WorldWideScience

Sample records for behavioral health outcomes

  1. Health behaviors and work-related outcomes among school employees.

    Science.gov (United States)

    LeCheminant, James D; Merrill, Ray M; Masterson, Travis

    2015-05-01

    To determine the association between selected health behaviors and work-related outcomes among 2398 school-based employees who voluntarily enrolled in a worksite wellness program. This study presents participants' baseline data collected from a personal health assessment used by Well-Steps, a third-party wellness company. Employees with high levels of exercise, fruit/vegetable consumption, or restful sleep exhibited higher job-performance and job-satisfaction, and lower absenteeism (p job-performance (Prevalence Ratio=1.09; 95% CI=1.05-1.13), job-satisfaction (Prevalence Ratio=1.53; 95% CI=1.30-1.80), and lower absenteeism (Prevalence Ratio=1.16; 95% CI=1.08-1.325). Further, number of co-occurring health behaviors influenced other satisfaction and emotional health outcomes. Selected healthy behaviors, individually or co-occurring, are associated with health outcomes potentially important at the worksite.

  2. Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study.

    Science.gov (United States)

    Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin; Fu, Hua

    2017-01-01

    To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion.

  3. Psychosocial and Health Behavior Outcomes of Young Adults with Asthma or Diabetes.

    Science.gov (United States)

    Berge, Jerica M; Bauer, Katherine W; Eisenberg, Marla E; Denny, Kara; Neumark-Sztainer, Dianne

    2012-04-30

    Previous research has shown a relationship between childhood/adolescent chronic conditions and negative health behaviors, psychological outcomes, and social outcomes. Less is known about whether these negative outcomes are experienced by young adults with chronic health conditions. The purpose of this paper is to investigate how young adults' BMI, health behaviors, and psychological and social outcomes differ depending on whether they have diabetes, asthma, or neither of these chronic conditions. Data were drawn from the third wave of Project EAT-III: Eating and Activity in Young Adults, a population-based study of 2287 young adults (mean age = 25.3; range 19.8 - 31.2). General linear models were used to test differences in BMI, health behaviors (e.g., fast food intake) and psychosocial outcomes (e.g. depressive symptoms) by young adults' chronic disease status. Young adults with diabetes had higher BMIs, engaged in less physical activity and more unhealthy weight control behaviors and binge eating, had lower self-esteem and lower body satisfaction, and experienced more depressive symptoms and appearance-based teasing compared to young adults with asthma or no chronic conditions, after adjusting for age, race/ethnicity, socio-economic status (SES) and, when relevant, for BMI. There were no significant differences between young adults with asthma and young adults with no chronic condition on all of the psychosocial and health behavior outcomes. Young adults with diabetes reported higher prevalence of negative health behaviors and psychosocial outcomes. Providers may find it useful to assess for negative health behaviors and psychosocial variables with young adults with diabetes in order to improve treatment and quality of life for these individuals.

  4. Family Structure Changes and Children's Health, Behavior, and Educational Outcomes

    DEFF Research Database (Denmark)

    Rasmussen, Astrid Würtz

    More and more children do not grow up in traditional nuclear families. Instead, they grow up in single-parent households or in families with a step-parent. Hence, it is important to improve our understanding of the impact of "shocks" in family structure due to parental relationship dissolution...... on children. In this study I empirically test whether children are traumatized both in the short and the long run by shocks in the family structure during childhood. I focus on educational, behavioral, and health outcomes. A population sample of Danish children born in January to May 1985 is used...... for the analysis. The empirical cross-sectional analysis indicates a negative relation between the number of family structure changes and children.s health, behavior, and educational outcomes. These results are con.rmed by a differences-in-differences analysis of health outcomes. This suggests...

  5. Associations of military divorce with mental, behavioral, and physical health outcomes.

    Science.gov (United States)

    Wang, Lawrence; Seelig, Amber; Wadsworth, Shelley MacDermid; McMaster, Hope; Alcaraz, John E; Crum-Cianflone, Nancy F

    2015-06-19

    Divorce has been linked with poor physical and mental health outcomes among civilians. Given the unique stressors experienced by U.S. service members, including lengthy and/or multiple deployments, this study aimed to examine the associations of recent divorce on health and military outcomes among a cohort of U.S. service members. Millennium Cohort participants from the first enrollment panel, married at baseline (2001-2003), and married or divorced at follow-up (2004-2006), (N = 29,314). Those divorced were compared to those who remained married for mental, behavioral, physical health, and military outcomes using logistic regression models. Compared to those who remained married, recently divorced participants were significantly more likely to screen positive for new-onset posttraumatic stress disorder, depression, smoking initiation, binge drinking, alcohol-related problems, and experience moderate weight gain. However, they were also more likely be in the highest 15(th) percentile of physical functioning, and be able to deploy within the subsequent 3-year period after divorce. Recent divorce among military members was associated with adverse mental health outcomes and risky behaviors, but was also associated with higher odds of subsequent deployment. Attention should be given to those recently divorced regarding mental health and substance abuse treatment and prevention strategies.

  6. Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

    Science.gov (United States)

    Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

  7. Relations of behavioral autonomy to health outcomes among emerging adults with and without type 1 diabetes.

    Science.gov (United States)

    Helgeson, Vicki S; Reynolds, Kerry A; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Sedentary behavior and health outcomes: an overview of systematic reviews.

    Directory of Open Access Journals (Sweden)

    Leandro Fornias Machado de Rezende

    Full Text Available 1 To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2 To assess the methodological quality of the systematic reviews found.Medline; Excerpta Medica (Embase; PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers.This overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted.

  9. Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes

    DEFF Research Database (Denmark)

    von Arx, Lill-Brith Wium; Gydesen, Helge; Skovlund, Søren

    2016-01-01

    Objective: While the prevalence of type 2 diabetes is growing, it is increasingly well recognized that treatment outcomes in primary care practice are often suboptimal. The aim of this study is to examine the extent to which treatment beliefs and health behaviors predict diabetes health outcome......-reported survey administered to all insulin-treated people in the registry (n=3160). The survey was constructed to operationalize key concepts of diabetes management, diabetes treatment beliefs, and health behaviors. Results: In total, 1033 respondents answered the survey. The majority of treatment beliefs...... and health behaviors examined were predictors of glycemic control and, to a large extent, lipid profile. Absence from, or a low frequency of, self-measured blood glucose, non-adherence to general medical advice and the prescribed treatment, a low primary care utilization, and perceived low treatment efficacy...

  10. Treatment beliefs, health behaviors and their association with treatment outcome in type 2 diabetes

    Science.gov (United States)

    von Arx, Lill-Brith Wium; Gydesen, Helge; Skovlund, Søren

    2016-01-01

    Objective While the prevalence of type 2 diabetes is growing, it is increasingly well recognized that treatment outcomes in primary care practice are often suboptimal. The aim of this study is to examine the extent to which treatment beliefs and health behaviors predict diabetes health outcome as measured by glycated hemoglobin (HbA1c) level, blood pressure, and lipid profile. Research design and methods This was a large-scale cross-sectional, registry-based study involving a well-defined type 2 diabetes population, in the county of Funen, Denmark. Registry data were combined with a 27-item self-reported survey administered to all insulin-treated people in the registry (n=3160). The survey was constructed to operationalize key concepts of diabetes management, diabetes treatment beliefs, and health behaviors. Results In total, 1033 respondents answered the survey. The majority of treatment beliefs and health behaviors examined were predictors of glycemic control and, to a large extent, lipid profile. Absence from, or a low frequency of, self-measured blood glucose, non-adherence to general medical advice and the prescribed treatment, a low primary care utilization, and perceived low treatment efficacy were factors positively associated with HbA1c levels, s-cholesterol, and low-density lipoprotein. Conversely, infrequent self-measured blood glucose was associated with a significantly higher likelihood of having a blood pressure below 130/80 mm Hg. Perceived low treatment efficacy was the only health belief associated with poorer levels of health outcome other than HbA1c. Conclusions Health behaviors were stronger predictors for health outcomes than treatment beliefs. Self-reported adherence to either the treatment regimen or general medical advice most consistently predicted both glycemic control and cardiovascular risk factors. PMID:27110367

  11. Family Structure Changes and Children's Health, Behavior, and Educational Outcomes

    DEFF Research Database (Denmark)

    Rasmussen, Astrid Würtz

    More and more children do not grow up in traditional nuclear families. Instead they grow up in single parent households or in families with a step-parent. Hence it is important to improve our understanding of the impact of "shocks" in family structure due to parental relationship dissolution...... on children. In this study I empirically test whether children are traumatized both in the short and the long run by shocks in the family structure during childhood. I focus on educational, behavioral, and health outcomes. A population sample of Danish children born in January to May 1983, 1984, and 1985...... is used for the analysis. The empirical cross-sectional analysis indicates a negative relation between the number of family structure changes and children.s educational outcomes. Children experiencing many family structure changes also seem to have worse health outcomes....

  12. The Influence of Violence Victimization on Sexual Health Behaviors and Outcomes.

    Science.gov (United States)

    Latimer, Jennifer; Fleckman, Julia; Wallace, Maeve; Rountree, Michele; Theall, Katherine

    2017-05-01

    This study examines the implications of a history of personal violence on health and health behaviors. A secondary analysis of cross-sectional data involving adults (n = 214) from a semirural area in southern Louisiana between October 2008 and December 2010 was conducted to ascertain the association between a personal history of violence victimization and indicators of sexual health behaviors and outcomes: communication with sexual partners about HIV status, consistent condom use, and sexually transmitted infection (STI). While violence victimization is widely accepted as a risk factor for high-risk sex behavior, the mechanisms underlying violence victimization's influence on sexual health outcomes remain unclear. Bivariate analyses demonstrated a significant positive association between experience of physical abuse and lifetime history of STI. Surprisingly, respondents reporting lifetime physical violence were more than two times more likely to ask sexual partners about HIV status [odds ratio (OR) for physical attack = 2.23, 95% confidence intervals (CI) = 1.00-4.97; OR for physical injury = 4.60, 95% CI = 1.79-11.85]. Consistent condom use was not significantly associated with violence exposure in adjusted models. There was no evidence that communication with sexual partners mediated the relationship between experiences of violence and condom use. The link between personal history of violence and condom use may be mediated through alternative pathways beyond communication.

  13. Effects of state-level Earned Income Tax Credit laws in the U.S. on maternal health behaviors and infant health outcomes.

    Science.gov (United States)

    Markowitz, Sara; Komro, Kelli A; Livingston, Melvin D; Lenhart, Otto; Wagenaar, Alexander C

    2017-12-01

    The purpose of this paper is to investigate the effects of state-level Earned Income Tax Credit (EITC) laws in the U.S. on maternal health behaviors and infant health outcomes. Using multi-state, multi-year difference-in-differences analyses, we estimated effects of state EITC generosity on maternal health behaviors, birth weight and gestation weeks. We find little difference in maternal health behaviors associated with state-level EITC. In contrast, results for key infant health outcomes of birth weight and gestation weeks show small improvements in states with EITCs, with larger effects seen among states with more generous EITCs. Our results provide evidence for important health benefits of state-level EITC policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Family-Level Factors and African American Children's Behavioral Health Outcomes: A Systematic Review

    Science.gov (United States)

    Washington, Tyreasa; Rose, Theda; Colombo, Gia; Hong, Jun Sung; Coard, Stephanie Irby

    2015-01-01

    Background: Considerable prior research targeting African American children has focused on the pervasiveness of problematic behavior and negative risk factors associated with their development, however the influence of family on better behavioral health outcomes has largely been ignored. Objective: The purpose of this review is to examine…

  15. Associations of Military Divorce with Mental, Behavioral, and Physical Health Outcomes

    Science.gov (United States)

    2015-06-19

    sion was similar among recent divorcees and those who were single. Understanding the temporal proximity of the association between a recent divorce ...Shapiro E. Alcohol consumption and divorce : Which causes which? J Divorce . 1988;12(1):127–36. 60. Lee MR, Chassin L, Mackinnon D. The effect of marriage...Naval Health Research Center Associations of Military Divorce With Mental, Behavioral, and Physical Health Outcomes Lawrence Wang Amber Seelig

  16. If you drink, don't smoke: Joint associations between risky health behaviors and labor market outcomes.

    Science.gov (United States)

    Böckerman, Petri; Hyytinen, Ari; Kaprio, Jaakko; Maczulskij, Terhi

    2018-06-01

    This paper examines the links between risky health behaviors and labor market success. We provide new evidence on the joint relationships between the most prominent forms of risky health behavior - alcohol consumption, smoking and physical inactivity - and long-term labor market outcomes. We use twin data for Finnish men and women linked to register-based individual information on earnings and labor market attachment. The twin data allow us to account for shared family and environmental factors and to measure risky health behaviors in 1975 and 1981. The long-term labor market outcomes were measured in adulthood as an average over the period 1990-2009. The sample sizes are 2156 and 2498 twins, for men and women, respectively. We find that being both a smoker and a heavy drinker in early adulthood is negatively related to long-term earnings and employment later in life, especially for men. We conclude that how and why risky health behaviors cluster and how that affects individual level outcomes call for more attention. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Preventing Health Damaging Behaviors and Negative Health Outcomes in Army and Marine Corps Personnel during the First Tour of Duty

    National Research Council Canada - National Science Library

    Boyer, Cherrie B; Shafer, Mary-Ann

    2007-01-01

    .... The common thread through these negative health outcomes is volitional behavior. Such behaviors do not only result in illness or injury, but also negatively impact performance of military duties and threaten military readiness...

  18. Preventing Health Damaging Behaviors and Negative Health Outcomes in Army and Marine Corps Personnel During the First Tour of Duty

    National Research Council Canada - National Science Library

    Boyer, Cherrie B; Shafer, Mary-Ann

    2006-01-01

    .... The common thread through these negative health outcomes is volitional behavior. Such behaviors do not only result in illness or injury, but also negatively impact performance of military duties and threaten military readiness...

  19. Health behavior in persons with spinal cord injury: development and initial validation of an outcome measure.

    Science.gov (United States)

    Pruitt, S D; Wahlgren, D R; Epping-Jordan, J E; Rossi, A L

    1998-10-01

    To describe the development and initial psychometric properties of a new outcome measure for health behaviors that delay or prevent secondary impairments associated with spinal cord injury (SCI). Persons with SCI were surveyed during routine annual physical evaluations. Veterans Affairs Medical Center Spinal Cord Injury Unit, which specializes in primary care for persons with SCI. Forty-nine persons with SCI, aged 19-73 years, 1-50 years post-SCI. The newly developed Spinal Cord Injury Lifestyle Scale (SCILS). Internal consistency is high (alpha = 0.81). Correlations between clinicians' ratings of participants' health behavior and the new SCILS provide preliminary support for construct validity. The SCILS is a brief, self-report measure of health-related behavior in persons with SCI. It is a promising new outcome measure to evaluate the effectiveness of clinical and educational efforts for health maintenance and prevention of secondary impairments associated with SCI.

  20. Factors associated with health care access and outcome.

    Science.gov (United States)

    Paek, Min-So; Lim, Jung-Won

    2012-01-01

    This study aims to (1) assess ethnic differences in health care access and health outcome between Asian Americans and whites and between Asian American subgroups, (2) examine effects of cultural factors, and (3) investigate moderating effects of health risk behaviors between cultural characteristics and health care access and outcome. Data were derived from the 2007 California Health Interview Survey. Asian Americans (n = 4,462) and whites (n = 4,470) were included. There were significant ethnic differences in health care access and health perception between Asian Americans and Whites and across Asian American subgroups. Health risk behaviors moderated relationships between cultural factors and health care access and outcome. Findings reveal that ethnicity affects an individual's health care access and health perception, and their health behaviors are an important factor that may improve or worsen outcomes. This study may increase our knowledge base of research and interventions to enhance ethnic minority populations' health care accessibility and perceptions.

  1. Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial.

    Science.gov (United States)

    Hawkes, Anna L; Chambers, Suzanne K; Pakenham, Kenneth I; Patrao, Tania A; Baade, Peter D; Lynch, Brigid M; Aitken, Joanne F; Meng, Xingqiong; Courneya, Kerry S

    2013-06-20

    Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form-36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m(2)], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months. At 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (-0.9 kg/m(2); P = .001), energy from total fat (-7.0%; P = .006), and energy from saturated fat (-2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.

  2. School promotion of healthful diet and physical activity: impact on learning outcomes and self-reported behavior.

    Science.gov (United States)

    Parcel, G S; Simons-Morton, B; O'Hara, N M; Baranowski, T; Wilson, B

    1989-01-01

    The Go For Health Program included classroom health education and environmental changes in school lunch and physical education to foster healthful diet and exercise among elementary school children. Interventions were based on social learning theory and implementation was based on an organizational change strategy for school innovations. Two schools were assigned to intervention and two to control conditions. Cognitive measures (behavioral capability, self-efficacy, behavioral expectations) and self-reported diet and exercise behavior were assessed at baseline and following intervention. Data were analyzed by ANOVA using the student and then the school as the unit of analysis. Statistically significant changes were observed for diet behavioral capability, self-efficacy, and behavioral expectations, use of salt, and exercise behavioral capability (fourth grade), self-efficacy (fourth grade) and frequency of participation in aerobic activity. The results provide evidence for program impact on learning outcomes and student behavior.

  3. Associations between change in sedentary behavior and outcome in standard behavioral weight loss treatment.

    Science.gov (United States)

    Kerrigan, Stephanie G; Call, Christine; Schaumberg, Katherine; Forman, Evan; Butryn, Meghan L

    2018-03-01

    Sedentary behavior, particularly in prolonged periods, is an important determinant of health. Little research exploring changes in sedentary behavior during behavioral weight loss programs exists. This study evaluated the magnitude of changes in total and prolonged sedentary behavior and how these changes related to changes in weight and cardiovascular outcomes during a behavioral weight loss program. Participants (n = 450) in two lifestyle modification programs underwent assessments of sedentary behavior (by accelerometry), weight, waist circumference, blood pressure, and resting heart rate at baseline and after 6 months of treatment. Sedentary behavior was defined as both total and prolonged (≥30 continuous minutes) sedentary minutes/day. Reductions in total and prolonged sedentary time were significant and were accounted for by increases in moderate-to-vigorous physical activity (MVPA). Only changes in MVPA significantly predicted change in weight when entered into a model simultaneously with changes in sedentary behavior. Changes in total and prolonged sedentary time were not associated with changes in waist circumference, heart rate, or blood pressure. Change in sedentary time was not independently associated with change in health outcomes during a behavioral weight loss treatment. High variability in changes in sedentary time indicate that individual differences may be important to examine. Reducing sedentary time may not be powerful enough to impact these health outcomes above the effects of other changes made during these programs; alternatively, it may be that increasing focus in treatment on reducing sedentary time may engender greater decreases in sedentariness, which could lead to better health outcomes.

  4. Family Structure Changes and Children's Health, Behavior, and Educational Outcomes

    DEFF Research Database (Denmark)

    Rasmussen, Astrid Würtz

    More and more children do not grow up in traditional nuclear families. Instead they grow up in single parent households or in families with a step-parent. Hence it is important to improve our understanding of the impact of 'shocks' in family structure due to parental relationship dissolution...... on children. In this study I empirically test whether children are traumatized by shocks in the family structure during childhood. I focus on both educational, behavioral, and health outcomes. A population sample of Danish children born in January to May 1983, 1984, and 1985 is used for the analysis...

  5. Does the perception that God controls health outcomes matter for health behaviors?

    Science.gov (United States)

    Karvinen, Kristina H; Carr, Lucas J

    2014-04-01

    The purpose of this study was to examine the associations between God Locus of Health Control, health behaviors, and beliefs utilizing a cross-sectional online survey (N = 549). Results indicated that God Locus of Health Control was correlated with alcohol use, physical activity, perceived risk of chronic disease, and beliefs that poor health behaviors contribute to chronic disease (all p values God Locus of Health Control was only an independent correlate of the belief that physical inactivity contributed to chronic disease. Insights from this study may be important for future faith-based health behavior change interventions.

  6. School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature

    Science.gov (United States)

    Wheaton, Anne G.; Chapman, Daniel P.; Croft, Janet B.

    2016-01-01

    Background: Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy…

  7. Province-Level Income Inequality and Health Outcomes in Canadian Adolescents

    Science.gov (United States)

    McGrath, Jennifer J.

    2015-01-01

    Objective To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Methods Participants (aged 12–17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Results Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Conclusions Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. PMID:25324533

  8. Improving multiple health risk behaviors in primary care: lessons from the Prescription for Health Common Measures, Better Outcomes (COMBO) study.

    Science.gov (United States)

    Fernald, Douglas H; Dickinson, L Miriam; Froshaug, Desireé B; Balasubramanian, Bijal A; Holtrop, Jodi Summers; Krist, Alex H; Glasgow, Russell E; Green, Larry A

    2012-01-01

    Four health behaviors--smoking, risky drinking, physical inactivity, and unhealthy diets--contribute substantially to health care burden and are common among primary care patients. However, there is insufficient evidence to recommend broadly brief interventions to address all 4 of these in frontline primary care. This study took advantage of a multinetwork initiative to reflect on health behavior outcomes and the challenges of using a common set of measures to assess health behavior-change strategies for multiple health behaviors in routine primary care practice. Standardized, brief practical health behavior and quality of life measures used across 7 practice-based research networks (PBRNs) with independent primary care interventions in 54 primary care practices between August 2005 and December 2007 were analyzed. Mixed-effects longitudinal models assessed whether intervention patients improved diet, physical activity, smoking, alcohol consumption, and unhealthy days over time. Separate analyses were conducted for each intervention. Of 4463 adults, 2199 had follow-up data, and all available data were used in longitudinal analyses. Adjusting for age, race/ethnicity, education, and baseline body mass index where available, diet scores improved significantly in 5 of 7 networks (P practically in PBRNs testing diverse strategies to improve behaviors; however, variations in implementation, instrumentation performance, and some features of study design overwhelmed potential cross-PBRN comparisons. For common measures to be useful for comparisons across practices or PBRNs, greater standardization of study designs and careful attention to practicable implementation strategies are necessary.

  9. A Multivariate Analysis of Adverse Childhood Experiences and Health Behaviors and Outcomes among College Students

    Science.gov (United States)

    Windle, Michael; Haardörfer, Regine; Getachew, Beth; Shah, Jean; Payne, Jackie; Pillai, Dina; Berg, Carla J.

    2018-01-01

    Objective: This study investigated associations between adverse childhood experiences (ACE) prior to age 18 years and multiple health behaviors (eg, cigarette and other substance use) and outcomes (eg, obesity, depression) for a large college sample. Participants: 2,969 college students from seven universities in the state of Georgia were included…

  10. Province-level income inequality and health outcomes in Canadian adolescents.

    Science.gov (United States)

    Quon, Elizabeth C; McGrath, Jennifer J

    2015-03-01

    To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Participants (aged 12-17 years; N = 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and conduct problems, but not for other outcomes. Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. The effects on health behavior and health outcomes of Internet-based asynchronous communication between health providers and patients with a chronic condition: a systematic review.

    Science.gov (United States)

    de Jong, Catharina Carolina; Ros, Wynand Jg; Schrijvers, Guus

    2014-01-16

    In support of professional practice, asynchronous communication between the patient and the provider is implemented separately or in combination with Internet-based self-management interventions. This interaction occurs primarily through electronic messaging or discussion boards. There is little evidence as to whether it is a useful tool for chronically ill patients to support their self-management and increase the effectiveness of interventions. The aim of our study was to review the use and usability of patient-provider asynchronous communication for chronically ill patients and the effects of such communication on health behavior, health outcomes, and patient satisfaction. A literature search was performed using PubMed and Embase. The quality of the articles was appraised according to the National Institute for Health and Clinical Excellence (NICE) criteria. The use and usability of the asynchronous communication was analyzed by examining the frequency of use and the number of users of the interventions with asynchronous communication, as well as of separate electronic messaging. The effectiveness of asynchronous communication was analyzed by examining effects on health behavior, health outcomes, and patient satisfaction. Patients' knowledge concerning their chronic condition increased and they seemed to appreciate being able to communicate asynchronously with their providers. They not only had specific questions but also wanted to communicate about feeling ill. A decrease in visits to the physician was shown in two studies (P=.07, P=.07). Increases in self-management/self-efficacy for patients with back pain, dyspnea, and heart failure were found. Positive health outcomes were shown in 12 studies, where the clinical outcomes for diabetic patients (HbA1c level) and for asthmatic patients (forced expiratory volume [FEV]) improved. Physical symptoms improved in five studies. Five studies generated a variety of positive psychosocial outcomes. The effect of

  12. School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: a Review of the Literature

    Science.gov (United States)

    Chapman, Daniel P.; Croft, Janet B.

    2015-01-01

    BACKGROUND Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students’ academic performance, reduce engagement in risk behaviors, and improve health. METHODS This paper reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. RESULTS Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. CONCLUSIONS Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. PMID:27040474

  13. Information Architecture of Web-Based Interventions to Improve Health Outcomes: Systematic Review.

    Science.gov (United States)

    Pugatch, Jillian; Grenen, Emily; Surla, Stacy; Schwarz, Mary; Cole-Lewis, Heather

    2018-03-21

    The rise in usage of and access to new technologies in recent years has led to a growth in digital health behavior change interventions. As the shift to digital platforms continues to grow, it is increasingly important to consider how the field of information architecture (IA) can inform the development of digital health interventions. IA is the way in which digital content is organized and displayed, which strongly impacts users' ability to find and use content. While many information architecture best practices exist, there is a lack of empirical evidence on the role it plays in influencing behavior change and health outcomes. Our aim was to conduct a systematic review synthesizing the existing literature on website information architecture and its effect on health outcomes, behavioral outcomes, and website engagement. To identify all existing information architecture and health behavior literature, we searched articles published in English in the following databases (no date restrictions imposed): ACM Digital Library, CINAHL, Cochrane Library, Google Scholar, Ebsco, and PubMed. The search terms used included information terms (eg, information architecture, interaction design, persuasive design), behavior terms (eg, health behavior, behavioral intervention, ehealth), and health terms (eg, smoking, physical activity, diabetes). The search results were reviewed to determine if they met the inclusion and exclusion criteria created to identify empirical research that studied the effect of IA on health outcomes, behavioral outcomes, or website engagement. Articles that met inclusion criteria were assessed for study quality. Then, data from the articles were extracted using a priori categories established by 3 reviewers. However, the limited health outcome data gathered from the studies precluded a meta-analysis. The initial literature search yielded 685 results, which was narrowed down to three publications that examined the effect of information architecture on

  14. Transparency of outcome reporting and trial registration of randomized controlled trials in top psychosomatic and behavioral health journals: A systematic review.

    Science.gov (United States)

    Milette, Katherine; Roseman, Michelle; Thombs, Brett D

    2011-03-01

    The most reliable evidence for evaluating healthcare interventions comes from well-designed and conducted randomized controlled trials (RCTs). The extent to which published RCTs reflect the efficacy of interventions, however, depends on the completeness and accuracy of published results. The Consolidated Standards of Reporting Trials statement, initially developed in 1996, provides guidelines intended to improve the transparency of published RCT reports. A policy of the International Committee of Medical Journal Editors, initiated in 2005, requires clinical trials published in member journals to be registered in publicly accessible registries prior to patient enrollment. The objective of this study was to assess the clarity of outcome reporting, proportion of registered trials, and adequacy of outcome registration in RCTs published in top behavioral health journals. Eligible studies were primary or secondary reports of RCTs published in Annals of Behavioral Medicine, Health Psychology, Journal of Psychosomatic Research, and Psychosomatic Medicine from January 2008 to September 2009. Data were extracted for each study on adequacy of outcome reporting and registration. Of 63 articles reviewed, only 25 (39.7%) had adequately declared primary or secondary outcomes, whereas 38 (60.3%) had multiple primary outcomes or did not define outcomes. Only 13 studies (20.6%) were registered. Only 1 study registered sufficiently precise outcome information to compare with published outcomes, and registered and published outcomes were discrepant in that study. Greater attention to outcome reporting and trial registration by researchers, peer reviewers, and journal editors will increase the likelihood that effective behavioral health interventions are readily identified and made available to patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature.

    Science.gov (United States)

    Wheaton, Anne G; Chapman, Daniel P; Croft, Janet B

    2016-05-01

    Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health. This article reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  16. Cognitive behavioral therapy for suicidal behaviors: improving patient outcomes

    Directory of Open Access Journals (Sweden)

    Mewton L

    2016-03-01

    Full Text Available Louise Mewton,1 Gavin Andrews2 1National Health and Medical Research Council Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, 2Clinical Research Unit for Anxiety and Depression (CRUfAD, St Vincent's Hospital, Sydney, NSW, Australia Abstract: This systematic review provides an overview of the effectiveness of cognitive behavioral therapy (CBT in reducing suicidal cognitions and behavior in the adult population. We identified 15 randomized controlled trials of CBT for adults (aged 18 years and older that included suicide-related cognitions or behaviors as an outcome measure. The studies were identified from PsycINFO searches, reference lists, and a publicly available database of psychosocial interventions for suicidal behaviors. This review identified some evidence of the use of CBT in the reduction of both suicidal cognitions and behaviors. There was not enough evidence from clinical trials to suggest that CBT focusing on mental illness reduces suicidal cognitions and behaviors. On the other hand, CBT focusing on suicidal cognitions and behaviors was found to be effective. Given the current evidence, clinicians should be trained in CBT techniques focusing on suicidal cognitions and behaviors that are independent of the treatment of mental illness. Keywords: suicidal behaviors, suicidal cognitions, CBT

  17. Workplace social capital, mental health and health behaviors among Brazilian female workers.

    Science.gov (United States)

    Pattussi, Marcos Pascoal; Olinto, Maria Teresa Anselmo; Canuto, Raquel; da Silva Garcez, Anderson; Paniz, Vera Maria Vieira; Kawachi, Ichiro

    2016-09-01

    Previous studies have investigated the relationship between workplace social capital and mental health, yet few have sought to examine the mediating mechanisms. We sought to explore the role of workplace social capital on health related behaviors and on mental health among female employees in Brazil. A cross-sectional study was undertaken with 553 women aged 28-50 years working in the production line of a poultry processing plant. We assessed workplace social capital, common mental disorders, stress (Perceived Stress Scale) and health related behaviors (physical activity, healthy eating habits and co-occurrence of risk behaviors). We used structural equation modeling to clarify relationships between exposures, outcomes, and mediating variables. Our model demonstrated a direct effect of social capital on the outcomes studied. Higher workplace social capital was associated with lower stress and common mental disorders as well as more favorable health-related behaviors. Our model also showed an indirect effect of social capital on mental health and on behaviors that was mediated by lower levels of perceived stress. Workplace social cohesion may play an important role in the promotion of mental health and healthy behaviors among women employees.

  18. Wealth and Health Behavior: Testing the Concept of a Health Cost.

    Science.gov (United States)

    van Kippersluis, Hans; Galama, Titus J

    2014-11-01

    Wealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of unhealthy consumption. The health cost increases with wealth and the degree of unhealthiness, leading wealthier individuals to consume more healthy and moderately unhealthy, but fewer severely unhealthy goods. The empirical evidence presented suggests that differences in health costs may indeed partially explain behavioral differences, and ultimately health outcomes, between wealth groups.

  19. Consumer preferences for health and nonhealth outcomes of health promotion: results from a discrete choice experiment.

    Science.gov (United States)

    Alayli-Goebbels, Adrienne F G; Dellaert, Benedict G C; Knox, Stephanie A; Ament, André J H A; Lakerveld, Jeroen; Bot, Sandra D M; Nijpels, G; Severens, J L

    2013-01-01

    Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their relative importance compared with health outcomes. This study explored consumer preferences for health and nonhealth outcomes of HP in the context of lifestyle behavior change. A discrete choice experiment was conducted among participants in a lifestyle intervention (n = 132) and controls (n = 141). Respondents made 16 binary choices between situations that can be experienced after lifestyle behavior change. The situations were described by 10 attributes: future health state value, start point of future health state, life expectancy, clothing size above ideal, days with sufficient relaxation, endurance, experienced control over lifestyle choices, lifestyle improvement of partner and/or children, monetary cost per month, and time cost per week. With the exception of "time cost per week" and "start point of future health state," all attributes significantly determined consumer choices. Thus, both health and nonhealth outcomes affected consumer choice. Marginal rates of substitution between the price attribute and the other attributes revealed that the attributes "endurance," "days with sufficient relaxation," and "future health state value" had the greatest impact on consumer choices. The "life expectancy" attribute had a relatively low impact and for increases of less than 3 years, respondents were not willing to trade. Health outcomes and nonhealth outcomes of lifestyle behavior change were both important to consumers in this study. Decision makers should respond to consumer preferences and consider nonhealth outcomes when deciding about HP interventions. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All

  20. Environmental correlates to behavioral health outcomes in Alzheimer's special care units.

    Science.gov (United States)

    Zeisel, John; Silverstein, Nina M; Hyde, Joan; Levkoff, Sue; Lawton, M Powell; Holmes, William

    2003-10-01

    We systematically measured the associations between environmental design features of nursing home special care units and the incidence of aggression, agitation, social withdrawal, depression, and psychotic problems among persons living there who have Alzheimer's disease or a related disorder. We developed and tested a model of critical health-related environmental design features in settings for people with Alzheimer's disease. We used hierarchical linear modeling statistical techniques to assess associations between seven environmental design features and behavioral health measures for 427 residents in 15 special care units. Behavioral health measures included the Cohen-Mansfield physical agitation, verbal agitation, and aggressive behavior scales, the Multidimensional Observation Scale for Elderly Subjects depression and social withdrawal scales, and BEHAVE-AD (psychotic symptom list) misidentification and paranoid delusions scales. Statistical controls were included for the influence of, among others, cognitive status, need for assistance with activities of daily living, prescription drug use, amount of Alzheimer's staff training, and staff-to-resident ratio. Although hierarchical linear modeling minimizes the risk of Type II-false positive-error, this exploratory study also pays special attention to avoiding Type I error-the failure to recognize possible relationships between behavioral health characteristics and independent variables. We found associations between each behavioral health measure and particular environmental design features, as well as between behavioral health measures and both resident and nonenvironmental facility variables. This research demonstrates the potential that environment has for contributing to the improvement of Alzheimer's symptoms. A balanced combination of pharmacologic, behavioral, and environmental approaches is likely to be most effective in improving the health, behavior, and quality of life of people with Alzheimer

  1. Hungry to learn: the prevalence and effects of food insecurity on health behaviors and outcomes over time among a diverse sample of university freshmen.

    Science.gov (United States)

    Bruening, Meg; van Woerden, Irene; Todd, Michael; Laska, Melissa N

    2018-01-18

    To examine longitudinal associations between food insecurity (FI) and health behaviors/outcomes among a diverse sample of university freshmen. Freshman students (n = 1138; 65% female; 49% non-white) participating in the Social impact of Physical Activity and nutRition in College study completed surveys on health behaviors and had height/weight measured up to 4 times (T1-T4) in Arizona during 2015-2016. Structural equation models were estimated to determine if, after adjusting for covariates, FI predicted concurrent behaviors/outcomes and subsequent behaviors/outcomes. Analyses reported here were conducted in 2017. The prevalence of FI was significantly higher at the end of each semester (35% and 36%, respectively) than at the start of the year (28%). Longitudinally, FI was not related to any health behaviors/outcomes at future time points. However, FI was significantly and inversely associated with concurrent breakfast consumption on most days of the week (OR = 0.67, 99% CI = 0.46, 0.99), daily evening meal consumption (OR = 0.55, 99% CI = 0.36, 0.86) healthy eating habits on campus (OR = 0.68, 99% CI = 0.46, 1.00), healthy physical activity habits on campus (OR = 0.66, 99% CI = 0.44, 1.00), and positively related to the likelihood of experiencing stress (OR = 1.69, 99% CI = 1.16, 2.46) and depressed mood (OR = 1.98, 99% CI = 1.34, 2.91). Compared with US prevalence rates, the sample FI prevalence was high. FI was related to poorer eating patterns, physical activity behaviors, and mental health, even after adjusting for prior levels of behavior.

  2. Behavioral health leadership: new directions in occupational mental health.

    Science.gov (United States)

    Adler, Amy B; Saboe, Kristin N; Anderson, James; Sipos, Maurice L; Thomas, Jeffrey L

    2014-10-01

    The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership. One emerging approach focuses on domain-specific leadership behaviors that may moderate the impact of combat deployment on mental health. In a recent study, US soldiers deployed to Afghanistan rated leaders on behaviors promoting management of combat operational stress. When soldiers rated their leaders high on these behaviors, soldiers also reported better mental health and feeling more comfortable with the idea of seeking mental health treatment. These associations held even after controlling for overall leadership ratings. Operational stress leader behaviors also moderated the relationship between combat exposure and soldier health. Domain-specific leadership offers an important step in identifying measures to moderate the impact of high-risk occupations on employee health.

  3. Physiology of Sedentary Behavior and Its Relationship to Health Outcomes

    Science.gov (United States)

    Thyfault, John P; Du, Mengmeng; Kraus, William E; Levine, James A; Booth, Frank W

    2014-01-01

    Purpose This paper reports on the findings and recommendations of the “Physiology of Sedentary Behavior and its Relationship to Health Outcomes” group, a part of a larger workshop entitled Sedentary Behavior: Identifying Research Priorities sponsored by the National Heart, and Lung and Blood Institute and the National Institute on Aging, which aimed to establish sedentary behavior research priorities. Methods The discussion within our workshop lead to the formation of critical physiological research objectives related to sedentary behaviors, that if appropriately researched would greatly impact our overall understanding of human health and longevity. Results and Conclusions Primary questions are related to physiological “health outcomes” including the influence of physical activity vs. sedentary behavior on function of a number of critical physiological systems (aerobic capacity, skeletal muscle metabolism and function, telomeres/genetic stability, and cognitive function). The group also derived important recommendations related to the “central and peripheral mechanisms” that govern sedentary behavior and how energy balance has a role in mediating these processes. General recommendations for future sedentary physiology research efforts include that studies of sedentary behavior, including that of sitting time only, should focus on the physiological impact of a “lack of human movement” in contradistinction to the effects of physical movement and that new models or strategies for studying sedentary behavior induced adaptations and links to disease development are needed to elucidate underlying mechanism(s). PMID:25222820

  4. A Review of Hip Hop-Based Interventions for Health Literacy, Health Behaviors, and Mental Health.

    Science.gov (United States)

    Robinson, Cendrine; Seaman, Elizabeth L; Montgomery, LaTrice; Winfrey, Adia

    2017-07-01

    African-American children and adolescents experience an undue burden of disease for many health outcomes compared to their White peers. More research needs to be completed for this priority population to improve their health outcomes and ameliorate health disparities. Integrating hip hop music or hip hop dance into interventions may help engage African-American youth in health interventions and improve their health outcomes. We conducted a review of the literature to characterize hip hop interventions and determine their potential to improve health. We searched Web of Science, Scopus, PsycINFO, and EMBASE to identify studies that assessed hip hop interventions. To be included, studies had to (1) be focused on a psychosocial or physical health intervention that included hip hop and (2) present quantitative data assessing intervention outcomes. Twenty-three articles were identified as meeting all inclusion criteria and were coded by two reviewers. Articles were assessed with regards to sample characteristics, study design, analysis, intervention components, and results. Hip hop interventions have been developed to improve health literacy, health behavior, and mental health. The interventions were primarily targeted to African-American and Latino children and adolescents. Many of the health literacy and mental health studies used non-experimental study designs. Among the 12 (of 14) health behavior studies that used experimental designs, the association between hip hop interventions and positive health outcomes was inconsistent. The number of experimental hip hop intervention studies is limited. Future research is required to determine if hip hop interventions can promote health.

  5. School outcomes of children with special health care needs.

    Science.gov (United States)

    Forrest, Christopher B; Bevans, Katherine B; Riley, Anne W; Crespo, Richard; Louis, Thomas A

    2011-08-01

    To examine the associations between having a special health care need and school outcomes measured as attendance, student engagement, behavioral threats to achievement, and academic achievement. A total of 1457 children in the fourth through sixth grades from 34 schools in 3 school districts and their parents provided survey data; parents completed the Children With Special Health Care Needs Screener. School records were abstracted for attendance, grades, and standardized achievement test scores. Across 34 schools, 33% of children screened positive for special health care needs. After adjusting for sociodemographic and school effects, children with special health care needs had lower motivation to do well in school, more disruptive behaviors, and more frequent experiences as a bully victim. They experienced significantly lower academic achievement, as measured by grades, standardized testing, and parental-assessed academic performance. These findings were observed for children who qualified as having a special health care need because they had functional limitations attributed to a chronic illness or a behavioral health problem but not for those who qualified only because they took prescription medications. Specific subgroups of children with special health care needs are at increased risk for poor school outcomes. Health and school professionals will need to collaborate to identify these children early, intervene with appropriate medical and educational services, and monitor long-term outcomes.

  6. School Outcomes of Children With Special Health Care Needs

    Science.gov (United States)

    Bevans, Katherine B.; Riley, Anne W.; Crespo, Richard; Louis, Thomas A.

    2011-01-01

    OBJECTIVE: To examine the associations between having a special health care need and school outcomes measured as attendance, student engagement, behavioral threats to achievement, and academic achievement. PARTICIPANTS AND METHODS: A total of 1457 children in the fourth through sixth grades from 34 schools in 3 school districts and their parents provided survey data; parents completed the Children With Special Health Care Needs Screener. School records were abstracted for attendance, grades, and standardized achievement test scores. RESULTS: Across 34 schools, 33% of children screened positive for special health care needs. After adjusting for sociodemographic and school effects, children with special health care needs had lower motivation to do well in school, more disruptive behaviors, and more frequent experiences as a bully victim. They experienced significantly lower academic achievement, as measured by grades, standardized testing, and parental-assessed academic performance. These findings were observed for children who qualified as having a special health care need because they had functional limitations attributed to a chronic illness or a behavioral health problem but not for those who qualified only because they took prescription medications. CONCLUSIONS: Specific subgroups of children with special health care needs are at increased risk for poor school outcomes. Health and school professionals will need to collaborate to identify these children early, intervene with appropriate medical and educational services, and monitor long-term outcomes. PMID:21788226

  7. Integrated Theory of Health Behavior Change: background and intervention development.

    Science.gov (United States)

    Ryan, Polly

    2009-01-01

    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 health behavior change, and new theories are needed to better understand how practitioners can facilitate health behavior change. In this article, the Integrated Theory of Health Behavior Change is described, and an example of its use as foundation to intervention development is presented. The Integrated Theory of Health Behavior Change suggests that health behavior 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.

  8. Physical activity and sedentary behavior patterns are associated with selected adolescent health risk behaviors.

    Science.gov (United States)

    Nelson, Melissa C; Gordon-Larsen, Penny

    2006-04-01

    Little is known about how physical activity (PA), sedentary behavior, and various adolescent health risk behaviors are associated. The objective of this study was to examine relationships between PA and sedentary behavior patterns and an array of risk behaviors, including leading causes of adolescent morbidity/mortality. Nationally representative self-reported data were collected (National Longitudinal Study of Adolescent Health; wave I: 1994-1995; II: 1996; N = 11957). Previously developed and validated cluster analyses identified 7 homogeneous groups of adolescents sharing PA and sedentary behaviors. Poisson regression predicted the relative risk of health risk behaviors, other weekly activities, and self-esteem across the 7 PA/sedentary behavior clusters controlling for demographics and socioeconomic status. Main outcome measures were adolescent risk behaviors (eg, truancy, cigarette smoking, sexual intercourse, delinquency), other weekly activities (eg, work, academic performance, sleep), self-esteem. Relative to high television (TV) and video viewers, adolescents in clusters characterized by skating and video gaming, high overall sports and sports participation with parents, using neighborhood recreation center, strict parental control of TV, reporting few activities overall, and being active in school were less likely to participate in a range of risky behaviors, ranging from an adjusted risk ratio (ARR) of 0.42 (outcome: illegal drug use, cluster: strict parental control of TV) to 0.88 (outcome: violence, cluster: sports with parents). Active teens were less likely to have low self-esteem (eg, adolescents engaging in sports with parents, ARR: 0.73) and more likely to have higher grades (eg, active in school, ARR: 1.20). Participation in a range of PA-related behaviors, particularly those characterized by high parental sports/exercise involvement, was associated with favorable adolescent risk profiles. Adolescents with high TV/video viewership were less

  9. Pregnancy-related Health Behavior of Women with Congenital Heart Disease : Room for Behavioral Change Interventions

    NARCIS (Netherlands)

    Moons, Philip; Budts, Werner; Costermans, Els; Huyghe, Els; Pieper, Petronella G.; Drenthen, Wim

    2009-01-01

    Background. Pregnancy in women with congenital heart disease is associated with maternal and neonatal complications. In order to reduce risks for unfavorable outcomes, pregnant women need to adopt specific health behaviors. We investigated the pregnancy-related health behavior of women with

  10. Targeting couple and parent-child coercion to improve health behaviors.

    Science.gov (United States)

    Smith Slep, Amy M; Heyman, Richard E; Mitnick, Danielle M; Lorber, Michael F; Beauchaine, Theodore P

    2018-02-01

    This phase of the NIH Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change," that seeks to identify targets related to stress reactivity, self-regulation, and social processes for maximal effects on multiple health outcomes. Within this framework, our project focuses on interpersonal processes associated with health: coercive couple and parent-child conflict. Diabetes and poor oral health portend pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. Coercive couple and parent-child conflict constitute potent and destructive influences on a wide range of adult and child health outcomes. Such interaction patterns give rise to disturbed environmental stress reactivity (e.g., disrupted sympathetic nervous and parasympathetic nervous systems) and a wide range of adverse health outcomes in children and adults, including dental caries, obesity, and diabetes-related metabolic markers. In this work, we seek to identify/develop/validate assays assessing coercion, identify/develop and test brief interventions to reduce coercion, and test whether changes in coercion trigger changes in health behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Driving: a road to unhealthy lifestyles and poor health outcomes.

    Science.gov (United States)

    Ding, Ding; Gebel, Klaus; Phongsavan, Philayrath; Bauman, Adrian E; Merom, Dafna

    2014-01-01

    Driving is a common part of modern society, but its potential effects on health are not well understood. The present cross-sectional study (n = 37,570) examined the associations of driving time with a series of health behaviors and outcomes in a large population sample of middle-aged and older adults using data from the Social, Economic, and Environmental Factor Study conducted in New South Wales, Australia, in 2010. Multiple logistic regression was used in 2013 to examine the associations of usual daily driving time with health-related behaviors (smoking, alcohol use, diet, physical activity, sedentary behavior, sleep) and outcomes (obesity, general health, quality of life, psychological distress, time stress, social functioning), adjusted for socio-demographic characteristics. Findings suggested that longer driving time was associated with higher odds for smoking, insufficient physical activity, short sleep, obesity, and worse physical and mental health. The associations consistently showed a dose-response pattern and more than 120 minutes of driving per day had the strongest and most consistent associations with the majority of outcomes. This study highlights driving as a potential lifestyle risk factor for public health. More population-level multidisciplinary research is needed to understand the mechanism of how driving affects health.

  12. Driving: a road to unhealthy lifestyles and poor health outcomes.

    Directory of Open Access Journals (Sweden)

    Ding Ding

    Full Text Available BACKGROUND: Driving is a common part of modern society, but its potential effects on health are not well understood. PURPOSE: The present cross-sectional study (n = 37,570 examined the associations of driving time with a series of health behaviors and outcomes in a large population sample of middle-aged and older adults using data from the Social, Economic, and Environmental Factor Study conducted in New South Wales, Australia, in 2010. METHODS: Multiple logistic regression was used in 2013 to examine the associations of usual daily driving time with health-related behaviors (smoking, alcohol use, diet, physical activity, sedentary behavior, sleep and outcomes (obesity, general health, quality of life, psychological distress, time stress, social functioning, adjusted for socio-demographic characteristics. RESULTS: Findings suggested that longer driving time was associated with higher odds for smoking, insufficient physical activity, short sleep, obesity, and worse physical and mental health. The associations consistently showed a dose-response pattern and more than 120 minutes of driving per day had the strongest and most consistent associations with the majority of outcomes. CONCLUSION: This study highlights driving as a potential lifestyle risk factor for public health. More population-level multidisciplinary research is needed to understand the mechanism of how driving affects health.

  13. How behavioral science can advance digital health.

    Science.gov (United States)

    Pagoto, Sherry; Bennett, Gary G

    2013-09-01

    The field of behavioral science has produced myriad data on health behavior change strategies and leveraged such data into effective human-delivered interventions to improve health. Unfortunately, the impact of traditional health behavior 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 health behavior 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 Health Behavior Change features a collection of studies that leverage health technologies to measure, change, and/or understand health behavior. 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 health behavior 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.

  14. Changing health behaviors with social marketing.

    Science.gov (United States)

    Suarez-Almazor, M E

    2011-08-01

    Social marketing uses marketing techniques to promote healthy attitudes and behaviors. As in traditional marketing, the development and implementation of social marketing programs is based on the four P's: product, price, place, and promotion, but it also incorporates the partnership and participation of stakeholders to enhance public health and engage policy makers. The "product" in social marketing is generally a behavior, such as a change in lifestyle (e.g., diet) or an increase in a desired health practice (e.g., screening). In order for people to desire this product, it must offer a solution to a problem that is weighed with respect to the price to pay. The price is not just monetary, and it often involves giving something up, such as time (e.g., exercising) or a wanted, satisfying behavior (e.g., smoking). In its development phase, social marketing incorporates qualitative methods to create messages that are powerful and potentially effective. The implementation of the programs commonly involves mass campaigns with advertisement in various media. There have been a few social media campaigns targeting bone health that have been disseminated with substantial outreach. However, these have not been systematically evaluated, specifically with respect to change in behavior and health outcomes. Future campaigns should identify target behaviors that are amenable to change such as bone mass measurement screening or exercise. Audience segmentation will be crucial, since a message for young women to increase peak bone mass would be very different from a message for older individuals who have just experienced a fracture. Campaigns should involve key stakeholders, including policy makers, health providers, and the public. Finally, success must be carefully evaluated, not just by the outreach of the campaign, but also by a change in relevant behaviors and a decrease in deleterious health outcomes.

  15. [Health behavior change: motivational interviewing].

    Science.gov (United States)

    Pócs, Dávid; Hamvai, Csaba; Kelemen, Oguz

    2017-08-01

    Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.

  16. Leveraging Behavioral Economics to Improve Heart Failure Care and Outcomes.

    Science.gov (United States)

    Chang, Leslie L; DeVore, Adam D; Granger, Bradi B; Eapen, Zubin J; Ariely, Dan; Hernandez, Adrian F

    2017-08-22

    Behavioral challenges are often present in human illness, so behavioral economics is increasingly being applied in healthcare settings to better understand why patients choose healthy or unhealthy behaviors. The application of behavioral economics to healthcare settings parallels recent shifts in policy and reimbursement structures that hold providers accountable for outcomes that are dependent on patient behaviors. Numerous studies have examined the application of behavioral economics principles to policy making and health behaviors, but there are limited data on applying these concepts to the management of chronic conditions, such as heart failure (HF). Given its increasing prevalence and high associated cost of care, HF is a paradigm case for studying novel approaches to improve health care; therefore, if we can better understand why patients with HF make the choices they do, then we may be more poised to help them manage their medications, influence daily behaviors, and encourage healthy decision making. In this article, we will give a brief explanation of the core behavioral economics concepts that apply to patients with HF. We will also examine how to craft these concepts into tools such as financial incentives and social networks that may improve the management of patients with HF. We believe that behavioral economics can help us understand barriers to change, encourage positive behaviors, and offer additional approaches to improving the outcomes of patients with HF. © 2017 American Heart Association, Inc.

  17. Celebrities' impact on health-related knowledge, attitudes, behaviors, and status outcomes: protocol for a systematic review, meta-analysis, and meta-regression analysis.

    Science.gov (United States)

    Hoffman, Steven J; Mansoor, Yasmeen; Natt, Navneet; Sritharan, Lathika; Belluz, Julia; Caulfield, Timothy; Freedhoff, Yoni; Lavis, John N; Sharma, Arya M

    2017-01-21

    Celebrities are highly influential people whose actions and decisions are watched and often emulated by wide audiences. Many celebrities have used their prominent social standing to offer medical advice or endorse health products, a trend that is expected to increase. However, the extent of the impact that celebrities have in shaping the public's health-related knowledge, attitudes, behaviors, and status is unclear. This systematic review seeks to answer the following questions: (1) Which health-related outcomes are influenced by celebrities? (2) How large of an impact do celebrities actually have on these health-related outcomes? (3) Under what circumstances do celebrities produce either beneficial or harmful impacts? Ten databases were searched, including MEDLINE, EMBASE, PsycINFO, PubMed, CINAHL, Communication Complete, Sociological Abstracts, Social Sciences Citation Index, Journals @ Scholars Portal, and ProQuest Dissertations & Theses A&I. Two reviewers conducted title and abstract screening and full-text screening to identify primary studies that employed empirical methods (either quantitative or qualitative) to examine celebrities' impact on health-related knowledge, attitudes, behaviors, or status outcomes. The results of this review will contribute to our understanding of celebrity influences and how to design positive evidence-based celebrity health promotion activities. In addition, these findings can help inform the development of media reporting guidelines pertaining to celebrity health news and provide guidance to public health authorities on whether and how to respond to or work with celebrities. PROSPERO CRD42015019268.

  18. Socioeconomic status and self-reported oral health in Iranian adolescents: the role of selected oral health behaviors and psychological factors.

    Science.gov (United States)

    Ravaghi, Vahid; Underwood, Martin; Marinho, Valeria; Eldridge, Sandra

    2012-01-01

    This study investigated health inequality for self-reported oral health outcomes among adolescents. The role of oral health behaviors and psychological factors in explaining oral health inequality was investigated using the hypothesis of mediation. This was a cross-sectional study that used self-completed questionnaires. This study sampled 639 (315 male and 324 female) 15- to 17-year-old adolescents (second and third grade high school students) of both sexes in the city of Sanandaj in the province of Kurdistan, western Iran. Socioeconomic indicators of the study were subjective socioeconomic status, wealth index, and parental education. Oral health behaviors were measured as toothbrushing frequency, dental flossing frequency, and dental visits. Psychological factors were self-esteem, anxiety, and depression. Self-reported oral health outcomes were single item self-rated oral health and the experience of dental pain. Regression analysis was used to test four conditions for the hypothesis of mediation. The results showed that the inequality is present in oral health for some pairs of relationships between socioeconomic status and oral health outcomes. Adjustment for oral health behaviors and psychological factors, individually and simultaneously, led to loss of statistical significance for some pairs of the relationships. However, adjustment for oral health behaviors and psychological factors led to only small changes in the associations between socioeconomic status and self-reported oral health outcomes. This study found a graded oral health inequality, but no strong evidence to support the hypothesis that oral health behaviors and psychological factors mediate oral health inequality for self-reported oral health outcomes. © 2012 American Association of Public Health Dentistry.

  19. Emerging Adults' Stress and Health: The Role of Parent Behaviors and Cognitions

    Science.gov (United States)

    Donnelly, Reesa; Renk, Kimberly; McKinney, Cliff

    2013-01-01

    Although parent behaviors and cognitions are important for stress/health outcomes throughout development, little research examines whether cognitions mediate the relationship between parent behaviors and stress/health outcomes. As a result, the current study examined the reports of 160 emerging adults regarding their mothers' and fathers'…

  20. Contextual and intrapersonal predictors of adolescent risky sexual behavior and outcomes.

    Science.gov (United States)

    Shneyderman, Yuliya; Schwartz, Seth J

    2013-08-01

    The present study was designed to test a model of contextual and intrapersonal predictors of adolescent risky sexual behaviors and of sexually transmitted infection diagnoses. Using Waves I and II from the National Longitudinal Study of Adolescent Health, the authors estimated a structural model in which intrapersonal factors such as adolescents' attitudes about sex, perceived parental norms, knowledge about sexual health, and birth-control self-efficacy partially mediated the effects of contextual factors such as parent-adolescent relationship quality, school connectedness, and exposure to AIDS and pregnancy education on a number of risky sexual behaviors and outcomes: early sex initiation, sex under the influence of substances, condom use at last intercourse, and having been diagnosed with a sexually transmitted infection. Different patterns of direct and mediated effects emerged for each sexual outcome. Results are discussed in terms of the complex interplay between environment and individual and in terms of how, when, and with whom to intervene in order to improve adolescent sexual health outcomes.

  1. Long-Term Refugee Health: Health Behaviors and Outcomes of Cambodian Refugee and Immigrant Women

    Science.gov (United States)

    Nelson-Peterman, Jerusha L.; Toof, Robin; Liang, Sidney L.; Grigg-Saito, Dorcas C.

    2015-01-01

    Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently…

  2. Health-Related Behaviors and Academic Achievement Among High School Students - United States, 2015.

    Science.gov (United States)

    Rasberry, Catherine N; Tiu, Georgianne F; Kann, Laura; McManus, Tim; Michael, Shannon L; Merlo, Caitlin L; Lee, Sarah M; Bohm, Michele K; Annor, Francis; Ethier, Kathleen A

    2017-09-08

    Studies have shown links between educational outcomes such as letter grades, test scores, or other measures of academic achievement, and health-related behaviors (1-4). However, as reported in a 2013 systematic review, many of these studies have used samples that are not nationally representative, and quite a few studies are now at least 2 decades old (1). To update the relevant data, CDC analyzed results from the 2015 national Youth Risk Behavior Survey (YRBS), a biennial, cross-sectional, school-based survey measuring health-related behaviors among U.S. students in grades 9-12. Analyses assessed relationships between academic achievement (i.e., self-reported letter grades in school) and 30 health-related behaviors (categorized as dietary behaviors, physical activity, sedentary behaviors, substance use, sexual risk behaviors, violence-related behaviors, and suicide-related behaviors) that contribute to leading causes of morbidity and mortality among adolescents in the United States (5). Logistic regression models controlling for sex, race/ethnicity, and grade in school found that students who earned mostly A's, mostly B's, or mostly C's had statistically significantly higher prevalence estimates for most protective health-related behaviors and significantly lower prevalence estimates for most health-related risk behaviors than did students with mostly D's/F's. These findings highlight the link between health-related behaviors and education outcomes, suggesting that education and public health professionals can find their respective education and health improvement goals to be mutually beneficial. Education and public health professionals might benefit from collaborating to achieve both improved education and health outcomes for youths.

  3. Working toward financial sustainability of integrated behavioral health services in a public health care system.

    Science.gov (United States)

    Monson, Samantha Pelican; Sheldon, J Christopher; Ivey, Laurie C; Kinman, Carissa R; Beacham, Abbie O

    2012-06-01

    The need, benefit, and desirability of behavioral health integration 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 behavioral health services without evidence that such programs offer clear financial benefits and financial sustainability. The tendency among mental health professionals is to consider positive clinical outcomes (e.g., reduced depression) as being globally valued indicators of program success. Although such outcomes may be highly valued by primary care providers and patients, administrative decision makers may require demonstration of more tangible financial outcomes. These differing views require program developers and evaluators to consider multiple outcome domains including clinical/psychological symptom reduction, potential cost benefit, and cost offset. The authors describe a process by which a pilot demonstration project is being implemented to demonstrate programmatic outcomes with a focus on the following: 1) clinician efficiency, 2) improved health outcomes, and 3) direct revenue generation associated with the inclusion of integrated primary care in a public health care system. The authors subsequently offer specific future directions and commentary regarding financial evaluation in each of these domains.

  4. Predictors in Internet-delivered cognitive behavior therapy and behavioral stress management for severe health anxiety.

    Science.gov (United States)

    Hedman, Erik; Andersson, Erik; Lekander, Mats; Ljótsson, Brjánn

    2015-01-01

    Severe health anxiety can be effectively treated with exposure-based Internet-delivered cognitive behavior therapy (ICBT), but information about which factors that predict outcome is scarce. Using data from a recently conducted RCT comparing ICBT (n = 79) with Internet-delivered behavioral stress management (IBSM) (n = 79) the presented study investigated predictors of treatment outcome. Analyses were conducted using a two-step linear regression approach and the dependent variable was operationalized both as end state health anxiety at post-treatment and as baseline-to post-treatment improvement. A hypothesis driven approach was used where predictors expected to influence outcome were based on a previous predictor study by our research group. As hypothesized, the results showed that baseline health anxiety and treatment adherence predicted both end state health anxiety and improvement. In addition, anxiety sensitivity, treatment credibility, and working alliance were significant predictors of health anxiety improvement. Demographic variables, i.e. age, gender, marital status, computer skills, educational level, and having children, had no significant predictive value. We conclude that it is possible to predict a substantial proportion of the outcome variance in ICBT and IBSM for severe health anxiety. The findings of the present study can be of high clinical value as they provide information about factors of importance for outcome in the treatment of severe health anxiety. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. The role of health-related behaviors in the socioeconomic disparities in oral health.

    Science.gov (United States)

    Sabbah, Wael; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

    2009-01-01

    This study aimed to examine the socioeconomic disparities in health-related behaviors and to assess if behaviors eliminate socioeconomic disparities in oral health in a nationally representative sample of adult Americans. Data are from the US Third National Health and Nutrition Examination Survey (1988-1994). Behaviors were indicated by smoking, dental visits, frequency of eating fresh fruits and vegetables and extent of calculus, used as a marker for oral hygiene. Oral health outcomes were gingival bleeding, loss of periodontal attachment, tooth loss and perceived oral health. Education and income indicated socioeconomic position. Sex, age, ethnicity, dental insurance and diabetes were adjusted for in the regression analysis. Regression analysis was used to assess socioeconomic disparities in behaviors. Regression models adjusting and not adjusting for behaviors were compared to assess the change in socioeconomic disparities in oral health. The results showed clear socioeconomic disparities in all behaviors. After adjusting for behaviors, the association between oral health and socioeconomic indicators attenuated but did not disappear. These findings imply that improvement in health-related behaviors may lessen, but not eliminate socioeconomic disparities in oral health, and suggest the presence of more complex determinants of these disparities which should be addressed by oral health preventive policies.

  6. The impact of Telephonic Health Coaching on Health Outcomes in a High-risk Population.

    Science.gov (United States)

    Lawson, Karen L; Jonk, Yvonne; O'Connor, Heidi; Riise, Kirsten Sundgaard; Eisenberg, David M; Kreitzer, Mary Jo

    2013-05-01

    Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. This study describes an intervention offered as a benefit to health plan members and examines health and behavioral outcomes of participants. High-risk health plan enrollees were invited to participate in a telephonic health coaching intervention addressing the whole person and focusing on motivating health behavior changes. Outcomes of self-reported lifestyle behaviors, perceived health, stress levels, quality of life, readiness to make changes, and patient activation levels were reported at baseline and upon program completion. Retrospectively, these data were extracted from administrative and health coaching records of participants during the first 2 full years of the program. Less than 7% of the 114 615 potential candidates self-selected to actively participate in health coaching, those with the highest chronic disease load being the most likely to participate. Of 6940 active participants, 1082 fully completed health inventories, with 570 completing Patient Activation Measure (PAM). The conditions most often represented in the active participants were depression, congestive heart failure, diabetes, hyperlipidemia, hypertension, osteoporosis, asthma, and low back pain. In 6 months or less, 89% of participants met at least one goal. Significant improvements occurred in stress levels, healthy eating, exercise levels, and physical and emotional health, as well as in readiness to make change and PAM scores. The types of client-selected goals most often met were physical activity, eating habits, stress management, emotional health, sleep, and pain management, resulting in improved overall quality of life regardless of condition. Positive shifts in activation levels and readiness to change suggest that health coaching is an intervention deserving of future prospective research studies to

  7. A Systematic Review of Oral Health Behavior Research in American Adolescents

    Science.gov (United States)

    Calderon, Susana J.; Mallory, Caroline

    2014-01-01

    Despite improvements in prevention, oral diseases are a problem among adolescents, linked to poor health outcomes and poor school performance. Little is known about adolescent oral health behavior. This systematic review describes factors that influence oral health behavior in adolescents. Inclusion criteria for the literature search were American…

  8. Parental Efficacy and Role Responsibility for Assisting in Child's Healthful Behaviors

    Science.gov (United States)

    Ice, Christa L.; Neal, William A.; Cottrell, Lesley

    2014-01-01

    The epidemic of childhood obesity, and its subsequent impact on negative health outcomes, continues to plague the United States. Better health outcomes have been linked to increased child achievement in school. Due to the strong influence parents have on children's healthful behaviors particularly in younger years, it's imperative to examine the…

  9. Perceived health competence predicts health behavior and health-related quality of life in patients with cardiovascular disease.

    Science.gov (United States)

    Bachmann, Justin M; Goggins, Kathryn M; Nwosu, Samuel K; Schildcrout, Jonathan S; Kripalani, Sunil; Wallston, Kenneth A

    2016-12-01

    Evaluate the effect of perceived health competence, a patient's belief in his or her ability to achieve health-related goals, on health behavior and health-related quality of life. We analyzed 2063 patients hospitalized with acute coronary syndrome and/or congestive heart failure at a large academic hospital in the United States. Multivariable linear regression models investigated associations between the two-item perceived health competence scale (PHCS-2) and positive health behaviors such as medication adherence and exercise (Health Behavior Index) as well as health-related quality of life (5-item Patient Reported Outcome Information Measurement System Global Health Scale). After multivariable adjustment, perceived health competence was highly associated with health behaviors (pperceived health competence was associated with a decrease in health-related quality of life between hospitalization and 90days after discharge (pPerceived health competence predicts health behavior and health-related quality of life in patients hospitalized with cardiovascular disease as well as change in health-related quality of life after discharge. Patients with low perceived health competence may be at risk for a decline in health-related quality of life after hospitalization and thus a potential target for counseling and other behavioral interventions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI

    Directory of Open Access Journals (Sweden)

    Christine E. Blake

    2013-01-01

    Full Text Available Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS. Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES adults with baseline examination between 1987 and 2002 (n=19,003. Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and multivariate logistic regression. Results. Compared to men, women were more likely to be dieting (32% women; 18% men and had higher weight dissatisfaction. Men and women with greater weight dissatisfaction reported more dieting, yo-yo dieting, and snacking and consuming fewer meals, being less active, and having to eat either more or less than desired to maintain weight regardless of weight status. Those who were overweight or obese and dissatisfied with their weight had the poorest health. Conclusion. Greater satisfaction with one’s weight was associated with positive health behaviors and health outcomes in both men and women and across weight status groups.

  11. Perseverative Cognition and Health Behaviors: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Faye Clancy

    2016-11-01

    Full Text Available Recent developments in stress theory have emphasized the significance of perseverative cognition (worry and rumination in furthering our understanding of stress-disease relationships. Substantial evidence has shown that perseverative cognition (PC is associated with somatic outcomes and numerous physiological concomitants have been identified (i.e., cardiovascular, autonomic and endocrine nervous system activity parameters. However, there has been no synthesis of the evidence regarding the association between PC and health behaviors. This is important given such behaviors may also directly and/or indirectly influence health and disease outcomes (triggered by PC. Therefore, the aim of the current review was to synthesise available studies that have explored the relationship between worry and rumination and health behaviors (health risk: behaviors which, if performed, would be detrimental to health; health promoting: behaviors which, if performed, would be beneficial for health. A systematic review and meta-analyses of the literature were conducted. Studies were included in the review if they reported the association between PC and health behavior. Studies identified in MEDLINE or PsycINFO (k = 7504 were screened, of which19 studies met the eligibility criteria. Random-effects meta-analyses suggested increased PC was generally associated with increased health risk behaviors but not health promoting behaviors. Further analyses indicated that increases in rumination, (r = .122, but not reflection (r = -.080, or worry, r = .048 were associated with health risk behaviors. In conclusion, these results showed that increases in PC are associated with increases in health risk behaviors (substance use, alcohol consumption, unhealthy eating and smoking that are driven primarily through rumination. These findings provide partial support for our hypothesis that in Brosschot and colleagues (2006 original perseverative cognition hypothesis, there may be scope

  12. Changing work, changing health: can real work-time flexibility promote health behaviors and well-being?

    Science.gov (United States)

    Moen, Phyllis; Kelly, Erin L; Tranby, Eric; Huang, Qinlei

    2011-12-01

    This article investigates a change in the structuring of work time, using a natural experiment to test whether participation in a corporate initiative (Results Only Work Environment; ROWE) predicts corresponding changes in health-related outcomes. Drawing on job strain and stress process models, we theorize greater schedule control and reduced work-family conflict as key mechanisms linking this initiative with health outcomes. Longitudinal survey data from 659 employees at a corporate headquarters shows that ROWE predicts changes in health-related behaviors, including almost an extra hour of sleep on work nights. Increasing employees' schedule control and reducing their work-family conflict are key mechanisms linking the ROWE innovation with changes in employees' health behaviors; they also predict changes in well-being measures, providing indirect links between ROWE and well-being. This study demonstrates that organizational changes in the structuring of time can promote employee wellness, particularly in terms of prevention behaviors.

  13. Game on… girls: associations between co-playing video games and adolescent behavioral and family outcomes.

    Science.gov (United States)

    Coyne, Sarah M; Padilla-Walker, Laura M; Stockdale, Laura; Day, Randal D

    2011-08-01

    Video game use has been associated with several behavioral and health outcomes for adolescents. The aim of the current study was to assess the relationship between parental co-play of video games and behavioral and family outcomes. Participants consisted of 287 adolescents and their parents who completed a number of video game-, behavioral-, and family-related questionnaires as part of a wider study. Most constructs included child, mother, and father reports. At the bivariate level, time spent playing video games was associated with several negative outcomes, including heightened internalizing and aggressive behavior and lowered prosocial behavior. However, co-playing video games with parents was associated with decreased levels of internalizing and aggressive behaviors, and heightened prosocial behavior for girls only. Co-playing video games was also marginally related to parent-child connectedness for girls, even after controlling for age-inappropriate games played with parents. This is the first study to show positive associations for co-playing video games between girls and their parents. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Analysis of Health Behavior Theories for Clustering of Health Behaviors.

    Science.gov (United States)

    Choi, Seung Hee; Duffy, Sonia A

    The objective of this article was to review the utility of established behavior theories, including the Health Belief Model, Theory of Reasoned Action, Theory of Planned Behavior, Transtheoretical Model, and Health Promotion Model, for addressing multiple health behaviors among people who smoke. It is critical to design future interventions for multiple health behavior changes tailored to individuals who currently smoke, yet it has not been addressed. Five health behavior theories/models were analyzed and critically evaluated. A review of the literature included a search of PubMed and Google Scholar from 2010 to 2016. Two hundred sixty-seven articles (252 studies from the initial search and 15 studies from the references of initially identified studies) were included in the analysis. Most of the health behavior theories/models emphasize psychological and cognitive constructs that can be applied only to one specific behavior at a time, thus making them not suitable to address multiple health behaviors. However, the Health Promotion Model incorporates "related behavior factors" that can explain multiple health behaviors among persons who smoke. Future multiple behavior interventions guided by the Health Promotion Model are necessary to show the utility and applicability of the model to address multiple health behaviors.

  15. Why are there social gradients in preventative health behavior? A perspective from behavioral ecology.

    Directory of Open Access Journals (Sweden)

    Daniel Nettle

    2010-10-01

    Full Text Available Within affluent populations, there are marked socioeconomic gradients in health behavior, with people of lower socioeconomic position smoking more, exercising less, having poorer diets, complying less well with therapy, using medical services less, ignoring health and safety advice more, and being less health-conscious overall, than their more affluent peers. Whilst the proximate mechanisms underlying these behavioral differences have been investigated, the ultimate causes have not.This paper presents a theoretical model of why socioeconomic gradients in health behavior might be found. I conjecture that lower socioeconomic position is associated with greater exposure to extrinsic mortality risks (that is, risks that cannot be mitigated through behavior, and that health behavior competes for people's time and energy against other activities which contribute to their fitness. Under these two assumptions, the model shows that the optimal amount of health behavior to perform is indeed less for people of lower socioeconomic position.The model predicts an exacerbatory dynamic of poverty, whereby the greater exposure of poor people to unavoidable harms engenders a disinvestment in health behavior, resulting in a final inequality in health outcomes which is greater than the initial inequality in material conditions. I discuss the assumptions of the model, and its implications for strategies for the reduction of health inequalities.

  16. Mobile Health Interventions for Improving Health Outcomes in Youth: A Meta-analysis.

    Science.gov (United States)

    Fedele, David A; Cushing, Christopher C; Fritz, Alyssa; Amaro, Christina M; Ortega, Adrian

    2017-05-01

    Mobile health interventions are increasingly popular in pediatrics; however, it is unclear how effective these interventions are in changing health outcomes. To determine the effectiveness of mobile health interventions for improving health outcomes in youth 18 years or younger. Studies published through November 30, 2016, were collected through PubMed, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, and PsychINFO. Backward and forward literature searches were conducted on articles meeting study inclusion criteria. Search terms included telemedicine, eHealth, mobile health, mHealth, app, and mobile application. Search results were limited to infants, children, adolescents, or young adults when possible. Studies were included if quantitative methods were used to evaluate an application of mobile intervention technology in a primary or secondary capacity to promote or modify health behavior in youth 18 years or younger. Studies were excluded if the article was an unpublished dissertation or thesis, the mean age of participants was older than 18 years, the study did not assess a health behavior and disease outcome, or the article did not include sufficient statistics. Inclusion and exclusion criteria were applied by 2 independent coders with 20% overlap. Of 9773 unique articles, 36 articles (containing 37 unique studies with a total of 29 822 participants) met the inclusion criteria. Of 9773 unique articles, 36 articles (containing 37 unique studies) with a total of 29 822 participants met the inclusion criteria. Effect sizes were calculated from statistical tests that could be converted to standardized mean differences. All aggregate effect sizes and moderator variables were tested using random-effects models. Change in health behavior or disease control. A total of 29 822 participants were included in the studies. In studies that reported sex, the total number of females was 11 226 (53.2%). Of those

  17. Cognitive ability and health-related behaviors during adolescence

    DEFF Research Database (Denmark)

    Ciarrochi, Joseph; Heaven, Patrick C L; Skinner, Timothy

    2012-01-01

    Longitudinal research on the links between intelligence and health behaviors among adolescents is rare. We report longitudinal data in which we assessed the relationships between intelligence as assessed in Grade 7 and consequential health outcomes in Grade 11. The mean age of respondents (N=420;...

  18. Association of physiological and psychological health outcomes with physical activity and sedentary behavior in adults with type 2 diabetes

    Science.gov (United States)

    Garcia, Jeanette M; Cox, Daniel; Rice, David J

    2017-01-01

    Purpose To examine the association between change in moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) over a 6-month period with physiological and psychological factors in adults with type 2 diabetes (T2D). Methods Participants included 26 middle-aged (mean age=56.1±10.8 years; 42% women), overweight/obese (mean body mass index (BMI) =37.22±8.78 kg/m2) adults who had been diagnosed with T2D within the past 5 years (mean HbA1c=7.81%). Participants underwent a physical examination, blood tests, and psychological questionnaires, including a self-report questionnaire that assessed the consumption of high glycemic and low glycemic load foods. Participants wore an Actigraph accelerometer for 7 days to assess MVPA and SB. All measures were collected at baseline and at the 6-month follow-up. Spearman rank correlations and regression models were conducted to examine the relationship between activity variables, and the association of activity measures with health outcomes at the 6-month follow-up. Results Decreases in duration of SB bouts and increases in MVPA were associated with decreased levels of HbA1c (p<0.05). Over 50% of the variance in HbA1c levels could be attributed to changes in MVPA and SB. Conclusions MVPA and SB were independently associated with diabetes-related health outcomes. Results suggest that emphasis should be placed on increasing MVPA while decreasing SB, particularly duration of SB bouts. This suggests that even small changes in daily behavior may contribute to improvement in diabetes-related health outcomes. PMID:28405340

  19. Perspectives on differing health outcomes by city: accounting for Glasgow's excess mortality.

    Science.gov (United States)

    Fraser, Simon Ds; George, Steve

    2015-01-01

    Several health outcomes (including mortality) and health-related behaviors are known to be worse in Scotland than in comparable areas of Europe and the United Kingdom. Within Scotland, Greater Glasgow (in West Central Scotland) experiences disproportionately poorer outcomes independent of measurable variation in socioeconomic status and other important determinants. Many reasons for this have been proposed, particularly related to deprivation, inequalities, and variation in health behaviors. The use of models (such as the application of Bradford Hill's viewpoints on causality to the different hypotheses) has provided useful insights on potentially causal mechanisms, with health behaviors and inequalities likely to represent the strongest individual candidates. This review describes the evolution of our understanding of Glasgow's excess mortality, summarizes some of the key work in this area, and provides some suggestions for future areas of exploration. In the context of demographic change, the experience in Glasgow is an important example of the complexity that frequently lies behind observed variations in health outcomes within and between populations. A comprehensive explanation of Glasgow's excess mortality may continue to remain elusive, but is likely to lie in a complex and difficult-to-measure interplay of health determinants acting at different levels in society throughout the life course. Lessons learned from the detailed examination of different potentially causative determinants in Scotland may provide useful methodological insights that may be applied in other settings. Ongoing efforts to unravel the causal mechanisms are needed to inform public health efforts to reduce health inequalities and improve outcomes in Scotland.

  20. Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes.

    Science.gov (United States)

    Hendriksen, Ingrid J M; Snoijer, Mirjam; de Kok, Brenda P H; van Vilsteren, Jeroen; Hofstetter, Hedwig

    2016-06-01

    Evaluation of the effectiveness of a workplace health promotion program on employees' vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors' role on these outcomes. The 5-month intervention included activities at management, team, and individual level targeting self-management to perform healthy behaviors: a kick-off session, vitality training sessions, workshops, individual coaching, and intervision. Outcome measures were collected using questionnaires, health checks, and sickness absence data at baseline, after the intervention and at 10 months follow-up. For analysis linear and generalized mixed models were used. Vitality, work performance, sickness absence, and self-management significantly improved. Good organizational support and involved supervisors were significantly associated with lower sickness absence. Including all organizational levels and focusing on increasing self-management provided promising results for improving vitality, health, and work-related outcomes.

  1. Tracking Success: Outputs Versus Outcomes-A Comparison of Accredited and Non-Accredited Public Health Agencies' Community Health Improvement Plan objectives.

    Science.gov (United States)

    Perrault, Evan K; Inderstrodt-Stephens, Jill; Hintz, Elizabeth A

    2018-06-01

    With funding for public health initiatives declining, creating measurable objectives that are focused on tracking and changing population outcomes (i.e., knowledge, attitudes, or behaviors), instead of those that are focused on health agencies' own outputs (e.g., promoting services, developing communication messages) have seen a renewed focus. This study analyzed 4094 objectives from the Community Health Improvement Plans (CHIPs) of 280 local PHAB-accredited and non-accredited public health agencies across the United States. Results revealed that accredited agencies were no more successful at creating outcomes-focused objectives (35% of those coded) compared to non-accredited agencies (33% of those coded; Z = 1.35, p = .18). The majority of objectives were focused on outputs (accredited: 61.2%; non-accredited: 63.3%; Z = 0.72, p = .47). Outcomes-focused objectives primarily sought to change behaviors (accredited: 85.43%; non-accredited: 80.6%), followed by changes in knowledge (accredited: 9.75%; non-accredited: 10.8%) and attitudes (accredited: 1.6%; non-accredited: 5.1%). Non-accredited agencies had more double-barreled objectives (49.9%) compared to accredited agencies (32%; Z = 11.43, p < .001). The authors recommend that accreditation procedures place a renewed focus on ensuring that public health agencies strive to achieve outcomes. It is also advocated that public health agencies work with interdisciplinary teams of Health Communicators who can help them develop procedures to effectively and efficiently measure outcomes of knowledge and attitudes that are influential drivers of behavioral changes.

  2. Understanding Health and Health-Related Behavior of Users of Internet Health Information.

    Science.gov (United States)

    Wimble, Matt

    2016-10-01

    Little is known about how actual use of Internet health-related information is associated with health or health-related behavior. Using a nationally representative sample of 34,525 from 2012, this study examined the demographics of users of Internet health-related information (users), reports estimates of association with several health and behavioral outcomes adjusting for demographic factors, and analyzed the sample by education level, race, gender, and age. Analysis of a large nationally representative sample shows evidence that users of health-related information (users) on the Internet are younger, more educated, more likely to be insured, more likely to be female, and less likely to be African American. After adjusting for demographic differences, users are more likely to have been diagnosed with hypertension, cancer, stroke, and high cholesterol, but no evidence of current hypertension, weight-related issues, or being in fair or poor health. Users are less likely to smoke and among smokers are more likely to attempt quitting. Users are more likely to exercise, get a flu shot, pap smear, mammogram, HIV test, colon cancer screening, blood pressure check, and cholesterol check, but likely to be heavy drinkers. With few exceptions, results appear robust across gender, age groups, level of education, and ethnicity. Use is generally positively associated with prior diagnosis for several conditions and behaviors related to improved health, but I find no relationship with existing health status. The association between use of health-related Internet information and health-related behavior seems robust across levels of education, age, gender, and race.

  3. Changing Work, Changing Health: Can Real Work-Time Flexibility Promote Health Behaviors and Well-Being?

    Science.gov (United States)

    Moen, Phyllis; Kelly, Erin L.; Tranby, Eric; Huang, Qinlei

    2012-01-01

    This article investigates a change in the structuring of work time, using a natural experiment to test whether participation in a corporate initiative (Results Only Work Environment; ROWE) predicts corresponding changes in health-related outcomes. Drawing on job strain and stress process models, we theorize greater schedule control and reduced work-family conflict as key mechanisms linking this initiative with health outcomes. Longitudinal survey data from 659 employees at a corporate headquarters shows that ROWE predicts changes in health-related behaviors, including almost an extra hour of sleep on work nights. Increasing employees’ schedule control and reducing their work-family conflict are key mechanisms linking the ROWE innovation with changes in employees’ health behaviors; they also predict changes in well-being measures, providing indirect links between ROWE and well-being. This study demonstrates that organizational changes in the structuring of time can promote employee wellness, particularly in terms of prevention behaviors. PMID:22144731

  4. Measuring Population Health Outcomes

    OpenAIRE

    Parrish, R. Gibson

    2010-01-01

    An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

  5. The interplay between healthy behaviors and health outcomes among older adults in Russia

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A. Selivanova (Anna)

    2014-01-01

    markdownabstract__Abstract__ Background: Worldwide, populations are aging and the health of elderly individuals is deteriorating. Healthy habits may slow the process of health deterioration, but research investigating relationships between health and various health behaviors is lacking. This

  6. Teachable moments for health behavior change and intermediate patient outcomes.

    Science.gov (United States)

    Flocke, Susan A; Clark, Elizabeth; Antognoli, Elizabeth; Mason, Mary Jane; Lawson, Peter J; Smith, Samantha; Cohen, Deborah J

    2014-07-01

    Teachable moments (TM) are opportunities created through physician-patient interaction and used to encourage patients to change unhealthy behaviors. We examine the effectiveness of TMs to increase patients' recall of advice, motivation to modify behavior, and behavior change. A mixed-method observational study of 811 patient visits to 28 primary care clinicians used audio-recordings of visits to identify TMs and other types of advice in health behavior change talk. Patient surveys assessed smoking, exercise, fruit/vegetable consumption, height, weight, and readiness for change prior to the observed visit and 6-weeks post-visit. Compared to other identified categories of advice (i.e. missed opportunities or teachable moment attempts), recall was greatest after TMs occurred (83% vs. 49-74%). TMs had the greatest proportion of patients change in importance and confidence and increase readiness to change; however differences were small. TMs had greater positive behavior change scores than other categories of advice; however, this pattern was statistically non-significant and was not observed for BMI change. TMs have a greater positive influence on several intermediate markers of patient behavior change compared to other categories of advice. TMs show promise as an approach for clinicians to discuss behavior change with patients efficiently and effectively. Copyright © 2014. Published by Elsevier Ireland Ltd.

  7. Behavioral intervention technologies: evidence review and recommendations for future research in mental health.

    Science.gov (United States)

    Mohr, David C; Burns, Michelle Nicole; Schueller, Stephen M; Clarke, Gregory; Klinkman, Michael

    2013-01-01

    A technical expert panel convened by the Agency for Healthcare Research and Quality and the National Institute of Mental Health was charged with reviewing the state of research on behavioral intervention technologies (BITs) in mental health and identifying the top research priorities. BITs refers to behavioral and psychological interventions that use information and communication technology features to address behavioral and mental health outcomes. This study on the findings of the technical expert panel. Videoconferencing and standard telephone technologies to deliver psychotherapy have been well validated. Web-based interventions have shown efficacy across a broad range of mental health outcomes. Social media such as online support groups have produced disappointing outcomes when used alone. Mobile technologies have received limited attention for mental health outcomes. Virtual reality has shown good efficacy for anxiety and pediatric disorders. Serious gaming has received little work in mental health. Research focused on understanding reach, adherence, barriers and cost is recommended. Improvements in the collection, storage, analysis and visualization of big data will be required. New theoretical models and evaluation strategies will be required. Finally, for BITs to have a public health impact, research on implementation and application to prevention is required. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Effect of housing relocation and neighborhood environment on adolescent mental and behavioral health.

    Science.gov (United States)

    Byck, Gayle R; Bolland, John; Dick, Danielle; Swann, Gregory; Henry, David; Mustanski, Brian

    2015-11-01

    This study examined whether relocating from a high-poverty neighborhood to a lower poverty neighborhood as part of a federal housing relocation program (HOPE VI; Housing Opportunities for People Everywhere) had effects on adolescent mental and behavioral health compared to adolescents consistently living in lower poverty neighborhoods. Sociodemographic, risk behavior, and neighborhood data were collected from 592 low-income, primarily African-American adolescents and their primary caregivers. Structured psychiatric interviews were conducted with adolescents. Prerelocation neighborhood, demographic, and risk behavior data were also included. Hierarchical Linear Modeling (HLM) was used to test associations between neighborhood variables and risk outcomes. HLM was used to test whether the effect of neighborhood relocation and neighborhood characteristics might explain differences in sexual risk taking, substance use, and mental health outcomes. Adolescents who relocated of HOPE VI neighborhoods (n = 158) fared worse than control group participants (n = 429) on most self-reported mental health outcomes. The addition of subjective neighborhood measures generally did not substantively change these results. Our findings suggest that moving from a high-poverty neighborhood to a somewhat lower poverty neighborhood is not associated with better mental health and risk behavior outcomes in adolescents. The continued effects of having grown up in a high-poverty neighborhood, the small improvements in their new neighborhoods, the comparatively short length of time they lived in their new neighborhood, and/or the stress of moving appears to worsen most of the mental health outcomes of HOPE VI compared to control group participants who consistently lived in the lower poverty neighborhoods. © 2015 Association for Child and Adolescent Mental Health.

  9. Amplifying Health Through Community Gardens: A Framework for Advancing Multicomponent, Behaviorally Based Neighborhood Interventions.

    Science.gov (United States)

    Alaimo, Katherine; Beavers, Alyssa W; Crawford, Caroline; Snyder, Elizabeth Hodges; Litt, Jill S

    2016-09-01

    The article presents a framework for understanding the relationship between community garden participation, and the myriad ways gardens and participation lead to emotional, social, and health impacts. Existing empirical research relating community gardens to health behaviors, such as physical activity and diet, and longer-term chronic disease-related outcomes is summarized. The research areas discussed include the effects of community garden participation on individual, social, emotional, and environmental processes; health behaviors including diet and physical activity; and health outcomes such as self-rated health, obesity, and mental health. Other mechanisms through which community gardens may affect population health are described. Applying a multitheoretical lens to explore associations between community garden participation and health enables us to delineate key aspects of gardening that elicit positive health behaviors and multifactorial health assets that could be applied to designing other types of health interventions.

  10. Self-Efficacy and Social Support Mediate the Relationship between Internal Health Locus of Control and Health Behaviors in College Students

    Science.gov (United States)

    Marr, Joni; Wilcox, Sara

    2015-01-01

    Background: Internal health locus of control has been associated with positive health outcomes and behaviors. Understanding the mechanisms of this relationship are key to designing and implementing effective health behavior intervention programs. Purpose: The purpose was to examine whether self-efficacy and social support mediate the relationship…

  11. Health Outcomes in Individuals with Problem and Pathological Gambling: An Analysis of the 2014 North Carolina Behavioral Risk Factor Survey System (BRFSS).

    Science.gov (United States)

    Van Patten, Ryan; Weinstock, Jeremiah; McGrath, Andrew B

    2018-03-01

    Problem and pathological gambling refers to subclinical and clinical levels of maladaptive gambling, respectively, and is associated with specific sociodemographic characteristics as well as a number of poor health outcomes. We examined such demographic, physical health, mental health, and health-related behaviors in a sample of 7045 low-risk gamblers and 244 problem/pathological gamblers. Participants completed the 2014 North Carolina Behavioral Risk Factor Surveillance System telephone survey. Using the National Opinion Research Center's Diagnostic Screen for Gambling Disorders-CLiP, participants were categorized as either "problem/pathological gamblers" or "low-risk gamblers." Problem/pathological gamblers were younger, more likely to be male, of ethnic minority status, unmarried, and of lower education than low-risk gamblers. No physical health variables differentiated the groups but problem/pathological gamblers reported experiencing significantly more adverse childhood experiences and engaging in significantly more tobacco and alcohol use compared to low-risk gamblers. Moreover, gender moderated relationships between gambling group and several of the alcohol use variables such that male problem/pathological gamblers exhibited greater alcohol use behavior than male low-risk gamblers but no such relationship was present in females. Overall, this study expands the current knowledgebase on disordered gambling and highlights the need to assess disordered gambling in public health samples. Clinical implications are discussed.

  12. Incentivizing health care behaviors in emerging adults: a systematic review

    Directory of Open Access Journals (Sweden)

    Yu CH

    2016-03-01

    Full Text Available Catherine H Yu,1,2 Giuliana Guarna,1 Pamela Tsao,3 Jude R Jesuthasan,1 Adrian NC Lau,3,4 Ferhan S Siddiqi,1 Julie Anne Gilmour,3 Danyal Ladha,1 Henry Halapy,5 Andrew Advani1–3 1Li Ka Shing Knowledge Institute, St Michael’s Hospital, 2Division of Endocrinology and Metabolism, Department of Medicine, St Michael’s Hospital, University of Toronto, 3Department of Medicine, Faculty of Medicine, University of Toronto, 4Division of Endocrinology, Department of Medicine, University Health Network, 5Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada Purpose: For emerging adults with chronic medical diseases, the transition from pediatric to adult health care is often a time of great upheaval, commonly associated with unhealthy self-management choices, loss to follow-up, and adverse outcomes. We conducted a systematic review to examine the use of incentive strategies to promote positive health-related behaviors in young adults with chronic medical diseases.Methods: The Medline, CINAHL, Embase, PsycInfo, and Cochrane databases were searched through June 2014. Studies of any design where an incentive was used to achieve a target behavior or outcome in a pediatric or emerging adult population (age <30 years with chronic medical conditions including addictions, were included.Results: A total of 26 studies comprising 10,880 patients met our inclusion criteria after screening 10,305 abstracts and 301 full-text articles. Of these studies, 20 examined the effects of behavioral incentives on cigarette smoking or substance abuse, including alcohol; four studies explored behavioral incentives in the setting of HIV or sexual health; and two articles studied individuals with other chronic medical conditions. Seventeen articles reported a statistically significant benefit of the behavioral incentive on one or more outcomes, although only half reported follow-up after the incentive period was terminated.Conclusion: While the majority of

  13. Trust, Behavior, and High School Outcomes

    Science.gov (United States)

    Romero, Lisa S.

    2015-01-01

    Purpose: The purpose of this paper is to contribute to the literature on student trust and to examine the relationship between student trust, behavior, and academic outcomes in high school. It asks, first, does trust have a positive effect on high school outcomes? Second, does trust influence student behavior, exerting an indirect effect on…

  14. Trajectories and outcomes among children with special health care needs.

    Science.gov (United States)

    Quach, Jon; Jansen, Pauline W; Mensah, Fiona K; Wake, Melissa

    2015-04-01

    Outcomes for children with special health care needs (SHCN) can vary by their patterns and persistence over time. We aimed to empirically establish typical SHCN trajectories throughout childhood and their predictive relationships with child and parent outcomes. The 2 cohorts of the nationally representative Longitudinal Study of Australian Children were recruited in 2004 at ages 0 to 1 (n = 5107, B cohort) and 4 to 5 years (n = 4983, K cohort). The parent-reported Children With SHCN Screener (Short Form) was completed at each of 4 biennial waves. Wave 4 outcomes were parent-reported behavior and health-related quality of life, teacher-reported learning, and directly assessed cognition. Both parents self-reported mental distress. We derived intracohort trajectories by using latent class analysis in Mplus. We compared mean outcome scores across trajectories by using linear regression, adjusting for socioeconomic position. Four distinct SHCN trajectories were replicated in both cohorts: persistent (B 6.8%, K 8.7%), emerging (B 4.1%, K 11.5%), transient (B 7.9%, K 4.2%), and none (B 81.3%, K 75.6%). Every outcome was adversely affected except fathers' mental health. From infancy to age 6 to 7 years, the persistent and emerging groups had similarly poor outcomes. From age 4 and 5 to 10 and 11 years, outcomes were incrementally poorer on moving from none to transient to emerging and to persistent SHCN. Effect sizes were largest for behavior, learning, and psychosocial outcomes. Adverse outcomes are shaped more by cumulative burden than point prevalence of SHCNs. In addition to providing care according to a child's need at any given time, prioritizing care toward persistent SHCNs may have the biggest benefits for children and parents. Copyright © 2015 by the American Academy of Pediatrics.

  15. How significant is the ‘significant other’? Associations between significant others’ health behaviors and attitudes and young adults’ health outcomes

    Directory of Open Access Journals (Sweden)

    Berge Jerica M

    2012-04-01

    Full Text Available Abstract Background Having a significant other has been shown to be protective against physical and psychological health conditions for adults. Less is known about the period of emerging young adulthood and associations between significant others’ weight and weight-related health behaviors (e.g. healthy dietary intake, the frequency of physical activity, weight status. This study examined the association between significant others’ health attitudes and behaviors regarding eating and physical activity and young adults’ weight status, dietary intake, and physical activity. Methods This study uses data from Project EAT-III, a population-based cohort study with emerging young adults from diverse ethnic and socioeconomic backgrounds (n = 1212. Logistic regression models examining cross-sectional associations, adjusted for sociodemographics and health behaviors five years earlier, were used to estimate predicted probabilities and calculate prevalence differences. Results Young adult women whose significant others had health promoting attitudes/behaviors were significantly less likely to be overweight/obese and were more likely to eat ≥ 5 fruits/vegetables per day and engage in ≥ 3.5 hours/week of physical activity, compared to women whose significant others did not have health promoting behaviors/attitudes. Young adult men whose significant other had health promoting behaviors/attitudes were more likely to engage in ≥ 3.5 hours/week of physical activity compared to men whose significant others did not have health promoting behaviors/attitudes. Conclusions Findings suggest the protective nature of the significant other with regard to weight-related health behaviors of young adults, particularly for young adult women. Obesity prevention efforts should consider the importance of including the significant other in intervention efforts with young adult women and potentially men.

  16. Facebook False Self-Presentation Behaviors and Negative Mental Health.

    Science.gov (United States)

    Wright, Elizabeth J; White, Katherine M; Obst, Patricia L

    2018-01-01

    As research examining what constitutes Facebook false self-presentation is lacking, the aim of this study was to develop a preliminary inventory of Facebook false self-presentation behaviors, as well as identify predictors and possible outcomes. Participants (N = 211) completed questions regarding frequency of engagement in Facebook false self-presentation behaviors, as well as self-esteem, social influences, motivation strategies, well-being, depression, anxiety, and stress. Results indicated the presence of two distinct false self-presentation behaviors: lying (e.g., untruthful status updates, profile creation) and liking behaviors (e.g., liking posts dishonestly), each associated with different predictors and outcomes. Results indicated that moral norms significantly predicted lying behaviors; and age, self-esteem, group norms, and moral norms significantly predicted liking behaviors. Unexpectedly, liking behaviors were associated with depression, anxiety, and stress, whereas lying behaviors were related to anxiety only. Findings highlight associations between online self-presentation strategies, in particular liking behaviors, on Facebook and possible offline negative mental health.

  17. The relationship between radon knowledge, concern and behavior, and health values, health locus of control and preventive health behaviors

    International Nuclear Information System (INIS)

    Kennedy, C.J.; Probart, C.K.; Dorman, S.M.

    1991-01-01

    Understanding similarities between health-related and radon-related knowledge, attitudes, and behaviors may suggest application of effective strategies of radon-related education in targeted populations. A mail survey was returned by 300 randomly selected homeowners in a community at risk for high home radon concentrations (50% response). While 64% were concerned, only 7% tested their homes. The expected association between radon knowledge, radon concern, and information-seeking was identified. In addition, those who tested their homes had greater knowledge and did more information seeking. Health values and radon concern were only weakly related. Environmental concern explained the greatest variance in radon concern (10%). Internal health locus of controls were more likely to have high radon concern. Of the preventive health behaviors, not smoking and seat belt use were the best predictors of variance in radon concern (5%). Segmenting the population is suggested for best educational outcome. Relating information to environmental issues may be helpful. Health-conscious people may need awareness of risks. Issues of self-control and radon testing and reduction may be helpful for some. Synergy between smoke and radon, compounded by smokers lack of concern suggests targeting smokers for education efforts

  18. Special issue: Behavioral Economics and Health Annual Symposium.

    Science.gov (United States)

    2011-09-01

    The application of behavioral economics to health and health care has captured the imagination of policymakers across the political spectrum. The idea is that many people are irrational in predictable ways, and that this both contributes to unhealthy behaviors like smoking and holds one of the keys to changing those behaviors. Because health care costs continue to increase, and a substantial portion of costs are incurred because of unhealthy behaviors, employers and insurers have great interest in using financial incentives to change behaviors. However, it is in the details that complexity and controversies emerge. Who should the targets be, and what outcomes should be rewarded? How should incentives be structured, to maximize their effectiveness and minimize unintended consequences? In what situations should we be intervening to affect decisions by people who may prefer to be obese or to smoke, and in what situations should we accept their preferences? To begin to answer these questions, the Penn-CMU Roybal P30 Center on Behavioral Economics and Health held its first annual Behavioral Economics and Health Symposium on March 24-25, 2011 with support from the Robert Wood Johnson Foundation. The symposium drew more than 50 researchers, scholars, and health professionals from a variety of disciplines, including medicine, public health, economics, law, management, marketing, and psychology. They heard perspectives on behavioral economics from public and private funders, the CEO of the University of Pennsylvania Health System, and the CEO of stickK.com, a start-up company that uses online, voluntary commitment contracts to help people achieve their goals. Participants formed eight working groups to review the current state-of-the-art in a variety of clinical contexts and to consider how behavioral economics could inform a research agenda to improve health. This Issue Brief summarizes the findings of these working groups and the symposium.

  19. Health Behaviors and Self-Reported Health Among Cancer Survivors by Sexual Orientation.

    Science.gov (United States)

    Jabson, Jennifer M; Farmer, Grant W; Bowen, Deborah J

    2015-03-01

    Health behaviors and self-reported health are important for understanding cancer survivor health. However, there is a paucity of published research about how cancer survivors' health behaviors and self-rated health vary by sexual orientation. This study examined cancer survivors' health behaviors and self-reported health by sexual orientation. This study used data from the National Health and Nutrition Examination Survey (NHANES) from 2001-2010. Self-reported health and cancer-related health behaviors were compared by sexual orientation. Propensity score adjustment was used to account for differences in age, race, education, gender and health insurance status. Of the 602 survivors eligible for the study, 4.3% identified as sexual minorities. Sexual minorities were 2.6 times more likely to report a history of illicit drug use (adjusted odds ratio [aOR]=2.4, 95% confidence interval [CI]: 1.04, 5.35), and 60% less likely to report their current health status as good (aOR=0.40, 95% CI: 0.18, 0.89), compared to heterosexual cancer survivors. These disparities persisted even after adjustment for socio-demographic characteristics. Our findings suggest that sexual minority cancer survivors may be at greater risk for poorer outcomes after cancer than other survivors. A possible explanation for the observed differences involves minority stress. Future research should test stress as an explanation for these differences. However, using population-methods to achieve this goal requires larger samples of lesbian, gay, and bisexual (LGB) cancer survivors.

  20. The Importance of the Distance to a Non-Residential Parent - An analysis of Children's Health, Behavior, and Educational Outcomes

    DEFF Research Database (Denmark)

    Rasmussen, Astrid Würtz; Stratton, Leslie S.

    between the household where the child resides and the child‟s other parent‟s household is employed to proxy for contact and instrumental variables techniques are employed to control for endogeneity. The preliminary results suggest that educational and behavioral outcomes are better for children who live...... with each of their biological parents. This shift away from maternal custody is based on the belief that having contact with each parent is in the child‟s best interest. As our concern in this study is the impact of contact with the non-residential parent on child outcomes, we limit our analysis to children...... who have experienced at least one parental separation or divorce. In order to track family structure over time we use a population sample of Danes and explore children‟s educational achievement, health outcomes, and criminal activity using detailed register data. Information on the travel distance...

  1. Sharing Health Information and Influencing Behavioral Intentions: The Role of Health Literacy, Information Overload, and the Internet in the Diffusion of Healthy Heart Information.

    Science.gov (United States)

    Crook, Brittani; Stephens, Keri K; Pastorek, Angie E; Mackert, Michael; Donovan, Erin E

    2016-01-01

    Low health literacy remains an extremely common and problematic issue, given that individuals with lower health literacy are more likely to experience health challenges and negative health outcomes. In this study, we use the first three stages of the innovation-decision process found in the theory of diffusion of innovations (Rogers, 2003). We incorporate health literacy into a model explaining how perceived health knowledge, information sharing, attitudes, and behavior are related. Results show that health information sharing explains 33% of the variance in behavioral intentions, indicating that the communicative practice of sharing information can positively impact health outcomes. Further, individuals with high health literacy tend to share less information about heart health than those with lower health literacy. Findings also reveal that perceived heart-health knowledge operates differently than health literacy to predict health outcomes.

  2. Does Integrated Behavioral Health Care Reduce Mental Health Disparities for Latinos? Initial Findings

    Science.gov (United States)

    Bridges, Ana J.; Andrews, Arthur R.; Villalobos, Bianca T.; Pastrana, Freddie A.; Cavell, Timothy A.; Gomez, Debbie

    2014-01-01

    Integrated behavioral health care (IBHC) is a model of mental health care service delivery that seeks to reduce stigma and service utilization barriers by embedding mental health professionals into the primary care team. This study explored whether IBHC service referrals, utilization, and outcomes were comparable for Latinos and non-Latino White primary care patients. Data for the current study were collected from 793 consecutive patients (63.8% Latino; M age = 29.02 years [SD = 17.96]; 35.1% under 18 years; 65.3% women; 54.3% uninsured) seen for behavioral health services in 2 primary care clinics during a 10.5 month period. The most common presenting concerns were depression (21.6%), anxiety (18.5%), adjustment disorder (13.0%), and externalizing behavior problems (9.8%). Results revealed that while Latino patients had significantly lower self-reported psychiatric distress, significantly higher clinician-assigned global assessment of functioning scores, and fewer received a psychiatric diagnosis at their initial visit compared to non-Latino White patients, both groups had comparable utilization rates, comparable and clinically significant improvements in symptoms (Cohen’s d values > .50), and expressed high satisfaction with integrated behavioral services. These data provide preliminary evidence suggesting integration of behavioral health services into primary care clinics may help reduce mental health disparities for Latinos. PMID:25309845

  3. Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study.

    Science.gov (United States)

    Sharma, Manasi; Fine, Shoshanna L; Brennan, Robert T; Betancourt, Theresa S

    2017-02-01

    This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10-17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.

  4. Diabetes, diet-health behavior, and obesity.

    Science.gov (United States)

    Anders, Sven; Schroeter, Christiane

    2015-01-01

    High-quality diets play an important role in diabetes prevention. Appropriate dietary adherence can improve insulin sensitivity and glycemic control, and thus contribute to lifestyle improvement. However, previous research suggests that dietary adherence is arguably among the most difficult cornerstones of diabetes management. The objectives of this study are (1) to estimate whether and to what extent individuals diagnosed with diabetes show significant differences in diet quality [healthy eating index (HEI)] compared to healthy individuals, (2) to quantify whether and to what extent diabetics experience significantly higher outcomes of body mass index (BMI), and (3) to estimate whether and to what extent dietary supplementation impacts diabetes patient's diet quality and/or BMI outcomes. We use data from the 2007-2008 U.S. National Health and Nutrition Examination Survey (NHANES). The NHANES is the primary, randomized, and nationally representative survey used to assess the health and nutritional status in the U.S. We apply propensity score matching (PSM) to account for selection bias and endogeneity between self-reported diet and health behavir (treatment) and BMI outcomes. We control for an individual's BMI as to capture the impact of past dietary behavior in its impact on HEI. Matching results suggest that regular dietary supplement consumption is associated with significant lower BMI outcomes of almost 1 kg/m(2). The close relationship between diabetes and obesity has been at the center of the diet-health policy debate across Canada and the U.S. Knowledge about this linkage may help to improve the understanding of the factors that impact dietary choices and their overall health outcomes, which may lead to a more efficient and effective promotion of dietary guidelines, healthy food choices, and targeted consumer health and lifestyle policies.

  5. Television viewing, psychological positive health, health complaints and health risk behaviors in Spanish children and adolescents.

    Science.gov (United States)

    Padilla-Moledo, C; Castro-Piñero, J; Ortega, F B; Pulido-Martos, M; Sjöström, M; Ruiz, J R

    2015-06-01

    The aim of this study was to study the correlation of television viewing with positive and negative health in youth. The present cross-sectional study comprised a total of 680 children and adolescents aged 6-17.9 (46% girls) representative of the province of Cádiz (south Spain). We used the Health Behavior in School-aged Children questionnaire to assess television viewing, positive and negative health. It was found that correlations between television viewing >2 hours and several outcomes were inconsistent. No effects were found for quality of family relationships, quality of peer relationships, perceived academic performance and health risk behaviors in children, or with perceived excellent health status, excellent life satisfaction, quality of peer relationships, perceived academic performance and health risk behaviors in adolescents. However viewing >2 hours of television was correlated with lower quality family relations in adolescents, and lower perceived excellent health status, lower life satisfaction and higher health complaints index in children. Correction for multiple comparisons would render all television relationships as non-significant. Our results suggest that negative television influences on children and adolescents are minimal. However excessive television viewing may be symptomatic of other underlying mental health problems for some children.

  6. [Health and health-related behaviors according to sexual attraction and behavior].

    Science.gov (United States)

    Pérez, Glòria; Martí-Pastor, Marc; Gotsens, Mercè; Bartoll, Xavier; Diez, Elia; Borrell, Carme

    2015-01-01

    to Describe perceived health, mental health and certain health-related behaviors according to sexual attraction and behavior in the population residing in Barcelona in 2011. Perceived health, mental health, chronic conditions and health-related behaviors were analyzed in 2675 people aged 15 to 64 years. The Barcelona Health Survey for 2011 was used, which included questions on sexual attraction and behavior. Multivariate robust Poisson regression models were fitted to obtain adjusted prevalence ratios. People feeling same-sex attraction reported a higher prevalence of worse perceived and mental health. These people and those who had had sex with persons of the same sex more frequently reported harmful health-related behaviors. Lesbian, gay, transgender and bisexual people may have health problems that should be explored in depth, prevented, and attended. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. The Impact of Health-Promoting Behaviors on Low-Income Children's Health: A Risk and Resilience Perspective

    Science.gov (United States)

    Yoo, Joan; Slack, Kristen S.; Holl, Jane L.

    2010-01-01

    This study's objective was to examine whether five child health-promoting behaviors by caregivers would be associated with caregivers' assessments of their children's health as "excellent," controlling for an array of risk factors for adverse health outcomes. The study used the third and fourth waves of the Illinois Families Study-Child…

  8. Assessing the Impact of De Novo Social Ties within Health Intervention Settings: New Questions for Health Behavior Intervention Research.

    Science.gov (United States)

    Tesdahl, Eric; Gesell, Sabina B

    2015-12-01

    Recent developments in the study of health and social networks have focused on linkages between health outcomes and naturally occurring social relations, such as friendship or kinship. Based on findings in this area, a new generation of health behavior intervention programs have been implemented that rely on the formation of new social relations among program participants. However, little is known about the qualities of these de novo social relations. We examined the social networks of 59 participants within a randomized controlled trial of an intervention designed to prevent excessive gestational weight gain. We employed exponential random graph modeling techniques to analyze supportive relationships formed between participants in the intervention arm, to detect unique effects of program participation on the likelihood of forming ties. Program participation had a positive effect on the likelihood of forming supportive social relations, however, in this particular timeframe we did not detect any additional effect of such relations on the health behaviors or outcomes of interest. Our findings raise two critical questions: do short-term group-level programs reliably lead to the formation of new social relations among participants; and do these relations have a unique effect on health outcomes relative to standard methods of health behavior intervention? © 2015 Wiley Periodicals, Inc.

  9. Delay Discounting as an Index of Sustainable Behavior: Devaluation of Future Air Quality and Implications for Public Health.

    Science.gov (United States)

    Berry, Meredith S; Nickerson, Norma P; Odum, Amy L

    2017-09-01

    Poor air quality and resulting annual deaths represent significant public health concerns. Recently, rapid delay discounting (the devaluation of future outcomes) of air quality has been considered a potential barrier for engaging in long term, sustainable behaviors that might help to reduce emissions (e.g., reducing private car use, societal support for clean air initiatives). Delay discounting has been shown to be predictive of real world behavior outside of laboratory settings, and therefore may offer an important framework beyond traditional variables thought to measure sustainable behavior such as importance of an environmental issue, or environmental attitudes/values, although more research is needed in this area. We examined relations between discounting of air quality, respiratory health, and monetary gains and losses. We also examined, relations between discounting and self-reported importance of air quality and respiratory health, and nature relatedness. Results showed rapid delay discounting of all outcomes across the time frames assessed, and significant positive correlations between delay discounting of air quality, respiratory health, and monetary outcomes. Steeper discounting of monetary outcomes relative to air quality and respiratory health outcomes was observed in the context of gains; however, no differences in discounting were observed across losses of monetary, air quality, and respiratory health. Replicating the sign effect, monetary outcomes were discounted more steeply than monetary losses. Importance of air quality, respiratory health and nature relatedness were significantly and positively correlated with one another, but not with degree of delay discounting of any outcome, demonstrating the need for more comprehensive measures that predict pro-environmental behaviors that might benefit individuals and public health over time. These results add to our understanding of decision-making, and demonstrate alarming rates of delay discounting of

  10. Health behaviors and mental health of students attending alternative high schools: a review of the research literature.

    Science.gov (United States)

    Johnson, Karen E; Taliaferro, Lindsay A

    2012-04-01

    The purpose of this review is to describe current knowledge about health-risk behaviors and mental health among alternative high school students. Substance use, diet and/or physical activity, sexual-risk behaviors, mental health, and violence were reviewed. Students were described as marginalized youth facing significant social environmental challenges. Findings from 43 studies published from 1997-2010 suggested a high prevalence of health-risk behaviors among alternative high school students. Very few studies were conducted by nurse researchers. Suggestions for future research include addressing social environmental factors, resiliency, and emotional/mental health outcomes. Alternative high schools offer a venue to conduct research and implement nursing interventions with high-risk, yet resilient, youth. © 2011, Wiley Periodicals, Inc.

  11. Direct and Mediated Relationships Between Participation in a Telephonic Health Coaching Program and Health Behavior, Life Satisfaction, and Optimism.

    Science.gov (United States)

    Sears, Lindsay E; Coberley, Carter R; Pope, James E

    2016-07-01

    The aim of this study was to examine the direct and mediated effects of a telephonic health coaching program on changes to healthy behaviors, life satisfaction, and optimism. This longitudinal correlational study of 4881 individuals investigated simple and mediated relationships between participation in a telephonic health risk coaching program and outcomes from three annual Well-being Assessments. Program participation was directly related to improvements in healthy behaviors, life satisfaction and optimism, and indirect effects of coaching on these variables concurrently and over a one-year time lag were also supported. Given previous research that improvements to life satisfaction, optimism, and health behaviors are valuable for individuals, employers, and communities, a clearer understanding of intervention approaches that may impact these outcomes simultaneously can drive greater program effectiveness and value on investment.

  12. Assessing the influence of health literacy on health information behaviors: A multi-domain skills-based approach.

    Science.gov (United States)

    Suri, Venkata Ratnadeep; Majid, Shaheen; Chang, Yun-Ke; Foo, Schubert

    2016-06-01

    The aim of this study is to investigate the relationship between five domain-specific skills of health literacy: Find Health Information (FHI), Appraise Health Information (AHI), Understand Health Information to act (UHI), Actively Manage One's Health (AMH), and E-health literacy (e-Heals), and health information seeking behaviors and three categories of health outcomes. A survey was implemented and data was collected from 1062 college going adults and analyzed using bivariate tests and multiple regression analysis. Among the five domain-specific Health Literacy skills, AHI and e-Heals were significantly associated with the use of traditional sources and the Internet for healthcare information respectively. Similarly and AMH and e-Heals were significantly associated with the use of traditional sources and the Internet for health lifestyle information respectively. Lastly AHI, AMH and e-Heals were significantly associated with the three categories of outcomes, and AFH was significantly associated with cognitive and instrumental outcomes, but not doctor-patient communication outcomes. Consumers' ability to use different health sources for both healthcare and health lifestyle information, and the three categories of health outcomes are associated with different domain-specific health literacy skills. Health literacy initiatives may be improved by focusing on clients to develop domain-specific skills that increase the likelihood of using health information sources and accrue benefits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. The School Nurse's Role in Behavioral Health of Students. Position Statement

    Science.gov (United States)

    McDermott, Elizabeth; Bohnenkamp, Jill Haak; Freedland, Mary; Baker, Dian; Palmer, Karla

    2017-01-01

    It is the position of the National Association of School Nurses (NASN) that registered, professional school nurses (hereinafter referred to as school nurses) serve a vital role in promoting positive behavioral health outcomes in students through evidence-based programs and curricula in schools and communities. Behavioral health is as critical to…

  14. Positive and Negative Associations between Adolescents’ Religiousness and Health Behaviors via Self-Regulation

    Science.gov (United States)

    Holmes, Christopher J.; Kim-Spoon, Jungmeen

    2015-01-01

    It has been proposed that self-regulation may be the explanatory mechanism for the relation between religiousness and positive health behaviors. However, different religious motivations have differential effects on a variety of health related outcomes, which may explain the adverse effects of religiousness found in some studies. The current study hypothesized that higher identification as religious motivation would be linked to higher health-promoting behavior and lower health-risk behavior through higher self-regulation, whereas higher introjection would be linked to lower health-promoting behavior and higher health-risk behavior through lower self-regulation. The sample included 220 adolescents (mean age = 15 years, 55% male) and their primary caregivers. Structural equation modeling results supported the hypotheses and indicated that adolescent self-regulation mediated the relations between their religious motivation and health behavior. The findings suggest that different types of religious motivation may be promotive or hindering for adolescents’ health. PMID:27595048

  15. Positive and Negative Associations between Adolescents' Religiousness and Health Behaviors via Self-Regulation.

    Science.gov (United States)

    Holmes, Christopher J; Kim-Spoon, Jungmeen

    It has been proposed that self-regulation may be the explanatory mechanism for the relation between religiousness and positive health behaviors. However, different religious motivations have differential effects on a variety of health related outcomes, which may explain the adverse effects of religiousness found in some studies. The current study hypothesized that higher identification as religious motivation would be linked to higher health-promoting behavior and lower health-risk behavior through higher self-regulation, whereas higher introjection would be linked to lower health-promoting behavior and higher health-risk behavior through lower self-regulation. The sample included 220 adolescents (mean age = 15 years, 55% male) and their primary caregivers. Structural equation modeling results supported the hypotheses and indicated that adolescent self-regulation mediated the relations between their religious motivation and health behavior. The findings suggest that different types of religious motivation may be promotive or hindering for adolescents' health.

  16. Early Empowerment Strategies Boost Self-Efficacy to Improve Cardiovascular Health Behaviors

    OpenAIRE

    Kashani, Mariam; Eliasson, Arn H; Walizer, Elaine M; Fuller, Clarie E; Engler, Renata J; Villines, Todd C; Vernalis, Marina N

    2016-01-01

    Background: Self-efficacy, defined as confidence in the ability to carry out behavior to achieve a desired goal, is considered to be a prerequisite for behavior change. Self-efficacy correlates with cardiovascular health although optimal timing to incorporate self-efficacy strategies is not well established. We sought to study the effect of an empowerment approach implemented in the introductory phase of a multicomponent lifestyle intervention on cardiovascular health outcomes. Design: Prospe...

  17. Targeting self-regulation to promote health behaviors in children.

    Science.gov (United States)

    Miller, Alison L; Gearhardt, Ashley N; Fredericks, Emily M; Katz, Benjamin; Shapiro, Lilly Fink; Holden, Kelsie; Kaciroti, Niko; Gonzalez, Richard; Hunter, Christine; Lumeng, Julie C

    2018-02-01

    Poor self-regulation (i.e., inability to harness cognitive, emotional, motivational resources to achieve goals) is hypothesized to contribute to unhealthy behaviors across the lifespan. Enhancing early self-regulation may increase positive health outcomes. Obesity is a major public health concern with early-emerging precursors related to self-regulation; it is therefore a good model for understanding self-regulation and health behavior. Preadolescence is a transition when children increase autonomy in health behaviors (e.g., eating, exercise habits), many of which involve self-regulation. This paper presents the scientific rationale for examining self-regulation mechanisms that are hypothesized to relate to health behaviors, specifically obesogenic eating, that have not been examined in children. We describe novel intervention protocols designed to enhance self-regulation skills, specifically executive functioning, emotion regulation, future-oriented thinking, and approach bias. Interventions are delivered via home visits. Assays of self-regulation and obesogenic eating behaviors using behavioral tasks and self-reports are implemented and evaluated to determine feasibility and psychometrics and to test intervention effects. Participants are low-income 9-12 year-old children who have been phenotyped for self-regulation, stress, eating behavior and adiposity through early childhood. Study goals are to examine intervention effects on self-regulation and whether change in self-regulation improves obesogenic eating. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. "Love me, parents!": impact evaluation of a national social and behavioral change communication campaign on maternal health outcomes in Tanzania.

    Science.gov (United States)

    Kaufman, Michelle R; Harman, Jennifer J; Smelyanskaya, Marina; Orkis, Jennifer; Ainslie, Robert

    2017-09-15

    Despite marked improvements over the last few decades, maternal mortality in Tanzania remains among the world's highest at 454 maternal deaths per 100,000 live births. Many factors contribute to this disparity, such as a lack of attendance at antenatal care (ANC) services and low rates of delivery at a health facility with a skilled provider. The Wazazi Nipendeni (Love me, parents) social and behavioral change communication campaign was launched in Tanzania in 2012 to improve a range of maternal health outcomes, including individual birth planning, timely ANC attendance, and giving birth in a healthcare facility. An evaluation to determine the impact of the national Wazazi Nipendeni campaign was conducted in five purposively selected regions of Tanzania using exit interviews with pregnant and post-natal women attending ANC clinics. A total of 1708 women were interviewed regarding campaign exposure, ANC attendance, and individual birth planning. Over one third of interviewed women (35.1%) reported exposure to the campaign in the last month. The more sources from which women reported hearing the Wazazi Nipendeni message, the more they planned for the birth of their child (β = 0.08, p = .001). Greater numbers of types of exposure to the Wazazi Nipendeni message was associated with an increase in ANC visits (β = 0.05, p = .004). Intervention exposure did not significantly predict the timing of the first ANC visit or HIV testing in the adjusted model, however, findings showed that exposure did predict whether women delivered at a health care facility (or not) and whether they tested for HIV with a partner in the unadjusted models. The Wazazi Nipendeni campaign shows promise that such a behavior change communication intervention could lead to better pregnancy and childbirth outcomes for women in low resource settings. For outcomes such as HIV testing, message exposure showed some promising effects, but demographic variables such as age and socioeconomic status

  19. [Socioeconomic differentials in health and health related behaviors: findings from the Korea Youth Panel Survey].

    Science.gov (United States)

    Khang, Young-Ho; Cho, Sung-Il; Yang, Seungmi; Lee, Moo-Song

    2005-11-01

    This study examined the socioeconomic differentials for the health and health related behaviors among South Korean middle school students. A nationwide cross-sectional interview survey of 3,449 middle school second-grade students and their parents was conducted using a stratified multi-stage cluster sampling method. The response rate was 93.3%. The socioeconomic position indicators were based on self-reported information from the students and their parents: parental education, father's occupational class, monthly family income, out-of-pocket expenditure for education, housing ownership, educational expectations, educational performance and the perceived economic hardships. The outcome variables that were measured were also based on the self-reported information from the students. The health measures included self-rated health conditions, psychological or mental problems, the feelings of loneliness at school, the overall satisfaction of life and the perceived level of stress. The health related behaviors included were smoking, alcohol drinking, sexual intercourse, violence, bullying and verbal and physical abuse by parents. Socioeconomic differences for the health and health related behaviors were found among the eighth grade boys and girls of South Korea. However, the pattern varied with gender, the socioeconomic position indicators and the outcome measures. The prevalence rates of the overall dissatisfaction with life for both genders differed according to most of the eight socioeconomic position indicators. All the health measures were significantly different according to the perceived economic hardship. However, the socioeconomic differences in the self-rated health conditions and the psychosocial or mental problems were not clear. The students having higher socioeconomic position tended to be a perpetrator of bullying while those students with lower socioeconomic position were more likely to be a victim. The perceived economic hardships predicted the health

  20. Diet and exercise intervention adherence and health-related outcomes among older long-term breast, prostate, and colorectal cancer survivors.

    Science.gov (United States)

    Winger, Joseph G; Mosher, Catherine E; Rand, Kevin L; Morey, Miriam C; Snyder, Denise C; Demark-Wahnefried, Wendy

    2014-10-01

    Diet and exercise interventions for cancer survivors result in health benefits; however, few studies have examined health outcomes in relation to adherence. We examined associations between adherence to components of a diet-exercise intervention and survivors' physical and mental health. A randomized controlled trial tested a telephone and mailed print intervention among 641 older, overweight, long-term survivors of breast, prostate, and colorectal cancer. Dietary and exercise behaviors were assessed at 14 time points throughout the year-long intervention; health outcomes were examined postintervention. Telephone session attendance had significant indirect relationships with health outcomes through intervention-period exercise and dietary behavior. Attendance showed positive indirect relationships with physical function (β = 0.11, p < 0.05), basic and advanced lower extremity function (β = 0.10, p < 0.05/β = 0.09, p < 0.05), and mental health (β = 0.05, p < 0.05), and a negative indirect relationship with body mass index (β = -0.06, p < 0.05). Session attendance is vital in facilitating improvement in health behaviors and attendant outcomes (Clinicaltrials.gov number NCT00303875).

  1. Health outcomes are about choices and values: an economic perspective on the health outcomes movement.

    Science.gov (United States)

    Shiell, A

    1997-01-01

    The aim of the health outcomes movement is to reorientate health services so that the spotlight shines less on what is done and more on what is achieved. The health outcomes movement, thus far, has been most successful in addressing what appear to be technical questions relating to the measurement and analysis of health outcomes and in placing their routine use on the agenda of clinical practice and health services planning. If there is one lesson to be drawn from an economic perspective, however, it is that health outcomes are about values and not just technicalities. The need to make choices forces one to consider whether what is achieved is also what is most valued. The success of health service delivery, be it at a clinical, planning or systems level, must therefore be measured against agreed objectives. It follows that time must be taken to establish what patients and the community want from their health services and what each is prepared to give up to achieve its ends. Value judgements are unavoidable. The challenge lies not in measuring the outcomes of health interventions but in deciding what the objectives of the health system ought to be.

  2. The Relationship of Built Environment to Health-Related Behaviors and Health Outcomes in Elderly Community Residents in a Middle Income Country.

    Science.gov (United States)

    Blay, Sergio L; Schulz, Amy J; Mentz, Graciela

    2015-07-16

    Few studies have examined the impact of the built environment (BE) on health behaviours and health outcomes in middle income countries. This study examines associations between self-assessed characteristics of the home and neighbourhood environment and health-related behaviours and health outcomes in an elderly population in Brazil. In a community sample of 6963 community dwellers 60 years old and older living in the state of Rio Grande do Sul, Brazil, associations between self-reported BE conditions and health behaviours and health outcomes were assessed using a structured questionnaire. Multivariate analysis was conducted to investigate these associations while accounting for other relevant characteristics. We found significant positive associations between adverse BE conditions and pulmonary, urinary conditions, gastrointestinal, problems, headache and depression. There were mixed associations between adverse BE conditions and musculoskeletal and sensory conditions, inverse associations with metabolic disorders. and no associations with dermatologic problems and cancer. After accounting for health related behaviours, results suggest a modest association between adverse BE conditions and hypertension, with no significant associations with other indicators of cardiovascular conditions (heart problems, stroke, varicose veins). The findings in this study suggest links between adverse conditions in the BE and health related behaviours in the hypothesized direction. Associations with the health conditions examined here are mixed. We find the strongest evidence for effects of adverse BE conditions for pulmonary and infectious conditions. Significant associations between the adverse BE indicators and health outcomes persist after accounting for health related behaviours, suggesting that BE conditions are linked to health pathways above and beyond the health related behaviours assessed in this study. Significance for public healthThe health outcomes for which we found

  3. Passion for Academics and Problematic Health Behaviors.

    Science.gov (United States)

    Bureau, Alexander T; Razon, Selen; Saville, Bryan K; Tokac, Umit; Judge, Lawrence W

    2017-01-01

    According to the Dualistic Model of Passion (39), passion entails valuing, liking, and spending time on an activity. The Dualistic Model also posits two types of passion for activities: harmonious passion (individual voluntarily engages in the activity) and obsessive passion (individual is compelled to engage in the activity). The purpose of the present study was to examine the possible links between college students' passion for academic activities and problematic health behaviors including smoking, excessive drinking, exercise addiction, disordered eating, and sleepiness, which is a possible indicator of sleep deprivation. Participants (n = 502) completed a survey gauging passion type and health behaviors. Regression analyses revealed obsessive passion for academic activities was positively associated with scores on measures of excessive drinking (β = .15, p= .008), exercise addiction (β = .19, ppassion for academic activities, in contrast, was negatively associated with excessive drinking behavior (β = -.16, p = .002) and sleep deprivation (β = -.13, p = .007) but was not associated with exercise addiction (β = .002, p = .97) and disordered eating (β = -.04, p = .37). These findings provide further support for the Dualistic Model of Passion. Students who are obsessively passionate about their academic activities are more likely to engage in poor health behaviors and, in turn, may experience greater negative outcomes than students who are harmoniously passionate about their academics.

  4. Association between Autistic Traits in Preschool Children and Later Emotional/Behavioral Outcomes

    Science.gov (United States)

    Saito, Aya; Stickley, Andrew; Haraguchi, Hideyuki; Takahashi, Hidetoshi; Ishitobi, Makoto; Kamio, Yoko

    2017-01-01

    Although children with a greater number of autistic traits are likely to have other mental health problems, research on the association between earlier autistic traits in preschool children and later emotional/behavioral outcomes is scarce. Using data from 189 Japanese community-based children, this study examined whether autistic traits at age 5…

  5. Do schools influence student risk-taking behaviors and emotional health symptoms?

    Science.gov (United States)

    Denny, Simon J; Robinson, Elizabeth M; Utter, Jennifer; Fleming, Theresa M; Grant, Sue; Milfont, Taciano L; Crengle, Sue; Ameratunga, Shanthi N; Clark, Terryann

    2011-03-01

    Many schools engage in health promotion, health interventions, and services aimed at improving the health and well-being outcomes for students. The purpose of this study was to examine the effects of schools on student health risk-taking behaviors and depressive symptoms. A nationally representative sample (n = 9,056) of students from 96 secondary schools completed a health and well-being survey using Internet Tablets that included questions on school climate, health risk-taking behaviors, and mental health. Teachers (n = 2,901) and school administrators (n = 91) completed questionnaires on aspects of the school climate which included teacher well-being and burnout, the staff work environment, health and welfare services for students, and school organizational support for student health and well-being. Multilevel models were used to estimate school effects on the health risk-taking behaviors and depression symptoms among students. Schools where students reported a more positive school climate had fewer students with alcohol use problems, and fewer students engaging in violence and risky motor vehicle behaviors. Schools where teachers reported better health and welfare services for students had fewer students engaging in unsafe sexual health behaviors. Schools where teachers reported higher levels of well-being had fewer students reporting significant levels of depressive symptoms. More positive school climates and better school health and welfare services are associated with fewer health risk-taking behaviors among students. However, the overall school effects were modest, especially for cigarette use and suicidal behaviors. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Case-mix adjustment of consumer reports about managed behavioral health care and health plans.

    Science.gov (United States)

    Eselius, Laura L; Cleary, Paul D; Zaslavsky, Alan M; Huskamp, Haiden A; Busch, Susan H

    2008-12-01

    To develop a model for adjusting patients' reports of behavioral health care experiences on the Experience of Care and Health Outcomes (ECHO) survey to allow for fair comparisons across health plans. Survey responses from 4,068 individuals enrolled in 21 managed behavioral health plans who received behavioral health care within the previous year (response rate = 48 percent). Potential case-mix adjustors were evaluated by combining information about their predictive power and the amount of within- and between-plan variability. Changes in plan scores and rankings due to case-mix adjustment were quantified. The final case-mix adjustment model included self-reported mental health status, self-reported general health status, alcohol/drug treatment, age, education, and race/ethnicity. The impact of adjustment on plan report scores was modest, but large enough to change some plan rankings. Adjusting plan report scores on the ECHO survey for differences in patient characteristics had modest effects, but still may be important to maintain the credibility of patient reports as a quality metric. Differences between those with self-reported fair/poor health compared with those in excellent/very good health varied by plan, suggesting quality differences associated with health status and underscoring the importance of collecting quality information.

  7. The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol.

    Science.gov (United States)

    Minian, Nadia; deRuiter, Wayne K; Lingam, Mathangee; Corrin, Tricia; Dragonetti, Rosa; Manson, Heather; Taylor, Valerie H; Zawertailo, Laurie; Ebnahmady, Arezoo; Melamed, Osnat C; Rodak, Terri; Hahn, Margaret; Selby, Peter

    2018-03-01

    Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. PROSPERO CRD42017064430.

  8. Antisocial Behavioral Syndromes and Three-Year Quality of Life Outcomes in United States Adults

    Science.gov (United States)

    Goldstein, Risë B.; Dawson, Deborah A.; Smith, Sharon M.; Grant, Bridget F.

    2013-01-01

    Objective To examine 3-year quality-of-life (QOL) outcomes among United States adults with Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) antisocial personality disorder (ASPD), syndromal adult antisocial behavior without conduct disorder (CD) before age 15 (AABS, not a DSM-IV diagnosis), or no antisocial behavioral syndrome at baseline. Method Face-to-face interviews (n= 34,653). Psychiatric disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM-IV Version. Health-related QOL was assessed using the Short-Form 12-Item Health Survey, version 2 (SF-12v2). Other outcomes included past-year Perceived Stress Scale-4 (PSS-4) scores, employment, receipt of Supplemental Security Income (SSI), welfare, and food stamps, and participation in social relationships. Results ASPD and AABS predicted poorer employment, financial dependency, social relationship, and physical health outcomes. Relationships of antisociality to SSI and food stamp receipt and physical health scales were modified by baseline age. Both antisocial syndromes predicted higher PSS-4, AABS predicted lower SF-12v2 Vitality, and ASPD predicted lower SF-12v2 Social Functioning scores in women. Conclusion Similar prediction of QOL by ASPD and AABS suggests limited utility of requiring CD before age 15 to diagnose ASPD. Findings underscore the need to improve prevention and treatment of antisocial syndromes. PMID:22375904

  9. Happiness, subjective and objective oral health status, and oral health behaviors among Korean elders.

    Science.gov (United States)

    Yoon, Hyun-Seo; Kim, Hae-Young; Patton, Lauren L; Chun, Jin-Ho; Bae, Kwang-Hak; Lee, Mi-Ok

    2013-10-01

    This study aims to comprehensively assess the association of subjective and objective oral health status and oral health behaviors with happiness, under consideration of demographic, socioeconomic, and general health-related factors. This study also aims to test whether subjective oral health outcomes are better predictors of happiness compared with objective oral health outcomes. The data were collected from 479 community-dwelling elders aged 65 years or over selected by a cluster sampling method. A questionnaire and an oral examination were implemented. A multiple regression method was conducted to assess associations with happiness index (HI). The mean age of the elders was 74.6 years. Mean (standard deviation, SD) HI, EuroQol-visual analog scale (EQ-VAS) and 14-item oral health impact profile (OHIP-14) index were 5.7 (SD 2.3), 59.8 (SD 21.1), and 16.3 (SD 13.1). In the final model, a significant association with HI of the OHIP-14 index (P = 0.091) among all the participants and significant associations of oral symptoms (P = 0.038), wearing a removable denture (P = 0.039), and of the oral health behavior of daily toothbrushing (P = 0.007) among poorer oral health QoL group were confirmed under consideration of other related factors. While correlations of HI to subjective measures of health, EQ-VAS and OHIP-14 score were moderate to weak, those to objective measures of health were only weak or insignificant. Oral impacts which might persistently affect one's daily life need to be considered in designing and delivering public services aimed to promote people's happiness. With oral health impacts and behaviors accounting for 10% of happiness among elders, public and community services for the elderly that support oral health and daily toothbrushing for the dentate are critical for the well-being of our elders. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Montessori-based activities among persons with late-stage dementia: Evaluation of mental and behavioral health outcomes.

    Science.gov (United States)

    Wilks, Scott E; Boyd, P August; Bates, Samantha M; Cain, Daphne S; Geiger, Jennifer R

    2017-01-01

    Objectives Literature regarding Montessori-based activities with older adults with dementia is fairly common with early stages of dementia. Conversely, research on said activities with individuals experiencing late-stage dementia is limited because of logistical difficulties in sampling and data collection. Given the need to understand risks and benefits of treatments for individuals with late-stage dementia, specifically regarding their mental and behavioral health, this study sought to evaluate the effects of a Montessori-based activity program implemented in a long-term care facility. Method Utilizing an interrupted time series design, trained staff completed observation-based measures for 43 residents with late-stage dementia at three intervals over six months. Empirical measures assessed mental health (anxiety, psychological well-being, quality of life) and behavioral health (problem behaviors, social engagement, capacity for activities of daily living). Results Group differences were observed via repeated measures ANOVA and paired-samples t-tests. The aggregate, longitudinal results-from baseline to final data interval-for the psychological and behavioral health measures were as follows: problem behaviors diminished though not significantly; social engagement decreased significantly; capacities for activities of daily living decreased significantly; quality of life increased slightly but not significantly; anxiety decreased slightly but not significantly; and psychological well-being significantly decreased. Conclusion Improvements observed for quality of life and problem behaviors may yield promise for Montessori-based activities and related health care practices. The rapid physiological and cognitive deterioration from late-stage dementia should be considered when interpreting these results.

  11. Happiness and health behaviors in South Korean adolescents: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Su Yeon Kye

    2016-05-01

    Full Text Available OBJECTIVES: We examined the associations between happiness and a wide range of health behaviors in South Korean adolescents. METHODS: Study data were derived from the ninth Korea Youth Risk Behavior Web-based Survey administered from June to July 2013. In addition to happiness levels, the questionnaire included items on sociodemographics and health-related lifestyle factors (smoking, drinking, eating breakfast, fruit and vegetable consumption, physical activity, sedentary behavior, and hours of sleep. RESULTS: The multivariate analysis revealed that higher levels of happiness were associated with not smoking or drinking, eating breakfast, eating fruits daily, vegetable consumption, participating in at least 60 minutes of physical activity a day, avoiding sedentary behavior, and hours of sleep. Additionally, sex differences were found in relationships between happiness and eating fruit daily, participation in physical activity, and sedentary behavior. CONCLUSIONS: These results encourage public health professionals to consider the psychological aspects of adolescent life in working to improve their health behaviors and outcomes.

  12. Happiness and health behaviors in South Korean adolescents: a cross-sectional study.

    Science.gov (United States)

    Kye, Su Yeon; Kwon, Jeong Hyun; Park, Keeho

    2016-01-01

    We examined the associations between happiness and a wide range of health behaviors in South Korean adolescents. Study data were derived from the ninth Korea Youth Risk Behavior Web-based Survey administered from June to July 2013. In addition to happiness levels, the questionnaire included items on sociodemographics and health-related lifestyle factors (smoking, drinking, eating breakfast, fruit and vegetable consumption, physical activity, sedentary behavior, and hours of sleep). The multivariate analysis revealed that higher levels of happiness were associated with not smoking or drinking, eating breakfast, eating fruits daily, vegetable consumption, participating in at least 60 minutes of physical activity a day, avoiding sedentary behavior, and hours of sleep. Additionally, sex differences were found in relationships between happiness and eating fruit daily, participation in physical activity, and sedentary behavior. These results encourage public health professionals to consider the psychological aspects of adolescent life in working to improve their health behaviors and outcomes.

  13. The impact of nutritional supplement intake on diet behavior and obesity outcomes.

    Directory of Open Access Journals (Sweden)

    Sven Anders

    Full Text Available After decades-old efforts to nudge consumers towards healthier lifestyles through dietary guidelines, diet-related diseases are on the rise. In addition, a growing share of U.S. consumers proactively chooses nutritional supplements as an alternative preventative way of maintaining good health, a $25.5 billion industry in the United States. This paper investigates possible linkages between the economics of consumer supplement choices and the relationship to important dietary and health outcomes. We use National Health and Nutrition Examination Survey (NHANES data to estimate the impact of nutritional supplements intake on respondent's body weight outcomes, controlling for diet quality.: The focus of this article is to determine whether nutritional supplements takers differ from non-takers with regard to their health outcomes when controlling for differences in diet quality, based on individual Healthy Eating Index (HEI-2010 score. The analysis applies treatment effects estimators that account for the selection bias and endogeneity of self-reported behavior and diet-health outcomes. The analysis demonstrates a negative association between supplement intake and BMI but no significant effect on an individual's diet quality. Our findings suggest that individuals proactively invest into their health by taking nutritional supplements instead of improving diet quality through more nutritious food choices. Our results provide important contributions to the literature on a key food policy issue. Knowledge of the determinants of supplement demand in the context of strong diet-health trends should also be helpful to stakeholders in the U.S. produce sector in their competition over consumer market share.

  14. Health behavior disparities: a universal trend or a peculiarity for the developed countries?

    Directory of Open Access Journals (Sweden)

    Andreeva, Tatiana

    2011-05-01

    Full Text Available BACKGROUND. It is generally recognized that those poorer and less educated are more likely to have unhealthy behaviors. These disparities by socio-economic status (SES are observed with regards to different behaviors known to influence health outcomes in terms of diseases and deaths. However, this consistent pattern was found in population-wide studies in developed countries, while in certain demographic groups it was not seen. So the objective was to check if the SES-behavior association pattern was present in available data collected in Ukraine.METHODS. For current study, all available datasets were considered if they included data on SES, education, and gender. Outcomes were measurements of health behaviors including use of psychoactive substances, food consumption, and physical activity.RESULTS. Prevalence of many health behaviors differs in men and women in Ukraine. More men than women use legal and illegal drugs. With regard to education and SES, Ukrainian data reveals either absence of association found in developed countries or its inverted pattern: till recently, women with university education were more likely to smoke than those less educated; teenagers from more affluent families use alcohol more likely than those from poorer ones.CONCLUSION. Inconsistency of SES-behavior association patterns in Ukraine with those seen in the West may be due to a different perception of health behaviors in people who grew up in the former Soviet Union. Behaviors pertinent to men were considered rather masculine and risky than those health-related. We theorize that the revealed absence of SES-behavior association may be because the behaviors are not perceived as those related to health which is an important resource for life. If a behavior is not known as a ‘health behavior’, the society is less likely to stratify with regard to its practicing. So, if the hypothesis is correct, there may be more disparities in younger cohorts than in older ones

  15. Social Environmental Correlates of Health Behaviors in a Faith-Based Policy and Environmental Change Intervention.

    Science.gov (United States)

    Hermstad, April; Honeycutt, Sally; Flemming, Shauna StClair; Carvalho, Michelle L; Hodge, Tarccara; Escoffery, Cam; Kegler, Michelle C; Arriola, Kimberly R Jacob

    2018-03-01

    Diet and physical activity are behavioral risk factors for many chronic diseases, which are among the most common health conditions in the United States. Yet most Americans fall short of meeting established dietary and physical activity guidelines. Faith-based organizations as settings for health promotion interventions can affect members at multiple levels of the social ecological model. The present study investigated whether change in the church social environment was associated with healthier behavior at church and in general at 1-year follow-up. Six churches received mini-grants and technical assistance for 1 year to support policy and environmental changes for healthy eating (HE) and physical activity (PA). Socioenvironmental (social support and social norms) and behavioral (HE and PA at church and in general) outcomes were derived from baseline and 1-year follow-up church member surveys ( n = 258). Three of six churches demonstrated significant improvements in all three socioenvironmental aspects of HE. Two of five churches exhibited significant socioenvironmental improvements for PA at follow-up. Church social environmental changes were related to health behaviors at church and in general ( p Change in social support for HE, social support for PA, and social norms for PA were each associated with three church-based and general behavioral outcomes. Social norms for healthy eating were related to two general behavior outcomes and social norms for unhealthy eating to one general behavioral outcome. Study findings demonstrate that socioenvironmental characteristics are essential to multilevel interventions and merit consideration in designing policy and environmental change interventions.

  16. The influence of social networking sites on health behavior change: a systematic review and meta-analysis

    Science.gov (United States)

    Laranjo, Liliana; Arguel, Amaël; Neves, Ana L; Gallagher, Aideen M; Kaplan, Ruth; Mortimer, Nathan; Mendes, Guilherme A; Lau, Annie Y S

    2015-01-01

    Objective Our aim was to evaluate the use and effectiveness of interventions using social networking sites (SNSs) to change health behaviors. Materials and methods Five databases were scanned using a predefined search strategy. Studies were included if they focused on patients/consumers, involved an SNS intervention, had an outcome related to health behavior change, and were prospective. Studies were screened by independent investigators, and assessed using Cochrane's ‘risk of bias’ tool. Randomized controlled trials were pooled in a meta-analysis. Results The database search retrieved 4656 citations; 12 studies (7411 participants) met the inclusion criteria. Facebook was the most utilized SNS, followed by health-specific SNSs, and Twitter. Eight randomized controlled trials were combined in a meta-analysis. A positive effect of SNS interventions on health behavior outcomes was found (Hedges’ g 0.24; 95% CI 0.04 to 0.43). There was considerable heterogeneity (I2 = 84.0%; T2 = 0.058) and no evidence of publication bias. Discussion To the best of our knowledge, this is the first meta-analysis evaluating the effectiveness of SNS interventions in changing health-related behaviors. Most studies evaluated multi-component interventions, posing problems in isolating the specific effect of the SNS. Health behavior change theories were seldom mentioned in the included articles, but two particularly innovative studies used ‘network alteration’, showing a positive effect. Overall, SNS interventions appeared to be effective in promoting changes in health-related behaviors, and further research regarding the application of these promising tools is warranted. Conclusions Our study showed a positive effect of SNS interventions on health behavior-related outcomes, but there was considerable heterogeneity. Protocol registration The protocol for this systematic review is registered at http://www.crd.york.ac.uk/PROSPERO with the number CRD42013004140. PMID:25005606

  17. Narrative review of provider behavior in primary care behavioral health: How process data can inform quality improvement.

    Science.gov (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R; Possemato, Kyle; Johnson, Emily M; King, Paul R; Shepardson, Robyn L; Vair, Christina L; Reyner, Jacqueline; Funderburk, Jennifer S; Maisto, Stephen A; Wray, Laura O

    2017-09-01

    Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice. For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles. Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high. This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Physical health, lifestyle beliefs and behaviors, and mental health of entering graduate health professional students: Evidence to support screening and early intervention.

    Science.gov (United States)

    Mazurek Melnyk, Bernadette; Slevin, Caitlin; Militello, Lisa; Hoying, Jacqueline; Teall, Alice; McGovern, Colleen

    2016-04-01

    Little is known about the physical health, lifestyle beliefs and behaviors, and mental health among first-year health professional graduate students. Therefore, the purpose of this study was to describe these attributes as well as to explore the relationships among them. A descriptive correlational study was conducted on the baseline data from a wellness onboarding intervention study with 93 health sciences students from seven different colleges within a large public land grant university in the Midwest United States. Nearly 40% of the sample was overweight/obese, and 19% of students had elevated total cholesterol levels. Only 44% met the recommended 30 min of exercise 5 days per week. Forty-one percent reported elevated depressive symptoms and 28% had elevated anxiety. Four students reported suicidal ideation. Inverse relationships existed among depression/anxiety and healthy lifestyle beliefs/behaviors. Students entering health professional schools are at high risk for depression, anxiety, and unhealthy behaviors, which could be averted through screening and early evidence-based interventions. Assessing the physical health, lifestyle behaviors, and mental health of first-year health sciences professional students is important to identify health problems and modifiable at-risk behaviors so that early interventions can be implemented to improve outcomes. ©2016 American Association of Nurse Practitioners.

  19. Relationship between Frequency and Intensity of Physical Activity and Health Behaviors of Adolescents

    Science.gov (United States)

    Delisle, Tony T.; Werch, Chudley E.; Wong, Alvin H.; Bian, Hui; Weiler, Robert

    2010-01-01

    Background: While studies have determined the importance of physical activity in advancing health outcomes, relatively few have explored the relationship between exercise and various health behaviors of adolescents. The purpose of this study is to examine the relationship between frequency and intensity of physical activity and both health risk…

  20. Preconception Health Behaviors of Low-Income Women.

    Science.gov (United States)

    Ayoola, Adejoke B; Sneller, Krista; Ebeye, Tega D; Dykstra, Megan Jongekrijg; Ellens, Victoria L; Lee, HaEun Grace; Zandee, Gail L

    2016-01-01

    Preconception behaviors have a significant impact on birth outcomes, particularly among low-income minority groups, and women with unplanned pregnancies. This study examined women's perceived health status and behaviors such as drinking, smoking, exercise, and use of multivitamins and folic acid. This was a descriptive study based on a convenience sample of women living in urban underserved neighborhoods. Univariate and bivariate analyses were conducted using STATA 13. The sample consisted of 123 women ages 18 to 51 years (mean = 30.57); 51.22% were Hispanic, 36.59% African American, and 12.2% Caucasian. Over 70% had a household income of less than $20,000, 57.72% had no health insurance in the last year, and 58.54% were not married. These women were below the Healthy People 2020 goals for drinking, smoking, and multivitamin use, especially those who were planning to get pregnant in the next 6 months or not sure of their pregnancy planning status. There were no significant differences on any of the preconception health behavior variables based on pregnancy intention. Nurses and healthcare providers should emphasize importance of practicing healthy behaviors during the preconception period among low-income ethnic minority women specifically those living in urban medically underserved areas who are unsure of their pregnancy planning status or are at risk of unintended pregnancy.

  1. Attention-deficit/hyperactivity disorder and adverse health outcomes

    Science.gov (United States)

    Nigg, Joel

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention–disorganization and/or hyperactivity–impulsivity. In DSM-IV, the diagnostic criteria required impairment in social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes. PMID:23298633

  2. The Association Between Household Consumer Durable Assets and Maternal Health-Seeking Behavior in Ghana.

    Science.gov (United States)

    Ansong, Eric

    2015-01-01

    This article examined the association between household consumer durable assets and maternal health-seeking behavior. Several studies have suggested a relationship between households' socioeconomic status (SES) and health outcomes. However, SES is a multidimensional concept that encompasses variables, such as wealth, education, and income. By grouping these variables together as one construct, prior studies have not provided enough insight into possible independent associations with health outcomes. This study used data from the 2008 Ghana Demographic and Health Survey of 2,065 women aged between 15 and 49 years to examine the association between household consumer durables (a component of SES) and maternal health-seeking behavior in Ghana. Results from a set of generalized linear models indicated that household consumer durable assets were positively associated with four measures of maternal health-seeking behaviors, namely, seeking prenatal care from skilled health personnel, delivery by skilled birth attendant, place of delivery, and the number of antenatal visits. Also, households with more assets whose residents lived in urban areas were more likely to use skilled health personnel before and during delivery, and at an approved health facility, compared those who lived in rural areas. Implications for health interventions and policies that focus on the most vulnerable households are discussed.

  3. A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: feasibility and outcomes of a randomized controlled trial.

    Science.gov (United States)

    Koniak-Griffin, Deborah; Brecht, Mary-Lynn; Takayanagi, Sumiko; Villegas, Juan; Melendrez, Marylee; Balcázar, Héctor

    2015-01-01

    Low-income Latinas (Hispanics) face risk for cardiovascular disease due to high rates of overweight/obesity, sedentary lifestyle, and other factors. Limited access to health care and language barriers may prevent delivery of health promotion messages. Targeted approaches, including the integration of community health workers, may be required to promote healthy lifestyle and prevent chronic disease in underserved ethnic minority groups. The term commonly used to refer to female community health workers in Latino communities is "promotora(s)." This study evaluates the outcomes and feasibility of a promotora-led lifestyle behavior intervention for overweight, immigrant Latinas. A community prevention model was employed in planning and implementing this study. A randomized controlled trial design was used. A Community Advisory Board provided expertise in evaluating feasibility of study implementation in the community and other important guidance. The sample was comprised of 223 women aged 35-64 years, predominantly with low income and ≤8th grade education. The culturally tailored Lifestyle Behavior Intervention included group education (8 classes based upon Su Corazon, Su Vida), followed by 4 months of individual teaching and coaching (home visits and telephone calls). The control group received a comparable length educational program and follow-up contacts. Evaluations were conducted at baseline and at 6 and 9 months using a dietary habits questionnaire, accelerometer readings of physical activity, and clinical measures (body mass index, weight, waist circumference, blood pressure, lipids, blood glucose). Data were collected between January 2010 and August 2012. Women in the intervention group improved significantly in dietary habits, waist circumference, and physical activity in comparison to those in the control group. A treatment dosage effect was observed for weight and waist circumference. Knowledge about heart disease increased. High attendance at classes and

  4. Mental Health, Behavioral and Developmental Issues for Youth in Foster Care.

    Science.gov (United States)

    Deutsch, Stephanie A; Lynch, Amy; Zlotnik, Sarah; Matone, Meredith; Kreider, Amanda; Noonan, Kathleen

    2015-10-01

    Youth in foster care represent a unique population with complex mental and behavioral health, social-emotional, and developmental needs. For this population with special healthcare needs, the risk for adverse long-term outcomes great if needs go unaddressed or inadequately addressed while in placement. Although outcomes are malleable and effective interventions exist, there are barriers to optimal healthcare delivery. The general pediatrician as advocate is paramount to improve long-term outcomes. Copyright © 2015 Mosby, Inc. All rights reserved.

  5. Effective intervention strategies to improve health outcomes for cardiovascular disease patients with low health literacy skills: a systematic review.

    Science.gov (United States)

    Lee, Tae Wha; Lee, Seon Heui; Kim, Hye Hyun; Kang, Soo Jin

    2012-12-01

    Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes. Copyright © 2012. Published by Elsevier B.V.

  6. Impact of hospital atmosphere on perceived health care outcome.

    Science.gov (United States)

    Narang, Ritu; Polsa, Pia; Soneye, Alabi; Fuxiang, Wei

    2015-01-01

    Healthcare service quality studies primarily examine the relationships between patients' perceived quality and satisfaction with healthcare services, clinical effectiveness, service use, recommendations and value for money. These studies suggest that patient-independent quality dimensions (structure, process and outcome) are antecedents to quality. The purpose of this paper is to propose an alternative by looking at the relationship between hospital atmosphere and healthcare quality with perceived outcome. Data were collected from Finland, India, Nigeria and the People's Republic of China. Regression analysis used perceived outcome as the dependent variable and atmosphere and healthcare service quality as independent variables. Findings - Results showed that atmosphere and healthcare service quality have a statistically significant relationship with patient perceived outcomes. The sample size was small and the sampling units were selected on convenience; thus, caution must be exercised in generalizing the findings. The study determined that service quality and atmosphere are considered significant for developing and developed nations. This result could have significant implications for policy makers and service providers developing healthcare quality and hospital atmosphere. Studies concentrate on healthcare outcome primarily regarding population health status, mortality, morbidity, customer satisfaction, loyalty, quality of life, customer behavior and consumption. However, the study exposes how patients perceive their health after treatment. Furthermore, the authors develop the healthcare service literature by considering atmosphere and perceived outcome.

  7. Evaluation of an mHealth intervention aiming to improve health-related behavior and sleep and reduce fatigue among airline pilots.

    Science.gov (United States)

    van Drongelen, Alwin; Boot, Cécile Rl; Hlobil, Hynek; Twisk, Jos Wr; Smid, Tjabe; van der Beek, Allard J

    2014-11-01

    The aim of this study was to evaluate the effects of an mHealth intervention (intervention using mobile technology) consisting of tailored advice regarding exposure to daylight, sleep, physical activity, and nutrition, and aiming to improve health-related behavior, thereby reducing sleep problems and fatigue and improving health perception of airline pilots. A randomized controlled trial was conducted among 502 airline pilots. The intervention group was given access to both the MORE Energy mobile application (app) with tailored advice and a website with background information. The control group was directed to a website with standard information about fatigue. Health-related behavior, fatigue, sleep, and health perception outcomes were measured through online questionnaires at baseline and at three and six months after baseline. The effectiveness of the intervention was determined using linear and Poisson mixed model analyses. After six months, compared to the control group, the intervention group showed a significant improvement on fatigue (β= -3.76, P<0.001), sleep quality (β= -0.59, P=0.007), strenuous physical activity (β=0.17, P=0.028), and snacking behavior (β= -0.81, P<0.001). No significant effects were found for other outcome measures. The MORE Energy mHealth intervention reduced self-reported fatigue compared to a minimal intervention. Some aspects of health-related behavior (physical activity and snacking behavior) and sleep (sleep quality) improved as well, but most did not. The results show offering tailored advice through an mHealth intervention is an effective means to support employees who have to cope with irregular flight schedules and circadian disruption. This kind of intervention might therefore also be beneficial for other working populations with irregular working hours.

  8. Mapping health outcomes from ecosystem services

    NARCIS (Netherlands)

    Keune, Hans; Oosterbroek, Bram; Derkzen, Marthe; Subramanian, Suneetha; Payyappalimana, Unnikrishnan; Martens, Pim; Huynen, Maud; Burkhard, Benjamin; Maes, Joachim

    The practice of mapping ecosystem services (ES) in relation to health outcomes is only in its early developing phases. Examples are provided of health outcomes, health proxies and related biophysical indicators. This chapter also covers main health mapping challenges, design options and

  9. [Outcomes evaluation of the school staff health promotion project].

    Science.gov (United States)

    Woynarowska-Sołdan, Magdalena

    This article presents selected outcomes of a 3-year project "Health promotion of school staff in health-promoting schools," as well as the achievements and difficulties in its implementation. The research was conducted on 644 teachers and 226 members of non-teaching staff in 21 schools. The method involved opinion poll and authored questionnaires. A 2-part model of outcome evaluation was developed. Most participants appreciated the changes that took place within the 3 years of the project implementation. These included the improved level of their knowledge about health, health-conducive behaviors (62-93%) and the physical and social environment of the school (50-92%). Changes were more frequently acknowledged by teachers. About 80% of the participants had a positive attitude to the project, but only 20% assessed their involvement as considerable. About 90% believed that health promotion activities should be continued. According to the project leaders, insufficient support and financial resources, and difficulties in motivating school employees, particularly the nonteaching staff, to undertake health-promotion activities were the major handicaps in the project implementation. The project outcomes can be assessed as satisfying. They revealed that it is posssible to initiate health promotion among school staff. This can be effective on condition that participants are motivated, actively engaged in the project and supported by the head teacher and the local community. Necessarily, school leaders should be prepared to promote health among adults and to gain support from school policy decision makers, school administration, trade unions and universities involved in teacher training. Med Pr 2016;67(2):187-200. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  10. Outcomes evaluation of the school staff health promotion project

    Directory of Open Access Journals (Sweden)

    Magdalena Woynarowska-Sołdan

    2016-04-01

    Full Text Available Background: This article presents selected outcomes of a 3-year project “Health promotion of school staff in health-promoting schools,” as well as the achievements and difficulties in its implementation. Material and Methods: The research was conducted on 644 teachers and 226 members of non-teaching staff in 21 schools. The method involved opinion poll and authored questionnaires. A 2-part model of outcome evaluation was developed. Results: Most participants appreciated the changes that took place within the 3 years of the project implementation. These included the improved level of their knowledge about health, health-conducive behaviors (62–93% and the physical and social environment of the school (50–92%. Changes were more frequently acknowledged by teachers. About 80% of the participants had a positive attitude to the project, but only 20% assessed their involvement as considerable. About 90% believed that health promotion activities should be continued. According to the project leaders, insufficient support and financial resources, and difficulties in motivating school employees, particularly the nonteaching staff, to undertake health-promotion activities were the major handicaps in the project implementation. Conclusions: The project outcomes can be assessed as satisfying. They revealed that it is posssible to initiate health promotion among school staff. This can be effective on condition that participants are motivated, actively engaged in the project and supported by the head teacher and the local community. Necessarily, school leaders should be prepared to promote health among adults and to gain support from school policy decision makers, school administration, trade unions and universities involved in teacher training. Med Pr 2016;67(2:187–200

  11. The integration of behavioral health interventions in children's health care: services, science, and suggestions.

    Science.gov (United States)

    Kolko, David J; Perrin, Ellen

    2014-01-01

    Because the integration of mental or behavioral health services in pediatric primary care is a national priority, a description and evaluation of the interventions applied in the healthcare setting is warranted. This article examines several intervention research studies based on alternative models for delivering behavioral health care in conjunction with comprehensive pediatric care. This review describes the diverse methods applied to different clinical problems, such as brief mental health skills, clinical guidelines, and evidence-based practices, and the empirical outcomes of this research literature. Next, several key treatment considerations are discussed to maximize the efficiency and effectiveness of these interventions. Some practical suggestions for overcoming key service barriers are provided to enhance the capacity of the practice to deliver behavioral health care. There is moderate empirical support for the feasibility, acceptability, and clinical utility of these interventions for treating internalizing and externalizing behavior problems. Practical strategies to extend this work and address methodological limitations are provided that draw upon recent frameworks designed to simplify the treatment enterprise (e.g., common elements). Pediatric primary care has become an important venue for providing mental health services to children and adolescents due, in part, to its many desirable features (e.g., no stigma, local setting, familiar providers). Further adaptation of existing delivery models may promote the delivery of effective integrated interventions with primary care providers as partners designed to address mental health problems in pediatric healthcare.

  12. Predicting Health Care Utilization After Behavioral Health Referral Using Natural Language Processing and Machine Learning

    OpenAIRE

    Roysden, Nathaniel; Wright, Adam

    2015-01-01

    Mental health problems are an independent predictor of increased healthcare utilization. We created random forest classifiers for predicting two outcomes following a patient’s first behavioral health encounter: decreased utilization by any amount (AUROC 0.74) and ultra-high absolute utilization (AUROC 0.88). These models may be used for clinical decision support by referring providers, to automatically detect patients who may benefit from referral, for cost management, or for risk/protection ...

  13. Predicting Health Care Utilization After Behavioral Health Referral Using Natural Language Processing and Machine Learning.

    Science.gov (United States)

    Roysden, Nathaniel; Wright, Adam

    2015-01-01

    Mental health problems are an independent predictor of increased healthcare utilization. We created random forest classifiers for predicting two outcomes following a patient's first behavioral health encounter: decreased utilization by any amount (AUROC 0.74) and ultra-high absolute utilization (AUROC 0.88). These models may be used for clinical decision support by referring providers, to automatically detect patients who may benefit from referral, for cost management, or for risk/protection factor analysis.

  14. The influence of social networking sites on health behavior change: a systematic review and meta-analysis.

    Science.gov (United States)

    Laranjo, Liliana; Arguel, Amaël; Neves, Ana L; Gallagher, Aideen M; Kaplan, Ruth; Mortimer, Nathan; Mendes, Guilherme A; Lau, Annie Y S

    2015-01-01

    Our aim was to evaluate the use and effectiveness of interventions using social networking sites (SNSs) to change health behaviors. Five databases were scanned using a predefined search strategy. Studies were included if they focused on patients/consumers, involved an SNS intervention, had an outcome related to health behavior change, and were prospective. Studies were screened by independent investigators, and assessed using Cochrane's 'risk of bias' tool. Randomized controlled trials were pooled in a meta-analysis. The database search retrieved 4656 citations; 12 studies (7411 participants) met the inclusion criteria. Facebook was the most utilized SNS, followed by health-specific SNSs, and Twitter. Eight randomized controlled trials were combined in a meta-analysis. A positive effect of SNS interventions on health behavior outcomes was found (Hedges' g 0.24; 95% CI 0.04 to 0.43). There was considerable heterogeneity (I(2) = 84.0%; T(2) = 0.058) and no evidence of publication bias. To the best of our knowledge, this is the first meta-analysis evaluating the effectiveness of SNS interventions in changing health-related behaviors. Most studies evaluated multi-component interventions, posing problems in isolating the specific effect of the SNS. Health behavior change theories were seldom mentioned in the included articles, but two particularly innovative studies used 'network alteration', showing a positive effect. Overall, SNS interventions appeared to be effective in promoting changes in health-related behaviors, and further research regarding the application of these promising tools is warranted. Our study showed a positive effect of SNS interventions on health behavior-related outcomes, but there was considerable heterogeneity. Protocol registration The protocol for this systematic review is registered at http://www.crd.york.ac.uk/PROSPERO with the number CRD42013004140. © The Author 2014. Published by Oxford University Press on behalf of the American Medical

  15. Behavioral Informatics and Computational Modeling in Support of Proactive Health Management and Care.

    Science.gov (United States)

    Pavel, Misha; Jimison, Holly B; Korhonen, Ilkka; Gordon, Christine M; Saranummi, Niilo

    2015-12-01

    Health-related behaviors are among the most significant determinants of health and quality of life. Improving health behavior is an effective way to enhance health outcomes and mitigate the escalating challenges arising from an increasingly aging population and the proliferation of chronic diseases. Although it has been difficult to obtain lasting improvements in health behaviors on a wide scale, advances at the intersection of technology and behavioral science may provide the tools to address this challenge. In this paper, we describe a vision and an approach to improve health behavior interventions using the tools of behavioral informatics, an emerging transdisciplinary research domain based on system-theoretic principles in combination with behavioral science and information technology. The field of behavioral informatics has the potential to optimize interventions through monitoring, assessing, and modeling behavior in support of providing tailored and timely interventions. We describe the components of a closed-loop system for health interventions. These components range from fine grain sensor characterizations to individual-based models of behavior change. We provide an example of a research health coaching platform that incorporates a closed-loop intervention based on these multiscale models. Using this early prototype, we illustrate how the optimized and personalized methodology and technology can support self-management and remote care. We note that despite the existing examples of research projects and our platform, significant future research is required to convert this vision to full-scale implementations.

  16. Adaptive Encoding of Outcome Prediction by Prefrontal Cortex Ensembles Supports Behavioral Flexibility.

    Science.gov (United States)

    Del Arco, Alberto; Park, Junchol; Wood, Jesse; Kim, Yunbok; Moghaddam, Bita

    2017-08-30

    The prefrontal cortex (PFC) is thought to play a critical role in behavioral flexibility by monitoring action-outcome contingencies. How PFC ensembles represent shifts in behavior in response to changes in these contingencies remains unclear. We recorded single-unit activity and local field potentials in the dorsomedial PFC (dmPFC) of male rats during a set-shifting task that required them to update their behavior, among competing options, in response to changes in action-outcome contingencies. As behavior was updated, a subset of PFC ensembles encoded the current trial outcome before the outcome was presented. This novel outcome-prediction encoding was absent in a control task, in which actions were rewarded pseudorandomly, indicating that PFC neurons are not merely providing an expectancy signal. In both control and set-shifting tasks, dmPFC neurons displayed postoutcome discrimination activity, indicating that these neurons also monitor whether a behavior is successful in generating rewards. Gamma-power oscillatory activity increased before the outcome in both tasks but did not differentiate between expected outcomes, suggesting that this measure is not related to set-shifting behavior but reflects expectation of an outcome after action execution. These results demonstrate that PFC neurons support flexible rule-based action selection by predicting outcomes that follow a particular action. SIGNIFICANCE STATEMENT Tracking action-outcome contingencies and modifying behavior when those contingencies change is critical to behavioral flexibility. We find that ensembles of dorsomedial prefrontal cortex neurons differentiate between expected outcomes when action-outcome contingencies change. This predictive mode of signaling may be used to promote a new response strategy at the service of behavioral flexibility. Copyright © 2017 the authors 0270-6474/17/378363-11$15.00/0.

  17. Chronic Disease Prevalence and Healthy Lifestyle Behaviors Among US Health Care Professionals.

    Science.gov (United States)

    Dayoub, Elias; Jena, Anupam B

    2015-12-01

    Although health care professionals may be assumed to make healthier lifestyle choices and have better health outcomes than others because of their greater health literacy, little is known about how actual health outcomes of health care professionals compare with those of the overall population. We analyzed how trends in obesity, diabetes, hypertension, and coronary artery disease prevalence as well as several health behaviors (smoking, alcohol use, and exercise) varied between health care professionals and the general US population from 2002 to 2013, using nationally representative data collected by the National Health Interview Survey. We estimated multivariate logistic regressions of each disease and behavior adjusted for age, race, sex, geographic region, and year. Although rates of obesity, diabetes, and hypertension were lower among health care professionals compared with the overall population, disease was still common among health care professionals and increased over time at a rate similar to that of the overall population. For example, obesity prevalence was lower among health care professionals but increased similarly from 2002 to 2013 (health care professionals, 20.5% in 2002 to 22.1% in 2013; other occupations, 28.4% to 31.7%; P=.64 for difference in trend). Diabetes prevalence was modestly lower among health care professionals but increased at a similar rate (health care professionals, 7.4% in 2005 to 8.6% in 2013; other occupations, 8.7% to 9.9%; P=.67 for difference in trend). Similar patterns were noted in hypertension. Coronary artery disease prevalence declined over time among health care professionals but increased for others. Health care professionals reported better health behaviors than others in smoking and physical activity but not in moderate to heavy alcohol use. Copyright © 2015 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  18. The Effects of Low Birth Weight on School Performance and Behavioral Outcomes of Elementary School Children in Oman

    Directory of Open Access Journals (Sweden)

    M. Mazharul Islam

    2015-07-01

    Full Text Available Objectives: Our study aimed to examine the effects of low birth weight (LBW on the school performance and behavior of elementary school children in Oman. Methods: Data were gathered through a cross-sectional survey of nine elementary schools from the Muscat and A’Dhahirah regions. The study utilized a unique database created by linking information from the children’s health cards and current academic and behavioral performance records. Information on children’s performance in various areas such as language, mathematics, science, information technology, sports, and behavior were obtained from the school registers. Birth weight (BW and selected sociodemographic data were obtained from the copy of their health cards kept by each school. A total of 542 elementary school children aged 7–11 years, who had completed grades 2–4, were surveyed.  Results: Data from the school register revealed a very high rate (17.7% of LBW and, overall, 12% of the children exhibited below average performance on selected outcome measures. The below average school performance varied from 5–17% across the six selected areas of school performance. The highest rate of below average performance was observed in science (17%, followed by arithmetic and language (16% each. BW showed significant differential effects on school performance and behavioral outcomes, which remained significant after controlling for the effect of potential confounders. It was found that LBW children were 2–6 times more likely to have poorer school performance in all areas than their normal BW peers. Conclusion: Early intervention programs or special care for LBW children in school could be an effective means of improving educational outcomes and the behavior of these children. Attempts should be made to reduce or prevent poor pregnancy outcomes, which, in turn, would reduce the cost of the health, education, and social services systems.

  19. Scaling-Stimulated Salivary Antioxidant Changes and Oral-Health Behavior in an Evaluation of Periodontal Treatment Outcomes

    Directory of Open Access Journals (Sweden)

    Po-Sheng Yang

    2014-01-01

    Full Text Available Aim. Our goal was to investigate associations among scaling-stimulated changes in salivary antioxidants, oral-health-related behaviors and attitudes, and periodontal treatment outcomes. Materials and Methods. Thirty periodontitis patients with at least 6 pockets with pocket depths of >5 mm and more than 16 functional teeth were enrolled in the study. Patients were divided into three groups: an abandoned group (AB group, a nonprogress outcome group (NP group, and an effective treatment group (ET group. Nonstimulated saliva was collected before and after scaling were received to determine superoxide dismutase (SOD and the total antioxidant capacity (TAOC. Results. Salivary SOD following scaling significantly increased from 83.09 to 194.30 U/g protein in patients who had irregular dental visit patterns (<1 visit per year. After scaling, the TAOC was significantly higher in patients who had regular dental visits than in patients who had irregular dental visits (3.52 versus 0.70 mmole/g protein, P<0.01. The scaling-stimulated increase in SOD was related to a higher severity of periodontitis in the NP group, while the scaling-stimulated increase in the TAOC was inversely related to the severity of periodontitis in the AB group. Conclusions. These results demonstrate the importance of scaling-stimulated salivary antioxidants as prognostic biomarkers of periodontal treatment.

  20. Relationships between patient activation, disease-specific knowledge and health outcomes among people with diabetes: a survey study

    NARCIS (Netherlands)

    Hendriks, M.; Rademakers, J.

    2014-01-01

    Background: Nowadays, patients are expected to be involved in their health care, well-informed and able to adjust their behavior to maintain a good health. Investigating patient activation and its relationships with patient characteristics and health-related outcomes will provide further insight

  1. Adolescent health-risk behavior and community disorder.

    Directory of Open Access Journals (Sweden)

    Sarah E Wiehe

    Full Text Available Various forms of community disorder are associated with health outcomes but little is known about how dynamic context where an adolescent spends time relates to her health-related behaviors.Assess whether exposure to contexts associated with crime (as a marker of community disorder correlates with self-reported health-related behaviors among adolescent girls.Girls (N = 52, aged 14-17, were recruited from a single geographic urban area and monitored for 1 week using a GPS-enabled cell phone. Adolescents completed an audio computer-assisted self-administered interview survey on substance use (cigarette, alcohol, or marijuana use and sexual intercourse in the last 30 days. In addition to recorded home and school address, phones transmitted location data every 5 minutes (path points. Using ArcGIS, we defined community disorder as aggregated point-level Unified Crime Report data within a 200-meter Euclidian buffer from home, school and each path point. Using Stata, we analyzed how exposures to areas of higher crime prevalence differed among girls who reported each behavior or not.Participants lived and spent time in areas with variable crime prevalence within 200 meters of their home, school and path points. Significant differences in exposure occurred based on home location among girls who reported any substance use or not (p 0.04 and sexual intercourse or not (p 0.01. Differences in exposure by school and path points were only significant among girls reporting any substance use or not (p 0.03 and 0.02, respectively. Exposure also varied by school/non-school day as well as time of day.Adolescent travel patterns are not random. Furthermore, the crime context where an adolescent spends time relates to her health-related behavior. These data may guide policy relating to crime control and inform time- and space-specific interventions to improve adolescent health.

  2. Health behaviors of postmenopausal women

    Directory of Open Access Journals (Sweden)

    Maria Jasińska

    2014-03-01

    Full Text Available Introduction: Health status and health-related quality of life of postmenopausal women are issues, which nowadays pose a serious challenge to many domains of science. Climacteric symptoms which occur at this stage of life, lower its quality and make a negative contribution to self-reported health status, are mostly observed in a particular group of women. Evaluation of health behaviors performed using a standardized questionnaire, the Health Behavior Inventory (HBI, may help establish a comprehensive diagnosis of women’s health, and thus select effective interventions. A systemic approach to menopause assumes that full fitness of women and good quality of their lives can be maintained not only by means of pharmacotherapy but also other forms of action, especially health education oriented towards changes in the lifestyle and promotion of healthy behaviors. The aim of this study is to perform a HBI-based assessment of women’s health behaviors in such categories as healthy eating habits (HEH, preventive behaviors (PB, positive mental attitudes (PMA, and health practices (HP. Material and methods: The study involved 151 healthy postmenopausal women. A research tool was a standardized questionnaire, the Health Behavior Inventory (HBI. Results: The surveyed women obtained 70% of the maximum score on average, which suggests a medium level of health behaviors in this group. The levels of health behaviors in the categories of positive mental attitudes and health practices significantly differed between older women and their younger counterparts (higher levels were observed among older respondents. There were also significant differences in the levels of healthy behaviors between women with secondary and higher education (those better educated declared healthy behaviors more often. There was no correlation between the level of health behaviors and the BMI of the surveyed women. Conclusions : Older women attached greater

  3. Systematic review of pediatric health outcomes associated with childhood adversity.

    Science.gov (United States)

    Oh, Debora Lee; Jerman, Petra; Silvério Marques, Sara; Koita, Kadiatou; Purewal Boparai, Sukhdip Kaur; Burke Harris, Nadine; Bucci, Monica

    2018-02-23

    Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity. PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected. Mental and behavioral health outcomes were excluded, as were physical health outcomes that were a direct result of adversity (i.e. abusive head trauma). Data were extracted and risk of bias was assessed by 2 independent reviewers. After identifying 15940 records, 35 studies were included in this review. Selected studies indicated that exposure to childhood adversity was associated with delays in cognitive development, asthma, infection, somatic complaints, and sleep disruption. Studies on household dysfunction reported an effect on weight during early childhood, and studies on maltreatment reported an effect on weight during adolescence. Maternal mental health issues were associated with elevated cortisol levels, and maltreatment was associated with blunted cortisol levels in childhood. Furthermore, exposure to childhood adversity was associated with alterations of immune and inflammatory response and stress-related accelerated telomere erosion. Childhood adversity affects brain development and multiple body systems, and the physiologic manifestations can be detectable in childhood. A history of childhood adversity should be considered in the differential diagnosis of developmental delay, asthma, recurrent infections requiring hospitalization, somatic complaints, and sleep disruption. The variability in children's response to adversity suggests complex underlying mechanisms and poses a challenge in the development of uniform diagnostic guidelines. More large longitudinal studies are needed to better

  4. Vegan lifestyle behaviors: an exploration of congruence with health-related beliefs and assessed health indices.

    Science.gov (United States)

    Dyett, Patricia A; Sabaté, Joan; Haddad, Ella; Rajaram, Sujatha; Shavlik, David

    2013-08-01

    This study aimed to investigate health belief as a major motive for diet and lifestyle behaviors of 100 vegans in the United States; and to determine congruence with selected health and nutrition outcomes. Response data from an administered questionnaire was analyzed. Statistical analyses determined the most common factors influencing diet choice; the number of vegans practicing particular lifestyle behaviors; body mass index; and prevalence of self-reported chronic disease diagnoses. Nutrient intakes were analyzed and assessed against Dietary Reference Intakes. Health was the most reported reason for diet choice (47%). In the health belief, animal welfare, and religious/other motive categories, low percentages of chronic disease diagnoses were reported: 27%, 11%, and 15%, respectively. There were no significant differences in health behaviors and indices among vegan motive categories, except for product fat content choices. Within the entire study population, health-related vegan motive coincided with regular exercise; 71% normal BMI (mean=22.6); minimal alcohol and smoking practices; frequently consumed vegetables, nuts, and grains; healthy choices in meal types, cooking methods, and low-fat product consumption; and adequate intakes for most protective nutrients when compared to reference values. But incongruence was found with 0% intake adequacy for vitamin D; and observation of excessive sodium use. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Systematic review of employer-sponsored wellness strategies and their economic and health-related outcomes.

    Science.gov (United States)

    Kaspin, Lisa C; Gorman, Kathleen M; Miller, Ross M

    2013-02-01

    This review determines the characteristics and health-related and economic outcomes of employer-sponsored wellness programs and identifies possible reasons for their success. PubMed, ABI/Inform, and Business Source Premier databases, and Corporate Wellness Magazine were searched. English-language articles published from 2005 to 2011 that reported characteristics of employer-sponsored wellness programs and their impact on health-related and economic outcomes among US employees were accepted. Data were abstracted, synthesized, and interpreted. Twenty references were accepted. Wellness interventions were classified into health assessments, lifestyle management, and behavioral health. Improved economic outcomes were reported (health care costs, return on investment, absenteeism, productivity, workers' compensation, utilization) as well as decreased health risks. Programs associated with favorable outcomes had several characteristics in common. First, the corporate culture encouraged wellness to improve employees' lives, not only to reduce costs. Second, employees and leadership were strongly motivated to support the wellness programs and to improve their health in general. Third, employees were motivated by a participation-friendly corporate policy and physical environment. Fourth, successful programs adapted to the changing needs of the employees. Fifth, community health organizations provided support, education, and treatment. Sixth, successful wellness programs utilized technology to facilitate health risk assessments and wellness education. Improved health-related and economic outcomes were associated with employer-sponsored wellness programs. Companies with successful programs tended to include wellness as part of their corporate culture and supported employee participation in several key ways.

  6. mHealth to promote pregnancy and interconception health among African-American women at risk for adverse birth outcomes: a pilot study.

    Science.gov (United States)

    Foster, Jennifer; Miller, Lindsey; Isbell, Sheila; Shields, Tekesia; Worthy, Natasha; Dunlop, Anne Lang

    2015-01-01

    The use of mobile phone applications (mHealth) to provide health education and behavioral prompts is 1 of the 12 common mHealth functions identified by the World Health Organization as innovations to strengthen health systems. Among low-income pregnant and parenting women, health education is widely recognized as a way to improve maternal and infant health outcomes, but the efficacy of written health education materials to change knowledge and behavior for this population is questionable. mHealth prompts, in contrast, is a promising alternative. A team of researchers in medicine/epidemiology, anthropology/midwifery, computer science/sensors, and community-based case management created and pilot tested a mHealth application (mHealth app) for African-American women at high risk for adverse birth outcomes. We tested the acceptability and feasibility of the interactive application among women during the reproductive stages of early and late pregnancy, postpartum, and interconception. Interview data from 14 women in the various reproductive stages revealed that most women found the mHealth messages helpful. Also, 62 Ob-Gyn physicians and nurses and 19 Family Medicine residents provided feedback. Women's responses to specific messages trended down over time. Women in the postpartum phase had the highest response rate to particular text messages, followed by those in the pregnancy phase. Responses dropped off dramatically during the interconception period. About 21% of women lost their phones. Unexpected findings were that all participants already had smartphones, women wanted messages about depression, and clinicians wanted the app to link to case management for individualized medical care. Logistical challenges to app management were limitations but are useful for consideration before scale-up. This study corroborates findings in the health literacy literature that women most at risk for adverse birth outcomes need additional face-to-face support with mHealth

  7. Applying the concept of culture to reduce health disparities through health behavior research.

    Science.gov (United States)

    Kagawa Singer, Marjorie

    2012-11-01

    Culture is often cited as an underlying cause of the undue burden of disease borne by communities of color along the entire life cycle. However, culture is rarely defined or appropriately measured. Scientifically, culture is a complex, integrated, and dynamic conceptual framework that is incongruent with the way it is operationalized in health behavior theories: as a unidimensional, static, and immutable character element of a homogeneous population group. This paper lays out this contradiction and proposes a more scientifically grounded approach to the use of culture. The premise is that if the concept of culture were better operationalized, results from studies of diverse population groups would produce findings that are more scientifically valid and relevant to the community. Practitioners could then use these findings to develop more effective strategies to reduce health disparities and improve the health of all population groups. Six steps are proposed to increase our ability to achieve greater clarity on what culture is and to identify how it impacts health behavior and ultimately health outcomes, enabling researchers to build a stronger science of cultural diversity. Copyright © 2012. Published by Elsevier Inc.

  8. Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

    Science.gov (United States)

    Mauriello, Leanne M; Van Marter, Deborah F; Umanzor, Cindy D; Castle, Patricia H; de Aguiar, Emma L

    2016-09-01

    To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. Women were recruited from six locations of federally funded health centers across three states. Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors. © 2016 by American Journal of Health Promotion, Inc.

  9. Risky music-listening behaviors and associated health-risk behaviors.

    Science.gov (United States)

    Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

    2012-06-01

    To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

  10. The perception of pre- and post-natal marijuana exposure on health outcomes: A content analysis of twitter messages.

    Science.gov (United States)

    Dakkak, H; Brown, R; Twynstra, J; Charbonneau, K; Seabrook, J A

    2018-05-23

    The prevalence of marijuana use during pregnancy ranges from 3- 30% , and most of this is for recreational purposes. Marijuana exposure during pregnancy has been linked with low birth weight babies and other adverse child health outcomes. Twitter is a popular news and social networking outlet, and is frequently used to access information about population health and behavior. The primary objective of this study was to investigate the types of messages disseminated on Twitter about marijuana use and infant and maternal health. The secondary objective was to describe the reported health outcomes associated with prenatal and postnatal marijuana use. Tweets were collected from the inception of Twitter (2006) until April 2017. If tweets included links, these links were examined to investigate the source of the message and to clarify the user's intent. In total, 550 tweets were captured, with most tweets (77.6%) having a neutral tweet tone, suggesting uncertainty about the health effects associated with pre- and post-natal marijuana exposure. The sources attached to the original tweets, however, were more likely to report on negative health outcomes. The most common health outcomes associated with prenatal marijuana exposure were: poor brain development (27.3%), inadequate development of the nervous system (23.6%), low birth weight (23.3%), poor behavioral outcomes (21.0%), and infant memory issues (19.3%). The inverse association between marijuana use and the quality and quantity of milk produced by the mother was the most commonly reported tweet for the lactation period.

  11. PREMATURITY, NEONATAL HEALTH STATUS, AND LATER CHILD BEHAVIORAL/EMOTIONAL PROBLEMS: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Cassiano, Rafaela G M; Gaspardo, Claudia M; Linhares, Maria Beatriz M

    2016-05-01

    Preterm birth can impact on child development. As seen previously, children born preterm present more behavioral and/or emotional problems than do full-term counterparts. In addition to gestational age, neonatal clinical status should be examined to better understand the differential impact of premature birth on later developmental outcomes. The aim of the present study was to systematically review empirical studies on the relationship between prematurity, neonatal health status, and behavioral and/or emotional problems in children. A systematic search of the PubMed, PsycINFO, Web of Science, and LILACS databases for articles published from 2009 to 2014 was performed. The inclusion criteria were empirical studies that evaluated behavioral and/or emotional problems that are related to clinical neonatal variables in children born preterm. Twenty-seven studies were reviewed. Results showed that the degree of prematurity and birth weight were associated with emotional and/or behavioral problems in children at different ages. Prematurity that was associated with neonatal clinical conditions (e.g., sepsis, bronchopulmonary dysplasia, and hemorrhage) and such treatments as corticoids and steroids increased the risk for these problems. The volume and abnormalities of specific brain structures also were associated with these outcomes. In conclusion, the neonatal health problems associated with prematurity present a negative impact on later child emotional and adapted behavior. © 2016 Michigan Association for Infant Mental Health.

  12. Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth.

    Science.gov (United States)

    Tobler, Amy L; Maldonado-Molina, Mildred M; Staras, Stephanie A S; O'Mara, Ryan J; Livingston, Melvin D; Komro, Kelli A

    2013-01-01

    We examined perceived frequency and intensity of racial/ethnic discrimination and associations with high-risk behaviors/conditions among adolescents. With surveys from 2490 racial/ethnic minority adolescents primarily with low socioeconomic status, we used regression analysis to examine associations between racial/ethnic discrimination and behavioral health outcomes (alcohol use, marijuana use, physical aggression, delinquency, victimization, depression, suicidal ideation, and sexual behaviors). Most adolescents (73%) experienced racial/ethnic discrimination and 42% of experiences were 'somewhat-' or 'very disturbing.' Adolescents reporting frequent and disturbing racial/ethnic discrimination were at increased risk of all measured behaviors, except alcohol and marijuana use. Adolescents who experienced any racial/ethnic discrimination were at increased risk for victimization and depression. Regardless of intensity, adolescents who experienced racial/ethnic discrimination at least occasionally were more likely to report greater physical aggression, delinquency, suicidal ideation, younger age at first oral sex, unprotected sex during last intercourse, and more lifetime sexual partners. Most adolescents had experienced racial/ethnic discrimination due to their race/ethnicity. Even occasional experiences of racial/ethnic discrimination likely contribute to maladaptive behavioral and mental health outcomes among adolescents. Prevention and coping strategies are important targets for intervention.

  13. Mechanisms of Behavioral and Affective Treatment Outcomes in a Cognitive Behavioral Intervention for Boys.

    Science.gov (United States)

    Burke, Jeffrey D; Loeber, Rolf

    2016-01-01

    Evidence for effective treatment for behavioral problems continues to grow, yet evidence about the effective mechanisms underlying those interventions has lagged behind. The Stop Now and Plan (SNAP) program is a multicomponent intervention for boys between 6 and 11. This study tested putative treatment mechanisms using data from 252 boys in a randomized controlled trial of SNAP versus treatment as usual. SNAP includes a 3 month group treatment period followed by individualized intervention, which persisted through the 15 month study period. Measures were administered in four waves: at baseline and at 3, 9 and 15 months after baseline. A hierarchical linear modeling strategy was used. SNAP was associated with improved problem-solving skills, prosocial behavior, emotion regulation skills, and reduced parental stress. Prosocial behavior, emotion regulation skills and reduced parental stress partially mediated improvements in child aggression. Improved emotion regulation skills partially mediated treatment-related child anxious-depressed outcomes. Improvements in parenting behaviors did not differ between treatment conditions. The results suggest that independent processes may drive affective and behavioral outcomes, with some specificity regarding the mechanisms related to differing treatment outcomes.

  14. Academic Deans and Suicidal Individuals: Comparison and Contrast of Selected Behavioral Outcomes.

    Science.gov (United States)

    DiNapoli, Joan B.

    The research question for this dissertation study was: Do behavioral outcomes identified in people who commit suicide exist in people who publicly exhibit productive behavioral outcomes and have not attempted suicide? More specifically, do selective affective and physiological behavioral outcomes identified in people who kill themselves exist is…

  15. Investigating the Associations among Overtime Work, Health Behaviors, and Health: A Longitudinal Study among Full-time Employees

    NARCIS (Netherlands)

    Taris, T.W.; Ybema, J.F.; Beckers, D.G.J.; Verheijden, M.W.; Geurts, S.A.; Kompier, M.A.J.

    2011-01-01

    BACKGROUND: It has often been suggested that high levels of overtime lead to adverse health outcomes. One mechanism that may account for this association is that working overtime leads to elevated levels of stress, which could affect worker's behavioral decisions or habits (such as smoking and lack

  16. When Brain Beats Behavior: Neuroforecasting Crowdfunding Outcomes.

    Science.gov (United States)

    Genevsky, Alexander; Yoon, Carolyn; Knutson, Brian

    2017-09-06

    Although traditional economic and psychological theories imply that individual choice best scales to aggregate choice, primary components of choice reflected in neural activity may support even more generalizable forecasts. Crowdfunding represents a significant and growing platform for funding new and unique projects, causes, and products. To test whether neural activity could forecast market-level crowdfunding outcomes weeks later, 30 human subjects (14 female) decided whether to fund proposed projects described on an Internet crowdfunding website while undergoing scanning with functional magnetic resonance imaging. Although activity in both the nucleus accumbens (NAcc) and medial prefrontal cortex predicted individual choices to fund on a trial-to-trial basis in the neuroimaging sample, only NAcc activity generalized to forecast market funding outcomes weeks later on the Internet. Behavioral measures from the neuroimaging sample, however, did not forecast market funding outcomes. This pattern of associations was replicated in a second study. These findings demonstrate that a subset of the neural predictors of individual choice can generalize to forecast market-level crowdfunding outcomes-even better than choice itself. SIGNIFICANCE STATEMENT Forecasting aggregate behavior with individual neural data has proven elusive; even when successful, neural forecasts have not historically supplanted behavioral forecasts. In the current research, we find that neural responses can forecast market-level choice and outperform behavioral measures in a novel Internet crowdfunding context. Targeted as well as model-free analyses convergently indicated that nucleus accumbens activity can support aggregate forecasts. Beyond providing initial evidence for neuropsychological processes implicated in crowdfunding choices, these findings highlight the ability of neural features to forecast aggregate choice, which could inform applications relevant to business and policy. Copyright

  17. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior.

    Science.gov (United States)

    Akulume, Martha; Kiwanuka, Suzanne N

    2016-01-01

    Objective . The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology . One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation). Results . For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers' segregation behavior, but intention emerged as the strongest and most significant ( r = 0.524, P theory of planned behavior model explained 52.5% of the variance in health workers' segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion . Generally, health workers' health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers' health care waste segregation behaviors.

  18. Relationship between weight-related behavioral profiles and health outcomes by sexual orientation and gender

    OpenAIRE

    VanKim, Nicole A.; Erickson, Darin J.; Eisenberg, Marla E.; Lust, Katherine; Rosser, B. R. Simon; Laska, Melissa N.

    2016-01-01

    Objective Examine relationships between weight-related factors and weight status, body dissatisfaction, chronic health conditions, and quality of life across sexual orientation and gender. Methods Two- and four-year college students participated in the College Student Health Survey (n=28,703; 2009-2013). Risk differences were calculated to estimate relationships between behavioral profiles and weight status, body satisfaction, diagnosis of a chronic condition, and quality of life, stratified ...

  19. Health lifestyle behaviors among U.S. adults

    Directory of Open Access Journals (Sweden)

    Jarron M. Saint Onge

    2017-12-01

    Full Text Available Existing research that studies individual health behaviors and conceive of behaviors as simplistically reflecting narrow intentions toward health may obscure the social organization of health behaviors. Instead, we examine how eight health behaviors group together to form distinct health behavior niches. Using nationally-representative data from U.S. adults aged 18 and over from the 2004–2009 National Health Interview Survey (NHIS, we use Latent Class Analysis to identify classes of behavior based on smoking status, alcohol use, physical activity, physician visits, and flu vaccination. We identify 7 distinct health behavior classes including concordant health promoting (44%, concordant health compromising (26%, and discordant classes (30%. We find significant race/ethnic, sex, regional, and age differences in class membership. We show that health behavior classes are associated with prospective mortality, suggesting that they are valid representations of health lifestyles. We discuss the implications of our results for sociological theories of health behaviors, as well as for multiple behavior interventions seeking to improve population health.

  20. Relationship between objectively measured sedentary behavior and health outcomes in schizophrenia patients: The PsychiActive project.

    Science.gov (United States)

    Bueno-Antequera, Javier; Oviedo-Caro, Miguel Ángel; Munguía-Izquierdo, Diego

    2017-11-21

    This study aimed to investigate possible relationships between sedentary behavior and body mass index (BMI), cardiorespiratory fitness (CRF), and health-related quality of life (HRQoL) in schizophrenia patients. Variables contributing to the variability in sedentary behavior were identified. Eighty-two schizophrenia outpatients (mean age±SD: 41.0±8.7years, 87% men, mean illness duration±SD: 17.1±8.9years) wore a multisensor armband for 7 consecutive full days to objectively measure sedentary behavior. BMI, walking capacity (6-minute walking test) as a proxy for CRF estimation and HRQoL (Short Form 36-Item Health Survey questionnaire version 2) were also assessed. Correlation (Pearson or Spearman coefficients) and multiple regression analysis were used. Sedentary behavior was significantly associated with BMI, CRF, and the physical component summary score of HRQoL (r values, -0.34-0.41; all Pdiet, smoking, and antipsychotic medication (all Psedentary behavior. Consistent relationships between sedentary behavior and BMI, CRF, and the physical component summary score of HRQoL were found in schizophrenia patients. All the identified determinants of sedentary behavior are modifiable and may be important areas for future interventions in this population. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Socioeconomic Status and Poor Health Outcome at 10 Years of Follow-Up in the Multi-Ethnic Study of Atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Steven Shea

    Full Text Available Predictors of healthy aging have not been well-studied using longitudinal data with demographic, clinical, subclinical, and genetic information. The objective was to identify predictors of poor health outcome at 10 years of follow-up in the Multi-Ethnic Study of Atherosclerosis (MESA.Prospective cohort study.Population-based sample from 6 U.S. communities.4,355 participants In the MESA Study.Poor health outcome at 10 years of follow-up was defined as having died or having clinical cardiovascular disease, depression, cognitive impairment, chronic obstructive pulmonary disease, or cancer other than non-melanoma skin cancer. Absolute risk regression was used to estimate risk differences in the outcome adjusting for demographic variables, clinical and behavioral risk factors, subclinical cardiovascular disease, and ApoE genotype. Models were weighted to account for selective attrition.Mean age at 10 years of follow-up was 69.5 years; 1,480 participants had a poor health outcome, 2,157 participants were in good health, and 718 were unknown. Older age, smoking, not taking a statin, hypertension, diabetes, and higher coronary calcium score were associated with higher probability of poor health outcome. After multivariable adjustment, participants in the lowest income and educational categories had 7 to 14% greater absolute risk of poor health outcome at 10 years of follow-up compared to those in the next highest categories of income or education (P = 0.002 for both. Those in the lowest categories of both income and education had 21% greater absolute risk of poor health outcome compared to those in the highest categories of both income and education.Low income and educational level predict poor health outcome at 10 years of follow-up in an aging cohort, independent of clinical and behavioral risk factors and subclinical cardiovascular disease.

  2. Translational science matters: forging partnerships between biomedical and behavioral science to advance the public's health.

    Science.gov (United States)

    Mensah, George A; Czajkowski, Susan M

    2018-03-29

    The prevention and effective treatment of many chronic diseases such as cardiovascular disease, cancer and diabetes are dependent on behaviors such as not smoking, adopting a physically-active lifestyle, eating a healthy diet, and adhering to prescribed medical and behavioral regimens. Yet adoption and maintenance of these behaviors pose major challenges for individuals, their families and communities, as well as clinicians and health care systems. These challenges can best be met through the integration of the biomedical and behavioral sciences that is achieved by the formation of strategic partnerships between researchers and practitioners in these disciplines to address pressing clinical and public health problems. The National Institutes of Health has supported a number of clinical trials and research initiatives that demonstrate the value of biomedical and behavioral science partnerships in translating fundamental discoveries into significant improvements in health outcomes. We review several such examples of collaborations between biomedical and behavioral researchers, describe key initiatives focused on advancing a transdisciplinary translational perspective, and outline areas which require insights, tools and findings from both the biomedical and behavioral sciences to advance the public's health.

  3. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Martha Akulume

    2016-01-01

    Full Text Available Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention and external variables (sociodemographic factors, personal characteristics, organizational characteristics, professional characteristics, and moral obligation. Results. For their most recent client 21.5% of the health workers reported that they most definitely segregated health care waste while 5.5% did not segregate. All the theory of planned behavior constructs were significant predictors of health workers’ segregation behavior, but intention emerged as the strongest and most significant (r=0.524, P<0.001. The theory of planned behavior model explained 52.5% of the variance in health workers’ segregation behavior. When external variables were added, the new model explained 66.7% of the variance in behavior. Conclusion. Generally, health workers’ health care waste segregation behavior was high. The theory of planned behavior significantly predicted health workers’ health care waste segregation behaviors.

  4. Children's behavioral health needs and satisfaction and commitment of foster and adoptive parents: Do trauma-informed services make a difference?

    Science.gov (United States)

    Barnett, Erin R; Cleary, Sarah E; Butcher, Rebecca L; Jankowski, Mary K

    2018-05-03

    Caring for children in foster or adoptive care with behavioral health needs can severely stress parents, contributing to adverse outcomes for children and families. Trauma-informed services from the child welfare and mental health sectors may help prevent poor outcomes by helping children and parents identify and understand trauma and its impact on children's behavioral health and receive effective treatment. To help understand the role of trauma-informed services for the child welfare population, we examined whether trauma-informed child welfare and mental health services moderated the relationship between children's behavioral health needs and parent satisfaction and commitment. The researchers analyzed data from a cross-sectional statewide survey of foster and adoptive parents (n = 512 respondents, 42% of 1,206 contacted) from one state. Foster (but not adoptive) parent ratings of trauma-informed mental health services significantly moderated the relationship between children's behavioral health needs and foster and adoptive parent satisfaction and commitment. As ratings of trauma-informed mental health services increased, the association between child behavioral health needs and parent satisfaction and commitment became nonsignificant, suggesting a buffering effect. Trauma-informed child welfare services did not moderate the relationship for foster or adoptive parents. Leaders and policymakers are urged to promote trauma-informed mental health services for children involved with child welfare to potentially buffer foster parents against lower parenting satisfaction and commitment. More research is needed to replicate and expand on these findings and to examine the effectiveness of trauma-informed services on other relevant child and family outcomes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. Investigating the Associations among Overtime Work, Health Behaviors, and Health: A Longitudinal Study among Full-time Employees

    NARCIS (Netherlands)

    Taris, T.W.; Ybema, J.F.; Beckers, D.G.J.; Verheijden, M.W.; Geurts, S.A.E.; Kompier, M.A.J.

    2011-01-01

    It has often been suggested that high levels of overtime lead to adverse health outcomes. One mechanism that may account for this association is that working overtime leads to elevated levels of stress, which could affect worker's behavioral decisions or habits (such as smoking and lack of physical

  6. Using mHealth technologies to improve the identification of behavioral health problems in urban primary care settings.

    Science.gov (United States)

    Staeheli, Martha; Aseltine, Robert H; Schilling, Elizabeth; Anderson, Daren; Gould, Bruce

    2017-01-01

    Behavioral health disorders remain under recognized and under diagnosed among urban primary care patients. Screening patients for such problems is widely recommended, yet is challenging to do in a brief primary care encounter, particularly for this socially and medically complex patient population. In 2013, intervention patients at an urban Connecticut primary clinic were screened for post-traumatic stress disorder, depression, and risky drinking (n = 146) using an electronic tablet-based screening tool. Screening data were compared to electronic health record data from control patients (n = 129) to assess differences in the prevalence of behavioral health problems, rates of follow-up care, and the rate of newly identified cases in the intervention group. Results from logistic regressions indicated that both groups had similar rates of disorder at baseline. Patients in the intervention group were five times more likely to be identified with depression (p Post-traumatic stress disorder was virtually unrecognized among controls but was observed in 23% of the intervention group (p behavioral health problems identified in the intervention group were new cases. Follow-up rates were significantly higher in the intervention group relative to controls, but were low overall. This tablet-based electronic screening tool identified significantly higher rates of behavioral health disorders than have been previously reported for this patient population. Electronic risk screening using patient-reported outcome measures offers an efficient approach to improving the identification of behavioral health problems and improving rates of follow-up care.

  7. eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management.

    Science.gov (United States)

    Rollo, Megan E; Aguiar, Elroy J; Williams, Rebecca L; Wynne, Katie; Kriss, Michelle; Callister, Robin; Collins, Clare E

    2016-01-01

    Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM) behaviors that require tailored education and support. Electronic health (eHealth) technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided.

  8. Impact of Health Behaviors and Health Management on Employment After SCI: Psychological Health and Health Management.

    Science.gov (United States)

    Reed, Karla S; Meade, Michelle A; Krause, James S

    2016-01-01

    Objective: The purpose of this study was to examine the relationship between employment and psychological health and health management as described by individuals with spinal cord injury (SCI) who were employed at least once following injury. Methods: A qualitative approach used 6 focus groups at 2 sites with 44 participants who were at least 10 years post SCI. All had been employed at some point since injury. Heterogeneous and homogeneous groups were delineated based on specific characteristics, such as education, gender, or race. Group sessions followed a semi-structured interview format with questions about personal, environmental, and policy related factors influencing employment following SCI. All group sessions were recorded, transcribed, and coded into conceptual categories to identify topics, themes, and patterns. Inferences were drawn about their meaning. NVivo 10 software using the constant comparative method was used for data analysis. Results: Narratives discussed the relationship between employment and psychological and emotional health and health management. Four themes were identified: (1) adjustment and dealing with emotional reactions, (2) gaining self-confidence, (3) preventing burnout, and (4) attitudes and perspectives. Most themes reflected issues that varied based on severity of injury as well as stage of employment. Conclusions: Individuals with SCI who are successful in working following injury must determine how to perform the behaviors necessary to manage their health and prevent emotional or physical complications. The emotional consequences of SCI must be recognized and addressed and specific behaviors enacted in order to optimize employment outcomes.

  9. Systematic Review of Exercise Effects on Health Outcomes in Women with Breast Cancer

    Directory of Open Access Journals (Sweden)

    ChaeWeon Chung, PhD, RN

    2013-09-01

    Conclusion: Well-designed exercises are effective and beneficial for improving women's physical, physiological, and psychological health outcomes after breast cancer treatment as well as to facilitate changes in exercise behaviors. The feasibility of applying intervention protocols, efficiency of interventions, and strengths of exercise protocols should be further examined.

  10. Sociodemographic and social contextual predictors of multiple health behavior change: data from the Healthy Directions-Small Business study.

    Science.gov (United States)

    Harley, Amy E; Sapp, Amy L; Li, Yi; Marino, Miguel; Quintiliani, Lisa M; Sorensen, Glorian

    2013-03-01

    Multiple modifiable health behaviors contribute to the chronic diseases that are the leading causes of death in the USA. Disparities for meeting recommended health behavior guidelines exist across occupational classes and socioeconomic levels. The purpose of this paper was to investigate sociodemographic and social contextual predictors of multiple health behavior change in a worksite intervention. We analyzed data on four diet and exercise variables from an intervention trial with worksite-level randomization. Eight hundred forty-one employees had complete data from baseline (response rate = 84 %) and follow-up surveys (response rate = 77 %). Multilevel logistic regression estimated associations between least absolute shrinkage and selection operator-selected sociodemographic and social contextual predictor variables and the multiple health behavior change outcome (changing 2+ versus 0 behaviors). Gender, being married/partnered, and perceived discrimination were significantly associated with multiple health behavior change. Sociodemographic and social contextual factors predict multiple health behavior change and could inform the design and delivery of worksite interventions targeting multiple health behaviors.

  11. Contribution of health workforce to health outcomes: empirical evidence from Vietnam.

    Science.gov (United States)

    Nguyen, Mai Phuong; Mirzoev, Tolib; Le, Thi Minh

    2016-11-16

    In Vietnam, a lower-middle income country, while the overall skill- and knowledge-based quality of health workforce is improving, health workers are disproportionately distributed across different economic regions. A similar trend appears to be in relation to health outcomes between those regions. It is unclear, however, whether there is any relationship between the distribution of health workers and the achievement of health outcomes in the context of Vietnam. This study examines the statistical relationship between the availability of health workers and health outcomes across the different economic regions in Vietnam. We constructed a panel data of six economic regions covering 8 years (2006-2013) and used principal components analysis regressions to estimate the impact of health workforce on health outcomes. The dependent variables representing the outcomes included life expectancy at birth, infant mortality, and under-five mortality rates. Besides the health workforce as our target explanatory variable, we also controlled for key demographic factors including regional income per capita, poverty rate, illiteracy rate, and population density. The numbers of doctors, nurses, midwives, and pharmacists have been rising in the country over the last decade. However, there are notable differences across the different categories. For example, while the numbers of nurses increased considerably between 2006 and 2013, the number of pharmacists slightly decreased between 2011 and 2013. We found statistically significant evidence of the impact of density of doctors, nurses, midwives, and pharmacists on improvement to life expectancy and reduction of infant and under-five mortality rates. Availability of different categories of health workforce can positively contribute to improvements in health outcomes and ultimately extend the life expectancy of populations. Therefore, increasing investment into more equitable distribution of four main categories of health workforce

  12. The behavioral economics of health and health care.

    Science.gov (United States)

    Rice, Thomas

    2013-01-01

    People often make decisions in health care that are not in their best interest, ranging from failing to enroll in health insurance to which they are entitled, to engaging in extremely harmful behaviors. Traditional economic theory provides a limited tool kit for improving behavior because it assumes that people make decisions in a rational way, have the mental capacity to deal with huge amounts of information and choice, and have tastes endemic to them and not open to manipulation. Melding economics with psychology, behavioral economics acknowledges that people often do not act rationally in the economic sense. It therefore offers a potentially richer set of tools than provided by traditional economic theory to understand and influence behaviors. Only recently, however, has it been applied to health care. This article provides an overview of behavioral economics, reviews some of its contributions, and shows how it can be used in health care to improve people's decisions and health.

  13. Oncology healthcare providers' knowledge, attitudes, and practice behaviors regarding LGBT health.

    Science.gov (United States)

    Shetty, Gina; Sanchez, Julian A; Lancaster, Johnathan M; Wilson, Lauren E; Quinn, Gwendolyn P; Schabath, Matthew B

    2016-10-01

    There are limited data on lesbian, gay, bisexual, and transgender (LGBT) healthcare experiences and interactions with the providers. This study assessed knowledge, attitudes, and practice behaviors of oncology providers regarding LGBT health. A 32-item web-based survey was emailed to 388 oncology providers at a single institution. The survey assessed: demographics, knowledge, attitudes, and practice behaviors. 108 providers participated in the survey (28% response rate). LGBT cultural competency at the institution. Results from the open comments section identified multiple misconceptions. This study revealed knowledge gaps about LGBT health risks. Cultural competency training may aid oncology providers to understand the need to inquire about patients' gender identity and sexual orientation. Health care providers who incorporate the routine collection of gender identity and sexual orientation (SOGI) in their patient history taking may improve patient care by offering tailored education and referrals. While identifying as LGBT does not in itself increase risk for adverse health outcomes, this population tends to have increased risk behaviors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs : What Broader Non-Health Outcomes Matter Most?

    NARCIS (Netherlands)

    Benning, Tim M; Alayli-Goebbels, Adrienne F G; Aarts, Marie-Jeanne; Stolk, Elly; de Wit, G Ardine; Prenger, Rilana; Braakman-Jansen, Louise M A; Evers, Silvia M A A

    2015-01-01

    BACKGROUND: Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of

  15. Exploring Outcomes to Consider in Economic Evaluations of Health Promotion Programs: What Broader Non-Health Outcomes Matter Most?

    NARCIS (Netherlands)

    Benning, Tim M.; Alayli-Goebbels, Adrienne F.G.; Aarts, Marie-Jeanne; Stolk, Elly; de Wit, G. Ardine; Prenger, Hendrikje Cornelia; Braakman-Jansen, Louise Marie Antoinette; Evers, Silvia M.A.A.

    2015-01-01

    Background Attention is increasing on the consideration of broader non-health outcomes in economic evaluations. It is unknown which non-health outcomes are valued as most relevant in the context of health promotion. The present study fills this gap by investigating the relative importance of

  16. Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data.

    Science.gov (United States)

    Lucenko, Barbara A; Sharkova, Irina V; Huber, Alice; Jemelka, Ron; Mancuso, David

    2015-09-01

    This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12-17 and their biological parents. Measures from administrative records reflected presence of parental domestic violence, mental illness, substance abuse, criminal justice involvement, child abuse and/or neglect, homelessness, and death of a biological parent. Mental health and substance abuse status of adolescents were analyzed as functions of adverse experiences and other youth characteristics using logistic regression. In multivariate analyses, all predictors except parental domestic violence were statistically significant for substance abuse; parental death, parental mental illness, child abuse or neglect and homelessness were statistically significant for mental illness. Odds ratios for child abuse/neglect were particularly high in both models. The ability to identify risks during childhood using administrative data suggests the potential to target prevention and early intervention efforts for children with specific family risk factors who are at increased risk for developing behavioral health problems during adolescence. This study illustrates the utility of administrative data in understanding adverse experiences on children and the advantages and disadvantages of this approach. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Processes and outcomes in school health promotion

    DEFF Research Database (Denmark)

    Simovska, Venka

    2012-01-01

    This is the second special issue of Health Education which features research, theory and practice based perspectives on what counts as desirable outcomes of health promotion in schools in terms of health as well as education, and the effective processes in schools which lead to these outcomes....... The focus in the first special issue was on highlighting the argument that the question about the outcomes of the health-promoting schools should not be limited to narrowly defined health outcomes but needs to be closely linked with the core tasks and values of the school. Building further on this argument......, the papers in this issue feature a number of research issues of relevance for the effectiveness of the health-promoting schools approach, as well as a variety of research and evaluation methodologies contributing to the debate about what counts as reliable evidence within the health-promoting schools...

  18. Predicting Health Care Utilization After the First Behavioral Health Visit Using Natural Language Processing and Machine Learning

    OpenAIRE

    Roysden, Nathaniel

    2016-01-01

    Mental health problems are an independent predictor of increased healthcare utilization. We created random forest classifiers for predicting two outcomes following a patient’s first behavioral health encounter: decreased utilization by any amount (AUROC 0.74) and ultra-high absolute utilization (AUROC 0.88). These models may be used for clinical decision support by referring providers, to automatically detect patients who may benefit from referral, for cost management, or for risk/protection ...

  19. BMI, health behaviors, and quality of life in children and adolescents: a school-based study.

    Science.gov (United States)

    Chen, Gang; Ratcliffe, Julie; Olds, Tim; Magarey, Anthea; Jones, Michelle; Leslie, Eva

    2014-04-01

    To explore the relationship between weight status (BMI) and health-related quality of life in children and adolescents through application of the Child Health Utility 9D, a new generic preference-based instrument. Data were collected from primary and high school students in rural and metropolitan regions of South Australia. Consenting participants (2588 in grades 4-6 and 765 in grades 9-10) were weighed and measured and categorized as underweight, healthy weight, overweight, or obese according to International Obesity Taskforce BMI cutoff points (primary outcome). Participants also completed a questionnaire including the Child Health Utility 9D and standardized measures of physical activity, sedentary behavior, sleep patterns, and eating behavior (secondary outcomes). Descriptive and multivariate linear regression analyses were undertaken to calculate mean utility differences. In comparison with healthy-weight primary school students, adjusted mean utilities were lower for overweight (-0.016, P = .02) or obese (-0.039, P = .001) students. For high school students, the adjusted mean utilities were also lower for overweight and obese students but were nonsignificant (-0.018, P > .10). Physical activity, sedentary behavior, sleep patterns, and eating behavior were all found to be significantly associated with utilities. Irrespective of BMI, young people engaging in more physical activities or less sedentary behavior, and having healthier sleep patterns or eating behavior exhibited higher utilities. Associations between utilities and sleep patterns or eating behavior were stronger than the associations with BMI. Future economic evaluations for obesity interventions should more formally investigate the relationship between changes over time in weight status and health-related quality of life for children and adolescents.

  20. Adverse childhood experiences and association with health, mental health, and risky behavior in the kingdom of Saudi Arabia.

    Science.gov (United States)

    Almuneef, Maha; Hollinshead, Dana; Saleheen, Hassan; AlMadani, Sereen; Derkash, Bridget; AlBuhairan, Fadia; Al-Eissa, Majid; Fluke, John

    2016-10-01

    The aim of this study is to determine if ACEs impact the health and risk behavior burden among Kingdom of Saudi Arabia (KSA) adults. In 2013, a cross-sectional study was conducted across KSA to identify the retrospective prevalence of ACEs and their association with high risk behaviors and chronic diseases. Surveys from 10,156 adults in all 13 Saudi regions were obtained using an Arabic version of the WHO ACE-IQ (KSA ACE-IQ). Compared to respondents reporting no ACEs, even just one ACE contributed significantly to the odds of experiencing diabetes mellitus (OR=1.3), depression (OR=1.32), or anxiety (OR=1.79) outcomes. Two ACEs were necessary for statistically significant, higher odds to emerge for hypertension (OR=1.46), mental illness (OR=1.93), smoking (OR=1.17), alcohol use (OR=1.75), and drug use (OR=1.45). Respondents who reported four or more ACEs had greater odds of coronary heart disease (OR=1.94), and obesity (OR=2.25). Compared to those reporting no ACEs, respondents reporting four or more ACEs had over four times the odds of Alcohol or Drug Use, Mental Illness, Depression, and/or Anxiety outcomes and more than twice the odds of diabetes, hypertension, obesity, and/or smoking outcomes. Findings from this analysis underscore the potential benefit of providing focused preventative approaches to mitigating ACEs in KSA in relation to both the specific and cumulative burden of health and risky behavior outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Behavioral Health Services in the Changing Landscape of Private Health Plans.

    Science.gov (United States)

    Horgan, Constance M; Stewart, Maureen T; Reif, Sharon; Garnick, Deborah W; Hodgkin, Dominic; Merrick, Elizabeth L; Quinn, Amity E

    2016-06-01

    Health plans play a key role in facilitating improvements in population health and may engage in activities that have an impact on access, cost, and quality of behavioral health care. Although behavioral health care is becoming more integrated with general medical care, its delivery system has unique aspects. The study examined how health plans deliver and manage behavioral health care in the context of the Affordable Care Act (ACA) and the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA). This is a critical time to examine how health plans manage behavioral health care. A nationally representative survey of private health plans (weighted N=8,431 products; 89% response rate) was conducted in 2010 during the first year of MHPAEA, when plans were subject to the law but before final regulations, and just before the ACA went into effect. The survey addressed behavioral health coverage, cost-sharing, contracting arrangements, medical home innovations, support for technology, and financial incentives to improve behavioral health care. Coverage for inpatient and outpatient behavioral health services was stable between 2003 and 2010. In 2010, health plans were more likely than in 2003 to manage behavioral health care through internal arrangements and to contract for other services. Medical home initiatives were common and almost always included behavioral health, but financial incentives did not. Some plans facilitated providers' use of technology to improve care delivery, but this was not the norm. Health plans are key to mainstreaming and supporting delivery of high-quality behavioral health services. Since 2003, plans have made changes to support delivery of behavioral health services in the context of a rapidly changing environment.

  2. Practices and perceptions of animal contact and associated health outcomes in pregnant women and new mothers

    Directory of Open Access Journals (Sweden)

    Hsin-Yi eWeng

    2016-02-01

    Full Text Available Companion animals play an important role in our society. However, pregnant women and new mothers might have specific concerns about animal-associated health outcomes because of their altered immune function and posture as well as their newborn babies. The study was conducted to collect baseline data for developing an evidence-based intervention for pregnant women and new mothers to help them adopt certain behaviors to prevent adverse animal-associated health outcomes. A survey, using the Health Belief Model as the theoretical framework, was developed and administered to 326 women attending the Women, Infants, and Children programs in Illinois and Indiana in 2015. Prevalence of dog and cat ownership was estimated to be 39% (95% CI 33%–45% and 26% (95% CI 21%–31%, respectively. Regardless of pet ownership, 74% of the respondents reported having some type of animal contact in the past month. Pregnancy or the birth of a child altered some animal contact practices among the study participants; particularly a discontinuation or decrease in cleaning cat litter boxes. Reports of diseases contracted from animals were low (4% in this study. By contrast, animal-associated injuries were prevalent (42%, and the majority were caused by animals the respondents owned (56%. Overall, respondents indicated that they appreciated the benefits of a program addressing animal-associated health outcomes and did not indicate strong resistance to adopting certain behaviors. The majority recognized human health-care providers as a source of information about animal contact and associated health outcomes but less frequently identified veterinarians as a source for such information. In addition, although most of the respondents felt that health-care providers and veterinarians should initiate discussions about preventing animal-associated illness and injuries, only 41% among those who had visited doctors or prenatal care services reported that their health-care providers

  3. Nurses' health promoting lifestyle behaviors in a community hospital.

    Science.gov (United States)

    Kurnat-Thoma, Emma; El-Banna, Majeda; Oakcrum, Monica; Tyroler, Jill

    2017-06-01

    To examine nurses' health-promoting lifestyle behaviors, describe their self-reported engagement in employee wellness program benefit options, and explore relationships between nurse demographic factors, health characteristics and lifestyle behaviors. Nurses adopting unhealthy lifestyle behaviors are at significantly higher risk for developing a number of chronic diseases and are at increased susceptibility to exhaustion, job dissatisfaction and turnover. Strengthening professional nurses' abilities to engage in healthy lifestyle behaviors could serve as a valuable tool in combating negative workplace stress, promote improved work-life balance and personal well-being, and help retain qualified health-care providers. In a 187-bed community hospital in the Washington D.C. metropolitan area, we conducted an IRB-approved exploratory descriptive study. We examined 127 nurses' demographic characteristics, self-reported employer wellness program use, and measured their healthy lifestyle behaviors using the 52-item Health-Promoting Lifestyle Profile-II (HPLP-II) survey instrument. Nurse demographic and HPLP-II scores were analyzed in SPSS v20.0. Inferential univariate statistical testing examined relationships between nurse demographic factors, health and job characteristics, and HPLP-II score outcomes. Nurses over 40years old were more likely to report participation in hospital wellness program options. Statistically significant age differences were identified in total HPLP-II score (p=0.005), and two subscale scores-spiritual growth (p=0.002) and interpersonal relations (p=0.000). Post-hoc testing identified nurse participants 40-49years old and ≥50years old experienced slightly lower total HPLP-II score, subscale scores in comparison to younger colleagues. Nurses ≥40years old may benefit from additional employer support and guidance to promote and maintain healthy lifestyles, personal well-being, and positive interpersonal relationships. Copyright © 2017 Elsevier

  4. ACADEMIC YOUTH’S HEALTH BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Agnieszka Radzimińska

    2016-12-01

    Full Text Available Introduction: A very important role in the protection of human health is their life style, their habits and patterns of conduct. Early adulthood is the best period to achieve long-term benefits from a selection of healthy living. However, the results of studies on health-related behavior of youth in Poland and in the world are not satisfactory. The purpose of the study: The purpose of the research was to assess the health behaviors of students of higher education in Bydgoszcz. Material: The study involved 272 students (124 women and 148 men Bydgoszcz higher education students in the following fields of study: physiotherapy, nutrition, logistics and national security. The Inventory of Health-Related Behavior by Zygfryd Juczyński has been used in the research. The statistical analysis was performed using the package PQ Stat 1.6.2. Results: Throughout the treatment group an average level of health-related behavior has been shown. The results of the different categories of health-related behavior were lower than the results of the standardization groups. A higher level of health behavior has been shown in a group of medical students compared to non-medical students. The results for women were higher than men's results. Conclusions: The results of personal research and the research findings of other authors demonstrate that there is a need for implementation of programs of health promotion and health education in all fields of study.

  5. Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered.

    Science.gov (United States)

    Nowicki, Grzegorz Józef; Misztal-Okońska, Patrycja; Ślusarska, Barbara; Rudnicka-Drożak, Ewa; Młynarska, Magdalena; Czekierdowski, Artur

    2018-02-27

    Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered ( n = 235), pregnant women ( n = 121) and childless women ( n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values "positive mental attitude" and "health practices", in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was "a successful family life", while the most appreciated symbol of happiness was "love and friendship". Our results suggest that the system of values and the perception of happiness symbols may influence women's health behaviors. Positioning "health" in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed.

  6. Envisioning the Next Generation of Behavioral Health and Criminal Justice Interventions

    Science.gov (United States)

    Epperson, Matthew W.; Wolff, Nancy; Morgan, Robert D.; Fisher, William H.; Frueh, B. Christopher; Huening, Jessica

    2014-01-01

    The purpose of this paper is to cast a vision for the next generation of behavioral health and criminal justice interventions for persons with serious mental illnesses in the criminal justice system. The limitations of first generation interventions, including their primary focus on mental health treatment connection, are discussed. A person-place framework for understanding the complex factors that contribute to criminal justice involvement for this population is presented. We discuss practice and research recommendations for building more effective interventions to address both criminal justice and mental health outcomes. PMID:24666731

  7. Using findings in multimedia learning to inform technology-based behavioral health interventions.

    Science.gov (United States)

    Aronson, Ian David; Marsch, Lisa A; Acosta, Michelle C

    2013-09-01

    Clinicians and researchers are increasingly using technology-based behavioral health interventions to improve intervention effectiveness and to reach underserved populations. However, these interventions are rarely informed by evidence-based findings of how technology can be optimized to promote acquisition of key skills and information. At the same time, experts in multimedia learning generally do not apply their findings to health education or conduct research in clinical contexts. This paper presents an overview of some key aspects of multimedia learning research that may allow those developing health interventions to apply informational technology with the same rigor as behavioral science content. We synthesized empirical multimedia learning literature from 1992 to 2011. We identified key findings and suggested a framework for integrating technology with educational and behavioral science theory. A scientific, evidence-driven approach to developing technology-based interventions can yield greater effectiveness, improved fidelity, increased outcomes, and better client service.

  8. Mindful Climate Action: Health and Environmental Co-Benefits from Mindfulness-Based Behavioral Training

    Directory of Open Access Journals (Sweden)

    Bruce Barrett

    2016-10-01

    Full Text Available Greenhouse gases from human activities are causing climate change, creating risks for people around the globe. Behaviors involving transportation, diet, energy use, and purchasing drive greenhouse gas emissions, but are also related to health and well-being, providing opportunity for co-benefits. Replacing shorter automobile trips with walking or cycling, or eating plants rather than animals, for example, may increase personal health, while also reducing environmental impact. Mindfulness-based practices have been shown to enhance a variety of health outcomes, but have not been adapted towards environmental purposes. We designed the Mindful Climate Action (MCA curriculum to help people improve their health while simultaneously lowering their carbon footprints. Combining mindfulness-based practices with the Stages of Change theory, the MCA program aims to: (1 improve personal health and well-being; (2 decrease energy use; (3 reduce automobile use; (4 increase active transport; (5 shift diet towards plant-based foods; and (6 reduce unnecessary purchasing. Mindfulness practices will foster attentional awareness, openness, and response flexibility, supporting positive behavior change. We plan to test MCA in a randomized controlled trial, with rigorous assessment of targeted outcomes. Our long-term goal is to refine and adapt the MCA program to a variety of audiences, in order to enhance public health and environmental sustainability.

  9. Behavioral Health and Performance (BHP) Work-Rest Cycles

    Science.gov (United States)

    Leveton, Lauren B.; Whitmire, Alexandra

    2011-01-01

    BHP Program Element Goal: Identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration and return to terrestrial life. BHP Requirements: a) Characterize and assess risks (e.g., likelihood and consequences). b) Develop tools and technologies to prevent, monitor, and treat adverse outcomes. c) Inform standards. d) Develop technologies to: 1) reduce risks and human systems resource requirements (e.g., crew time, mass, volume, power) and 2) ensure effective human-system integration across exploration mission.

  10. Health outcome after major trauma: what are we measuring?

    Science.gov (United States)

    Hoffman, Karen; Cole, Elaine; Playford, E Diane; Grill, Eva; Soberg, Helene L; Brohi, Karim

    2014-01-01

    Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries. Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

  11. Relationship between weight-related behavioral profiles and health outcomes by sexual orientation and gender.

    Science.gov (United States)

    VanKim, Nicole A; Erickson, Darin J; Eisenberg, Marla E; Lust, Katherine; Rosser, B R Simon; Laska, Melissa N

    2016-07-01

    Examine relationships between weight-related factors and weight status, body dissatisfaction, chronic health conditions, and quality of life across sexual orientation and gender. Two- and four-year college students participated in the College Student Health Survey (n = 28,703; 2009-2013). Risk differences were calculated to estimate relationships between behavioral profiles and weight status, body satisfaction, diagnosis of a chronic condition, and quality of life, stratified by gender and sexual orientation. Four behavioral profiles, characterized as "healthier eating habits, more physically active," "healthier eating habits," "moderate eating habits," and "unhealthy weight control," were utilized based on latent class analyses, estimated from nine weight-related behavioral survey items. Sexual orientation differences in weight and quality of life were identified. For example, sexual minority groups reported significantly poorer quality of life than their heterosexual counterparts (females: 22.5%-38.6% (sexual minority) vs. 19.8% (heterosexual); males: 14.3%-26.7% (sexual minority) vs. 11.8% (heterosexual)). Compared with the "healthier eating habits, more physically active" profile, the "unhealthy weight control" profile was associated with obesity, poor body satisfaction, and poor quality of life in multiple gender/sexual orientation subgroups. Interventions are needed to address obesity, body dissatisfaction, and poor quality of life among sexual minority college students. © 2016 The Obesity Society.

  12. Geotagged US Tweets as Predictors of County-Level Health Outcomes, 2015-2016.

    Science.gov (United States)

    Nguyen, Quynh C; McCullough, Matt; Meng, Hsien-Wen; Paul, Debjyoti; Li, Dapeng; Kath, Suraj; Loomis, Geoffrey; Nsoesie, Elaine O; Wen, Ming; Smith, Ken R; Li, Feifei

    2017-11-01

    To leverage geotagged Twitter data to create national indicators of the social environment, with small-area indicators of prevalent sentiment and social modeling of health behaviors, and to test associations with county-level health outcomes, while controlling for demographic characteristics. We used Twitter's streaming application programming interface to continuously collect a random 1% subset of publicly available geo-located tweets in the contiguous United States. We collected approximately 80 million geotagged tweets from 603 363 unique Twitter users in a 12-month period (April 2015-March 2016). Across 3135 US counties, Twitter indicators of happiness, food, and physical activity were associated with lower premature mortality, obesity, and physical inactivity. Alcohol-use tweets predicted higher alcohol-use-related mortality. Social media represents a new type of real-time data that may enable public health officials to examine movement of norms, sentiment, and behaviors that may portend emerging issues or outbreaks-thus providing a way to intervene to prevent adverse health events and measure the impact of health interventions.

  13. Impact of parent-child communication interventions on sex behaviors and cognitive outcomes for black/African-American and Hispanic/Latino youth: a systematic review, 1988-2012.

    Science.gov (United States)

    Sutton, Madeline Y; Lasswell, Sarah M; Lanier, Yzette; Miller, Kim S

    2014-04-01

    We reviewed human immunodeficiency virus (HIV) and sexually transmitted infection (STI)- behavioral interventions implemented with disproportionately affected black/African-American and Hispanic/Latino youth and designed to improve parent-child communications about sex. We compared their effectiveness in improving sex-related behavior or cognitive outcomes. A search of electronic databases identified peer-reviewed studies published between 1988 and 2012. Eligible studies were U.S.-based parent-child communication interventions with active parent components, experimental and quasiexperimental designs, measurement of youth sexual health outcomes, and enrollment of ≥ 50% black/African-American or Hispanic/Latino youth. We conducted systematic, primary reviews of eligible papers to abstract data on study characteristics and youth outcomes. Fifteen studies evaluating 14 interventions were eligible. Although youth outcome measures and follow-up times varied, 13 of 15 studies (87%) showed at least one significantly improved youth sexual health outcome compared with controls (p communication skills with their youth. Parent-child communication interventions that include parents of youth disproportionately affected by HIV/STIs can effectively reduce sexual risk for youth. These interventions may help reduce HIV/STI-related health disparities and improve sexual health outcomes. Published by Elsevier Inc.

  14. Cognitive Ability and Health-Related Behaviors during Adolescence: A Prospective Study across Five Years

    Science.gov (United States)

    Ciarrochi, Joseph; Heaven, Patrick C. L.; Skinner, Timothy

    2012-01-01

    Longitudinal research on the links between intelligence and health behaviors among adolescents is rare. We report longitudinal data in which we assessed the relationships between intelligence as assessed in Grade 7 and consequential health outcomes in Grade 11. The mean age of respondents (N = 420; 188 males, 232 females) was 12.30 years (SD =…

  15. Adolescents' expectations for the future predict health behaviors in early adulthood.

    Science.gov (United States)

    McDade, Thomas W; Chyu, Laura; Duncan, Greg J; Hoyt, Lindsay T; Doane, Leah D; Adam, Emma K

    2011-08-01

    Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual's investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.-perceived chances of living to middle age and perceived chances of attending college-are associated with an individual's engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. "Go Girls!": psychological and behavioral outcomes associated with a group-based healthy lifestyle program for adolescent girls.

    Science.gov (United States)

    Dowd, A Justine; Chen, Michelle Y; Jung, Mary E; Beauchamp, Mark R

    2015-03-01

    The objective of this study was to assess changes in adolescent girls' health-enhancing cognitions and behaviors targeted by the Go Girls! group-based mentorship lifestyle program. Three hundred and ten adolescent girls (nested within 40 Go Girls! groups) completed questionnaires that assessed cognitions (attitudes, self-regulatory efficacy, and intentions) and behaviors (physical activity and dietary) at four time points (two pre-program, one at the end of the program, and one at 7-week follow-up). Hierarchical linear modeling was used to examine changes in the outcome variables among Go Girls! participants (M age = 11.68 years, SD = 0.80). No significant changes occurred in the outcome variables during the baseline comparison period (Time 1-2). When compared to the average of the baseline assessments, 7 weeks after completing the program, girls reported significant improvements in physical activity (M Baseline PAtotal = 3.82, SD = 3.49; M T4 PAtotal = 4.38, SD = 3.75) and healthy eating (M Baseline = 10.71, SD = 1.13; M T4 = 11.35, SD = 1.05) behavior and related cognitions (d values ≥0.65). Findings provide preliminary support for programs that foster belongingness and target health behaviors through mentorship models.

  17. Health outcome after major trauma: what are we measuring?

    Directory of Open Access Journals (Sweden)

    Karen Hoffman

    Full Text Available Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.MEDLINE, EMBASE, and CINAHL (from 2006-2012 were searched for studies evaluating health outcome after traumatic injuries.Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF were used to evaluate to what extent outcome measures captured health impacts.34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%, functional activities (11% and environmental factors (2%.Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

  18. Decoding Pigeon Behavior Outcomes Using Functional Connections among Local Field Potentials.

    Science.gov (United States)

    Chen, Yan; Liu, Xinyu; Li, Shan; Wan, Hong

    2018-01-01

    Recent studies indicate that the local field potential (LFP) carries information about an animal's behavior, but issues regarding whether there are any relationships between the LFP functional networks and behavior tasks as well as whether it is possible to employ LFP network features to decode the behavioral outcome in a single trial remain unresolved. In this study, we developed a network-based method to decode the behavioral outcomes in pigeons by using the functional connectivity strength values among LFPs recorded from the nidopallium caudolaterale (NCL). In our method, the functional connectivity strengths were first computed based on the synchronization likelihood. Second, the strength values were unwrapped into row vectors and their dimensions were then reduced by principal component analysis. Finally, the behavioral outcomes in single trials were decoded using leave-one-out combined with the k -nearest neighbor method. The results showed that the LFP functional network based on the gamma-band was related to the goal-directed behavior of pigeons. Moreover, the accuracy of the network features (74 ± 8%) was significantly higher than that of the power features (61 ± 12%). The proposed method provides a powerful tool for decoding animal behavior outcomes using a neural functional network.

  19. Schools' mental health services and young children's emotions, behavior, and learning.

    Science.gov (United States)

    Reback, Randall

    2010-01-01

    Recent empirical research has found that children's noncognitive skills play a critical role in their own success, young children's behavioral and psychological disorders can severely harm their future outcomes, and disruptive students harm the behavior and learning of their classmates. Yet relatively little is known about wide-scale interventions designed to improve children's behavior and mental health. This is the first nationally representative study of the provision, financing, and impact of school-site mental health services for young children. Elementary school counselors are school employees who provide mental health services to all types of students, typically meeting with students one-on-one or in small groups. Given counselors' nonrandom assignment to schools, it is particularly challenging to estimate the impact of these counselors on student outcomes. First, cross-state differences in policies provide descriptive evidence that students in states with more aggressive elementary counseling policies make greater test score gains and are less likely to report internalizing or externalizing problem behaviors compared to students with similar observed characteristics in similar schools in other states. Next, difference-in-differences estimates exploiting both the timing and the targeted grade levels of states' counseling policy changes provide evidence that elementary counselors substantially influence teachers' perceptions of school climate. The adoption of state-funded counselor subsidies or minimum counselor–student ratios reduces the fraction of teachers reporting that their instruction suffers due to student misbehavior and reduces the fractions reporting problems with students physically fighting each other, cutting class, stealing, or using drugs. These findings imply that there may be substantial public and private benefits derived from providing additional elementary school counselors.

  20. Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Melissa L. Walls

    2017-09-01

    Full Text Available American Indian (AI communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose–response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.

  1. Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes.

    Science.gov (United States)

    Walls, Melissa L; Sittner, Kelley J; Aronson, Benjamin D; Forsberg, Angie K; Whitbeck, Les B; al'Absi, Mustafa

    2017-09-16

    American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose-response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients.

  2. Assessment of parental oral health knowledge and behaviors among American Indians of a Northern Plains tribe.

    Science.gov (United States)

    Wilson, Anne; Brega, Angela G; Batliner, Terrence S; Henderson, William; Campagna, Elizabeth J; Fehringer, Karen; Gallegos, Joaquin; Daniels, Dallas; Albino, Judith

    2014-01-01

    Investigate the relationship between sociodemographic variables and oral health knowledge and behaviors of American Indian (AI) parents as the initial step in a program aimed at reducing caries experience among AI children. Survey data were collected from a sample of 147 AI parents of children ages 0-7 years who are residents of a Northern Plains reservation. Questions addressed sociodemographic variables for parents/their children and parent oral health knowledge and behavior. Overall knowledge was measured as percentage of items answered correctly. Overall behavior was measured as percentage of items reflecting behavior consistent with accepted oral health recommendations. Oral health knowledge and behaviors, and the relationship between them, were evaluated across groups defined by quartiles. Parent sociodemographic variables were not significantly associated with behavior scores. Female gender, higher level of education, and higher income were significantly and positively associated with mean knowledge scores. Behavior and knowledge scores were significantly correlated. On average, survey participants identified the best answer for 75 percent of knowledge items and engaged in 58 percent of optimal oral health behaviors. Participants in higher oral health knowledge quartiles had greater adherence with recommended oral health behaviors than those in lower quartiles. Surveyed AI parents had reasonably high levels of knowledge about oral health and caries prevention for their children but engaged at relatively lower levels in parental behaviors necessary to promote oral health. Strategies focused on behavior change, rather than knowledge alone, may be most likely to affect oral health outcomes for AI children. © 2013 American Association of Public Health Dentistry.

  3. Responsible leader behavior in health sectors.

    Science.gov (United States)

    Longest, Beaufort

    2017-02-06

    Purpose The purpose of this paper is to expand attention to responsible leader behavior in the world's health sectors by explaining how this concept applies to health sectors, considering why health sector leaders should behave responsibly, reviewing how they can do so, and asserting potential impact through an applied example. Design/methodology/approach This paper is a viewpoint, reflecting conceptualizations rooted in leadership literature which are then specifically applied to health sectors. A definition of responsible leader behavior is affirmed and applied specifically in health sectors. Conceptualizations and viewpoints about practice of responsible leader behavior in health sectors and potential consequences are then discussed and asserted. Findings Leadership failures and debacles found in health, but more so in other sectors, have led leadership researchers to offer insights, many of them empirical, into the challenges of leadership especially by more clearly delineating responsible leader behavior. Practical implications Much of what has been learned in the research about responsible leader behavior offers pathways for health sector leaders to more fully practice responsible leadership. Social implications This paper asserts and provides a supporting example that greater levels of responsible leader behavior in health sectors hold potentially important societal benefits. Originality/value This paper is the first to apply emerging conceptualizations and early empirical findings about responsible leader behavior specifically to leaders in health sectors.

  4. Social media indicators of the food environment and state health outcomes.

    Science.gov (United States)

    Nguyen, Q C; Meng, H; Li, D; Kath, S; McCullough, M; Paul, D; Kanokvimankul, P; Nguyen, T X; Li, F

    2017-07-01

    Contextual factors can influence health through exposures to health-promoting and risk-inducing factors. The aim of this study was to (1) build, from geotagged Twitter and Yelp data, a national food environment database and (2) to test associations between state food environment indicators and health outcomes. This is a cross-sectional study based upon secondary analyses of publicly available data. Using Twitter's Streaming Application Programming Interface (API), we collected and processed 4,041,521 food-related, geotagged tweets between April 2015 and March 2016. Using Yelp's Search API, we collected data on 505,554 unique food-related businesses. In linear regression models, we examined associations between food environment characteristics and state-level health outcomes, controlling for state-level differences in age, percent non-Hispanic white, and median household income. A one standard deviation increase in caloric density of food tweets was related to higher all-cause mortality (+46.50 per 100,000), diabetes (+0.75%), obesity (+1.78%), high cholesterol (+1.40%), and fair/poor self-rated health (2.01%). More burger Yelp listings were related to higher prevalence of diabetes (+0.55%), obesity (1.35%), and fair/poor self-rated health (1.12%). More alcohol tweets and Yelp bars and pub listings were related to higher state-level binge drinking and heavy drinking, but lower mortality and lower percent reporting fair/poor self-rated health. Supplemental analyses with county-level social media indicators and county health outcomes resulted in finding similar but slightly attenuated associations compared to those found at the state level. Social media can be utilized to create indicators of the food environment that are associated with area-level mortality, health behaviors, and chronic conditions. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  5. Modifying and developing health behavior.

    Science.gov (United States)

    Green, L W

    1984-01-01

    The literatures on both behavior modification and behavioral development have engendered innovations in public health programs, addressing problems of patient adherance to preventive and therapeutic regimens, delay in seeking diagnosis of illness symptoms, risk-taking behavior, and other aspects of lifestyle associated with health. Because most of this literature derives from psychology, there has been a distinct bias in the construction of interventions, pointing them directly at individuals, usually in a counseling or small group mode of delivery. These developments served public health well enough during a decade or so when the preoccupation was with utilization of health services and medical management of chronic diseases. With the publication of the Lalonde Report in Canada in 1974, the passage of Public Law 94-317 in 1976 in the United States, and similar initiatives in other English-speaking and European countries, the recognition of the greater complexities of lifestyle development and modification in the absence of symptoms has taken hold. Policy makers and public health workers seek a more efficient and equitable set of strategies to meet the behavioral health challenges of modern society without placing the entire weight of responsibility for behavior on the individual or on therapeutic practitioners. Concurrently, on a more global scale and in the developing countries, a concern has emerged for strategies that give individuals, families, and communities a greater role in deciding their own health priorities. The convergence of these two trends--one seeking to distribute responsibility for lifestyle more equitably and the other seeking to distribute responsibility for planning health programs more equitably --calls for policies, strategies, and interventions that will place similar emphasis on health education and organizational, economic, and environmental supports for health behavior. The combination of these elements of support for behavior calls, in

  6. Behavioral and Mental Health Correlates of Youth Stalking Victimization

    Science.gov (United States)

    Reidy, Dennis E.; Smith-Darden, Joanne P.; Kernsmith, Poco D.

    2018-01-01

    Introduction Although recognized as a public health problem, little attention has been paid to the problem of stalking among youth. Latent profile analysis was used to identify latent groups of adolescent stalking victims and their behavioral and mental health correlates. Methods A cross-sectional sample of 1,236 youths were randomly selected from 13 schools stratified by community risk level (i.e., low, moderate, and high risk) and gender. Students completed surveys assessing behavioral indicators of stalking victimization, as well as substance use, sexual behavior, dating violence, and psychiatric symptoms. Data were collected in 2013 and data analyses were performed in 2015. Results Analysis indicated the presence of a non-victim class, a minimal exposure class, and a victim class for boys and girls alike. Approximately 14% of girls and 13% of boys were in the stalking victim class. Adolescents in the victim class reported more symptoms of post-traumatic stress, mood disorder, and hopelessness, as well as more instances of alcohol use, binge drinking, and physical dating violence victimization. Girls in the victim class also reported engaging in sexting behaviors and oral sex with significantly more partners than their non-victim peers. Conclusions These findings provide valuable knowledge of the prevalence and pertinent health correlates of stalking victimization in adolescence. The data suggest a substantial proportion of adolescents are victims of stalking and are likewise at risk for a number of deleterious health outcomes. As such, this population merits further attention by prevention researchers and practitioners. PMID:27743623

  7. Analysis of Health Behaviors and Personal Values of Childless Women, Pregnant Women and Women Who Recently Delivered

    Science.gov (United States)

    Misztal-Okońska, Patrycja; Rudnicka-Drożak, Ewa; Młynarska, Magdalena; Czekierdowski, Artur

    2018-01-01

    Preconception lifestyle modifications and reduction of several known risk factors may have an influence on future pregnancy outcomes. The aim of the study was to analyze health behaviors and personal values as well as to assess the relationship between these factors in women without children, in pregnant women and in women who had already delivered babies. The questionnaire survey included the Health Behavior Inventory (HBI), the Personal Value List (PVL) and sociodemographic data and was conducted in 538 women. These women were divided into three groups: women who had recently delivered (n = 235), pregnant women (n = 121) and childless women (n = 182). Pregnant women demonstrated a significantly higher level of declared health behaviors, and also, they rated higher on the subscales values “positive mental attitude” and “health practices”, in comparison to women who had recently delivered and to childless women. In all tested groups, the highest rated personal value was “a successful family life”, while the most appreciated symbol of happiness was “love and friendship”. Our results suggest that the system of values and the perception of happiness symbols may influence women’s health behaviors. Positioning “health” in the hierarchy of personal values as the most important one may facilitate the introduction of healthy behaviors. This, in turn, could reduce several adverse pregnancy outcomes that are potentially modifiable with changing preconception health attitudes. Our results also identify several unanswered questions and highlight areas where new research is needed. PMID:29495488

  8. Does non-standard work mean non-standard health? Exploring links between non-standard work schedules, health behavior, and well-being

    Directory of Open Access Journals (Sweden)

    Megan R. Winkler

    2018-04-01

    Full Text Available The last century has seen dramatic shifts in population work circumstances, leading to an increasing normalization of non-standard work schedules (NSWSs, defined as non-daytime, irregular hours. An ever-growing body of evidence links NSWSs to a host of non-communicable chronic conditions; yet, these associations primarily concentrate on the physiologic mechanisms created by circadian disruption and insufficient sleep. While important, not all NSWSs create such chronobiologic disruption, and other aspects of working time and synchronization could be important to the relationships between work schedules and chronic disease. Leveraging survey data from Project EAT, a population-based study with health-related behavioral and psychological data from U.S. adults aged 25–36 years, this study explored the risks for a broad range of less healthful behavioral and well-being outcomes among NSWS workers compared to standard schedule workers (n = 1402. Variations across different NSWSs (evening, night/rotating, and irregular schedules were also explored. Results indicated that, relative to standard schedule workers, workers with NSWSs are at increased risk for non-optimal sleep, substance use, greater recreational screen time, worse dietary practices, obesity, and depression. There was minimal evidence to support differences in relative risks across workers with different types of NSWSs. The findings provide insight into the potential links between NSWSs and chronic disease and indicate the relevancy social disruption and daily health practices may play in the production of health and well-being outcomes among working populations. Keywords: United States, Work schedule tolerance, Health behavior, Mental health, Substance abuse, Obesity

  9. Outcome mapping for health system integration

    Directory of Open Access Journals (Sweden)

    Tsasis P

    2013-03-01

    Full Text Available Peter Tsasis,1 Jenna M Evans,2 David Forrest,3 Richard Keith Jones4 1School of Health Policy and Management, Faculty of Health, York University, Toronto, Canada; 2Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada; 3Global Vision Consulting Ltd, Victoria, Canada; 4R Keith Jones and Associates, Victoria, Canada Abstract: Health systems around the world are implementing integrated care strategies to improve quality, reduce or maintain costs, and improve the patient experience. Yet few practical tools exist to aid leaders and managers in building the prerequisites to integrated care, namely a shared vision, clear roles and responsibilities, and a common understanding of how the vision will be realized. Outcome mapping may facilitate stakeholder alignment on the vision, roles, and processes of integrated care delivery via participative and focused dialogue among diverse stakeholders on desired outcomes and enabling actions. In this paper, we describe an outcome-mapping exercise we conducted at a Local Health Integration Network in Ontario, Canada, using consensus development conferences. Our preliminary findings suggest that outcome mapping may help stakeholders make sense of a complex system and foster collaborative capital, a resource that can support information sharing, trust, and coordinated change toward integration across organizational and professional boundaries. Drawing from the theoretical perspectives of complex adaptive systems and collaborative capital, we also outline recommendations for future outcome-mapping exercises. In particular, we emphasize the potential for outcome mapping to be used as a tool not only for identifying and linking strategic outcomes and actions, but also for studying the boundaries, gaps, and ties that characterize social networks across the continuum of care. Keywords: integrated care, integrated delivery systems, complex adaptive systems, social capital

  10. Are health behavior change interventions that use online social networks effective? A systematic review.

    Science.gov (United States)

    Maher, Carol A; Lewis, Lucy K; Ferrar, Katia; Marshall, Simon; De Bourdeaudhuij, Ilse; Vandelanotte, Corneel

    2014-02-14

    The dramatic growth of Web 2.0 technologies and online social networks offers immense potential for the delivery of health behavior change campaigns. However, it is currently unclear how online social networks may best be harnessed to achieve health behavior change. The intent of the study was to systematically review the current level of evidence regarding the effectiveness of online social network health behavior interventions. Eight databases (Scopus, CINAHL, Medline, ProQuest, EMBASE, PsycINFO, Cochrane, Web of Science and Communication & Mass Media Complete) were searched from 2000 to present using a comprehensive search strategy. Study eligibility criteria were based on the PICOS format, where "population" included child or adult populations, including healthy and disease populations; "intervention" involved behavior change interventions targeting key modifiable health behaviors (tobacco and alcohol consumption, dietary intake, physical activity, and sedentary behavior) delivered either wholly or in part using online social networks; "comparator" was either a control group or within subject in the case of pre-post study designs; "outcomes" included health behavior change and closely related variables (such as theorized mediators of health behavior change, eg, self-efficacy); and "study design" included experimental studies reported in full-length peer-reviewed sources. Reports of intervention effectiveness were summarized and effect sizes (Cohen's d and 95% confidence intervals) were calculated wherever possible. Attrition (percentage of people who completed the study), engagement (actual usage), and fidelity (actual usage/intended usage) with the social networking component of the interventions were scrutinized. A total of 2040 studies were identified from the database searches following removal of duplicates, of which 10 met inclusion criteria. The studies involved a total of 113,988 participants (ranging from n=10 to n=107,907). Interventions included

  11. Gender Differences in the Effects of Behavioral Problems on School Outcomes

    DEFF Research Database (Denmark)

    Kristoffersen, Jannie H. G.; Smith, Nina

    Questionnaire (SDQ) of about 6,000 children born in 1990-92 in a large region in Denmark. The sample is merged with register information on parents and students observed until the age of 19. We find significant and large negative coefficients of the externalizing behavioral indicators. The effects tend......Behavioral problems are important determinants of school outcomes and later success in the labor market. We analyze whether behavioral problems affect girls and boys differently with respect to school outcomes. The study is based on teacher and parent evaluations of the Strength and Difficulties...... to be larger when based on parents' SDQ scores compared to teachers' SDQ scores. According to our estimations, the school outcomes for girls with abnormal externalizing behavior are not significantly different from those of boys with the same behavioral problems. A decomposition of the estimates indicates...

  12. Power of Peer Support to Change Health Behavior to Reduce Risks for Heart Disease and Stroke for African American Men in a Faith-Based Community.

    Science.gov (United States)

    Lee, Sohye; Schorr, Erica; Hadidi, Niloufar Niakosari; Kelley, Robin; Treat-Jacobson, Diane; Lindquist, Ruth

    2018-02-01

    Peer support has powerful potential to improve outcomes in a program of health behavior change; yet, how peer support is perceived by participants, its role, and how it contributes to intervention efficacy is not known, especially among African Americans. The purpose of this study was to identify the subjectively perceived experience and potential contributions of peer support to the outcomes of a peer group behavioral intervention designed to change health behavior to reduce risks for heart disease and stroke in African American men in a faith-based community. A peer support group intervention was implemented to increase health knowledge and to improve health behaviors in line with the American Heart Association's Life Simple 7 domains (get active, control cholesterol, eat better, manage blood pressure, lose weight, reduce blood sugar, and stop smoking). Fourteen peer group sessions and eight follow-up interviews with program participants were recorded, transcribed, and analyzed. Seven key themes emerged, including (1) enhancing access to health behavior information and resources, (2) practicing and applying problem-solving skills with group feedback and support, (3) discussing health behavior challenges and barriers, (4) sharing health behavior changes, (5) sharing perceived health outcome improvements and benefits, (6) feelings of belonging and being cared for, and (7) addressing health of family and community. Qualitative findings revealed a positive perception of peer support and greater understanding of potential reasons why it may be an effective strategy for African American men.

  13. Broadening measures of success: results of a behavioral health translational research training program.

    Science.gov (United States)

    Baldwin, Julie A; Williamson, Heather J; Eaves, Emery R; Levin, Bruce L; Burton, Donna L; Massey, Oliver T

    2017-07-24

    While some research training programs have considered the importance of mentoring in inspiring professionals to engage in translational research, most evaluations emphasize outcomes specific to academic productivity as primary measures of training program success. The impact of such training or mentoring programs on stakeholders and local community organizations engaged in translational research efforts has received little attention. The purpose of this evaluation is to explore outcomes other than traditional academic productivity in a translational research graduate certificate program designed to pair graduate students and behavioral health professionals in collaborative service-learning projects. Semi-structured qualitative interviews with scholars, community mentors, and academic mentors were conducted regarding a translational research program to identify programmatic impacts. Interviews were transcribed and coded by the research team to identify salient themes related to programmatic outcomes. Results are framed using the Translational Research Impact Scale which is organized into three overarching domains of potential impact: (1) research-related impacts, (2) translational impacts, and (3) societal impacts. This evaluation demonstrates the program's impact in all three domains of the TRIS evaluation framework. Graduate certificate participants (scholars) reported that gaining experience in applied behavioral health settings added useful skills and expertise to their present careers and increased their interest in pursuing translational research. Scholars also described benefits resulting from networks gained through participation in the program, including valuable ties between the university and community behavioral health organizations. This evaluation of the outcomes of a graduate certificate program providing training in translational research highlights the need for more community-oriented and practice-based measures of success. Encouraging practitioner

  14. Concordance in the Health Behaviors of Couples by Age: A Cross-sectional Study

    Directory of Open Access Journals (Sweden)

    Seungmin Jeong

    2018-01-01

    Full Text Available Objectives To investigate concordance in the health behaviors of women and their partners according to age and to investigate whether there was a stronger correlation between the health behaviors of housewives and those of their partners than between the health behaviors of non-housewives and those of their partners. Methods We used data obtained from women participants in the 2015 Korea Community Health Survey who were living with their partners. The outcome variables were 4 health behaviors: smoking, drinking, eating salty food, and physical activity. The main independent variables were the partners’ corresponding health behaviors. We categorized age into 4 groups (19-29, 30-49, 50-64, and ≥ 65 years and utilized multivariate logistic regression analysis, stratifying by age group. Another logistic regression analysis was stratified by whether the participant identified as a housewife. Results Data from 64 971 women older than 18 years of age were analyzed. Of the 4 health behaviors, the risk of smoking (adjusted odds ratio [aOR], 4.65; 95% confidence interval [CI], 3.93 to 5.49 was highest when the participant’s partner was also a smoker. Similar results were found for an inactive lifestyle (aOR, 2.56; 95% CI, 2.45 to 2.66, eating salty food (aOR, 2.48; 95% CI, 2.36 to 2.62; and excessive drinking (aOR, 1.89; 95% CI, 1.80 to 1.98. In comparison to non-housewives, housewives had higher odds of eating salty food. Conclusions The health behaviors of women were positively correlated with those of their partners. The magnitude of the concordance differed by age group.

  15. Impact of bullying in childhood on adult health, wealth, crime, and social outcomes.

    Science.gov (United States)

    Wolke, Dieter; Copeland, William E; Angold, Adrian; Costello, E Jane

    2013-10-01

    Bullying is a serious problem for schools, parents, and public-policymakers alike. Bullying creates risks of health and social problems in childhood, but it is unclear if such risks extend into adulthood. A large cohort of children was assessed for bullying involvement in childhood and then followed up in young adulthood in an assessment of health, risky or illegal behavior, wealth, and social relationships. Victims of childhood bullying, including those that bullied others (bully-victims), were at increased risk of poor health, wealth, and social-relationship outcomes in adulthood even after we controlled for family hardship and childhood psychiatric disorders. In contrast, pure bullies were not at increased risk of poor outcomes in adulthood once other family and childhood risk factors were taken into account. Being bullied is not a harmless rite of passage but throws a long shadow over affected people's lives. Interventions in childhood are likely to reduce long-term health and social costs.

  16. Associations between Mental Health and Ebola-Related Health Behaviors: A Regionally Representative Cross-sectional Survey in Post-conflict Sierra Leone.

    Directory of Open Access Journals (Sweden)

    Theresa S Betancourt

    2016-08-01

    Full Text Available Little attention has been paid to potential relationships between mental health, trauma, and personal exposures to Ebola virus disease (EVD and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors.Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between war exposures, post-traumatic stress disorder (PTSD symptoms, depression, anxiety, and personal EVD exposure (e.g., having family members or friends diagnosed with EVD and EVD-related health behaviors among 1,008 adults (98% response rate from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January-April 2015. Primary outcomes were EVD risk behaviors (14 items, Cronbach's α = 0.84 and EVD prevention behaviors (16 items, Cronbach's α = 0.88. Main predictors comprised war exposures (8 items, Cronbach's α = 0.85, anxiety (10 items, Cronbach's α = 0.93, depression (15 items, Cronbach's α = 0.91, and PTSD symptoms (16 items, Cronbach's α = 0.93. Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037, PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008, having a friend diagnosed with EVD (b = -0.04; 95% CI -0.08, -0.00; p = 0.036, and war exposures (b = -0.09; 95% CI -0.17, -0.02; p = 0.013. EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008, having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011, and higher levels of war exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003, independent of mental health. PTSD symptoms were associated with lower levels of EVD prevention behavior

  17. The Effect of Health Beliefs, Media Perceptions, and Communicative Behaviors on Health Behavioral Intention: An Integrated Health Campaign Model on Social Media.

    Science.gov (United States)

    Yoo, Sun-Wook; Kim, Jarim; Lee, Yeunjae

    2018-01-01

    Social media have recently gained attention as a potential health campaign tool. This study examines this line of expectation concerning the role social media may play in health campaigns by testing an integrated health campaign model that combines insights from research on social media-specific perceptions and communicative behaviors in order to predict health behaviors. Specifically, this study aims to (a) develop a more holistic social media campaign model for predicting health behaviors in the social media context, (b) investigate how social media channel-related perceptions affect preventive health behaviors, and (c) investigate how communicative behaviors mediate perceptions and behavioral intention. The study conducted an online survey of 498 females who followed the Purple Ribbon Twitter campaign (@pprb), a cervical cancer prevention campaign. The results indicated that information acquisition mediated perceived risk's effect on intention. Information acquisition also mediated the relationships between intention and information selection and information transmission. On the other hand, social media-related perceptions indirectly impacted behavioral intention through communicative behaviors. The findings' theoretical and practical implications are discussed.

  18. Does Mother Know Best? Parental Discrepancies in Assessing Child Behavioral and Educational Outcomes

    DEFF Research Database (Denmark)

    Gupta, Nabanita Datta; Lausten, Mette; Pozzoli, Dario

    2018-01-01

    We investigate the degree of correspondence between parents’ reports on child behavioral and educational outcomes using wave four of a rich Danish longitudinal survey of children (the DALSC). All outcomes are measured at age 11 when the children are expected to be in fifth grade. Once discrepancies...... are detected, we analyze whether they are driven by noisy evaluations or by systematic bias, focusing on the role of parental characteristics and response heterogeneity. We then explicitly assess the relative importance of the mother’s versus the father’s assessments in explaining child academic performance...... and diagnosed mental health to investigate whether one parent is systematically a better informant of their child’s outcomes than the other. Our results show that parental psychopathology, measured as maternal distress, is a source of systematic misreporting of child functioning, that the parent–child...

  19. Family-based risk reduction of obesity and metabolic syndrome: an overview and outcomes of the Idaho Partnership for Hispanic Health.

    Science.gov (United States)

    Schwartz, Rachel; Powell, Linda; Keifer, Matthew

    2013-01-01

    Mexican American women have the highest incidence of metabolic syndrome among all U.S. demographic groups. This paper details an innovative approach to reducing the risks for metabolic syndrome among Hispanic families in rural Idaho. Compañeros en Salud (CeS) is a promotora-led wellness program and community-based participatory research project from the Idaho Partnership for Hispanic Health. As behavior change is the first line of prevention and treatment of obesity and metabolic syndrome, the program aimed to improve nutrition and physical activity behaviors as well as increase community support and infrastructure for healthy living. CeS has demonstrated substantial improvement in health outcomes, with statistically significant reductions in weight, BMI, metabolic syndrome risk, A1c, glucose, blood pressure, and cholesterol, from pre-intervention to post-intervention and/or pre-intervention to one-year follow-up. These outcomes suggest the CeS model as a promising best practice for effecting individual and family-level physiologic and behavioral outcomes for obesity prevention.

  20. Veterans Health Administration Behavioral Health Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of VHA hospitals with behavioral health measure data. VHA reports data on a set of core performance measures for Hospital-Based Inpatient Psychiatric Services...

  1. Impact factor analysis: combining prediction with parameter ranking to reveal the impact of behavior on health outcome

    DEFF Research Database (Denmark)

    Doryab, Afsaneh; Frost, Mads; Faurholt-Jepsen, Maria

    2015-01-01

    An increasing number of healthcare systems allow people to monitor behavior and provide feedback on health and wellness. Most applications, however, only offer feedback on behavior in form of visualization and data summaries. This paper presents a different approach—called impact factor analysis—...... in monitoring and control of mental illness, and we argue that the impact factor analysis can be useful in the design of other health and wellness systems....... ten bipolar patients, in which we were able to estimate mood values with an average mean absolute error of 0.5. This was used to rank the behavior parameters whose variations indicate changes in the mental state. The rankings acquired from our algorithms correspond to the patients’ rankings......, identifying physical activity and sleep as the highest impact parameters. These results revealed the feasibility of identifying behavioral impact factors. This data analysis motivated us to design an impact factor inference engine as part of the MONARCA system. To our knowledge, this is a novel approach...

  2. Benefits Innovations in Employee Behavioral Health.

    Science.gov (United States)

    Sherman, Bruce; Block, Lori

    2017-01-01

    More and more employers recognize the business impact of behavioral health concerns in the workplace. This article provides insights into some of the current innovations in behavioral health benefits, along with their rationale for development. Areas of innovation include conceptual and delivery models, technological advance- ments, tools for engaging employees and ways of quantifying the business value of behavioral health benefits. The rapid growth of innovative behavioral health services should provide employers with confidence that they can tailor a program best suited to their priorities, organizational culture and cost limitations.

  3. Health Risk Behavior in Foster Youth

    Science.gov (United States)

    Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie; Monasterio, Erica; Robbins, Nancy

    2010-01-01

    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. PMID:19490278

  4. Self-rated health in rural Appalachia: health perceptions are incongruent with health status and health behaviors

    Directory of Open Access Journals (Sweden)

    Pyle Donald N

    2011-04-01

    Full Text Available Abstract Background Appalachia is characterized by poor health behaviors, poor health status, and health disparities. Recent interventions have not demonstrated much success in improving health status or reducing health disparities in the Appalachian region. Since one's perception of personal health precedes his or her health behaviors, the purpose of this project was to evaluate the self-rated health of Appalachian adults in relation to objective health status and current health behaviors. Methods Appalachian adults (n = 1,576 were surveyed regarding health behaviors - soda consumer (drink ≥ 355 ml/d, or non-consumer (drink 30 min > 1 d/wk and sedentary (exercise Results Respondents reported being healthy, while being sedentary (65%, hypertensive (76%, overweight (73%, or hyperlipidemic (79%. Between 57% and 66% of the respondents who considered themselves healthy had at least two disease conditions or poor health behaviors. Jaccard Binary Similarity coefficients and odds ratios showed the probability of reporting being healthy when having a disease condition or poor health behavior was high. Conclusions The association between self-rated health and poor health indicators in Appalachian adults is distorted. The public health challenge is to formulate messages and programs about health and health needs which take into account the current distortion about health in Appalachia and the cultural context in which this distortion was shaped.

  5. Relationships Between eHealth Literacy and Health Behaviors in Korean Adults.

    Science.gov (United States)

    Kim, Sun-Hee; Son, Youn-Jung

    2017-02-01

    The Internet is a useful and accessible source for health-related information for modern healthcare consumers. Individuals with adequate eHealth literacy have an incentive to use the Internet to access health-related information, and they consider themselves capable of using Web-based knowledge for health. This cross-sectional study aimed to describe the relationship between eHealth literacy and health behaviors. A total of 230 adults aged 18 to 39 years and residing in South Korea participated in the study. The mean (SD) score for eHealth literacy was 25.52 (4.35) of a total possible score of 40. The main source of health information was the Internet. Using hierarchical linear regression, the results showed that eHealth literacy was the strongest predictor of health behaviors after adjusting for general characteristics. These findings indicate that eHealth literacy can be an important factor in promoting individual health behaviors. Further research on eHealth literacy and actual health behaviors including intention and self-reported health behaviors are required to explain the impact of eHealth literacy on overall health status.

  6. The effect of low birth weight on height, weight and behavioral outcomes in the medium-run

    DEFF Research Database (Denmark)

    Datta Gupta, Nabanita; Deding, Mette; Lausten, Mette

    2013-01-01

    as physical growth at ages 6 months, 3½, 7½ and 11 years using data from the Danish Longitudinal Survey of Children. Observing the same children at different points in time enabled us to chart the evolution of anthropometric and behavioral deficits among children born with low birth weight and helped......A number of studies have documented negative long term effects of low birth weight. Yet, not much is known about the dynamics of the process leading to adverse health and educational outcomes in the long run. While previous studies focusing mainly on LBW effects on physical growth and cognitive...... outcomes have found effects of the same size at both school age and young adulthood, others have found a diminishing negative effect over time. The purpose of this paper was to bring new evidence to this issue by analyzing the medium run effects of low birth weight on child behavioral outcomes as well...

  7. Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis.

    Science.gov (United States)

    Adam, Emma K; Quinn, Meghan E; Tavernier, Royette; McQuillan, Mollie T; Dahlke, Katie A; Gilbert, Kirsten E

    2017-09-01

    Changes in levels of the stress-sensitive hormone cortisol from morning to evening are referred to as diurnal cortisol slopes. Flatter diurnal cortisol slopes have been proposed as a mediator between chronic psychosocial stress and poor mental and physical health outcomes in past theory and research. Surprisingly, neither a systematic nor a meta-analytic review of associations between diurnal cortisol slopes and health has been conducted to date, despite extensive literature on the topic. The current systematic review and meta-analysis examined associations between diurnal cortisol slopes and physical and mental health outcomes. Analyses were based on 179 associations from 80 studies for the time period up to January 31, 2015. Results indicated a significant association between flatter diurnal cortisol slopes and poorer health across all studies (average effect size, r=0.147). Further, flatter diurnal cortisol slopes were associated with poorer health in 10 out of 12 subtypes of emotional and physical health outcomes examined. Among these subtypes, the effect size was largest for immune/inflammation outcomes (r=0.288). Potential moderators of the associations between diurnal cortisol slopes and health outcomes were examined, including type of slope measure and study quality indices. The possible roles of flatter slopes as either a marker or a mechanism for disease etiology are discussed. We argue that flatter diurnal cortisol slopes may both reflect and contribute to stress-related dysregulation of central and peripheral circadian mechanisms, with corresponding downstream effects on multiple aspects of biology, behavior, and health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Associations of health behaviors, school performance and psychosocial problems in adolescents in The Netherlands.

    Science.gov (United States)

    Busch, Vincent; Laninga-Wijnen, Lydia; Schrijvers, Augustinus Jacobus Petrus; De Leeuw, Johannes Rob Josephus

    2017-04-01

    School-based health-promoting interventions show promising results in improving various health outcomes of adolescents. Unfortunately, much is still unknown about the relations between health behaviors and school performances, while improving these would give schools a stronger incentive to invest in health promotion. This paper presents the associations of several health behaviors with school performances and studies the mediating effects of psychosocial problems. Health behavior and socio-demographic data were gathered from 905 Dutch high school students via an online survey, completed in-class. These data were matched with school records of the students' overall grade average (GA) on the three core subjects in Dutch high schools (Dutch, English and Math). The associations between health behaviors and school performances, and the potentially mediating effects of psychosocial problems, were studied via mixed-effects regression models. Smoking, being bullied, compulsive and excessive internet use and low physical activity were directly associated with lower school grades. Additionally, being bullied, bullying, smoking, excessive and compulsive internet use were associated with students' grades via mediation of psychosocial problems. This means that lower school grades were (also) associated with those behaviors through the effects of psychosocial problems in those students. This study showed the strong links between health behaviors and academic achievements among adolescents. Schools and health promoters should be educated more on these relations, so that they are aware of this common interest to get more support for health-promoting interventions. Additionally, the role of psychosocial problems in the relations between behaviors and school performances should be studied further in future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Development and initial feasibility of an organizational measure of behavioral health integration in medical care settings.

    Science.gov (United States)

    McGovern, Mark P; Urada, Darren; Lambert-Harris, Chantal; Sullivan, Steven T; Mazade, Noel A

    2012-12-01

    In the advent of health care reform, models are sought to integrate behavioral health and routine medical care services. Historically, the behavioral health specialty has not itself been integrated, but instead bifurcated by substance use and mental health across treatment systems, care providers and even research. With the present opportunity to transform the health care delivery system, it is incumbent upon policymakers, researchers and clinicians to avoid repeating this historical error, and provide integrated behavioral health services in medical contexts. An organizational measure designed to assess this capacity is described: the Dual Diagnosis Capability in Health Care Settings (DDCHCS). The DDCHCS was used to assess a sample of federally-qualified health centers (N=13) on the degree of behavioral health integration. The measure was found to be feasible and sensitive to detecting variation in integrated behavioral health services capacity. Three of the 13 agencies were dual diagnosis capable, with significant variation in DDCHCS dimensions measuring staffing, treatment practices and program milieu. In general, mental health services were more integrated than substance use. Future research should consider a revised version of the measure, a larger and more representative sample, and linking organizational capacity with patient outcomes. Copyright © 2012. Published by Elsevier Inc.

  10. Outcomes of Sexual Behaviors among Sexual Minority Youth

    Science.gov (United States)

    Morgan, Elizabeth M.

    2014-01-01

    Very little is known about outcomes of sexual behavior for sexual minority youth. In this chapter, I review relevant literature and draw on findings from my own research to initiate an inquiry into this important topic. I begin with a brief overview of the range of sexual behaviors of sexual minority adolescents and young adults. Next, I describe…

  11. What Older Adolescents Expect from Physical Activity: Implicit Cognitions Regarding Health and Appearance Outcomes

    Science.gov (United States)

    McFadden, K.; Berry, T. R.; McHugh, T. F.; Rodgers, W. M.

    2018-01-01

    Objective: To explore older adolescents' reflective and impulsive thoughts about health- and social/appearance-related physical activity (PA) outcomes and investigate how those thoughts relate to their PA behavior. Participants: One hundred and forty-four undergraduate students (109 women; 35 men) aged 17-19 years (M = 18.11, SD = 0.65)…

  12. Dark triad traits and health outcomes: An exploratory study

    Directory of Open Access Journals (Sweden)

    Jasna Hudek-Knežević

    2016-04-01

    Full Text Available On the sample of 637 participants (358 women and 279 men we explored the relationshipbetween Dark Triad traits (psychopathy, Machiavellianism and Narcissism and various healthindicators including subjective (positive and negative mood and perceived physical symptoms,protective health behaviors as well as some more objective health indicators (number ofhospitalizations, number of diseases, having specific chronic diseases, injuries and addictions.Because of the moderate relations between Dark Triad and broad personality traits that also exerttheir influence on various health-related indices, we examined the unique effects of Dark Triad traitson health indicators above and beyond five-factor personality traits as well as sociodemographicvariables related to health (gender, age and education.When sociodemographic variables, as well as five-factor personality traits were controlled inhierarchical regression analyses, Dark Triad traits significantly improved the prediction of almostall subjective health indicators, protective health behaviors, number of hospitalizations and numberof diseases. The effect sizes obtained were relatively low, and psychopathy was the most consistentpredictor.Regarding chronic diseases, injuries and addictions, the results of hierarchical binary logisticregressions showed that when sociodemographic variables were controlled, psychopathy was apositive predictor of the risk of digestive diseases, tobacco use and injuries, Machiavellianismnegatively predicted the risk of injuries, while Narcissism negatively predicted the risk of skindiseases and tobacco use. When five-factor personality traits were controlled, psychopathy was alsoa positive predictor of digestive diseases, tobacco use and injuries. Machiavellianism was a positivepredictor of high blood pressure, and negative predictor of cancer, spine and back diseases andinjuries, while Narcissism was a negative predictor of skin diseases.The results obtained are discussed

  13. Active Commuting: Workplace Health Promotion for Improved Employee Well-Being and Organizational Behavior.

    Science.gov (United States)

    Page, Nadine C; Nilsson, Viktor O

    2016-01-01

    Objective: This paper describes a behavior change intervention that encourages active commuting using electrically assisted bikes (e-bikes) for health promotion in the workplace. This paper presents the preliminary findings of the intervention's impact on improving employee well-being and organizational behavior, as an indicator of potential business success. Method: Employees of a UK-based organization participated in a workplace travel behavior change intervention and used e-bikes as an active commuting mode; this was a change to their usual passive commuting behavior. The purpose of the intervention was to develop employee well-being and organizational behavior for improved business success. We explored the personal benefits and organizational co-benefits of active commuting and compared these to a travel-as-usual group of employees who did not change their behavior and continued taking non-active commutes. Results: Employees who changed their behavior to active commuting reported more positive affect, better physical health and more productive organizational behavior outcomes compared with passive commuters. In addition, there was an interactive effect of commuting mode and commuting distance: a more frequent active commute was positively associated with more productive organizational behavior and stronger overall positive employee well-being whereas a longer passive commute was associated with poorer well-being, although there was no impact on organizational behavior. Conclusion: This research provides emerging evidence of the value of an innovative workplace health promotion initiative focused on active commuting in protecting and improving employee well-being and organizational behavior for stronger business performance. It considers the significant opportunities for organizations pursuing improved workforce well-being, both in terms of employee health, and for improved organizational behavior and business success.

  14. Improving health outcomes with better patient understanding and education

    Directory of Open Access Journals (Sweden)

    Robert John Adams

    2010-10-01

    Full Text Available Robert John AdamsThe Health Observatory, The Queen Elizabeth Hospital Campus, The University of Adelaide, Woodville, South Australia, AustraliaAbstract: A central plank of health care reform is an expanded role for educated consumers interacting with responsive health care teams. However, for individuals to realize the benefits of health education also requires a high level of engagement. Population studies have documented a gap between expectations and the actual performance of behaviours related to participation in health care and prevention. Interventions to improve self-care have shown improvements in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Significant clinical benefits have been seen from trials of self-management or lifestyle interventions across conditions such as diabetes, coronary heart disease, heart failure and rheumatoid arthritis. However, the focus of many studies has been on short-term outcomes rather that long term effects. There is also some evidence that participation in patient education programs is not spread evenly across socio economic groups. This review considers three other issues that may be important in increasing the public health impact of patient education. The first is health literacy, which is the capacity to seek, understand and act on health information. Although health literacy involves an individual’s competencies, the health system has a primary responsibility in setting the parameters of the health interaction and the style, content and mode of information. Secondly, much patient education work has focused on factors such as attitudes and beliefs. That small changes in physical environments can have large effects on behavior and can be utilized in self-management and chronic disease research. Choice architecture involves reconfiguring the context or physical environment in a way that makes it more likely that people will choose certain behaviours. Thirdly

  15. Sexual health behaviors and sexual orientation in a U.S. national sample of college students.

    Science.gov (United States)

    Oswalt, Sara B; Wyatt, Tammy J

    2013-11-01

    Many studies have examined differences in sexual behavior based on sexual orientation with results often indicating that those with same-sex partners engage in higher risk sexual behavior than people with opposite sex partners. However, few of these studies were large, national sample studies that also include those identifying as unsure. To address that gap, this study examined the relationship of sexual orientation and sexual health outcomes in a national sample of U.S. college students. The Fall 2009 American College Health Association-National College Health Assessment was used to examine sexual health related responses from heterosexual, gay, lesbian, bisexual, and unsure students (N = 25,553). Responses related to sexual behavior, safer sex behaviors, prevention and screening behaviors, and diagnosis of sexual health related conditions were examined. The findings indicated that sexual orientation was significantly associated with engaging in sexual behavior in the last 30 days. Sexual orientation was also significantly associated with the number of sexual partners in the previous 12 months, with unsure men having significantly more partners than gay, bisexual and heterosexual men and heterosexual men having significantly less partners than gay, bisexual and unsure men. Bisexual women had significantly more partners than females reporting other sexual orientations. Results examining the associations between sexual orientation and safer sex, prevention behaviors, and screening behaviors were mixed. Implications for practice, including specific programmatic ideas, were discussed.

  16. Effects of Mindfulness Interventions on Health Outcomes in Older Lesbian/Bisexual Women.

    Science.gov (United States)

    Ingraham, Natalie; Eliason, Michele J; Garbers, Samantha; Harbatkin, Dawn; Minnis, Alexandra M; McElroy, Jane A; Haynes, Suzanne G

    2016-07-07

    Lesbian and bisexual (LB) women are at higher risk for obesity, but no reported interventions focus on older LB women who are overweight or obese. The Healthy Weight in Lesbian and Bisexual Women study funded five programs (n = 266 LB women age ≥40); two examined effects of mindfulness interventions on health outcomes. Analysis of variance and regression measured the impact of mindfulness-based programs on health behaviors and quality of life (MCS). Outcomes were also compared between intervention sites (mindfulness vs. standard weight loss approaches). Mindful Eating Questionnaire (MEQ) subscale scores improved significantly from preassessment to postassessment in mindfulness interventions. LB women who reported an increase (top tertile) in mindful eating had the most significant increase in MCS scores (35.3%) compared with those with low gains (low and medium tertile) in mindfulness (3.8%). MEQ score increase predicted 40.8% of the variance (adjusted) in MCS score, R(2) = .431, F(6,145) = 18.337, p mindfulness were significantly related to increases in physical activity and some nutrition outcomes. Mindfulness intervention sites showed within-person improvements in MCS and fruit and vegetable intake, whereas standard intervention sites showed within-person decreases in alcohol intake and increases in physical activity level. Although weight loss was not a primary outcome at the mindfulness sites, small but significant weight loss and weight-to-height ratio decreases were reported at all five sites. Increases in mindfulness were associated with a number of significant self-reported health improvements, including a great increase in perceived mental health quality of life. Mindfulness may be a promising practice to address health issues in aging LB women. Copyright © 2016 Jacobs Institute of Women's Health. All rights reserved.

  17. Group cognitive behavioral therapy for patients with generalized social anxiety disorder in Japan: outcomes at 1-year follow up and outcome predictors

    Directory of Open Access Journals (Sweden)

    Kawaguchi A

    2013-02-01

    Full Text Available Akiko Kawaguchi,1 Norio Watanabe,1 Yumi Nakano,2 Sei Ogawa,1 Masako Suzuki,1 Masaki Kondo,1 Toshi A Furukawa,3 Tatsuo Akechi11Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; 2Sugiyama Jogakuen University School of Human Sciences, Nisshin, Japan; 3Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JapanBackground: Social anxiety disorder (SAD is one of the most common psychiatric disorders worldwide. Cognitive behavioral therapy (CBT is an effective treatment option for patients with SAD. In the present study, we examined the efficacy of group CBT for patients with generalized SAD in Japan at 1-year follow-up and investigated predictors with regard to outcomes.Methods: This study was conducted as a single-arm, naturalistic, follow-up study in a routine Japanese clinical setting. A total of 113 outpatients with generalized SAD participated in group CBT from July 2003 to August 2010 and were assessed at follow-ups for up to 1 year. Primary outcome was the total score on the Social Phobia Scale/Social Interaction Anxiety Scale (SPS/SIAS at 1 year. Possible baseline predictors were investigated using mixed-model analyses.Results: Among the 113 patients, 70 completed the assessment at the 1-year follow-up. The SPS/SIAS scores showed significant improvement throughout the follow-ups for up to 1 year. The effect sizes of SPS/SIAS at the 1-year follow-up were 0.68 (95% confidence interval 0.41–0.95/0.76 (0.49–1.03 in the intention-to-treat group and 0.77 (0.42–1.10/0.84 (0.49–1.18 in completers. Older age at baseline, late onset, and lower severity of SAD were significantly associated with good outcomes as a result of mixed-model analyses.Conclusions: CBT for patients with generalized SAD in Japan is effective for up to 1 year after treatment. The effect sizes were as large as those in

  18. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

    Directory of Open Access Journals (Sweden)

    Candida Graham

    2014-01-01

    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  19. Patient activation and disparate health care outcomes in a racially diverse sample of chronically ill older adults.

    Science.gov (United States)

    Ryvicker, Miriam; Peng, Timothy R; Feldman, Penny Hollander

    2012-11-01

    The Patient Activation Measure (PAM) assesses people's ability to self-manage their health. Variations in PAM score have been linked with health behaviors, outcomes, and potential disparities. This study assessed the relative impacts of activation, socio-demographic and clinical factors on health care outcomes in a racially diverse sample of chronically ill, elderly homecare patients. Using survey and administrative data from 249 predominantly non-White patients, logistic regression was conducted to examine the effects of activation level and patient characteristics on the likelihood of subsequent hospitalization and emergency department (ED) use. Activation was not a significant predictor of hospitalization or ED use in adjusted models. Non-Whites were more likely than Whites to have a hospitalization or ED visit. Obesity was a strong predictor of both outcomes. Further research should examine potential sources of disadvantage among chronically ill homecare patients to design effective interventions to reduce health disparities in this population.

  20. Family Structure Changes and Children's Health, Behavior, and Educational Outcomes

    DEFF Research Database (Denmark)

    Rasmussen, Astrid Würtz

    decreased to 73% in 2005. Hence it is important to improve our understanding of the impact of "shocks" in family structure due to parental relationship dissolution on children. International studies mainly suggest a negative relationship between non-nuclear family structure and child outcomes. There are two...... relation between family structure changes and children's outcomes. Children who have experienced family structure changes during childhood seem to have worse educational outcomes and a higher propensity to being hospitalized and convicted of a crime. The children in the dataset experience up to 13 family...... structure changes during childhood. More family structure changes implies worse outcomes and might actually be more important than the number of years a child has spent in a single parent household. The age at which the family structure change occurs also seems to be important at least for some outcomes....

  1. Cognitive-behavioral therapy for persistent pain: does adherence after treatment affect outcome?

    Science.gov (United States)

    Curran, Charlotte; Williams, Amanda C de C; Potts, Henry W W

    2009-02-01

    It is a tenet of cognitive behavioral treatment of persistent pain problems that ex-patients should adhere to treatment methods over the longer term, in order to maintain and to extend treatment gains. However, no research has quantified the causal influence of adherence on short-term outcome in this field. The aims of this study are to assess determinants of adherence to treatment recommendations in several domains, and to examine the extent to which cognitive and behavioral adherence predicts better outcome of cognitive behavioral treatment for persistent pain. Longitudinal data from a sample of 2345 persistent pain patients who attended a multicomponent treatment programme were subjected to structural equation modeling. Adherence emerged as a mediating factor linking post-treatment and follow-up treatment outcome, but contributed only 3% unique variance to follow-up outcomes. Combined end-of-treatment outcomes and adherence factors accounted for 72% of the variance in outcome at one-month follow-up. Notwithstanding shortcomings in the measurement of adherence, these findings question the emphasis normally given to adherence in the maintenance of behavioral and cognitive change, and clinical implications are discussed.

  2. The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity.

    Science.gov (United States)

    Alcaraz, Kassandra I; Sly, Jamilia; Ashing, Kimlin; Fleisher, Linda; Gil-Rivas, Virginia; Ford, Sabrina; Yi, Jean C; Lu, Qian; Meade, Cathy D; Menon, Usha; Gwede, Clement K

    2017-02-01

    Health disparities persist despite ongoing efforts. Given the United States' rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the ConNECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.

  3. Identifying sexual orientation health disparities in adolescents: analysis of pooled data from the Youth Risk Behavior Survey, 2005 and 2007.

    Science.gov (United States)

    Mustanski, Brian; Van Wagenen, Aimee; Birkett, Michelle; Eyster, Sandra; Corliss, Heather L

    2014-02-01

    We studied sexual orientation disparities in health outcomes among US adolescents by pooling multiple Youth Risk Behavior Survey (YRBS) data sets from 2005 and 2007 for 14 jurisdictions. Here we describe the methodology for pooling and analyzing these data sets. Sexual orientation-related items assessed sexual orientation identity, gender of sexual contacts, sexual attractions, and harassment regarding sexual orientation. Wording of items varied across jurisdictions, so we created parallel variables and composite sexual minority variables. We used a variety of statistical approaches to address issues with the analysis of pooled data and to meet the aims of individual articles, which focused on a range of health outcomes and behaviors related to cancer, substance use, sexual health, mental health, violence, and injury.

  4. Mediating role of stress reactivity in the effects of prenatal tobacco exposure on childhood mental health outcomes.

    Science.gov (United States)

    Park, Aesoon; O'Malley, Stephanie S; King, Sarah L; Picciotto, Marina R

    2014-02-01

    Prenatal tobacco exposure, through maternal smoking during pregnancy, has been associated with adverse mental health outcomes in childhood. However, the mechanisms by which prenatal tobacco exposure compromises mental health later in life are unclear. We hypothesized that sensitized reactivity to stressful life events in early childhood mediates the effect of prenatal tobacco exposure on mental health outcomes in middle childhood, after accounting for earlier mental health outcomes. Data were from 12,308 mothers and their children drawn from the Avon Longitudinal Study of Parents and Children, a large prospective population-based study. Mothers' self-reports of smoking during pregnancy, mothers' ratings of their child's reactivity to stressful life events, and teachers' and mothers' ratings of the Strengths and Difficulties Questionnaire assessing 5 domains of mental health outcomes were measured. A positive association was found between prenatal tobacco exposure and stress reactivity between the ages of 2 and 6. In turn, stress reactivity was positively associated with peer (isolation), hyperactivity, conduct, and emotional problems (but not prosocial behaviors) between the ages of 7 and 11, after accounting for the mental health outcome at age 4 and other confounders. Heightened stress reactivity in preschool ages mediated the effect of prenatal tobacco exposure on adverse mental health outcomes between the ages of 7 and 11. Interventions to assist children exposed to tobacco smoke during gestation in coping with stressful life events may help mitigate psychiatric symptoms in this population.

  5. Some current dimensions of the behavioral economics of health-related behavior change.

    Science.gov (United States)

    Bickel, Warren K; Moody, Lara; Higgins, Stephen T

    2016-11-01

    Health-related behaviors such as tobacco, alcohol and other substance use, poor diet and physical inactivity, and risky sexual practices are important targets for research and intervention. Health-related behaviors are especially pertinent targets in the United States, which lags behind most other developed nations on common markers of population health. In this essay we examine the application of behavioral economics, a scientific discipline that represents the intersection of economics and psychology, to the study and promotion of health-related behavior change. More specifically, we review what we consider to be some core dimensions of this discipline when applied to the study health-related behavior change. Behavioral economics (1) provides novel conceptual systems to inform scientific understanding of health behaviors, (2) translates scientific understanding into practical and effective behavior-change interventions, (3) leverages varied aspects of behavior change beyond increases or decreases in frequency, (4) recognizes and exploits trans-disease processes and interventions, and (5) leverages technology in efforts to maximize efficacy, cost effectiveness, and reach. These dimensions are overviewed and their implications for the future of the field discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Theoretically informed correlates of hepatitis B knowledge among four Asian groups: the health behavior framework.

    Science.gov (United States)

    Maxwell, Annette E; Stewart, Susan L; Glenn, Beth A; Wong, Weng Kee; Yasui, Yutaka; Chang, L Cindy; Taylor, Victoria M; Nguyen, Tung T; Chen, Moon S; Bastani, Roshan

    2012-01-01

    Few studies have examined theoretically informed constructs related to hepatitis B (HBV) testing, and comparisons across studies are challenging due to lack of uniformity in constructs assessed. The present analysis examined relationships among Health Behavior Framework factors across four Asian American groups to advance the development of theory-based interventions for HBV testing in at-risk populations. Data were collected from 2007-2010 as part of baseline surveys during four intervention trials promoting HBV testing among Vietnamese-, Hmong-, Korean- and Cambodian-Americans (n = 1,735). Health Behavior Framework constructs assessed included: awareness of HBV, knowledge of transmission routes, perceived susceptibility, perceived severity, doctor recommendation, stigma of HBV infection, and perceived efficacy of testing. Within each group we assessed associations between our intermediate outcome of knowledge of HBV transmission and other constructs, to assess the concurrent validity of our model and instruments. While the absolute levels for Health Behavior Framework factors varied across groups, relationships between knowledge and other factors were generally consistent. This suggests similarities rather than differences with respect to posited drivers of HBV-related behavior. Our findings indicate that Health Behavior Framework constructs are applicable to diverse ethnic groups and provide preliminary evidence for the construct validity of the Health Behavior Framework.

  7. Crime, violence, and behavioral health: collaborative community strategies for risk mitigation.

    Science.gov (United States)

    Pinals, Debra A

    2015-06-01

    Criminal conduct is not always violent, and violence does not always lead to criminal charges. Moreover, crime and violence have multifaceted etiologies. Most violence in society is not attributable to mental illness. Where there is a small relationship between violence and mental illness, the risk of violence increases for individuals with substance use histories. Underlying trauma can also play a role. Antisocial attitudes, behaviors, and peer groups further increase the risk that individuals, including those with mental illness, will find themselves at risk of criminal recidivism. Criminal histories among public mental health populations, and mental health and substance use disorders among criminal populations are each higher than general population comparisons. Care within behavioral health settings should therefore target decreased criminal recidivism and decreased violence as part of recovery for those individuals at risk, using trauma-informed approaches and peer supports. Interventions that show promise bring criminal justice and behavioral health systems together, and include police-based diversion, specialty courts, court-based alternatives to incarceration, and coordinated re-entry programs. This article reviews these options along with specific risk management strategies, such as using risk, needs, and responsivity factors as a means of improving overall outcomes for persons with mental illness, while minimizing their risk of further criminalization and victimization.

  8. The Effects of Prenatal Care Utilization on Maternal Health and Health Behaviors.

    Science.gov (United States)

    Yan, Ji

    2017-08-01

    While many economic studies have explored the role of prenatal care in infant health production, the literature is sporadic on the effects of prenatal care on the mother. This research contributes to this understudied but important area using a unique large dataset of sibling newborns delivered by 0.17 million mothers. We apply within-mother estimators to find robust evidence that poor prenatal care utilization due to late onset of care, low frequency of care visits, or combinations of the two significantly increases the risks of maternal insufficient gestational weight gain, prenatal smoking, premature rupture of membranes, precipitous labor, no breastfeeding, postnatal underweight, and postpartum smoking. The magnitude of the estimates relative to the respective sample means of the outcome variables ranges from 3% to 33%. The results highlight the importance of receiving timely and sufficient prenatal care in improving maternal health and health behaviors during pregnancy as well as after childbirth. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Does gender matter? Exploring mental health recovery court legal and health outcomes.

    Science.gov (United States)

    Kothari, Catherine L; Butkiewicz, Robert; Williams, Emily R; Jacobson, Caron; Morse, Diane S; Cerulli, Catherine

    2014-12-05

    Based upon therapeutic justice principles, mental health courts use legal leverage to improve access and compliance to treatment for defendants who are mentally ill. Justice-involved women have a higher prevalence of mental illness than men, and it plays a greater role in their criminal behavior. Despite this, studies examining whether women respond differently than men to mental health courts are lacking. Study goals were to examine gender-related differences in mental health court participation, and in criminal justice, psychiatric and health-related outcomes. This study utilized a quasi-experimental pre-posttest design without a control group. The data were abstracted from administrative records of Kalamazoo Community Mental Health and Substance Abuse agency, the county jail and both county hospitals, 2008 through 2011. Generalized estimating equation regression was used to assess gender-differences in pre-post program outcomes (jail days, psychiatric and medical hospitalization days, emergency department visits) for the 30 women and 63 men with a final mental health court disposition. Program-eligible females were more likely than males to become enrolled in mental health court. Otherwise they were similar on all measured program-participation characteristics: treatment compliance, WRAP participation and graduation rate. All participants showed significant reductions in emergency department visits, but women-completers had significantly steeper drops than males: from 6.7 emergency department visits to 1.3 for women, and from 4.1 to 2.4 for men. A similar gender pattern emerged with medical-hospitalization-days: from 2.2 medical hospital days down to 0.1 for women, and from 0.9 days up to 1.8 for men. While women had fewer psychiatric hospitalization days than men regardless of program involvement (2.5 and 4.6, respectively), both genders experienced fewer days after MHRC compared to before. Women and men showed equal gains from successful program completion in

  10. Effects of electronic health information technology implementation on nursing home resident outcomes.

    Science.gov (United States)

    Pillemer, Karl; Meador, Rhoda H; Teresi, Jeanne A; Chen, Emily K; Henderson, Charles R; Lachs, Mark S; Boratgis, Gabriel; Silver, Stephanie; Eimicke, Joseph P

    2012-02-01

    To examine the effects of electronic health information technology (HIT) on nursing home residents. The study evaluated the impact of implementing a comprehensive HIT system on resident clinical, functional, and quality of care outcome indicators as well as measures of resident awareness of and satisfaction with the technology. The study used a prospective, quasi-experimental design, directly assessing 761 nursing home residents in 10 urban and suburban nursing homes in the greater New York City area. No statistically significant impact of the introduction of HIT on residents was found on any outcomes, with the exception of a significant negative effect on behavioral symptoms. Residents' subjective assessment of the HIT intervention were generally positive. The absence of effects on most indicators is encouraging for the future development of HIT in nursing homes. The single negative finding suggests that further investigation is needed on possible impact on resident behavior. © The Author(s) 2012

  11. Role of Video Games in Improving Health-Related Outcomes

    Science.gov (United States)

    Primack, Brian A.; Carroll, Mary V.; McNamara, Megan; Klem, Mary Lou; King, Brandy; Rich, Michael O.; Chan, Chun W.; Nayak, Smita

    2012-01-01

    Context Video games represent a multibillion-dollar industry in the U.S. Although video gaming has been associated with many negative health consequences, it may also be useful for therapeutic purposes. The goal of this study was to determine whether video games may be useful in improving health outcomes. Evidence acquisition Literature searches were performed in February 2010 in six databases: the Center on Media and Child Health Database of Research, MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials. Reference lists were hand-searched to identify additional studies. Only RCTs that tested the effect of video games on a positive, clinically relevant health consequence were included. Study selection criteria were strictly defined and applied by two researchers working independently. Study background information (e.g., location, funding source), sample data (e.g., number of study participants, demographics), intervention and control details, outcomes data, and quality measures were abstracted independently by two researchers. Evidence synthesis Of 1452 articles retrieved using the current search strategy, 38 met all criteria for inclusion. Eligible studies used video games to provide physical therapy, psychological therapy, improved disease self-management, health education, distraction from discomfort, increased physical activity, and skills training for clinicians. Among the 38 studies, a total of 195 health outcomes were examined. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. Study quality was generally poor; for example, two thirds (66%) of studies had follow-up periods of video games to improve health outcomes, particularly in the areas of psychological therapy and physical therapy. RCTs with

  12. Parental investments in child health - maternal health behaviours and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

    consumption, exercise and diet during pregnancy on birth outcomes and considers the problem of identifying the causal effect of these endogenous maternal health behaviours. The analysis controls for a wide range of covariates and exploits sibling variation in the Danish National Birth Cohort. The paper...... the ways in which child health is generated, and - for children of higher birth order - earlier children's outcomes will shape parental investments in child health....

  13. Neuroeconomics and behavioral health economics

    DEFF Research Database (Denmark)

    Larsen, Torben

    2009-01-01

      Objective: Neuroeconomics integrates behavioral economics, psychology and neuroscience. Recently, this line of research is summarized in a neuroeconomic model (NeM) which addresses behavioral health from a new angle as surveyed in this study. Data and Method Firstly, NeM is used as framework...... for explanation of the neural dynamics of normal decision making. Secondly, the literature is reviewed for evidence on hypothesized applications of NeM in behavioral health. Results I. The present bias as documented by neuroeconomic game-trials is explained by NeM as rooted in the basal activation of Amygdala...... mechanism. In this case neuroeconomics may serve as an evidence-based public monitoring across specific historical meditation settings. Conclusion Neuroeconomics reveal the action-mechanism of dominant behavioral health interventions as integrated home care for patients suffering from stroke, heart failure...

  14. Serotonin transporter genotype linked to adolescent substance use treatment outcome through externalizing behavior

    Directory of Open Access Journals (Sweden)

    Tammy eChung

    2014-07-01

    Full Text Available Meta-analyses suggest that the serotonin transporter linked polymorphic region (5-HTTLPR short (S allele, relative to the long (L allele, is associated with risk for alcohol dependence, particularly among individuals with early onset antisocial alcoholism. Youth in substance use treatment tend to show antisocial or externalizing behaviors, such as conduct problems, which predict worse treatment outcome. This study examined a pathway in which 5-HTTLPR genotype is associated with externalizing behavior, and the intermediate phenotype of externalizing behavior serves as a link between 5-HTTLPR genotype and substance use treatment outcome in youth. Adolescents (n=142 who were recruited from addictions treatment were genotyped for 5-HTTLPR polymorphisms (S and LG carriers vs. LALA, assessed for externalizing and internalizing behaviors shortly after starting treatment, and followed over 6-months. 5-HTTLPR genotype was not associated with internalizing behaviors, and was not directly associated with 6-month substance use outcomes. However, 5-HTTLPR genotype was associated with externalizing behaviors (S and LG > LALA, and externalizing behaviors predicted alcohol and marijuana problem severity at 6-month follow-up. Results indicated an indirect (p<.05 and non-specific (i.e., both alcohol and marijuana severity effect of 5-HTTLPR genotype on youth substance use treatment outcomes, with externalizing behaviors as an important linking factor. Adolescents in substance use treatment with low expressing (S and LG 5-HTTLPR alleles and externalizing behavior might benefit from intervention that addresses serotonergic functioning, externalizing behaviors, and substance use to improve outcomes.

  15. A Carotenoid Health Index Based on Plasma Carotenoids and Health Outcomes

    Science.gov (United States)

    Donaldson, Michael S.

    2011-01-01

    While there have been many studies on health outcomes that have included measurements of plasma carotenoids, this data has not been reviewed and assembled into a useful form. In this review sixty-two studies of plasma carotenoids and health outcomes, mostly prospective cohort studies or population-based case-control studies, are analyzed together to establish a carotenoid health index. Five cutoff points are established across the percentiles of carotenoid concentrations in populations, from the tenth to ninetieth percentile. The cutoff points (mean ± standard error of the mean) are 1.11 ± 0.08, 1.47 ± 0.08, 1.89 ± 0.08, 2.52 ± 0.13, and 3.07 ± 0.20 µM. For all cause mortality there seems to be a low threshold effect with protection above every cutoff point but the lowest. But for metabolic syndrome and cancer outcomes there tends to be significant positive health outcomes only above the higher cutoff points, perhaps as a triage effect. Based on this data a carotenoid health index is proposed with risk categories as follows: very high risk: 4 µM. Over 95 percent of the USA population falls into the moderate or high risk category of the carotenoid health index. PMID:22292108

  16. Wildcat wellness coaching feasibility trial: protocol for home-based health behavior mentoring in girls.

    Science.gov (United States)

    Cull, Brooke J; Rosenkranz, Sara K; Dzewaltowski, David A; Teeman, Colby S; Knutson, Cassandra K; Rosenkranz, Richard R

    2016-01-01

    Childhood obesity is a major public health problem, with one third of America's children classified as either overweight or obese. Obesity prevention and health promotion programs using components such as wellness coaching and home-based interventions have shown promise, but there is a lack of published research evaluating the impact of a combined home-based and wellness coaching intervention for obesity prevention and health promotion in young girls. The main objective of this study is to test the feasibility of such an intervention on metrics related to recruitment, intervention delivery, and health-related outcome assessments. The secondary outcome is to evaluate the possibility of change in health-related psychosocial, behavioral, and biomedical outcomes in our sample of participants. Forty girls who are overweight or obese (aged 8-13 years) will be recruited from a Midwestern college town. Participants will be recruited through posted flyers, newspaper advertisements, email, and social media. The volunteer convenience sample of girls will be randomized to one of two home-based wellness coaching interventions: a general health education condition or a healthy eating physical activity skills condition. Trained female wellness coaches will conduct weekly hour-long home visits for 12 consecutive weeks. Assessments will occur at baseline, post-intervention (3 months after baseline), and follow-up (6 months after baseline) and will include height, weight, waist circumference, body composition, pulmonary function, blood pressure, systemic inflammation, physical activity (Actical accelerometer), and self-reported survey measures (relevant to fruit and vegetable consumption, physical activity, and quality of life). This study will evaluate the feasibility of home-based wellness coaching interventions for overweight and obese girls and secondarily assess the preliminary impact on health-related psychosocial, behavioral, and biomedical outcomes. Results will provide

  17. Impact of bullying victimization on suicide and negative health behaviors among adolescents in Latin America.

    Science.gov (United States)

    Romo, Matthew L; Kelvin, Elizabeth A

    2016-11-01

    To compare the prevalence of bullying victimization, suicidal ideation, suicidal attempts, and negative health behaviors (current tobacco use, recent heavy alcohol use, truancy, involvement in physical fighting, and unprotected sexual intercourse) in five different Latin American countries and determine the association of bullying victimization with these outcomes, exploring both bullying type and frequency. Study data were from Global School-based Student Health Surveys from Bolivia, Costa Rica, Honduras, Peru, and Uruguay, which covered nationally representative samples of school-going adolescents. The surveys used a two-stage clustered sample design, sampling schools and then classrooms. Logistic regression models were run to determine the statistical significance of associations with bullying. Among the 14 560 school-going adolescents included in this study, the prevalence of any bullying victimization in the past 30 days was 37.8%. Bullying victimization was associated with greater odds of suicidal ideation with planning (adjusted odds ratio (AOR): 3.12; P bullying victimization on suicide outcomes was also observed. Bullying victimization was associated with higher odds of current tobacco use (AOR: 2.14; P bullying victimization varied by country, its association with suicidal ideation and behavior and negative health behaviors remained relatively consistent. Addressing bullying needs to be made a priority in Latin America, and an integrated approach that also includes mental and physical health promotion is needed.

  18. Assessing the Nexus of Built, Natural, and Social Environments and Public Health Outcomes

    Science.gov (United States)

    Archer, R.; Alexander, S.; Douglas, J.

    2017-12-01

    This study investigates community-related environmental justice concerns and chemical and non-chemical health stressors from built, natural, and social environments in Southeast Los Angeles (SELA) County and East Oakland, California. The geographical distribution of health outcomes is related to the built and natural environments, as well as impacts from the social environment. A holistic systems view is important in assessing healthy behaviors within a community, because they do not occur in isolation. Geospatial analysis will be performed to integrate a total environment framework and explore the spatial patterns of exposure to chemical and non-chemical stressors and access to health-promoting environments. Geographic Information Systems (GIS) analysis using primary and secondary existing data will be performed to determine how social environments impact exposure to chemical health stressors and access to health-promoting built and natural environments. This project will develop a comprehensive list of health-promoting built and natural environments (e.g., parks and community gardens) and polluting sites (e.g., shipping ports and sources of pollution not included in federal regulatory databases) in East Oakland and SELA. California Department of Public Health and U.S. Decennial Census data will also be included for geospatial analysis to overlay the distribution of air pollution-related morbidities (e.g. asthma, diabetes, and cancer) and access to health-promoting built and natural environments and related community assets, exposure to polluting industries, social disorganization, and public health outcomes in the target areas. This research will help identify the spatial and temporal distribution and cumulative impacts of critical pollution hotspots causing community environmental health impacts. The research team will also map how social environments impact exposure to chemical health stressors and access to health-promoting built and natural environments. The

  19. Parental influence on children's oral health-related behavior.

    Science.gov (United States)

    Poutanen, Raija; Lahti, Satu; Tolvanen, Mimmi; Hausen, Hannu

    2006-10-01

    The aim of this study was to determine whether there are differences between oral health-related knowledge, attitudes, beliefs and behaviors of children and their parents, and to identify the family-related factors associated with children's poor or good oral health-related behavior. The data were gathered by means of questionnaires from 11-12-year-old schoolchildren and their parents who replied without having knowledge of the answers of the others. Differences between subgroups of children were analyzed by cross-tabulation, and the factors related to children's good or poor oral health-related behavior by logistic regression analyses. Parents of children who reported good oral health-related behavior had better knowledge and more favorable behaviors than those of other parents. Predictors for a child's poor oral health-related behavior were the child's poor knowledge, male gender, the parent's frequent consumption of sweets, and the parent's infrequent use of xylitol gum. When a less strict threshold for the child's poor oral health-related behavior was used, more predictors entered the model: the parent's unfavorable use of fluoride toothpaste; among girls, the parent's lack of knowledge; and among children whose mother's occupation level was high, the parent's infrequent use of xylitol gum. The parents of children whose oral health behavior was favorable were more likely to have a high level occupation and favorable oral health-related behaviors. Oral health-related knowledge of children and their parents seems to be associated with children's oral health-related behavior. Parents' behaviors, but not attitudes, were associated with children's oral health behavior.

  20. Predictors of course and outcome in hypochondriasis after cognitive-behavioral treatment.

    Science.gov (United States)

    Hiller, Wolfgang; Leibbrand, Rolf; Rief, Winfried; Fichter, Manfred M

    2002-01-01

    Predictors of treatment outcome were evaluated in a clinical sample suffering from hypochondriasis. The sample consisted of 96 patients with hypochondriacal disorder according to DSM-IV or high syndrome scores on the Illness Attitude Scales (IAS) or Whiteley Index (WI). After intense inpatient cognitive-behavioral treatment (CBT), 60% of the patients were classified as responders because of substantial improvements or recovery from hypochondriacal symptomatology. Non-responders were characterized by a higher degree of pre-treatment hypochondriasis, more somatization symptoms and general psychopathology (SCL-90R), more dysfunctional cognitions related to bodily functioning, higher levels of psychosocial impairments, and more utilization of the health care system as indicated by the number of hospital days and costs for inpatient treatments and medication. No predictive value was found for sociodemographic variables, comorbidity with other mental disorders and chronicity. Multiple linear regression showed that pre-treatment variables significantly predicted IAS scores at post-treatment (R(2) = 0.59), changes during treatment (0.10), IAS scores at follow-up two years later (0.41) and changes between baseline and follow-up (0.25). The results demonstrate the relevance of various psychopathological variables and health care utilization as important indicators for outcome and further course of clinical hypochondriasis. Copyright 2002 S. Karger AG, Basel

  1. Framing Mechanisms Linking HIV-Related Stigma, Adherence to Treatment, and Health Outcomes

    Science.gov (United States)

    Hatcher, Abigail M.; Weiser, Sheri D.; Johnson, Mallory O.; Rice, Whitney S.; Turan, Janet M.

    2017-01-01

    We present a conceptual framework that highlights how unique dimensions of individual-level HIV-related stigma (perceived community stigma, experienced stigma, internalized stigma, and anticipated stigma) might differently affect the health of those living with HIV. HIV-related stigma is recognized as a barrier to both HIV prevention and engagement in HIV care, but little is known about the mechanisms through which stigma leads to worse health behaviors or outcomes. Our conceptual framework posits that, in the context of intersectional and structural stigmas, individual-level dimensions of HIV-related stigma operate through interpersonal factors, mental health, psychological resources, and biological stress pathways. A conceptual framework that encompasses recent advances in stigma science can inform future research and interventions aiming to address stigma as a driver of HIV-related health. PMID:28426316

  2. Health message framing effects on attitudes, intentions, and behavior: a meta-analytic review.

    Science.gov (United States)

    Gallagher, Kristel M; Updegraff, John A

    2012-02-01

    Message framing has been an important focus in health communication research, yet prior meta-analyses found limited support for using framing to increase persuasiveness of health messages. This meta-analysis distinguished the outcomes used to assess the persuasive impact of framed messages (attitudes, intentions, or behavior). One hundred eighty-nine effect sizes were identified from 94 peer-reviewed, published studies which compared the persuasive impact of gain- and loss-framed messages. Gain-framed messages were more likely than loss-framed messages to encourage prevention behaviors (r = 0.083, p = 0.002), particularly for skin cancer prevention, smoking cessation, and physical activity. No effect of framing was found when persuasion was assessed by attitudes/intentions or among studies encouraging detection. Gain-framed messages appear to be more effective than loss-framed messages in promoting prevention behaviors. Research should examine the contexts in which loss-framed messages are most effective, and the processes that mediate the effects of framing on behavior.

  3. Health Literacy and Women's Reproductive Health: A Systematic Review

    Science.gov (United States)

    Vitko, Michelle; O'Conor, Rachel; Bailey, Stacy Cooper

    2016-01-01

    Abstract Background: Health literacy is thought to impact women's reproductive health, yet no comprehensive systematic reviews have been conducted on the topic. Our objective was to systematically identify, investigate, and summarize research on the relationship between health literacy and women's reproductive health knowledge, behaviors, and outcomes. Methods: PRISMA guidelines were used to guide this review. English language, peer-reviewed research articles indexed in MEDLINE as of February 2015 were searched, along with study results posted on Clinicaltrials.gov. Articles were included if they (1) described original data-driven research conducted in developed countries, (2) were published in a peer-reviewed journal, (3) measured health literacy using a validated assessment, (4) reported on the relationship between health literacy and reproductive health outcomes, related knowledge, or behaviors, and (5) consisted of a study population that included reproductive age women. Results: A total of 34 articles met eligibility criteria and were included in this review. Data were abstracted from articles by two study authors using a standardized form. Abstracted data were then reviewed and summarized in table format. Overall, health literacy was associated with reproductive health knowledge across a spectrum of topics. It was also related to certain health behaviors, such as prenatal vitamin use and breastfeeding. Its relationship with other reproductive behaviors and outcomes remains unclear. Conclusions: Health literacy plays an important role in reproductive knowledge and may impact behaviors and outcomes. While further research is necessary, healthcare providers should utilize health literacy best practices now to promote high-quality care for patients. PMID:27564780

  4. Neurobiological factors as predictors of cognitive-behavioral therapy outcome in individuals with antisocial behavior: a review of the literature.

    Science.gov (United States)

    Cornet, Liza J M; de Kogel, Catharina H; Nijman, Henk L I; Raine, Adrian; van der Laan, Peter H

    2014-11-01

    This review focuses on the predictive value of neurobiological factors in relation to cognitive-behavioral therapy outcome among individuals with antisocial behavior. Ten relevant studies were found. Although the literature on this topic is scarce and diverse, it appears that specific neurobiological characteristics, such as physiological arousal levels, can predict treatment outcome. The predictive value of neurobiological factors is important as it could give more insight into the causes of variability in treatment outcome among individuals with antisocial behavior. Furthermore, results can contribute to improvement in current treatment selection procedures and to the development of alternative treatment options. © The Author(s) 2013.

  5. The role of narcissism in health-risk and health-protective behaviors.

    Science.gov (United States)

    Hill, Erin M

    2016-09-01

    This study examined the role of narcissism in health-risk and health-protective behaviors in a sample of 365 undergraduate students. Regression analyses were used to test the influence of narcissism on health behaviors. Narcissism was positively predictive of alcohol use, marijuana use, and risky driving behaviors, and it was associated with an increased likelihood of consistently having a healthy eating pattern. Narcissism was also positively predictive of physical activity. Results are discussed with reference to the potential short-term and long-term health implications and the need for future research on the factors involved in the relationship between narcissism and health behaviors. © The Author(s) 2015.

  6. International and Interdisciplinary Identification of Health Care Transition Outcomes.

    Science.gov (United States)

    Fair, Cynthia; Cuttance, Jessica; Sharma, Niraj; Maslow, Gary; Wiener, Lori; Betz, Cecily; Porter, Jerlym; McLaughlin, Suzanne; Gilleland-Marchak, Jordan; Renwick, Amy; Naranjo, Diana; Jan, Sophia; Javalkar, Karina; Ferris, Maria

    2016-03-01

    There is a lack of agreement on what constitutes successful outcomes for the process of health care transition (HCT) among adolescent and young adults with special health care needs. To present HCT outcomes identified by a Delphi process with an interdisciplinary group of participants. A Delphi method involving 3 stages was deployed to refine a list of HCT outcomes. This 18-month study (from January 5, 2013, of stage 1 to July 3, 2014, of stage 3) included an initial literature search, expert interviews, and then 2 waves of a web-based survey. On this survey, 93 participants from outpatient, community-based, and primary care clinics rated the importance of the top HCT outcomes identified by the Delphi process. Analyses were performed from July 5, 2014, to December 5, 2014. Health care transition outcomes of adolescents and young adults with special health care needs. Importance ratings of identified HCT outcomes rated on a Likert scale from 1 (not important) to 9 (very important). The 2 waves of surveys included 117 and 93 participants as the list of outcomes was refined. Transition outcomes were refined by the 3 waves of the Delphi process, with quality of life being the highest-rated outcome with broad agreement. The 10 final outcomes identified included individual outcomes (quality of life, understanding the characteristics of conditions and complications, knowledge of medication, self-management, adherence to medication, and understanding health insurance), health services outcomes (attending medical appointments, having a medical home, and avoidance of unnecessary hospitalization), and a social outcome (having a social network). Participants indicated that different outcomes were likely needed for individuals with cognitive disabilities. Quality of life is an important construct relevant to HCT. Future research should identify valid measures associated with each outcome and further explore the role that quality of life plays in the HCT process. Achieving

  7. Masculine Discrepancy Stress and Psychosocial Maladjustment: Implications for Behavioral and Mental Health of Adolescent Boys.

    Science.gov (United States)

    Reidy, Dennis E; Smith-Darden, Joanne P; Vivolo-Kantor, Alana M; Malone, Carolyn A; Kernsmith, Poco D

    2017-01-01

    Gender role discrepancy (GRD), or nonconformity to socially prescribed gender roles, has been linked to a multitude of adverse mental and behavioral health outcomes. Masculine discrepancy stress (MDS), stress about being perceived not to conform to one's gender role, may explain the relationship between GRD and deleterious health outcomes. However, research on MDS has primarily been restricted to adult males. This leaves a critical gap pertaining to the potential effect of MDS on adolescent boys, who may be more malleable and susceptible to the influence and pressures of gender socialization. In the current study, data are drawn from a sample of adolescent male students ( N = 592) who completed self-report questionnaires. We employed structural equation modeling to test the effects of GRD and MDS on psychosocial maladjustment measured via sexual behavior, substance use, violence, mood disorder symptoms, and hopelessness. In addition, we controlled for critical risk factors including sociodemographic characteristics, adverse childhood experiences, trauma symptoms, and neighborhood disorganization. Findings indicate significant potentiating effects of MDS on maladjustment while there were direct protective effects of GRD. These data suggest that developing prevention strategies that incorporate social norms pertaining to gender socialization may have an impact on multiple behavioral and mental health problems.

  8. Applying Behavioral Economics to Public Health Policy

    Science.gov (United States)

    Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

    2016-01-01

    Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

  9. Workplace Social Support and Behavioral Health Prior to Long-Duration Spaceflight.

    Science.gov (United States)

    Deming, Charlene A; Vasterling, Jennifer J

    2017-06-01

    Preparation and training for long-duration spaceflight bring with them psychosocial stressors potentially affecting the well-being and performance of astronauts, before and during spaceflight. Social support from within the workplace may mitigate behavioral health concerns arising during the preflight period and enhance resiliency before and during extended missions. The purpose of this review was to evaluate evidence addressing the viability of workplace social support as a pre-mission countermeasure, specifically addressing: 1) the observed relationships between workplace social support and behavioral health; 2) perceived need, acceptability, and format preference for workplace social support among high-achievers; 3) potential barriers to delivery/receipt of workplace social support; 4) workplace social support interventions; and 5) delivery timeframe and anticipated duration of workplace social support countermeasure benefits. We conducted an evidence review examining workplace social support in professional contexts sharing one or more characteristics with astronauts and spaceflight. Terms included populations of interest, social support constructs, and behavioral health outcomes. Abstracts of matches were subsequently reviewed for relevance and quality. Research findings demonstrate clear associations between workplace social support and behavioral health, especially following exposure to stress. Further, studies indicate strong need for support and acceptability of support countermeasures, despite barriers. Our review revealed two general formats for providing support (i.e., direct provision of support and training to optimize skills in provision and receipt of support) with potential differentiation of expected duration of benefits, according to format. Workplace social support countermeasures hold promise for effective application during pre-mission phases of long-duration spaceflight. Specific recommendations are provided.Deming CA, Vasterling JJ

  10. What Factors Affect Health Seeking Behavior?

    African Journals Online (AJOL)

    reducing cost, disability and death from diseases. (2). However, good health ... The Health Belief Model where the concept is the 'perceived susceptibility', which refers ... behavioral intentions and actions (6). ... integrated behavioral model.

  11. Parental self-efficacy and oral health-related knowledge are associated with parent and child oral health behaviors and self-reported oral health status.

    Science.gov (United States)

    de Silva-Sanigorski, Andrea; Ashbolt, Rosie; Green, Julie; Calache, Hanny; Keith, Benedict; Riggs, Elisha; Waters, Elizabeth

    2013-08-01

    This study sought to advance understanding of the influence of psychosocial factors on oral health by examining how parental self-efficacy (with regard to acting on their child's oral health needs) and oral health knowledge relate to parental and child oral health behaviors and self-rated oral health. Parents of children in grades 0/1 and 5/6 (n = 804) and children in grades 5/6 (n = 377, mean age 11.5 ± 1.0, 53.9% female) were recruited from a stratified random sample of 11 primary (elementary) schools. Participants completed surveys capturing psychosocial factors, oral health-related knowledge, and parental attitudes about oral health. Parents also rated their own oral health status and the oral health of their child. Correlations and logistic regression analysis (adjusted for socioeconomic status, child age, and gender) examined associations between psychosocial factors and the outcomes of interest (parent and child behaviors and self-rated oral health status). Higher parental self-efficacy was associated with more frequent toothbrushing (by parent and child), and more frequent visits to a dental professional. These associations were particularly strong with regard to dental visits for children, with parents with the highest tertile for self-efficacy 4.3 times more likely to report that their child attended a dentist for a checkup at least once a year (95%CI 2.52-7.43); and 3 times more likely to report their child brushing their teeth at least twice a day (Adjusted Odds Ratio 3.04, 95%CI 1.64-5.64) compared with those parents in the lowest tertile for self-efficacy. No associations with oral health knowledge were found when examined by tertile of increasing knowledge. Oral health self-efficacy and knowledge are potentially modifiable risk factors of oral health outcomes, and these findings suggest that intervening on these factors could help foster positive dental health habits in families. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Longitudinal Effects of Gendered Harassment Perpetration and Victimization on Mental Health Outcomes in Adolescence.

    Science.gov (United States)

    Rinehart, Sarah J; Espelage, Dorothy L; Bub, Kristen L

    2017-08-01

    Gendered harassment, including sexual harassment and homophobic name-calling, is prevalent in adolescents and is linked to negative outcomes including depression, anxiety, suicidality, substance abuse, and personal distress. However, much of the extant literature is cross-sectional and rarely are perpetrators of these behaviors included in studies of outcomes. Therefore, the current study examined the effects of longitudinal changes in gendered harassment perpetration and victimization on changes in mental health outcomes among a large sample of early adolescents. Given that these behaviors commonly occur in the context of a patriarchal society (males hold power), we also investigated the impact of gender on gendered harassment. Participants included 3,549 students from four Midwestern middle schools (50.4% female, 49% African American, 34% White) at two time points (13 and 17 years old). Results indicated that increases from age 13 to 17 years in sexual harassment perpetration and victimization and homophobic name-calling perpetration and victimization predicted increases in depression symptoms and substance use. Gender did not moderate these pathways. These findings highlight that negative outcomes are associated with changes in gendered harassment among adolescents and emphasize the importance of prevention efforts. Implications for school interventions are discussed.

  13. What Is the Story with Narratives? How Using Narratives in Journalism Changes Health Behavior.

    Science.gov (United States)

    Shaffer, Victoria A; Scherer, Laura D; Focella, Elizabeth S; Hinnant, Amanda; Len-Ríos, María E; Zikmund-Fisher, Brian J

    2018-09-01

    Health journalists frequently use narratives to bring news stories to life, with little understanding about how this influences the health behavior of readers. This study was designed to examine the effect of a New York Times health news article about a person who developed a life-threatening illness after using ibuprofen on readers' future use of ibuprofen. We recruited an Internet sample (N = 405) to participate in a longitudinal study examining ibuprofen use before, immediately following, and two weeks after reading the story. Ibuprofen use two-weeks after reading the heath news article was significantly lower than baseline use. Furthermore, intentions to use ibuprofen were also significantly reduced suggesting that the observed behavior change may persist beyond the two-week period studied. Health journalists should be cautious in their use of stories about health outcomes, particularly when those stories deviate from data about objective risks.

  14. Effective behavioral intervention strategies using mobile health applications for chronic disease management: a systematic review.

    Science.gov (United States)

    Lee, Jung-Ah; Choi, Mona; Lee, Sang A; Jiang, Natalie

    2018-02-20

    Mobile health (mHealth) has continuously been used as a method in behavioral research to improve self-management in patients with chronic diseases. However, the evidence of its effectiveness in chronic disease management in the adult population is still lacking. We conducted a systematic review to examine the effectiveness of mHealth interventions on process measures as well as health outcomes in randomized controlled trials (RCTs) to improve chronic disease management. Relevant randomized controlled studies that were published between January 2005 and March 2016 were searched in six databases: PubMed, CINAHL, EMBASE, the Cochrane Library, PsycINFO, and Web of Science. The inclusion criteria were RCTs that conducted an intervention using mobile devices such as smartphones or tablets for adult patients with chronic diseases to examine disease management or health promotion. Of the 12 RCTs reviewed, 10 of the mHealth interventions demonstrated statistically significant improvement in some health outcomes. The most common features of mHealth systems used in the reviewed RCTs were real-time or regular basis symptom assessments, pre-programed reminders, or feedbacks tailored specifically to the data provided by participants via mHealth devices. Most studies developed their own mHealth systems including mobile apps. Training of mHealth systems was provided to participants in person or through paper-based instructions. None of the studies reported the relationship between health outcomes and patient engagement levels on the mHealth system. Findings from mHealth intervention studies for chronic disease management have shown promising aspects, particularly in improving self-management and some health outcomes.

  15. Electronic health records: eliciting behavioral health providers' beliefs.

    Science.gov (United States)

    Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

    2012-04-01

    Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

  16. The Prevalence of Postgraduate Education in Youth Health Among High School Clinicians and Associated Student Health Outcomes.

    Science.gov (United States)

    Denny, Simon; Farrant, Bridget; Utter, Jennifer; Fleming, Theresa; Bullen, Pat; Peiris-John, Roshini; Clark, Terryann

    2016-11-01

    Despite numerous calls to improve training in adolescent health, there is little known about the prevalence or effectiveness of specialized training in adolescent health. A two-stage random sampling cluster design was used to collect nationally representative data from 8,500 students from 91 high schools. Student data were linked to data from a survey of school health clinicians from participating schools on their level of training in youth health. Multilevel models accounting for demographic characteristics of students were used to estimate the association between nurses and physicians training in youth health and health outcomes among students. Almost all nurses and physicians reported some training in youth health, either having attended lectures or study days in youth health (n = 60, 80%) or completed postgraduate papers in youth health (n = 13, 17.3%). Students in schools where the nurses and physicians had received postgraduate training in youth health were less likely than students from schools with clinicians having attended lectures or study days in youth health to report emotional and behavior difficulties (11.8 vs. 12.7, p = .002) and binge drinking (19.6% vs. 24.9%, p = .03). There were no significant associations between depressive symptoms, suicide risk, cigarette, marijuana, contraception use, or motor vehicle risk behaviors among students and level of training among clinicians in their schools' health service. Postgraduate training in youth health among nurses and physicians in school health services is associated with fewer students reporting mental health difficulties and binge alcohol use. These findings support specialized training in youth health for clinicians working predominantly with young people. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Self-Efficacy and Outcome Expectancy in Beginning Weight Training Class: Their Relations to Students' Behavioral Intention and Actual Behavior

    Science.gov (United States)

    Gao, Zan; Xiang, Ping; Lee, Amelia M.; Harrison, Louis, Jr.

    2008-01-01

    This study was an initial attempt to investigate the relationships among self-efficacy, outcome expectancy, behavioral intention, and actual behavior over time in a beginning weight training class. A total of 109 participants completed questionnaires assessing their self-efficacy, outcome expectancy, and intentions for future weight training.…

  18. Health Outcomes Survey - Limited Data Set

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) limited data sets (LDS) are comprised of the entire national sample for a given 2-year cohort (including both respondents...

  19. Association of health professional leadership behaviors on health promotion practice beliefs.

    Science.gov (United States)

    Stone, Jacqueline D; Belcher, Harolyn M E; Attoh, Prince; D'Abundo, Michelle; Gong, Tao

    2017-04-01

    Leadership is a process by which an individual influences a group or individual to achieve a common goal, in this case health promotion for individuals with disabilities. (1) To examine the association between the transformational leadership behaviors of the Association of University Centers on Disabilities (AUCD) network professionals and their practice beliefs about health promotion activities, specifically cardiovascular fitness and healthy weight, for people with disabilities. (2) To determine if discipline and/or years of practice moderate the association between transformational leadership behaviors and practice beliefs regarding health promotion. There is a positive association between transformational leadership behaviors and health professionals practice beliefs regarding health promotion activities for persons with disabilities. A quantitative cross-sectional web-based survey design was used to determine the association between leadership behaviors and practices beliefs regarding health promotion for people with disabilities. The Multifactor Leadership Questionnaire and an adapted version of the Role of Health Promotion in Physical Therapy Survey were used to measure leadership and practice beliefs, respectively. Multiple regression analysis was applied to determine the association of leadership behaviors with health promotion practice beliefs variables. Transformational leadership behaviors of the AUCD network professionals were positively associated with health promotion practice beliefs about cardiovascular fitness for people with disabilities. Years post licensure and discipline did not moderate the association between transformational leadership and practice beliefs regarding health promotion. Transformational leadership may facilitate health professionals' health promotion practices for people with disabilities. Further research and training in leadership is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Health Mentor-Reported Outcomes and Perceptions of Student Team Performance in a Longitudinal Interprofessional Education Program.

    Science.gov (United States)

    Umland, Elena; Collins, Lauren; Baronner, Ashley; Lim, Edwin; Giordano, Carolyn

    2016-01-01

    The need to evaluate the impact of interprofessional education (IPE) on learner outcomes is clear, but assessment of IPE's impact on patient health and well-being is lacking. This mixed-methods study evaluated perspectives of community volunteers, health mentors (HMs) who have at least one chronic condition, who participated in an IPE curriculum. In May 2014, 93 HMs concluding the Health Mentors Program completed a survey evaluating their student teams according to the Interprofessional Education Collaborative core competencies' four domains and program impact on health/wellbeing using a 4-point Likert scale (1=strongly disagree; 4=strongly agree). The average response to statements regarding the four domains of values/ethics, roles/responsibilities, communication, and teamwork statements were all >3.0. HMs rated program satisfaction on a 10-point scale (1=least satisfied, 10=most satisfied) and answered open-ended outcome questions. The average program satisfaction score was 9.13±1.43; increased motivation to make and maintain healthy behaviors was reported. In a follow-up focus group with 10 mentors, high satisfaction levels from working with interprofessional student teams were reported, and substantial improvements in managing health conditions and improving overall health status were relayed. Further studies will determine if the patient-reported outcomes of the mentors correlate with objective health measures.

  1. Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

    OpenAIRE

    Walls, Melissa L.; Sittner, Kelley J.; Aronson, Benjamin D.; Forsberg, Angie K.; Whitbeck, Les B.; al’Absi, Mustafa

    2017-01-01

    American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical...

  2. Associations Between County Wealth, Health and Social Services Spending, and Health Outcomes.

    Science.gov (United States)

    McCullough, J Mac; Leider, Jonathon P

    2017-11-01

    Each year, the County Health Rankings rate the health outcomes of each county in the U.S. A common refrain is that poor counties perform worse than wealthier ones. This article examines that assumption and specifically analyzes characteristics of counties that have performed better in terms of health outcomes than their wealth alone would suggest. Data from the 2013 County Health Rankings were used, as were 2012 financial and demographic information collected by the U.S. Census Bureau. A logistic model was constructed to examine the odds of a county "overperforming" in the rankings relative to community wealth. Analyses were performed in 2016. Communities that were wealthier performed better on the rankings. However, more than 800 of 3,141 counties overperformed by ranking in a better health outcomes quartile than their county's wealth alone would suggest. Regression analyses found that for each additional percentage point of total public spending that was allocated toward community health care and public health, the odds of being an overperformer increased by 3.7%. Community wealth correlates with health, but not always. Population health outcomes in hundreds of counties overperform what would be expected given community wealth alone. These counties tend to invest more in community health care and public health spending and other social services. Although the level of a community's wealth is outside the control of practitioners, shifting the proportion of spending to certain social services may positively impact population health. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Design, Intervention Fidelity, and Behavioral Outcomes of a School-Based Water, Sanitation, and Hygiene Cluster-Randomized Trial in Laos

    Directory of Open Access Journals (Sweden)

    Anna N. Chard

    2018-03-01

    Full Text Available Evidence of the impact of water, sanitation, and hygiene (WASH in schools (WinS interventions on pupil absence and health is mixed. Few WinS evaluations rigorously report on output and outcome measures that allow for comparisons of effectiveness between interventions to be made, or for an understanding of why programs succeed. The Water, Sanitation, and Hygiene for Health and Education in Laotian Primary Schools (WASH HELPS study was a randomized controlled trial designed to measure the impact of the United Nations Children’s Fund (UNICEF Laos WinS project on child health and education. We also measured the sustainability of intervention outputs and outcomes, and analyzed the effectiveness of group hygiene activities on behavior change and habit formation. Here, we present the design and intermediate results from this study. We found the WinS project improved the WASH environment in intervention schools; 87.8% of schools received the intervention per design. School-level adherence to outputs was lower; on average, schools met 61.4% of adherence-related criteria. The WinS project produced positive changes in pupils’ school WASH behaviors, specifically increasing toilet use and daily group handwashing. Daily group hygiene activities are effective strategies to improve school WASH behaviors, but a complementary strategy needs to be concurrently promoted for effective and sustained individual handwashing practice at critical times.

  4. Relationships between patient activation, disease-specific knowledge and health outcomes among people with diabetes: a survey study

    OpenAIRE

    Hendriks, M.; Rademakers, J.

    2014-01-01

    Background: Nowadays, patients are expected to be involved in their health care, well-informed and able to adjust their behavior to maintain a good health. Investigating patient activation and its relationships with patient characteristics and health-related outcomes will provide further insight into the gains to be expected if patients are more involved in their healthcare. Methods: Based on claims data, 5,346 people were selected who received diabetes care in the last 12 months. They receiv...

  5. Helping Smokers Quit: The Smoking Cessation Leadership Center Engages Behavioral Health by Challenging Old Myths and Traditions.

    Science.gov (United States)

    Schroeder, Steven A; Clark, Brian; Cheng, Christine; Saucedo, Catherine B

    2018-01-01

    Smoking is much more common among persons with behavioral health conditions (mental illnesses and/or substance use disorders). Persons with these disorders are more likely to die from smoking-related causes than any other reason. Studies have shown that stopping smoking can improve mental health function, as well as improve outcomes for substance use disorders. Yet, for a variety of reasons, smoking cessation has not been integrated into the treatment of behavioral health conditions, and in many instances tobacco use was not only condoned but encouraged. Beginning in 2007, the Smoking Cessation Leadership Center (SCLC) began engaging relevant agencies in an attempt to stimulate more vigorous smoking cessation activities. Partners included the federal Substance Abuse and Mental Health Services Administration, advocacy organizations such as the National Alliance on Mental Illness and Community Anti-Drug Coalitions of America, and clinical groups such as the American Psychiatric Nurses Association, the American Psychiatric Association, American Psychological Association, National Council on Behavioral Health, and National Association of State Mental Health Program Directors. A signature program featured 16 individual state summits involving agencies and groups from multiple sectors, all aiming to lower smoking rates in behavioral health populations. These activities mark an evolving culture change within behavioral health.

  6. Health Care Waste Segregation Behavior among Health Workers in Uganda: An Application of the Theory of Planned Behavior

    OpenAIRE

    Akulume, Martha; Kiwanuka, Suzanne N.

    2016-01-01

    Objective. The goal of this study was to assess the appropriateness of the theory of planned behavior in predicting health care waste segregation behaviors and to examine the factors that influence waste segregation behaviors. Methodology. One hundred and sixty-three health workers completed a self-administered questionnaire in a cross-sectional survey that examined the theory of planned behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) and externa...

  7. Can life coaching improve health outcomes?

    DEFF Research Database (Denmark)

    Ammentorp, Jette

    26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013.......26. Ammentorp J, Uhrenfeldt L, Angel F, Ehrensvärd, Carlsen E, Kofoed P-E. Can life coaching improve health outcomes? – A systematic review of intervention studies. Poster presented at the International Conference on Communication in Healthcare, Montreal Canada, 30 Sept 2013....

  8. Impact of Patient-centered eHealth Applications on Patient Outcomes: A Review on the Mediating Influence of Human Factor Issues.

    Science.gov (United States)

    Wildenbos, G A; Peute, L W; Jaspers, M W M

    2016-11-10

    To examine the evidence of the impact of patient- centered eHealth applications on patient care and to analyze if and how reported human factor issues mediated the outcomes. We searched PubMed (2014-2015) for studies evaluating the impact of patient-centered eHealth applications on patient care (behavior change, self-efficacy, and patient health-related outcomes). The Systems Engineering Initiative for Patient Safety (SEIPS 2.0) model was used as a guidance framework to identify the reported human factors possibly impacting the effectiveness of an eHealth intervention. Of the 348 potentially relevant papers, 10 papers were included for data analysis. None of the 10 papers reported a negative impact of the eHealth intervention. Seven papers involved a randomized controlled trial (RCT) study. Six of these RCTs reported a positive impact of the eHealth intervention on patient care. All 10 papers reported on human factor issues possibly mediating effects of patient-centered eHealth. Human factors involved patient characteristics, perceived social support, and (type of) interaction between patient and provider. While the amount of patient-centered eHealth interventions increases, many questions remain as to whether and to what extent human factors mediate their use and impact. Future research should adopt a formal theory-driven approach towards human factors when investigating those factors' influence on the effectiveness of these interventions. Insights could then be used to better tailor the content and design of eHealth solutions according to patient user profiles, so as to enhance eHealth interventions impact on patient behavior, self-efficacy, and health-related outcomes.

  9. Anticipated regret and health behavior: A meta-analysis.

    Science.gov (United States)

    Brewer, Noel T; DeFrank, Jessica T; Gilkey, Melissa B

    2016-11-01

    Risk beliefs are central to most theories of health behavior, yet many unanswered questions remain about an increasingly studied risk construct, anticipated regret. The authors sought to better understand anticipated regret's role in motivating health behaviors. The authors systematically searched electronic databases for studies of anticipated regret and behavioral intentions or health behavior. They used random effects meta-analysis to synthesize effect sizes from 81 studies (n = 45,618). Anticipated regret was associated with both intentions (r+ = .50, p emotions and risk appraisals. Anticipated inaction regret has a stronger and more stable association with health behavior than previously thought. The field should give greater attention to understanding how anticipated regret differs from similar constructs, its role in health behavior theory, and its potential use in health behavior interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. Oral health related knowledge and health behavior of parents and school children

    OpenAIRE

    Lalić Maja; Aleksić Ema; Gajić Mihajlo; Malešević Đoka

    2013-01-01

    Introduction. The family provides the background for developing behaviors, attitudes and knowledge related to oral health of children. The aim of this study was to compare oral health behavior of parents and their children and to asses the impact of parental behavior on children’s oral health. Material and Methods. This cross-sectional study included 99 parent - child pairs (12 to 15 years old). Data on oral health behavior, knowledge and attitudes regarding oral hygiene, fluorides and ...

  11. Nativity, Chronic Health Conditions, and Health Behaviors in Filipino Americans.

    Science.gov (United States)

    Bayog, Maria L G; Waters, Catherine M

    2018-05-01

    Nearly half of Americans have a chronic health condition related to unhealthful behavior. One in four Americans is an immigrant; yet immigrants' health has been studied little, particularly among Asian American subpopulations. Years lived in United States, hypertension, diabetes, smoking, walking, adiposity, and fruit/vegetable variables in the 2011-2012 California Health Interview Survey were analyzed to examine the influence of nativity on chronic health conditions and health behaviors in 555 adult Filipinos, the second largest Asian American immigrant subpopulation. Recent and long-term immigrant Filipinos had higher odds of having hypertension and diabetes, but lower odds of smoking and overweight/obesity compared with second-generation Filipinos. Being born in the United States may be protective against chronic health conditions, but not for healthful behaviors among Filipinos. Chronic disease prevention and health promotion strategies should consider nativity/length of residence, which may be a more consequential health determinant than other immigration and acculturation characteristics.

  12. The perceived importance of physical activity: associations with psychosocial and health-related outcomes.

    Science.gov (United States)

    Wójcicki, Thomas R; Szabo, Amanda N; White, Siobhan M; Mailey, Emily L; Kramer, Arthur F; McAuley, Edward

    2013-03-01

    The purpose of this study was to assess the extent to which participation in a 12-month exercise program changed the degree of importance that older adults attached to physical activity. In addition, associations among changes in physical activity importance and health-related and psychosocial outcomes were examined. Community-dwelling older adults (N = 179) were recruited to participate in a 12-month exercise trial examining the association between changes in physical activity and fitness with changes in brain structure and psychological health. Participants were randomly assigned to a walking condition or a flexibility, toning, and balance condition. Physical, psychological, and cognitive assessments were taken at months 0, 6, and 12. Involvement in a 12-month exercise program increased the importance that participants placed on physical activity; this positive change was similar across exercise condition and sex. Changes in importance, however, were only associated with changes in physical health status and outcome expectations for exercise midway through the intervention. There were no significant associations at the end of the program. Regular participation in physical activity can positively influence the perceived importance of the behavior itself. Yet, the implications of such changes on physical activity-related outcomes remain equivocal and warrant further investigation.

  13. Gender Differences in Deviance and Health Risk Behaviors Among Young-Adults Undergraduate Students.

    Science.gov (United States)

    Korn, Liat; Bonny-Noach, Hagit

    2018-01-02

    Deviant and health risk behaviors among young-adults are associated with many adverse outcomes. This study aims to evaluate a broad variety of behaviors by gender differences and their contribution to predicting cannabis use in undergraduate students. This research is based on a structured, self-reported anonymous questionnaire distributed to 1,432 young adult undergraduate students at an Israeli University, 533 males and 899 females (mean age 27.4; SD 6.01). The findings demonstrate a significant proportion of sampled young adults reported to be involved in deviant and health risk behaviors and that all risky behaviors were more frequently significant in males than in females. Among drivers 72% reported speeding, 60% reported failure to keep distance, 44% reported being involved at a car accident as a driver, 40% reported not stopping at a stop sign, and quarter reported driving after drinking alcohol. These findings also expand how certain risk behaviors contribute to predicting cannabis use. The relatively high prevalence of some of these risky behaviors among normative young adults suggests that risky behaviors are considered as normative behavior for this group, especially among man, and therefore, policymakers need to consider prevention and harm reduction interventions relevant to this risk group.

  14. Credit with Health Education in Benin: A Cluster Randomized Trial Examining Impacts on Knowledge and Behavior.

    Science.gov (United States)

    Karlan, Dean; Thuysbaert, Bram; Gray, Bobbi

    2017-02-08

    We evaluate whether health education integrated into microcredit lending groups reduces health risks by improving health knowledge and self-reported behaviors among urban and rural borrowers in eastern Benin. In 2007, we randomly assigned 138 villages in the Plateau region of Benin to one of four variations of a group liability credit product, varying lending groups' gender composition and/or inclusion of health education using a 2 × 2 design. Women in villages receiving health education, regardless of gender composition of the groups, showed improved knowledge of malaria and of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), but not of childhood illness danger signs. No significant changes in health behavior were observed except an increase in HIV/AIDS prevention behavior, a result predominantly driven by an increase in respondents' self-reported ability to procure a condom, likely an indicator of increased perceived access rather than improved preventative behavior. Women in villages assigned to mixed-gender groups had significantly lower levels of social capital, compared with villages assigned to female-only groups. This suggests there may be an important trade-off to consider for interventions seeking improved health outcomes and social capital through provision of services to mixed-gender groups. Although bundling health education with microcredit can expand health education coverage and lower service-delivery costs, the approach may not be sufficient to improve health behaviors. © The American Society of Tropical Medicine and Hygiene.

  15. Time series clustering analysis of health-promoting behavior

    Science.gov (United States)

    Yang, Chi-Ta; Hung, Yu-Shiang; Deng, Guang-Feng

    2013-10-01

    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.

  16. Transformational leadership behaviors in allied health professions.

    Science.gov (United States)

    Wylie, David A; Gallagher, Helen L

    2009-01-01

    The aim of this study was to explore self-reported transformational leadership behavior profiles within the six largest allied health profession groups in the National Health Service in Scotland and to determine whether factors such as seniority of grade, locus of employment, and/or leadership training have a positive influence on transformational leadership behaviors. A postal survey comprising the shorter version of the Multifactorial Leadership Questionnaire (MLQ) and contextual demographic information was completed by 753 allied health professionals from four Health Board areas across Scotland who were randomly selected through a modified cluster sampling technique. The MLQ contains 36 items that measure nine identified leadership factors; however, only the responses to the five transformational leadership factors are reported here. The study identified significant differences in transformational leadership behaviors between individual allied health professions. Radiographers and podiatrists scored consistently lower than the other professional groups across the range of transformational behaviors. Seniority of grade significantly influenced the scores, with higher-graded staff reporting greater leadership behaviors (p leadership training also positively influenced transformational behaviors (p transformational leadership behaviors between individual allied health professions, indicating that some professional groups are inherently advantaged in embracing the modernization agenda. This highlights an as-yet missed opportunity for effectively targeting and evaluating multidisciplinary leadership training programs across the allied health professions.

  17. Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes.

    Science.gov (United States)

    Mohr, David C; Schult, Tamara; Eaton, Jennifer Lipkowitz; Awosika, Ebi; McPhaul, Kathleen M

    2016-05-01

    The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.

  18. Addressing Younger Workers’ Needs: The Promoting U through Safety and Health (PUSH Trial Outcomes

    Directory of Open Access Journals (Sweden)

    Diane S. Rohlman

    2016-08-01

    Full Text Available Most younger workers, less than 25 years old, receive no training in worker safety. We report the feasibility and outcomes of a randomized controlled trial of an electronically delivered safety and health curriculum for younger workers entitled, PUSH (Promoting U through Safety and Health. All younger workers (14–24 years old hired for summer work at a large parks and recreation organization were invited to participate in an evaluation of an online training and randomized into an intervention or control condition. Baseline and end-of-summer online instruments assessed acceptability, knowledge, and self-reported attitudes and behaviors. One-hundred and forty participants (mean age 17.9 years completed the study. The innovative training was feasible and acceptable to participants and the organization. Durable increases in safety and health knowledge were achieved by intervention workers (p < 0.001, effect size (Cohen’s d 0.4. However, self-reported safety and health attitudes did not improve with this one-time training. These results indicate the potential utility of online training for younger workers and underscore the limitations of a single training interaction to change behaviors. Interventions may need to be delivered over a longer period of time and/or include environmental components to effectively alter behavior.

  19. Addressing Younger Workers’ Needs: The Promoting U through Safety and Health (PUSH) Trial Outcomes

    Science.gov (United States)

    Rohlman, Diane S.; Parish, Megan; Elliot, Diane L.; Hanson, Ginger; Perrin, Nancy

    2016-01-01

    Most younger workers, less than 25 years old, receive no training in worker safety. We report the feasibility and outcomes of a randomized controlled trial of an electronically delivered safety and health curriculum for younger workers entitled, PUSH (Promoting U through Safety and Health). All younger workers (14–24 years old) hired for summer work at a large parks and recreation organization were invited to participate in an evaluation of an online training and randomized into an intervention or control condition. Baseline and end-of-summer online instruments assessed acceptability, knowledge, and self-reported attitudes and behaviors. One-hundred and forty participants (mean age 17.9 years) completed the study. The innovative training was feasible and acceptable to participants and the organization. Durable increases in safety and health knowledge were achieved by intervention workers (p < 0.001, effect size (Cohen’s d) 0.4). However, self-reported safety and health attitudes did not improve with this one-time training. These results indicate the potential utility of online training for younger workers and underscore the limitations of a single training interaction to change behaviors. Interventions may need to be delivered over a longer period of time and/or include environmental components to effectively alter behavior. PMID:27517968

  20. Physiological and behavioral indices of emotion dysregulation as predictors of outcome from cognitive behavioral therapy and acceptance and commitment therapy for anxiety.

    Science.gov (United States)

    Davies, Carolyn D; Niles, Andrea N; Pittig, Andre; Arch, Joanna J; Craske, Michelle G

    2015-03-01

    Identifying for whom and under what conditions a treatment is most effective is an essential step toward personalized medicine. The current study examined pre-treatment physiological and behavioral variables as predictors and moderators of outcome in a randomized clinical trial comparing cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders. Sixty individuals with a DSM-IV defined principal anxiety disorder completed 12 sessions of either CBT or ACT. Baseline physiological and behavioral variables were measured prior to entering treatment. Self-reported anxiety symptoms were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline. Higher pre-treatment heart rate variability was associated with worse outcome across ACT and CBT. ACT outperformed CBT for individuals with high behavioral avoidance. Subjective anxiety levels during laboratory tasks did not predict or moderate treatment outcome. Due to small sample sizes of each disorder, disorder-specific predictors were not tested. Future research should examine these predictors in larger samples and across other outcome variables. Lower heart rate variability was identified as a prognostic indicator of overall outcome, whereas high behavioral avoidance was identified as a prescriptive indicator of superior outcome from ACT versus CBT. Investigation of pre-treatment physiological and behavioral variables as predictors and moderators of outcome may help guide future treatment-matching efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. A systematic review of eHealth behavioral interventions targeting smoking, nutrition, alcohol, physical activity and/or obesity for young adults.

    Science.gov (United States)

    Oosterveen, Emilie; Tzelepis, Flora; Ashton, Lee; Hutchesson, Melinda J

    2017-06-01

    A systematic review of randomized control trials (RCT) was undertaken to evaluate the effectiveness of eHealth behavioral interventions aiming to improve smoking rates, nutrition behaviors, alcohol intake, physical activity levels and/or obesity (SNAPO) in young adults. Seven electronic databases were searched for RCTs published in English from 2000 to April 2015 and evaluating eHealth interventions aiming to change one or multiple SNAPO outcomes, and including young adult (18-35years) participants. Of 2,159 articles identified, 45 studies met the inclusion criteria. Most interventions targeted alcohol (n=26), followed by smoking (n=7), physical activity (n=4), obesity (n=4) and nutrition (n=1). Three interventions targeted multiple behaviors. The eHealth interventions were most often delivered via websites (79.5%). Most studies (n=32) compared eHealth interventions to a control group (e.g. waiting list control, minimal intervention), with the majority (n=23) showing a positive effect on a SNAPO outcome at follow-up. Meta-analysis demonstrated a significantly lower mean number of drinks consumed/week in brief web or computer-based interventions compared to controls (Mean Difference -2.43 [-3.54, -1.32], PeHealth delivery modes, with inconsistent results across target behaviors and technology types. Nine studies compared eHealth to other modes of delivery (e.g. in person) with all finding no difference in SNAPO outcomes between groups at follow-up. This review provides some evidence for the efficacy of eHealth SNAPO interventions for young adults, particularly in the short-term and for alcohol interventions. But there is insufficient evidence for their efficacy in the longer-term, as well as which mode of delivery is most effective. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  2. Outcome-based health equity across different social health insurance schemes for the elderly in China.

    Science.gov (United States)

    Liu, Xiaoting; Wong, Hung; Liu, Kai

    2016-01-14

    Against the achievement of nearly universal coverage for social health insurance for the elderly in China, a problem of inequity among different insurance schemes on health outcomes is still a big challenge for the health care system. Whether various health insurance schemes have divergent effects on health outcome is still a puzzle. Empirical evidence will be investigated in this study. This study employs a nationally representative survey database, the National Survey of the Aged Population in Urban/Rural China, to compare the changes of health outcomes among the elderly before and after the reform. A one-way ANOVA is utilized to detect disparities in health care expenditures and health status among different health insurance schemes. Multiple Linear Regression is applied later to examine the further effects of different insurance plans on health outcomes while controlling for other social determinants. The one-way ANOVA result illustrates that although the gaps in insurance reimbursements between the Urban Employee Basic Medical Insurance (UEBMI) and the other schemes, the New Rural Cooperative Medical Scheme (NCMS) and Urban Residents Basic Medical Insurance (URBMI) decreased, out-of-pocket spending accounts for a larger proportion of total health care expenditures, and the disparities among different insurances enlarged. Results of the Multiple Linear Regression suggest that UEBMI participants have better self-reported health status, physical functions and psychological wellbeing than URBMI and NCMS participants, and those uninsured. URBMI participants report better self-reported health than NCMS ones and uninsured people, while having worse psychological wellbeing compared with their NCMS counterparts. This research contributes to a transformation in health insurance studies from an emphasis on the opportunity-oriented health equity measured by coverage and healthcare accessibility to concern with outcome-based equity composed of health expenditure and health

  3. Burnout and health behaviors in health professionals from seven European countries.

    Science.gov (United States)

    Alexandrova-Karamanova, Anna; Todorova, Irina; Montgomery, Anthony; Panagopoulou, Efharis; Costa, Patricia; Baban, Adriana; Davas, Asli; Milosevic, Milan; Mijakoski, Dragan

    2016-10-01

    Within an underlying health-impairing process, work stressors exhaust employees' mental and physical resources and lead to exhaustion/burnout and to health problems, with health-impairing behaviors being one of the potential mechanisms, linking burnout to ill health. The study aims to explore the associations between burnout and fast food consumption, exercise, alcohol consumption and painkiller use in a multinational sample of 2623 doctors, nurses and residents from Greece, Portugal, Bulgaria, Romania, Turkey, Croatia and Macedonia, adopting a cross-national approach. Data are part of the international cross-sectional quantitative ORCAB survey. The measures included the Maslach Burnout Inventory and the Health Behaviors Questionnaire. Burnout was significantly positively associated with higher fast food consumption, infrequent exercise, higher alcohol consumption and more frequent painkiller use in the full sample, and these associations remained significant after the inclusion of individual differences factors and country of residence. Cross-national comparisons showed significant differences in burnout and health behaviors, and some differences in the statistical significance and magnitude (but not the direction) of the associations between them. Health professionals from Turkey, Greece and Bulgaria reported the most unfavorable experiences. Burnout and risk health behaviors among health professionals are important both in the context of health professionals' health and well-being and as factors contributing to medical errors and inadequate patient safety. Organizational interventions should incorporate early identification of such behaviors together with programs promoting health and aimed at the reduction of burnout and work-related stress.

  4. Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes

    Science.gov (United States)

    Hammer, Leslie B.; Truxillo, Donald M.; Bodner, Todd; Rineer, Jennifer; Pytlovany, Amy C.; Richman, Amy

    2015-01-01

    The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based), followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety. PMID:26557703

  5. Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes

    Directory of Open Access Journals (Sweden)

    Leslie B. Hammer

    2015-01-01

    Full Text Available The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based, followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety.

  6. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    Science.gov (United States)

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  7. Associations between Indigenous Australian oral health literacy and self-reported oral health outcomes

    Directory of Open Access Journals (Sweden)

    Jamieson Lisa M

    2010-03-01

    Full Text Available Abstract Objectives To determine oral health literacy (REALD-30 and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. Methods 468 participants (aged 17-72 years, 63% female completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate modelling was used to calculate risk indicators for poor self-reported oral health. Results REALD-30 scores were lower among those who believed teeth should be infrequently brushed, believed cordial was good for teeth, did not own a toothbrush or owned a toothbrush but brushed irregularly. Tooth removal risk indicators included being older, problem-based dental attendance and believing cordial was good for teeth. Poor self-rated oral health risk indicators included being older, healthcare card ownership, difficulty paying dental bills, problem-based dental attendance, believing teeth should be brushed infrequently and irregular brushing. Perceived need for dental care risk indicators included being female and problem-based dental attendance. Perceived gum disease risk indicators included being older and irregular brushing. Feeling uncomfortable about oro-facial appearance risk indicators included problem-based dental attendance and irregular brushing. Food avoidance risk indicators were being female, difficulty paying dental bills, problem-based dental attendance and irregular brushing. Poor oral health-related quality of life risk indicators included difficulty paying dental bills and problem-based dental attendance. Conclusions REALD-30 was significantly associated with oral health literacy-related outcomes. Oral health literacy-related outcomes were risk indicators for each of the poor self-reported oral health domains among this marginalised population.

  8. Parent-based adolescent sexual health interventions and effect on communication outcomes: a systematic review and meta-analyses.

    Science.gov (United States)

    Santa Maria, Diane; Markham, Christine; Bluethmann, Shirley; Mullen, Patricia Dolan

    2015-03-01

    Parent-based adolescent sexual health interventions aim to reduce sexual risk behaviors by bolstering parental protective behaviors. Few studies of theory use, methods, applications, delivery and outcomes of parent-based interventions have been conducted. A systematic search of databases for the period 1998-2013 identified 28 published trials of U.S. parent-based interventions to examine theory use, setting, reach, delivery mode, dose and effects on parent-child communication. Established coding schemes were used to assess use of theory and describe methods employed to achieve behavioral change; intervention effects were explored in meta-analyses. Most interventions were conducted with minority parents in group sessions or via self-paced activities; interventions averaged seven hours, and most used theory extensively. Meta-analyses found improvements in sexual health communication: Analysis of 11 controlled trials indicated a medium effect on increasing communication (Cohen's d, 0.5), and analysis of nine trials found a large effect on increasing parental comfort with communication (0.7); effects were positive regardless of delivery mode or intervention dose. Intervention participants were 68% more likely than controls to report increased communication and 75% more likely to report increased comfort. These findings point to gaps in the range of programs examined in published trials-for example, interventions for parents of sexual minority youth, programs for custodial grandparents and faith-based services. Yet they provide support for the effectiveness of parent-based interventions in improving communication. Innovative delivery approaches could extend programs' reach, and further research on sexual health outcomes would facilitate the meta-analysis of intervention effectiveness in improving adolescent sexual health behaviors. Copyright © 2015 by the Guttmacher Institute.

  9. Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures.

    Science.gov (United States)

    Deighton, Jessica; Croudace, Tim; Fonagy, Peter; Brown, Jeb; Patalay, Praveetha; Wolpert, Miranda

    2014-01-01

    There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures' psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against

  10. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    Science.gov (United States)

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-12-01

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  11. Problematic digital gaming behavior and its relation to the psychological, social and physical health of Finnish adolescents and young adults.

    Science.gov (United States)

    Männikkö, Niko; Billieux, Joël; Kääriäinen, Maria

    2015-12-01

    The aim of this study was to identify problematic gaming behavior among Finnish adolescents and young adults, and evaluate its connection to a variety of psychological, social, and physical health symptoms. This cross-sectional study was conducted with a random sample of 293 respondents aged from 13 to 24 years. Participants completed an online survey. Problematic gaming behavior was measured with the Game Addiction Scale (GAS). Self-reports covered health measures such as psychological health (psychopathological symptoms, satisfaction with life), social health (preferences for social interaction), and physical health (general health, Body Mass Index [BMI], body discomfort, physical activity). Problematic gaming behavior was found to relate to psychological and health problems, namely fatigue, sleep interference, depression and anxiety symptoms. Multiple linear regression indicated that the amount of weekly gaming, depression and a preference for online social interaction predicted increased problematic gaming symptoms. This research emphasized that problematic gaming behavior had a strong negative correlation to a variety of subjective health outcomes.

  12. Associations between media use and health information-seeking behavior on vaccinations in South Korea

    Directory of Open Access Journals (Sweden)

    Jiyeon Kim

    2017-09-01

    Full Text Available Abstract Background Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population. Methods This study relied on a national survey of Korean adults (n = 1367. Participants were adult males and females age 20 and older. Web and face-to-face surveys were conducted throughout July 2014. The main outcome was vaccination (categorized as yes or no. Independent variables were time spent on media, frequency of health information-seeking behavior, and types of health information sought. Results Controlling for co-variates, logistic regression analysis was conducted to identify factors that influence Korean adults being vaccinated. Results revealed that accessible information about emerging infectious diseases, listening to the radio, and reading the newspaper were associated with increased odds of being vaccinated. Active seeking health information as well as being female and of higher socio-economic status were positively correlated with Korean adults being vaccinated. Conclusion It is critical to promote health information-seeking behavior and use diverse media channels to increase acceptance and awareness of emerging infectious diseases and vaccinations. Because there are differences in vaccination awareness depending on social class, it is critical to reduce communication inequality, strengthen accessibility to vaccinations, and devise appropriate risk communication strategies that ensure Korean adults receive vaccinations.

  13. Associations between media use and health information-seeking behavior on vaccinations in South Korea.

    Science.gov (United States)

    Kim, Jiyeon; Jung, Minsoo

    2017-09-11

    Although vaccinations are critical for preventing emerging infectious diseases, scant research has been conducted on risk communication. With socio-economic characteristics, health behavior, and underlying diseases under control, we investigated associations between media use, health information-seeking behavior, health information type, and vaccination in the population. This study relied on a national survey of Korean adults (n = 1367). Participants were adult males and females age 20 and older. Web and face-to-face surveys were conducted throughout July 2014. The main outcome was vaccination (categorized as yes or no). Independent variables were time spent on media, frequency of health information-seeking behavior, and types of health information sought. Controlling for co-variates, logistic regression analysis was conducted to identify factors that influence Korean adults being vaccinated. Results revealed that accessible information about emerging infectious diseases, listening to the radio, and reading the newspaper were associated with increased odds of being vaccinated. Active seeking health information as well as being female and of higher socio-economic status were positively correlated with Korean adults being vaccinated. It is critical to promote health information-seeking behavior and use diverse media channels to increase acceptance and awareness of emerging infectious diseases and vaccinations. Because there are differences in vaccination awareness depending on social class, it is critical to reduce communication inequality, strengthen accessibility to vaccinations, and devise appropriate risk communication strategies that ensure Korean adults receive vaccinations.

  14. Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents’ preventive oral health knowledge and behaviors for their young children

    Science.gov (United States)

    Hoeft, Kristin S.; Barker, Judith C.; Shiboski, Stephen; Guzman, Estela Pantoja; Hiatt, Robert A.

    2016-01-01

    Objectives To determine the effectiveness of the Contra Caries Oral Health Education Program (CCOHEP) for improving low-income, Spanish-speaking parents’ oral health knowledge and behaviors for their young children. Mexican American children in the United States suffer disproportionately high prevalence and severity of early childhood caries, yet few evaluated, theory-based behavioral interventions exist for this population. CCOHEP is a theory-based curriculum consisting of four 2-hour interactive classes designed for and by Spanish speakers and led by designated community health educators (promotoras). Topics included children’s oral hygiene, caries etiology, dental procedures, nutrition, child behavior management and parent skill-building activities. Methods Low-income Spanish-speaking parents/caregivers of children aged 0–5 years were recruited through community services in an agricultural city in California. Survey questions from the Oral Health Basic Research Facts Questionnaire measuring oral health related behaviors and knowledge were verbally administered before, immediately after, and 3 months after attendance at CCOHEP. Five questions measured aspects of parental tooth brushing for their children (frequency, using fluoridated toothpaste, brushing before bed, not drinking or eating after nighttime brushing, adult assistance), three questions measured other oral health behaviors, and 16 questions measured oral health-related knowledge. Analyses of within-person changes between pre- and posttests, and again between post-test and three month follow up consisted of McNemar’s test for binary outcomes and sign tests for ordinal outcomes. Results Overall, 105 caregivers participated in CCOHEP (n= 105 pretest, n=95 posttest, n=79 second posttest). At baseline, all parents self-reported doing at least one aspect of toothbrushing correctly, but only 13% reported performing all five aspects according to professional guidelines. At posttest, 44% of parents

  15. Examining intrinsic versus extrinsic exercise goals: cognitive, affective, and behavioral outcomes.

    Science.gov (United States)

    Sebire, Simon J; Standage, Martyn; Vansteenkiste, Maarten

    2009-04-01

    Grounded in self-determination theory (SDT), this study had two purposes: (a) examine the associations between intrinsic (relative to extrinsic) exercise goal content and cognitive, affective, and behavioral outcomes; and (b) test the mediating role of psychological need satisfaction in the Exercise Goal Content --> Outcomes relationship. Using a sample of 410 adults, hierarchical regression analysis showed relative intrinsic goal content to positively predict physical self-worth, self-reported exercise behavior, psychological well-being, and psychological need satisfaction and negatively predict exercise anxiety. Except for exercise behavior, the predictive utility of relative intrinsic goal content on the dependent variables of interest remained significant after controlling for participants' relative self-determined exercise motivation. Structural equation modeling analyses showed psychological need satisfaction to partially mediate the effect of relative intrinsic goal content on the outcome variables. Our findings support further investigation of exercise goals commensurate with the goal content perspective advanced in SDT.

  16. Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization.

    Science.gov (United States)

    Bao, Yuhua; Casalino, Lawrence P; Pincus, Harold Alan

    2013-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools-accountability measures and payment designs-to improve access to and quality of care for patients with behavioral health needs.

  17. Associations of eHealth Literacy With Health Behavior Among Adult Internet Users.

    Science.gov (United States)

    Mitsutake, Seigo; Shibata, Ai; Ishii, Kaori; Oka, Koichiro

    2016-07-18

    In the rapidly developing use of the Internet in society, eHealth literacy-having the skills to utilize health information on the Internet-has become an important prerequisite for promoting healthy behavior. However, little is known about whether eHealth literacy is associated with health behavior in a representative sample of adult Internet users. The aim of this study was to examine the association between eHealth literacy and general health behavior (cigarette smoking, physical exercise, alcohol consumption, sleeping hours, eating breakfast, eating between meals, and balanced nutrition) among adult Internet users in Japan. The participants were recruited among registrants of a Japanese Internet research service company and asked to answer a cross-sectional Internet-based survey in 2012. The potential respondents (N=10,178) were randomly and blindly invited via email from the registrants in accordance with the set sample size and other attributes. eHealth literacy was assessed using the Japanese version of the eHealth Literacy Scale. The self-reported health behaviors investigated included never smoking cigarettes, physical exercise, alcohol consumption, sleeping hours, eating breakfast, not eating between meals, and balanced nutrition. We obtained details of sociodemographic attributes (sex, age, marital status, educational attainment, and household income level) and frequency of conducting Internet searches. To determine the association of each health behavior with eHealth literacy, we performed a logistic regression analysis; we adjusted for sociodemographic attributes and frequency of Internet searching as well as for other health behaviors that were statistically significant with respect to eHealth literacy in univariate analyses. We analyzed the data of 2115 adults (response rate: 24.04%, 2142/10,178; male: 49.74%, 1052/2115; age: mean 39.7, SD 10.9 years) who responded to the survey. Logistic regression analysis showed that individuals with high eHealth

  18. Wealth and health behavior: Testing the concept of a health cost

    NARCIS (Netherlands)

    J.L.W. van Kippersluis (Hans); T.J. Galama (Titus)

    2014-01-01

    textabstractWealthier individuals engage in healthier behavior. This paper seeks to explain this phenomenon by exploiting both inheritances and lottery winnings to test a theory of health behavior. We distinguish between the direct monetary cost and the indirect health cost (value of health lost) of

  19. Health status, health conditions, and health behaviors among Amish women. Results from the Central Pennsylvania Women's Health Study (CePAWHS).

    Science.gov (United States)

    Miller, Kirk; Yost, Berwood; Flaherty, Sean; Hillemeier, Marianne M; Chase, Gary A; Weisman, Carol S; Dyer, Anne-Marie

    2007-01-01

    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 in Central Pennsylvania. Compared with women in the general population, Amish women rated their physical health approximately at the same level, but reported less stress, fewer symptoms of depression, and had higher aggregate scores for mental health. Amish women reported low levels of intimate partner violence, high levels of social support, and they perceived low levels of unfair treatment owing to gender compared with the general population. Amish women also reported higher fertility, fewer low birthweight babies, but the same number of preterm births as the general population. The findings suggest that these outcomes may be due to higher levels of social support and better preconceptional behavior among Amish women.

  20. A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects.

    Science.gov (United States)

    Lippke, Sonia; Fleig, Lena; Wiedemann, Amelie U; Schwarzer, Ralf

    2015-10-01

    Preventive health behaviors, such as regular physical activity and healthy nutrition, are recommended to maintain employability and to facilitate the health of employees. Theory-based workplace health promotion needs to include psychological constructs and consider the motivational readiness (so-called stages of change) of employees. According to the stages, people can be grouped as nonintenders (not motivated to change and not performing the goal behavior), intenders (decided to adopt the goal behavior but not started yet), or actors (performing the goal behavior already). The tailoring to these stages can be done computer based and should make workplace health promotion more effective. It was tested whether a parsimonious computer-based health promotion program implemented at the workplace was effective in terms of lifestyle changes and psychological outcomes as well as body weight. We hypothesized that the stage-matched intervention would outperform the one-size-fits-all active control condition (standard care intervention). In a randomized controlled trial, a total of 1269 employees were recruited by a trained research assistant at their workplace during a routine medical examination. After excluding noneligible employees, 560 completed Time 1 (T1), and 384 also completed Time 2 (T2), achieving a retention rate of 68.6%. Two fully automated computer-based treatments were adopted: (1) an active control condition with information about benefits of exercise and healthy nutrition (n=52), or (2) a stage-matched multiple-behavior intervention that provided different psychological treatments to 9 subgroups, addressing stages of change (nonintenders, intenders, and actors per behavior; n=332). Baseline assessments (T1) on behavior, psychological constructs, and body weight were repeated after 4 weeks (T2). The stage-matched intervention outperformed the active control condition for lifestyle changes containing physical activity and nutrition (χ(2) 1=3.5; P=.04, for N

  1. Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: why we should measure them all.

    Science.gov (United States)

    Asada, Yukiko; Whipp, Alyce; Kindig, David; Billard, Beverly; Rudolph, Barbara

    2014-06-13

    Regular reporting of health inequalities is essential to monitoring progress of efforts to reduce health inequalities. While reporting of population health became increasingly common, reporting of a subpopulation group breakdown of each indicator of the health of the population is rarely a standard practice. This study reports education-, sex-, and race-related inequalities in four health outcomes in each of the selected 93 counties in the United States in a systematic and comparable manner. This study is a cross-sectional analysis of large, publicly available data, 2008, 2009, and 2010 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan/Micropolitan Area Risk Trends (SMART) and 2008, 2009, and 2010 United States Birth Records from the National Vital Statistics System. The study population is American adults older than 25 years of age residing in the selected 93 counties, representing about 30% of the US population, roughly equally covering all geographic regions of the country. Main outcome measures are: (1) Attribute (group characteristic)-specific inequality: education-, sex-, or race-specific inequality in each of the four health outcomes (poor or fair health, poor physical health days, poor mental health days, and low birthweight) in each county; (2) Overall inequality: the average of these three attribute-specific inequalities for each health outcome in each county; and (3) Summary inequality in total morbidity: the weighted average of the overall inequalities across the four health outcomes in each county. The range of inequality across the counties differed considerably by health outcome; inequality in poor or fair health had the widest range and the highest median among inequalities in all health outcomes. In more than 70% of the counties, education-specific inequality was the largest in all health outcomes except for low birthweight. It is feasible to extend population health reporting to include reporting of a subpopulation group

  2. Youth with Behavioral Health Disorders Aging Out of Foster Care: a Systematic Review and Implications for Policy, Research, and Practice.

    Science.gov (United States)

    Kang-Yi, Christina D; Adams, Danielle R

    2017-01-01

    This systematic review aimed to (1) identify and summarize empirical studies on youth with behavioral health disorders aging out of foster care and (2) address implications for behavioral health policy, research, and practice. We identified previous studies by searching PubMed, PsycINFO, EBSCO, and ISI Citation Indexes and obtaining references from key experts in the child welfare field. A total of 28 full articles published between 1991 and 2014 were reviewed and summarized into the key areas including systems of care, disability type, transition practice area, study methods, study sample, transition outcome measures, study analysis, and study findings. Considering how fast youth who have behavioral health disorders fall through the crack as they exit foster care, one cannot understate the importance of incorporating timely and appropriate transition planning and care coordination for youth who have behavioral health disorders aging out of foster care into the usual case management performed by behavioral health systems and service providers.

  3. Department of Defense Birth and Infant Health Registry: select reproductive health outcomes, 2003-2014.

    Science.gov (United States)

    Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J

    2017-11-01

    Established following a 1998 directive, the Department of Defense Birth and Infant Health Registry (Registry) team conducts surveillance of select reproductive health outcomes among military families. Data are compiled from the Military Health System Data Repository and Defense Manpower Data Center to define the Registry cohort and outcomes of interest. Outcomes are defined using ICD-9/ICD-10 and Current Procedural Terminology codes, and include: pregnancy outcomes (e.g., live births, losses), birth defects, preterm births, and male:female infant sex ratio. This report includes data from 2003-2014 on 1,304,406 infants among military families and 258,332 pregnancies among active duty women. Rates of common adverse infant and pregnancy outcomes were comparable to or lower than those in the general US population. These observations, along with prior Registry analyses, provide reassurance that military service is not independently associated with increased risks for select adverse reproductive health outcomes. The Registry's diverse research portfolio demonstrates its unique capabilities to answer a wide range of questions related to reproductive health. These data provide the military community with information to identify successes and areas for improvement in prevention and care.

  4. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review.

    Science.gov (United States)

    Aidala, Angela A; Wilson, Michael G; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K; Caban, Maria; Rourke, Sean B

    2016-01-01

    Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking "upstream" economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual's control that affect housing and residential environments and the health resources or risk exposures such contexts provide. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in high-income countries. We defined housing status to include

  5. Housing Status, Medical Care, and Health Outcomes Among People Living With HIV/AIDS: A Systematic Review

    Science.gov (United States)

    Wilson, Michael G.; Shubert, Virginia; Gogolishvili, David; Globerman, Jason; Rueda, Sergio; Bozack, Anne K.; Caban, Maria; Rourke, Sean B.

    2016-01-01

    Background. Accumulating evidence suggests responses to HIV that combine individual-level interventions with those that address structural or contextual factors that influence risks and health outcomes of infection. Housing is such a factor. Housing occupies a strategic position as an intermediate structural factor, linking “upstream” economic, social, and cultural determinants to the more immediate physical and social environments in which everyday life is lived. The importance of housing status for HIV prevention and care has been recognized, but much of this attention has focused on homeless individuals as a special risk group. Analyses have less often addressed community housing availability and conditions as factors influencing population health or unstable, inadequate, or unaffordable housing as a situation or temporary state. A focus on individual-level characteristics associated with literal homelessness glosses over social, economic, and policy drivers operating largely outside any specific individual’s control that affect housing and residential environments and the health resources or risk exposures such contexts provide. Objectives. We examined the available empirical evidence on the association between housing status (broadly defined), medical care, and health outcomes among people with HIV and analyzed results to inform future research, program development, and policy implementation. Search methods. We searched 8 electronic health and social science databases from January 1, 1996, through March 31, 2014, using search terms related to housing, dwelling, and living arrangements and HIV and AIDS. We contacted experts for additional literature. Selection criteria. We selected articles if they were quantitative analyses published in English, French, or Spanish that included at least 1 measure of housing status as an independent variable and at least 1 health status, health care, treatment adherence, or risk behavior outcome among people with HIV in

  6. Comparison of health risk behavior, awareness, and health benefit beliefs of health science and non-health science students: An international study.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa; Yung, Tony K C; Aounallah-Skhiri, Hajer; Rehman, Rehana

    2016-06-01

    This study determines the differences in health risk behavior, knowledge, and health benefit beliefs between health science and non-health science university students in 17 low and middle income countries. Anonymous questionnaire data were collected in a cross-sectional survey of 13,042 undergraduate university students (4,981 health science and 8,061 non-health science students) from 17 universities in 17 countries across Asia, Africa, and the Americas. Results indicate that overall, health science students had the same mean number of health risk behaviors as non-health science university students. Regarding addictive risk behavior, fewer health science students used tobacco, were binge drinkers, or gambled once a week or more. Health science students also had a greater awareness of health behavior risks (5.5) than non-health science students (4.6). Linear regression analysis found a strong association with poor or weak health benefit beliefs and the health risk behavior index. There was no association between risk awareness and health risk behavior among health science students and an inverse association among non-health science students. © 2015 Wiley Publishing Asia Pty Ltd.

  7. Development of a health information technology acceptance model using consumers' health behavior intention.

    Science.gov (United States)

    Kim, Jeongeun; Park, Hyeoun-Ae

    2012-10-01

    For effective health promotion using health information technology (HIT), it is mandatory that health consumers have the behavioral intention to measure, store, and manage their own health data. Understanding health consumers' intention and behavior is needed to develop and implement effective and efficient strategies. To develop and verify the extended Technology Acceptance Model (TAM) in health care by describing health consumers' behavioral intention of using HIT. This study used a cross-sectional descriptive correlational design. We extended TAM by adding more antecedents and mediating variables to enhance the model's explanatory power and to make it more applicable to health consumers' behavioral intention. Additional antecedents and mediating variables were added to the hypothetical model, based on their theoretical relevance, from the Health Belief Model and theory of planned behavior, along with the TAM. We undertook structural equation analysis to examine the specific nature of the relationship involved in understanding consumers' use of HIT. Study participants were 728 members recruited from three Internet health portals in Korea. Data were collected by a Web-based survey using a structured self-administered questionnaire. The overall fitness indices for the model developed in this study indicated an acceptable fit of the model. All path coefficients were statistically significant. This study showed that perceived threat, perceived usefulness, and perceived ease of use significantly affected health consumers' attitude and behavioral intention. Health consumers' health status, health belief and concerns, subjective norm, HIT characteristics, and HIT self-efficacy had a strong indirect impact on attitude and behavioral intention through the mediators of perceived threat, perceived usefulness, and perceived ease of use. An extended TAM in the HIT arena was found to be valid to describe health consumers' behavioral intention. We categorized the concepts in

  8. Dedicated pediatric behavioral health unit: serving the unique and individual needs of children in behavioral health crisis.

    Science.gov (United States)

    Grover, Purva; Lee, Timothy

    2013-02-01

    Pediatric mental health emergencies are an increasing part of emergency medical practice because emergency departments have become the safety net for a fragmented mental health infrastructure that is experiencing critical shortages in services in all sectors. The emergency services for behavioral health unit at Akron Children's Hospital is an innovative model for delivering care to pediatric patients with mental health emergencies. A multidisciplinary team using the expertise of emergency services, psychiatry, social work, parent advisory counsel, security services, and engineering/architecture developed the emergency services for behavioral health unit blueprint, process, and staffing model.

  9. Skilled migration and health outcomes in developing countries.

    Science.gov (United States)

    Uprety, Dambar

    2018-04-30

    Many studies have found that health outcomes decline when health professionals leave the country, but do such results remain consistent in gender- and income-disaggregated skilled migration? To help uncover explanations for such a pro-migration nature of health outcomes, the present study revisits this topic but allows for associations of skilled migration with mortality and life expectancy to differ between male and female, and between low- and high-income countries. Using a panel of 133 developing countries as source and 20 OECD countries as destination from 1980 to 2010 allowing the coefficient on emigration across different education levels to differ, the study finds the negative effect of high-skilled emigration on health outcomes. Such effect is more pronounced for high-skilled female migration than those for male and for low-income countries than for middle-and high-income countries. Results also show that such adverse effect is larger for African countries than non-African ones. However, the low-skilled migration appears to be insignificant to affect health outcomes in developing countries. Thus, skilled migration is detrimental to longevity in developing countries but unskilled migration is not.

  10. Understanding persuasion contexts in health gamification: A systematic analysis of gamified health behavior change support systems literature.

    Science.gov (United States)

    Alahäivälä, Tuomas; Oinas-Kukkonen, Harri

    2016-12-01

    Gamification is increasingly used as a design strategy when developing behavior change support systems in the healthcare domain. It is commonly agreed that understanding the contextual factors is critical for successful gamification, but systematic analyses of the persuasive contexts have been lacking so far within gamified health intervention studies. Through a persuasion context analysis of the gamified health behavior change support systems (hBCSSs) literature, we inspect how the contextual factors have been addressed in the prior gamified health BCSS studies. The implications of this study are to provide the practitioners and researchers examples of how to conduct a systematic analysis to help guide the design and research on gamified health BCSSs. The ideas derived from the analysis of the included studies will help identify potential pitfalls and shortcomings in both the research and implementations of gamified health behavior change support systems. We systematically analyzed the persuasion contexts of 15 gamified health intervention studies. According to our results, gamified hBCSSs are implemented under different facets of lifestyle change and treatments compliance, and use a multitude of technologies and methods. We present a set of ideas and concepts to help improve endeavors in studying gamified health intervention through comprehensive understanding of the persuasive contextual factors. Future research on gamified hBCSSs should systematically compare the different combinations of contextual factors, related theories, chosen gamification strategies, and the study of outcomes to help understand how to achieve the most efficient use of gamification on the different aspects of healthcare. Analyzing the persuasion context is essential to achieve this. With the attained knowledge, those planning health interventions can choose the 'tried-and-tested' approaches for each particular situation, rather than develop solutions in an ad-hoc manner. Copyright © 2016

  11. Effectiveness of Telebehavioral Health Program Nurse Case Managers (NCM): Data Collection Tools and the Process for NCM-Sensitive Outcome Measures.

    Science.gov (United States)

    Carlson, Judy; Cohen, Roslyn; Bice-Stephens, Wynona

    2014-01-01

    As a part of our nation's pursuit of improvements in patient care outcomes, continuity of care, and cost containment, the case manager has become a vital member on interdisciplinary teams and in health care agencies. Telebehavioral health programs, as a relatively new method of delivering behavioral health care, have recently begun to incorporate case management into their multidisciplinary teams. To determine the efficacy and efficiency of healthcare programs, program managers are charged with the determination of the outcomes of the care rendered to patient populations. However, programs that use telehealth methods to deliver care have unique structures in place that impact ability to collect outcome data. A military medical center that serves the Pacific region developed surveys and processes to distribute, administer, and collect information about a telehealth environment to obtain outcome data for the nurse case manager. This report describes the survey development and the processes created to capture nurse case manager outcomes. Additionally, the surveys and processes developed in this project for measuring outcomes may be useful in other settings and disciplines.

  12. Core Health Outcomes In Childhood Epilepsy (CHOICE): protocol for the selection of a core outcome set.

    Science.gov (United States)

    Morris, Christopher; Dunkley, Colin; Gibbon, Frances M; Currier, Janet; Roberts, Deborah; Rogers, Morwenna; Crudgington, Holly; Bray, Lucy; Carter, Bernie; Hughes, Dyfrig; Tudur Smith, Catrin; Williamson, Paula R; Gringras, Paul; Pal, Deb K

    2017-11-28

    There is increasing recognition that establishing a core set of outcomes to be evaluated and reported in trials of interventions for particular conditions will improve the usefulness of health research. There is no established core outcome set for childhood epilepsy. The aim of this work is to select a core outcome set to be used in evaluative research of interventions for children with rolandic epilepsy, as an exemplar of common childhood epilepsy syndromes. First we will identify what outcomes should be measured; then we will decide how to measure those outcomes. We will engage relevant UK charities and health professional societies as partners, and convene advisory panels for young people with epilepsy and parents of children with epilepsy. We will identify candidate outcomes from a search for trials of interventions for childhood epilepsy, statutory guidance and consultation with our advisory panels. Families, charities and health, education and neuropsychology professionals will be invited to participate in a Delphi survey following recommended practices in the development of core outcome sets. Participants will be able to recommend additional outcome domains. Over three rounds of Delphi survey participants will rate the importance of candidate outcome domains and state the rationale for their decisions. Over the three rounds we will seek consensus across and between families and health professionals on the more important outcomes. A face-to-face meeting will be convened to ratify the core outcome set. We will then review and recommend ways to measure the shortlisted outcomes using clinical assessment and/or patient-reported outcome measures. Our methodology is a proportionate and pragmatic approach to expediently produce a core outcome set for evaluative research of interventions aiming to improve the health of children with epilepsy. A number of decisions have to be made when designing a study to develop a core outcome set including defining the scope

  13. Socioeconomic inequalities in dental health among middle-aged adults and the role of behavioral and psychosocial factors: evidence from the Spanish National Health Survey.

    Science.gov (United States)

    Capurro, Diego Alberto; Davidsen, Michael

    2017-02-16

    The goal of this analysis was to describe socioeconomic inequalities in dental health among Spanish middle-aged adults, and the role of behavioral and psychosocial factors in explaining these inequalities. This cross-sectional study used survey data from the 2006 Spanish National Health Survey and focused on adults ages 30 - 64. The outcome was dental health status based on the presence of self-reported dental problems. We used education, income, and occupational class as indicators of socioeconomic position and applied logistic regression analysis to estimate associations. We included behavioral and psychosocial variables in the models and compared non-adjusted to adjusted estimates to assess their potential role in explaining socioeconomic gradients. Results showed clear socioeconomic gradients in dental health among middle-aged adults. The percentage of people who reported more dental problems increased among those with lower levels of education, income, and occupation. These gradients were statistically significant (p socioeconomic position. Substantial unexplained associations remained significant after adjusting the model by behavioral and psychosocial variables. This study shows significant socioeconomic gradients in dental health among middle-aged adults in Spain. Behavioral and psychosocial variables were insufficient to explain the inequalities described, suggesting the intervention of other factors. Further research should incorporate additional explanations to better understand and comprehensively address socioeconomic inequalities in dental health.

  14. Coping profiles, perceived stress and health-related behaviors: a cluster analysis approach.

    Science.gov (United States)

    Doron, Julie; Trouillet, Raphael; Maneveau, Anaïs; Ninot, Grégory; Neveu, Dorine

    2015-03-01

    Using cluster analytical procedure, this study aimed (i) to determine whether people could be differentiated on the basis of coping profiles (or unique combinations of coping strategies); and (ii) to examine the relationships between these profiles and perceived stress and health-related behaviors. A sample of 578 French students (345 females, 233 males; M(age)= 21.78, SD(age)= 2.21) completed the Perceived Stress Scale-14 ( Bruchon-Schweitzer, 2002), the Brief COPE ( Muller and Spitz, 2003) and a series of items measuring health-related behaviors. A two-phased cluster analytic procedure (i.e. hierarchical and non-hierarchical-k-means) was employed to derive clusters of coping strategy profiles. The results yielded four distinctive coping profiles: High Copers, Adaptive Copers, Avoidant Copers and Low Copers. The results showed that clusters differed significantly in perceived stress and health-related behaviors. High Copers and Avoidant Copers displayed higher levels of perceived stress and engaged more in unhealthy behavior, compared with Adaptive Copers and Low Copers who reported lower levels of stress and engaged more in healthy behaviors. These findings suggested that individuals' relative reliance on some strategies and de-emphasis on others may be a more advantageous way of understanding the manner in which individuals cope with stress. Therefore, cluster analysis approach may provide an advantage over more traditional statistical techniques by identifying distinct coping profiles that might best benefit from interventions. Future research should consider coping profiles to provide a deeper understanding of the relationships between coping strategies and health outcomes and to identify risk groups. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Complex systems and health behavior change: insights from cognitive science.

    Science.gov (United States)

    Orr, Mark G; Plaut, David C

    2014-05-01

    To provide proof-of-concept that quantum health behavior can be instantiated as a computational model that is informed by cognitive science, the Theory of Reasoned Action, and quantum health behavior theory. We conducted a synthetic review of the intersection of quantum health behavior change and cognitive science. We conducted simulations, using a computational model of quantum health behavior (a constraint satisfaction artificial neural network) and tested whether the model exhibited quantum-like behavior. The model exhibited clear signs of quantum-like behavior. Quantum health behavior can be conceptualized as constraint satisfaction: a mitigation between current behavioral state and the social contexts in which it operates. We outlined implications for moving forward with computational models of both quantum health behavior and health behavior in general.

  16. Health Care Seeking Behavior of Persons with Acute Chagas Disease in Rural Argentina: A Qualitative View

    Directory of Open Access Journals (Sweden)

    Ignacio Llovet

    2016-01-01

    Full Text Available Chagas disease (CD is a tropical parasitic disease largely underdiagnosed and mostly asymptomatic affecting marginalized rural populations. Argentina regularly reports acute cases of CD, mostly young individuals under 14 years old. There is a void of knowledge of health care seeking behavior in subjects experiencing a CD acute condition. Early treatment of the acute case is crucial to limit subsequent development of disease. The article explores how the health outcome of persons with acute CD may be conditioned by their health care seeking behavior. The study, with a qualitative approach, was carried out in rural areas of Santiago del Estero Province, a high risk endemic region for vector transmission of CD. Narratives of 25 in-depth interviews carried out in 2005 and 2006 are analyzed identifying patterns of health care seeking behavior followed by acute cases. Through the retrospective recall of paths for diagnoses, weaknesses of disease information, knowledge at the household level, and underperformance at the provincial health care system level are detected. The misdiagnoses were a major factor in delaying a health care response. The study results expose lost opportunities for the health care system to effectively record CD acute cases.

  17. Behavioral and quality-of-life outcomes in different service models for methadone maintenance treatment in Vietnam.

    Science.gov (United States)

    Tran, Bach Xuan; Nguyen, Long Hoang; Nong, Vuong Minh; Nguyen, Cuong Tat; Phan, Huong Thu Thi; Latkin, Carl A

    2016-02-02

    Integrating HIV/AIDS and methadone maintenance treatment (MMT) services with existing health care delivery system is critical in sustaining efforts to fight HIV/AIDS in large injection-driven epidemics. However, efficiency of different integrative service models is unknown. This study assessed behavioral and health-related quality-of-life (HRQOL) outcomes of MMT in four service delivery models and explored factors associated with these outcomes of interest. A cross-sectional survey was conducted in two HIV epicenters in Vietnam: Hanoi and Nam Dinh Province. All patients in five selected MMT clinics were invited to participate, and 1016 were interviewed (80-90% response rate). Respondents had a mean age of 35.8, taken MMT for average 16.5 months and 3.3% on MMT for 36-60 months. The MMT integrated with rural district health center (DHC) has the highest prevalence of concurrent drug use (11.3%). The percentage of condom use (last sexual intercourse) with primary and casual partners was lowest in the MMT at urban DHCs. Patients at the rural DHC reported very high proportions of pain/discomfort (37.8%), anxiety/depression (43.1%), and mobility (13.3%). In regression models, poorer HRQOL outcomes were found in MMT models in the rural areas or without general health care, and among those patients who were HIV positive, reported concurrent drug use, and had higher numbers of previous drug rehabilitation episodes. Mobility and anxiety/depression are factors that increased the likelihood of concurrent drug use among MMT patients. Outcomes of MMT were diverse across different integrative service models. Policies on rapid expansion of the MMT program in Vietnam should also emphasize on the integration with comprehensive health care services including psychological supports for patients.

  18. NADA Protocol for Behavioral Health. Putting Tools in the Hands of Behavioral Health Providers: The Case for Auricular Detoxification Specialists

    Directory of Open Access Journals (Sweden)

    Elizabeth B Stuyt

    2018-02-01

    Full Text Available Background: The National Acupuncture Detoxification Association (NADA protocol, a simple standardized auricular treatment has the potential to provide vast public health relief on issues currently challenging our world. This includes but is not limited to addiction, such as the opioid epidemic, but also encompasses mental health, trauma, PTSD, chronic stress, and the symptoms associated with these conditions. Simple accessible tools that improve outcomes can make profound differences. We assert that the NADA protocol can have greatest impact when broadly applied by behavioral health professionals, Auricular Detoxification Specialists (ADSes. Methods: The concept of ADS is described and how current laws vary from state to state. Using available national data, a survey of practitioners in three selected states with vastly different laws regarding ADSes, and interviews of publicly funded programs which are successfully incorporating the NADA protocol, we consider possible effects of ADS-friendly conditions. Results: Data presented supports the idea that conditions conducive to ADS practice lead to greater implementation. Program interviews reflect settings in which adding ADSes can in turn lead to improved outcomes. Discussion: The primary purpose of non-acupuncturist ADSes is to expand the access of this simple but effective treatment to all who are suffering from addictions, stress, or trauma and to allow programs to incorporate acupuncture in the form of the NADA protocol at minimal cost, when and where it is needed. States that have changed laws to allow ADS practice for this standardized ear acupuncture protocol have seen increased access to this treatment, benefiting both patients and the programs.

  19. NADA Protocol for Behavioral Health. Putting Tools in the Hands of Behavioral Health Providers: The Case for Auricular Detoxification Specialists.

    Science.gov (United States)

    Stuyt, Elizabeth B; Voyles, Claudia A; Bursac, Sara

    2018-02-07

    Background: The National Acupuncture Detoxification Association (NADA) protocol, a simple standardized auricular treatment has the potential to provide vast public health relief on issues currently challenging our world. This includes but is not limited to addiction, such as the opioid epidemic, but also encompasses mental health, trauma, PTSD, chronic stress, and the symptoms associated with these conditions. Simple accessible tools that improve outcomes can make profound differences. We assert that the NADA protocol can have greatest impact when broadly applied by behavioral health professionals, Auricular Detoxification Specialists (ADSes). Methods: The concept of ADS is described and how current laws vary from state to state. Using available national data, a survey of practitioners in three selected states with vastly different laws regarding ADSes, and interviews of publicly funded programs which are successfully incorporating the NADA protocol, we consider possible effects of ADS-friendly conditions. Results: Data presented supports the idea that conditions conducive to ADS practice lead to greater implementation. Program interviews reflect settings in which adding ADSes can in turn lead to improved outcomes. Discussion: The primary purpose of non-acupuncturist ADSes is to expand the access of this simple but effective treatment to all who are suffering from addictions, stress, or trauma and to allow programs to incorporate acupuncture in the form of the NADA protocol at minimal cost, when and where it is needed. States that have changed laws to allow ADS practice for this standardized ear acupuncture protocol have seen increased access to this treatment, benefiting both patients and the programs.

  20. Work stress and health risk behavior.

    Science.gov (United States)

    Siegrist, Johannes; Rödel, Andreas

    2006-12-01

    This contribution discusses current knowledge of associations between psychosocial stress at work and health risk behavior, in particular cigarette smoking, alcohol consumption and overweight, by reviewing findings from major studies in the field published between 1989 and 2006. Psychosocial stress at work is measured by the demand-control model and the effort-reward imbalance model. Health risk behavior was analyzed in the broader context of a health-related Western lifestyle with socially and economically patterned practices of consumption. Overall, the review, based on 46 studies, only modestly supports the hypothesis of a consistent association between work stress and health risk behavior. The relatively strongest relationships have been found with regard to heavy alcohol consumption among men, overweight, and the co-manifestation of several risks. Suggestions for further research are given, and the need to reduce stressful experience in the framework of worksite health promotion programs is emphasized.

  1. Applying the Health Belief Model to college students' health behavior

    Science.gov (United States)

    Kim, Hak-Seon; Ahn, Joo

    2012-01-01

    The purpose of this research was to investigate how university students' nutrition beliefs influence their health behavioral intention. This study used an online survey engine (Qulatrics.com) to collect data from college students. Out of 253 questionnaires collected, 251 questionnaires (99.2%) were used for the statistical analysis. Confirmatory Factor Analysis (CFA) revealed that six dimensions, "Nutrition Confidence," "Susceptibility," "Severity," "Barrier," "Benefit," "Behavioral Intention to Eat Healthy Food," and "Behavioral Intention to do Physical Activity," had construct validity; Cronbach's alpha coefficient and composite reliabilities were tested for item reliability. The results validate that objective nutrition knowledge was a good predictor of college students' nutrition confidence. The results also clearly showed that two direct measures were significant predictors of behavioral intentions as hypothesized. Perceived benefit of eating healthy food and perceived barrier for eat healthy food to had significant effects on Behavioral Intentions and was a valid measurement to use to determine Behavioral Intentions. These findings can enhance the extant literature on the universal applicability of the model and serve as useful references for further investigations of the validity of the model within other health care or foodservice settings and for other health behavioral categories. PMID:23346306

  2. The Effect of Doctor-Consumer Interaction on Social Media on Consumers’ Health Behaviors: Cross-Sectional Study

    Science.gov (United States)

    Wu, Tailai; Deng, Zhaohua; Gaskin, Darrell J; Zhang, Donglan; Wang, Ruoxi

    2018-01-01

    Background Both doctors and consumers have engaged in using social media for health purposes. Social media has changed traditional one-to-one communication between doctors and patients to many-to-many communication between doctors and consumers. However, little is known about the effect of doctor-consumer interaction on consumers’ health behaviors. Objective The aim of this study was to investigate how doctor-consumer interaction in social media affects consumers’ health behaviors. Methods On the basis of professional-client interaction theory and social cognitive theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interactions influence consumers’ health behaviors through declarative knowledge (DK), self-efficacy (SE), and outcome expectancy (OE). To validate our proposed research model, we employed the survey method and developed corresponding measurement instruments for constructs in our research model. A total of 352 valid answers were collected, and partial least square was performed to analyze the data. Results Instrumental doctor-consumer interaction was found to influence consumers’ DK (t294=5.763, Pinteraction also impacted consumers’ DK (t294=4.025, Peffect of instrumental interaction on health behaviors, whereas the three mediators fully mediated the effect of affective interaction on health behaviors. Conclusions Compared with many intentional intervention programs, doctor-consumer interaction can be treated as a natural cost-effective intervention to promote consumers’ health behaviors. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. DK, SE, and OE are working mechanisms of doctor-consumer interaction. PMID:29490892

  3. Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials.

    Science.gov (United States)

    James, Erica; Freund, Megan; Booth, Angela; Duncan, Mitch J; Johnson, Natalie; Short, Camille E; Wolfenden, Luke; Stacey, Fiona G; Kay-Lambkin, Frances; Vandelanotte, Corneel

    2016-08-01

    Growing evidence points to the benefits of addressing multiple health behaviors rather than single behaviors. This review evaluates the relative effectiveness of simultaneous and sequentially delivered multiple health behavior change (MHBC) interventions. Secondary aims were to identify: a) the most effective spacing of sequentially delivered components; b) differences in efficacy of MHBC interventions for adoption/cessation behaviors and lifestyle/addictive behaviors, and; c) differences in trial retention between simultaneously and sequentially delivered interventions. MHBC intervention trials published up to October 2015 were identified through a systematic search. Eligible trials were randomised controlled trials that directly compared simultaneous and sequential delivery of a MHBC intervention. A narrative synthesis was undertaken. Six trials met the inclusion criteria and across these trials the behaviors targeted were smoking, diet, physical activity, and alcohol consumption. Three trials reported a difference in intervention effect between a sequential and simultaneous approach in at least one behavioral outcome. Of these, two trials favoured a sequential approach on smoking. One trial favoured a simultaneous approach on fat intake. There was no difference in retention between sequential and simultaneous approaches. There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches. Given only three of the six trials observed a difference in intervention effectiveness for one health behavior outcome, and the relatively consistent finding that the sequential and simultaneous approaches were more effective than a usual/minimal care control condition, it appears that both approaches should be considered equally efficacious. PROSPERO registration number: CRD42015027876. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. [Oral health related knowledge and health behavior of parents and school children].

    Science.gov (United States)

    Lalić, Maja; Aleksić, Ema; Gajić, Mihajlo; Malesević, Doka

    2013-01-01

    The family provides the background for developing behaviors, attitudes and knowledge related to oral health of children. The aim of this study was to compare oral health behavior of parents and their children and to asses the impact of parental behavior on children's oral health. This cross-sectional study included 99 parent--child pairs (12 to 15 years old). Data on oral health behavior, knowledge and attitudes regarding oral hygiene, fluorides and nutrition of parents and their children were collected by questionnaires. The parental dental health was assessed according to self-reported data on tooth loss and prosthodontic rehabilitation, while the dental status of children was determined by clinical examination. The parents reported the use of dental floss (p knowledge on fluorides. Approximately one third of parents thought they should not control sugar consumption of their child. There was a statistically significant correlation between parental oral hygiene and their habit to control the child in brushing with the child's oral health status. Oral health education activities directed towards the prevention of risk factors for developing caries should involve both parents and their children, because parental behavior is a significant predictor of children's oral health.

  5. A Nationally Scaled Telebehavioral Health Program for Chronic Pain: Characteristics, Goals, and Psychological Outcomes.

    Science.gov (United States)

    Mochari-Greenberger, Heidi; Peters, Aimee; Vue, Lee; Pande, Reena L

    2017-08-01

    Millions of U.S. adults suffer from chronic pain with a high prevalence of comorbid mental health issues. Telehealth-delivered behavioral therapy for chronic pain has been evaluated in the research setting. The purpose of this study was 1) to describe a nationally scaled, standardized, telebehavioral therapy program for patients with chronic pain and behavioral comorbidities, and 2) evaluate characteristics, goals, and psychosocial outcomes among program participants. This was mixed-methods retrospective cohort analysis among consecutive program graduates (mean age 53y; 24% male). The 8-week program was delivered by a licensed therapist and a behavior coach through telephone/secure video and tailored to each participant's behavioral health needs and goals. Participant chief complaints, behavioral goals, and mood triggers were abstracted by deidentified clinical record review using structured qualitative research methods. Depression, anxiety, and stress symptom data were collected at baseline and program graduation using the validated Depression Anxiety Stress Scales 21. Back pain (42%) and hip/leg/knee pain (28%) comprised the most common chief complaints. Pain management (44%) and weight loss (43%) were the most frequently cited goals. At baseline, approximately half of participants had elevated depression (59%), anxiety (54%), and/or stress (48%) scores. Triggers for depressed, anxious, or stressed mood included severe pain (47%), health concerns (46%), and interpersonal relationship challenges (45%). At graduation, significant improvement in median depression (-54%), anxiety (-50%), and stress (-33%) symptom scores was observed among those with non-normal baseline values (p health program for chronic pain experienced significant improvement in depression, anxiety, and stress symptoms and shared several complaints, goals, and mood triggers.

  6. Adverse obstetric outcomes during delivery hospitalizations complicated by suicidal behavior among US pregnant women.

    Science.gov (United States)

    Zhong, Qiu-Yue; Gelaye, Bizu; Smoller, Jordan W; Avillach, Paul; Cai, Tianxi; Williams, Michelle A

    2018-01-01

    The effects of suicidal behavior on obstetric outcomes remain dangerously unquantified. We sought to report on the risk of adverse obstetric outcomes for US women with suicidal behavior at the time of delivery. We performed a cross-sectional analysis of delivery hospitalizations from 2007-2012 National (Nationwide) Inpatient Sample. From the same hospitalization record, International Classification of Diseases codes were used to identify suicidal behavior and adverse obstetric outcomes. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained using logistic regression. Of the 23,507,597 delivery hospitalizations, 2,180 were complicated by suicidal behavior. Women with suicidal behavior were at a heightened risk for outcomes including antepartum hemorrhage (aOR = 2.34; 95% CI: 1.47-3.74), placental abruption (aOR = 2.07; 95% CI: 1.17-3.66), postpartum hemorrhage (aOR = 2.33; 95% CI: 1.61-3.37), premature delivery (aOR = 3.08; 95% CI: 2.43-3.90), stillbirth (aOR = 10.73; 95% CI: 7.41-15.56), poor fetal growth (aOR = 1.70; 95% CI: 1.10-2.62), and fetal anomalies (aOR = 3.72; 95% CI: 2.57-5.40). No significant association was observed for maternal suicidal behavior with cesarean delivery, induction of labor, premature rupture of membranes, excessive fetal growth, and fetal distress. The mean length of stay was longer for women with suicidal behavior. During delivery hospitalization, women with suicidal behavior are at increased risk for many adverse obstetric outcomes, highlighting the importance of screening for and providing appropriate clinical care for women with suicidal behavior during pregnancy.

  7. Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents' preventive oral health knowledge and behaviors for their young children.

    Science.gov (United States)

    Hoeft, K S; Barker, J C; Shiboski, S; Pantoja-Guzman, E; Hiatt, R A

    2016-12-01

    To determine the effectiveness of the Contra Caries Oral Health Education Program (CCOHEP) for improving low-income, Spanish-speaking parents' oral health knowledge and behaviors for their young children. Mexican American children in the United States suffer disproportionately high prevalence and severity of early childhood caries, yet few evaluated, theory-based behavioral interventions exist for this population. CCOHEP is a theory-based curriculum consisting of four 2-h interactive classes designed for and by Spanish speakers and led by designated community health educators (promotoras). Topics included children's oral hygiene, caries etiology, dental procedures, nutrition, child behavior management, and parent skill-building activities. Low-income Spanish-speaking parents/caregivers of children aged 0-5 years were recruited through community services in an agricultural city in California. Survey questions from the Oral Health Basic Research Facts Questionnaire measuring oral health-related behaviors and knowledge were verbally administered before, immediately after, and 3 months after attendance at CCOHEP. Five questions measured aspects of parental toothbrushing for their children (frequency, using fluoridated toothpaste, brushing before bed, not drinking or eating after nighttime brushing, adult assistance), three questions measured other oral health behaviors, and 16 questions measured oral health-related knowledge. Analyses of within-person changes between pre- and post-tests and again between post-test and 3-month follow-up consisted of McNemar's test for binary outcomes and sign tests for ordinal outcomes. Overall, 105 caregivers participated in CCOHEP (n = 105 pretest, n = 95 post-test, n = 79 second post-test). At baseline, all parents self-reported doing at least one aspect of toothbrushing correctly, but only 13% reported performing all five aspects according to professional guidelines. At post-test, 44% of parents reported completing all aspects of

  8. eHealth technologies to support nutrition and physical activity behaviors in diabetes self-management

    Directory of Open Access Journals (Sweden)

    Rollo ME

    2016-11-01

    Full Text Available Megan E Rollo,1 Elroy J Aguiar,2 Rebecca L Williams,1 Katie Wynne,3 Michelle Kriss,3 Robin Callister,4 Clare E Collins1 1School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia; 2Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA; 3Department of Diabetes and Endocrinology, John Hunter Hospital, Hunter New England Health, New Lambton, NSW, Australia;\t4School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia Abstract: Diabetes is a chronic, complex condition requiring sound knowledge and self-management skills to optimize glycemic control and health outcomes. Dietary intake and physical activity are key diabetes self-management (DSM behaviors that require tailored education and support. Electronic health (eHealth technologies have a demonstrated potential for assisting individuals with DSM behaviors. This review provides examples of technologies used to support nutrition and physical activity behaviors in the context of DSM. Technologies covered include those widely used for DSM, such as web-based programs and mobile phone and smartphone applications. In addition, examples of novel tools such as virtual and augmented reality, video games, computer vision for dietary carbohydrate monitoring, and wearable devices are provided. The challenges to, and facilitators for, the use of eHealth technologies in DSM are discussed. Strategies to support the implementation of eHealth technologies within practice and suggestions for future research to enhance nutrition and physical activity behaviors as a part of broader DSM are provided. Keywords: diabetes self-management, eHealth, nutrition, physical activity, smartphones, wearables

  9. Nurse practitioner's and certified nurse midwives' knowledge, opinions and practice behaviors regarding periodontal disease and adverse pregnancy outcomes.

    Science.gov (United States)

    Wooten, Katherine T; Lee, Jessica; Jared, Heather; Boggess, Kim; Wilder, Rebecca S

    2011-01-01

    The purpose of this study was to assess the knowledge, opinions and practice behaviors of nurse practitioners (NP) and certified nurse midwives (CNM) regarding periodontal disease and adverse pregnancy outcomes. A 45 item survey was developed, approved, pretested, revised and mailed to 404 North Carolina NPs and CNMs who provide prenatal care. Data was entered into an excel database and transferred to SPSS for Windows for complete analysis. Linear regression modeling was used to determine statistical significance. A total of 219 NPs and CNMs responded to the mailed survey, achieving a response rate of 54%. NPs and CNMs reported having limited knowledge regarding oral health. The majority felt they should collaborate with oral health care professionals to screen patients for periodontal disease. Most agreed they needed more information about periodontal disease and adverse pregnancy outcomes. NPs and CNMs who frequently examine women could serve an important role in screening for oral health problems and making appropriate dental health referrals. Increased basic and continuing education could prepare these professionals for collaborative care with oral health care professionals. This study suggests that collaboration between NPs and CNMs with dental professionals could lead to improved oral health care for pregnant patients.

  10. Characterizing Community-Based Mental Health Services for Children with Autism Spectrum Disorders and Disruptive Behavior Problems

    Science.gov (United States)

    Brookman-Frazee, Lauren I.; Taylor, Robin; Garland, Ann F.

    2010-01-01

    This study describes the characteristics of children with autism spectrum disorders (ASD) with disruptive behavior problems served in community-based mental health clinics, characterizes psychotherapy process and outcome, and examines differences between children with ASD and a non-ASD comparison group. Results indicate that children with ASD…

  11. Effect of genetic testing for risk of type 2 diabetes mellitus on health behaviors and outcomes: study rationale, development and design

    Directory of Open Access Journals (Sweden)

    Cho Alex H

    2012-01-01

    Full Text Available Abstract Background Type 2 diabetes is a prevalent chronic condition globally that results in extensive morbidity, decreased quality of life, and increased health services utilization. Lifestyle changes can prevent the development of diabetes, but require patient engagement. Genetic risk testing might represent a new tool to increase patients' motivation for lifestyle changes. Here we describe the rationale, development, and design of a randomized controlled trial (RCT assessing the clinical and personal utility of incorporating type 2 diabetes genetic risk testing into comprehensive diabetes risk assessments performed in a primary care setting. Methods/Design Patients are recruited in the laboratory waiting areas of two primary care clinics and enrolled into one of three study arms. Those interested in genetic risk testing are randomized to receive either a standard risk assessment (SRA for type 2 diabetes incorporating conventional risk factors plus upfront disclosure of the results of genetic risk testing ("SRA+G" arm, or the SRA alone ("SRA" arm. Participants not interested in genetic risk testing will not receive the test, but will receive SRA (forming a third, "no-test" arm. Risk counseling is provided by clinic staff (not study staff external to the clinic. Fasting plasma glucose, insulin levels, body mass index (BMI, and waist circumference are measured at baseline and 12 months, as are patients' self-reported behavioral and emotional responses to diabetes risk information. Primary outcomes are changes in insulin resistance and BMI after 12 months; secondary outcomes include changes in diet patterns, physical activity, waist circumference, and perceived risk of developing diabetes. Discussion The utility, feasibility, and efficacy of providing patients with genetic risk information for common chronic diseases in primary care remain unknown. The study described here will help to establish whether providing type 2 diabetes genetic risk

  12. Risky music-listening behaviors and associated health-risk behaviors

    NARCIS (Netherlands)

    I. Vogel (Ineke); P.M. van de Looij-Jansen (Petra); C.L. Mieloo (Cathelijne); A. Burdorf (Alex); F. de Waart (Frouwkje)

    2012-01-01

    textabstractOBJECTIVE: To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes,

  13. Understanding Youth's Health-Compromising Behaviors in Germany: An Application of the Risk-Behavior Framework.

    Science.gov (United States)

    Hazard, Barbara P.; Lee, Che-Fu

    1999-01-01

    Analyzed the health-compromising behaviors of German youth using responses of 2,330 seventh, eighth, and ninth graders from the German Youth Study. Smoking and drinking are not seen by these students as health-threatening behaviors, but as socially appealing behaviors. Discusses implications for health education. (SLD)

  14. The impact of health care professionals' service orientation on patients' innovative behavior.

    Science.gov (United States)

    Henrike, Hannemann-Weber; Schultz, Carsten

    2014-01-01

    The increasing availability of medical information and the rising relevance of patient communities drive the active role of health consumers in health care processes. Patients become experts on their disease and provide valuable stimuli for novel care solutions. Medical encounters evolve toward a more collaborative health care service process, where patients are accepted as equal partners. However, the patient's active role depends on the interaction with the involved health care professionals. The aim of this article is to examine whether the service orientation of health care professionals and their proactive and adaptive work behavior and the extent of shared goals within the necessary interdisciplinary health professional team influence patients' innovative behavior. We address six rare diseases and use interview and survey data to test theoretically derived hypotheses. The sample consists of 86 patients and their 160 health care professionals. Sixty patients provided additional information via interviews. Patients' innovative behavior is reflected by the number of generated ideas as well as the variety of ideas. The service orientation of work teams plays an important role in the innovation process of patients. As hypothesized, the extent of shared goals within the health care teams has a direct effect on patients' idea generation. Work adaptivity and proactivity and shared goals both reinforce the positive effect of service orientation. Furthermore, significant associations between the three independent variables and the second outcome variable of patient's idea variety are confirmed. The study underlines (1) the important role of patients within health care service innovation processes, (2) the necessity of a service-oriented working climate to foster the development of innovative care solutions for rare diseases, and (3) the need for an efficient cooperation and open mindset of health care professionals to motivate and support patient innovation.

  15. An Evaluation of Army Wellness Center Clients' Health-Related Outcomes.

    Science.gov (United States)

    Rivera, L Omar; Ford, Jessica Danielle; Hartzell, Meredith Marie; Hoover, Todd Allan

    2018-01-01

    To examine whether Army community members participating in a best-practice based workplace health promotion program (WHPP) experience goal-moderated improvements in health-related outcomes. Pretest/posttest outcome evaluation examining an autonomously participating client cohort over 1 year. Army Wellness Center facilities on 19 Army installations. Army community members sample (N = 5703), mostly Active Duty Soldiers (64%). Assessment of health risks with feedback, health assessments, health education classes, and health coaching sessions conducted by health educators at a recommended frequency of once a month for 3 to 12 months. Initial and follow-up outcome assessments of body mass index (BMI), body fat, cardiorespiratory fitness, blood pressure, and perceived stress. Mixed model linear regression testing for goal-moderated improvements in outcomes. Clients experienced significant improvements in body fat (-2% change), perceived stress (-6% to -12% change), cardiorespiratory fitness (+6% change), and blood pressure (-1% change) regardless of health-related goal. Only clients with a weight loss goal experienced BMI improvement (-1% change). Follow-up outcome assessment rates ranged from 44% (N = 2509) for BMI to 6% (N = 342) for perceived stress. Army Wellness Center clients with at least 1 follow-up outcome assessment experienced improvements in military readiness correlates and chronic disease risk factors. Evaluation design and follow-up-related limitations notwithstanding results suggest that best practices in WHPPs can effectively serve a globally distributed military force.

  16. Gender differences in behavioral problems and shool outcomes

    DEFF Research Database (Denmark)

    Kristoffersen, Jannie H. Grøne; Obel, Carsten; Smith, Nina

    2014-01-01

    This study analyzes gender differences in behavioral problems and school outcomes. The study is based on teacher and parent evaluations using the Strengths and Difficulties Questionnaire for approximately 6000 Danish children 10–12 years of age who were born in 1990–1992. The sample has been merged...

  17. Effects of patient health literacy, patient engagement and a system-level health literacy attribute on patient-reported outcomes: a representative statewide survey.

    Science.gov (United States)

    Kaphingst, Kimberly A; Weaver, Nancy L; Wray, Ricardo J; Brown, Melissa L R; Buskirk, Trent; Kreuter, Matthew W

    2014-10-07

    question asking may be more important to patient knowledge and health behaviors than patients' health literacy skills. Findings support focused research to examine the effects of organizational attributes on patient health outcomes and system-level interventions that might enhance patient health.

  18. Worksite Health Program Promoting Changes in Eating Behavior and Health Attitudes.

    Science.gov (United States)

    Mache, Stefanie; Jensen, Sarah; Jahn, Reimo; Steudtner, Mirko; Ochsmann, Elke; Preuß, Geraldine

    2015-11-01

    The aim of the present study was to evaluate the effectiveness of a worksite multicomponent health promotion intervention on eating behavior and attitudes, changes in body weight, and readiness to make eating behavior changes among workers over a 12-month intervention period. A total of 3,095 workers of a logistic company participated in a quasi-experimental comparison group study design. The intervention group received a multicomponent health training. Two of the main elements of the multicomponent intervention were physical exercise training and nutrition counseling/training. During the pilot year, participants completed a survey at baseline and again after 12 months to assess physical activity-, health-, and diet-related factors. Results showed that participants' body weight did not significantly decrease in the intervention group. Mean weight loss in the intervention groups was 0.5 kg (body mass index = 0.1 kg/m(2)). Eating behaviors in the intervention group improved more than in the comparison group. Some positive intervention effects were observed for the cognitive factors (e.g., changes in eating attitudes). Baseline readiness to change eating behavior was significantly improved over time. We demonstrated initial results of a long-term multicomponent worksite health promotion program with regard to changes in body weight, eating behavior, and attitudes. This evaluation of a 12-month pilot study suggests that a worksite health promotion program may lead to improvements in nutritional health behaviors for a number of workers. An investigation of long-term effects of this multicomponent intervention is strongly recommended. © 2015 Society for Public Health Education.

  19. What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials.

    Science.gov (United States)

    Kotronoulas, Grigorios; Kearney, Nora; Maguire, Roma; Harrow, Alison; Di Domenico, David; Croy, Suzanne; MacGillivray, Stephen

    2014-05-10

    The systematic use of patient-reported outcome measures (PROMs) has been advocated as an effective way to standardize cancer practice. Yet, the question of whether PROMs can lead to actual improvements in the quality of patient care remains under debate. This review examined whether inclusion of PROM in routine clinical practice is associated with improvements in patient outcomes, processes of care, and health service outcomes during active anticancer treatment. A systematic review of five electronic databases (Medline, EMBASE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], PsycINFO, and Psychology and Behavioral Sciences Collection [PBSC]) was conducted from database inception to May 2012 to locate randomized and nonrandomized controlled trials of patients receiving active anticancer treatment or supportive care irrespective of type of cancer. Based on prespecified eligibility criteria, we included 26 articles that reported on 24 unique controlled trials. Wide variability in the design and use of interventions delivered, outcomes evaluated, and cancer- and modality-specific context was apparent. Health service outcomes were only scarcely included as end points. Overall, the number of statistically significant findings were limited and PROMs' intervention effect sizes were predominantly small-to-moderate. The routine use of PROMs increases the frequency of discussion of patient outcomes during consultations. In some studies, PROMs are associated with improved symptom control, increased supportive care measures, and patient satisfaction. Additional effort is required to ensure patient adherence, as well as additional support to clinicians who will respond to patient concerns and issues, with clear system guidelines in place to guide their responses. More research is required to support PROM cost-benefit in terms of patient safety, clinician burden, and health services usage.

  20. A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects

    Science.gov (United States)

    Fleig, Lena; Wiedemann, Amelie U; Schwarzer, Ralf

    2015-01-01

    Background Preventive health behaviors, such as regular physical activity and healthy nutrition, are recommended to maintain employability and to facilitate the health of employees. Theory-based workplace health promotion needs to include psychological constructs and consider the motivational readiness (so-called stages of change) of employees. According to the stages, people can be grouped as nonintenders (not motivated to change and not performing the goal behavior), intenders (decided to adopt the goal behavior but not started yet), or actors (performing the goal behavior already). The tailoring to these stages can be done computer based and should make workplace health promotion more effective. Objective It was tested whether a parsimonious computer-based health promotion program implemented at the workplace was effective in terms of lifestyle changes and psychological outcomes as well as body weight. We hypothesized that the stage-matched intervention would outperform the one-size-fits-all active control condition (standard care intervention). Methods In a randomized controlled trial, a total of 1269 employees were recruited by a trained research assistant at their workplace during a routine medical examination. After excluding noneligible employees, 560 completed Time 1 (T1), and 384 also completed Time 2 (T2), achieving a retention rate of 68.6%. Two fully automated computer-based treatments were adopted: (1) an active control condition with information about benefits of exercise and healthy nutrition (n=52), or (2) a stage-matched multiple-behavior intervention that provided different psychological treatments to 9 subgroups, addressing stages of change (nonintenders, intenders, and actors per behavior; n=332). Baseline assessments (T1) on behavior, psychological constructs, and body weight were repeated after 4 weeks (T2). Results The stage-matched intervention outperformed the active control condition for lifestyle changes containing physical activity and

  1. Health promoting practices and personal lifestyle behaviors of Brazilian health professionals

    Directory of Open Access Journals (Sweden)

    Karen D. Hidalgo

    2016-10-01

    Full Text Available Abstract Background This study was conducted to examine the lifestyle behaviors and health promoting practices of physicians, nurses, and community health workers in Brazil. Methods A random sample of primary health care units in Brazil was selected, and a pretested questionnaire was administered via phone interviews, in 2011, to 182 physicians, 347 nurses, and 269 community health workers, totaling 798 health professionals. The total initial sample included 1600 eligible health professionals. Variables measured included physical activity, alcohol intake, hours of sleep, diet, and perceived self-efficacy to provide preventive counseling on related lifestyle behaviors. Results More than 25 % of physicians, nurses, and community health workers reported eating 0–2 portions of fruits and vegetables per day. In terms of cervical and breast cancer, nurses reported to be ‘very prepared’ to advise patients on these topics more frequently than physicians. The prevalence of smoking ranged from 4.9 % among nurses to 7.4 % among community health workers. The proportion of physical inactivity ranged from 40.3 % among nurses to 52.1 % among community health workers. Conclusion A reasonably high proportion of physicians, nurses, and community health workers report not engaging in healthy lifestyle behaviors that impact chronic diseases, thus, they may be less likely to encourage such behaviors in their patients.

  2. Business travel and behavioral and mental health.

    Science.gov (United States)

    Rundle, Andrew G; Revenson, Tracey A; Friedman, Michael

    2017-12-21

    Assess associations between business travel and behavioral and mental health. Cross-sectional analyses of de-identified electronic medical record data from EHE International, Inc. a provider of corporate wellness programs. Higher levels of business travel were associated with poorer outcomes. Compared to traveling 1-6 nights/month for work, those who traveled 21 + nights were more likely to: smoke (prevalence ratio = 3.74, 95% CI 2.56, 5.46), report trouble sleeping (PR = 1.37, 95% CI 1.09, 1.71), be sedentary (PR = 1.95, 95%CI 1.56, 2.43) and score above clinical thresholds for alcohol dependence (CAGE score>1: PR = 2.04, 95% CI 1.26, 3.29), and mild or worse anxiety (GAD-7 Score>4: PR = 1.69, 95% CI 1.29, 2.21) and depression symptoms (PHQ-9 Score>4: PR = 2.27, 95%CI 1.70, 3.03). Employers should provide programs to help employees manage stress and maintain health while traveling for work.

  3. Identifiable Data Files - Health Outcomes Survey (HOS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) identifiable data files are comprised of the entire national sample for a given 2-year cohort (including both respondents...

  4. Core outcome sets in women's and newborn health: a systematic review.

    Science.gov (United States)

    Duffy, Jmn; Rolph, R; Gale, C; Hirsch, M; Khan, K S; Ziebland, S; McManus, R J

    2017-09-01

    Variation in outcome collection and reporting is a serious hindrance to progress in our specialty; therefore, over 80 journals have come together to support the development, dissemination, and implementation of core outcome sets. This study systematically reviewed and characterised registered, progressing, or completed core outcome sets relevant to women's and newborn health. Systematic search using the Core Outcome Measures in Effectiveness Trial initiative and the Core Outcomes in Women's and Newborn Health initiative databases. Registry entries, protocols, systematic reviews, and core outcome sets. Descriptive statistics to describe characteristics and results. There were 49 core outcome sets registered in maternal and newborn health, with the majority registered in 2015 (n = 22; 48%) or 2016 (n = 16; 32%). Benign gynaecology (n = 8; 16%) and newborn health (n = 3; 6%) are currently under-represented. Twenty-four (52%) core outcome sets were funded by international (n = 1; core outcome sets were completed: reconstructive breast surgery (11 outcomes), preterm birth (13 outcomes), epilepsy in pregnancy (29 outcomes), and maternity care (48 outcomes). The quantitative, qualitative, and consensus methods used to develop core outcome sets varied considerably. Core outcome sets are currently being developed across women's and newborn health, although coverage of topics is variable. Development of further infrastructure to develop, disseminate, and implement core outcome sets is urgently required. Forty-nine women's and newborn core outcome sets registered. 50% funded. 7 protocols, 20 systematic reviews, and 4 core outcome sets published. @coreoutcomes @jamesmnduffy. © 2017 Royal College of Obstetricians and Gynaecologists.

  5. Behavioral and Mental Health Correlates of Youth Stalking Victimization: A Latent Class Approach.

    Science.gov (United States)

    Reidy, Dennis E; Smith-Darden, Joanne P; Kernsmith, Poco D

    2016-12-01

    Although recognized as a public health problem, little attention has been paid to the problem of stalking among youth. Latent profile analysis was used to identify latent groups of adolescent stalking victims and their behavioral and mental health correlates. A cross-sectional sample of 1,236 youths were randomly selected from 13 schools stratified by community risk level (i.e., low, moderate, and high risk) and gender. Students completed surveys assessing behavioral indicators of stalking victimization, as well as substance use, sexual behavior, dating violence, and psychiatric symptoms. Data were collected in 2013 and data analyses were performed in 2015. Analysis indicated the presence of a non-victim class, a minimal exposure class, and a victim class for boys and girls alike. Approximately 14% of girls and 13% of boys were in the stalking victim class. Adolescents in the victim class reported more symptoms of post-traumatic stress, mood disorder, and hopelessness, as well as more instances of alcohol use, binge drinking, and physical dating violence victimization. Girls in the victim class also reported engaging in sexting behaviors and oral sex with significantly more partners than their non-victim peers. These findings provide valuable knowledge of the prevalence and pertinent health correlates of stalking victimization in adolescence. The data suggest a substantial proportion of adolescents are victims of stalking and are likewise at risk for a number of deleterious health outcomes. As such, this population merits further attention by prevention researchers and practitioners. Published by Elsevier Inc.

  6. The Relationship between Health Locus of Control and Health Behaviors in Emergency Medicine Personnel.

    Science.gov (United States)

    Pourhoseinzadeh, Mansour; Gheibizadeh, Mahin; Moradikalboland, Mehrnaz

    2017-10-01

    Health locus of control defined as individual beliefs based on past experiences in health issues and having external or internal control over them, could affect health. Health locus of control plays a role in health behaviors. We aimed to investigate the relationship between health locus of control and health behavior in emergency medical personnel in Ahvaz during 2016. This is a cross-sectional descriptive study, which began in August 2016 for a period of six months on 215 emergency medical personnel in Ahvaz who were selected randomly. The data were collected by a demographic questionnaire, Rotter's locus of control questionnaire, and health behavior questionnaire and analyzed using SPSS software, version 22. The correlation between variables was estimated by Pearson's correlation coefficient and independent t test. The level of significance for all statistical tests was set at 0.05. We found no significant relationship between health locus of control (external and internal) and health behavior (P>0.05).Health behaviors were very good in terms of personal health (86.5%), nutrition (53%), and sleep and rest (48.4%), and poor in terms of physical activity (52.6%) and stress management (79.5%). Furthermore, 79.5% of the emergency personnel, in general, had poor heath behaviors. Leaders and officials in the field of health must necessarily design programs in relation to health locus of control and the factors developing and affecting it as well as the role of health locus of control in doing correct behaviors.

  7. Health expenditure and child health outcomes in Sub-Saharan Africa

    African Journals Online (AJOL)

    This study sought to understand the relationship between child health outcomes and health spending while investigating lagged effects. The study employed panel data from 45 Sub-Saharan African countries between 1995 and 2011 obtained from the World Bank's World Development Indicators. Fixed and Random effect ...

  8. Occupational Risks and Pregnancy and Infant Health Outcomes in Florida Farmworkers

    Directory of Open Access Journals (Sweden)

    Jennifer Runkle

    2014-08-01

    Full Text Available The agricultural industry has some of the highest incidence rates and numbers of occupational injuries and illnesses in the United States. Injuries and illnesses in agriculture result from accidents, falls, excessive heat, repetitive motion and adverse pesticide exposure. Women working in agriculture are exposed to the same hazards and risks as their male counterparts, but can face additional adverse impacts on their reproductive health. Yet, few occupational risk assessment studies have considered the reproductive health of female farmworkers. The objective of this community-based participatory research study was to conduct a retrospective, cross-sectional survey to collect information on workplace conditions and behaviors and maternal, pregnancy and infant health outcomes among a sample of female nursery and fernery farmworkers in Central Florida. Survey results showed that nursery workers were more likely to report health symptoms during their pregnancy than fernery workers. We also observed a self-reported increased risk of respiratory illness in the first year of life for infants whose mothers worked in ferneries. Our findings confirm that agricultural work presents potential reproductive hazards for women of childbearing age.

  9. Treatment agreement, adherence, and outcome in cognitive behavioral treatments for insomnia.

    Science.gov (United States)

    Dong, Lu; Soehner, Adriane M; Bélanger, Lynda; Morin, Charles M; Harvey, Allison G

    2018-03-01

    Patient adherence has been identified as an important barrier to the implementation of evidence-based psychological treatments. In cognitive behavioral treatments (CBT) for insomnia, the current study examined (a) the validity of therapist ratings of patient agreement and adherence against an established behavioral measure of adherence, and (b) the relationship between treatment agreement, adherence, and outcome. Participants were 188 adults meeting DSM-IV-TR criteria for chronic insomnia who were randomized to receive behavior therapy, cognitive therapy, or CBT for insomnia. Treatment agreement/adherence was measured by (a) weekly therapist ratings of patient agreement and homework completion, and (b) adherence to behavioral strategies (ABS) derived from patient-reported sleep diary. Outcome measures were Insomnia Severity Index and insomnia remission (Insomnia Severity Index adherence, and ABS measures during treatment significantly predicted insomnia remission at posttreatment, and all but therapist rating of homework completion predicted remission at 6-month follow-up. Greater patient agreement and adherence (therapist ratings and ABS) during treatment predicted better treatment outcome. Therapist-rated treatment agreement and adherence correspond well with patient-reported sleep diary-derived adherence measure. These simple, deployable therapist-rated patient agreement and adherence can potentially be useful for treatments for other disorders. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Sexual function in F-111 maintenance workers: the study of health outcomes in aircraft maintenance personnel.

    Science.gov (United States)

    Brown, Anthony; Gibson, Richard; Tavener, Meredith; Guest, Maya; D'Este, Catherine; Byles, Julie; Attia, John; Horsley, Keith; Harrex, Warren; Ross, James

    2009-06-01

    In Australia, four formal F-111 fuel tank deseal/reseal (DSRS) repair programs were implemented over more than two decades, each involving different processes and using a range of hazardous substances. However, health concerns were raised by a number of workers. The "Study of Health Outcomes in Aircraft Maintenance Personnel" was commissioned by the Australian Department of Defence to investigate potential adverse health outcomes as a result of being involved in the deseal/reseal processes. To compare measures of sexual function in F-111 aircraft fuel tank DSRS maintenance workers, against two appropriate comparison groups. Exposed and comparison participants completed a postal questionnaire which included general questions of health and health behavior, and two specific questions on sexual functioning. They also completed the International Index of Erectile Function (IIEF) questionnaire. Logistic regression was used to explore exposure status and outcome while adjusting for potential confounders. The three outcomes of interest for this study were the proportion of participants with erectile dysfunction (ED) according to the IIEF, the proportion with self-reported loss of interest in sex, and the proportion with self-reported problems with sexual functioning. Compared with each of the comparison groups, a larger proportion of the exposed group reported sexual problems and were classified as having ED according to the IIEF. In logistic regression, the odds of all three outcomes were higher for exposed participants relative to each comparison group and after adjustment for potentially confounding variables including anxiety and depression. There was a consistent problem with sexual functioning in the exposed group that is not explained by anxiety and depression, and it appears related to DSRS activities.

  11. Health Behaviors and Academic Performance Among Korean Adolescents.

    Science.gov (United States)

    So, Eun Sun; Park, Byoung Mo

    2016-06-01

    This study aimed to examine the most prominent health-related behaviors impacting the academic performance of Korean adolescents. The 2012 Korea Youth Risk Behavior Web-Based Survey data were analyzed using an ordinal regression analysis after adjusting for general and other health behaviors. Before adjustment, all health behaviors were significantly associated with academic performance. After adjustment for other health behaviors and confounding factors, only smoking [odds ratio (OR) = 2.07, 95% confidence interval (CI) (1.98, 2.16), p academic performance, and engaging in a regular diet [OR = 0.65, 95% CI (0.65, 0.62), p academic performance. Regular diet, reducing smoking and alcohol drinking, and physical activity should be the target when designing health interventions for improving academic performance in Korean adolescents. Copyright © 2016. Published by Elsevier B.V.

  12. Comparisons of Website Visit Behavior between Purchase Outcomes and Product Categories

    Directory of Open Access Journals (Sweden)

    Chatpong Tangmanee

    2017-10-01

    Full Text Available The online retail business has grown substantially. Given distinctive product categories (e.g. search or experience goods, owners must put an effort in the design of websites so every visit may end with a purchase. Clickstream panel data allowing examination into website visiting behavior (i.e. the number of pages viewed (or pageview or the visit duration are increasingly accessible. However, it is unclear whether the differences of the two visiting behavior between purchase outcome or product categories are significant. The present study hopes to fill the void. An analysis of 27,528 visit sessions extracted from ComScore verifies that (1 the difference of page views between purchase outcomes and that between product categories were significant and (2 only the difference of visit duration between the product categories was significant but that between purchase outcomes was insignificant. In addition to theoretical insight into online behavior across purchasing horizons and product categories using clickstream data, online retail practitioners could apply the findings to enhance the possibility of the purchases at their online stores.

  13. Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

    Science.gov (United States)

    Miller, Benjamin F; Ross, Kaile M; Davis, Melinda M; Melek, Stephen P; Kathol, Roger; Gordon, Patrick

    2017-01-01

    The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop.

    Science.gov (United States)

    Michie, Susan; Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

    2017-06-29

    Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom's Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key

  15. Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop

    Science.gov (United States)

    Yardley, Lucy; West, Robert; Patrick, Kevin; Greaves, Felix

    2017-01-01

    Devices and programs using digital technology to foster or support behavior change (digital interventions) are increasingly ubiquitous, being adopted for use in patient diagnosis and treatment, self-management of chronic diseases, and in primary prevention. They have been heralded as potentially revolutionizing the ways in which individuals can monitor and improve their health behaviors and health care by improving outcomes, reducing costs, and improving the patient experience. However, we are still mainly in the age of promise rather than delivery. Developing and evaluating these digital interventions presents new challenges and new versions of old challenges that require use of improved and perhaps entirely new methods for research and evaluation. This article discusses these challenges and provides recommendations aimed at accelerating the rate of progress in digital behavior intervention research and practice. Areas addressed include intervention development in a rapidly changing technological landscape, promoting user engagement, advancing the underpinning science and theory, evaluating effectiveness and cost-effectiveness, and addressing issues of regulatory, ethical, and information governance. This article is the result of a two-day international workshop on how to create, evaluate, and implement effective digital interventions in relation to health behaviors. It was held in London in September 2015 and was supported by the United Kingdom’s Medical Research Council (MRC), the National Institute for Health Research (NIHR), the Methodology Research Programme (PI Susan Michie), and the Robert Wood Johnson Foundation of the United States (PI Kevin Patrick). Important recommendations to manage the rapid pace of change include considering using emerging techniques from data science, machine learning, and Bayesian approaches and learning from other disciplines including computer science and engineering. With regard to assessing and promoting engagement, a key

  16. A positive perspective of knowledge, attitude, and practices for health-promoting behaviors of adolescents with congenital heart disease.

    Science.gov (United States)

    Huang, Hui-Ru; Chen, Chi-Wen; Chen, Chin-Mi; Yang, Hsiao-Ling; Su, Wen-Jen; Wang, Jou-Kou; Tsai, Pei-Kwei

    2018-03-01

    Health-promoting behaviors could serve as a major strategy to optimize long-term outcomes for adolescents with congenital heart disease. The associations assessed from a positive perspective of knowledge, attitudes, and practice model would potentially cultivate health-promoting behaviors during adolescence. The purpose of this study was to examine the relationships between disease knowledge, resilience, family functioning, and health-promoting behaviors in adolescents with congenital heart disease. A total of 320 adolescents with congenital heart disease who were aged 12-18 years were recruited from pediatric cardiology outpatient departments, and participated in a cross-sectional survey. The participants completed the Leuven Knowledge Questionnaire for Congenital Heart Disease; Haase Adolescent Resilience in Illness Scale; Family Adaptability, Partnership, Growth, Affection, and Resolve; and Adolescent Health Promotion scales. The collected data were analyzed using descriptive statistics and three multiple regression models. Greater knowledge of prevention of complications and higher resilience had a more powerful effect in enhancing health-promoting behaviors. Having symptoms and moderate or severe family dysfunction were significantly more negatively predictive of health-promoting behaviors than not having symptoms and positive family function. The third model explained 40% of the variance in engaging in health-promoting behaviors among adolescents with congenital heart disease. The findings of this study provide new insights into the role of disease knowledge, resilience, and family functioning in the health-promoting behavior of adolescents with congenital heart disease. Continued efforts are required to plan family care programs that promote the acquisition of sufficient disease knowledge and the development of resilience for adolescents with congenital heart disease.

  17. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    Science.gov (United States)

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

    2008-01-01

    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  18. The Science of Sustaining Health Behavior Change: The Health Maintenance Consortium

    Science.gov (United States)

    Ory, Marcia G.; Smith, Matthew Lee; Mier, Nelda; Wernicke, Meghan M.

    2013-01-01

    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. PMID:20604691

  19. Forum: Learning Outcomes in Communication. Upside Down/Side Up: Problematizing Teacher Communication Behaviors and Learning Outcomes in Communication

    Science.gov (United States)

    Dannels, Deanna P.; Toale, Mary C.; Backlund, Philip M.; Frederick, John G. M.; Love, Brad

    2016-01-01

    Could teacher communication behaviors generally assumed to be positive ever be detrimental to student realization of particular outcomes? This essay argues for increased scholarly attention to this question. The authors advocate a research agenda that explores the potential "downside" of teacher communication behaviors (TCBs);…

  20. The eHealth Behavior Management Model: a stage-based approach to behavior change and management.

    Science.gov (United States)

    Bensley, Robert J; Mercer, Nelda; Brusk, John J; Underhile, Ric; Rivas, Jason; Anderson, Judith; Kelleher, Deanne; Lupella, Melissa; de Jager, André C

    2004-10-01

    Although the Internet has become an important avenue for disseminating health information, theory-driven strategies for aiding individuals in changing or managing health behaviors are lacking. The eHealth Behavior Management Model combines the Transtheoretical Model, the behavioral intent aspect of the Theory of Planned Behavior, and persuasive communication to assist individuals in negotiating the Web toward stage-specific information. It is here - at the point of stage-specific information - that behavioral intent in moving toward more active stages of change occurs. The eHealth Behavior Management Model is applied in three demonstration projects that focus on behavior management issues: parent-child nutrition education among participants in the U.S. Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children; asthma management among university staff and students; and human immunodeficiency virus prevention among South African women. Preliminary results have found the eHealth Behavior Management Model to be promising as a model for Internet-based behavior change programming. Further application and evaluation among other behavior and disease management issues are needed.

  1. Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations.

    Science.gov (United States)

    Bronkhorst, Babette; Tummers, Lars; Steijn, Bram; Vijverberg, Dominique

    2015-01-01

    In recent years, the high prevalence of mental health problems among health care workers has given rise to great concern. The academic literature suggests that employees' perceptions of their work environment can play a role in explaining mental health outcomes. We conducted a systematic review of the literature in order to answer the following two research questions: (1) how does organizational climate relate to mental health outcomes among employees working in health care organizations and (2) which organizational climate dimension is most strongly related to mental health outcomes among employees working in health care organizations? Four search strategies plus inclusion and quality assessment criteria were applied to identify and select eligible studies. As a result, 21 studies were included in the review. Data were extracted from the studies to create a findings database. The contents of the studies were analyzed and categorized according to common characteristics. Perceptions of a good organizational climate were significantly associated with positive employee mental health outcomes such as lower levels of burnout, depression, and anxiety. More specifically, our findings indicate that group relationships between coworkers are very important in explaining the mental health of health care workers. There is also evidence that aspects of leadership and supervision affect mental health outcomes. Relationships between communication, or participation, and mental health outcomes were less clear. If health care organizations want to address mental health issues among their staff, our findings suggest that organizations will benefit from incorporating organizational climate factors in their health and safety policies. Stimulating a supportive atmosphere among coworkers and developing relationship-oriented leadership styles would seem to be steps in the right direction.

  2. Improving outcomes in cancer diagnosis, prevention and control: barriers, facilitators and the need for health literacy in Ibadan Nigeria.

    Science.gov (United States)

    Adedimeji, Adebola A; Lounsbury, David; Popoola, Oluwafemi; Asuzu, Chioma; Lawal, Akinmayowa; Oladoyin, V; Crifase, Cassandra; Agalliu, Ilir; Shankar, Viswanathan; Adebiyi, Akindele

    2017-10-01

    Cancers constitute a significant public health problem in Nigeria. Breast, cervix and prostate cancers are leading causes of cancer-related deaths. Changing diets, lifestyles, HIV/AIDS and macro-structural factors contribute to cancer morbidity and mortality. Poor health information linking cancer risk to individual behaviors, environmental pollutants and structural barriers undermine prevention/control efforts. Studies suggest increasing health literacy and empowering individuals to take preventive action will improve outcomes and mitigate impact on a weak health system. We obtained qualitative data from 80 men, women, and young adults in 11 focus groups to assess beliefs, risk-perceptions, preventive behaviors and perceptions of barriers and facilitators to cancer control in Ibadan, Nigeria and conducted thematic analysis. Participants demonstrated awareness of cancers and mentioned several risk factors related to individual behaviors and the environment. Nonetheless, myths and misconceptions as well as micro, meso and macro level barriers impede prevention and control efforts. Developing and implementing comprehensive context-relevant health literacy interventions in community settings are urgently needed.Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. UPMC Prescription for Wellness: A Quality Improvement Case Study for Supporting Patient Engagement and Health Behavior Change.

    Science.gov (United States)

    Maners, Rebecca J; Bakow, Eric; Parkinson, Michael D; Fischer, Gary S; Camp, Geoffrey R

    Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system. Building on the national Agency for Healthcare Research and Quality and Robert Wood Johnson Foundation-funded Prescription for Health multisite demonstration, this QI case study provides important lessons for transforming patient-physician-practice support systems to better address lifestyle and care management challenges critical to producing better outcomes.

  4. Determinants of Consumer eHealth Information Seeking Behavior.

    Science.gov (United States)

    Sandefer, Ryan H; Westra, Bonnie L; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M

    2015-01-01

    Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access.

  5. A 40-Day Journey to Better Health: Utilizing the DanielFast to Improve Health Outcomes in Urban Church-Based Settings

    Directory of Open Access Journals (Sweden)

    Nicole A. Vaughn

    2018-03-01

    Full Text Available Background: As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chronic disease prevention among underserved groups, particularly in urban settings. This research study evaluated Philadelphia area Keystone First members and church participants enrolled in a group health education program to determine the impact of the Daniel Fast on physical health and the adoption of healthy behaviors. Methods: Participants attended six-weekly health education sessions in two participating churches, and were provided with a digital healthy eating platform. Results: There was a statistically significant decrease from baseline to post assessment for weight, waist circumference and cholesterol. Participants reported a significant improvement in their overall well-being, social and physical functioning, vitality and mental health. Conclusion: Results of this study demonstrate that dietary recommendations and comprehensive group health education delivered in churches and reinforced on a digital platform can improve physical health, knowledge and psychosocial outcomes.

  6. The Effect of Doctor-Consumer Interaction on Social Media on Consumers' Health Behaviors: Cross-Sectional Study.

    Science.gov (United States)

    Wu, Tailai; Deng, Zhaohua; Feng, Zhanchun; Gaskin, Darrell J; Zhang, Donglan; Wang, Ruoxi

    2018-02-28

    Both doctors and consumers have engaged in using social media for health purposes. Social media has changed traditional one-to-one communication between doctors and patients to many-to-many communication between doctors and consumers. However, little is known about the effect of doctor-consumer interaction on consumers' health behaviors. The aim of this study was to investigate how doctor-consumer interaction in social media affects consumers' health behaviors. On the basis of professional-client interaction theory and social cognitive theory, we propose that doctor-consumer interaction can be divided into instrumental interaction and affective interaction. These two types of interactions influence consumers' health behaviors through declarative knowledge (DK), self-efficacy (SE), and outcome expectancy (OE). To validate our proposed research model, we employed the survey method and developed corresponding measurement instruments for constructs in our research model. A total of 352 valid answers were collected, and partial least square was performed to analyze the data. Instrumental doctor-consumer interaction was found to influence consumers' DK (t 294 =5.763, Pinteraction also impacted consumers' DK (t 294 =4.025, Pinteraction on health behaviors, whereas the three mediators fully mediated the effect of affective interaction on health behaviors. Compared with many intentional intervention programs, doctor-consumer interaction can be treated as a natural cost-effective intervention to promote consumers' health behaviors. Meanwhile, both instrumental and affective interaction should be highlighted for the best interaction results. DK, SE, and OE are working mechanisms of doctor-consumer interaction. ©Tailai Wu, Zhaohua Deng, Zhanchun Feng, Darrell J Gaskin, Donglan Zhang, Ruoxi Wang. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 28.02.2018.

  7. A 6-year update of the health policy and advocacy priorities of the Society of Behavioral Medicine.

    Science.gov (United States)

    Buscemi, Joanna; Bennett, Gary G; Gorin, Sherri Sheinfeld; Pagoto, Sherry L; Sallis, James F; Wilson, Dawn K; Fitzgibbon, Marian L

    2017-12-01

    Government policy affects virtually every topic of interest to health behavior researchers, from research funding to reimbursement for clinical services to application of evidence to impact health outcomes. This paper provides a 6-year update on the expansion of Society of Behavioral Medicine's (SBM) public policy and advocacy agenda and proposed future directions. SBM's Health Policy Council is responsible for ensuring coordination of the policy-related activities of the Health Policy Committee (HPC), the Civic and Public Engagement Committee (CPEC), and the Scientific and Professional Liaison Council (SPLC). These committees and councils have written letters to Congress, signed onto advocacy letters with hundreds of organizations, and developed and disseminated 15 health policy briefs, the majority of which have been presented to legislative staffers on Capitol Hill. With the assistance of the SPLC, SBM has collaborated on policy efforts with like-minded organizations to increase the impact of the Society's policy work. Moving forward, SBM plans to continue to increase efforts to disseminate policy work more broadly and develop long-term relationships with Congressional staffers. SBM leadership realizes that to remain relevant, demonstrate impact, and advance the role of behavioral medicine, we must advance a policy agenda that reflects our mission of better health through behavior change.

  8. BEHAVIORAL HAZARD IN HEALTH INSURANCE*

    Science.gov (United States)

    Baicker, Katherine; Mullainathan, Sendhil; Schwartzstein, Joshua

    2015-01-01

    A fundamental implication of standard moral hazard models is overuse of low-value medical care because copays are lower than costs. In these models, the demand curve alone can be used to make welfare statements, a fact relied on by much empirical work. There is ample evidence, though, that people misuse care for a different reason: mistakes, or “behavioral hazard.” Much high-value care is underused even when patient costs are low, and some useless care is bought even when patients face the full cost. In the presence of behavioral hazard, welfare calculations using only the demand curve can be off by orders of magnitude or even be the wrong sign. We derive optimal copay formulas that incorporate both moral and behavioral hazard, providing a theoretical foundation for value-based insurance design and a way to interpret behavioral “nudges.” Once behavioral hazard is taken into account, health insurance can do more than just provide financial protection—it can also improve health care efficiency. PMID:23930294

  9. Public Health Nurses and Mothers Challenge and Shift the Meaning of Health Outcomes

    Directory of Open Access Journals (Sweden)

    Megan Aston

    2016-02-01

    Full Text Available Maternal, child, and newborn health is a priority area in Canada and around the world. The work of public health nurses (PHNs is often invisible and misunderstood. The purpose of this qualitative research project was to explore how universal and targeted home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs ( n = 16 and mothers ( n = 16 in Nova Scotia, Canada. Feminist poststructuralism and discourse analysis were used to analyze interviews. Concepts of relations of power enabled an understanding of how health outcomes had been socially and institutionally constructed through binary relations. PHNs and mothers spoke about the importance of “softer” health outcomes, including maternal self-confidence and empowerment that had been constructed as less important than health outcomes that were seen to be more tangible and physical. Findings from this research could be used to guide practice and planning of postpartum home visiting programs.

  10. Associations between multiple health risk behaviors and mental health among Chinese college students.

    Science.gov (United States)

    Ye, Yong-ling; Wang, Pei-gang; Qu, Geng-cong; Yuan, Shuai; Phongsavan, Philayrath; He, Qi-qiang

    2016-01-01

    Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95% CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.

  11. Applying the reasoned action approach to understanding health protection and health risk behaviors.

    Science.gov (United States)

    Conner, Mark; McEachan, Rosemary; Lawton, Rebecca; Gardner, Peter

    2017-12-01

    The Reasoned Action Approach (RAA) developed out of the Theory of Reasoned Action and Theory of Planned Behavior but has not yet been widely applied to understanding health behaviors. The present research employed the RAA in a prospective design to test predictions of intention and action for groups of protection and risk behaviors separately in the same sample. To test the RAA for health protection and risk behaviors. Measures of RAA components plus past behavior were taken in relation to eight protection and six risk behaviors in 385 adults. Self-reported behavior was assessed one month later. Multi-level modelling showed instrumental attitude, experiential attitude, descriptive norms, capacity and past behavior were significant positive predictors of intentions to engage in protection or risk behaviors. Injunctive norms were only significant predictors of intention in protection behaviors. Autonomy was a significant positive predictor of intentions in protection behaviors and a negative predictor in risk behaviors (the latter relationship became non-significant when controlling for past behavior). Multi-level modelling showed that intention, capacity, and past behavior were significant positive predictors of action for both protection and risk behaviors. Experiential attitude and descriptive norm were additional significant positive predictors of risk behaviors. The RAA has utility in predicting both protection and risk health behaviors although the power of predictors may vary across these types of health behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Health and imaging outcomes in axial spondyloarthritis

    NARCIS (Netherlands)

    Machado, P.M.

    2016-01-01

    This thesis focuses on the assessment and monitoring of health and imaging outcomes in axial spondyloarthritis (SpA) and the relationship between these outcomes. Four major contributions to the understanding and management of axial SpA were made: 1) the improvement and facilitation of the assessment

  13. High Intensity Interval Training for Maximizing Health Outcomes.

    Science.gov (United States)

    Karlsen, Trine; Aamot, Inger-Lise; Haykowsky, Mark; Rognmo, Øivind

    Regular physical activity and exercise training are important actions to improve cardiorespiratory fitness and maintain health throughout life. There is solid evidence that exercise is an effective preventative strategy against at least 25 medical conditions, including cardiovascular disease, stroke, hypertension, colon and breast cancer, and type 2 diabetes. Traditionally, endurance exercise training (ET) to improve health related outcomes has consisted of low- to moderate ET intensity. However, a growing body of evidence suggests that higher exercise intensities may be superior to moderate intensity for maximizing health outcomes. The primary objective of this review is to discuss how aerobic high-intensity interval training (HIIT) as compared to moderate continuous training may maximize outcomes, and to provide practical advices for successful clinical and home-based HIIT. Copyright © 2017. Published by Elsevier Inc.

  14. Health Outcomes and Costs of Social Work Services: A Systematic Review.

    Science.gov (United States)

    Steketee, Gail; Ross, Abigail M; Wachman, Madeline K

    2017-12-01

    Efforts to reduce expensive health service utilization, contain costs, improve health outcomes, and address the social determinants of health require research that demonstrates the economic value of health services in population health across a variety of settings. Social workers are an integral part of the US health care system, yet the specific contributions of social work to health and cost-containment outcomes are unknown. The social work profession's person-in-environment framework and unique skillset, particularly around addressing social determinants of health, hold promise for improving health and cost outcomes. To systematically review international studies of the effect of social work-involved health services on health and economic outcomes. We searched 4 databases (PubMed, PsycINFO, CINAHL, Social Science Citation Index) by using "social work" AND "cost" and "health" for trials published from 1990 to 2017. Abstract review was followed by full-text review of all studies meeting inclusion criteria (social work services, physical health, and cost outcomes). Of the 831 abstracts found, 51 (6.1%) met criteria. Full text review yielded 16 studies involving more than 16 000 participants, including pregnant and pediatric patients, vulnerable low-income adults, and geriatric patients. We examined study quality, health and utilization outcomes, and cost outcomes. Average study quality was fair. Studies of 7 social work-led services scored higher on quality ratings than 9 studies of social workers as team members. Most studies showed positive effects on health and service utilization; cost-savings were consistent across nearly all studies. Despite positive overall effects on outcomes, variability in study methods, health problems, and cost analyses render generalizations difficult. Controlled hypothesis-driven trials are needed to examine the health and cost effects of specific services delivered by social workers independently and through interprofessional team

  15. The mediating effect of mindful non-reactivity in exposure-based cognitive behavior therapy for severe health anxiety.

    Science.gov (United States)

    Hedman, Erik; Hesser, Hugo; Andersson, Erik; Axelsson, Erland; Ljótsson, Brjánn

    2017-08-01

    Exposure-based cognitive behavior therapy (CBT) has been shown to be effective in the treatment of severe health anxiety, but little is known about mediators of treatment effect. The aim of the present study was to investigate mindful non-reactivity as a putative mediator of health anxiety outcome using data from a large scale randomized controlled trial. We assessed mindful non-reactivity using the Five Facets Mindfulness Questionnaire-Non-Reactivity scale (FFMQ-NR) and health anxiety with the Short Health Anxiety Inventory (SHAI). Participants with severe health anxiety (N=158) were randomized to internet-delivered exposure-based CBT or behavioral stress management (BSM) and throughout the treatment, both the mediator and outcome were measured weekly. As previously reported, exposure-based CBT was more effective than BSM in reducing health anxiety. In the present study, latent process growth modeling showed that treatment condition had a significant effect on the FFMQ-NR growth trajectory (α-path), estimate=0.18, 95% CI [0.04, 0.32], p=.015, indicating a larger increase in mindful non-reactivity among participants receiving exposure-based CBT compared to the BSM group. The FFMQ-NR growth trajectory was significantly correlated with the SHAI trajectory (β-path estimate=-1.82, 95% CI [-2.15, -1.48], panxiety. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Health risk behavior of youth in foster care.

    Science.gov (United States)

    Gramkowski, Bridget; Kools, Susan; Paul, Steven; Boyer, Cherrie B; Monasterio, Erica; Robbins, Nancy

    2009-05-01

    Many adolescent health problems are predominantly caused by risk behavior. Foster adolescents have disproportionately poor health; therefore, identification of risk behavior is critical. Data from a larger study were analyzed to investigate the health risk behavior of 56 youth in foster care using the Child Health and Illness Profile-Adolescent Edition. Data indicated that youth in foster care had some increased risk behavior when compared with a normative adolescent population. Younger adolescents and those in relative placement had less risky behavior. Risk behavior was increased for youth in foster care when they were in group homes, had experienced a parental death, or had a history of physical or emotional abuse or attempted suicide. These results point to areas of strength and vulnerability for youth in foster care and suggest areas for clinicians and caregivers of these adolescents to focus interventions towards harm reduction and enhancement of resiliency.

  17. Health and school outcomes during children's transition into adolescence.

    Science.gov (United States)

    Forrest, Christopher B; Bevans, Katherine B; Riley, Anne W; Crespo, Richard; Louis, Thomas A

    2013-02-01

    Normative biopsychosocial stressors that occur during entry into adolescence can affect school performance.As a set of resources for adapting to life's challenges, good health may buffer a child from these potentially harmful stressors. This study examined the associations between health (measured as well-being, functioning, symptoms, and chronic conditions) and school outcomes among children aged 9-13 years in 4th-8th grades. We conducted a prospective cohort study of 1,479 children from 34 schools followed from 2006 to 2008. Survey data were obtained from children and their parents, and school records were abstracted. Measures of child self-reported health were dichotomized to indicate presence of a health asset. Outcomes included attendance, grade point average, state achievement test scores, and child-reported school engagement and teacher connectedness. Both the transition into middle school and puberty had independent negative influences on school outcomes. Chronic health conditions that affected children's functional status were associated with poorer academic achievement. The number of health assets that a child possessed was positively associated with school outcomes. Low levels of negative stress experiences and high physical comfort had positive effects on teacher connectedness, school engagement, and academic achievement, whereas bullying and bully victimization negatively affected these outcomes. Children with high life satisfaction were more connected with teachers, more engaged in schoolwork, and earned higher grades than those who were less satisfied. As children enter adolescence, good health may buffer them from the potentially negative effects of school and pubertal transitions on academic success. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  18. Personal health and consumer informatics. The impact of health oriented social media applications on health outcomes.

    Science.gov (United States)

    Gibbons, M C

    2013-01-01

    The rapid evolution in the world-wide use of Social Media tools suggests the emergence of a global phenomenon that may have implications in the Personal Health and Consumer Health Informatics domains. However the impact of these tools on health outcomes is not known. The goal of this research was to review the randomized controlled trial (RCT) evidence of the impact of health oriented Social Media informatics tools on health outcomes. Evaluations of Social Media consumer health tools were systematically reviewed. Research was limited to studies published in the English language, published in Medline, published in the calendar year 2012 and limited to studies that utilized a RCT methodological design. Two high quality Randomized Controlled Trials among over 600 articles published in Medline were identified. These studies indicate that Social Media interventions may be able to significantly improve pain control among patients with chronic pain and enhance weight loss maintenance among individuals attempting to lose weight. Significantly more research needs to be done to confirm these early findings, evaluate additional health outcomes and further evaluate emerging health oriented Social Media interventions. Chronic pain and weight control have both socially oriented determinants. These studies suggest that understanding the social component of a disease may ultimately provide novel therapeutic targets and socio-clinical interventional strategies.

  19. Outcomes Across the Value Chain for a Comprehensive Employee Health and Wellness Intervention: A Cohort Study by Degrees of Health Engagement.

    Science.gov (United States)

    Long, D Adam; Reed, Roger W; Duncan, Ian

    2016-07-01

    Evaluate a large employer's wellness intervention by studying outcomes across the value chain, and testing Health Engagement's (HE) dose-response relationship to outcomes. Evaluation included 37 measures across eight outcomes domains (OD) using repeated measures, analysis of variance and logistic regression. Participants with higher HE had better pre-post percent changes than control: 1.7% higher for Motivation (OD1), 3.4% for Behavior (OD2), 1.0% for Emotion (OD3), 5.8% for Biometrics (OD4), 6.3% for Compliance (OD5), and 5.2% for Claims (OD6). They also had 0.5% less Productivity loss (OD7), and odds of Turnover (OD8) one-quarter to one-half that of control. A dose-response relationship with degrees of HE was also shown. Three outcomes domains (OD6 to OD8) can be monetized for cost-benefit analysis. Authors recommend, however, staying focused on driving HE and using metrics from all OD to assess value.

  20. Preschool outcomes following prenatal serotonin reuptake inhibitor exposure: differences in language and behavior, but not cognitive function.

    Science.gov (United States)

    Johnson, Katrina C; Smith, Alicia K; Stowe, Zachary N; Newport, D Jeffrey; Brennan, Patricia A

    2016-02-01

    To test the hypothesis that prenatal exposure to serotonin reuptake inhibitors (SRIs) is associated with language and behavioral outcomes in preschool-aged children, while accounting for confounds such as concomitant exposures and maternal mental illness. An observational, prospective, longitudinal study of mental illness in pregnancy was conducted at a university-based women's mental health clinic (April 2010-November 2012). A sample of 178 mother-child dyads participated in a laboratory visit at preschool age (2.5-5.5 years). The majority of women (87%) received psychotropic medication during pregnancy. Psychiatric status (based on DSM-IV), other medication use, and substance use were serially assessed and tested as confounds. Primary outcome measures included standardized measures of expressive language and cognitive function and mother and alternate caregiver ratings of child behavior problems, including the Pervasive Developmental Disorders (PDD) subscale of the Child Behavior Checklist. Linear regression analyses revealed that, after controlling for relevant covariates, expressive language scores from the Test of Early Language Development, 3rd edition, were negatively associated with prenatal SRI exposure (β = -0.15, t = -2.41), while the PDD behavioral problems subscales completed by alternate caregivers and mothers were positively associated with prenatal SRI exposure (β = 0.17, t = 2.01; β = 0.16, t = 2.00, respectively). Cognitive function, measured using the Differential Ability Scales, 2nd edition, was not associated with any medication exposures. The current data suggest a small but significant association between prenatal SRI exposure and preschool outcomes, including expressive language and behavior problems. These data corroborate data from recent, population-based studies, although overall, published findings are mixed. Replication and identification of moderating risk factors are needed to understand potential clinical implications.

  1. Mental- and physical-health indicators and sexually explicit media use behavior by adults.

    Science.gov (United States)

    Weaver, James B; Weaver, Stephanie Sargent; Mays, Darren; Hopkins, Gary L; Kannenberg, Wendi; McBride, Duane

    2011-03-01

    Converging evidence from culturally diverse contexts indicates that sexually explicit media use behavior (SEMB; i.e., pornography consumption) is associated with risky sexual health perceptions and behaviors, many that involve high risks of HIV/STD transmission. Essentially unexplored, and the focus here, are potential relationships between SEMB and nonsexual mental- and physical-health indicators. Variability in six continuously measured health indicators (depressive symptoms, mental- and physical-health diminished days, health status, quality of life, and body mass index) was examined across two levels (users, nonusers) of SEMB. A sample of 559 Seattle-Tacoma Internet-using adults was surveyed in 2006. Multivariate general linear models parameterized in a SEMB by respondent gender (2 × 2) factorial design were computed incorporating adjustments for several demographics. SEMB was reported by 36.7% (n = 205) of the sample. Most SEMB users (78%) were men. After adjusting for demographics, SEMB users, compared to nonusers, reported greater depressive symptoms, poorer quality of life, more mental- and physical-health diminished days, and lower health status. The findings show that mental- and physical-health indicators vary significantly across SEMB, suggesting the value of incorporating these factors in future research and programmatic endeavors. In particular, the findings suggest that evidence-based sexual health promotion strategies simultaneously addressing individuals' SEMB and their mental health needs might be a useful approach to improve mental health and address preventable sexual health outcomes associated with SEMB. © 2010 International Society for Sexual Medicine.

  2. Consumer Preferences for Health and Nonhealth Outcomes of Health Promotion: Results from a Discrete Choice Experiment

    NARCIS (Netherlands)

    Alayli-Goebbels, A.F.G.; Dellaert, B.G.C.; Knox, S.A.; Ament, A.J.H.A.; Lakerveld, J.; Bot, S.D.M.; Nijpels, G.; Severens, J.L.

    2013-01-01

    Objective: Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their

  3. The Relationships Between Female Adolescents' Media Use, Indoor Tanning Outcome Expectations, and Behavioral Intentions.

    Science.gov (United States)

    Myrick, Jessica Gall; Noar, Seth M; Kelley, Dannielle; Zeitany, Alexandra E

    2017-06-01

    Unlike other types of cancer, skin cancer incidence rates are on the rise and adolescent females are particularly likely to tan indoors, a major risk factor. However, little research has examined the role of media use in encouraging or discouraging this dangerous behavior in this population. To empirically assess the links between media use, indoor tanning-related outcome expectations, and behavioral intentions. A survey of adolescent females ( N = 510) ages 15 to 18 in the Southeastern United States assessed demographics, types of media use, and indoor tanning intentions. Significant correlations between media use and indoor tanning outcome expectations were found. Use of interpersonal and social media (i.e., talking on the phone, texting, and online social media) were positively associated with positive outcome expectations about indoor tanning and negatively associated with negative outcome expectations. A path analysis revealed that interpersonal/social media use had indirect associations with indoor tanning intentions via tanning outcome expectations. Mass media use (e.g., news media, entertainment media, and magazines) was not significantly associated with most indoor tanning outcome expectations but did have a direct negative association with behavioral intentions. There are important relationships between media use, indoor tanning outcome expectations, and behavioral intentions. Interpersonal and social media use may help cultivate outcome expectations that encourage indoor tanning, which in turn may increase intentions to tan, while news media consumption in particular may reduce intentions to tan. These findings highlight the social nature of adolescent females and point to specific intervention channels for reducing indoor tanning among this population.

  4. Association Between Spousal Suicide and Mental, Physical, and Social Health Outcomes

    Science.gov (United States)

    Runeson, Bo; Bolton, James M.; Wilcox, Holly C.; Forman, Julie L; Krogh, Jesper; Shear, M. Katherine; Nordentoft, Merete; Conwell, Yeates

    2017-01-01

    population. Compared with spouses bereaved by other manners of death, those bereaved by suicide had higher risks for developing mental disorders (men: incidence rate ratio, 1.7; 95% CI, 1.5-1.9; women: incidence rate ratio, 2.0; 95% CI, 1.9-2.2), suicidal behaviors, mortality, and municipal support. Additionally, a higher level of mental health care use was noted. Conclusions and Relevance Exposure to suicide is stressful and affects the bereaved spouse on a broad range of outcomes. The excess risks of mental, physical, and social health outcomes highlight a need for more support directed toward spouses bereaved by suicide. PMID:28329305

  5. Family Meals and Child Academic and Behavioral Outcomes

    Science.gov (United States)

    Miller, Daniel P.; Waldfogel, Jane; Han, Wen-Jui

    2012-01-01

    This study investigates the link between the frequency of family breakfasts and dinners and child academic and behavioral outcomes in a panel sample of 21,400 children aged 5-15. It complements previous work by examining younger and older children separately and by using information on a large number of controls and rigorous analytic methods to…

  6. Family structure and risk behaviors: the role of the family meal in assessing likelihood of adolescent risk behaviors

    Directory of Open Access Journals (Sweden)

    Goldfarb S

    2014-02-01

    Full Text Available Samantha Goldfarb, Will L Tarver, Bisakha Sen Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Background: Previous literature has asserted that family meals are a key protective factor for certain adolescent risk behaviors. It is suggested that the frequency of eating with the family is associated with better psychological well-being and a lower risk of substance use and delinquency. However, it is unclear whether there is evidence of causal links between family meals and adolescent health-risk behaviors. Purpose: The purpose of this article is to review the empirical literature on family meals and adolescent health behaviors and outcomes in the US. Data sources: A search was conducted in four academic databases: Social Sciences Full Text, Sociological Abstracts, PsycINFO®, and PubMed/MEDLINE. Study selection: We included studies that quantitatively estimated the relationship between family meals and health-risk behaviors. Data extraction: Data were extracted on study sample, study design, family meal measurement, outcomes, empirical methods, findings, and major issues. Data synthesis: Fourteen studies met the inclusion criteria for the review that measured the relationship between frequent family meals and various risk-behavior outcomes. The outcomes considered by most studies were alcohol use (n=10, tobacco use (n=9, and marijuana use (n=6. Other outcomes included sexual activity (n=2; depression, suicidal ideation, and suicide attempts (n=4; violence and delinquency (n=4; school-related issues (n=2; and well-being (n=5. The associations between family meals and the outcomes of interest were most likely to be statistically significant in unadjusted models or models controlling for basic family characteristics. Associations were less likely to be statistically significant when other measures of family connectedness were included. Relatively few analyses used

  7. The business cycle and health behaviors.

    Science.gov (United States)

    Xu, Xin

    2013-01-01

    While it is well documented that economic expansions provide widespread and immediate financial benefits, the evidence on how an economic downturn affects individual's health behaviors is surprisingly mixed. In this paper, we take a structural approach to investigate the effects of wages and working hours on health behaviors of low-educated persons using variations in wages and hours caused by changes in local economic activity. In the empirical analysis, we adopt a two-sample instrumental variables approach to combine the data on individual health behaviors from the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) with the data on individual employment from the Current Population Survey (CPS). The total sample size of the combined CPS-BRFSS data for the time period of 1984-2005 is 967,594, while that of the combined CPS-NHIS data for the time period of 1976-2001 is 364,078. We find that increases in wages caused by economic expansions are associated with greater consumption of cigarettes in the United States. We also find that increases in hours of work caused by economic expansions are associated with more cigarette consumption, but less physical activity and physician visits. More importantly, the evidence suggests that most of such effects associated with changes in hours of work can be attributed to the changes at the extensive margin of employment, meaning the changes in employment status, rather than the changes at the intensive margin, meaning changes in hours of work conditional on being employed. These findings imply that changes in employment may have heterogeneous impacts on time-intensive and less time-intensive health behaviors and also provide additional evidence on the importance of time in health production, particularly for time-intensive activities. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Seeking better health care outcomes: the ethics of using the "nudge".

    Science.gov (United States)

    Blumenthal-Barby, J S; Burroughs, Hadley

    2012-01-01

    Policymakers, employers, insurance companies, researchers, and health care providers have developed an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. In this article, we examine how principles from behavioral economics and psychology are being used to nudge people (the public, patients, or health care providers) toward particular decisions or behaviors related to health or health care, and we identify the ethically relevant dimensions that should be considered for the utilization of each principle.

  9. Categorizing Health Outcomes and Efficacy of mHealth Apps for Persons With Cognitive Impairment: A Systematic Review.

    Science.gov (United States)

    Bateman, Daniel R; Srinivas, Bhavana; Emmett, Thomas W; Schleyer, Titus K; Holden, Richard J; Hendrie, Hugh C; Callahan, Christopher M

    2017-08-30

    Use of mobile health (mHealth) apps is growing at an exponential rate in the United States and around the world. Mild cognitive impairment (MCI), Alzheimer disease, and related dementias are a global health problem. Numerous mHealth interventions exist for this population, yet the effect of these interventions on health has not been systematically described. The aim of this study is to catalog the types of health outcomes used to measure effectiveness of mHealth interventions and assess which mHealth interventions have been shown to improve the health of persons with MCI, Alzheimer disease, and dementia. We searched 13 databases, including Ovid MEDLINE, PubMed, EMBASE, the full Cochrane Library, CINAHL, PsycINFO, Ei Compendex, IEEE Xplore, Applied Science & Technology Source, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar from inception through May 2017 for mHealth studies involving persons with cognitive impairment that were evaluated using at least one quantitative health outcome. Proceedings of the Annual ACM Conferences on Human Factors in Computing Systems, the ACM User Interface Software and Technology Symposium, and the IEEE International Symposium on Wearable Computers were searched in the ACM Digital Library from 2012 to 2016. A hand search of JMIR Publications journals was also completed in July 2017. After removal of duplicates, our initial search returned 3955 records. Of these articles, 24 met final inclusion criteria as studies involving mHealth interventions that measured at least one quantitative health outcome for persons with MCI, Alzheimer disease, and dementia. Common quantitative health outcomes included cognition, function, mood, and quality of life. We found that 21.2% (101/476) of the fully reviewed articles were excluded because of a lack of health outcomes. The health outcomes selected were observed to be inconsistent between studies. For those studies with quantitative health outcomes, more than half (58%) reported

  10. Longitudinal Relations Among Parenting Styles, Prosocial Behaviors, and Academic Outcomes in U.S. Mexican Adolescents.

    Science.gov (United States)

    Carlo, Gustavo; White, Rebecca M B; Streit, Cara; Knight, George P; Zeiders, Katharine H

    2018-03-01

    This article examined parenting styles and prosocial behaviors as longitudinal predictors of academic outcomes in U.S. Mexican youth. Adolescents (N = 462; Wave 1 M age  = 10.4 years; 48.1% girls), parents, and teachers completed parenting, prosocial behavior, and academic outcome measures at 5th, 10th, and 12th grades. Authoritative parents were more likely to have youth who exhibited high levels of prosocial behaviors than those who were moderately demanding and less involved. Fathers and mothers who were less involved and mothers who were moderately demanding were less likely than authoritative parents to have youth who exhibited high levels of prosocial behaviors. Prosocial behaviors were positively associated with academic outcomes. Discussion focuses on parenting, prosocial behaviors, and academic attitudes in understanding youth academic performance. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  11. Social Networks, Interpersonal Social Support, and Health Outcomes: A Health Communication Perspective

    OpenAIRE

    Wright, Kevin

    2016-01-01

    This manuscript discusses the development, impact, and several major research findings of studies in the area of social network support and health outcomes. The review focuses largely on the development of online social support networks and the ways in which they may interact with face-to-face support networks to influence physical and psychological health outcomes. The manuscript discusses this area, and it presents a research agenda for future work in this area from an Associate Editor’s pe...

  12. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    Directory of Open Access Journals (Sweden)

    Yong-Bing Liu

    2015-08-01

    Full Text Available Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008 and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452. Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points. There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001. The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001. The elderly with higher health literacy scores were significantly less likely to have risky behaviors

  13. Broadening perspectives on pediatric oral health care provision: social determinants of health and behavioral management.

    Science.gov (United States)

    Fisher-Owens, Susan

    2014-01-01

    Dental caries is not just the most common chronic childhood disease, with not insignificant burden of disease during childhood, but also lifelong impact. Traditional models that focus on the "mouth in the chair" have been helpful but insufficient to identify structural root causes for its high incidence, thus having a limited ability to prevent the disease. The addition of social and behavioral determinants to strictly biologic models provides the full context of care, enabling providers to better tailor their guidance and improve health outcomes. In-office behavioral management involves understanding these determinants and applying appropriate techniques; these not only can help reset family and patient expectations but can actually increase compliance. Lastly, children with multiple medical issues require additional focus, as they can carry greater burden of disease, making it even more critical during office visits to offer multifactorial compliance strategies for these patients and their parents.

  14. A Place-Based Community Health Worker Program: Feasibility and Early Outcomes, New York City, 2015

    Science.gov (United States)

    Lopez, Priscilla M.; Islam, Nadia; Feinberg, Alexis; Myers, Christa; Seidl, Lois; Drackett, Elizabeth; Riley, Lindsey; Mata, Andrea; Pinzon, Juan; Benjamin, Elisabeth; Wyka, Katarzyna; Dannefer, Rachel; Lopez, Javier; Trinh-Shevrin, Chau; Maybank, Karen Aletha; Thorpe, Lorna E.

    2017-01-01

    Introduction This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes. Methods This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n=1,663; six focus groups, n=55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease self-management and goal setting through six individual CHW-led health coaching sessions, instrumental support, and facilitated access to insurance/clinical care navigation from community-based HAs. Feasibility measures included CHW service satisfaction and successful goal setting. Preliminary outcomes included clinical measures (blood pressure, BMI); disease management behaviors and self-efficacy; and preventive behaviors (physical activity). Results At the 3-month follow-up, nearly all intervention participants reported high satisfaction with their CHW (90%) and HA (76%). Intervention participants showed significant improvements in self-reported physical activity (p=0.005) and, among hypertensive participants, self-reported routine blood pressure self-monitoring (p=0.013) compared with comparison participants. No improvements were observed in self-efficacy or clinical measures at the 3-month follow-up. Conclusions Housing-based initiatives involving CHW and HA teams are acceptable to public housing residents and can be effectively implemented to achieve rapid improvements in physical activity and chronic disease self-management. At 3-month assessment, additional time and efforts are

  15. Cognitive behavioral therapy for compulsive buying behavior: Predictors of treatment outcome.

    Science.gov (United States)

    Granero, R; Fernández-Aranda, F; Mestre-Bach, G; Steward, T; Baño, M; Agüera, Z; Mallorquí-Bagué, N; Aymamí, N; Gómez-Peña, M; Sancho, M; Sánchez, I; Menchón, J M; Martín-Romera, V; Jiménez-Murcia, S

    2017-01-01

    Compulsive buying behavior (CBB) is receiving increasing consideration in both consumer and psychiatric-epidemiological research, yet empirical evidence on treatment interventions is scarce and mostly from small homogeneous clinical samples. To estimate the short-term effectiveness of a standardized, individual cognitive behavioral therapy intervention (CBT) in a sample of n=97 treatment-seeking patients diagnosed with CBB, and to identify the most relevant predictors of therapy outcome. The intervention consisted of 12 individual CBT weekly sessions, lasting approximately 45minutes each. Data on patients' personality traits, psychopathology, sociodemographic factors, and compulsive buying behavior were used in our analysis. The risk (cumulative incidence) of poor adherence to the CBT program was 27.8%. The presence of relapses during the CBT program was 47.4% and the dropout rate was 46.4%. Significant predictors of poor therapy adherence were being male, high levels of depression and obsessive-compulsive symptoms, low anxiety levels, high persistence, high harm avoidance and low self-transcendence. Cognitive behavioral models show promise in treating CBB, however future interventions for CBB should be designed via a multidimensional approach in which patients' sex, comorbid symptom levels and the personality-trait profiles play a central role. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. Using patient-reported outcomes in schizophrenia: the Scottish Schizophrenia Outcomes Study.

    Science.gov (United States)

    Hunter, Robert; Cameron, Rosie; Norrie, John

    2009-02-01

    The primary aim of the Scottish Schizophrenia Outcomes Study (SSOS) was to assess the feasibility and utility of routinely collecting outcome data in everyday clinical settings. Data were collected over three years in the Scottish National Health Service (NHS). There were two secondary aims of SSOS: first, to compare data from patient-rated, objective, and clinician-rated outcomes, and second, to describe trends in outcome data and service use across Scotland over the three years of the study (2002-2005). This study used a naturalistic, longitudinal, observational cohort design. A representative sample of 1,015 persons with ICD-10 F20-F29 diagnoses (schizophrenia, schizotypal disorders, or delusional disorders) was assessed annually using the clinician-rated measure, the Health of the Nation Outcome Scale (HoNOS), and the patient-reported assessment, the Avon Mental Health Measure (Avon). Objective outcomes data and information on services and interventions were collected. Data were analyzed with regression modeling. Of the 1,015 persons recruited, 78% of the cohort (N=789) completed the study. Over the study period, significant decreases were seen in the number of hospitalizations, incidence of attempted suicide and self-harm, and civil detentions. Avon scores indicated significant improvement on all subscales (behavior, social, access, and mental health) and on the total score. However, HoNOS scores on the behavior and symptom subscales did not change, scores on the impairment subscale increased significantly (indicating increased levels of impairment), and scores on the social subscale decreased significantly (indicating improved social functioning). This study has demonstrated that it is feasible within the Scottish NHS to routinely collect meaningful outcomes data in schizophrenia. Patient-reported assessments were also successfully collected and used in care plans. This model shows that it is possible to incorporate patient-reported assessments into routine

  17. Health Promotion Behaviors of Women and Affecting Factors

    Directory of Open Access Journals (Sweden)

    Naile Bilgili

    2009-12-01

    Full Text Available AIM: Women should be healthy and have health promotion behaviors, so they can accomplish both their maternal and social tasks. This descriptive study was conducted to determine the healthy life-style behaviors of married women and the factors which could affect those behaviors. METHOD: The population comprised all married women older than 15 years and who live in Ankara Kale region. Three hundred-sixty five married women were included in the study. The questionnaire form and the healthy life-style behaviors scale was used for data collection. RESULTS: The mean score taken from scale was 112.2±19.4. The scores of the women who graduated from middle school / high school, who have sufficient income and good socio-economic status, who have a perception of physical health fairly good and who have any chronic disease in their families, have significantly higher mean scores from healthy life-style behaviors scale and subgroups (p<0.05 CONCLUSION: Health promotion behaviors of the women was low and some factors like education level, income, socioeconomic status, perception of health, having any chronic illness and using regular medicine affected healthy life-style behaviors. It is recommended that nurses, who have education and consultation roles, should inform the women about health promotion behaviors and encourage them to use that information in their lives. [TAF Prev Med Bull 2009; 8(6.000: 497-502

  18. A small business worksite wellness model for improving health behaviors.

    Science.gov (United States)

    Merrill, Ray M

    2013-08-01

    To evaluate the effectiveness of a wellness program delivered by WellSteps, LLC, aimed at improving employee health behaviors in small companies that lack the resources to independently develop and manage a wellness program. Analyses are based on 618 employees from five diverse companies that completed an initial personal health assessment. Exercise and dietary behaviors significantly improved across the five companies. Significant improvements in health perception and life satisfaction also resulted and were associated with improvements in health behaviors. Three of the five companies, each with fewer than 50 employees, were most effective in influencing positive health behaviors, health perceptions, and life satisfaction. The worksite wellness program effectively improved health behaviors, health perceptions, and life satisfaction.

  19. Links between teacher assessment and child self-assessment of mental health and behavior among children affected by HIV/AIDS.

    Science.gov (United States)

    Du, Hongfei; Li, Xiaoming; Weinstein, Traci L; Chi, Peilian; Zhao, Junfeng; Zhao, Guoxiang

    2015-01-01

    Teachers are considered to be one of the most important influences in the lives of students. Teachers' assessments of students may be a primary source of information on children's mental and behavioral health; however, this topic has received little attention in research. We examined this issue through linking teachers' ratings of students and mental and behavioral outcomes of children affected by HIV. The hypothesis is that teacher ratings will be predictive of specific child mental and behavioral health outcomes. A quantitative cross-sectional design with self-administered paper-and-pencil instruments was used. The sample included 1221 children (aged 6-18, grades 1-11) affected by HIV including 755 orphans who lost one or both parents to AIDS and 466 vulnerable children living with HIV-infected parents in a central province of China. The corresponding teacher sample included 185 participants. Each child completed an assessment inventory of demographic information and mental and behavioral health measures. Teachers completed a questionnaire about children's school performance. SEM analyses revealed a good model fit according to all fit indices: comparative fit index = 0.93, root mean square error of approximation = 0.07, and standardized root mean square residual = 0.04. Structural equation modeling revealed that problem ratings by teachers were positively associated with child loneliness and behavioral problems, social competence ratings by teachers were negatively related to child depression, and personal growth and social interaction ratings by teachers were negatively related to child loneliness, depression, and trauma. The current study represents a unique contribution to the field in that it recognizes that teachers can be a valuable source of information on children's psychological health. Results from this study have implications for health prevention and intervention for children and families suffering from HIV/AIDS.

  20. Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

    OpenAIRE

    Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

    2013-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the H...

  1. Discounting of qualitatively different delayed health outcomes in current and never smokers

    Science.gov (United States)

    Friedel, Jonathan E.; DeHart, William B.; Frye, Charles C. J.; Rung, Jillian M.; Odum, Amy L.

    2016-01-01

    In delay discounting, temporally remote outcomes have less value. Cigarette smoking is associated with steeper discounting of money and consumable outcomes. It is presently unclear whether smokers discount health outcomes more than non-smokers. We sought to establish the generality of steep discounting for different types of health outcomes in cigarette smokers. Seventy participants (38 smokers and 32 non-smokers) completed four hypothetical outcome delay-discounting tasks: a gain of $500, a loss of $500, a temporary boost in health, and temporary cure from a debilitating disease. Participants reported the duration of each health outcome that would be equivalent to $500; these durations were then used in the respective discounting tasks. Delays ranged from 1 week to 25 years. Smokers’ indifference points for monetary gains, boosts in health, and temporary cures were lower than indifference points from non-smokers. Indifference points of one outcome were correlated with indifference points of other outcomes. Smokers demonstrate steeper discounting across a range of delayed outcomes. How a person discounts one outcome predicts how they will discount other outcomes. These two findings support our assertion that delay discounting is in part a trait. PMID:26691848

  2. Aging Men’s Health-Related Behaviors

    Directory of Open Access Journals (Sweden)

    Terry Peak

    2014-11-01

    Full Text Available This conceptual review summarizes the current research on older men and their health-related behaviors with special attention given to the influence of the hegemonic masculinity framework over the life span. The authors consider whether masculinity precepts can be modified to enable men to alter their gendered morbidity/mortality factors and achieve healthier and longer lives. Also included is an overview of the gender-based research and health education efforts to persuade men to adopt more effective health-related behaviors or health practices earlier in the life span. Given the current attention being paid to men’s health, for example, their higher risk of morbidity and mortality both generally and at younger ages, and the associated health care costs tied to those risks, the ethical and economic implications of this review may prove useful.

  3. Child Social Exclusion Risk and Child Health Outcomes in Australia.

    Directory of Open Access Journals (Sweden)

    Itismita Mohanty

    Full Text Available This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia's only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services.The paper used data from the National Centre for Social and Economic Modelling (NATSEM, University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database.The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children's health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index.The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children's health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage.

  4. [COMMUNICATION AND HEALTH OUTCOMES IN PATIENTS SUFFERING FROM GASTROINTESTINAL DISEASES].

    Science.gov (United States)

    Petriček, G; Cerovečki, V; Adžić, Z Ožvačić

    2015-11-01

    Although survey results indicate clear connection between the physician-patient communication and health outcomes, mechanisms of their action are still insufficiently clear. The aim was to investigate the specificity of communication with patients suffering from gastrointestinal diseases and the impact of good communication on measurable outcomes. We performed PubMed (Medline) search using the following key words: communication, health outcomes, and gastrointestinal diseases. Seven pathways through which communication can lead to better health include increased access to care, greater patient knowledge and shared understanding, higher quality medical decisions, enhanced therapeutic alliances, increased social support, patient agency and empowerment, and better management of emotions. Although these pathways were explored with respect to cancer care, they are certainly applicable to other health conditions as well, including the care of patients suffering from gastrointestinal diseases. Although proposing a number of pathways through which communication can lead to improved health, it should be emphasized that the relative importance of a particular pathway will depend on the outcome of interest, the health condition, where the patient is in the illness trajectory, and the patient’s life circumstances. Besides, research increasingly points to the importance of placebo effect, and it is recommended that health professionals encourage placebo effect by applying precisely targeted communication skills, as the unquestionable and successful part of many treatments. It is important that the clinician knows the possible positive and negative effects of communication on health outcomes, and in daily work consciously maximizes therapeutic effects of communication, reaching its proximal (understanding, satisfaction, clinician-patient agreement, trust, feeling known, rapport, motivation) and intermediate outcomes (access to care, quality medical decision, commitment to

  5. Gender, health behavior, and intimate relationships: lesbian, gay, and straight contexts.

    Science.gov (United States)

    Reczek, Corinne; Umberson, Debra

    2012-06-01

    Many studies focus on health behavior within the context of intimate ties. However, this literature is limited by reliance on gender socialization theory and a focus on straight (i.e., heterosexual) marriage. We extend this work with an analysis of relationship dynamics around health behavior in 20 long-term straight marriages as well as 15 gay and 15 lesbian long-term cohabiting partnerships in the United States (N = 100 individual in-depth interviews). We develop the concept of "health behavior work" to align activities done to promote health behavior with theories on unpaid work in the home. Respondents in all couple types describe specialized health behavior work, wherein one partner works to shape the other partner's health behavior. In straight couples, women perform the bulk of specialized health behavior work. Most gay and lesbian respondents-but few straight respondents--also describe cooperative health behavior work, wherein partners mutually influence one another's health behaviors. Findings suggest that the gendered relational context of an intimate partnership shapes the dynamics of and explanations for health behavior work. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Longitudinal associations between health behaviors and mental health in low-income adults.

    Science.gov (United States)

    Walsh, Jennifer L; Senn, Theresa E; Carey, Michael P

    2013-03-01

    Although there are established relationships between physical and mental health, few studies have explored the relationship between health behaviors and mental health over time. To explore rates of health-compromising behaviors (HCBs) and the longitudinal relationship between HCBs and depression, anxiety, and stress, five waves of data were collected over 1 year from 482 patients at an urban public health clinic (47 % female, 68 % African-American, M age = 28). Smoking (61 %), binge drinking (52 %), illegal drug use (53 %), unprotected sex with non-primary partners (55 %), and fast food consumption (71 %) were common, while consumption of fruits or vegetables (30 %) and breakfast (17 %) were rare. Cross-lagged models identified within-time associations between HCBs and depression/anxiety and stress. Additionally, depression/anxiety and stress predicted later HCBs, but HCBs did not predict later mental health. Results suggest that targeting mental health may be important to promoting improvements across multiple health behaviors.

  7. HOUSEHOLD NUCLEATION, DEPENDENCY AND CHILD HEALTH OUTCOMES IN GHANA.

    Science.gov (United States)

    Annim, Samuel Kobina; Awusabo-Asare, Kofi; Amo-Adjei, Joshua

    2015-09-01

    This study uses three key anthropometric measures of nutritional status among children (stunting, wasting and underweight) to explore the dual effects of household composition and dependency on nutritional outcomes of under-five children in Ghana. The objective is to examine changes in household living arrangements of under-five children to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, towards single-family households - especially the nuclear family, containing a husband and wife and their children alone. A negative relationship between levels of dependency, as measured by the number of children in the household, and child health outcomes is premised on the grounds that high dependency depletes resources, both tangible and intangible, to the disadvantage of young children. Data were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHSs), from 1993 to 2008, for the first objective - to explore changes in household composition. For the second objective, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing towards nucleation. The main finding is that in households with the same number of dependent children, in nucleated households children under age 5 have better health outcomes compared with children under age 5 in non-nucleated households. The results also indicate that the effect of dependency on child health outcomes is mediated by household nucleation and wealth status and that, as such, high levels of dependency do not necessarily translate into negative health outcomes for children under age 5, based on anthropometric measures.

  8. Magazine reading and involvement and young adults' sexual health knowledge, efficacy, and behaviors.

    Science.gov (United States)

    Walsh, Jennifer L; Ward, L Monique

    2010-07-01

    These studies investigate connections between magazine reading and involvement and young people's sexual health knowledge, self-efficacy, intentions, and contraception use. Study 1 assessed sexual health behaviors and magazine reading among 579 undergraduate students (69% were female; 68% were White; M(age) = 19.73). As expected, more frequent reading of mainstream magazines was associated with greater sexual health knowledge, safe-sex self-efficacy, and consistency of using contraception, although results varied across sex and magazine genre. Study 2 replicated and expanded on these findings with a survey of 422 undergraduate students (51% were female; 71% were White; 49% were age 18 or younger), incorporating a more extensive knowledge scale, questions about safe-sex intentions, and measures of magazine involvement. Results suggest that magazine use is associated with positive sexual health outcomes among young people.

  9. Health Outcomes and Costs of Social Work Services: A Systematic Review

    Science.gov (United States)

    Ross, Abigail M.; Wachman, Madeline K.

    2017-01-01

    Background. Efforts to reduce expensive health service utilization, contain costs, improve health outcomes, and address the social determinants of health require research that demonstrates the economic value of health services in population health across a variety of settings. Social workers are an integral part of the US health care system, yet the specific contributions of social work to health and cost-containment outcomes are unknown. The social work profession’s person-in-environment framework and unique skillset, particularly around addressing social determinants of health, hold promise for improving health and cost outcomes. Objectives. To systematically review international studies of the effect of social work–involved health services on health and economic outcomes. Search Methods. We searched 4 databases (PubMed, PsycINFO, CINAHL, Social Science Citation Index) by using “social work” AND “cost” and “health” for trials published from 1990 to 2017. Selection Criteria. Abstract review was followed by full-text review of all studies meeting inclusion criteria (social work services, physical health, and cost outcomes). Data Collection and Analysis. Of the 831 abstracts found, 51 (6.1%) met criteria. Full text review yielded 16 studies involving more than 16 000 participants, including pregnant and pediatric patients, vulnerable low-income adults, and geriatric patients. We examined study quality, health and utilization outcomes, and cost outcomes. Main Results. Average study quality was fair. Studies of 7 social work–led services scored higher on quality ratings than 9 studies of social workers as team members. Most studies showed positive effects on health and service utilization; cost-savings were consistent across nearly all studies. Conclusions. Despite positive overall effects on outcomes, variability in study methods, health problems, and cost analyses render generalizations difficult. Controlled hypothesis-driven trials are needed to

  10. Forging Multidisciplinary Collaboration to Improve Mental/Behavioral Health.

    Science.gov (United States)

    Vaughn, Wanda M; Bunde, Paula K; Remick-Erickson, Kara; Rebeck, Shelby; Denny, Darla

    2017-09-01

    Five Johnson and Johnson fellows validated the lack of communication regarding students with mental/behavioral health issues and took a leadership position within their school district to address the problem. An open-ended survey revealed inconsistent and fragmented support given to students with mental/behavioral health concerns. A multidisciplinary task force was formed consisting of stakeholders including district and nondistrict community members. The procedure for district staff to address students' behavioral/mental health concerns was adapted by representatives from all stakeholders and was distributed district wide and uploaded to the district's staff website for general access. Training of district employees in Youth Mental Health First Aid has provided the foundation for communicating and implementing a standardized approach for identifying, responding, and referring students with mental/behavioral health concerns. Open dialog, better communication and understanding of disciplines, and more initiatives aimed at improving the mental health of all students has resulted from the collaboration started with this initiative.

  11. Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review.

    Science.gov (United States)

    Hamine, Saee; Gerth-Guyette, Emily; Faulx, Dunia; Green, Beverly B; Ginsburg, Amy Sarah

    2015-02-24

    Adherence to chronic disease management is critical to achieving improved health outcomes, quality of life, and cost-effective health care. As the burden of chronic diseases continues to grow globally, so does the impact of non-adherence. Mobile technologies are increasingly being used in health care and public health practice (mHealth) for patient communication, monitoring, and education, and to facilitate adherence to chronic diseases management. We conducted a systematic review of the literature to evaluate the effectiveness of mHealth in supporting the adherence of patients to chronic diseases management ("mAdherence"), and the usability, feasibility, and acceptability of mAdherence tools and platforms in chronic disease management among patients and health care providers. We searched PubMed, Embase, and EBSCO databases for studies that assessed the role of mAdherence in chronic disease management of diabetes mellitus, cardiovascular disease, and chronic lung diseases from 1980 through May 2014. Outcomes of interest included effect of mHealth on patient adherence to chronic diseases management, disease-specific clinical outcomes after intervention, and the usability, feasibility, and acceptability of mAdherence tools and platforms in chronic disease management among target end-users. In all, 107 articles met all inclusion criteria. Short message service was the most commonly used mAdherence tool in 40.2% (43/107) of studies. Usability, feasibility, and acceptability or patient preferences for mAdherence interventions were assessed in 57.9% (62/107) of studies and found to be generally high. A total of 27 studies employed randomized controlled trial (RCT) methods to assess impact on adherence behaviors, and significant improvements were observed in 15 of those studies (56%). Of the 41 RCTs that measured effects on disease-specific clinical outcomes, significant improvements between groups were reported in 16 studies (39%). There is potential for mHealth tools to

  12. Toward a Unified Integration Approach: Uniting Diverse Primary Care Strategies Under the Primary Care Behavioral Health (PCBH) Model.

    Science.gov (United States)

    Sandoval, Brian E; Bell, Jennifer; Khatri, Parinda; Robinson, Patricia J

    2017-12-12

    Primary care continues to be at the center of health care transformation. The Primary Care Behavioral Health (PCBH) model of service delivery includes patient-centered care delivery strategies that can improve clinical outcomes, cost, and patient and primary care provider satisfaction with services. This article reviews the link between the PCBH model of service delivery and health care services quality improvement, and provides guidance for initiating PCBH model clinical pathways for patients facing depression, chronic pain, alcohol misuse, obesity, insomnia, and social barriers to health.

  13. Editorial: 3rd Special Issue on behavior change, health, and health disparities.

    Science.gov (United States)

    Higgins, Stephen T

    2016-11-01

    This Special Issue of Preventive Medicine (PM) is the 3rd that we have organized on behavior change, health, and health disparities. This is a topic of critical importance to improving U.S. population health. There is broad scientific consensus that personal behaviors such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. Hence, effectively promoting health-related behavior change needs to be a key component of health care research and policy. There is also broad recognition that while these problems extend throughout the population, they disproportionately impact economically disadvantaged populations and other vulnerable populations and represent a major contributor to health disparities. Thus, behavior change represents an essential step in curtailing health disparities, which receives special attention in this 3rd Special Issue. We also devote considerable space to the longstanding challenges of reducing cigarette smoking and use of other tobacco and nicotine delivery products in vulnerable populations, obesity, and for the first time food insecurity. Across each of these topics we include contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Occupational exposures and health outcomes among Latina hotel cleaners.

    Science.gov (United States)

    Hsieh, Yu-Chin Jerrie; Apostolopoulos, Yorghos; Hatzudis, Kiki; Sönmez, Sevil

    2014-01-01

    The poor working conditions of Latina hotel cleaners render them particularly vulnerable to elevated occupational hazards that lead to adverse health outcomes. This article presents a comprehensive review of occupational risks (including physical, chemical, biological, and psychosocial risk factors) and health outcomes (including musculoskeletal disorders, respiratory diseases, dermatological diseases and allergies, and psychological disorders) for Latina hotel cleaners, within their unique sociocultural contexts. Preventive interventions for improving Latina hotel cleaners' work and health conditions are recommended.

  15. Behavioral Health Emergencies Managed by School Nurses Working with Adolescents

    Science.gov (United States)

    Ramos, Mary M.; Greenberg, Cynthia; Sapien, Robert; Bauer-Creegan, Judith; Hine, Beverly; Geary, Cathy

    2013-01-01

    Background: As members of interdisciplinary teams, school nurses provide behavioral health services. Studies indicate that school nurses may lack sufficient continuing education in adolescent behavioral health and in the management of behavioral health emergencies, specifically. We conducted this study to describe the adolescent behavioral health…

  16. Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes

    NARCIS (Netherlands)

    Hendriksen, I.J.M.; Snoijer, M.; Kok, B.P. de; Vlisteren, J. van; Hofstetter, H.

    2016-01-01

    Objective: Evaluation of the effectiveness of a workplace health promotion program on employees’ vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors’ role on these outcomes. Methods: The 5-month intervention included activities at

  17. Emotional responses to behavioral economic incentives for health behavior change.

    Science.gov (United States)

    van der Swaluw, Koen; Lambooij, Mattijs S; Mathijssen, Jolanda J P; Zeelenberg, Marcel; Polder, Johan J; Prast, Henriëtte M

    2018-03-05

    Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals do not get their prize but receive feedback on what their forgone earnings would have been. This counterfactual feedback should provoke anticipated regret and increase commitment to health goals. We explored which emotions were actually expected upon missing out on a prize due to unsuccessful weight loss and which incentive-characteristics influence their likelihood and intensity. Participants reported their expected emotional response after missing out on a prize in one of 12 randomly presented incentive-scenarios, which varied in incentive type, incentive size and deadline distance. Participants primarily reported feeling disappointment, followed by regret. Regret was expected most when losing a lottery prize (vs. a fixed incentive) and intensified with prize size. Multiple features of the participant and the lottery incentive increase the occurrence and intensity of regret. As such, our findings can be helpful in designing behavioral economic incentives that leverage emotions to support health behavior change.

  18. Health behaviors of Bydgoszcz high school graduates

    Directory of Open Access Journals (Sweden)

    Alicja Kostencka

    2016-10-01

    Full Text Available Lifestyle affects the physical, mental, social development, health and learning ability. It seems that there are differences in the health behaviors  of young females and males, however these differences are not well described. The aim of the current study was to assess the lifestyle of eighteen-years old and to compare their health behaviors of young persons according to their gender. The study was conducted among 98 students of high schools in Bydgoszcz (35 females and 68 males. All participants were 18 years old. The questionnaire was prepared especially for the purposes of the study, a part of the questions of this questionnaire was taken from the Canada Fitness Survey. The physical activity, mode of nutrition, use of stimulants, hours of sleep, time spent in front of screens and the level of stress were taken into consideration while assessing the teenagers’ lifestyle. The lifestyle of high school graduates is worrisome. It is characterized by low level of physical activity, irregular nutrition, not enough fruits, vegetables and water consumed. A large group of young people drink alcohol, smoke tobacco and marijuana, sleep too short. Males also spend too many hours in front of a television, computer or other similar device. Differences in the health behaviors of  women and men appear to be significant. The prevalence of alcohol abuse in this group is very high and affects both sexes. The sex differences in the health-promoting behaviors among men and women in this group of adolescents seems to diminish. Observed unhealthy behaviors indicates the urgent need for health education, especially those that educate the student about the value of the person, the value of health, and the development of social skills that underlie personal development. The foremost priority is  risk prevention implementation in primary schools. Further research and continuous monitoring of health behaviors in different age groups  is needed as well as  to

  19. Leading during change: the effects of leader behavior on sickness absence in a Norwegian health trust.

    Science.gov (United States)

    Bernstrøm, Vilde Hoff; Kjekshus, Lars Erik

    2012-09-17

    Organizational change often leads to negative employee outcomes such as increased absence. Because change is also often inevitable, it is important to know how these negative outcomes could be reduced. This study investigates how the line manager's behavior relates to sickness absence in a Norwegian health trust during major restructuring. Leader behavior was measured by questionnaire, where employees assessed their line manager's behavior (N = 1008; response rate 40%). Data on sickness absence were provided at department level (N = 35) and were measured at two times. Analyses were primarily conducted using linear regression; leader behavior was aggregated and weighted by department size. The results show a relationship between several leader behaviors and sickness absence. The line managers' display of loyalty to their superiors was related to higher sickness absence; whereas task monitoring was related to lower absence. Social support was related to higher sickness absence. However, the effect of social support was no longer significant when the line manager also displayed high levels of problem confrontation. The findings clearly support the line manager's importance for employee sickness absence during organizational change. We conclude that more awareness concerning the manager's role in change processes is needed.

  20. Employee Health Behaviors, Self-Reported Health Status, and Association With Absenteeism: Comparison With the General Population.

    Science.gov (United States)

    Yun, Young Ho; Sim, Jin Ah; Park, Eun-Gee; Park, June Dong; Noh, Dong-Young

    2016-09-01

    To perform a comparison between health behaviors and health status of employees with those of the general population, to evaluate the association between employee health behaviors, health status, and absenteeism. Cross-sectional study enrolled 2433 employees from 16 Korean companies in 2014, and recruited 1000 general population randomly in 2012. The distribution of employee health behaviors, health status, and association with absenteeism were assessed. Employees had significantly worse health status and low rates of health behaviors maintenance compared with the general population. Multiple logistic regression model revealed that regular exercise, smoking cessation, work life balance, proactive living, religious practice, and good physical health status were associated with lower absenteeism. Maintaining health behaviors and having good health status were associated with less absenteeism. This study suggests investment of multidimensional health approach in workplace health and wellness (WHW) programs.

  1. Indicators of fetal and infant health outcomes

    NARCIS (Netherlands)

    Buitendijk, Simone; Zeitlin, Jennifer; Cuttini, Marina; Langhoff-Roos, Jens; Bottu, Jean

    2003-01-01

    OBJECTIVE: To assess the ability of the member states of the European Union to produce the indicators recommended by the PERISTAT project on perinatal health indicators and to provide an overview of fetal and infant health outcomes for these countries according to the information now available.

  2. The Effect of a Community Health Worker Utilized Mobile Health Application on Maternal Health Knowledge and Behavior: A Quasi-Experimental Study

    Directory of Open Access Journals (Sweden)

    Onaedo Ilozumba

    2018-05-01

    Full Text Available BackgroundMobile technology (mHealth is increasingly being used to achieve improved access and quality of maternal care, particularly in rural areas of low- and middle-income countries. In 2011, a mobile application—Mobile for Mothers (MfM—was implemented in Jharkhand, India to support home visits by community health workers. The objective of this study is to assess the impact of the mHealth intervention on maternal health.MethodsHouseholds from three subdistricts in the Deoghar district of Jharkhand were selected using a multistage cluster sampling approach. Households from the Sarwan subdistrict received the MfM intervention, those from Devipur subdistrict received other interventions asides MfM from the implementing non-governmental organization (NGO, while households from Mohanpur subdistrict received the current standard of care. Women (n = 2,200 between the ages of 18 and 45 who had delivered a baby in the past 1 year were enrolled into the study. The primary outcomes of interest were maternal health knowledge, antenatal care (ANC attendance, and delivery in a health facility.ResultsPost-intervention, women in the MfM group had higher maternal health knowledge, were more likely to attend four or more ANC visits, and deliver at the health facility when compared with the NGO and standard care group. After controlling for predictors, women in the intervention group significantly performed better than both the NGO and standard care groups on all three-outcome variables (all P > 0.05.ConclusionThe results indicate that although the MfM mHealth intervention could influence adherence and practice of recommended maternal health behaviors, it could not overcome key sociocultural determinants of maternal health such as caste and educational status, which are specific to the Indian context. mHealth holds continued promise for maternal health but implementers and policy makers must additionally address health system and sociocultural

  3. Association of Online Health Information-Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia.

    Science.gov (United States)

    Jamal, Amr; Khan, Samina A; AlHumud, Ahmed; Al-Duhyyim, Abdulaziz; Alrashed, Mohammed; Bin Shabr, Faisal; Alteraif, Alwalid; Almuziri, Abdullah; Househ, Mowafa; Qureshi, Riaz

    2015-08-12

    Health information obtained from the Internet has an impact on patient health care outcomes. There is a growing concern over the quality of online health information sources used by diabetic patients because little is known about their health information-seeking behavior and the impact this behavior has on their diabetes-related self-care, in particular in the Middle East setting. The aim of this study was to determine the online health-related information-seeking behavior among adult type 2 diabetic patients in the Middle East and the impact of their online health-related information-seeking behavior on their self-care activities. A cross-sectional survey was conducted on 344 patients with type 2 diabetes attending inpatient and outpatient primary health care clinics at 2 teaching hospitals in Riyadh, Saudi Arabia. The main outcome measures included the ability of patients to access the Internet, their ability to use the Internet to search for health-related information, and their responses to Internet searches in relation to their self-care activities. Further analysis of differences based on age, gender, sociodemographic, and diabetes-related self-care activities among online health-related information seekers and nononline health-related information seekers was conducted. Among the 344 patients, 74.1% (255/344) were male with a mean age of 53.5 (SD 13.8) years. Only 39.0% (134/344) were Internet users; 71.6% (96/134) of them used the Internet for seeking health-related information. Most participants reported that their primary source of health-related information was their physician (216/344, 62.8%) followed by television (155/344, 45.1%), family (113/344, 32.8%), newspapers (100/344, 29.1%), and the Internet (96/344, 27.9%). Primary topics participants searched for were therapeutic diet for diabetes (55/96, 57%) and symptoms of diabetes (52/96, 54%) followed by diabetes treatment (50/96, 52%). Long history of diabetes, familial history of the disease

  4. A Scoping Review of Observational Studies Examining Relationships between Environmental Behaviors and Health Behaviors

    Directory of Open Access Journals (Sweden)

    Jayne Hutchinson

    2015-05-01

    Full Text Available Individual lifestyles are key drivers of both environmental change and chronic disease. We undertook a scoping review of peer-reviewed studies which examined associations between environmental and health behaviors of individuals in high-income countries. We searched EconLit, Medline, BIOSIS and the Social Science Citation Index. A total of 136 studies were included. The majority were USA-based cross-sectional studies using self-reported measures. Most of the evidence related to travel behavior, particularly active travel (walking and cycling and physical activity (92 studies or sedentary behaviors (19 studies. Associations of public transport use with physical activity were examined in 18 studies, and with sedentary behavior in one study. Four studies examined associations between car use and physical activity. A small number included other environmental behaviors (food-related behaviors (n = 14, including organic food, locally-sourced food and plate waste and other health behaviors ((n = 20 smoking, dietary intake, alcohol. These results suggest that research on individual environmental and health behaviors consists largely of studies examining associations between travel mode and levels of physical activity. There appears to be less research on associations between other behaviors with environmental and health impacts, and very few longitudinal studies in any domain.

  5. Parental Outcomes Following Participation in Cognitive Behavior Therapy for Children with Autism Spectrum Disorder.

    Science.gov (United States)

    Maughan, Andrea L; Weiss, Jonathan A

    2017-10-01

    Children with autism spectrum disorder (ASD) benefit from parent involvement in their therapy, and there is evidence that this involvement may improve parent functioning as well. We examined changes in parent mental health, parenting, and expressed emotion, following participation in a randomized controlled trial of cognitive behavior therapy for 57 children with ASD. Post-intervention, improvements occurred in the treatment group in parent depression and emotion regulation, compared to waitlisted parents. Treatment effects also occurred across all parents in depression, emotion regulation, perceptions of their children and mindful parenting. Though preliminary, these results have implications for intervention development and evaluation by focusing on parent outcomes in child treatment.

  6. Associations between Modifiable Health-Risk Behaviors and Personality Types

    Directory of Open Access Journals (Sweden)

    Jon C. Schommer

    2017-05-01

    Full Text Available Objectives: The first objective for this study was to explore if characteristics of personality type (using the Preferred Communication Style Questionnaire are associated with the following modifiable health-risk behaviors: smoking, exercise, alcohol consumption, nutrition, sleep, depression-related stress, anxiety-related stress, healthcare professional usage, and self-discipline. The second objective for this study was to explore if characteristics of personality type are associated with (1 the quality of patient-physician relationships, (2 patient-physician communication, and (3 preferred method for receiving information. Methods: Data were collected from 10,500 adult individuals residing in the United States via an on-line, self-administered survey coordinated by Qualtrics Panels from March 14-30, 2016. Chi-square analysis was used for making comparisons between categories of personality types and items related to health-risk behaviors. Statistical significance was set at p < 0.05. However, chi-square analysis with large sample sizes (e.g. 10,500 in this study readily yields statistical significance. Practical significance was set at four or more percentage points above or below the overall mean. Results: Regarding objective 1, personality type was associated with all nine health-risk behaviors studied. Personality types within the Experiencer temperament (17% of the U.S. population accounted for 46% of the undesirable scores we computed for health-risk behaviors. The Idealist temperament (17% of population accounted for 32% of the undesirable scores. Conceptualizers (10% of population accounted for 17% of the undesirable scores and Traditionalists (46% of population accounted for 5% of the undesirable scores. Regarding objective 2, the findings showed that personality type was associated with (1 the importance people place on the patient-physician relationship, (2 which characteristics of that relationship are most desirable, (3 desire for

  7. Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Disaster Response App.

    Science.gov (United States)

    Seligman, Jamie; Felder, Stephanie S; Robinson, Maryann E

    2015-10-01

    The Substance Abuse and Mental Health Services Administration (SAMHSA) in the Department of Health and Human Services offers extensive disaster behavior health resources to assist disaster survivors in preparing for, responding to, and recovering from natural and manmade disasters. One of SAMHSA's most innovative resources is the SAMHSA Behavioral Health Disaster Response App (SAMHSA Disaster App). The SAMHSA Disaster App prepares behavioral health responders for any type of traumatic event by allowing them to access disaster-related materials and other key resources right on their phone, at the touch of a button. The SAMHSA Disaster App is available on iPhone, Android, and BlackBerry devices.

  8. Editorial: 2nd Special Issue on behavior change, health, and health disparities.

    Science.gov (United States)

    Higgins, Stephen T

    2015-11-01

    This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policy makers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. An eHealth program versus a standard care supervised health program and associated health outcomes in individuals with mobility disability: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Berglind, Daniel; Nyberg, Gisela; Willmer, Mikaela; Persson, Margareta; Wells, Michael; Forsell, Yvonne

    2018-04-27

    Young adults with mobility disability (MD) are less likely to engage in regular physical activity (PA) compared with their able-bodied peers and inactive adults with a MD are more likely to report one or more chronic diseases compared to those who are physically active. Despite the vast amount of research published in the field of PA interventions over the past decades, little attention has been focused on interventions aiming to increase PA among individuals with MD. Thus, we propose to compare the effects of an eHealth program compared to a usual care supervised health program on levels of PA and other health behaviors. The current intervention will use a randomized controlled trial (RCT) design with two treatment groups (an eHealth program and a usual care supervised health program) in young adults with newly acquired MD. In total, 110 young adults (aged 18-40 years) with a MD, acquired within the past 3 years, will be recruited to participate in a 12-week intervention. The primary study outcome is accelerometer-measured time spent in moderate to vigorous PA. Secondary outcomes includes health-related quality of life, depression, stress, fitness, body composition, diet, musculoskeletal pain, motivation to exercise and work ability. There is a lack of RCTs investigating effective ways to increase levels of PA in young adults with MD. Increased levels of PA among this physically inactive population have the potential to substantially improve health-related outcomes, possibly more so than in the general population. The trial will put strong emphasis on optimizing exercise adherence and investigating feasibility in the two treatment programs. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (2017/1206-31/1). International Standard Randomised Controlled Trial Number (ISRCTN), reference number ISRCTN22387524 . Prospectively registered February 4, 2018.

  10. Health literacy and health-promoting behaviors among multiethnic groups of women in Taiwan.

    Science.gov (United States)

    Tsai, Hsiu-Min; Cheng, Ching-Yu; Chang, Shu-Chen; Yang, Yung-Mei; Wang, Hsiu-Hung

    2014-01-01

    To understand the current status of health literacy and the relationship between health literacy and health-promoting behaviors among multiethnic groups of women in Taiwan. Convenience and snowball sampling methods were used to recruit study participants. Data were collected using a cross-sectional questionnaire survey. We recruited community female adults who lived in greater Taipei or Taoyuan areas (northern Taiwan) from January 1, 2010 through June 30, 2011. A total of 378 female participants were contacted, of which 351 consented to participate and 347 completed valid questionnaires for analysis. Health literacy was measured with the Taiwan Health Literacy Scale, and health-promoting behaviors were measured by the Chinese version of the Health-Promoting Lifestyle Profile. Participants had a moderate level of health literacy, and one third of them had inadequate health literacy. Participants with inadequate health literacy were more likely to be younger, not a high school graduate, and Vietnamese; to have a low monthly family income and no diagnosed diseases; to use a second language; and to regard TV/radio as the most useful source of health information. Health literacy alone could significantly predict health-promoting behaviors among the participants. Our findings confirmed that low health literacy is prevalent among underprivileged women in Taiwan. Health-related programs that are literacy sensitive and culturally appropriate are needed to teach and encourage health-promoting behaviors. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

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

    Science.gov (United States)

    Resnicow, Ken; Vaughan, Roger

    2006-09-12

    The study of health behavior change, including nutrition and physical activity behaviors, has been rooted in a cognitive-rational paradigm. Change is conceptualized as a linear, deterministic process where individuals weigh pros and cons, and at the point at which the benefits outweigh the cost change occurs. Consistent with this paradigm, the associated statistical models have almost exclusively assumed a linear relationship between psychosocial predictors and behavior. Such a perspective however, fails to account for non-linear, quantum influences on human thought and action. Consider why after years of false starts and failed attempts, a person succeeds at increasing their physical activity, eating healthier or losing weight. Or, why after years of success a person relapses. This paper discusses a competing view of health behavior change that was presented at the 2006 annual ISBNPA meeting in Boston. Rather than viewing behavior change from a linear perspective it can be viewed as a quantum event that can be understood through the lens of Chaos Theory and Complex Dynamic Systems. Key principles of Chaos Theory and Complex Dynamic Systems relevant to understanding health behavior change include: 1) Chaotic systems can be mathematically modeled but are nearly impossible to predict; 2) Chaotic systems are sensitive to initial conditions; 3) Complex Systems involve multiple component parts that interact in a nonlinear fashion; and 4) The results of Complex Systems are often greater than the sum of their parts. Accordingly, small changes in knowledge, attitude, efficacy, etc may dramatically alter motivation and behavioral outcomes. And the interaction of such variables can yield almost infinite potential patterns of motivation and behavior change. In the linear paradigm unaccounted for variance is generally relegated to the catch all "error" term, when in fact such "error" may represent the chaotic component of the process. The linear and chaotic paradigms are

  12. Socioeconomic position, health behaviors, and C-reactive protein: A moderated-mediation analysis

    Science.gov (United States)

    Kershaw, Kiarri N.; Mezuk, Briana; Abdou, Cleopatra M.; Rafferty, Jane A.; Jackson, James S.

    2010-01-01

    Objective We sought to understand the link between low SEP and cardiovascular disease (CVD) by examining the association between SEP, health-related coping behaviors, and C-reactive protein (CRP), an inflammatory marker and independent risk factor for CVD in a US sample of adults. Design We used a multiple mediation model to evaluate how these behaviors work in concert to influence CRP levels and whether these relationships were moderated by gender and race/ethnicity. Main outcome measures CRP levels were divided into two categories: elevated CRP (3.1–10.0 mg/L) and normal CRP (≤ 3.0 mg/L). Results Both poverty and low educational attainment were associated with elevated CRP, and these associations were primarily explained through higher levels of smoking and lower levels of exercise. In the education model, poor diet also emerged as a significant mediator. These behaviors accounted for 87.9% of the total effect of education on CRP and 55.8% the total effect of poverty on CRP. We also found significant moderation of these mediated effects by gender and race/ethnicity. Conclusion These findings demonstrate the influence of socioeconomically-patterned environmental constraints on individual-level health behaviors. Specifically, reducing socioeconomic inequalities may have positive effects on CVD disparities through reducing cigarette smoking and increasing vigorous exercise. PMID:20496985

  13. Parental behaviors and sleep outcomes in infants and toddlers: a cross-cultural comparison.

    Science.gov (United States)

    Mindell, Jodi A; Sadeh, Avi; Kohyama, Jun; How, Ti Hwei

    2010-04-01

    To assess the prevalence of parental behaviors and other factors of sleep ecology and to analyze their relationships with sleep outcomes in a large sample of children ages birth to 36months in multiple countries/regions. Parents of 29,287 infants and toddlers (48% boys; Australia, Canada, China, Hong Kong, India, Indonesia, Korea, Japan, Malaysia, New Zealand, Philippines, Singapore, Taiwan, Thailand, United Kingdom, United States, and Vietnam) completed an internet-based expanded version of the Brief Infant Sleep Questionnaire. Overall, there is a high level of parental involvement in sleep onset and sleep maintenance for young children, with significant differences in parenting behaviors across cultural groups. For predominantly-Caucasian, the most common behavior occurring at bedtime is falling asleep independently in own crib/bed (57%), compared to just 4% of those children living in predominantly-Asian regions. Parental behaviors and sleep ecology, including parental presence at sleep onset, bedtime, and bedtime routine, significantly explain a portion of the variance in sleep patterns. Overall, parental behaviors are more highly predictive of nighttime sleep outcomes in predominantly-Caucasian regions. Finally, parental involvement in sleep onset mediates the relationship between cosleeping and sleep outcomes. Overall, the best predictors of nighttime sleep are related to parental behaviors at bedtime and during the night. Furthermore, sleep disruption and decreased total sleep associated with bed sharing and room sharing are mediated by parental presence at bedtime. These findings provide additional support for addressing parental behaviors in behavioral interventions for infant and toddler sleep problems. Copyright 2010 Elsevier B.V. All rights reserved.

  14. Role of video games in improving health-related outcomes: a systematic review.

    Science.gov (United States)

    Primack, Brian A; Carroll, Mary V; McNamara, Megan; Klem, Mary Lou; King, Brandy; Rich, Michael; Chan, Chun W; Nayak, Smita

    2012-06-01

    Video games represent a multibillion-dollar industry in the U.S. Although video gaming has been associated with many negative health consequences, it also may be useful for therapeutic purposes. The goal of this study was to determine whether video games may be useful in improving health outcomes. Literature searches were performed in February 2010 in six databases: the Center on Media and Child Health Database of Research, MEDLINE, CINAHL, PsycINFO, EMBASE, and the Cochrane Central Register of Controlled Trials. Reference lists were hand-searched to identify additional studies. Only RCTs that tested the effect of video games on a positive, clinically relevant health consequence were included. Study selection criteria were strictly defined and applied by two researchers working independently. Study background information (e.g., location, funding source); sample data (e.g., number of study participants, demographics); intervention and control details; outcomes data; and quality measures were abstracted independently by two researchers. Of 1452 articles retrieved using the current search strategy, 38 met all criteria for inclusion. Eligible studies used video games to provide physical therapy, psychological therapy, improved disease self-management, health education, distraction from discomfort, increased physical activity, and skills training for clinicians. Among the 38 studies, a total of 195 health outcomes were examined. Video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. Study quality was generally poor; for example, two thirds (66%) of studies had follow-up periods of video games to improve health outcomes, particularly in the areas of psychological therapy and physical therapy. RCTs with appropriate rigor will help build evidence in this

  15. HUMAN HEALTH OUTCOMES AND ACCOUNTABILITY - RISK POLICY REPORT

    Science.gov (United States)

    EPA is identifying human health "outcomes" as part of a significant shift in how the Agency frames questions and assesses its impact on environmental quality. These outcomes, while complementing traditional process indicators such as decreases in emissions, discharges and pollut...

  16. The behavioral and health consequences of sleep deprivation among U.S. high school students: relative deprivation matters.

    Science.gov (United States)

    Meldrum, Ryan Charles; Restivo, Emily

    2014-06-01

    To evaluate whether the strength of the association between sleep deprivation and negative behavioral and health outcomes varies according to the relative amount of sleep deprivation experienced by adolescents. 2011 Youth Risk Behavior Survey data of high school students (N=15,364) were analyzed. Associations were examined on weighted data using logistic regression. Twelve outcomes were examined, ranging from weapon carrying to obesity. The primary independent variable was a self-reported measure of average number of hours slept on school nights. Participants who reported deprivations in sleep were at an increased risk of a number of negative outcomes. However, this varied considerably across different degrees of sleep deprivation. For each of the outcomes considered, those who slept less than 5h were more likely to report negative outcomes (adjusted odds ratios ranging from 1.38 to 2.72; psleeping 8 or more hours. However, less extreme forms of sleep deprivation were, in many instances, unrelated to the outcomes considered. Among U.S. high school students, deficits in sleep are significantly and substantively associated with a variety of negative outcomes, and this association is particularly pronounced for students achieving fewer than 5h of sleep at night. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Impact of bullying victimization on suicide and negative health behaviors among adolescents in Latin America

    Directory of Open Access Journals (Sweden)

    Matthew L. Romo

    Full Text Available ABSTRACT Objective To compare the prevalence of bullying victimization, suicidal ideation, suicidal attempts, and negative health behaviors (current tobacco use, recent heavy alcohol use, truancy, involvement in physical fighting, and unprotected sexual intercourse in five different Latin American countries and determine the association of bullying victimization with these outcomes, exploring both bullying type and frequency. Methods Study data were from Global School–based Student Health Surveys from Bolivia, Costa Rica, Honduras, Peru, and Uruguay, which covered nationally representative samples of school-going adolescents. The surveys used a two-stage clustered sample design, sampling schools and then classrooms. Logistic regression models were run to determine the statistical significance of associations with bullying. Results Among the 14 560 school-going adolescents included in this study, the prevalence of any bullying victimization in the past 30 days was 37.8%. Bullying victimization was associated with greater odds of suicidal ideation with planning (adjusted odds ratio (AOR: 3.12; P < 0.0001 and at least one suicide attempt (AOR: 3.07; P < 0.0001. An increasing exposure–response effect of increasing days of bullying victimization on suicide outcomes was also observed. Bullying victimization was associated with higher odds of current tobacco use (AOR: 2.14; P < 0.0001; truancy (AOR: 1.76; P < 0.0001; physical fighting (AOR: 2.40; P < 0.0001; and unprotected sexual intercourse (AOR: 1.77; P < 0.0001. Conclusions Although the prevalence of bullying victimization varied by country, its association with suicidal ideation and behavior and negative health behaviors remained relatively consistent. Addressing bullying needs to be made a priority in Latin America, and an integrated approach that also includes mental and physical health promotion is needed.

  18. Cultural values and population health: a quantitative analysis of variations in cultural values, health behaviours and health outcomes among 42 European countries.

    Science.gov (United States)

    Mackenbach, Johan P

    2014-07-01

    Variations in 'culture' are often invoked to explain cross-national variations in health, but formal analyses of this relation are scarce. We studied the relation between three sets of cultural values and a wide range of health behaviours and health outcomes in Europe. Cultural values were measured according to Inglehart׳s two, Hofstede׳s six, and Schwartz׳s seven dimensions. Data on individual and collective health behaviours (30 indicators of fertility-related behaviours, adult lifestyles, use of preventive services, prevention policies, health care policies, and environmental policies) and health outcomes (35 indicators of general health and of specific health problems relating to fertility, adult lifestyles, prevention, health care, and violence) in 42 European countries around the year 2010 were extracted from harmonized international data sources. Multivariate regression analysis was used to relate health behaviours to value orientations, controlling for socioeconomic confounders. In univariate analyses, all scales are related to health behaviours and most scales are related to health outcomes, but in multivariate analyses Inglehart׳s 'self-expression' (versus 'survival') scale has by far the largest number of statistically significant associations. Countries with higher scores on 'self-expression' have better outcomes on 16 out of 30 health behaviours and on 19 out of 35 health indicators, and variations on this scale explain up to 26% of the variance in these outcomes in Europe. In mediation analyses the associations between cultural values and health outcomes are partly explained by differences in health behaviours. Variations in cultural values also appear to account for some of the striking variations in health behaviours between neighbouring countries in Europe (Sweden and Denmark, the Netherlands and Belgium, the Czech Republic and Slovakia, and Estonia and Latvia). This study is the first to provide systematic and coherent empirical evidence that

  19. Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese

    Science.gov (United States)

    Liu, Yong-Bing; Liu, Liu; Li, Yan-Fei; Chen, Yan-Li

    2015-01-01

    Background: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. Methods: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. Results: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p

  20. Sexual health behavior interventions for U.S. Latino adolescents: a systematic review of the literature.

    Science.gov (United States)

    Cardoza, Vicky J; Documét, Patricia I; Fryer, Craig S; Gold, Melanie A; Butler, James

    2012-04-01

    To identify sexual health behavior interventions targeting U.S. Latino adolescents. A systematic literature review. Peer-reviewed articles published between 1993 and 2011, conducted in any type of setting. Male and female Latino adolescents ages 11-21 years. Interventions promoting sexual abstinence, pregnancy prevention, sexually transmitted infection (STI) prevention, and/or HIV/AIDS prevention. Changes in knowledge, attitudes, engagement in risky sexual behaviors, rates of STIs, and/or pregnancy. Sixty-eight articles were identified. Fifteen were included in this review that specifically addressed Latino adolescent sexual health behavior. Among the reviewed interventions, most aimed to prevent or reduce STI and HIV/AIDS incidence by focusing on behavior change at two levels of the social ecological model: individual and interpersonal. Major strengths of the articles included addressing the most critical issues of sexual health; using social ecological approaches; employing different strategies to deliver sexual health messages; and employing different intervention designs in diverse geographical locations with the largest population of Latino communities. Most of the interventions targeted female adolescents, stressing the need for additional interventions that target Latino adolescent males. Latino adolescent sexual health is a new research field with gaps that need to be addressed in reducing negative sexual health outcomes among this population. More research is needed to produce new or validate existing, age-specific, and culturally-sensitive sexual health interventions for Latino male and female adolescents. Further, this research should also be conducted in areas of the U.S. with the newest Latino migration (e.g., North Carolina). Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  1. The theory of music, mood and movement to improve health outcomes.

    Science.gov (United States)

    Murrock, Carolyn J; Higgins, Patricia A

    2009-10-01

    This paper presents a discussion of the development of a middle-range nursing theory of the effects of music on physical activity and improved health outcomes. Due to the high rate of physical inactivity and the associated negative health outcomes worldwide, nurses need new evidence-based theories and interventions to increase physical activity. The theory of music, mood and movement (MMM) was developed from physical activity guidelines and music theory using the principles of statement and theory synthesis. The concepts of music, physical activity and health outcomes were searched using the CINAHL, MEDLINE, ProQuest Nursing and Allied Health Source, PsycINFO and Cochrane Library databases covering the years 1975-2008. The theory of MMM was synthesized by combining the psychological and physiological responses of music to increase physical activity and improve health outcomes. It proposes that music alters mood, is a cue for movement, and makes physical activity more enjoyable leading to improved health outcomes of weight, blood pressure, blood sugar and cardiovascular risk factor management, and improved quality of life. As it was developed from the physical activity guidelines, the middle-range theory is prescriptive, produces testable hypotheses, and can guide nursing research and practice. The middle-range theory needs to be tested to determine its usefulness for nurses to develop physical activity programmes to improve health outcomes across various cultures.

  2. [The health preserving behavior in adolescents].

    Science.gov (United States)

    Al'bitskii, V Iu; Makeev, N I

    2010-01-01

    The article deals with the results of study of health preserving behavior of 310 students of senior classes of high schools of town of Jukovsky of Moskovskaya oblast. The higher level of prevalence of harmful habits among adolescents is revealed. It is emphasized that among girls the prevalence of harmful habits is not at large lower than among boys. The lower level of medical activities of respondents is explained by mistrusting physicians of curative preventive establishments, fear of queues, self-confidence in one's own knowledge and low level of medical awareness. The priority of physical culture and sport in the life of adolescents is reducing. The reorientation of trends in modern fashion to the behavior stereotypes with motional activities restriction occurs. The making of conditions to develop consistent health preserving behavior can become the most important reserve of preservation and enhancement of adolescents' health.

  3. Parent-child communication processes: preventing children's health-risk behavior.

    Science.gov (United States)

    Riesch, Susan K; Anderson, Lori S; Krueger, Heather A

    2006-01-01

    Review individual, family, and environmental factors that predict health-risk behavior among children and to propose parent-child communication processes as a mechanism to mediate them. Improving parent-child communication processes may: reduce individual risk factors, such as poor academic achievement or self-esteem; modify parenting practices such as providing regulation and structure and acting as models of health behavior; and facilitate discussion about factors that lead to involvement in health-risk behaviors. Assessment strategies to identify youth at risk for health-risk behavior are recommended and community-based strategies to improve communication among parents and children need development.

  4. Health literacy mediates the relationship between educational attainment and health behavior

    DEFF Research Database (Denmark)

    Friis, Karina; Lasgaard, Mathias; Rowlands, Gill

    2016-01-01

    behavior (smoking, physical inactivity, poor diet) and obesity. The study included respondents ages 25 years or older drawn from a large population-based survey conducted in 2013 (N = 29,473). Two scales from the Health Literacy Questionnaire were used: (a) Understanding health information well enough...... to know what to do and (b) Ability to actively engage with health care providers. Multiple mediation analyses were conducted using the Karlson-Holm-Breen method. The study showed that health literacy in general and the ability to understand health information in particular mediated the relationship......Individuals with a lower education level frequently have unhealthier behaviors than individuals with a higher education level, but the pathway is not fully understood. The aim of this study was to investigate whether health literacy mediates the association between educational attainment and health...

  5. Potential value of electronic prescribing in health economic and outcomes research

    Directory of Open Access Journals (Sweden)

    Catherine E Cooke

    2010-11-01

    Full Text Available Catherine E Cooke1, Brian J Isetts2, Thomas E Sullivan3, Maren Fustgaard4, Daniel A Belletti51PosiHealth Inc., Ellicott City, MD, USA; 2Department of Pharmaceutical Care and Health Systems, University of Minnesota College of Pharmacy, Minneapolis, MN, USA; 3Women’s Health Center, Danvers, MA, USA; 4Assistant Director for Regional Outcomes Research, 5Associate Director for Regional Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, NJ, USAAbstract: Improving access and quality while reducing expenditures in the United States health system is expected to be a priority for many years. The use of health information technology (HIT, including electronic prescribing (eRx, is an important initiative in efforts aimed at improving safety and outcomes, increasing quality, and decreasing costs. Data from eRx has been used in studies that document reductions in medication errors, adverse drug events, and pharmacy order-processing time. Evaluating programs and initiatives intended to improve health care can be facilitated through the use of HIT and eRx. eRx data can be used to conduct research to answer questions about the outcomes of health care products, services, and new clinical initiatives with the goal of providing guidance for clinicians and policy makers. Given the recent explosive growth of eRx in the United States, the purpose of this manuscript is to assess the value and suggest enhanced uses and applications of eRx to facilitate the role of the practitioner in contributing to health economics and outcomes research.Keywords: electronic prescribing, outcomes research, health information technology

  6. Health-related behaviors and technology usage among college students.

    Science.gov (United States)

    Melton, Bridget F; Bigham, Lauren E; Bland, Helen W; Bird, Matthew; Fairman, Ciaran

    2014-07-01

    To examine associations between technology usage and specific health factors among college students. The research employed was a quantitative, descriptive, cross-sectional design; undergraduate students enrolled in spring 2012 general health education courses were recruited to participate. To explore college students' specific technology usage and health-related behaviors, a 28-item questionnaire was utilized. Statistical significant differences of technology usage were found between 3 of the 4 health-related behaviors under study (BMI, sleep, and nutrition) (p technology usage continues to evolve within the college student population, health professionals need to understand its implications on health behaviors.

  7. Problem-Solving and Mental Health Outcomes of Women and Children in the Wake of Intimate Partner Violence

    Directory of Open Access Journals (Sweden)

    John Maddoux

    2014-01-01

    Full Text Available The environmental stress of intimate partner violence is common and often results in mental health problems of depression, anxiety, and PTSD for women and behavioral dysfunctions for their children. Problem-solving skills can serve to mitigate or accentuate the environmental stress of violence and associated impact on mental health. To better understand the relationship between problem-solving skills and mental health of abused women with children, a cross-sectional predictive analysis of 285 abused women who used justice or shelter services was completed. The women were asked about social problem-solving, and mental health symptoms of depression, anxiety, and PTSD as well as behavioral functioning of their children. Higher negative problem-solving scores were associated with significantly P<0.001 greater odds of having clinically significant levels of PTSD, anxiety, depression, and somatization for the woman and significantly P<0.001 greater odds of her child having borderline or clinically significant levels of both internalizing and externalizing behaviors. A predominately negative problem-solving approach was strongly associated with poorer outcomes for both mothers and children in the aftermath of the environmental stress of abuse. Interventions addressing problem-solving ability may be beneficial in increasing abused women’s abilities to navigate the daily stressors of life following abuse.

  8. Communicating about eating behaviors. A qualitative study of Chilean women and their health-care providers.

    Science.gov (United States)

    Gálvez, Patricia; Valencia, Alejandra; Palomino, Ana M; Cataldo, Marjorie; Schwingel, Andiara

    2015-01-01

    Good communication between health care providers (HCPs) and patients is critical in achieving positive health outcomes. The purpose of this article was to compare the perceptions of Chilean woman and their HCPs with respect to determinants of eating behaviors. Semi-structured interviews were conducted with women (n=15) visiting a public health care center in Chile and with their HCPs (n=8) who were in charge of promoting healthy eating behaviors among women. Data from the interviews indicated similarities and inconsistencies in determinants of eating behaviors between the groups. Both mentioned many important factors that influence women's eating behaviors, including food preferences, dietary knowledge, self-control and self-efficacy, family, food cost, and food availability. HCPs appeared to be less aware of the role that personality traits and past experiences play as potential determinants which women mentioned. In contrast, women were less aware of the influence of anxiety and low self-esteem on eating choices, which HCPs noted as key factors. Although it was encouraging to see agreement between women and their HCPs in some areas, it is important to work on increasing understanding among the groups with respect to the important role psychological factors play in influencing eating behavior. We suggest that HCPs should focus on the importance of women's personality traits and past eating behaviors, as well as work on improving women's self-esteem and helping to decrease their anxiety levels. HCPs should be encouraged to develop good communication with each person in order to help them understand the roles that external and internal factors play in eating behaviors.

  9. An Integrative Behavioral Health Care Model Using Automated SBIRT and Care Coordination in Community Health Care.

    Science.gov (United States)

    Dwinnells, Ronald; Misik, Lauren

    2017-10-01

    Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.

  10. Prediction of rat behavior outcomes in memory tasks using functional connections among neurons.

    Directory of Open Access Journals (Sweden)

    Hu Lu

    Full Text Available BACKGROUND: Analyzing the neuronal organizational structures and studying the changes in the behavior of the organism is key to understanding cognitive functions of the brain. Although some studies have indicated that spatiotemporal firing patterns of neuronal populations have a certain relationship with the behavioral responses, the issues of whether there are any relationships between the functional networks comprised of these cortical neurons and behavioral tasks and whether it is possible to take advantage of these networks to predict correct and incorrect outcomes of single trials of animals are still unresolved. METHODOLOGY/PRINCIPAL FINDINGS: This paper presents a new method of analyzing the structures of whole-recorded neuronal functional networks (WNFNs and local neuronal circuit groups (LNCGs. The activity of these neurons was recorded in several rats. The rats performed two different behavioral tasks, the Y-maze task and the U-maze task. Using the results of the assessment of the WNFNs and LNCGs, this paper describes a realization procedure for predicting the behavioral outcomes of single trials. The methodology consists of four main parts: construction of WNFNs from recorded neuronal spike trains, partitioning the WNFNs into the optimal LNCGs using social community analysis, unsupervised clustering of all trials from each dataset into two different clusters, and predicting the behavioral outcomes of single trials. The results show that WNFNs and LNCGs correlate with the behavior of the animal. The U-maze datasets show higher accuracy for unsupervised clustering results than those from the Y-maze task, and these datasets can be used to predict behavioral responses effectively. CONCLUSIONS/SIGNIFICANCE: The results of the present study suggest that a methodology proposed in this paper is suitable for analysis of the characteristics of neuronal functional networks and the prediction of rat behavior. These types of structures in cortical

  11. Maternal employment and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

    selection of mothers between pregnancies drives the results, I focus on mothers whose change in employment status is likely not to be driven by underlying health (unemployed mothers and students). Given generous welfare bene ts and strict workplace regulations in Denmark, my findings support a residual......I use Danish survey and administrative data to examine the impact of maternal employment during pregnancy on birth outcomes. As healthier mothers are more likely to work and health shocks to mothers may impact employment and birth outcomes, I combine two strategies: First, I control extensively...... for time-varying factors that may correlate with employment and birth outcomes, such as pre-pregnancy family income and maternal occupation, pregnancy-related health shocks, maternal sick listing, and health behaviors (smoking and alcohol consumption). Second, to account for remaining time...

  12. Gender differences in the effects of community violence on mental health outcomes in a sample of low-income youth receiving psychiatric care.

    Science.gov (United States)

    Javdani, Shabnam; Abdul-Adil, Jaleel; Suarez, Liza; Nichols, Sara R; Farmer, A David

    2014-06-01

    Previous research suggests that community violence impacts mental health outcomes, but much of this research has not (a) distinguished between different types of community violence, (b) examined gender differences, and (c) focused on youth living in urban poverty. The current study addresses these questions. Participants were 306 youth (23 % girls) and one parent/guardian receiving outpatient psychiatric services for disruptive behavior disorders in a large urban city. Youth and parents reported on youth's experience of different types of community violence (being a direct victim, hearing reports, and witnessing violence), and whether violence was directed toward a stranger or familiar. Outcomes included youth externalizing, internalizing, and posttraumatic stress symptoms assessed via parent and youth reports. Being a direct victim of violence accords risk for all mental health outcomes similarly for both boys and girls. However, gender differences emerged with respect to indirect violence, such that girls who hear reports of violence against people they know are at increased risk for all assessed mental health outcomes, and girls who witness violence against familiars are at increased risk for externalizing mental health symptoms in particular. There are gender differences in violence-related mental health etiology, with implications for intervention assessment and design.

  13. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

    Science.gov (United States)

    2012-01-01

    Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN) has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services. PMID:22640939

  14. Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN

    Directory of Open Access Journals (Sweden)

    Burgess Philip

    2012-05-01

    Full Text Available Abstract Background Australia’s National Mental Health Strategy has emphasised the quality, effectiveness and efficiency of services, and has promoted the collection of outcomes and casemix data as a means of monitoring these. All public sector mental health services across Australia now routinely report outcomes and casemix data. Since late-2003, the Australian Mental Health Outcomes and Classification Network (AMHOCN has received, processed, analysed and reported on outcome data at a national level, and played a training and service development role. This paper documents the history of AMHOCN’s activities and achievements, with a view to providing lessons for others embarking on similar exercises. Method We conducted a desktop review of relevant documents to summarise the history of AMHOCN. Results AMHOCN has operated within a framework that has provided an overarching structure to guide its activities but has been flexible enough to allow it to respond to changing priorities. With no precedents to draw upon, it has undertaken activities in an iterative fashion with an element of ‘trial and error’. It has taken a multi-pronged approach to ensuring that data are of high quality: developing innovative technical solutions; fostering ‘information literacy’; maximising the clinical utility of data at a local level; and producing reports that are meaningful to a range of audiences. Conclusion AMHOCN’s efforts have contributed to routine outcome measurement gaining a firm foothold in Australia’s public sector mental health services.

  15. The Behavioral Health Role in Nursing Facility Social Work.

    Science.gov (United States)

    Myers, Dennis R; Rogers, Robin K; LeCrone, Harold H; Kelley, Katherine

    2017-09-01

    Types of compromised resident behaviors licensed nursing facility social workers encounter, the behavioral health role they enact, and effective practices they apply have not been the subject of systematic investigation. Analyses of 20 in-depth interviews with Bachelor of Social Work (BSW)/Master of Social Work (MSW) social workers averaging 8.8 years of experience identified frequently occurring resident behaviors: physical and verbal aggression/disruption, passive disruption, socially and sexually inappropriateness. Six functions of the behavioral health role were care management, educating, investigating, preventing, mediating, and advocating. Skills most frequently applied were attention/affirmation/active listening, assessment, behavior management, building relationship, teamwork, and redirection. Narratives revealed role rewards as well as knowledge deficits, organizational barriers, personal maltreatment, and frustrations. Respondents offered perspectives and prescriptions for behavioral health practice in this setting. The findings expand understanding of the behavioral health role and provide an empirical basis for more research in this area. Recommendations, including educational competencies, are offered.

  16. Impact of social isolation on behavioral health in elderly: Systematic review.

    Science.gov (United States)

    Choi, Hanbyul; Irwin, Michael R; Cho, Hyong Jin

    2015-12-22

    To examine and compare the effects of subjective and objective social isolation on behavioral health in elderly adults. A systematic search of PubMed was performed for original research articles from peer-reviewed journals examining one of the following topics: "Social isolation and sleep disturbance", "social isolation and depression", or "social isolation and fatigue in older adults". Studies were selected following the criteria established based on the aim of this review. Data were extracted from the articles by two independent reviewers. Due to the heterogeneity in study designs and outcome measures of the included studies, qualitative and narrative analyses were conducted. The set criteria were used to select a total of 16 studies for the review. Of the 16, 13 were cross-sectional studies. The characteristics of study populations were identified as follows. A total of 12 studies randomly selected subjects irrespective of pre-existing health conditions. Consequently, an unspecified number of the study subjects had chronic diseases in the studies compared. In addition, cultural and ethnic backgrounds of studies in this review were diverse, and included subjects living in North America, South America, Asia, Europe, and Oceania. Both subjective and objective types of social isolation increased behavioral symptoms, such as sleep disturbance, depressive symptoms, and fatigue in older adults. Furthermore, a few recent studies reported stronger effects of subjective social isolation than objective social isolation on sleep disturbance and depressive symptoms. Social isolation affects behavioral health in older adults. Compared to the objective social isolation, subjective social isolation contributes more significantly to sleep disturbance and depression.

  17. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes.

    Science.gov (United States)

    Poole, Robin; Kennedy, Oliver J; Roderick, Paul; Fallowfield, Jonathan A; Hayes, Peter C; Parkes, Julie

    2017-11-22

    Objectives  To evaluate the existing evidence for associations between coffee consumption and multiple health outcomes. Design  Umbrella review of the evidence across meta-analyses of observational and interventional studies of coffee consumption and any health outcome. Data sources  PubMed, Embase, CINAHL, Cochrane Database of Systematic Reviews, and screening of references. Eligibility criteria for selecting studies  Meta-analyses of both observational and interventional studies that examined the associations between coffee consumption and any health outcome in any adult population in all countries and all settings. Studies of genetic polymorphisms for coffee metabolism were excluded. Results  The umbrella review identified 201 meta-analyses of observational research with 67 unique health outcomes and 17 meta-analyses of interventional research with nine unique outcomes. Coffee consumption was more often associated with benefit than harm for a range of health outcomes across exposures including high versus low, any versus none, and one extra cup a day. There was evidence of a non-linear association between consumption and some outcomes, with summary estimates indicating largest relative risk reduction at intakes of three to four cups a day versus none, including all cause mortality (relative risk 0.83 (95% confidence interval 0.79 to 0.88), cardiovascular mortality (0.81, 0.72 to 0.90), and cardiovascular disease (0.85, 0.80 to 0.90). High versus low consumption was associated with an 18% lower risk of incident cancer (0.82, 0.74 to 0.89). Consumption was also associated with a lower risk of several specific cancers and neurological, metabolic, and liver conditions. Harmful associations were largely nullified by adequate adjustment for smoking, except in pregnancy, where high versus low/no consumption was associated with low birth weight (odds ratio 1.31, 95% confidence interval 1.03 to 1.67), preterm birth in the first (1.22, 1.00 to 1.49) and second (1

  18. Shifting management of a community volunteer system for improved child health outcomes: results from an operations research study in Burundi.

    Science.gov (United States)

    Weiss, Jennifer; Makonnen, Raphael; Sula, Delphin

    2015-01-01

    Community-based strategies that foster frequent contact between caregivers of children under five and provide credible sources of health information are essential to improve child survival. Care Groups are a community-based implementation strategy for the delivery of social and behavior change interventions. This study assessed if supervision of Care Group activities by Ministry of Health (MOH) personnel could achieve the same child health outcomes as supervision provided by specialized non-governmental organization (NGO) staff. The study was a pretest-posttest quasi-experimental design implemented in Burundi. A total of 45 MOH-led Care Groups with 478 Care Group Volunteers (CGVs) were established in the intervention area; and 50 NGO-led Care Groups with 509 CGVs were formed in the comparison area. Data were collected from 593 and 700 mothers of children 0-23 months at baseline and endline, respectively. Pearson's chi-squared test and difference-in-difference analysis assessed changes in 40 child health and nutrition outcomes. A qualitative process evaluation was also conducted midway through the study. The MOH-led Care Group model performed at least as well as the NGO-led model in achieving specific child health and nutrition outcomes. Mothers of children 0-23 months in the intervention and comparison sites reported similar levels of knowledge and practices for 38 of 40 dependent variables measured in the study, and these results remained unchanged after accounting for differences in the indicator values at baseline. Process monitoring data confirmed that the MOH-led Care Group model and the NGO-led Care Group model were implemented with similar intervention strength. The study demonstrated that behavior change interventions traditionally led by NGOs can be implemented through the existing MOH systems and achieve similar results, thereby increasing the potential for sustainable child health outcomes. Future research on the MOH-led Care Group model is required to

  19. The effect of individual factors on health behaviors among college students: the mediating effects of eHealth literacy.

    Science.gov (United States)

    Hsu, WanChen; Chiang, ChiaHsun; Yang, ShuChing

    2014-12-12

    College students' health behavior is a topic that deserves attention. Individual factors and eHealth literacy may affect an individual's health behaviors. The integrative model of eHealth use (IMeHU) provides a parsimonious account of the connections among the digital divide, health care disparities, and the unequal distribution and use of communication technologies. However, few studies have explored the associations among individual factors, eHealth literacy, and health behaviors, and IMeHU has not been empirically investigated. This study examines the associations among individual factors, eHealth literacy, and health behaviors using IMeHU. The Health Behavior Scale is a 12-item instrument developed to measure college students' eating, exercise, and sleep behaviors. The eHealth Literacy Scale is a 12-item instrument designed to measure college students' functional, interactive, and critical eHealth literacy. A nationally representative sample of 525 valid college students in Taiwan was surveyed. A questionnaire was administered to collect background information about participants' health status, degree of health concern, major, and the frequency with which they engaged in health-related discussions. This study used Amos 6.0 to conduct a confirmatory factor analysis to identify the best measurement models for the eHealth Literacy Scale and the Health Behavior Scale. We then conducted a multiple regression analysis to examine the associations among individual factors, eHealth literacy, and health behaviors. Additionally, causal steps approach was used to explore indirect (mediating) effects and Sobel tests were used to test the significance of the mediating effects. The study found that perceptions of better health status (t520=2.14-6.12, PeHealth literacy and adoption of healthy eating, exercise, and sleep behaviors. Moreover, eHealth literacy played an intermediary role in the association between individual factors and health behaviors (Sobel test=2.09-2.72, PeHealth

  20. Health-related quality of life, emotional and behavioral problems in mild to moderate prematures at (pre-)school age

    NARCIS (Netherlands)

    Ketharanathan, N.; Lee, W.; Mol, A.C. de

    2011-01-01

    BACKGROUND: There is a gap in the knowledge of longterm outcome of mild to moderate prematures compared to the extreme prematures or very low birth weight infants. AIM: Determine health-related quality of life (HRQoL) and prevalence of emotional and behavioral problems in (pre-)school age children