23136285
Seidenberg, Philip D; Hamer, Davidson H; Iyer, Hari; Pilingana, Portipher; Siazeele, Kazungu; Hamainza, Busiku; MacLeod, William B; Yeboah-Antwi, Kojo
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 a systematic approach to bring together stakeholders across multiple domains. In this process we create a diagram using constructs from multiple healthbehavior theories at all levels of the social ecological framework as variables in causal loop diagrams. The goal of this process is to elucidate the reciprocal relationships between explanatory factors at various levels of the social ecological framework that render so many public health problems intractable. To illustrate, we detail a theory-based, replicable process for creating a qualitative diagram to enrich understanding of caregiver and provider behavior around adherence to pediatric asthma action plans. We describe how such diagramming can serve as the foundation for translating evidence into practice to address real-world challenges. Key insights gained include recognition of the complex, multilevel factors affecting whether, and how effectively, parents/caregivers and medical providers co-create an asthma action plan, and important "feedback" dynamics at play that can support or derail ongoing collaboration. Although this article applies this method to asthma action plan adherence in children, the method and resulting diagrams are applicable and adaptable to other healthbehaviors requiring continuous, daily action. PMID:23709516
Gillen, Emily M; Hassmiller Lich, Kristen; Yeatts, Karin B; Hernandez, Michelle L; Smith, Timothy W; Lewis, Megan A
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
Background Although health disparity research has investigated social structural, cultural, or psychological factors, the interrelations\\u000a among these factors deserve greater attention.\\u000a \\u000a \\u000a \\u000a \\u000a Purpose This study aims to examine cancer screening emotions and their relations to screening fatalism as determinants of breast cancer\\u000a screening among women from diverse socioeconomic and ethnic backgrounds.\\u000a \\u000a \\u000a \\u000a \\u000a Methods An integrative conceptual framework was used to test the multivariate relations among
Patricia M. Flynn; Hector Betancourt; Sarah R. Ormseth
\\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
In this article, I make the case for using an integrative approach to health, broadly defined as social, emotional, mental, and physical well-being; for studying health among the young as an important marker for future health and well-being across the life course; and for understanding health disparities among the young as both causes and consequences of social stratification. An integrative approach bridges biomedical sciences with social and behavioral sciences by understanding the linkages between social, behavioral, psychological, and biological factors in health. It is furthermore vital that integration occur in all steps of the research process: in theory, design, data collection, and analysis. I use the National Longitudinal Study of Adolescent Health, or Add Health, as an example of an integrative approach to health and of the importance of adolescence and the transition to adulthood years for setting health trajectories into adulthood. Evidence is also presented on the linkages between health trajectories during adolescence and the transition to adulthood and social stratification in adulthood.
|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, &…
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, &…
As the diversity in the patient population is growing, there is also an increasing number of diverse caregivers. Among them are the Filipino health care providers, most of whom are nurses. Understanding the culture, health care beliefs, and practices of Filipino nurses is important, as it affects the way they assess the needs and provide care for their clients. This
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
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. (PsycINFO Database Record (c) 2013 APA, all rights reserved). 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...
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...
The field of behavioral science has produced myriad data on healthbehavior change strategies and leveraged such data into effective human-delivered interventions to improve health. Unfortunately, the impact of traditional healthbehavior change interventions has been heavily constrained by patient and provider burden, limited ability to measure and intervene upon behavior in real time, variable adherence, low rates of implementation, and poor third-party coverage. Digital health technologies, including mobile phones, sensors, and online social networks, by being available in real time, are being explored as tools to increase our understanding of healthbehavior and to enhance the impact of behavioral interventions. The recent explosion of industry attention to the development of novel health technologies is exciting but has far outpaced research. This Special Section of Translational Behavioral Medicine, Smartphones, Sensors, and Social Networks: A New Age of HealthBehavior Change features a collection of studies that leverage health technologies to measure, change, and/or understand healthbehavior. We propose five key areas in which behavioral science can improve the impact of digital health technologies on public health. First, research is needed to identify which health technologies actually impact behavior and health outcomes. Second, we need to understand how online social networks can be leveraged to impact healthbehavior on a large scale. Third, a team science approach is needed in the developmental process of health technologies. Fourth, behavioral scientists should identify how a balance can be struck between the fast pace of innovation and the much slower pace of research. Fifth, behavioral scientists have an integral role in informing the development of health technologies and facilitating the movement of health technologies into the healthcare system. PMID:24073178
Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective structural health monitoring solution by integrating and extending technologies from various engineering and information technology disciplines. It is the authors opinion that all structural health monitoring systems must be application specific. Therefore, a specific application, monitoring welded moment resisting steel frame connections in structures subjected to seismic excitation, is described along with the motivation for choosing this application. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMS) technology, and statistical pattern recognition algorithms. The proposed system is based on an assessment of the deficiencies associated with many current structural health monitoring technologies including past efforts by the authors. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.
Structural health monitoring is the implementation of a damage detection strategy for aerospace, civil and mechanical engineering infrastructure. Typical damage experienced by this infrastructure might be the development of fatigue cracks, degradation of structural connections, or bearing wear in rotating machinery. The goal of the research effort reported herein is to develop a robust and cost-effective structural health monitoring solution by integrating and extending technologies from various engineering and information technology disciplines. It is the author's opinion that all structural health monitoring systems must be application specific. Therefore, a specific application, monitoring welded moment resisting steel frame connections in structures subjected to seismic excitation, is described along with the motivation for choosing this application. The structural health monitoring solution for this application will integrate structural dynamics, wireless data acquisition, local actuation, micro-electromechanical systems (MEMS) technology, and statistical pattern recognition algorithms. The proposed system is based on an assessment of the deficiencies associated with many current structural health monitoring technologies including past efforts by the authors. This paper provides an example of the integrated approach to structural health monitoring being undertaken at Los Alamos National Laboratory and summarizes progress to date on various aspects of the technology development.
Farrar, Charles R.; Sohn, Hoon; Fugate, Michael L.; Czarnecki, Jerry J.
Health protective behaviors are receiving increasing attention for maintaining health and preventing disease. Most research has examined specific healthbehaviors individually, with relatively few studies of the relationships between many health protective behaviors. This investigation examined how health protective behaviors were related with each other using data from the American Family Report, a survey of a national sample of 1,247 adults in U.S. families. Eighteen health protective behaviors were not all consistently intercorrelated with each other, with only 39% of the correlations significant at p less than .001. Factor analysis using oblique rotation revealed six underlying dimensions of health protective behaviors: not smoking, planned exercise, routine exercise, moderate drinking, absence of sedative use, and general healthbehaviors. These dimensions were associated with sociodemographic variables, particularly with higher education being associated with healthier behavior. The multidimensional nature of health protective behaviors needs to be considered in programs for enhancing prevention and health promotion. PMID:2341603
This research integrates the Theory of Planned Behavior (TPB) with aspects of social support and explores the utility of variables within each model in predicting the attainment of important health goals. Incorporating an idiographic methodology, 290 respondents ranging in age from 27 to 87 years were administered a postal survey and completed a brief follow-up telephone survey months later. The postal survey included measures of respondent's most important health goals, attitudes, motivation to comply with subjective norms, control beliefs, behavioral intention, and plan-of-action for attaining the health goal, as well as aspects of social support. The follow-up telephone survey inquired into respondents' successful goal attainment and health. Results indicate association, between TPB components and aspects of social support. Further, the emotional and instrumental support provided by a family member or friend and size of social support network were found to be unique predictors of health goal attainment after controlling for TPB components. The importance of personalized goals and social support in designing health interventions for older adults is discussed. PMID:15566011
The positive correlation between schooling and good health is well documented. One explanation is that schooling helps people choose healthier life-styles by improving their knowledge of the relationships between healthbehaviors and health outcomes. That is, schooling improves the household's allocative efficiency in producing health. This empirical study uses direct measures of health knowledge to test this explanation. Part of
In this article, I make the case for using an integrative approach to health, broadly defined as social, emotional, mental,\\u000a and physical well-being; for studying health among the young as an important marker for future health and well-being across\\u000a the life course; and for understanding health disparities among the young as both causes and consequences of social stratification.\\u000a An integrative
The North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services works with partners to reduce the impact of behavioralhealth conditions in communities throughout the state. We review state-funded behavioralhealth initiatives that provide support to military personnel and their families, with special attention to public services and co-location efforts. PMID:21678691
Stein, Flo; Lancaster, Michael; Yaggy, Susan; Dickens, Regina Schaaf
Objectives. We examined the extent to which within-school segregation, as measured by unevenness in the distribution of Black and White adolescents across levels of the English curriculum (advanced placement–international baccalaureate–honors, general, remedial, or no English), was associated with smoking, drinking, and educational aspirations, which previous studies found are related to school racial/ethnic composition. Methods. We analyzed data from wave 1 of the National Longitudinal Study of Adolescent Health, restricting our sample to non-Hispanic Blacks (n = 2731) and Whites (n = 4158) who from 1994 to 1995 attended high schools that enrolled Black and White students. Results. White female students had higher predicted probabilities of smoking or drinking than did Black female students; the largest differences were in schools with high levels of within-school segregation. Black male students had higher predicted probabilities of high educational aspirations than did White male students in schools with low levels of within-school segregation; this association was attenuated for Black males attending schools with moderate or high levels of within-school segregation. Conclusions. Our results provide evidence that within-school segregation may influence both students' aspirations and their behaviors.
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. PMID:22140401
This report is the third in a series on the healthbehaviors of people in the Metropolitan Area. The data is from a 1981 study by the Minnesota Department of Health's Center for Health Statistics. The purpose of the reports is twofold: to increase the awa...
This paper reports upon an empirical study of healthbehaviors in adolescents and their parents. The study aimed at assessing: effects of parental healthbehaviors on that of their adolescents child; whether mother's and father's healthbehaviors have additive effects on the respective healthbehaviors of their child; and whether eventual effects of parental healthbehaviors decrease with increasing age
Despite their shared history, the Andean countries are socially and politically diverse, with heterogeneous health realities and complex integration processes. General developments such as the Latin American Free Trade Association and Latin American Integration Association have existed for decades, along with others of a regional scope, like the Andean Community of Nations, Caribbean Community, and Central American Common Market. The health field has a specific instrument in the Andean Region called the Hipólito Unánue Agreement, created in 1971. Integration processes have concentrated on economic aspects, based on preferential customs agreements that have led to an important long-term increase in trade. Less progress has been made in the field of health in terms of sharing national experiences, knowledge, and capabilities. Analysis of experiences in health has shown that integration depends on the countries' respective strengths and to a major extent on national political processes. PMID:17625652
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…
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 maintain a healthy relationship between the two. Problem areas focused on in this paper
Although mental illness treatment protocols exist, the organization and financing of screening and treatment services inhibit access. These challenges are compounded for refugees, immigrants, and other groups vulnerable due to their ethnicity, race, or culture. By creating a system-wide, collaborative, integrated model that recognizes and addresses critical clinical and economic aspects in the delivery of services, high quality, evidence-based care
RationaleDespite great strides in improving prenatal care utilization among American women, key perinatal indicators have remained stagnant or worsened in the past decade, and the United States continues to rank near the bottom compared to other developed countries. A new approach is needed if we are to achieve improvements in perinatal health.
This article highlights the important role of healthbehavior and health education (HBHE) research in public health genetics. Broadly defined, public health genetics is the integration of genetic advancements and technologies in the study and practice of public health. The potential role of HBHE within this area is presented across two intersecting continua—namely, the continuum between research and practice and
The Allegheny Initiative for Mental HealthIntegration for the Homeless (AIM-HIGH) was a 3-year urban initiative in Pennsylvania that sought to enhance integration and coordination of medical and behavioral services for homeless persons through system-, provider-, and client-level interventions. On a system level, AIM-HIGH established partnerships between several key medical and behavioralhealth agencies. On a provider level, AIM-HIGH conducted 5 county-wide conferences regarding homeless integration, attended by 637 attendees from 72 agencies. On a client level, 5 colocated medical and behavioralhealth care clinics provided care to 1986 homeless patients in 4084 encounters, generating 1917 referrals for care. For a modest investment, AIM-HIGH demonstrated that integration of medical and behavioralhealth services for homeless persons can occur in a large urban environment. PMID:17267708
Gordon, Adam J; Montlack, Melissa L; Freyder, Paul; Johnson, Diane; Bui, Thuy; Williams, Jennifer
|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.
Athletes are people for whom physical health is a key value. Health promoting behaviors are an integral part of athletes’ success. The aim of this article is to identify health criteria and health-related behaviors among athletes and their determinants in terms of temperament and personality features. The concept of healthy lifestyle as understood by athletes and their most important health
|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,…
In this paper, we review current approaches employed by both public health and computer science to develop tailored persuasive messages to foster health-related behavior change. It is based on this review that we propose an integrated framework for merging public health and computer science approaches. We believe that such a framework can lead to new methods to extend current tailoring
Rita Kukafka; Frances Morrison; Stephen B. Johnson
Dental hygienists help their clients develop health promoting behaviors, by providing essential information about general health, and oral health in particular. Individual health practices such as oral self-care are based on personal choices. The guiding principles found in healthbehavior models provide useful methods to the oral health care providers in promoting effective individual client behaviors. Theories provide explanations about observable facts in a systematic manner. Research regarding healthbehavior has explored the effectiveness and applicability of various health models in oral healthbehavior modification. The Health Belief Model, Transtheoretical Model and Stages of Change, Theory of Reasoned Action, Self-Efficacy, Locus of Control, and Sense of Coherence are examples of models that focus on individuals assuming responsibility for their own health. Understanding the strengths of each and their applicability to healthbehaviors is critical for oral health care providers who work with patients to adopt methods and modify behaviors that contribute to good oral health. This paper describes healthbehavior models that have been applied to oral health education, presents a critical analysis of the effectiveness of each model in oral health education, and provides examples of application to oral health education. PMID:16201062
Researchers and practitioners in healthbehavior and health education (HBHE) can play a pivotal leadership role in the integration of genomic advances to improve the public's health. The purpose of this article is to outline research and practice opportunities at the intersection of genomics and HBHE. We begin this article by briefly summarizing…
Wang, Catharine; Bowen, Deborah J.; Kardia, Sharon L. R.
|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…
This paper provides a critical review of the applicability of theoretical models of healthbehavior to workplace self-protective behavior. Value-expectancy, environmental\\/contextual, and behavior change models are reviewed. On this basis, an integrative framework is proposed that conceptualizes self-protective behavior as consisting of four stages or phases: hazard appraisal, decision making, initiation, and adherence. In addition, five general constructs are identified
The role of psychosocial protective factors in adolescent health-enhancing behaviors—healthy diet, regular exercise, adequate sleep, good dental hygiene, and seatbelt use—was investigated among 1,493 Hispanic, White, and Black high school students in a large, urban school district. Both proximal (health-related) and distal (conventionality-related) protective factors have significant positive relations with health-enhancing behavior and with the development of health-enhancing behavior. In
This article develops and tests a model of the individual and joint effects of various consumer characteristics on health information acquisition behaviors (e.g., using media sources) and health maintenance behaviors (e.g., restricting diet). Theory development overviews the interdisciplinary literature on health and proposes that health motivation independently influences consumers' preventive healthbehaviors while the effect of health ability on health
Religions typically prescribe their followers to display distinct behavior in consumption, production, and exchange. Well-known are the examples of Catholics not eating meat on Fridays during Lent, Hindus being vegetarian and Muslims and Jews avoiding pork, Muslims praying five times a day, and Jews and Christians observing the Sabbath. As a common theme in these examples, individuals are asked to
Problem Adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore identification of risk behavior is critical. Method A secondary analysis of data from a larger study investigated the health risk behavior of 56 foster youth using the CHIP-AE. Findings Foster youth had some increased risk behavior. Younger adolescents and those in kinship care had less risky behavior. Youth had more risk behavior when: in group homes, parental death, histories of physical or emotional abuse, or history of attempted suicide. Conclusions These results point to areas of strength and vulnerability in foster youth.
BACKGROUND: Most school health education programs focus on a single behavioral domain. Integrative programs that address multiple behaviors may be more efficient, but only if the elements of change are similar for these behaviors. The objective of this study was to examine which effective elements of school health education are similar across three particular behavioral domains. METHODS: A systematic review
Louk WH Peters; Gerjo Kok; Geert TM Ten Dam; Goof J Buijs; Theo GWM Paulussen
Research findings have shown the protective effect of religiosity - among both Christians and Israeli Jews - in terms of morbidity and mortality. To explore the relationship between religiosity and healthbehavior as a possible explanation for these findings we conducted 3056 telephone interviews, representing the Israeli adult urban Jewish population. Health status, healthbehavior, frequency of medical checkups, and
Purpose of the Study: This study examines health-risk behaviors among "Baby Boomer" caregivers and non-caregivers. Design and Methods: Data from the 2009 California Health Interview Survey of the state's non-institutionalized population provided individual-level, caregiving, and healthbehavior characteristics for 5,688 informal caregivers and…
Hoffman, Geoffrey J.; Lee, Jihey; Mendez-Luck, Carolyn A.
|Purpose of the Study: This study examines health-risk behaviors among "Baby Boomer" caregivers and non-caregivers. Design and Methods: Data from the 2009 California Health Interview Survey of the state's non-institutionalized population provided individual-level, caregiving, and healthbehavior characteristics for 5,688 informal caregivers and…
Hoffman, Geoffrey J.; Lee, Jihey; Mendez-Luck, Carolyn A.
This article examines integrality as one of the doctrinal principles of the Brazilian State Health Policy - the Unified Health System (SUS) - whose aim is to offer health care as a right and as a service. Integrality is the foundation around which managerial activity practices are organized and whose main challenge is guaranteeing access to the health care system's most complex assistance levels. We developed an analytical reference grounded on three dimensions: service organization, knowledge, the practices of health workers and government policy formulation with input from the population. Managerial practices are fertile ground for integrality and are the political arena in which public managers of different government levels, private service providers, health care workers and organized civil society participate. Integrality in health care can only occur through the democratic interaction of subjects involved in the creation of government responses which are capable of contemplating the differences expressed in the health care needs. PMID:17680089
Pinheiro, Roseni; Ferla, Alcindo; da Silva Júnior, Aluisio Gomes
Introduction Integratedhealth systems are considered a solution to the challenge of maintaining the accessibility and integrity of healthcare in numerous jurisdictions worldwide. However, decision makers in a Canadian health region indicated they were challenged to find evidence-based information to assist with the planning and implementation of integrated healthcare systems. Methods A systematic literature review of peer-reviewed literature from health sciences and business databases, and targeted grey literature sources. Results Despite the large number of articles discussing integration, significant gaps in the research literature exist. There was a lack of high quality, empirical studies providing evidence on how health systems can improve service delivery and population health. No universal definition or concept of integration was found and multiple integration models from both the healthcare and business literature were proposed in the literature. The review also revealed a lack of standardized, validated tools that have been systematically used to evaluate integration outcomes. This makes measuring and comparing the impact of integration on system, provider and patient level challenging. Discussion and conclusion Healthcare is likely too complex for a one-size-fits-all integration solution. It is important for decision makers and planners to choose a set of complementary models, structures and processes to create an integratedhealth system that fits the needs of the population across the continuum of care. However, in order to have evidence available, decision makers and planners should include evaluation for accountability purposes and to ensure a better understanding of the effectiveness and impact of health systems integration.
Armitage, Gail D.; Suter, Esther; Oelke, Nelly D.; Adair, Carol E.
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
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)
The purpose of this study was to investigate the relationships among health status, personal definition of health, and healthbehavior choice in the elderly. Self-assessed health status was measured using a modified Cantril Ladder, personal definition of health was measured using the Laffrey Health Conception Scale (LHCS), and healthbehavior…
Cognitive architectures are promising tools for creating simulations of human behavior because they were designed to model the cognitive processes that choose that behavior. However, the fact that multiple factors - e.g. physical, social, moral, political, economic - influence the actions of human beings is an obstacle to using these architectures because the various mechanisms the mind uses to consider each factor are currently best modeled using many different computational methods and no single architecture can easily implement them all. This paper presents a cognitive architecture for integrating models based on many different computational methods. It is intended to enable more realistic models and simulations of human behavior.
Everyone prefers health to ill-health, though some worry more about ill health than others and for others abstract health concerns seem to pale compared with the prospect of immediate hedonic pleasures. Two studies (n = 90, n = 70) utilized a ‘fit’ in self-regulatory focus approach (Higgins, 2000) to describe when and how worrying about health (versus focus on hedonic
Abstract Based on extensive literature review and empirical validation this paper aims to develop and test an integrative model of corporate entrepreneurial b ehavior. Indeed, how much do we know about the tactics that corporate entrepreneurs employ to promote entrepreneurial projects? Entrepreneurial behavior is generally defined as th e discovery, evaluation, and exploitation of entrepreneurial opportunities. Still, more investig ation
During the past 30 years, tobacco use among adolescents has substantially increased, resulting in major health problems associated with tobacco consumption. The purpose of this study was to identify adolescent smoking behaviors and to determine the relationship among smoking, specific demographic variables, and health risk behaviors. The sample consisted of 93 self-selecting adolescents. An ex post facto design was used
Nancy H. Busen; Vickie Modeland; Kamiar Kouzekanani
|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.
|As an objective toward its mission of providing HIV-AIDS education, the Higher Education Consortium for AIDS Prevention surveyed students of Florida's State University System to determine their health risk behaviors. The instrument used, the "Health Risk Behavior Survey for University Students," was adapted for college students from one used by…
|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…
Behavioralhealth services is a collective term used to describe all health problems manifested through an individual's behavior. Treatment may include a full range of mental health, alcohol and drug abuse services, as well as related social services, cri...
Fear of dental procedures and associated anxiety are widely accepted as important deterents to optimal oral health. Such health care-related fears and anxieties are also common in many areas of medicine. For both medical and dental care a large body of psychologically derived therapeutic modalities have evolved. These methods have been shown to interact positively with pharmacological therapies also designed to help patients better tolerate medical and dental treatment. Despite these findings, behavioral interventions have not found widespread acceptance in medical and dental practice. A multidimensional model which emphasizes the simultaneous consideration of pharmacologic, psychologic, and clinical dental factors is suggested in order to arrive at therapeutic decisions. Further research could address more powerful behavioral modalities, safer pharmacologic methods, and behavioral and pharmacologic combinations which interact optimally for particular clinical conditions.
The present paper argues that health promotion efforts, particularly those directed to resistant and high-risk workers, should be integrated into a corporate health strategy in which equal concern is expressed for individual lifestyle modification and the provision of safe and healthful working conditions. The current popularity of work-site health promotion is discussed, and the health promotion and occupational safety and health movements are compared and contrasted. Following this, ecologic models of health promotion are examined as a vehicle for addressing environmental and organizational influences, and this line of thinking is expanded into an integrative model of worker health. The proposed model features three interactive systems: (1) job demands and worker characteristics, (2) work environment, and (3) extraorganizational influences, and assigns an expanded role to environmental factors in promoting and protecting worker health. The principal goal of integrative programming is to devise complementary behavioral and environmental interventions that will have mutually reinforcing effects on workplace health problems. The remainder of the paper outlines the three phases of implementing such a program. PMID:8113926
\\u000a Behaviors such as tobacco smoking, alcohol consumption, physical activity (or a sedentary lifestyle) and diet are major determinants\\u000a of health because of their causal effects on cardiovascular diseases, cancers, and many other chronic diseases (The World\\u000a Health Report, 2002). Some other health-related behaviors such as the abuse of narcotic drugs (which lead to premature death\\u000a for a variety of reasons)
The purpose of this paper is to present a new theoretical framework for dealing with health-protective behaviors (HPBs), including\\u000a behaviors designed to prevent diseases or maintain health after it has become impaired. In the first part, we present and\\u000a evaluate four common theories applied with regard to HPBs (health belief model, reasoned action, subjective expected utility,\\u000a and protection motivation). The
Purpose of the Study: This study examines health-risk behaviors among “Baby Boomer” caregivers and non-caregivers. Design and Methods: Data from the 2009 California Health Interview Survey of the state’s non-institutionalized population provided individual-level, caregiving, and healthbehavior characteristics for 5,688 informal caregivers and 12,941 non-caregivers. Logistic regression models were estimated separately for four individual health-risk behaviors—smoking, sedentary behavior, and regular soda and fast-food consumption—as well as a global health-risk measure. Results: Controlling for psychological distress and personal characteristics and social resources such as age, gender, income and education, work and marital status, and neighborhood safety, caregivers had greater odds than non-caregivers of overall negative healthbehavior and of smoking and regular soda and fast-food consumption. We did not observe significant differences in odds of negative behavior related to stress for spousal caregivers and caregivers in the role for longer periods of time or those providing more hours of weekly care compared with other caregivers. Implications: Our study found evidence that Baby Boomer caregivers engage in poor healthbehaviors that are associated with exposure to caregiving. Baby Boomer caregivers may be at risk for certain behavioral factors that are associated with disability and chronic illness.
Hoffman, Geoffrey J.; Lee, Jihey; Mendez-Luck, Carolyn A.
American medicine faces many contradictions and dilemmas. This is especially the case with regard to preventive healthbehavior. This paper explores the effects of several issues, contradictions and dilemmas on the American experience with primary preventive healthbehavior. These issues include: individualism, victim blaming, therapeutic nihilism, the over abundance of health information, America as a culture of risk takers, and the dilemma of the jungle vs the zoo. Four types of healthbehavior are defined. The first type of healthbehavior is the primary prevention of disease, defect, injury or disability. The second type is detection of asymptomatic disease, injury and defect. Third, is the promotion of enhanced levels of health, wellness and quality of life. And the fourth, at a more societal level, protective behaviors to make environmental transactions safe from disease, injury, defect and disability. These four types of healthbehavior are each explored in relation to societal values, technology and economics to determine which of these facilitate or impede healthbehavior at both the individual and societal levels. PMID:8235735
The social and behavioral sciences are at a crossroads in public health. In this paper, we attempt to describe a path toward the further integration of the natural and behavioral sciences with respect to the study of behavior and health. Three innovations are proposed. First, we extend and modify the “stream of causation” metaphor along two axes: time, and levels
In the presence of numerous healthbehavior theories, it is difficult to determine which of the many theories is most precise in explaining health-related behavior. New models continue to be introduced to the field, despite already existing disparity, overlap, and lack of unification among health promotion theories. This paper will provide an overview of current arguments and frameworks for testing and developing a comprehensive set of healthbehavior theories. In addition, the authors make a unique contribution to the HIV healthbehavior theory literature by moving beyond current healthbehavior theory critiques to argue that one of the field’s preexisting, but less popular theories, Social Action Theory (SAT), offers a pragmatic and broad framework to address many of the accuracy issues within HIV healthbehavior theory. The authors conclude this article by offering a comprehensive plan for validating model accuracy, variable influence, and behavioral applicability of SAT.
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
Advanced high performance materials and components such as CFRP, GFRP and Smart Structures require improved testing techniques. The first part of our contribution deals with nonlinear vibrometry as a defect selective non-destructive testing method. This method uses higher harmonics (which are generated only at defects) to locate the defect by scanning across the surface of the sample with a laser interferometer. For input coupling of the elastic wave both an external (like ultrasound welding converters) or internal (integrated piezo actuators) excitation source can be used. The external detection tools are a microphone or a scanning laser vibrometer. With this technique, we characterized Smart Structures made of aerospace materials and composites with embedded piezoelectric actuators. The next part is about health monitoring techniques and diagnostics where integrated elements are used for excitation and detection. Thus, we monitored the transfer function over a large frequency spectrum and especially its changes caused e.g. by defects. Changes in the properties of structures by fatigue, impacts, and thermoplasticity have been successfully observed. Also the changes in reinforced plastics under tensile stress have been monitored. The results were correlated with destructive measurements. For health monitoring we also present the impedance analysis of embedded piezo ceramic sensors. A defect causes changes in the modal response of the hole structure and that effect can be detected using the phase angle of the electric impedance of the piezo element. Additionally some types of defects cause a non-linear behavior of the structure which was verified by extracting higher harmonics as a reaction to sinusoidal single frequency excitation.
Pfleiderer, Klaus; Stoessel, Rainer; Busse, Gerhard
Introduction To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.
Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna
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...
Health Link Alberta is a model of successful regional integration. Launched as a single-region service in 2000, Health Link Alberta was rolled out as a province-wide service in 2003, operating as one service from two sites (Calgary and Edmonton). Provincial integration of Health Link Alberta was successful because it took the time to establish collaborative governance structures, build relationships with regional and provincial stakeholders, recognize and accommodate regional and local needs, and develop the processes and tools that it needed to deliver a quality, consistent and accessible service for all Albertans. Within three years, Health Link Alberta achieved 63% awareness and 46% utilization among all Alberta households. PMID:20057251
In the presence of numerous healthbehavior theories, it is difficult to determine which of the many theories is most precise in explaining health-related behavior. New models continue to be introduced to the field, despite already existing disparity, overlap, and lack of unification among health promotion theories. This paper will provide an overview of current arguments and frameworks for testing
\\u000a This exploration of the interaction between the legal system and behavioralhealth starts with a narrative description of\\u000a the legal causes of action that are likely to involve behavioralhealth concerns, either as an issue in dispute or as a factor\\u000a in the dispute resolution process. The discussion then turns to what does and does not work in the legal
Homoeopathy is a therapy which involves many components and three main agents: the patient, with his or her condition and personal characteristics; the medication used, with its composition and manufacturing procedure; and the physician, with his or her approach to treatment and concepts of health. The development of research and evaluation structures, combined with a critical education in the discipline, would help to improve practices and define homoeopathy's potential role in relation to the other therapies, both conventional and unconventional, used in Western health systems.
|This study explored the relationship between student adjustment theory and college student healthbehaviors. Specifically, this research examined first-year freshmen college student physical activity and nutrition behaviors and impact on adjustment to college (N = 37,564). The design for this study was a non-experimental "ex post facto"…
Tailored health communication research represents a very promising line of inquiry that has the potential to produce major impacts on lifestyle behaviors. This study defines tailoring and discusses how tailored interventions operate, including comparing\\/ contrasting different tailoring channels. Next, the authors review the literature on tailored interventions to change lifestyle behaviors, with a focus on smoking cessation, dietary change, and
Seth M. Noar; Nancy Grant Harrington; Stephanie K. Van Stee; Rosalie Shemanski Aldrich
Motivational interviewing (MI) is an empirically supported intervention with a large evidentiary base in the adult behavioral medicine and addictions literature. In the last decade, a growing body of research has shown promise for the use of MI in healthbehavior change settings with pediatric populations. This article provides a description of MI and its differences from other pediatric counseling
Objectives. This study sought to determine the relationships between race\\/ethnicity, socioeconomic status (SES), and cardiovascular healthbehaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. Methods. Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial\\/ethnic minority concentration, urbanization) on dietary habits, physical ac- tivity, and smoking among 8165
|Investigated relative influence of background characteristics (age, gender, race, socioeconomic status, family type) and peer status on health-related behaviors (physical activity, eating habits, smoking, alcohol use, stress-related behaviors) in 589 junior high school students. Peer popularity provided no significant increment in prediction of…
This study explored the relationship between student adjustment theory and college student healthbehaviors. Specifically, this research examined first-year freshmen college student physical activity and nutrition behaviors and impact on adjustment to college (N = 37,564). The design for this study was a non-experimental "ex post facto"…
Few researchers have examined where African American men obtain, process, and use health information. A thematic analysis of data from eighteen exploratory focus groups conducted with 154 urban African American men aged 32 years and older revealed that men received health information from a variety of sources, including health professionals, media, and members of their social networks. At times, information raised their awareness of health issues, but trust in the source of the information influenced how this information was perceived. Medical professionals were the most common source of health information, but family members were the most trusted source of health information. Health problems and social support increased men's motivation to use health information in order to improve their health and healthy behaviors. These findings illustrate that it is critical to identify factors that influence what information men choose to believe and follow or decide to ignore. PMID:22178902
Griffith, Derek M; Ellis, Katrina R; Ober Allen, Julie
|With rising interest in the role of treatment integrity on student outcomes, research has primarily focused on isolating the techniques and procedures necessary to improve staff's acquisition and maintenance of adequate levels of integrity. Despite increasing numbers of publications on this topic, there has been little discussion of the variables…
Reed, Derek D.; Fienup, Daniel M.; Luiselli, James K.; Pace, Gary M.
With rising interest in the role of treatment integrity on student outcomes, research has primarily focused on isolating the techniques and procedures necessary to improve staff's acquisition and maintenance of adequate levels of integrity. Despite increasing numbers of publications on this topic, there has been little discussion of the variables…
Reed, Derek D.; Fienup, Daniel M.; Luiselli, James K.; Pace, Gary M.
|Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview…
This document reports on a study to analyze the success of a revised health/wellness course at Gettysburg College (Pennsylvania). The research focused on two questions: (1) what increased knowledge and behavioral change students report once they have completed their health course; and (2) after a period of time, what students will say about the…
The purpose of this research was to examine and describe the relationships among health status, marital status, income level, education level, age, and body mass index (BMI) with the added influence of spirituality on the health promotion behaviors of African American women, living in South Florida. The sample consisted of 137 women, 18 to 64 years of age, who were
|Examined cigarette smoking among health educators, their views about the effects of this behavior upon their audiences and beliefs about smoking in light of their professional role. Smokers and nonsmokers were significantly less included than former smokers to feel the role of health education is to convince people not to smoke. (Author/ABL)|
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
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.
Merrick, Elizabeth S. Levy; Hodgkin, Dominic; Horgan, Constance M.; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G.
This article is the second in a series of six on lifestyle assessment and behavior change. The first article presented an assessment tool called FANTASTIC, which has been tested for reliability and is currently in wide use. After assessment, family physicians must help patients decide to change—and give them guidance on how to change—unhealthy behaviors. This article explains how the family physician can use educational, behavioral and relaxation strategies to increase patients' motivation, maintain their commitment and teach them the skills needed to effect changes in healthbehavior.
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 foreign born population is an integral part of U.S. society and continues to experience a steady numerical increase. This study uses longitudinal data to determine the effects of culture and acculturation on the healthbehaviors of the foreign born. Drawing from the behavioral model of health service utilization for vulnerable populations (Gelberg, Andersen, & Leake, 2000), the assets effects
The current intervention trend for many of the mental health and behavioral problems faced by today's youth is an integrative approach that involves the community, families, and schools. Clinical assessment for serious mental health and behavioral problems can be an important component in the development of school-based screening programs. The…
This study evaluated the efficacy of a brief integrative multiple behavior intervention and assessed risk factors as mediators of behavioral outcomes among older adolescents. A randomized controlled trial was conducted with participants randomly assigned to either a brief intervention or standard care control with 3-month follow-up. A total of 479 students attending two public high schools participated. Participants receiving the intervention showed a significant reduction in quantity × frequency of alcohol use, and increases in fruit and vegetable consumption and frequency of relaxation activities, compared to those receiving the control, P's = .01. No effects were found on cigarette and marijuana use, exercise and sleep. Effect sizes were small with alcohol use cessation effects reaching medium size. Intervention effects were mediated by changes in peer influenceability for alcohol use, and self-efficacy and self-image for health promoting behaviors. Findings suggest that the brief intervention resulted in health risk and promoting behavior improvements for adolescents, with outcomes mediated by several risk factors. PMID:20661637
Werch, Chudley E; Bian, Hui; Carlson, Joan M; Moore, Michele J; Diclemente, Carlo C; Huang, I-Chan; Ames, Steven C; Thombs, Dennis; Weiler, Robert M; Pokorny, Steven B
This commentary discusses the role that Critical Access BehavioralHealth Agencies (CABHAs) currently play in meeting the behavioralhealth needs of people in North Carolina, the opportunities and challenges that CABHAs will confront under the state's section 1915(b)/(c) Medicaid waiver, and the future of CABHAs under the Affordable Care Act. PMID:22779152
Although research on HealthBehavior Theory (HBT) is being conducted at a rapid pace, the extent to which the field is truly moving forward in understanding healthbehavior has been questioned. This issue is examined in the current article. First, we discuss the problems within the HBT literature. Second, we discuss the proliferation of HBT and…
The goal of this study was to evaluate the effectiveness of a public health educational campaign to reduce backyard mosquito-larval habitats. Three communities each, within two New Jersey counties, were randomly selected to receive (1) both education and mosquito control, (2) education only, and (3)...
Background Appalachia is characterized by poor healthbehaviors, poor health status, and health disparities. Recent interventions have\\u000a not demonstrated much success in improving health status or reducing health disparities in the Appalachian region. Since one's\\u000a perception of personal health precedes his or her healthbehaviors, the purpose of this project was to evaluate the self-rated\\u000a health of Appalachian adults in relation
Brian N Griffith; Gretchen D Lovett; Donald N Pyle; Wayne C Miller
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
This paper presents an ongoing project in Sierra Leone to integratehealth information systems at district and national level through a novel approach. Employing solar-powered low-energy computers running Linux, a wide consortium of local and international actors have tried to counter the severe problems of electricity supply breakdowns and computer viruses. The paper discusses the experiences from this effort, as
J. Saeb; Edem Kwame Kossi; R. T. Golly-Kobrissa; O. Titlestad; J. Braa
Health risk behaviors among students attending 4-year colleges in California were examined. The Youth Risk Behavior Survey for College Students was administered in a two-stage (29 universities, 5,652 students) random sample. All campuses and 3,810 (69%) students participated in the survey. In the 30 days preceding the survey, 36.7% of the students had binged at least once while drinking; 25.3%
Kevin Patrick; Jennifer R. Covin; Mark Fulop; Karen Calfas; Chris Lovato
In response to calls to improve public health education and our own desire to provide a more relevant educational experience to our Master of Public Health students, the University of Alabama at Birmingham (UAB) School of Public Health designed, developed, and instituted a fully integrated public health core curriculum in the fall of 2001. This curriculum combines content from discipline-specific courses in biostatistics, environmental health, epidemiology, health administration, and the social and behavioral sciences, and delivers it in a 15 credit hour, team-taught course designed in modules covering such topics as tobacco, infectious diseases, and emergency preparedness. Weekly skills-building sessions increase student competence in data analysis and interpretation, communication, ethical decision-making, community-based interventions, and policy and program planning. Evaluations affirm that the integrated core is functioning as intended: as a means to provide critical content in the core disciplines in their applied context. As public health education continues to be debated, the UAB public healthintegrated core curriculum can serve as one model for providing quality instruction that is highly relevant to professional practice.
Petersen, Donna J.; Hovinga, Mary E.; Pass, Mary Ann; Kohler, Connie; Oestenstad, R. Kent; Katholi, Charles
Objective: This experimental longitudinal study was designed to examine the relationship between having a bone density through dual energy X ray absorptiometry (DXA) and osteoporosis preventing behaviors (OPB) among healthy postmenopausal women. Methods: Subjects were 203 healthy community-based women 50-65 years of age. Mediating variables were general knowledge of osteoporosis and revised health belief model variables. Treatment group women (n
Carol A. Sedlak; Margaret O. Doheny; Patricia J. Estok; Richard A. Zeller; Janice Winchell
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 about their children's health and health risk behaviors, underestimating the frequency of their children's alcohol,
We examined the relationships among age, health, beliefs, and possible-selves. Using a new approach based on health-related possible-selves, young-old and older individuals were separated into specific health types: (1) improvement or maintenance health hopes and (2) preventable or unpreventable health fears. The young-old perceived greater capability to achieve health hopes and reported more health activities than older individuals; the older group reported more maintenance than improvement. More unpreventable fears were related to experiencing higher pain and worse physical functioning. Health types provide useful information about individual differences in healthbehavior and beliefs and are sensitive to current health status. PMID:23221490
McGinty, Heather Lynn; Dark-Freudeman, Alissa; West, Robin Lea
|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 following behavior modification procedures were studied with hospitalized alcoholics: videotaped self-confrontation of drunken behavior, discrimination training for blood alcohol concentration, aversion training for overconsumption, discriminated avoidance practice, alcohol education, alternatives training, and behavior counseling. Some…
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.
We performed one of the first systematic, population-based surveys of women in Amish culture. We used these data to examine health status and health risks in a representative sample of 288 Amish women ages 18-45 living in Lancaster County, Pennsylvania, in particular for risks associated with preterm and low birthweight infants, compared with a general population sample of 2,002 women
Kirk Miller; Berwood Yost; Sean Flaherty; Marianne M. Hillemeier; Gary A. Chase; Carol S. Weisman; Anne-Marie Dyer
|It was hypothesized that a person's estimates of the preventability of health problems would be related to healthbehaviors such that a person who engages in healthfulbehavior should make higher estimates of preventability. A study was conducted to investigate the relationship between causal attribution of health problems and health-related…
Objectives Body weight, body mass index (BMI), body fat, and blood pressure are important indicators of a person's health. In this experimental study, we evaluated the effectiveness of an integrated personalized health care system, Health Improvement and Management System (HIMS)-everyday, which instantly provides subjects with biofeedback on their measured body weight, BMI, body fat and blood pressure using a database that stores subjects-customized information. Methods The subjects of this study used the system once or twice a week for 8 weeks. We analyzed the changes in their body weight, BMI, body fat, and blood pressure according to their respective usage of the system, and analyzed the changes in their perceived health status and health promoting behavior accordingly. Results Subjects' body weight, BMI, and blood pressure decreased significantly with respect to their individual usage of the system. Subjects who used the system more frequently showed significant improvement in their body weight, BMI, and body fat. However, subjects' perceived health status and health promoting behavior did not improve significantly. Conclusions The study showed that the biofeedback-based personalized health care system was effective in controlling middle-aged and elderly women' body weight, BMI, body fat, and blood pressure.
Lee, Hiye-Ja; Park, Seung-Hun; Ju, Se-Jin; Jin, Mi-Hwa; Park, Boc-Nam
Community Health Workers (CHWs) play a pivotal role in primary care, serving as liaisons between community members and medical providers. However, the growing reliance of health care systems worldwide on CHWs has outpaced research explaining their praxis – how they combine indigenous and technical knowledge, overcome challenges and impact patient outcomes. This paper thus articulates the CHW Praxis and Patient HealthBehavior Framework. Such a framework is needed to advance research on CHW impact on patient outcomes and to advance CHW training. The project that originated this framework followed Community-Based Participatory Research principles. A team of U.S.-Brazil research partners, including CHWs, worked together from conceptualization of the study to dissemination of its findings. The framework is built on an integrated conceptual foundation including learning/teaching and individual behavior theories. The empirical base of the framework comprises in-depth interviews with 30 CHWs in Brazil's Unified Health System, Mesquita, Rio de Janeiro. Data collection for the project which originated this report occurred in 2008–10. Semi-structured questions examined how CHWs used their knowledge/skills; addressed personal and environmental challenges; and how they promoted patient healthbehaviors. This study advances an explanation of how CHWs use self-identified strategies – i.e., empathic communication and perseverance – to help patients engage in healthbehaviors. Grounded in our proposed framework, survey measures can be developed and used in predictive models testing the effects of CHW praxis on healthbehaviors. Training for CHWs can explicitly integrate indigenous and technical knowledge in order for CHWs to overcome contextual challenges and enhance service delivery.
Pinto, Rogerio M.; da Silva, Sueli Bulhoes; Soriano, Rafaela
The impact of caring for a spouse with a progressive dementia on caregiver's healthbehaviors and health status was examined. Data collected from 44 spouse caregivers indicates that:• Providing full-time care interferes with preventive healthbehaviors (eating nutritiously, exercising) and contributes to high risk behaviors (overeating, alcohol and substance use);• Healthbehaviors are frequently used as coping strategies;• Caregivers rated
This study examined whether widowhood was associated with physical and mental health, healthbehaviors, and health outcomes using a cross-sectional (N = 72,247) and prospective (N = 55,724) design in women aged 50–79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better healthbehaviors than
Sara Wilcox; Kelly R. Evenson; Aaron Aragaki; Sylvia Wassertheil-Smoller; Charles P. Mouton; Barbara Lee Loevinger
There is a very substantial literature over the past 50 years on the advantages of early detection and intervention on the cognitive, communicative, and social-emotional development of infants and toddlers at risk for developmental delay due to premature birth or social disadvantage. Most of these studies excluded children with severe delays or other predisposing conditions, such as genetic or brain disorders. Many studies of children with biological or socio-developmental risk suggest that behavior disorders appear as early as three years and persist into adulthood if not effectively treated. By contrast, little is known about the infants and toddlers with established risk for severe delays, who make up a significant proportion of the population with dual diagnoses later in life.In the past decade, there has been a growing interest in early detection and intervention with children aged birth to three years, e.g. the P.L.99-457, Part C Birth-Three population, who may have disabilities and severe behavior problems, e.g. aggression, self-injury, and repetitive stereotyped behaviors. The available research is scattered in the behavior analytic literature, in the child development literature, as well as in the child mental health and psychiatry literature, the developmental disability literature, the animal modeling literature, and the genetics literature. The goal of this introductory overview is to integrate these literatures, by cross-referencing members of these various groups who have worked in this field, in order to provide the reader with an integrated picture of what is known and of future directions that need more research. PMID:23139733
Health-compromising behaviors such as physical inactivity and poor dietary habits are difficult to change. Most social-cognitive theories assume that an individual's intention to change is the best direct predictor of actual change. But people often do not behave in accordance with their intentions. This discrepancy between intention and behavior is due to several reasons. For example, unforeseen barriers could emerge,
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 objective of this study was to investigate health risk behavior among teenage offenders committed to a social-educational institution in a city in Greater Metropolitan Recife, Pernambuco State, Brazil. The sample included 241 males 12-18 years of age. Data were collected with a brief self-completed questionnaire used by the Centers for Disease Control and Prevention, translated and adapted for young Brazilians. 79.7% of subjects reported having carried a gun and 52.7% had been in fights involving physical aggression in the previous 12 months. Most of the young offenders smoked cigarettes (87.6%) and consumed alcohol (64.7%). The majority reported having sniffed inhalants (68.9%), and 81.3% had smoked marijuana. The vast majority (95.4%) reported being sexually initiated, most having had sex with more than one partner. Young offenders showed high rates of various health risk behaviors. PMID:18949233
Research that seeks to compare and contrast theories of behavior change and assess the utility of a particular theoretical model for changing two or more health-related behaviors is critical to advancing healthbehavior research. Theory- comparison can help us learn more about the processes by which people change and maintain healthbehaviors than does study of any single theory alone
This study compares community-based managed forests under different purposes of management, namely, state-driven “conservation” or community-designed utilization in two villages located in the Sopsai watershed, Nan Province, northern Thailand. The forest health under different intensity of uses is assessed in association with the collective behaviors and long-term purposes embedded in village social–cultural context. The study found no significant differences in
Nitaya Kijtewachakul; Ganesh P. Shivakoti; Edward L. Webb
The major morbidities and mortalities of adolescents are related to preventable risky behaviors, but how, when, and in whom these behaviors develop in early adolescence is unknown. The purpose of this study was to determine which set of risk factors and protective resources of school-age children were best predictors of health-risk behaviors in early adolescence. A longitudinal, cohort sequential design was used with a diverse sample of 1,934 children in grades 4 through 8. Parents provided demographic and neighborhood data for children through a mailed survey. Children completed valid scales annually at schools, using audio-computer-assisted self-interviewing (A-CASI) technology. Significant gender and racial/ethnic differences were found in carrying a weapon and using alcohol. Higher perceived levels of stress increased the risk for alcohol use as did riding in a car with a driver who was drinking. Healthbehaviors exhibited while in 4th through 6th grades protected early adolescents from alcohol use and riding in a car with a driver who was drinking. A parent's education and perceived safety in neighborhood protected against carrying a weapon and smoking. Many findings are similar to those of national samples, but others show positive differences in this localized sample, over 50% of whom were Latino. Protective resources suggest numerous nursing interventions to promote healthy adolescent development. PMID:21568625
|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.
|Results from the 1995 National College Health Risk Behavior Survey, which monitored health risk behaviors among U.S. college undergraduates via mailed surveys, indicate that many students' behaviors increase their likelihood of experiencing adverse health outcomes. Particularly high risks for college students include alcohol abuse, tobacco use,…
Douglas, Kathy A.; Collins, Janet L.; Warren, Charles; Kann, Laura; Gold, Robert; Clayton, Sonia; Ross, James G.; Kolbe, Lloyd J.
Objective. There has been a strong push toward the recognition and treatment of children with behavioralhealth problems by primary care pediatri- cians. This study was designed to assess the extent to which a sample of primary care pediatricians diagnose and treat behavioralhealth problems and to identify factors that may contribute to their behavioralhealth practice. Methods. A standard
Jane Williams; Kurt Klinepeter; Guy Palmes; Anita Pulley; Jane Meschan Foy
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.
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.
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
Behavioralhealth disorders result in significant economic loss through costs associated with inpatient admissions, lost work days and reduction in at-work productivity. Additionally, over 30% of health plan members with complex health issues have at least one behavioralhealth issue driving cost risk. This paper looks at graphical representations of cost as part of an effort to develop an overall
This study uses structural equation modeling and a panel design to explain participation in health protective behavior (HPB) among college students. The direct, indirect, and total effects of gender, social influences (parental and peer behavior), social attachments (activity involvement, social support, and romantic involvement), social triggers (personal health, acute illnesses, and personal or family health crisis), health value, and effort
Gregory L. Weiss; Daniel L. Larsen; W. Kevin Baker
Secondary HIV prevention, or “positive prevention,” is concerned with reducing HIV transmission risk behavior and optimizing the health and quality of life of people living with HIV/AIDS (PLWHA). The association between mental health and HIV transmission risk (i.e., sexual risk and poor medication adherence) is well established, although most of this evidence is observational. Further, a number of efficacious mental health treatments are available for PLWHA yet few positive prevention interventions integrate mental health treatment. We propose that mental health treatment, including behavioral and pharmacologic interventions, can lead to reductions in HIV transmission risk behavior and should be a core component of secondary HIV prevention. We present a conceptual model and recommendations to guide future research on the effect of mental health treatment on HIV transmission risk behavior among PLWHA.
Sikkema, Kathleen J.; Watt, Melissa H.; Drabkin, Anya S.; Meade, Christina S.; Hansen, Nathan B.; Pence, Brian W.
We have provided a detailed evaluation of how collaboration between an Ontario public health unit and its primary care providers facilitated an optimal response to the 2009 H1N1 influenza pandemic. Family health teams (integrated, interdisciplinary teams that provide a range of care options) provided flu assessment centers, with public health as a partner providing infection control advice, funding, coordination, antiviral medication, clinical care guidelines, supplemental nurse staffing, and arrangement of communication strategies with the public. The family health team structure offers a new capacity for timely, coordinated, and comprehensive response to public health emergencies, in partnership with public health, and provides a promising new direction for healthcare organization. PMID:22994249
Substance use disorders are highly prevalent among adults with mental health disorders. In many health service delivery areas, mental health and addictions services are delivered separately. However, current best practices indicate that integration of mental health and addictions services can lead to better outcomes for clients with co-occurring disorders, including fewer hospitalizations. Service integration in the community can occur in many ways, including full or partial program integration. While the delivery of mental health and addictions services must be responsive to the needs of the local community, fully integrated programs have the strongest evidence base for positive client outcomes. PMID:24066651
In response to a number of acts of violence and out of concern for the privacy of other patients, the ED at Akron (OH) Children's Hospital decided it was necessary to create a separate behaviorhealth unit. Here are some of the strategies they used: Rooms were designed (i.e., lighting and sound) to minimize the risk of escalation in agitated patients. Out of concern for patient safety, there is no heavy equipment or medical gasses in the rooms. ED leadership solicited input from patients' parents before finalizing their plans. PMID:21049776
Summary Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development\\u000a and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also\\u000a incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers.\\u000a \\u000a \\u000a \\u000a \\u000a Introduction The “product” in social marketing is generally a
Psychology has made significant strides in developing applications relevant to public health. However, improvements are still needed to integrate psychology into the public health infrastructure. The challenge for public health is to recognize psychology's special contributions to policy and practice, especially to prevention of disease and injury. The challenge for psychology is to assure coherent integration of relevant theories, knowledge
|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
A major problem in leadership research and theory has been lack of agreement about which behavior categories are relevant and meaningful. It is difficult to integrate findings from five decades of research unless the many diverse leadership behaviors can be integrated in a parsimonious and meaningful conceptual framework. An emerging solution is a hierarchical taxonomy with three metacategories (task, relations,
BACKGROUND: Health auxiliary personnel have an important role in oral health promotion when they graduate and start working in the health care system. This study aims to find out oral health knowledge and oral healthbehavior of male Health Sciences College students. METHODS: A questionnaire was distributed to all students at the male Health Sciences College in Kuwait (N =
Previous research suggests that time perspective relates to healthbehavior; however, researchers have frequently employed inconsistent operational definitions and have often used projective or unpublished measures. The Zimbardo Time Perspective Inventory was created to provide a sound, objective measure of five distinct time perspective components. We examined the independent prediction of both risky and protective healthbehaviors from future, hedonistic, and fatalistic time perspective in 1,568 undergraduates using the ZTPI. Healthbehaviors included alcohol, drug, tobacco, and seat belt use, sex behaviors, and exercise. Future time perspective was related to increased protective and decreased risky healthbehaviors, whereas hedonism exhibited an opposite pattern though was a stronger predictor; fatalism was related only to health-destructive behaviors. Gender interactions reveal that hedonism is a stronger predictor of risky healthbehaviors for females.
Henson, James M.; Carey, Michael P.; Carey, Kate B.; Maisto, Stephen A.
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
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 current research on the integration of HIT into clinical guidelines, a methodology for updating and altering the clinical guideline development process to include exploration of HIT and an updated version of the Patient Journey Modeling Architecture (PaJMa) to include a technology layer to assist in visually depicting how HIT can benefit healthcare. PMID:19963615
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…
Because all health conditions for which the National Institute of Mental Health (NIMH) is responsible manifest at the level of behavior, and all interventions must have an impact at the behavioral level, NIMH is firmly committed to the support of behavioral science. In an era in which research in areas that some view as reductionist—for example, genomics, genetics, functional genomics
Background: Lung cancer survivors are at an increased risk for recurrence and the development of secondary tumors and other comorbid conditions. However, little is known about lung cancer survivors' risk behaviors and the effect of these behaviors on overall health perceptions. Objective: The purpose of this study was to describe the prevalence of health risk behaviors among non-small cell lung
Lorraine S. Evangelista; Linda Sarna; Mary Lynn Brecht; Geraldine Padilla; Jenny Chen
The aim of this article is to bring clarity and unification to the question of how certain complex behaviors, such as feeding, learning, language, culture, and neural complexity, are related. Three critical ideas—the organizing principle of integrative levels, the tendency for increased complexity with evolutionary change, and the contextual nature of behavioral events—are central to the discussion. A theoretical framework
Gary Greenberg; Ty Partridge; Emily Weiss; Maury M. Haraway
|The purpose of this article is to provide an overview of the current state of research in the area of treatment integrity as it relates to behavioral consultation. To this end, four primary topics are discussed. First, a rationale for why treatment integrity is an important professional and methodological concern is presented. Second,…
Sanetti, Lisa M. Hagermoser; Kratochwill, Thomas R.
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.
Counseling psychology can make a contribution to the newly emerging fields of health-related behavioral science, but the nature of that contribution will depend on counseling psychology's willingness to develop new perspectives and practices. The present authors compare 2 of these health orientations, behavioral medicine and health psychology, in an effort to establish counseling psychology's relationship with either of these approaches.
Obesity, mood, and associated behaviors spread within social networks . Facebook, the primary representation of these networks, shapes our perceptions of social norms and the expectations we set for ourselves. As such, Facebook holds potential to influence healthbehaviors of individuals and improve public health. This panel explores that potential from a variety of perspectives including psychology, public health, privacy,
Margaret E. Morris; Sunny Consolvo; Sean A. Munson; Kevin Patrick; Janice Y. Tsai; Adam D. I. Kramer
The purpose of this study was to explore the relationship between older adults' religiosity, sense of meaning in life, and healthbehavior. Three dimensions of religiosity were assessed: religious orientation (intrinsic and extrinsic), sanctification of the body, and relationship with God. Five healthbehaviors were measured: smoking, exercise, taking responsibility for one's own health, nutritious eating, and stress management. In
The impact of dietary behaviors and food consumption and their relation to oral health are significant public health issues. Women and men exhibit different dietary behaviors. Understanding the influences of dietary behaviors on oral health from the perspective of gender disparities, however, is limited. This article provides the intersections of dietary factors and oral-systemic health for which women are at greater risk than men. Topics include the effect of dietary choices on oral health disparities seen in female patients. Interventional strategies at the local and community level that are designed to influence the balance between dietary habits and oral-systemic health are discussed. PMID:23570803
Kim, Juhee; DeBate, Rita DiGioacchino; Daley, Ellen
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 maintaining challenging behavior. Results of these assessments were used to design function-based behavioral interventions for each participant. Recommendations for the sensory-integration treatment were designed by an Occupational Therapist, trained in the use of sensory-integration theory and techniques. The sensory-integration techniques were not dependent on the results of the functional assessments. The study was conducted within an alternating treatments design, with initial baseline and final best treatment phase. For each participant, results demonstrated that the behavioral intervention was more effective than the sensory integration therapy in the treatment of challenging behavior. In the best treatment phase, the behavioral intervention alone was implemented and further reduction was observed in the rate of challenging behavior. Analysis of saliva samples revealed relatively low levels of cortisol and very little stress-responsivity across the SIT condition and the behavioral intervention condition, which may be related to the participants' capacity to perceive stress in terms of its social significance. PMID:21161577
Devlin, Sarah; Healy, Olive; Leader, Geraldine; Hughes, Brian M
Published research demonstrates an association between exposure to media sexual content and a variety of sex-related outcomes for adolescents. What is not known is the mechanism through which sexual content produces this "media effect" on adolescent beliefs, attitudes, and behavior. Using the Integrative Model of Behavioral Prediction, this article uses data from a longitudinal study of adolescents ages 16 to 18 (N = 460) to determine how exposure to sexual media content influences sexual behavior. Path analysis and structural equation modeling demonstrated that intention to engage in sexual intercourse is determined by a combination of attitudes, normative pressure, and self-efficacy but that exposure to sexual media content only affects normative pressure beliefs. By applying the Integrative Model, we are able to identify which beliefs are influenced by exposure to media sex and improve the ability of health educators, researchers, and others to design effective messages for health communication campaigns and messages pertaining to adolescents' engaging in sexual intercourse. PMID:21606378
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.\\u000aMETHODS: 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
Glorian Sorensen; Anne M. Stoddard; Mary K. Hunt; James R. Hebert; Judith K. Ockene; Jill Spitz Avrunin; Jay S. Himmelstein; S. Katharine Hammond
The objective of the current study was to compare the effects of sensory-integration therapy (SIT) and a behavioral intervention\\u000a on rates of challenging behavior (including self-injurious behavior) in four children diagnosed with Autism Spectrum Disorder.\\u000a For each of the participants a functional assessment was conducted to identify the variables maintaining challenging behavior.\\u000a Results of these assessments were used to design
Sarah Devlin; Olive Healy; Geraldine Leader; Brian M. Hughes
The Health Belief Model was used as a conceptual framework for exploring how health beliefs and perceptions of heterosexism and homophobia in health care relate to lesbians' breast healthbehaviors, including use of breast exams and mammograms, visits to health care providers, and use of complementary\\/alternative care. A total of 173 exclusively homosexual women completed survey measures assessing health beliefs,
Adolescence is an important stage of life when healthbehaviors and attitudes are established. The purpose of this research was to assess health risk behaviors among Guatemalan students in both an urban and rural school. Items were adapted from the Global School-based Student Health Survey and were used to measure and compare the prevalence of risk behaviors between these two demographically and culturally distant school-based samples. In general, the prevalence of adolescent health risk behaviors in both schools was lower than other Latin American countries. Many health risk behaviors were associated with location (urban vs. rural settings) and/or gender. Tobacco use, alcohol use, and sexual activity were higher among urban students. Boys were more likely than girls to use alcohol, use tobacco, and be sexually active. In addition, the prevalence of mental health problems was higher among girls and rural students. These findings imply that measures should be taken to design effective and appropriate health strategies for adolescents attending these schools. Health promotion programs in schools and communities should assist the youth in developing positive healthbehaviors and cultivating healthy lifestyles in an effort to reduce risk behaviors among adolescent populations. Further research is needed to extend our understanding of risk factors of healthbehavior in these adolescent populations and to identify effective preventative approaches and strategies that specifically cater to the location and culture of the students. PMID:23314522
Foulger, Lauren; Page, Randy M; Hall, P Cougar; Crookston, Benjamin T; West, Joshua H
The Patient Protection and Affordable Care Act encourages use of payment methods and incentives to promote integrated care delivery models including patient-centered medical homes, accountable care organizations, and primary care and behavioralhealthintegration. These models rely on interdisciplinary provider teams to coordinate patient care; health information and other technologies to assure, monitor, and assess quality, and payment and financial incentives such as bundling, pay-for-performance, and gain-sharing to encourage value-based health care. In this paper, we review evidence about integrated care delivery, payment methods, and financial incentives to improve value in health care purchasing, and address how these approaches can be used to advance health system change. PMID:22397058
Internet technologies are increasingly facilitating real-time monitoring of Bridges and Highways. The advances in wireless communications for instance, are allowing practical deployments for large extended systems. Sensor data, including video signals, can be used for long-term condition assessment, traffic-load regulation, emergency response, and seismic safety applications. Computer-based automated signal-analysis algorithms routinely process the incoming data and determine anomalies based on pre-defined response thresholds and more involved signal analysis techniques. Upon authentication, appropriate action may be authorized for maintenance, early warning, and/or emergency response. In such a strategy, data from thousands of sensors can be analyzed with near real-time and long-term assessment and decision-making implications. Addressing the above, a flexible and scalable (e.g., for an entire Highway system, or portfolio of Networked Civil Infrastructure) software architecture/framework is being developed and implemented. This framework will network and integrate real-time heterogeneous sensor data, database and archiving systems, computer vision, data analysis and interpretation, physics-based numerical simulation of complex structural systems, visualization, reliability & risk analysis, and rational statistical decision-making procedures. Thus, within this framework, data is converted into information, information into knowledge, and knowledge into decision at the end of the pipeline. Such a decision-support system contributes to the vitality of our economy, as rehabilitation, renewal, replacement, and/or maintenance of this infrastructure are estimated to require expenditures in the Trillion-dollar range nationwide, including issues of Homeland security and natural disaster mitigation. A pilot website (http://bridge.ucsd.edu/compositedeck.html) currently depicts some basic elements of the envisioned integratedhealth monitoring analysis framework.
Fraser, Michael; Elgamal, Ahmed; Conte, Joel P.; Masri, Sami; Fountain, Tony; Gupta, Amarnath; Trivedi, Mohan; El Zarki, Magda
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
Individual differences in behavioral inhibition and behavioral activation may place certain people at greater risk for neuropsychiatric disorders and engagement in risky behaviors. Therefore, studying the neural correlates of behavioral inhibition and activation may help us understand neural mechanisms underlying risk behaviors in both clinical and non-clinical populations. To investigate, we assessed the relationships between white matter integrity and measures of behavioral inhibition and behavioral activation in 51 healthy participants using diffusion tensor imaging (DTI) and the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scale. Scores on the Fun-Seeking subscale of the BAS positively correlated with DTI fractional anisotropy (FA) in the left corona radiata and adjacent superior longitudinal fasciculus, and with mean diffusivity (MD) in the left inferior longitudinal fasciculus and inferior fronto-occipital fasciculus after controlling for age, gender, and education. These findings suggest that the integrity of white matter connecting extensive brain regions implicated in self-control and the processing of rewards and emotions are associated with individual differences in the motivation for seeking and participating in fun and novel experiences.
Xu, Jiansong; Kober, Hedy; Carroll, Kathleen M.; Rounsaville, Bruce J.; Pearlson, Godfrey D.; Potenza, Marc N.
Individual differences in behavioral inhibition and behavioral activation may place certain people at greater risk for neuropsychiatric disorders and engagement in risky behaviors. Therefore, studying the neural correlates of behavioral inhibition and activation may help us understand neural mechanisms underlying risk behaviors in both clinical and non-clinical populations. To investigate, we assessed the relationships between white matter integrity and measures of behavioral inhibition and behavioral activation in 51 healthy participants using diffusion tensor imaging (DTI) and the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scale. Scores on the Fun-Seeking subscale of the BAS positively correlated with DTI fractional anisotropy in the left corona radiata and adjacent superior longitudinal fasciculus, and with mean diffusivity in the left inferior longitudinal fasciculus and inferior fronto-occipital fasciculus after controlling for age, gender, and education. These findings suggest that the integrity of white matter connecting extensive brain regions implicated in self-control and the processing of rewards and emotions are associated with individual differences in the motivation for seeking and participating in fun and novel experiences. PMID:21618658
Xu, Jiansong; Kober, Hedy; Carroll, Kathleen M; Rounsaville, Bruce J; Pearlson, Godfrey D; Potenza, Marc N
The importance of integrating information about patients in intelligent tutoring systems (ITS) is the opportunity given to the students to direct their own learning. We propose an integration-architecture for sharing patient clinical data among tutoring and health information systems (HISs). HL 7 is used as a standard messaging protocol for collecting the clinical patient data distributed over health information systems.
Carolina González; Juan C. Burguillo; Martín Llamas
The Behavior Change Consortium (BCC), with funding from 17 Offices and Institutes of the National Institutes of Health (NIH), the American Heart Association, and the Robert Wood Johnson Foundation, was launched 4 years ago with the vision of improving the science and practice of healthbehavior change and achieving major population health benefits (1). Judging by the products and accomplishments
Background. Behavior is influenced by individual-level attributes as well as by the conditions under which people live. Altering policies, practices, and the conditions of life can directly and indirectly influence individual behavior. This paper builds on existing ecological theories of healthbehavior by specifying structural mechanisms by which population-level factors effect change in individual healthbehaviors.Methods. This paper moves ecological
Deborah A. Cohen; Richard A. Scribner; Thomas A. Farley
This paper discusses the topic of how the integrity of safety-critical structural composites can be enhanced by the use of structural health monitoring (SHM) techniques. The paper starts with a presentation of how the certification of flight-critical composite structures can be achieved within the framework of civil aviation safety authority requirements. Typical composites damage mechanisms, which make this process substantially different from that for metallic materials are discussed. The opportunities presented by the use of SHM techniques in future civil aircraft developments are explained. The paper then focuses on active SHM with piezoelectric wafer active sensors (PWAS). After reviewing the PWAS-based SHM options, the paper follows with a discussion of the specifics of guided wave propagation in composites and PWAS-tuning effects. The paper presents a number of experimental results for damage detection in simple flat unidirectional and quasi-isotropic composite specimens. Calibrated through holes of increasing diameter and impact damage of various energies and velocities are considered. The paper ends with conclusions and suggestions for further work.
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
|Examined associations between healthbehaviors and lifetime sexual partners. Data from the 1995 National College Health Risk Behavior Survey indicated that having two or more lifetime partners related to infrequent seatbelt use, driving after drinking, fighting, considering suicide, and using certain substances. Significant sex interactions…
Ogletree, Roberta J.; Dinger, Mary K.; Vesely, Sara
|This book examines the relationship between adolescent risk-taking behaviors and health. The health-related problems of adolescents frequently are manifestations of social, economic, or behavioral factors. Following an overview (Siegal), the chapters in the first section of the book explore general and conceptual issues: (1) "Epidemiology of…
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
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 stated goals of World Health Organization-supported behavioral research are applied: to contribute to planning and policy decision-making, and to improve health care delivery methods. The evidence suggests the organization is getting less for its behavioral research dollar than it ought to: much research has been of poor quality, and researchers often appear more concerned with research design elegance than
Objective: Stress in pregnancy predicts earlier birth and lower birth weight. The authors investigated whether pregnancy-specific stress contributes uniquely to birth outcomes compared with general stress, and whether prenatal healthbehaviors explain this association. Design: Three structured prenatal interviews (N = 279) assessing state anxiety, perceived stress, life events, pregnancy-specific stress, and healthbehaviors. Main Outcome Measures: Gestational age at
Marci Lobel; Dolores Lacey Cannella; Jennifer E. Graham; Carla DeVincent; Jayne Schneider; Bruce A. Meyer
|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%…
Purpose: The purpose of this article is to explore how kin and nonkin social support networks influence healthbehaviors among older Samoan women.Method: Using a cross-sectional survey design, 290 Samoan women who were age 50 years and older were interviewed. Using separate logistic regressions, each healthbehavior was regressed on age and kin and nonkin social support networks after controlling
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
This research provides a study of the behavior of vertically integrated boundary-layer winds (IBLWs). This information should be helpful for both theoretical and practical applications, e.g., boundary-layer parameterization in general circulation models, air pollution models, and low-level parachuting operations. The study concerned itself with winds integrated up to a height of 300 m in the United States. The only data
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.
Health-care providers increasingly recognize the need to address behavioural and emotional influences on physical health in order to provide quality and cost-effective services. As behaviour change experts, psychologists can be critically important in new models of integrated care that focus on both physical and psychological health. However, to be effective, psychologists must be prepared to address the major issues facing
Mary Beth Kenkel; Patrick H. Deleon; Elaine Orabona Mantell; Angie E. Steep
Psychology has made significant strides in developing ap- plications relevant to public health. However, improve- ments are still needed to integrate psychology into the public health infrastructure. The challenge .(or public health is to recognize psychology's special contributions to poli~T and \\
Health law is intended to create an environment in which the promotion of health goes hand in hand with the protection of individual rights and the general principles of equality and justice. Over the years, the importance of health law has grown, both at national and international level. As health and human rights are closely interlinked, it is important to
The mechanisms by which animals manage sensorimotor integration and coordination of different behaviors can be investigated in robot models. In previous work the first author has build a robot that localizes sound based on close modeling of the auditory and neural system in the cricket. It is known that the cricket combines its response to sound with other sensorimotor activities such as an optomotor reflex and reactions to mechanical stimulation for the antennae and cerci. Behavioral evidence suggests some ways these behaviors may be integrated. We have tested the addition of an optomotor response, using an analog VLSI circuit developed by the second author, to the sound localizing behavior and have shown that it can, as in the cricket, improve the directness of the robot's path to sound. In particular it substantially improves behavior when the robot is subject to a motor disturbance. Our aim is to better understand how the insect brain functions in controlling complex combinations of behavior, with the hope that this will also suggest novel mechanisms for sensory integration on robots.
Consumer Health Informatics (CHI) means different things to patients, health professionals, and health care systems. A broader perspective on this new and rapidly developing field will enable us to understand and better apply its advances. This article provides an overview of CHI discussing its evolution and driving forces, along with advanced applications such as Personal Health Records, Internet transmission of personal health data, clinical e-mail, online pharmacies, and shared decision-making tools. Consumer Health Informatics will become integrated with medical care, electronic medical records, and patient education to impact the whole process and business of health care. PMID:12238015
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.
Objective Current literature suggests that certain sources of information are used in varying degrees among different socioeconomic and demographic groups; therefore, it is important to determine if specific classes of health information sources are more effective than others in promoting healthbehaviors. Purpose To determine if interpersonal versus mass media sources of health information are associated with meeting recommendations for healthbehaviors (nonsmoking, fruit/vegetable intake, and exercise) and cancer screening. Methods Multivariable logistic regression models were used to examine the relationship of health information sources (mass media sources including print, TV, Internet; and interpersonal sources including friends and family, community organizations, and healthcare providers); with meeting recommendations for healthy behaviors and cancer screening in the 2005 and 2007 Health Information National Trends Surveys (HINTS). Analyses were conducted in 2009. Results In the 2005 HINTS, participants reporting use of print media and community organizations as sources of health information over the past year were mostly likely to meet recommendations for healthbehaviors. In the 2007 HINTS, utilization of healthcare providers for health information was associated with meeting recommendations for healthbehaviors, particularly cancer screening. Conclusions Use of print media and interpersonal sources of health information are most consistently associated with self-reported healthbehaviors. Additional research should explore the relationship of health information sources to clinical outcomes. Social network interventions to promote adoption of healthbehaviors should be further developed.
Both the literature review and the results of a behavioral change project conducted at the University of Oregon indicate that health courses can bring about positive lifestyle changes when behavior is made a focus of the class. A multi-faceted behavioral intervention strategy was developed and used with 433 students enrolled in personal health classes during the fall term, 1983. At
Randall R. Cottrell; Martha Carey; Ray Tricker; Kathleen Zavela
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
Clement K. Gwede; Robert J. McDermott; Wayne W. Westhoff; Moses Mushore; Tsungai Mushore; Elijah Chitsika; Charles S. Majange; Peter Chauke
|An exploratory study examined the relationship between individual, family, and work variables and working mothers' health. The study also investigated the relationship between health management strategies and health. A cross-sectional survey design was used to gather data from 85 women who were married, employed 20 hours a week or more, and had…
The courtship behavior of Drosophila melanogaster serves as an excellent model system to study how complex innate behaviors are controlled by the nervous system. To understand how the underlying neural network controls this behavior, it is not sufficient to unravel its architecture, but also crucial to decipher its logic. By systematic analysis of how variations in sensory inputs alter the courtship behavior of a naïve male in the single-choice courtship paradigm, we derive a model describing the logic of the network that integrates the various sensory stimuli and elicits this complex innate behavior. This approach and the model derived from it distinguish (i) between initiation and maintenance of courtship, (ii) between courtship in daylight and in the dark, where the male uses a scanning strategy to retrieve the decamping female, and (iii) between courtship towards receptive virgin females and mature males. The last distinction demonstrates that sexual orientation of the courting male, in the absence of discriminatory visual cues, depends on the integration of gustatory and behavioral feedback inputs, but not on olfactory signals from the courted animal. The model will complement studies on the connectivity and intrinsic properties of the neurons forming the circuitry that regulates male courtship behavior.
Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries. PMID:14744719
|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…
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…
This paper describes elements of an integrated modeling approach to human behavior and energy consumption. Developing a sustainable society is a key aspect of international security, and understanding the areas where consumption and carbon emissions can be reduced is essential. We employ statistical analysis of residential energy consumption in the US and other countries to describe the underlying patterns of
|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…
This paper presents a qualitative simulation method for analyzing employee group behavior by integrating QSIM (Qualitative SIMulation) with basic causal reasoning. A description method for complex interactions between environment, management policy and group behaviour is designed. A qualitative simulation method including the simulation rules and a simulation engine is then proposed. The validation of the proposed method is tested, and
|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 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
|Objective: To explore the sexual and reproductive healthbehaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…
Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp
Arguments based on the philosophies of natural law, utilitarianism, paternalism, and distributive justice are examined for their pertinence to healthbehavior change strategies. Health educators should prepare individuals to make health-generating decisions but may need to limit the conditions under which they intervene. (Author/PP)
|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…
Objective: To explore the sexual and reproductive healthbehaviors of students from 13 community college campuses in California. Participants: Heterosexual college students, ages 18 to 24, who have had sexual intercourse (N = 4,487). Methods: The American College Health Association's National College Health Assessment (ACHA-NCHA) survey was…
Trieu, Sang Leng; Bratton, Sally; Marshak, Helen Hopp
There is a growing but still fragile understanding that competition and integration are not necessarily in conflict and can be used together. In one version, this might mean using competition to drive improvements in performance in planned care, and promoting integration to do so in relation to unplanned care and care for people with complex needs. In another, it entails arguing that competition between integrated systems might offer the best of all worlds, if policies can be designed to support evolution in that direction. This paper suggests that a bundle of policy interventions is needed to support the evolution of integrated systems of care. It examines how policies might be crafted to make this happen; How to avoid the wrong kind of integration to develop; and, how can policy-makers enable competition between integrated systems. PMID:22977423
|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…
This article describes three approaches to conducting integrated research on brain–behavior relations in infancy. These approaches include: conducting an integrative study that tests the same cognitive construct using behavioral and event-related potential (ERP) measures in separate experiments, measuring behavior and ERPs in different phases of the same experiment, and measuring behavior and ERPs simultaneously. We review studies that have utilized
Establishing a functional relationship between the independent and the dependent variable is the primary focus of applied behavior analysis. Accurate and reliable description and observation of both the independent and dependent variables are necessary to achieve this goal. Although considerable attention has been focused on ensuring the integrity of the dependent variable in the operant literature, similar effort has not been directed at ensuring the integrity of the independent variable. Inaccurate descriptions of the application of the independent variable may threaten the reliability and validity of operant research data. A survey of articles in the Journal of Applied Behavior Analysis demonstrated that the majority of articles published do not use any assessment of the actual occurrence of the independent variable and a sizable minority do not provide operational definitions of the independent variable. The feasibility and utility of ensuring the integrity of the independent variable is described.
This study examined the impact of a health promoting television program series on health knowledge and the key factors of the health belief model (HBM) that have led people to engage in healthy behavior (exercising, losing weight, changing eating habits, and not smoking/quitting smoking). Using data from a posttest comparison field study with 15) viewers and 146 nonviewers in Poland, we found that hierarchical regression analysis showed stronger support for the HBM factors of efficacy, susceptibility, seriousness, and salience in their contribution toward healthbehavior among television viewers compared with nonviewers. Cues to action variables (including television viewing) and health knowledge boosted efficacy among viewers. Without the advantage of receiving health information from the television series, nonviewers relied on their basic disease fears on one hand, and interest in good health on the other to take steps toward becoming healthier. A health promoting television series can increase health knowledge and enhance health beliefs, which in turn contribute to healthy behaviors. PMID:12166872
This paper intends to report an experience with the process of integrated planning in a Basic Health Unit at Riberiao Preto-SP. we selected as our object of analysis the interactions and dialogues that were expressed in the scope of the local health system. Therefore, we sought to consider the individual dynamics of this reality and the social agents involved (teachers, students, directors, health workers and community workers), trying to understand the communicative action according to HABERMAS (1989). We believe that this is an open space in the perspective of widening the level of integrated participation in the administration of public health services. PMID:10391719
The IntegratedHealth Interview Series (IHIS) is a public data repository that harmonizes four decades of the National Health Interview Survey (NHIS). The NHIS is the premier source of information on the health of the U.S. population. Since 1957 the survey has collected information on healthbehaviors, health conditions, and health care access. The long running time series of the NHIS is a powerful tool for health research. However, efforts to fully utilize its time span are obstructed by difficult documentation, unstable variable and coding definitions, and non-ignorable sample re-designs. To overcome these hurdles the IHIS, a freely available and web-accessible resource, provides harmonized NHIS data from 1969-2010. This paper describes the challenges of working with the NHIS and how the IHIS reduces such burdens. To demonstrate one potential use of the IHIS we examine utilization patterns in the U.S. from 1972-2008.
We propose a distributed system that enables global and ubiquitous health monitoring of patients. The biomedical data will\\u000a be collected by wearable health diagnostic devices, which will include various types of sensors and will be transmitted towards\\u000a the corresponding Health Monitoring Centers. The permanent medical data of patients will be kept in the corresponding Home\\u000a Data Bases, while the measured
Arjan Durresi; Arben Merkoci; Mimoza Durresi; Leonard Barolli
|Assessed the prevalence of dieting, investigating clusters of risk behaviors among adolescents. Data from the 1999 South Carolina Youth Risk Behavior Survey indicated that weight control behaviors related to several other important healthbehaviors. Differences existed between adolescents who used extreme weight loss measures and moderate dieters…
Rafiroiu, Anca Codruta; Sargent, Roger G.; Parra-Medina, Deborah; Drane, Wanzer J.; Valois, Robert F.
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
|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)…
Azzalis, L. A.; Giavarotti, L.; Sato, S. N.; Barros, N. M. T.; Junqueira, V. B. C.; Fonseca, F. L. A.
Many developing countries are undergoing industrialization and modernization, which has produced both positive and negative implications for health. This study was designed to adapt a well-known health measure to an Arab-Muslim population and to derive health promotion data for primary health care program planning for women in Jordan. A convenience sample of 512 literate females in Jordan was recruited from community settings such as secondary schools (teachers), primary health care centers (nursing staff and patients), universities (faculty and staff), colleges, and office worksites using an Arabic translated version of the Health Promoting Lifestyle Profile (HPLP) instrument. Subjects scored highest on self-actualization, interpersonal support, and nutrition but scored lower on the exercise and health responsibility domains. Unmarried women, however, scored higher on exercise and stress management. These findings support the development of educational efforts to increase women's awareness of relationships between lifestyle and health for both themselves and for their families. PMID:10889633
OBJECTIVES: This study obtained comprehensive health information from newly admitted correctional inmates. METHODS: Interviews were conducted with 1198 inmates on day 3 of their incarceration. RESULTS: Interviewers found a high prevalence of chronic medical and mental health issues, limited access to health care, high rates of infections and sexually transmitted diseases, substantial substance abuse, other unhealthy behaviors and violence, and a strong desire for help with health-related problems. CONCLUSIONS: The data document the need to apply the public health approach to correctional health care, including detection and early treatment of disease, education and prevention to facilitate health and behavior change, and continuity of care into the community.
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
...professionals, including integrativehealth practitioners who have expertise in (1) worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) Worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) Worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) Worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
...professionals, including integrativehealth practitioners who have expertise in (1) worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
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 ...
Background Health literacy concerns the knowledge and competences of persons to meet the complex demands of health in modern society. Although its importance is increasingly recognised, there is no consensus about the definition of health literacy or about its conceptual dimensions, which limits the possibilities for measurement and comparison. The aim of the study is to review definitions and models on health literacy to develop an integrated definition and conceptual model capturing the most comprehensive evidence-based dimensions of health literacy. Methods A systematic literature review was performed to identify definitions and conceptual frameworks of health literacy. A content analysis of the definitions and conceptual frameworks was carried out to identify the central dimensions of health literacy and develop an integrated model. Results The review resulted in 17 definitions of health literacy and 12 conceptual models. Based on the content analysis, an integrative conceptual model was developed containing 12 dimensions referring to the knowledge, motivation and competencies of accessing, understanding, appraising and applying health-related information within the healthcare, disease prevention and health promotion setting, respectively. Conclusions Based upon this review, a model is proposed integrating medical and public health views of health literacy. The model can serve as a basis for developing health literacy enhancing interventions and provide a conceptual basis for the development and validation of measurement tools, capturing the different dimensions of health literacy within the healthcare, disease prevention and health promotion settings.
Investigation of the association between job stressors and healthbehaviors has a long history that has been marked by mixed findings. Fransson et al. (Am J Epidemiol. 2012;176(12):1078-1089) find robust prospective and cross-sectional associations between job strain and leisure-time physical inactivity in combined data from 14 cohort studies. Further research to better understand the observed heterogeneity in the contributing cohorts and other studies will be crucial for application to intervention design and tailoring. The population health significance of these findings requires consideration of other job strain-healthbehavior (particularly the parallel analyses conducted for body mass index and smoking in the same data set) and job strain-health outcome associations, as well as these same associations for other job stressors. Job strain can be seen as a "fundamental cause" of work-related disease, in that intervention to reduce exposure to job strain could have beneficial impacts on many outcomes, making a compelling case for intervention. The significantly strengthened evidence linking job stressors to healthbehaviors provided by Fransson et al. may help to further direct workplace health promotion research, policy, and practice towards an approach that better integrates intervention on working conditions and healthbehaviors. The benefits to population health could be substantial. PMID:23144363
Research indicates that developing public health programs to modify parenting behaviors could lead to multiple beneficial health outcomes for children. Developing feasible effective parenting programs requires an approach that applies a theory-based model of parenting to a specific domain of child health and engages participant representatives in intervention development. This article describes this approach to intervention development in detail. Our presentation emphasizes three points that provide key insights into the goals and procedures of parenting program development. These are a generalized theoretical model of parenting derived from the child development literature, an established eight-step parenting intervention development process and an approach to integrating experiential learning methods into interventions for parents and children. By disseminating this framework for a systematic theory-based approach to developing parenting programs, we aim to support the program development efforts of public health researchers and practitioners who recognize the potential of parenting programs to achieve primary prevention of health risk behaviors in children.
Severe disparities in oral health and inequities in access to oral health care exist globally. In New Zealand, the cost of oral health services is high. Physician services and medicines are heavily subsidised by the government—however, in contrast, private financing, either as out-of-pocket payments or as private insurance, dominates dental care. Consequently, the use of services is often prompted by
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.
It has been suggested that prevailing theories do not fully incorporate the less rational, more emotional elements of adolescent health and risk behavior. To address this limitation, the perceived incentives construct from Tappe's Model of Personal Investment is split into intrinsic and extrinsic incentives, with the intrinsic incentives representing personal meanings of adolescent health and risk behaviors. Intrinsic incentives were operationalized using transcripts from focus group interviews for three behavioral domains: sleeping habits, eating habits at lunch and eating habits after school. The ensuing questionnaire was completed by 416 Dutch secondary school students with a mean age of 14 years. Intrinsic incentives, or the personal meaning with which behavior is imbued, predicted health and risk behaviors well in all three behavioral domains. The implications of these results for further research and for the development of health education programs are discussed. PMID:10158028
Several recent studies in the US, Canada, and the UK have demonstrated a positive relationship between family income and child health, though the mechanisms underlying this relationship are poorly understood. Using data from the 1988 US National Maternal and Infant Health Survey and the 1991 follow-up, this paper tests whether maternal health status and healthbehaviors during pregnancy and early
When health education researchers began to investigate how individuals make decisions related to health and the factors that influence healthbehaviors, they referred to frameworks shared by educational and learning research. Health education adopted the basic principles of the cognitive revolution, which were instrumental in advancing the field. There is currently a new challenge to confront: the widespread use of
Francisco G. Soto Mas; Jan Plass; William M. Kane; Richard L. Papenfuss
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.
We combined the health belief model with the theory of subjective expected utility to derive hypotheses about the relations among health beliefs and preventive decisions. The central implication of this combination of theories is the importance of conceptualizing, measuring, and communicating about health threats in ways that are clearly conditional on action. It is important to distinguish, for example, between
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
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
This article tested the ability of the theory of planned behavior (TPB) to predict patterns of behavior change associated with health screening. Attitudes, subjective norms, perceived behavioral control, and intentions were used to predict objective measures of attendance 1 month and 13 months later among participants who had never previously been screened (N = 389). Findings showed that the TPB
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.
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
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 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…
|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 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.|
Due to existing internal forces, a movement toward vertically integrated regional health systems is imperative in order to ensure the future viability of our health care system. However, in order for these systems to be successful, they must first overcome several imposing barriers. PMID:1399594
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
|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,…
|The experiences of adult educators in Massachusetts who have integrated a health unit into adult literacy classes were examined in an exploratory study. Over a 5-year period, 31 adult learning centers in Massachusetts received funding to incorporate health topics into their adult literacy curriculum. A total of 31 teachers from 24 of the sites…
Rudd, Rima E.; Zacharia, Catherine; Daube, Katharine
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.
OBJECTIVES: In this report, the authors present a representative case of the implementation of community assessment and the subsequent application of findings by a large, vertically integratedhealth care system. METHODS: Geographic information systems technology was used to access and analyze secondary data for a geographically defined community. Primary data included a community survey and asset maps. RESULTS: In this case presentation, information has been collected on demographics, prevalent health problems, access to health care, citizens' perceptions, and community assets. The assessment has been used to plan services for a new health center and to engage community members in health promotion interventions. CONCLUSIONS: Geographically focused assessments help target specific community needs and promote community participation. This project provides a practical application for integrating aspects of medicine and public health.
Asserts that psychologists can contribute to a reduction in national health expenditures by focusing on such illness- and accident-causing behaviors as smoking, alcohol use, improper diet, and speeding and the nonuse of seat belts in cars. (GC)
Improving the health of urban residents, particularly those living in slum areas, requires an integrated approach. Appropriate interventions must be based on a well-grounded understanding of health determinants. Social factors are as important as physical factors in determining health status and suggest alternative interventions. Employment, stress, social exclusion, social support, substance use, nutrition, transport, and conditions during childhood are among the most important social determinants of health status identified by the International Center for Health and Society. This paper uses social determinants of health approach to understand morbidity outcomes for people residing in the slums of Surat City, India. To quantify suboptimal healthbehavior and identify the determinants of health status for this population survey data on household characteristics, health-seeking behavior, socioeconomic status, food and personal habits, social life, and physical activity has been used. After controlling for socioeconomic and demographic factors, logistic regression analysis reveals that social exclusion, stress, and lack of social support are significantly associated with morbidity. Thus, understanding of social determinants of health by policy makers is important as the health sector has a crucial role in addressing disparities in social determinants.
Mohan, Palipudi VenkataTrinadaKrishna; Bansal, Rajkumar K.
The college years offer an opportunity for new experiences, personal freedom, and identity development; however, this period is also noted for the emergence of risky healthbehaviors that place college students at risk for health problems. Affiliation with on-campus organizations such as fraternities or sororities may increase a student's risk given the rituals and socially endorsed behaviors associated with Greek organizations. In this study, we examined alcohol and drug use, smoking, sexual behavior, eating, physical activity, and sleeping in 1595 college students (n = 265 Greek members, n = 1330 non-Greek members). Results show Greek members engaged in more risky healthbehaviors (e.g., alcohol use, cigarette smoking, sexual partners, and sex under the influence of alcohol or drugs) than non-Greek members. Greek and non-Greek members did not differ in condom use, unprotected sex, eating, and physical activity behaviors. Implications for prevention and intervention strategies among Greek members are discussed.
Scott-Sheldon, Lori A. J.; Carey, Kate B.; Carey, Michael P.
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.
The college years offer an opportunity for new experiences, personal freedom, and identity development; however, this period is also noted for the emergence of risky healthbehaviors that place college students at risk for health problems. Affiliation with on-campus organizations such as fraternities or sororities may increase a students' risk given the rituals and socially endorsed behaviors associated with Greek organizations. In this study, we examined alcohol and drug use, smoking, sexual behavior, eating, physical activity, and sleeping in 1,595 college students (n = 265 Greek members, n = 1,330 non-Greek members). Results show Greek members engaged in more risky healthbehaviors (e.g., alcohol use, cigarette smoking, sexual partners, and sex under the influence of alcohol or drugs) than non-Greek members. Greek and non-Greek members did not differ in condom use, unprotected sex, eating, and physical activity behaviors. Implications for prevention and intervention strategies among Greek members are discussed. PMID:17999173
Scott-Sheldon, Lori A J; Carey, Kate B; Carey, Michael P
A healthbehavioral counseling curriculum grounded in Motivational Interviewing and the Transtheoretical Model of behavior change was developed to enhance knowledge and clinical skill among physician assistant (PA) students in managing cancer risk behaviors. A literature and curriculum review informed course content, teaching strategies, and learning activities. The course was evaluated over two pilot years. Students demonstrated increased knowledge and skills regarding the basic principles of the intervention models. The course was integrated into the pre-clinical year of PA training and will be disseminated, beginning with a faculty development workshop for all PA training programs in Texas, USA.
McLaughlin, Robert J.; Fasser, Carl E.; Spence, Laurel R.; Holcomb, J. David
Large employers are beginning to create much more robust and potentially effective systems of integratedhealth management interventions. This organization-wide activity is referred to as a "Population Health Management" (PHM) approach. Best practices are also beginning to emerge in this area, and a number of technical developments are helping shape the patterns of response from innovative employers. This initiative is rapidly emerging as a critical part of overall business and health care strategy. PMID:16706008
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: There is a dearth of studies on the mechanisms of multiple risk behaviors, even though these behaviors are significant public health issues. The authors investigated whether healthbehavior interventions have transfer or compensatory effects on other healthbehaviors. Participants and Methods: The authors looked at transfer and compensation effects of 3 healthbehaviors (smoking, alcohol use, and physical activity)
Claudio Renato Nigg; Hye-ryeon Lee; Amy E. Hubbard; Kim Min-Sun
The healthbehavior of 1 st to 6 th year undergraduate medical students at Chiang Mai University was surveyed. From 1,066 medical students, 302 (28.3%) were selected by using stratified random sampling. Fourteen students with health risk behavior were described as follows: failing to have a physical examination (check up) in the past year (85.7%); never or rarely wearing a
To determine the criteria other than cost large employers use in selecting and monitoring behavioralhealth benefits, this study interviewed 31 of 44 (70.4%) randomly selected corporations employing at least 5,000 workers. While more than 60% of employers considered administrative efficiency and provider access to be very influential in their selection of behavioralhealth benefits, only 12.9% (95% confidence interval
The college years offer an opportunity for new experiences, personal freedom, and identity development; however, this period\\u000a is also noted for the emergence of risky healthbehaviors that place college students at risk for health problems. Affiliation\\u000a with on-campus organizations such as fraternities or sororities may increase a students’ risk given the rituals and socially\\u000a endorsed behaviors associated with Greek
Lori A. J. Scott-Sheldon; Kate B. Carey; Michael P. Carey
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
|Large literatures have shown important links between the quantity of completed education and health outcomes on one hand and the quality or selectivity of schooling on a host of adult outcomes, such as wages, on the other hand. However, little research attempts to produce evidence of the link between school quality and health. The paper presents…
Using content analysis of written narratives, this qualitative study explored the mental representations pharmacy students used to explain their own negative healthbehaviors. In a behavioral pharmacy recitation class, 150 students wrote narratives in response to a question about their own negative healthbehaviors. Each narrative was content analyzed. The top three adverse healthbehaviors were poor diet, smoking and
|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…
The worldHealth Organization's (WHO's) International Program for Chemical Safety has developed a framework for performing risk assessments that integrate the assessment of risks to human health and risks to nonhuman organisms and ecosystems. The WHO's framework recognizes that stakeholders and risk managers have their own processes that are parallel to the scientific process of risk assessment and may interact with the risk assessment at various points, depending on the context. Integration of health and ecology provides consistent expressions of assessment results, incorporates the interdependence of humans and the environment, uses sentinel organisms, and improves the efficiency and quality of assessments relative to independent human health and ecological risk assessments. The advantage of the framework to toxicologists lies in the opportunity to use understanding of toxicokinetics and toxicodynamics to inform the integrated assessment of all exposed species.
Suter, Glenn W. [U.S. Environmental Protection Agency, 26 W. Martin L. King Drive, MC-A130, Cincinnati, OH 45268 (United States)]. E-mail: firstname.lastname@example.org; Vermeire, Theo [National Institute of Public Health and the Environment (Netherlands); Munns, Wayne R. [U.S. Environmental Protection Agency, 26 W. Martin L. King Drive, MC-A130, Cincinnati, OH 45268 (United States); Sekizawa, Jun [Tokushima University (Japan)
The purpose of this study was to investigate the healthbehavior of a town ' s community leaders and other issues associated with that behavior. Structured questionnaires designed by the researchers were used to collect data at a meeting for the announcement of community building; they were filled out in the 10 or 20 minutes before the meeting began and 70 valid responses were received. The SPSS for Window version 10.0 software package was used for data analysis. The results of the study showed that the community leaders demonstrated higher standards of health-protective behaviors (i.e. elder/adult checkups, Pap smear exam and breast self-examination) than others living in the community. Variables such as gender, educational level, self-perceived health status, number of chronic illnesses were correlated with different types of dietary behavior. Subjects who were 40 years old and over, educated to junior high school or lower, who had performed less than one year of community service and were free of chronic illness engaged in relatively regular exercise. Subjects who had performed more than one year of community service were more likely to utilize the preventive services provided by national health insurance. It is recommended that public health nurses improve their cooperation with community leaders over providing health -related activities in order to promote better healthbehavior on the part of such leaders. PMID:15208774
Li-Chun, Chang; I-Chuan, Li; Bi-Ying, Hsiao; Wan-En, Cheng; Shu-Feng, Lin
Purpose: To investigate the aggregation of healthbehaviors among fourth graders in northern Taiwan. Methods: This study conducted an analysis of data collected from the 2001 Child and Adolescent Behaviors in Long-term Evolution (CABLE) project, which included a sample of 2075 fourth grade students. Factor analysis and cluster analysis were used to investigate the aggregation patterns. Results: After factor analysis,
Lee-Lan Yen; Ching-Ju Chiu; Wen-Chi Wu; Ling-Yen Pan
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.
|Over the past fifty years, research on adolescents' behavior has focused primarily on risk factors. The study of resiliency and what buffers adolescents from engaging in harmful healthbehaviors has received much less attention. This risk-focused approach has included examining what is lacking in a youth's life that may contribute to that youth's…
The value of health education practice lies in its effectiveness. Behavioral science theories have greater potential to enhance the effect- iveness of practice than is currently realized. Many have called for development of strategies to overcome current barriers to the use of theory in the field. Such strategies should explicate the potential of commonly taught behavioral science theories to facilitate
Studied the risk-taking behavior (i.e., smoking, intemperate drinking, and failure to fasten seat belts) of 4,539 Canadian adolescents. Results showed adolescents who lived in intact families engaged in less health-risk behavior than adolescents from separated or divorced families. Results from widowed families were mixed. (JAC)
Background: Studies have shown that screening reduces colorectal cancer mortality. We analyzed national survey data to determine rates of use of fecal occult blood testing (FOBT) and sigmoidoscopy, and to determine if these rates differ by demographic factors and other healthbehaviors.Methods: A total of 52,754 respondents aged ?50 years were questioned in the 1997 Behavioral Risk Factor Surveillance System
|Sexual assault is associated with a number of health risk behaviors in women. It has been hypothesized that these risk behaviors, such as hazardous drinking, may represent women's attempts to cope with psychological distress, such as symptoms of depression and anxiety. However, extant research has failed to evaluate these relationships among…
Littleton, Heather L.; Grills-Taquechel, Amie E.; Buck, Katherine S.; Rosman, Lindsey; Dodd, Julia C.
Over the last few years, there has been increased awareness and use of complementary/alternative therapies (CAM) in many countries without the health care infrastructure to support it. The National Centre for Complementary and Alternative Medicine referred to the combining of mainstream medical therapies and CAM as integrative medicine. The creation of integrativehealth care teams will definitely result in redefining roles, but more importantly in a change in how services are delivered. The purpose of this paper is to describe a model of the necessary health care agency resources to support an integrative practice model. A logic model is used to depict the findings of a review of current evidence. Logic models are designed to show relationships between the goals of a program or initiative, the resources to achieve desired outputs and the activities that lead to outcomes. The four major resource categories necessary for implementing integrative care are within the domains of a) professional and research development, b) health human resource planning, c) regulation and legislation and d) practice and management in clinical areas. It was concluded that the system outcomes from activities within these resource categories should lead to freedom of choice in health care; a culturally sensitive health care system and a broader spectrum of services for achieving public health goals.
... suicidal thoughts and behaviors and the signs and symptoms to look for ... Talking or thinking about wanting to hurt yourself or end your life; Becoming ... More results from www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders
This study screened potential predictors of maladaptive cold weather behaviors. Male Marine Corps volunteers (n = 161) completed questionnaires providing a battery of predictor measures, including: (a) Personal history variables related to cold injuries, ...
Personalization of healthcare has a number of claimants, including pHealth. However, to the citizen real personalization is the delivery of integrated support services to maintain their health and well-being, particularly in times of chronic illness and frailty. The integration of health and social care support has been identified a key but challenging step in this. The pHealth community faces the choice either of reinforcing the isolation of silos of care and thus fragmentation of service, or of seeking to become a unifying agent though thoughtful and considered development of sharing of monitoring from pHealth devices. PMID:22942029
Although several studies have been undertaken to evaluate the efficacy of health screening in causing changes in health-related\\u000a behavior, there are few findings with respect to the efficacy of annually repeated health screening.\\u000a \\u000a Using cross-sectional data drawn from a population consisting of white-collar workers in Osaka, Japan, the relation between\\u000a the results of annually repeated health screening and individual health
|Families experiencing severe conflict are often unable to effectively implement applied behavioral procedures due to interfering emotional responses (anger, blaming, anxiety and depression) and behavioral responses (yelling, crying and physical fighting), which often reduce effective implementation of applied behavioral procedures. Specific…
This paper describes the use of a particular therapeutic modality--behavioral groups--in a relatively new delivery system called a Health Maintenance Organization. The program described, run under the George Washington University Health Plan, offers short-term structured groups designed to aid people at particularly difficult or vulnerable…
Beginning in 1983, a national poll has been conducted annually to assess the extent to which the American public engaged in a core of 21 recommended health seeking behaviors. For the third consecutive year a national sample of approximately 1250 adults were interviewed concerning their self-reported compliance with a basic core of 21 health…
|This paper describes the use of a particular therapeutic modality--behavioral groups--in a relatively new delivery system called a Health Maintenance Organization. The program described, run under the George Washington University Health Plan, offers short-term structured groups designed to aid people at particularly difficult or vulnerable…
Mental health courts, premised on the notion of therapeu- tic justice, have become an increasingly appealing way of dealing with what is widely, although not uniformly, seen as the inappropriate incarceration of people who engage in criminal behavior caused by mental illness. Neverthe- less, mental health courts are not without their critics and a number of objections have been raised
|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.
|This semester-long activity requires students to reflect on their own strengths and weaknesses in attempting to take on a personally meaningful healthbehavior change challenge. This assignment affords them the opportunity to take a deeper look at theory and health concepts learned throughout the semester and to see how it has informed their own…
Young adults (ages 18-24) are especially vulnerable to homelessness in the United States, and those experiencing homelessness exhibit high prevalence for many kinds of abuse and negative health outcomes. This article reviews common behavioralhealth issues facing homeless youth and assesses collective wisdom on effective treatments and services for this vulnerable population. On the whole, the research remains focused on
Suzanne Zerger; Aaron J. Strehlow; Adi V. Gundlapalli
BACKGROUND: An integrated sense of professionalism enables health professionals to draw on relevant knowledge in context and to apply a set of professional responsibilities and ethical principles in the midst of changing work environments 12. Inculcating professionalism is therefore a critical goal of health professional education. Two multi-professional courses for first year Health Science students at the University of Cape
... 32 million Americans who are now uninsured. It reforms insurance markets to make them more competitive and ... residency training. Find out more information about health reform and the Patient Protection and Affordable Care Act ...
? Abstract 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 unremit- ting, particularly in older or unhealthy individuals, the long-term effects of stressors can damage,health. The relationship between,psychosocial stressors and disease
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
Musculoskeletal, cardiovascular, and mental health are all associated with the physical and psychosocial conditions of work, as well as with individual healthbehaviors. An integrated approach to workplace health-promotion programs should include attention to the work environment, especially in light of recent findings that work organization influences so-called lifestyle or healthbehaviors. Macroergonomics provides a framework to improve both physical and organizational features of work and, in the process, to empower individual workers. The Center for the Promotion of Health in the New England Workplace (CPH-NEW) is a research-to-practice effort examining the effectiveness of worksite programs that combine occupational safety and health--especially ergonomics--with health promotion, emphasizing the contribution of work organization to both. Two intervention studies are underway in three different sectors: health care, corrections, and manufacturing. Each study features participatory structures to facilitate employee input into health goal-setting, program design and development, and evaluation, with the goal of enhanced effectiveness and longer-term sustainability. PMID:19618803
Oral healthbehavior is voluntary and, therefore, requires motivation. Dentists serve as role models for their patients. We sought to determine the pediatric dentists' own adherence to oral healthbehavior recommendations through a 14-question survey administered to 129 pediatric dentists. A significant percentage of respondents fell short in brushing, flossing and regularity of dental exams. A trend was seen for decreasing exam frequency with decreasing population density and for increasing brushing frequency with increasing age. Although most dentists follow their profession's oral health guidelines, a significant percentage does not. PMID:21735865
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
Introduction. It is widely acknowledged that the behavior of parents affects their children's health. This study aimed to evaluate the relationship between oral healthbehavior of parents and oral health status and behavior of their children in a sample of preschool children in Iran. Method and Material. A random sample of over-five-year-old preschool children and their parents were enrolled in the study. Selection of schools was by clustering method. Parents were asked to fill a piloted questionnaire which included demographic characteristics, socioeconomic status, oral healthbehaviors of children and their parents. Oral health status of children was examined. The parent and their children oral health relationship were tested using regression and correlation analysis. Results. About 222 parents and children participated in the study. There was a significant relationship between history of having dental problems in parents and dmft index in their children (P = 0.01). There was a significant relationship between parental frequency of tooth brushing and child frequency of tooth brushing (P = 0.05); however, there was no significant relationship between parental frequency of dental visits and those of their children (P = 0.1). Conclusion. The study concluded that some important healthbehaviors in parents, such as tooth brushing habits are important determinants of these behaviors in their young children. So promoting parent knowledge and attitude could affect their children oral healthbehavior and status.
|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…
...and advice to the National Prevention, Health Promotion, and Public Health Council (hereafter referred to as the...lifestyle-based chronic disease prevention and management, integrativehealth care practices, and health promotion....
Beliefs about what constitutes health promoting behaviors vary by culture and class, and knowing how an older adult interprets a specific healthbehavior can improve health education and medical compliance. Ethnomedical approaches have investigated how people define disease and the therapies used to return to a state of health. However, little research has addressed how individuals define health, or the behaviors they use to maintain health. We analyze the behaviors elders state are needed to stay healthy, and their meanings for these behaviors. Narratives collected through in-depth interviews with 145 male and female rural North Carolina residents aged 70 and older, including African Americans, Native Americans and European Americans are analyzed using systematic text analysis. The participants' narratives include seven salient health maintenance domains: (1) Eating Right, (2) Drinking Water, (3) "Taking" Exercise, (4) Staying Busy, (5) Being with People, (6) Trusting in God and Participating in Church, and (7) Taking Care of Yourself. Several of these domains are multi-dimensional in the meanings the elders ascribe to them. There is also overlap in the content of some of the domains; they are not discrete in the minds of the elders and a specific healthbehavior can reflect more than one domain. Four themes cross-cut the domains: "balance and moderation", "the holistic view of health", "social integration", and "personal responsibility". Elders in these rural communities hold a definition of health that overlaps with, but is not synonymous with a biomedical model. These elders' concept of health seamlessly integrates physical, mental, spiritual, and social aspects of health, reflecting how health is embedded in the everyday experience of these elders. Staying healthy is maintaining the ability to function in a community. These results indicate that providers cannot assume that older patients will share their interpretation of general health promotion advice. PMID:11710428
Vertebrate sickness behaviors, which include lethargy, anorexia, and decreased libido, can facilitate defense against pathogens by conserving energy for use in other immune responses and by limiting parasites' access to nutrients. Such benefits come with considerable costs, however, as lethargy decreases the time available for other fitness-enhancing activities and dampened libido directly reduces reproductive prospects. While the degree of sickness behaviors expressed varies among individuals, populations, and species, the ecological and physiological factors driving this diversity remain unclear. Here, we consider how an organism's ecological context and life-history strategy may impact the ways in which it balances the costs and benefits of sickness behaviors to enable or suppress its expression. Striking an appropriate balance requires physiological assimilation of information about external ecological conditions as well as about the status of infection and host nutrition. This integration requires multi-directional communication among the endocrine, nervous, and immune systems, the purview of the field of psychoneuroimmunology. This discipline portrays cytokines, signaling molecules originally characterized solely by their roles within the immune system, as key mediators of a brain-immune network that ensures the adaptive expression of sickness behaviors. Study of these molecules and the behaviors they coordinate in an ecological context will greatly augment our understanding of the natural variation in immune function found among wild animals. PMID:21665814
In response to veterans' needs in the context of recent deployments, the Veterans Affairs (VA) health system has increased the number of its facilities and caregivers and has pioneered changes in policy and programs. We review significant recent initiatives to improve access to behavioralhealth services in the VA health system. PMID:21678688
Kudler, Harold; Straits-Tröster, Kristy; Brancu, Mira
|The widespread adoption of electronic health records (EHRs) is a public policy strategy to improve healthcare quality and reduce accelerating health care costs. Much research has focused on medical providers' perceptions of EHRs, but little is known about those of behavioralhealth providers. This research was informed by the theory of reasoned…
|Objective: The authors investigated the longitudinal impact of peer health education on the healthbehaviors of undergraduate students pertaining to alcohol and drug use, eating and nutrition, and sexual health. Participants: From fall 2003 to spring 2006, the authors annually administered a Web-based survey to a cohort of 2,000 randomly selected…
White, Sabina; Park, Yong S.; Israel, Tania; Cordero, Elizabeth D.
Prior research has established clear links between social support, loneliness, and various health outcomes. This study was designed to test several theoretically derived explanations for such associations. A survey of 265 adults ages 19–85 years was conducted with measures of social support, loneliness, stress, healthbehaviors, and general health. Results showed that loneliness was more strongly associated with number of
|This study examined the health-related quality of life and health-promoting behaviors in a convenience sample of low-income black men. Almost three-fourths reported their overall health as good or better. However, the mean number of recent (that is, past 30 days) mentally unhealthy days was 13.12, and more than half reported frequent (greater…
Calvert, Wilma J.; Isaac,, E. Paulette; Johnson, Sharon
The widespread adoption of electronic health records (EHRs) is a public policy strategy to improve healthcare quality and reduce accelerating health care costs. Much research has focused on medical providers' perceptions of EHRs, but little is known about those of behavioralhealth providers. This research was informed by the theory of reasoned…
Objective: The authors investigated the longitudinal impact of peer health education on the healthbehaviors of undergraduate students pertaining to alcohol and drug use, eating and nutrition, and sexual health. Participants: From fall 2003 to spring 2006, the authors annually administered a Web-based survey to a cohort of 2,000 randomly selected undergraduate students. Results: Students who had contact with peer
Sabina White; Yong S. Park; Tania Israel; Elizabeth D. Cordero
Objective To compare the characteristics, healthbehaviors, and health services utilization of U.S. adults who use complementary and alternative medicine (CAM) to treat illness to those who use CAM for health promotion. Data Source The 2007 National Health Interview Survey (NHIS). Study Design We compared adult (age ?18 years) NHIS respondents based on whether they used CAM in the prior year to treat an illness (n = 973), for health promotion (n = 3,281), or for both purposes (n = 3,031). We used complex survey design methods to make national estimates and examine respondents' self-reported health status, healthbehaviors, and conventional health services utilization. Principal Findings Adults who used CAM for health promotion reported significantly better health status and healthier behaviors overall (higher rates of physical activity and lower rates of obesity) than those who used CAM as treatment. While CAM Users in general had higher rates of conventional health services utilization than those who did not use CAM; adults who used CAM as treatment consumed considerably more conventional health services than those who used it for health promotion. Conclusion This study suggests that there are two distinct types of CAM User that must be considered in future health services research and policy decisions.
Davis, Matthew A; West, Alan N; Weeks, William B; Sirovich, Brenda E
...professionals, including integrativehealth practitioners who have expertise in (1) worksite health promotion; (2) community services, including community health centers; (3) preventive medicine; (4) health coaching; (5) public health...
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.
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
Dietary choice is a complex mechanism that is influenced by multiple internal and external factors that impact individuals across the life span. The study was designed to examine how individuals make snack food choices based on integration of food motives (cues), appropriateness (nutritional index) as functions of nutritional knowledge, food-related motives, and information processing styles. Community college students participated in
In psychotherapy research, practice, and training, there remains marked controversy about the merits of theoretical purism (i.e., model specific), versus integration, as well as how such principles may be represented in practice. Adding to the confusion is that many attributes of the therapeutic relationship, processes in therapy, and techniques have been popularized in the context of one or two theoretical approaches, but are incorporated into the practice of many approaches. This article demonstrates the various ways in which three core interventions (i.e., activity scheduling, self-monitoring, and identification, evaluation, and modification of thoughts) can be applied within the context of different cognitive and behavioral therapeutic models. It also demonstrates the role of in-session therapist language in describing the theoretical basis and processes underpinning therapeutic interventions. Case examples are presented to illustrate therapy provided by two hypothetical clinicians, Therapist A and Therapist B. Whether or not a practitioner elects to practice integrative psychotherapy, we advocate for consistency in the theoretical approach through the course of a service for a particular patient. Implications are outlined and discussed within the context of the current state of cognitive and behaviorally focused psychotherapies and integrative psychotherapy. (PsycINFO Database Record (c) 2013 APA, all rights reserved). PMID:24000858
Petrik, Alexandra M; Kazantzis, Nikolaos; Hofmann, Stefan G
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.
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 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 research has promise for increasing our understanding of how biological
|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…
The purpose of this chapter is to provide information on and a framework for the necessary and ongoing merger and collaboration\\u000a between the positive behavior support (PBS) and mental health communities to provide effective services for families and their\\u000a children who have challenging behaviors. While both communities have recognized the need to collaborate with families as equal\\u000a decision-making partners, the
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.
Summary Background Persons with an optimistic attitude do not give up despite obstacles and failures. Optimistic athletes compete more out of hope for success than out of fear of defeat. The purpose of my research was to determine if optimism also promotes good healthbehavior in athletes. Material/Methods In order to measure the role of optimism in shaping the healthbehavior of athletes, I examined a group of women (N=147) and men (N=385) who were currently in training for athletic competition. The control group consisted of women (N=262) and men (N=435) who were not and had never been competitive athletes. The “O-P” Attitude Questionnaire was used to measure optimism, while healthbehavior was measured with the Juczynski HealthBehavior Inventory, which measures proper nutrition habits, preventive behavior, positive attitude, and healthy practices. Results The level of pessimism in these athletes was average. The female athletes were less pessimistic than the female controls. A similar, highly significant difference occurred between the male athletes and non-athletes. Gender did not differentiate the level of optimism in either group. Among the women, optimism correlated with healthy practices, such as daily sleep and recreation habits, or physical activity. The greater the pessimism increased, positive attitudes declined in the female controls, the female athletes, and the male controls. Conclusions The athletes displayed greater optimism than the controls. Among the women, optimism correlated with good health practices.
In this paper, we contribute with empirical insight into the complexity of establishing and sustaining integration between\\u000a different information infrastructures in health care. An overall concern is to elaborate on how, despite many obstacles, the\\u000a integration effort moves forward. We see this as a collective achievement, where users have an essential role in terms of\\u000a mobilizing and coordinating the other
Mental health refers to a diverse field where individuals can cope with daily stress, realize their potential and maintain a state of well-being. In recent years, there has been increasing recognition of the influence of mental health on general health, and in particular on cardiovascular diseases and their risk factors. Epidemiological research has focused on several psychosocial components including social determinants, comorbid psychiatric disorders, psychological stress, coping styles, social support, burden on the family, well-being, life satisfaction, personality and cognitive factors in connection with cardiovascular diseases. There is epidemiological research in India that integrates mental health with common cardiovascular diseases such as coronary health disease and stroke. Data from mental health research is sufficiently compelling to highlight the role of chronic stress, socioeconomic status and psychiatric disorders such as depression, substance use, social networks and support in relation to vulnerability to cardiovascular diseases. There are psychosocial consequences of cardiovascular diseases including deficits in the domains of life skills, coping skills and neurocognition, in addition to caregiver burden. The implications of bio-psychosocial models of assessments and interventions that target complex individual and contextual variables simultaneously on cardiovascular treatment outcomes have highlighted the importance of studying mental health in Indian settings. Integration of mental health into mainstream research is the need of the hour. A multidimensional approach to accomplish this is required including at the level of research conceptualization, discussions with key stakeholders, at the policy level, at the institutional level, and at the clinical and community level. PMID:23448627
BACKGROUND: Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6–8 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was
The medical care system is not very effective in modifying healthbehavior of individuals, in particular, ensuring patient compliance with medication regimens, healthy diets, regular physical activity, and regular health screening, and in the avoidance of substance abuse. Telephone-Linked Care (TLC) is a telecommunications technology that enables computer-controlled telephone counseling with patients in their homes. It has been applied to
Monitoring for possible adverse events is ethically required by Institutional Review Boards and Good Clinical Practice guidelines for all human research involving the delivery of treatment interventions in a clinical trial. The monitoring of adverse events is a well-established and routine practice for contemporary clinical trials involving medications and medical devices. However, these same guidelines have not been fully integrated into clinical trials involving the use of behavioralhealth interventions and psychotherapy. Most behavioralhealth clinical trials limit adverse event monitoring to serious adverse events such as suicide attempts, completed suicides, and psychiatric hospitalizations. Other possible "side effects" of psychotherapy, such as temporary increases in anxiety, are often considered a normal part of therapy and are therefore not documented as possible adverse events. This manuscript reviews a variety of reasons for the limited adverse event monitoring in behavioralhealth clinical trials and highlights the importance of incorporating expanded adverse event monitoring into future behavioralhealth clinical trials. Without understanding the nature and prevalence of adverse events, patients cannot be informed adequately of the possible risks and benefits of behavioral interventions prior to engaging in treatment. PMID:23117077
Peterson, Alan L; Roache, John D; Raj, Jeslina; Young-McCaughan, Stacey
Few existing studies have examined health and oral health needs and treatment-seeking behavior among the homeless and injection drug users (IDUs). This paper describes the prevalence and correlates of health and oral health care needs and treatment-seeking behaviors in homeless IDUs recruited in San Francisco, California, from 2003 to 2005 (N?=?340). We examined sociodemographic characteristics, drug use patterns, HIV status via oral fluid testing, physical health using the Short Form 12 Physical Component Score, self-reported needs for physical and oral health care, and the self-reported frequency of seeking medical and oral health care. The sample had a lower health status as compared to the general population and reported a frequent need for physical and oral health care. In bivariate analysis, being in methadone treatment was associated with care-seeking behavior. In addition, being enrolled in Medi-Cal, California’s state Medicaid program, was associated with greater odds of seeking physical and oral health care. Methamphetamine use was not associated with higher odds of needing oral health care as compared to people who reported using other illicit drugs. Homeless IDUs in San Francisco have a large burden of unmet health and oral health needs. Recent cuts in Medi-Cal’s adult dental coverage may result in a greater burden of oral health care which will need to be provided by emergency departments and neighborhood dental clinics.
Wenger, Lynn; Lorvick, Jennifer; Shiboski, Caroline; Kral, Alex H.
The Healthy Howard Health Plan (HHHP) is an innovative health access plan providing healthcare and health coaching to previously uninsured adults in Howard County, Maryland. HHHP members who enrolled in HHHP between January 2009 to June 2010 are followed over time using a variety of self-reported data collection tools including a health risk assessment (HRA), the SF-12, a measure of health status, and the PAM, patient activation measure. We describe their unmet health needs, demographics, health status and behaviors at baseline and we describe changes in health-related behaviors over time. Demographic and baseline HRA results for 700 individuals who enrolled over the first 18 months reveal HHHP members generally were racially diverse (white: 37 %; African American: 23 %, and Asian: 30 %), married (50 %) females (59 %). Most (62 %) have a family income between 121 and 200 % of the federal poverty level, and were without health insurance for more than 1 year (56 %). Self-reported health and behaviors for 163 plan members who completed initial and follow up HRAs revealed increases in physical activity, fruit and vegetable consumption, and health status. Statistically significant differences were found in patient activation from baseline to follow up (44 vs 58 %, p value 0.0005). Patient demographics, health status, and healthbehaviors of these newly insured Americans may help policy makers and care providers prepare to meet their needs. We noted improvements in certain self-reported healthbehaviors and health status, suggesting participation in the Plan is associated with positive health impacts for some Plan members. PMID:23014801
McDonald, Eileen M; Frattaroli, Shannon; Edsall Kromm, Elizabeth; Ma, Xia; Pike, Maureen; Holtgrave, David
The association of knowledge of health risks, living arrangements, and perceived stress with health-risk behaviors was examined in a sample of college students included in the Health Promotion and Disease Prevention Supplement of the National Health Interview Survey. Regressions of each health-risk behavior (dependent variable) were performed on the predicted correlates. Although knowledge was not associated with participation in physical
Preventive and health promoting behaviors in pregnant minority women can be used to develop approaches to encourage healthy lifestyle and optimal utilization of health services, and to obtain better outcomes of pregnancy. Using the Health Promotion Model as a theoretical framework, this study employed a cross-sectional survey design to investigate factors that related to healthbehaviors of low-income pregnant Mexican American and African American women in selected sites in the southeast portion of the state of Texas. Results showed that Mexican American women had a significantly higher mean on the Powerful Others Locus of Control measure than the African American women. For African American subjects, the strongest effect was exerted by the social support variable, which had a negative effect on the healthbehavior variable. Findings suggest that more studies are needed to identify specific determinants of health promoting activities during pregnancy in ethnic minority groups. Designing programs that would motivate early involvement of low-income pregnant minority women in health care should be a top priority for professionals in maternity practice. PMID:17420521
Esperat, Christine; Du Feng; Yan Zhang; Owen, Donna
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
There has been a paradigm shift in community health nursing. In 1992, visiting nursing stations were first introduced. In 1994, the Community Health Act came into force and in recent years public health care insurance has become a major issue. In this paradigm shift, one of the roles of nursing in the community is to train people to become more autonomous as consumers of health care services, and to design and implement a system that enhances community members' health and provides support when they are ill. In 1990 and 1996, the national nursing curriculum was revised to reflect changes in the age of the population. Community health nursing now faces the challenge of developing a new nursing model that is in tune with Japanese cultural values. Dr. Katsunuma (1996) proposed two alternative approaches to health care services: the public health approach and the clinical approach. In this paper, it is suggested that home care offers a third alternative, which integrates the clinical approach with the public health approach. This third approach provides a paradigm for community health nursing that integrates individual health care with community health care. New roles and specialties for public health nurses include care management, care planning, community health nursing administration, and supervision. Community-based nursing centers that cooperate with schools of nursing will provide a setting and a concept for community health nursing. PMID:9444239
Objective To examine relationships between spiritual health locus of control beliefs and various healthbehaviors. Methods A cross-sectional survey of a national sample of African Americans assessed spiritual beliefs, fruit and vegetable consumption, physical activity, and alcohol consumption. Results Active spiritual beliefs were positively associated with fruit consumption and negatively associated with alcohol consumption. Passive spiritual beliefs were associated with lower vegetable and increased alcohol consumption. Among male participants, passive spiritual beliefs were associated with higher alcohol consumption. Conclusions Findings suggest that dimensions of spiritual health locus of control beliefs have complex and varying relationships with healthbehaviors.
Debnam, Katrina; Holt, Cheryl L.; Clark, Eddie M.; Roth, David L.; Foushee, Herman R.; Crowther, Martha; Fouad, Mona; Southward, Penny L.
Health fairs, carnivals, and exhibitions are health promotion strategies that have been frequently discussed in recent health-related literature. The primary purpose of this study was to determine if students attending a university health fair experienced greater reductions in health risk behavior compared with those not attending the fair. A second purpose of this study was to evaluate the impact of
Chudley E. Werch; David A. Schroeder; Linda L. Matthews
The need to integrate clinical practice and research has been stressed for many years in both public health and nursing. This article describes such a collaborative project between two rural upper Midwest public health nursing agencies and public health nursing faculty from a small, liberal arts, baccalaureate nursing program. The high-risk prenatal research project provided an opportunity for nursing staff and faculty research consultants to work together on a clinical study. A model for collaborative research is illustrated, and advantages and disadvantages for practice, administration, and research are discussed. PMID:1484810
The purpose of this study is to contribute to the conceptual understanding and practical application of social integration theory to healthbehaviors. We test whether community involvement in AIDS and GLBT organizations moderates the relationship of racial and homosexual stigmata to sexual risk behavior among gay and bisexual men and transgender persons of Latin American origin or descent. We use structural equation modeling to analyze data from a sample of 643 individuals recruited via respondent-driven sampling. Among those not involved in community organizations, homosexual and racial stigmata are related to sexual activity under the influence of alcohol and drugs, which is linked to sexual risk behavior. Among the involved group, the stigmata are not linked to sexual activity under the influence of alcohol and drugs, or to sexual risk behavior. The moderating role of community involvement seems to be more salient in those currently involved than those ever involved.
Ramirez-Valles, Jesus; Kuhns, Lisa M.; Campbell, Richard T.; Diaz, Rafael M.
The purpose of this study is to contribute to the conceptual understanding and practical application of social integration theory to healthbehaviors. We test whether community involvement in AIDS and GLBT organizations moderates the relationship of racial and homosexual stigmata to sexual risk behavior among gay and bisexual men and transgender persons of Latin American origin or descent. We use structural equation modeling to analyze data from a sample of 643 individuals recruited via respondent-driven sampling. Among those not involved in community organizations, homosexual and racial stigmata are related to sexual activity under the influence of alcohol and drugs, which is linked to sexual risk behavior. Among the involved group, the stigmata are not linked to sexual activity under the influence of alcohol and drugs, or to sexual risk behavior. The moderating role of community involvement seems to be more salient in those currently involved than those ever involved. PMID:20420293
Ramirez-Valles, Jesus; Kuhns, Lisa M; Campbell, Richard T; Diaz, Rafael M
The Canadian Cancer Society and the National Cancer Institute of Canada have charged their Centre for Behavioral Research and Program Evaluation with contributing to the development of the country’s systemic capacity to link research, policy, and practice related to population-level interventions. Local data collection and feedback systems are integral to this capacity. Canada’s School Health Action Planning and Evaluation System (SHAPES) allows data to be collected from all of a school’s students, and these data are used to produce computer-generated school “health profiles.” SHAPES is being used for intervention planning, evaluation, surveillance, and research across Canada. Strong demand and multipartner investment suggest that SHAPES is adding value in all of these domains. Such systems can contribute substantially to evidence-informed public health practice, public engagement, participatory action research, and relevant, timely population intervention research.
Cameron, Roy; Manske, Stephen; Brown, K. Stephen; Jolin, Mari Alice; Murnaghan, Donna; Lovato, Chris
The increasing number of papers during the last years reveals an existence of effect of geophysical factors on human health. The subject of this paper is to present some results obtained confirming this effect and short review of some scientific opinions about mechanisms, according to which geomagnetic field (GMF) variations could influence on human. We have investigated the influence of geomagnetic disturbances on physiological parameters of healthy people as well as the relationship with dynamic of myocardial infarction. Although there are objective difficulties, investigations in that field will be extremely useful for protecting man from harmful effects of geophysical factors.
Rationale: In studies that address health-related quality of life (QoL) and survival, subjects who die are usually censored from QoL assessments. This practice tends to inflate the apparent benefits of interventions with a high risk of mortality. Assessing a composite QoL-death outcome is a potential solution to this problem. Objectives: To determine the effect of lung volume reduction surgery (LVRS) on a composite endpoint consisting of the occurrence of death or a clinically meaningful decline in QoL defined as an increase of at least eight points in the St. George's Respiratory Questionnaire total score from the National Emphysema Treatment Trial. Methods: In patients with chronic obstructive pulmonary disease and emphysema randomized to receive medical treatment (n = 610) or LVRS (n = 608), we analyzed the survival to the composite endpoint, the hazard functions and constructed prediction models of the slope of QoL decline. Measurements and Main Results: The time to the composite endpoint was longer in the LVRS group (2 years) than the medical treatment group (1 year) (P < 0.0001). It was even longer in the subsets of patients undergoing LVRS without a high risk for perioperative death and with upper-lobe-predominant emphysema. The hazard for the composite event significantly favored the LVRS group, although it was most significant in patients with predominantly upper-lobe emphysema. The beneficial impact of LVRS on QoL decline was most significant during the 2 years after LVRS. Conclusions: LVRS has a significant effect on the composite QoL-survival endpoint tested, indicating its meaningful palliative role, particularly in patients with upper-lobe–predominant emphysema.
Benzo, Roberto; Farrell, Max H.; Chang, Chung-Chou H.; Martinez, Fernando J.; Kaplan, Robert; Reilly, John; Criner, Gerard; Wise, Robert; Make, Barry; Luketich, James; Fishman, Alfred P.; Sciurba, Frank C.
Objectives This study examined whether women with behavioralhealth needs are more likely to receive treatment for these problems in prison or in the community and to what extent prison disrupts or establishes involvement in treatment for these women. Methods Data were collected in August 2004 as part of a population survey of female inmates in the only state correctional facility for women in New Jersey. Results A total of 908 women were surveyed. Fifty-six percent of the women surveyed reported needing behavioralhealth treatment before incarceration, but only 62 percent of this group reported receiving such treatment in the community. The rate at which treatment matched need within this population before incarceration varied by type of treatment needed: it was the highest (58 percent) for women who needed treatment for mental health problems, lower (52 percent) for those who needed substance abuse treatment, and lowest (44 percent) for those who needed treatment for comorbid mental health and substance abuse problems. In comparison, the rate of match between need for and receipt of treatment in prison was higher for all three types of behavioralhealth treatment (78 percent, 57 percent, and 65 percent, respectively). Additionally, the findings suggest that prison did not disrupt the type of behavioralhealth treatment that inmates had previously received in the community. Conclusions At least in New Jersey, prison appears to improve access to behavioralhealth treatment among female inmates. Although this conclusion is consistent with the rehabilitation goals of incarceration, it also suggests that some women may have been able to avoid prison if treatment had been provided in the community, especially for substance-related problems.
This article profiles selected Safe Schools\\/Healthy Students (SS\\/HS) interventions in three Oregon communities that have completed Safe Schools\\/Healthy Students projects, representing a substantial investment in building school and community collaborations, expanding positive behavior supports in schools, and establishing school-based mental health services. The University of Oregon Institute on Violence and Destructive Behavior served as the local evaluator for these projects.
This article is a review of select empirical research studies examining television as an influence on children's healthbehaviors. The reader is first provided with an overview of the research on the role of television in children's lives. This is followed by an in-depth presentation of the research related to television content and its effect on risk-taking and the role of television commercials and their influence on nutrition and dietary behaviors. PMID:11077764
Rapid and innovative advances in participative Internet communications, referred to as "social media," offer opportunities for modifying healthbehavior. Social media let users choose to be either anonymous or identified. People of all demographics are adopting these technologies whether on their computers or through mobile devices, and they are increasingly using these social media for health-related issues. Although social media have considerable potential as tools for health promotion and education, these media, like traditional health promotion media, require careful application and may not always achieve their desired outcomes. This article summarizes current evidence and understanding of using social media for health promotion. More important, it discusses the need for evaluating the effectiveness of various forms of social media and incorporating outcomes research and theory in the design of health promotion programs for social media. PMID:21558472
The past two centuries have shown radical improvements in health and longevity, with hygiene as the key contributor to this trend in the 19th century and antibiotics and vaccinations in the 20th century. With most infectious diseases largely at bay in the developed world, the greatest contributors to suboptimal health today are largely behavioral. For example, there are three behavioral risk factors?tobacco use, poor diet, and inactivity?that contribute to four chronic diseases: heart disease, type 2 diabetes, lung disease, and some cancers. Together, these behaviors account for more than 50% of preventable deaths (see the Web site 3four50.com). While medical advances will surely continue, it is likely that the next great advancements in health in the 21st century will occur via more effective behavior management. PMID:24056791
Hekler, Erik B; Klasnja, Predrag; Traver, Vicente; Hendriks, Monique
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.
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.
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.
Linn, Lawrence S.; Cope, Dennis; Leake, Barbara; Yager, Joel
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.
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
A comfortable health monitoring system named WEALTHY is presented. The system is based on a textile wearable interface implemented by integrating sensors, electrodes, and connections in fabric form, advanced signal processing techniques, and modern telecommunication systems. Sensors, electrodes and connections are realized with conductive and piezoresistive yarns. The sensorized knitted fabric is produced in a one step process. The purpose
This theoretical study explores the links between the Triple Bottom Line (TBL) concept and the principles of HIA and considers the potential role of HIA to provide a mechanism for integratinghealth concerns within a broader agenda of government and business. TBL is a framework linked to the broader sustainability agenda that underpins and reviews environmental, economic and social performance
Due to the rapid development of modern medical information technology, the modality and amount of electronic health record (EHR) data can be incredibly large. Clinicians must rely on the comparison and inter-confirmation among those complex multi-modal EHR data to make accurate clinical diagnoses, treatment plans and preventive measures. Integrated visualization is needed to extract valuable information from EHR data. This
|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
This study utilizes a stress and coping framework which includes cognitive appraisal, personal and environmental resources, coping and stress to examine factors related to African-American caregivers’ breast cancer screenings, including mammograms, clinical examinations and self-examinations. Using data from the Black Rural and Urban Caregivers Mental Health and Functioning Study, we performed separate logistic regressions for each type of breast cancer screening. Results reveal that having a regular doctor checkup (coping), care recipients having a cancer diagnosis (cognitive appraisal, and living in urban areas (environment resources) are associated with receiving a mammogram. Having greater income, having at least a high school degree (both personal resources) and having a regular doctor checkup (coping) are associated with receiving a clinical examination. Increased caregiver strain (stress), being 40 years old or older, social support (coping) and living in rural areas are associated with performing a self-examination. Targeting African-American caregivers, particularly in rural areas, for increased education on the importance of receiving breast cancer screenings is crucial to addressing health disparities. Making resources available, encouraging caregivers to get a clinical examination and a mammogram and directing public education toward caregivers are important points of intervention.
Inoue, Megumi; Pickard, Joseph G.; Welch-Saleeby, Patricia; Johnson, Sharon
This report synthesizes the collective experiences of four managed behavioralhealth care organizations (MBHOs) that hold public sector managed care carve-out contracts. Four representatives of these MBHOs participated in a daylong focus group meeting, an...
To assess whether Health Risk Appraisal (HRA), a computer-scored lifestyle analysis questionnaire, can result in significant\\u000a changes in healthbehavior, a controlled clinical trial with one-year follow-up was conducted among entering freshmen at an\\u000a urban state university. Three hundred fifty entering freshmen were each assigned to one of four groups: HRA with feedback,\\u000a HRA without feedback, initial control, and final
Computer-assisted behavioralhealth counseling for high school students (n = 45) was compared with an educational intervention in which health tip sheets were distributed (n = 17) and with an assessment-only condition (n = 15). In addition, overweight subjects in the computer-assisted counseling condition received computer-generated feedback designed to encourage weight reduction. At the conclusion of the 12-week study period,
Kent F. Burnett; Patricia E. Magel; Susan Harrington; C. Barr Taylor
Two studies are presented investigating the role of attitudes toward death in self-reported health-protective behavior. The Multidimensional Death Attitudes Scale (MDAS), based on three existing measures of death attitudes, was administered to a group of health professionals (N 5 348). A principal components analysis revealed five factors, labeled Acceptance, Fear, Death as Passage, Death as Relief and Avoidance. The five-factor
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.
There seems to be a lack of a coherent and integrative theory and theoretically informed manuals in cognitive behavioral therapies that could negatively impact both the program of CBT as a platform for psychotherapy integration, as well as its efficacy and effectiveness. Although CBT is the golden psychological treatment for various disorders, overall, about 30-40% of the patients are still non-responsive to these interventions and various schools debate their status as promoters of the best theoretical view. The objective of the present paper is to use cognitive psychology/science as a tool to clarify several theoretical confusions in CBT, with impact on a coherent science and practice of CBT. As a general conclusion, we believe that CBT has reached preeminence in the clinical field betting on cold cognitions. Despite obvious advantages and accomplishments, this approach seems to loose its heuristic value. We believe that the next phase of CBT development lies in the construct of hot cognitions (which would increase its effectiveness) and in cognitive psychology (which would contribute to a coherent science of CBT beyond various schools). These developments could offer CBT the chance to be a platform for the integration of psychotherapy. PMID:16325974
The current enthusiasm over the prospect of space tourism and the belief among many that such civilian spaceflight is imminent are characterized herein. There are many concerns about screening and certifying passengers for future spaceflight. Efforts by several organizations to propose such screening are cited. The problem with some of these proposals, which treat all types of spaceflight the same, is that they are so restrictive that too few people would be eligible for space travel to have a viable tourism industry. However, not all types of spaceflight are the same, so the distinctions between them need to be clarified. Of the five types of spaceflight described, one is proposed as the most likely to be the first significant phase of space tourism: long-term microgravity flight in low Earth orbit. But because of human problems with long-term exposure to microgravity, this phase requires rather conservative screening and extensive training. However, prior to discussing the passenger issues related to this early phase of space tourism, the reasons why Earth-like gravity, as well as microgravity, must be made available to spacefarers before space tourism can take place on a grand scale need to be explained. Finally, major passenger medical and behavioral issues of the first phase of orbital space tourism-long-term microgravity flight-are discussed. PMID:15943209
Performance data on Medicaid managed behavioralhealth care are for the most part unavailable. The purpose of the current study is to provide a benchmark of Medicaid enrollees' evaluations of access to, and quality of, behavioralhealth services and to examine the factors that influence these ratings. Eight hundred eighty-five Minnesota Medicaid managed care enrollees who received behavioralhealth services
:Performance data on Medicaid managed behavioralhealth care are for the most part unavailable. The purpose of the current study is to provide a benchmark of Medicaid enrollees' evaluations of access to, and quality of, behavioralhealth services and to examine the factors that influence these ratings. Eight hundred eighty-five Minnesota Medicaid managed care enrollees who received behavioralhealth services
Timothy J. Beebe; Patricia A. Harrison; James A. McRae Jr; Stephen E. Asche
OBJECTIVE: Our purpose was to assess whether an intervention in the education of the mother and the support person involves a change in health-related behavior and use of health facilities.STUDY DESIGN: A randomized, controlled trial was conducted in four cities of Latin America on pregnant women at risk. Half of them (n = 1115) received a home intervention of four
José M. Belizán; Fernando Barros; Ana Langer; Ubaldo Farnot; Cesar Victora; José Villar
Health education graduate students were surveyed to assess perceptions of their professional responsibility to be role models of healthy behaviors, characteristics of a professional role model, and related socializing experiences during professional preparation. A total of 233 randomly selected health education graduate students participated in this study nationwide. Significant inverse associations were found between students’ year in graduate school and
Relations between instrumental and expressive traits, healthbehaviors, and self-reported physical health were examined among young adults. Individuals (169 men, 167 women) completed two measures of instrumental and expressive traits, the Bem Sex Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ). Ethnic background of the sample included 72% European Americans, 13% Latin Americans, 6% Asian Americans, 5% African Americans,
The assumption of this study is: the preventive care beliefs and practices of health science students stand-out among the general public. To test this assumption, a survey of beliefs, behaviors and disease prevention practices of medical, dental, undergraduate and graduate nursing students in three health science schools was carried out in New Jersey. All students in these three schools were
G. Reza Najem; Marian Rose Catherine Passannante; James D. Foster
Despite Census Bureau projections that youth from minority cultures will comprise the majority of the nation's youth in approximately a decade, little research has been conducted on culturally sensitive interventions (CSIs). Accordingly, this study sought to determine: (1) the effectiveness of CSIs designed to address health and behavioralhealth outcomes, (2) whether effectiveness varies depending on the class or type
David R. Hodge; Kelly F. Jackson; Michael G. Vaughn
Healthbehaviors and mental health symptoms of parents living with AIDS (PLAs) were examined as a function of their sexual and substance-use lifestyles. The lifestyles of PLAs were classified as (1) Safe and Clean: having only protected sex and abstaining from substance use, (2) Safe Users: having protected sex, but engaging in substance use, (3) Unsafe and Clean: having unprotected
Marguerita Lightfoot; Leah Robin; Mary Jane Rotheram-Borus; Debra A. Murphy; Marie M. Diaz; Julie Lehane; Laura R. Rosen
This paper illustrates the importance of organisational culture for Clinical Information Systems (CIS) integration. The study is based on data collected in intensive care units in the UK and Denmark. Data were collected using qualitative methods, i.e., observations, interviews and shadowing of health care providers, together with a questionnaire at each site. The data are analysed to extract salient variables for CIS integration, and it is shown that these variables can be separated into two categories that describe the ‘Actual Usefulness’ of the system and the ‘Organisational Culture’. This model is then extended to show that CIS integration directly affects the work processes of the organisation, forming an iterative process of change as a CIS is introduced and integrated.
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…
Many investigators are considering developing video games for health (video-G4Hs) but have questions about how to get started. This report provides guidance for investigators considering a G4H as a behavioral intervention procedure from a team of experienced G4H developers. Thirteen commonly asked q...
This study investigated motivational factors in health- promoting behavior in later aging. The participants were 162 members of the Terman Study of the Gifted (82 men and 80 women) who responded to a mailout questionnaire in 1999 at a mean age of 86. The motivational variables included questionnaire measures of the goal to be as healthy as possible, purpose in
|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
Using telephone surveys, researchers examined the healthbehaviors of 1,408 Texas college students. Results indicated that most had consumed alcohol at least once, and nearly one-third were regular smokers. Most were sexually active but did not use condoms. Over half had never received HIV/AIDS education in college. (SM)
We have previously identified dietary patterns among 1,475 male and 780 female normal healthy control subjects in a case?control study of cancer at various sites. In this paper we examine the presence, among persons exhibiting these dietary patterns, of individual healthbehaviors that may contribute to risks for cancer. Specifically we examine trimming of separable fat from meats, fats used
Elizabeth Randall; James R. Marshall; Saxon Graham; John Brasure
Examined potential differences between individuals with high and low Cook and Medley (1954) Hostility (Ho) scale scores in regard to (a) self-esteem and particular developmental experiences; (b) utilization of social support, experience of anger, and the manner in which anger is managed; and (c) potentially health-damaging behaviors. Individuals with high Ho scale scores were found to be low in covert
This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N = 102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and\\/or drugs during
|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
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…
This article is a review of select empirical research studies examining television as an influence on children's healthbehaviors. The reader is first provided with an overview of the research on the role of television in children's lives. This is followed by an in-depth presentation of the research related to television content and its effect on risk-taking and the role
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 strong social approval goal orientation may encourage
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
|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:…
|This study examined the priority healthbehaviors of South African youth by administering a questionnaire to 635 undergraduate students enrolled in a large metropolitan university in South Africa. Results indicate that 65.5% of the participants tried cigarettes at least once during their lifetime, over 15.2% had their first cigarette and 31.2%…
|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…
|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…
|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…
|A study of patterns of healthbehavior among rural and small-town children surveyed 1,950 K-6 students from seven southern Illinois elementary schools. Findings indicate that less than half of the students ate the recommended amounts of fruits, vegetables, and grain each day. Males and females smoked at about the same rates, but sixth-grade boys…
Recent advances in research and understanding of the behavioralhealth impacts of an emergency medical service (EMS) career have necessitated reconceptualization of previous approaches to prevention, mitigation, and intervention. Approaches modeled on critical incident stress debriefing have fallen into disfavor due to a growing body of research indicating little if any efficacy for these techniques while suggesting the potential for
|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…
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)
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:…
Self-presentation has been shown to play a role in the performance of a variety of potentially health-damaging behaviors such as substance abuse, exercise avoidance, failing to wear protective sports equipment, and failing to seek medical treatment (Leary, Tchividjian, & Kraxberger, 1994; Martin, Leary, & Rejeski, 2000). Using the two component model of impression management (Leary & Kowalski, 1990) as an
This article presents findings from a study that evaluated the utility of Protection Motivation Theory to explain cardiovascular healthbehaviors among people with schizophrenia (n = 83) and depression (n = 70). Results indicated that the prevalence of overweight, cigarette smoking and a sedentary lifestyle were greater among people with a mental illness compared to individuals without a mental illness.
Purpose Psychosocial and healthbehavior treatments and therapies can be extended beyond traditional research or clinical settings by using mobile technology to deliver interventions to individuals as they go about their daily lives. These Ecological Momentary Interventions [EMI] are treatments that are provided to people during their everyday lives (i.e., in real time) and in natural settings (i.e., real world). The goal of the present review is to synthesize and critique mobile technology-based EMI aimed at improving healthbehaviors and psychological and physical symptoms. Methods Twenty-seven interventions using palmtop computers or mobile phones to deliver ambulatory treatment for smoking cessation, weight loss, anxiety, diabetes management, eating disorders, alcohol use, and healthy eating and physical activity were identified. Results There is evidence that EMI can be successfully delivered, are accepted by patients, and are efficacious for treating a variety of healthbehaviors and physical and psychological symptoms. Limitations of the existing literature were identified and recommendations and considerations for research design, sample characteristics, measurement, statistical analyses, and clinical implementation are discussed. Conclusions Mobile technology-based EMI can be effectively implemented as interventions for a variety of healthbehaviors and psychological and physical symptoms. Future research should integrate the assessment and intervention capabilities of mobile technology to create dynamically and individually tailored EMI that are ecologically sensitive.
Individuals with developmental disabilities often have a concomitant psychiatric disorder severe enough to require treatment. The behavioral endpoint of psychiatric disorders may require integratedbehavioral and psychopharmacological treatments to stabilize their condition and enhance their quality of life. We used a mindfulness-based mentoring model to facilitate the integration of behavioral and psychopharmacological treatments at the treatment team level. Using a
Nirbhay N Singh; Robert G Wahler; Mohamed Sabaawi; Amanda B Goza; Subhashni D Singh; Enrique J Molina
This study examines the antecedents of recycling and composting intentions in the context of an integrated waste management behavior model. This model incorporates a wide variety of important factors from previous research on environmental behavior. The theory of planned behavior provides a theoretical framework to integrate these factors. The model was tested using both recycling and composting data from a
This study evaluated the effects of performance feedback on levels of treatment integrity in school-based behavioral consultation. Three teachers employed in a residential treatment community were responsible for treatment implementation. Treatment integrity was defined as the percentage of 2 minute intervals during which contingent teacher reinforcement for student on-task behavior was directly observed. Teacher and child behavior were monitored across
Kevin M. Jones; Katherine F. Wickstrom; Patrick C. Friman
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
A number of theories and models of special relevance to individual health education are presented, such as: the Knowledge-Attitude-Practice model; Social Learning Theory and Health Locus of Control; the Health Belief Model; the Theory of Reasoned Action; and Bandura's Social Cognitive Theory. Recently, promising attempts have been made to integrate several of the models. Across the models, the most important regulatory factors for behaviour seem to be social norms, personal expectations and environmental reinforcements. These factors should be considered by the doctor in attempts to induce changes in patients' health-related behaviour. In the future development of health behaviour models, social and environmental factors will probably be given even more attention. PMID:8424252
Mortality rates are lower for married individuals than they are for unmarried individuals, and marriage seems to be even more beneficial to men than women in this regard. A theoretical model of social integration and social control is developed to explain why this may occur. Drawing from this model, I hypothesize that marriage may be beneficial to health because many
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.
As a way of identifying a conduit to disseminate health information, this study aims to explore healthbehaviors and attitudes of a unique group of extensively socially-networked individuals who regularly are asked for their health advice. Respondents from a population-based consumer opinion panel (n = 2,639) were categorized as “extensively socially-networked” (75+ friends and acquaintances, and almost daily giving friends advice on
Uriyoan Colon-Ramos; Audie A. Atienza; Deanne Weber; Melissa Taylor; Christina Uy; Amy Yaroch
Physical function is a significant component of health-related quality of life among older adults. Potential correlates of healthy aging, including healthbehaviors and social network characteristics, were examined among 56,436 US women aged 55–72 in 1992. Healthy aging was assessed by maintenance of physical function measured by four sub-scales of the Medical Outcomes Study Short Form (SF)-36 Health Survey: physical
Yvonne L. Michael; Graham A. Colditz; Eugenie Coakley; Ichiro Kawachi
This study examined caregiver perceptions of mental health problems and counseling needs in low-income children with special health care needs (CSHCN). Interviewers collected data from 257 caregivers of CSHCN (61% males; 60% African American; Mean age = 8.4 years) attending six Midwestern inner-city health clinics. Measures included the Child Behavior Checklist (CBCL) and an investigator-designed questionnaire. CBCL T-scores indicated that
Janie Canty-Mitchell; Joan K Austin; Kim Jaffee; Rong Amy Qi; Nancy Swigonski
Background: Non-communicable diseases (NCDs) are major contributors of morbidity and mortality in the elderly. Estimating the prevalence of hypertension and studying the health seeking behavior is important. Aim: This study was designed to estimate the prevalence of hypertension and understand the health seeking behavior among the elderly in rural Puducherry, south India. Materials and Methods: A total of 211 elderly from a rural community were selected by systematic random sampling. Blood pressure (BP) was measured. Socio-demographic characteristics and health seeking behavior were assessed by interviews. Results: Prevalence of hypertension among study participants was 40.5%. Prevalence of hypertension among elderly male subjects was 39.2% and in female subjects was 40.8%. About 62% (53 out of 85 hypertensives) were already aware of their hypertensive status. About 54.7% (29) were diagnosed at government health facilities either at primary health centers (PHCs) or a government hospital. Conclusion: Burden of hypertension among the elderly is high in rural areas. Strategies to detect and treat hypertension in the elderly have to be implemented early.
The present research examines health persuasion from an embodied cognition perspective by proposing that engaging the motor system during health persuasion will lead individuals to engage in healthier behavior and have greater consistency between their intentions and behavior. In two studies, participants watched a health video while either imaging themselves performing the behavior or imaging themselves performing the behavior while
Approaching men's healthbehaviors from a gender socialization framework, we hypothesized that (a) men's healthbehaviors would significantly relate to their conformity to traditional masculine norms, (b) these behaviors would significantly differ as a function of their nationality, and (c) masculinity and nationality would significantly interact to predict men's healthbehaviors. Five hundred forty-six male college students (384 Kenyan men,
|Objective: There is a dearth of studies on the mechanisms of multiple risk behaviors, even though these behaviors are significant public health issues. The authors investigated whether healthbehavior interventions have transfer or compensatory effects on other healthbehaviors. Participants and Methods: The authors looked at transfer and…
Nigg, Claudio Renato; Lee, Hye-ryeon; Hubbard, Amy E.; Min-Sun, Kim
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
Two studies are presented investigating the role of attitudes toward death in self- reported health-protective behavior. The Multidimensional Death Attitudes Scale (MDAS), based on three existing measures of death attitudes, was administered to a group of health professionals (N = 348). A principal components analysis revealed five factors, labeled Acceptance, Fear, Death as Passage, Death as Relief and Avoidance. The five- factor structure also was replicated in a second, somewhat different sample (N = 100). Twenty-three items loaded highly on the five factors, and the subscales showed good internal consistency. The relationship between the five death attitudes and self-reported healthbehaviors was explored. Acceptance of death was associated positively with physical exercise controlling for demographic and psychological variables. Accepting death but not viewing death as relief were associated with self- reported lower levels of drinking and driving. PMID:22012319
|The Motivators of and Barriers to Health-Smart Behaviors Inventory (MB-HSBI) was developed for use in identifying self-reported motivators of and barriers to the following health-promoting behaviors (called "health-smart behaviors") that should occur daily to help promote health and overcome illnesses/diseases: eating a healthy breakfast, eating…
Tucker, Carolyn M.; Rice, Kenneth G.; Hou, Wei; Kaye, Lillian B.; Nolan, Sarah E. M.; Grandoit, Delphia J.; Gonzales, Lucia; Smith, Mary B.; Desmond, Frederic F.
The Motivators of and Barriers to Health-Smart Behaviors Inventory (MB-HSBI) was developed for use in identifying self-reported motivators of and barriers to the following health-promoting behaviors (called "health-smart behaviors") that should occur daily to help promote health and overcome illnesses/diseases: eating a healthy breakfast, eating…
Tucker, Carolyn M.; Rice, Kenneth G.; Hou, Wei; Kaye, Lillian B.; Nolan, Sarah E. M.; Grandoit, Delphia J.; Gonzales, Lucia; Smith, Mary B.; Desmond, Frederic F.
This study examined the prevalence of selected clinical preventive health services, health status indicators, health risk behaviors, and health-promoting behaviors among adults aged 18 to 24 years in the general U.S. population. The study analyzed data from the 2003 Behavioral Risk Factor Surveillance System. Nearly 30% of young adults lacked…
This study investigates the effects of socioeconomic and health programme factors on preventive and curative healthbehaviors and assesses the impact of preventive healthbehaviors on the incidence of diarrhoea among children under five years of age. Methodological approaches included focus groups to uncover local definitions of diarrhoeal disease, a baseline survey which collected data on maternal preventive healthbehaviors
Research suggests that more than ten percent of older adults experience behavioralhealth problems (including mental health problems and\\/or substance abuse). However, very few actually receive care from a behavioralhealth care provider or even a primary care provider. One major barrier to accessing and receiving care is the feeling of perceived stigma commonly associated with behavioralhealth problems. The
It is estimated that 5 to 10% of all colorectal cancer (CRC) cases are attributed to a hereditary cause. The primary hereditary cancer syndromes that confer an increased risk for colorectal cancers are Lynch syndrome/hereditary nonpolyposis colorectal cancer (HNPCC) and familial adenomatous polyposis (FAP). Through genetic testing, health care providers can identify patients and families who carry gene mutations and subsequently are at a substantially greater risk for developing colorectal cancer than the general population. Genetic testing provides risk information not only about an individual patient, but also his or her biological relatives. A variety of risk-reduction behaviors (including screening, surgery, and health and lifestyle behaviors) have been examined in Lynch syndrome and FAP populations. The research indicates that screening behaviors are less than optimal, although the rates vary from study to study. Prophylactic colectomy is the primary course of treatment for individuals who test positive for a FAP mutation, but the results are inconclusive for cancer-unaffected Lynch syndrome mutation carriers. Although research suggests that the adoption of healthy lifestyles and behaviors (e.g., diet, physical activity, weight control, smoking cessation, limited alcohol consumption) could have a favorable impact on colon cancer burden, there is minimal data on how these behaviors may moderate cancer risk among those at risk of hereditary colon cancer. To date, we know very little about the actual health and lifestyle behaviors of those at risk of hereditary colon cancer. Genetic testing and counseling at risk individuals may resolve uncertainty about their personal and familial cancer risk and provide information to guide and personalize decisions about their future health care.
Burton, Allison M.; Hovick, Shelly R.; Peterson, Susan K.
Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as ‘a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain’. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions.
This article is an integrative review that aimed to evaluate the available evidence in the literature on the development of strategies operationalized by community health agents for health promotion. Three databases were used - BDTD, LILACS and SciELO - and 2,179 publications were found, of which 58 were selected for analysis. The results were summarized in three empirical categories: Health promotion: challenges in reorienting the health care model, Educational practice in the daily work of community health agents and Vocational training in the perspective of Primary Health Care. The conclusion is that the construction of a model of care based on health promotion requires the incorporation of new educational, care-related and institutional practices. PMID:23887792
Pereira, Iara Cristina; Oliveira, Maria Amélia de Campos
The 2003 AMCHA Summit was an initial step. It served to provide a broad outline of the socio-political context and key issues involved in reducing disparities, and it provided some momentum for change. However, much more work remains to be done. The summit clearly demonstrated that the reduction of disparities requires a multi-level approach and multi-disciplinary leaders. As a neutral convener, AMCHA is in a unique position to help advance the debate and lead the field. The membership includes researchers, administrators, clinicians, and policy makers from all levels of the behavioralhealth system. As noted, a change agenda needs to include efforts at national, state, and local levels involving consumers, providers, purchasers, oversight organizations, and researchers. ACMHA is committed to advancing the field and helping the national effort to reduce disparities. Examples of potential projects include the following: Training: Much has been done to develop effective cultural-competency training modules and to guide states in its implementation. No one should reinvent the wheel at this time. Funding should be targeted to provide incentives to states for dissemination of existing training curricula and the documentation of effectiveness to all providers and administrators. Data: Nationally, the field will benefit from data standards for the collection of and reporting on system disparities. This will facilitate interstate comparisons and provide baseline data for change efforts. Conducting surveys of providers, health plans, and public behavioralhealth systems on the availability and current uses of data by race and ethnicity is one example of a useful first step in this process of setting data standards. Research: Further research on the nature and causes of disparity is needed. There should be systematic research on factors influencing access, treatment, and outcomes for people of different cultures. Initially, because of the difficulties in deciding on standardized outcome measures, the encounter and claims data will provide the most useful information for analysis. Later, as standardized outcome measures are more widely utilized and the data collected, it may be possible to look for racial and ethnic differences in outcomes. The research agenda needs to be developed with a focus on services and health systems research data. Demonstrations: Demonstration efforts are urgently needed, similar to Connecticut's initiative, that integrate data on disparities with provider reporting, performance contracting, and system-wide interventions. These best practices need to be shared with the field. Coordination: The Summit showed that many are eager to learn from others in this area. As we move from further research to demonstration initiatives, AMCHA can play a role in coordinating these projects, particularly at the state and perhaps local levels. State efforts can benefit from best-practice presentations from other states and by an improved understanding of the nature and scope of the change required at a programmatic and local level. Local efforts need to clearly incorporate the views and perspectives of members of the community and consumers. The 2003 ACMHA Summit provided a foundation and a framework for work to proceed at all levels of the behavioralhealth delivery system. To accomplish meaningful change, we challenge SAMHSA, and the other federal agencies to provide the leadership to (1) develop common and core-performance measures focused on the reduction of disparities, (2) coordinate the research agenda, and (3) facilitate the use of new information technologies to collect and review these data. This is completely consistent with the vision of federal "leadership by example" that has been outlined by the Institute of Medicine (2003b) for the implementation of the "Crossing the Quality Chasm" report. We need to facilitate the efforts of the states and the federal government to identify and reduce disparities and provide a forum for states to share the results of their efforts, to benchmark their pe
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...
Background Co-occurrence of different behaviors was investigated using the theoretical underpinnings of the Transtheoretical Model, the Theory of Triadic Influence and the concept of Transfer.\\u000a \\u000a \\u000a \\u000a \\u000a Purpose To investigate relationships between different healthbehaviors' stages of change, how behaviors group, and whether study\\u000a participants cluster in terms of their behaviors.\\u000a \\u000a \\u000a \\u000a \\u000a Method Relationships across stages for different behaviors were assessed in three studies with N?=?3,519,
Background An integrated sense of professionalism enables health professionals to draw on relevant knowledge in context and to apply a set of professional responsibilities and ethical principles in the midst of changing work environments [1,2]. Inculcating professionalism is therefore a critical goal of health professional education. Two multi-professional courses for first year Health Science students at the University of Cape Town, South Africa aim to lay the foundation for becoming an integratedhealth professional . In these courses a diagram depicting the domains of the integratedhealth professional is used to focus the content of small group experiential exercises towards an appreciation of professionalism. The diagram serves as an organising framework for conceptualising an emerging professional identity and for directing learning towards the domains of 'self as professional' [4,5]. Objective This paper describes how a diagrammatic representation of the core elements of an integratedhealth professional is used as a template for framing course content and for organising student learning. Based on the assumption that all health care professionals should be knowledgeable, empathic and reflective, the diagram provides students and educators with a visual tool for investigating the subjective and objective dimensions of professionalism. The use of the diagram as an integrating point of reference for individual and small group learning is described and substantiated with relevant literature. Conclusion The authors have applied the diagram with positive impact for the past six years with students and educators reporting that "it just makes sense". The article includes plans for formal evaluation. Evaluation to date is based on preliminary, informal feedback on the value of the diagram as a tool for capturing the domains of professionalism at an early stage in the undergraduate education of health professional students.
Altered reactivity to stress, either in the direction of exaggerated reactivity or diminished reactivity, may signal a dysregulation of systems intended to maintain homeostasis and a state of good health. Evidence has accumulated that diminished reactivity to psychosocial stress may signal poor health outcomes. One source of diminished cortisol and autonomic reactivity is the experience of adverse rearing during childhood and adolescence. The Oklahoma Family Health Patterns Project has examined a cohort of 426 healthy young adults with and without a family history of alcoholism. Regardless of family history, persons who had experienced high degrees of adversity prior to age 16 had a constellation of changes including reduced cortisol and heart rate reactivity, diminished cognitive capacity, and unstable regulation of affect, leading to behavioral impulsivity and antisocial tendencies. We present a model whereby this constellation of physiological, cognitive, and affective tendencies is consistent with altered central dopaminergic activity leading to changes in brain function that may foster impulsive and risky behaviors. These in turn may promote greater use of alcohol other drugs along with adopting poor healthbehaviors. This model provides a pathway from early life adversity to low stress reactivity that forms a basis for risky behaviors and poor health outcomes. PMID:23085387
Fueled by the rapid pace of discovery, humankind's ability to understand the ultimate causes of preventable common disease burdens and to identify solutions is now reaching a revolutionary tipping point. Achieving optimal health and well-being for all members of society lies as much in the understanding of the factors identified by the behavioral, social, and public health sciences as by the biological ones. Accumulating advances in mathematical modeling, informatics, imaging, sensor technology, and communication tools have stimulated several converging trends in science: an emerging understanding of epigenomic regulation; dramatic successes in achieving population health-behavior changes; and improved scientific rigor in behavioral, social, and economic sciences. Fostering stronger interdisciplinary partnerships to bring together the behavioral-social-ecologic models of multilevel "causes of the causes" and the molecular, cellular, and, ultimately, physiological bases of health and disease will facilitate breakthroughs to improve the public's health. The strategic vision of the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH) is rooted in a collaborative approach to addressing the complex and multidimensional issues that challenge the public's health. This paper describes OBSSR's four key programmatic directions (next-generation basic science, interdisciplinary research, systems science, and a problem-based focus for population impact) to illustrate how interdisciplinary and transdisciplinary perspectives can foster the vertical integration of research among biological, behavioral, social, and population levels of analysis over the lifespan and across generations. Interdisciplinary and multilevel approaches are critical both to the OBSSR's mission of integratingbehavioral and social sciences more fully into the NIH scientific enterprise and to the overall NIH mission of utilizing science in the pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability. PMID:18619402
Mabry, Patricia L; Olster, Deborah H; Morgan, Glen D; Abrams, David B
eHealth is expected to integrate a comprehensive set of patient data sources into a coherent continuum, but implementations vary and Portugal is still lacking on electronic patient data sharing. In this work, we present a clinical information hub to aggregate multi-institution patient data and bridge the information silos. This integration platform enables a coherent object model, services-oriented applications development and a trust framework. It has been instantiated in the Rede Telemática de Saúde (www.RTSaude.org) to support a regional Electronic Health Record approach, fed dynamically from production systems at eight partner institutions, providing access to more than 11,000,000 care episodes, relating to over 350,000 citizens. The network has obtained the necessary clearance from the Portuguese data protection agency. PMID:21893763
Treatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. This article describes a multisite effort by the Treatment Fidelity Workgroup of the National Institutes of HealthBehavior Change Consortium (BCC) to identify treatment fidelity concepts and strategies in healthbehavior intervention research. The work group reviewed treatment fidelity practices in
Albert J. Bellg; Belinda Borrelli; Barbara Resnick; Jacki Hecht; Daryl Sharp Minicucci; Marcia Ory; Gbenga Ogedegbe; Denise Orwig; Denise Ernst; Susan Czajkowski
Pesticides have a role in public health as part of sustainable integrated mosquito management. Other components of such management include surveillance, source reduction or prevention, biological control, repellents, traps, and pesticide-resistance management. We assess the future use of mosquito control pesticides in view of niche markets, incentives for new product development, Environmental Protection Agency registration, the Food Quality Protection Act, and improved pest management strategies for mosquito control.
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.
Background Little is known about the practitioners in managed behavioral healthcare organization (MBHO) networks who are treating mental and substance use disorders among privately insured patients in the United States. It is likely that the role of the private sector in treating behavioralhealth will increase due to the recent implementation of federal parity legislation and the inclusion of behavioralhealth as a required service in the insurance exchange plans created under healthcare reform. Further, the healthcare reform legislation has highlighted the need to ensure a qualified workforce in order to improve access to quality healthcare, and provides an additional focus on the behavioralhealth workforce. To expand understanding of treatment of mental and substance use disorders among privately insured patients, this study examines practitioner types, experience, specialized expertise, and demographics of in-network practitioners providing outpatient care in one large national MBHO. Methods Descriptive analyses used 2004 practitioner credentialing and other administrative data for one MBHO. The sample included 28,897 practitioners who submitted at least one outpatient claim in 2004. Chi-square and t-tests were used to compare findings across types of practitioners. Results About half of practitioners were female, 12% were bilingual, and mean age was 53, with significant variation by practitioner type. On average, practitioners report 15.3?years of experience (SD?=?9.4), also with significant variation by practitioner type. Many practitioners reported specialized expertise, with about 40% reporting expertise for treating children and about 60% for treating adolescents. Conclusions Overall, these results based on self-report indicate that the practitioner network in this large MBHO is experienced and has specialized training, but echo concerns about the aging of this workforce. These data should provide us with a baseline of practitioner characteristics as we enter an era that anticipates great change in the behavioralhealth workforce.
The addition of performance feedback increased treatment integrity for three teachers who implemented interventions in a residential treatment community. Findings support the need for direct assessment of treatment integrity in school-based behavioral consultation research and practice. (EMK)
Jones, Kevin M.; Wickstrom, Katherine F.; Friman, Patrick C.
|The addition of performance feedback increased treatment integrity for three teachers who implemented interventions in a residential treatment community. Findings support the need for direct assessment of treatment integrity in school-based behavioral consultation research and practice. (EMK)|
Jones, Kevin M.; Wickstrom, Katherine F.; Friman, Patrick C.