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PubMed1976

Family-interactional therapy in the management of cardiac-related high-risk behaviors.

This exploratory study examined the role of family interaction in structuring and maintaining high-risk behaviors in difficult-to-manage patients with heart disease and the use of time-limited, social systems-oriented therapy to modify such behaviors. The study was based on the assumption that "difficult to manage" patients with heart disease, ie, those who failed to modify their high-risk behavior patterns following a cardiac event--and their families, in their attempts to deal with the threat of heart attack, would interact with one another in a manner which would maintain, however unintentionally, the patient's high-risk behavior pattern. Nine such "difficult heart families" were referred to the project. In each case the patient's wife was seen individually for a maximum of five clinical interviews for the purpose of modifying her method of dealing with, and presumably maintaining, her husband's high-risk behaviors. Contact with the patient with heart disease was minimal and used for information-gathering only. In each case, when the wife made the prescribed changes in dealing with her husband, a desirable change in one or more of his high-risk behaviors followed.

Adult↗
PubMed2003

Longitudinal effect of intimate partner abuse on high-risk behavior among adolescents.

OBJECTIVE: To determine the longitudinal effect of abuse by an intimate partner on risk behavior among adolescents. DESIGN AND PARTICIPANTS: Linear regression analyses of longitudinal data from 4443 adolescents surveyed in 1995 (Wave I) and 1996 (Wave II) from the National Longitudinal Study of Adolescent Health Public Use Dataset. MAIN OUTCOME MEASURES: Abuse was assessed using a 5-point scale measuring if the subject had been insulted in public, sworn at, threatened with violence, pushed or shoved, or had something thrown at them by an intimate partner. The primary outcome measures were changes between Waves I and II in each of the following 5-risk behaviors: illicit substance use, antisocial behavior, violent behavior, suicidal behavior, and depression. RESULTS: Abuse between Waves I and II was associated with higher rates of all 5 risk behaviors at both Waves I and II among both sexes. After adjusting for sociodemographic factors, number of intimate partners, time between interviews, baseline risk behavior scores, and the most abusive relationship experienced prior to Wave I, more severe abuse having occurred between Waves I and II was significantly associated with increased levels of depression in both sexes and increased involvement in illicit substance use, antisocial behavior, and suicidal behavior among female adolescents. CONCLUSIONS: Abuse by an intimate partner is associated with higher levels of risk behavior in both sexes and incident abuse is associated with increased depression in both sexes and increased illicit substance use, antisocial behavior, and suicidal behavior among females. Intimate partner violence interventions should address the negative behaviors associated with abuse, particularly among female adolescents.

Adolescent↗
PubMed1995

Prevalence estimates and adolescent risk behavior: cross-cultural differences in social influence.

Prevalence estimates and prototype perceptions related to health risk behaviors were assessed in comparable samples of Danish and American adolescents (ages 13-15 years). Partly on the basis of observation and previous research, the assumption was made that the American sample would report more self-enhancement tendencies than would the Danish sample. Consistent with this assumption, which was supported by the data, 2 hypotheses were tested: (a) The Americans would overestimate the prevalence of the various risk behaviors (among their peers) more so than would the Danes and (b) those estimates would be more closely linked to their own risk behaviors for the American sample. Results supported both hypotheses; motivational explanations were proposed for both effects. In addition, perceptions of the prototypes associated with particular risk behaviors were assessed and were found to predict smoking behavior and willingness to engage in unprotected sexual intercourse for both samples. Implications for the study of adolescent risk behavior are discussed.

Adolescent↗
PubMed2004

Risk behaviors and resiliency within physically abused adolescents.

OBJECTIVE: This study examines the relationship between physical abuse and several risk behaviors, and thriving behaviors, and the relationship between potential protective factors and engagement in risk and thriving behaviors among victims of physical abuse. Three categories of potential protective factors were examined: (1) individual characteristics, (2) family processes, and (3) extra-familial factors. We expected that high levels of protective factors would reduce engagement in risk behaviors (i.e., alcohol use, tobacco use, drug use, sexual activity, antisocial behavior, attempted suicide, and purging) among abused adolescents. RESULTS: Across all the risk behaviors, abused adolescents reported a higher frequency of engagement than non-abused adolescents. Several protective factors were identified for the seven risk behaviors. Peer group characteristics was a significant predictor in all seven of the logistic regressions, followed by positive school climate (six models), religiosity (five models), other adult support (five models), family support (four models), view of the future (two models), and involvement in extra-curricular activities (two models). The variance accounted for by the models ranged from 2% (risk behavior of purging) to 26% (risk behavior of alcohol use and antisocial behavior). CONCLUSIONS: The findings indicate that, with the exception of sexual activity, the majority of abused adolescents were not engaging in risk behaviors; however, significantly more abused adolescents were engaging in risk behaviors than their non-abused counterparts. In addition, that protective factors were found to exist at various levels of the adolescents' ecology has strong implications for practice.

Adaptation, Psychological↗
PubMed1992

Malaria-related social and behavioral risk factors in Thailand: a review.

A review of the social and behavioral risk factors that have been implicated in malaria infection in Thailand was done as a basis for designing a conceptual framework in formulating recommendations of strategies and research needs to ensure better implementation and/or maximization of the effectiveness of existing malaria control measures in the country. These factors can be broadly divided into three categories: (1) social and behavioral risk factors favoring increased occurrence and transmission, ie population movements, irregular use or non-use of mosquito nets, partial or non-conformance with residual DDT house spraying, etc, (2) behavioral risk factors predisposing to occurrence of severe and complicated malaria, not clearly known, probably delayed treatment, (3) behavioral risk factors related to occurrence of drug resistance, ie treatment-seeking patterns, practices of drug utilization and population movements. Recommendations on research needs as well as strategies for a more effective control program are given.

Humans↗
PubMed1995

Prevalence of HIV-related risk behaviors and STDs among incarcerated adolescents.

PURPOSE: To determine the HIV-related risk behaviors and STDs in a population of incarcerated adolescents in order to strategically target education and prevention efforts. METHODS: A single point-in-time prevalence study based on an analysis of intake medical records of 1,215 incarcerated youth were analyzed for HIV risk behaviors and STD history. RESULTS: Incarcerated adolescents report high rates of risk behaviors for HIV infection and STDs, with 75% reporting three or more sex partners, 25% never using condoms and 19% having a current diagnosis of at least one STD. Significantly more females than males reported a history of STDs and had higher rates of current diagnoses of chlamydia/non-gonococcal urethritis, trichomonas and gonorrhea. CONCLUSIONS: Ethnic/racial and gender differences were found in risk behaviors for STDs among a sample of incarcerated adolescents.

Adolescent↗
PubMed1990

Behavioral Risk Factor Surveillance, 1988.

In 1988, 36 states (including the District of Columbia) participated in the Behavioral Risk Factor Surveillance System (BRFSS). This report provides state-specific estimates of the prevalence of certain health-risk behaviors and of the delivery of clinical preventive services as measured by the BRFSS during 1988. Because estimates vary considerably from state to state, national estimates are not always suitable for states to use in planning local programs. Therefore, the BRFSS will continue to provide state-specific data about health behaviors and the use of preventive health services. These data can be used to monitor trends in health behaviors that affect the burden of chronic diseases in the United States and to assess progress toward the year 2000 objectives for the nation.

Adolescent↗
PubMedDate not supplied

[Clustering patterns of behavioral risk factors linked to chronic disease among young adults in two localities in Bogota, Colombia: importance of sex differences].

BACKGROUND: The characterization of clustering behavioral risk factors may be used as a guideline for interventions aimed at preventing chronic diseases. This study determined the clustering patterns of some behavioral risk factors in young adults aged 18 to 29 years and established the factors associated with having two or more of them. METHODS: Patterns of clustering by gender were established in four behavioral risk factors (low consumption of fruits and vegetables, physical inactivity in leisure time, current tobacco consumption and acute alcohol consumption), in 1465 young adults participants through a multistage probabilistic sample. Regression models identified the sociodemografic variables associated with having two or more of the aforementioned behavioral risk factors. RESULTS: Having one, 32.9% two and 17.7% three or four. Acute alcohol consumption was the risk factor most frequent in the combined risk factor patterns among males; physical inactivity during leisure time being the most frequent among females. Among the females, having two or more behavioral risk factors was linked to be separated or divorced, this having been linked to work having been the main activity over the past 30 days among males. CONCLUSIONS: The combinations of behavioral risk factors studied and the factors associated with clustering show different patterns among males and females. These findings stressed the need of designing interventions sensitive to gender differences.

Adolescent↗
PubMed2005

Supportive social relationships and adolescent health risk behavior among secondary school students in El Salvador.

An increasing number of studies suggest that supportive social relationships in the family and school may exert a protective effect against a number of youth health risk behaviors. This study examines the association between perceived parental social support and perceived social cohesion at school with selected youth risk behavior outcomes (physical fighting, victimization, suicidal ideation, substance use, and sexual intercourse) among 930 female and male public secondary school students studying in the central region of El Salvador. The study questionnaire comprised closed-ended items of parent/school relationships and risk behaviors based on the United States Center for Disease Control and Prevention's Youth Risk Behavior Survey. In regression analyses, female students who perceived low parental social support were significantly more likely to report engaging in all risk behaviors examined, and female students with perceptions of low school social cohesion were more likely to report suicidal ideation, binge drinking, and drug use. Perceptions of parental social support and school social cohesion held fewer but still significant associations across risk behaviors for male students. Male students who reported low parental social support were significantly more likely to report suicidal ideation, drug use and physical fighting, while male students with low perceived school social cohesion were more likely to report physical fighting but less likely to report binge drinking. This study lends support to the importance of supportive social relationships for understanding youth risk behavior and suggests that supportive families and schools may operate differently for female and male students living in El Salvador.

Adolescent↗
PubMed1996

Decision making and risk behaviors of cancer-surviving adolescents and their peers.

The specific aims of this descriptive, comparative study were (1) to compare the decision-making quality and prevalence of risk behaviors (smoking, alcohol consumption, and illicit drug use) between 52 cancer-surviving adolescents and their peers; (2) to compare the relationship of decision-making quality and risk behavior prevalence in a subset of survivors who had a history of therapy with cognitive threat due to late effects of treatment to those without cognitive threat; and (3) to test the hypothesis that the higher the number of quality decision criteria adhered to, the fewer the risk behaviors exhibited by cancer-surviving adolescents. Findings indicated that the majority of teen survivors reported practicing poor-quality decision making for five of the seven criteria (peers, four of seven). There were no significant differences in decision making between teen survivors and their peers nor between survivors with cognitive threat and those without. Peers were significantly more likely to engage in one or more risk behaviors than teen survivors, but comparisons with two normative samples (state and national) revealed that cigarette smoking and alcohol use of the teen survivors were comparable with the general population. There was no significant difference in risk behaviors between survivors with a history of therapy with cognitive threat and those without. Survivors who reported higher adherence to quality decision criteria were less likely to report exhibiting risk behaviors than those with poorer decision making. Using the context of late effects due to cancer treatment, oncology nurses need to provide guidance in quality decision making as well as in risk behavior education.

Adolescent↗
PubMed1996

Substance use and other health risk behaviors in collegiate athletes.

OBJECTIVES: To (a) determine the prevalence of alcohol and other drug use, and health risk behaviors among a general university population; and (b) compare health risk-taking behaviors between genders, and varsity athletes and their non-athlete peers. DESIGN: Descriptive survey of multiple health risk behaviors, including physical, mental health, alcohol and other drug, and sexual risk taking. SETTING: Two large midwestern universities. PARTICIPANTS: A convenience sample of 86% of 1,210 eligible students (271 athletes and 775 nonathlete peers) completed a self-administered, anonymous questionnaire during team meetings or class sessions. INTERVENTION: None. MAIN OUTCOME MEASURES: Differences between gender and athlete status were assessed using Cochran-Mantel-Haenszel statistics for the following variables, determined by questionnaire responses: physical risk, mental health, alcohol and other drug use, and sexual behaviors. RESULTS: Common risk behaviors in the entire collegiate sample included riding in a car with a driver who was under the influence of alcohol, driving and swimming under the influence of alcohol, binge drinking, and low rate of condom use for all types of sexual intercourse. Risk-taking behaviors varied by gender, with men showing more risk behaviors than women, except for suicide and sexual behaviors. Male athletes had a higher prevalence of risk behaviors than their male nonathlete counterparts, in contrast to female athletes, who had fewer risk behaviors than their female nonathlete counterparts. CONCLUSION: In contrast to previous studies, results of the present study show, when results are stratified by gender, that not all athletes engage more frequently than nonathletes in high risk behaviors. Results suggest that educational and early intervention strategies to decrease risk may need to be tailored according to gender and athletic status.

Adolescent↗
PubMed1987

Drinking-driving and health lifestyle in the United States: Behavioral Risk Factors Surveys.

National patterns of self-reported drinking-driving were examined using aggregated Behavioral Risk Factor Survey data. Drinking-driving is reported by 6.1% of U.S. adults, is almost three times more prevalent among men than women and is most prevalent in 18-24-year-old men (15.4%). Sociodemographic characteristics of self-reported drinking drivers correspond with those characteristics based on alcohol-associated motor vehicle accident and arrest data. Heavy smokers and those who fail to use seatbelts are more likely to drink and drive than those without these health-risk behaviors. Men reporting stress in interpersonal relationships are more likely to drink and drive. Individuals who drink or smoke in response to stress are more likely to drink and drive than those who exercise in response to stress. The concurrent practice of drinking-driving with lack of seatbelt use, use of alcohol in response to stress and smoking probably contributes substantially to the risk of accident and serious injury among drinking drivers and has implications for both prevention and treatment programs.

Accidents, Traffic↗
PubMedDate not supplied

Health perceptions and risk behaviors of lung cancer survivors.

BACKGROUND: Lung cancer survivors are at an increased risk for recurrence and the development of secondary tumors and other comorbid conditions. However, little is known about lung cancer survivors' risk behaviors and the effect of these behaviors on overall health perceptions. OBJECTIVE: The purpose of this study was to describe the prevalence of health risk behaviors among non-small cell lung cancer survivors and their relationship perception to overall health. METHODS: One hundred forty-two survivors of non-small cell lung cancer with a minimum of 5 years disease free completed a battery of questionnaires to assess perception of health status and self-reported risk behaviors (smoking, exposure to secondhand smoke, alcohol use) and weight before and after diagnosis. Urinary cotinine level was used to verify smoking status, and actual height and weight were obtained to determine overweight status (body mass index, >/=25). Descriptive statistics and logistic regression were used to analyze the data. RESULTS: Seventy percent of participants reported their health as good to excellent. Although 81% quit smoking after diagnosis, 13.4% continued to smoke and 28% reported exposure to secondhand smoke. Approximately half the sample (58%) drank alcohol (16.3% quit after diagnosis) and was overweight (51%). A strong agreement between current smoking and exposure to secondhand smoke was observed. In a multivariate analysis, smoking (odds ratio [OR], 7.02; CI, 2.45 to 20.13), exposure to secondhand smoke (OR, 5.37; CI, 2.42 to 11.95), alcohol use (OR, 9.04; CI, 3.28 to 24.92), and overweight (OR, 8.51; CI, 3.44 to 21.10) were independent predictors of perceived poor health status. CONCLUSION: Although most lung cancer survivors have made healthy lifestyle changes, a substantial proportion has not. Our findings suggest the need for multiple risk factor interventions to decrease risk behaviors and improve overall health after a cancer diagnosis.

Aged↗
PubMed2005

Negative self-perceptions and sexual risk behavior among heterosexual methamphetamine users.

This research examined the relationship between negative self-perceptions and sexual risk behavior in a sample of 156 heterosexually identified, methamphetamine users from San Diego, California. The Beck Depression Inventory and the Self Esteem Rating Scale, respectively, were used to assess depression and negative self-perceptions. Measures of sexual risk behavior and methamphetamine use were developed specifically for this research. Data were gathered in 2001-2002. Participants were primarily male (76%), Caucasian (56%), never married (51%), and unemployed (73%), with a mean age of 39.1 years. Participants with high levels of negative self-perceptions evidenced the greatest degree of sexual risk behavior, including significantly more unprotected vaginal sex and a larger number of sexual partners as compared to individuals with low levels of negative self-perceptions. In cross-sectional analyses, negative self-perceptions predicted intensity of methamphetamine use and depressive symptoms. However, neither of these variables were found to mediate the relationship between negative self-perceptions and sexual risk behavior. Findings are discussed in relation to the need for further research into the role of negative self-perceptions as a determinant of sexual risk behavior among methamphetamine users.

Adolescent↗
PubMed1998

The association between health risk behaviors and sexual orientation among a school-based sample of adolescents.

OBJECTIVE: This study is one of the first to examine the association between sexual orientation and health risk behaviors among a representative, school-based sample of adolescents. DESIGN: This study was conducted on an anonymous, representative sample of 4159 9th- to 12th-grade students in public high schools from Massachusetts' expanded Centers for Disease Control and Prevention 1995 Youth Risk Behavior Survey. Sexual orientation was determined by the following question: "Which of the following best describes you?" A total of 104 students self-identified as gay, lesbian, or bisexual (GLB), representing 2.5% of the overall population. Of GLB youth, 66.7% were male and 70% were white (not Hispanic). Health risk and problem behaviors were analyzed comparing GLB youth and their peers. Those variables found to be significantly associated with GLB youth were then analyzed by multiple logistic regression models. RESULTS: GLB youth were more likely than their peers to have been victimized and threatened and to have been engaged in a variety of risk behaviors including suicidal ideation and attempts, multiple substance use, and sexual risk behaviors. Four separate logistic regression models were constructed. Model I, Onset of Behaviors Before Age 13, showed use of cocaine before age 13 years as strongly associated with GLB orientation (odds ratio [OR]: 6.10; 95% confidence interval [CI] = 2.45-15.20). Early initiation of sexual intercourse (2.15; 10.6-4.38), marijuana use (1.98; 1.04-4.09), and alcohol use (1.82; 1.03-3.23) also was associated with GLB orientation. Model II, Lifetime Frequencies of Behaviors, showed that frequency of crack cocaine use (1.38; 1.06-1.79), inhalant use (1.30; 1.05-1.61), and number of sexual partners (1.27; 1.06-1.43) was associated with GLB orientation. Model III, Frequency of Recent Behaviors, showed smokeless tobacco use in the past 30 days (1.38; 1. 20-1.59) and number of sexual partners in the previous 3 months (1. 47; 1.31-1.65) were associated with GLB orientation. Model IV, Frequency of Behaviors at School, showed having one's property stolen or deliberately damaged (1.23; 1.08-1.40) and using marijuana (1.29; 1.05-1.59) and smokeless tobacco (1.53; 1.30-1.81) were associated with GLB orientation. Overall, GLB respondents engaged disproportionately in multiple risk behaviors, reporting an increased mean number of risk behaviors (mean = 6.81 +/- 4.49) compared with the overall student population (mean = 3.45 +/- 3.15). CONCLUSION: GLB youth who self-identify during high school report disproportionate risk for a variety of health risk and problem behaviors, including suicide, victimization, sexual risk behaviors, and multiple substance use. In addition, these youth are more likely to report engaging in multiple risk behaviors and initiating risk behaviors at an earlier age than are their peers. These findings suggest that educational efforts, prevention programs, and health services must be designed to address the unique needs of GLB youth.

Adolescent↗
PubMed2000

Is offering post-exposure prevention for sexual exposures to HIV related to sexual risk behavior in gay men?

OBJECTIVE: To examine the impact of the availability of postexposure prevention (PEP) for sexual exposures to HIV on sexual risk behavior among gay men. METHODS: Two cross-sectional samples of 529 gay men in San Francisco (June 1998, January 1999) completed face-to-face street interviews assessing sexual risk behavior and whether they had heard of PEP in general as well as whether they knew that PEP was available in San Francisco. The second sample was collected after a community-wide outreach campaign had been conducted to increase people's knowledge that PEP was available in San Francisco. RESULTS: Of those who had heard of PEP at Time 1, 24% had recently had unprotected anal intercourse, versus 26% of those who had not heard of PEP. At Time 2, 37% of those who had heard of PEP had recently engaged in unprotected anal intercourse versus 26% of those who had not heard of PEP (chi2, 4.06; P = 0.03). At both time points, however, men who actually knew that PEP was available in San Francisco did not report more risk behavior than men who did not know PEP was available in San Francisco. In addition, only a small percentage at both time points self-reported that PEP had the effect of increasing their sexual risk behavior. CONCLUSIONS: There is little evidence that the availability of PEP for sexual exposures may be related to increased sexual risk-taking among gay men in San Francisco. The potential impact of PEP on risk behavior must, however, still be considered as part of the larger context of HIV/AIDS treatment optimism and possibly escalating levels of risk behavior among gay men.

Adult↗
PubMed2005

Socioeconomic factors and health risk behaviors among university students in Turkey: questionnaire study.

AIM: To explore relations between socioeconomic factors and health risk behaviors in university students in Turkey. METHODS: A total of 650 students currently enrolled at the university in Ankara were selected for the study by means of a circular sampling method. They answered a questionnaire on health risk behaviors. We used multivariate analysis to analyze the relations between socioeconomic variables and each of the following participants' behaviors in the last year: use of cigarettes, alcohol, or drugs; driving under the influence of alcohol; unprotected sex; attempted suicide; self-mutilation; physical fighting; carrying firearms or edged weapon; not wearing a safety belt in motor vehicles; or riding a motorcycle without a helmet. RESULTS: Health risk behaviors in university students were in general related to low socioeconomic status, except for alcohol use, which was related to high socioeconomic status. Among female students whose mothers had completed high school, 81.9% used alcohol, compared with less than 68% of female students whose mothers had not completed high school or had completed university (P<0.001). Also, 4.0% of female students whose mothers had completed high school had attempted suicide, compared with less than 1.5% of female students whose mothers had not completed high school or had completed university (P=0.026). In male students, important variables were parental education level and paternal employment status. Among male students who had unemployed fathers, 66.7% used cigarettes (P=0.015), 26.7% engaged in substance use (P<0.010), and 4.4 % attempted suicide (P<0.050) in comparison with 11.9 and 0.7%, respectively, of male students whose fathers were employed. Logistic regression showed male gender to be associated with an increase in all risk behaviors (odds ratio 1.114, 95% confidence interval 1.652-5.622, P<0.001). CONCLUSION: This study confirms the findings of similar studies in western developed countries, suggesting that relations between socioeconomic variables and health risk behaviors in young people reflect a basic phenomenon not greatly influenced by culture.

Adult↗
PubMed1991

The effects of behavioral risks on absenteeism and health-care costs in the workplace.

The impact of behavioral risk factors on absenteeism and health-care costs was analyzed among 45,976 employees in a large, diversified industrial work force. A cross-sectional design was used to evaluate health risk appraisal and physical-examination data collected from 1984 through 1988. Employees with any of six behavioral risks had significantly higher absenteeism (range = 10% to 32%) compared with those without risks. These differences led to significantly higher illness costs (defined as compensation, health care, and non-health care benefits) for those with risks compared with those without risks. Annual excess illness costs per person at risk were smoking, $960; overweight, $401; excess alcohol, $389; elevated cholesterol, $370; high blood pressure, $343; inadequate seatbelt use, $272; and lack of exercise, $130. Only one factor, lack of exercise, was not significant after adjusting for age, education, pay category, and the six other behavioral risks. The total cost to the company of excess illness was conservatively estimated at $70.8 million annually. These findings suggest that the cost of key behavioral risks provides an opportunity to manage health-care cost increases through health promotion, financial incentives for healthy lifestyle, and environmental changes that affect health behaviors.

Absenteeism↗