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Biomedical subjects

I M Rosenstock

Publications and source records attributed to I M Rosenstock.

At least 19 recordsLinked to original sources
PubMed1994

Alcohol, other drugs, and sexual risk-taking among young adults.

Recent studies based on small convenience samples of men and women have found the use of alcohol and other drugs to be associated with unprotected sexual intercourse that places women at elevated risk for sexually transmitted diseases and unintended pregnancy. An analysis of data from a representative sample of 12,069 younger adults indicates that the use of alcohol and other drugs is related to sexual risk-taking among both men and women after controlling for age, education, family income, and other variables.

Adolescent↗
PubMed1988

Social learning theory and the Health Belief Model.

The Health Belief Model, social learning theory (recently relabelled social cognitive theory), self-efficacy, and locus of control have all been applied with varying success to problems of explaining, predicting, and influencing behavior. Yet, there is conceptual confusion among researchers and practitioners about the interrelationships of these theories and variables. This article attempts to show how these explanatory factors may be related, and in so doing, posits a revised explanatory model which incorporates self-efficacy into the Health Belief Model. Specifically, self-efficacy is proposed as a separate independent variable along with the traditional health belief variables of perceived susceptibility, severity, benefits, and barriers. Incentive to behave (health motivation) is also a component of the model. Locus of control is not included explicitly because it is believed to be incorporated within other elements of the model. It is predicted that the new formulation will more fully account for health-related behavior than did earlier formulations, and will suggest more effective behavioral interventions than have hitherto been available to health educators.

Attitude to Health↗
PubMed1986

The role of self-efficacy in achieving health behavior change.

The concept of self-efficacy is receiving increasing recognition as a predictor of health behavior change and maintenance. The purpose of this article is to facilitate a clearer understanding of both the concept and its relevance for health education research and practice. Self-efficacy is first defined and distinguished from other related concepts. Next, studies of the self-efficacy concept as it relates to health practices are examined. This review focuses on cigarette smoking, weight control, contraception, alcohol abuse and exercise behaviors. The studies reviewed suggest strong relationships between self-efficacy and health behavior change and maintenance. Experimental manipulations of self-efficacy suggest that efficacy can be enhanced and that this enhancement is related to subsequent health behavior change. The findings from these studies also suggest methods for modifying health practices. These methods diverge from many of the current, traditional methods for changing health practices. Recommendations for incorporating the enhancement of self-efficacy into health behavior change programs are made in light of the reviewed findings.

Alcohol Drinking↗
PubMed1986

Evaluation of smoking prohibition policy in a health maintenance organization.

Four months after Group Health Cooperative of Puget Sound adopted a policy prohibiting smoking in its 35 facilities, we assessed attitudes and behavior of a sample of 447 employees. Results indicated that 85 per cent of employees approved of the decision to go smoke-free, the rate of reported smoking decreased, and a large proportion of non-smokers believed that their own and co-workers' work performance had improved. Suggestions for successful implementation of future programs are provided.

Air Pollution↗
PubMed1982

The health belief model and nutrition education.

Five axioms of learning explain the stability of dietary practices and suggest approaches to teaching more healthful habits. These axioms include the influence of prior beliefs and attitudes upon people's interpretations, the fact that effective learning is incremental, the value of reinforcement, the habitual nature of much behavior, and the fact that learning includes both cognitions and skills. The Health Belief Model (HBM), a specification of the first axiom, holds that people are likely to follow health recommendations if they are motivated about their health and if they believe that they are susceptible to an ill health condition; that the occurrence of that condition would have serious impact on their lives; that following a particular set of health recommendations would be beneficial in reducing either their susceptibility to or the severity of the condition; and that the psychological benefits of following the health recommendation outweighs its costs. Educational diagnosis may be made by identifying peoples' status on each variable in the HBM and then formulating an educational plan directed toward modifying beliefs, as needed, taking into account the other learning axioms. An ethical stance is adopted that holds that informed individuals should be entitled to maintain the practices they prefer.

Attitude to Health↗
PubMed1981

Linking research and practice in patient education for hypertension: patient responses to four educational interventions.

Data from a longitudinal study of 432 hypertensive patients under the care of private practitioners are used to answer two questions: How do patients react to educational interventions, and how are their responses related to changes in their adherence behaviors? The four educational interventions, introduced sequentially and tested in a factorial design, were written messages, nurse's phone call, self-monitoring and social support. Patients' reactions to the interventions were assessed, using data from questions asked at post-intervention interviews and information recorded during the interventions. Cognitive, attitudinal and behavioral data are examined. Findings indicate that respondents were cognizant of the interventions and viewed them positively; also, some predictions about intervention features were supported. However, actions which respondents attributed to the interventions were not found to be related to increased adherence, according to the test used in this study.

Attitude to Health↗
PubMed1981

A test of interventions to increase adherence to hypertensive medical regimens.

Low rates of adherence to hypertensive therapy limit patients' securing the full benefits of treatment. While some factors related to adherence have been identified research on the effectiveness of interventions to increase adherence levels is sparse. The present study was designed to assess the impact of a series of different interventions on a group of some 400 patients, all under the care of private physicians in a small community. A factorial design was employed to deliver four, sequential educational interventions, about four months apart, to randomly selected sub-groups. Interviews before and after each intervention provided information concerning self-reported adherence, health status, health beliefs, and personal characteristics. Pertinent medical records and pharmacy data were also obtained. The first intervention - printed material - did not significantly affect adherence. The second and fourth interventions - nurse telephone calls and social support - each increased medication taking and the third intervention - self-monitoring - led to better weight control. There was no cumulative impact of the interventions and different aspects of regimens were not significantly related to one another.

Antihypertensive Agents↗
PubMed1980

Dimensions of children's health beliefs.

Health beliefs interviews were conducted with 250 children aged 6-17 years. A factor analysis of the items resulted in six correlated factors which were interpreted as 1) specific health concerns, 2) general health concerns, 3) perceived parental concern, 4) perceived general susceptibility, 5) perceived susceptibility to specific conditions, and 6) perceived seriousness of and susceptibility to disease. Factor scores were computed and two-way analyses of variance (by age and sex of child) were conducted on six sets of factor scores. No significant sex differences or sex by age interaction effects were noted. Younger children scored significantly higher on "specific health concerns" and "perceived general susceptibility," while older children scored significantly higher on "perceived parental concern." Tests of differences among variances showed a tendency for the variability to be greater among younger children. The results are interpreted as providing partial support for a model of children's health beliefs and as a basis for further operationalization of concepts which are central to an understanding of motivated health behavior. Implications for practice are discussed.

Adolescent↗
PubMed1978

Construct validation of the health belief model.

A multitrait-multimethod design was employed to assess the construct validity of the Health Belief Model. The data were obtained from a nonrepresentative sample of 85 graduate students at The University of Michigan's School of Public Health. The traits consisted of the respondents' perceptions of: health interest, locus of control, susceptibility to influenza, severity of influenza, benefits provided by a flu shot, and the barriers or costs associated with getting a flu shot. Each trait was measured by three methods: a seven-point Likert scale, a fixed-alternative multiple choice scale, and a vignette. The results indicate that the Health Belief Model variables can be measured with a substantial amount of convergent validity using Likert or multiple choice questionnaire items. With regard to discriminant validity, evidence suggests that subjects' perceptions of barriers and benefits are quite different from their perceptions of susceptibility and severity. Perceptions of susceptibility and severity are substantially but not entirely independent. Perceived benefits and barriers demonstrate a strong negative relationship which suggests the possibility that these two variables represent opposite ends of a single continuum and not separate health beliefs. These preliminary results provide the basis for developing brief health belief scales that may be administered to samples of consumers and providers to assess educational needs. Such needs assessment, in turn, could then be used to tailor messages and programs to meet the particular needs of a client group.

Attitude to Health↗
PubMed1978

Factors influencing mothers' compliance with a medication regimen for asthmatic children.

This study lends support to the utility of a compliance-adapted health belief framework for exploring mothers' differential adherence to medication regiments prescribed for their asthmatic children. Most of the Model components behaved as hypothesized in predicting mothers' drug administration. The findings offer empirical evidence which can be applied to the purposes of identifying potential noncompliers and designating those specific, health-related orientations of the mother which are related to poor cooperation with therapy. Based on an educational diagnosis, the clinician may thus intervene to alter inappropriate health beliefs in order to enhance the likelihood of compliance for the asthmatic patient.

Adolescent↗
PubMed1977

Patient adherence to antihypertensive medical regimens.

The initial findings from a long-term study of patient adherence to antihypertensive medical regimens are reported; the research was designed to identify factors related to adherence. Data were collected by means of personal interviews and from medication records for a sample of 132 hypertensive patients of private physicians. Patient beliefs about their susceptibility to the effects of hypertension, about the severity of the condition, and about the efficacy of the regimen prescribed were all associated with compliance, when the self-report and pharmacy records were analyzed. A lesser degree of adherence was found to be related to the patient's feelings of dependence on the physician and to a lesser sense of personal control; those patients who found it difficult, for personal reasons, to comply with the regimen also exhibited a lesser degree of adherence. Although a patient's understanding about the disease was not related to adherence, his awareness of the purpose of the regimen was. Less educated and older patients showed less compliance. The compliance of patients in following dietary advice was less marked than was compliance in taking medication. Although preliminary, the results emphasize the importance of a patient's beliefs and his social situation in decisions to follow medical advice.

Adult↗