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Sampling elderly in the community: a comparison of commercial telemarketing lists and random digit dialing techniques for assessing health behaviors and health status.

A study of health behaviors in four communities in the western United States in 1988 provided the opportunity to compare two methods of sampling elderly respondents for a telephone interview. The Polk telemarketing lists were used to identify 1,407 respondents aged 65 years and older in four communities, where 253 respondents in the same age group were also identified by the method of random digit dialing. Individuals identified from the Polk lists received a letter prior to the initial telephone contact. The overall response rate was 49.3% for random digit dialing and 57.3% for the Polk lists. On the average, the identification of one elderly respondent using the Polk lists required about 20-25% as much interviewer time per subject identified as was required by the random digit dialing method. The elderly identified by the Polk lists were significantly older than those identified by random digit dialing, and the proportions of the Polk sample who were married, white, or had an income of greater than $10,000 were slightly higher than those of the random digit dialing sample. Among 40 variables measuring various health behaviors, indicators of health status, and participation in health-related programs and classes, only three differed significantly between the two samples. The authors conclude that sampling from commercial telemarketing lists was an efficient method of identifying elderly respondents and that in these four communities, the estimates of health behaviors and health status were comparable with those obtained by random digit dialing techniques.

Aged↗

Locus of control beliefs predicting oral and diabetes health behavior and health status.

Our study evaluates the correlation between dental and diabetes locus of control beliefs and the potentiality of locus of control beliefs in predicting oral health behavior, dental status, diabetes compliance, and HbA1c level by using situation-specific locus of control scales and considering the value dimension. Data were collected by means of a quantitative questionnaire, a clinical oral examination and patient records. The research population comprised 149 insulin-dependent diabetics who had teeth of their own. Variables were the frequencies of tooth brushing and dental visiting, oral indexes, diabetes adherence, and HbA1c level. Dental and diabetes locus of control beliefs correlated with each other. Dental locus of control associated with frequency of dental visiting, plaque index, decayed surfaces, and with root caries, but diabetes locus of control associated only weakly with adherence with diabetes self-care regimens and not at all with HbA1c level. Correlations between dental locus of control and oral indexes were stronger among those having high value for dental care. Although there were correlations between dental and diabetes locus of control beliefs, only dental locus of control beliefs are practicable for determining health behavior and health status. It is therefore concluded that locus of control beliefs are health behavior specific.

Adolescent↗

Filipino domestic workers in Hong Kong: health related behaviors, health locus of control and social support.

A total of 290 female Filipino domestic helpers residing in Hong Kong completed a concurrent cross sectional survey designed to provide an initial report of basic data which measured mental health symptoms, health-related behaviors, health locus of control and social support. The four top ranking symptoms of mental distress reported included waking in the early hours, loneliness, worry and taking a long time to get to sleep. In general, the level of health related behaviors was high, with a satisfactory diet and low rates of alcohol, nicotine and coffee consumption. However, few women surveyed had previously had a Pap smear. There were also low scores for other preventive health practices. Reinforcement for health behaviors was seen as either a matter of chance or being influenced by powerful others for two thirds of the women. The conclusion highlights the intersection between gender, immigration and social class by drawing attention to issues of acceptance and accessibility of healthcare services for immigrant within host countries. In addition, cultural directions for immigrant health education are outlined.

Adolescent↗

From preventive health behavior to health promotion: advancing a positive construct of health.

A concept analysis of preventive health behavior provided the foundation for this review of current health promotion research in nursing. Studies selected for review described or explained behavior for health promotion, illness prevention, or preventive health behavior. The major focus of this critical review is on the conceptualization and measurement of health promotion behaviors being investigated. Despite nursing's claim to an holistic idea of health, the biomedical model continues to influence indicators of health behavior and the context for promotion of healthy life styles. Major issues for future health promotion research relate to the lack of attention to theoretical definitions and multidimensional aspects of health behavior, and the triad of national strategies for health promotion are discussed.

Health↗

Using the telephone to improve health behavior and health service delivery.

The technology for using the telephone to deliver interventions to improve health behavior and health care has expanded dramatically and exciting innovations continue to emerge. These developments enable the telephone to be used to deliver individualized services to a broad cross section of target groups, while minimizing logistic and system barriers, and cost. However, as telephone-delivered interventions have proliferated, a number of questions remain concerning the elements that are essential to their effectiveness. We provide a broad overview of telephone interventions, published in the past 10 years to identify gaps in knowledge about these services, and make recommendations for future program development and evaluation.

Attitude to Health↗

Health behaviors and health promotion/disease prevention perceptions of medical students.

Health promotion and disease prevention must be addressed in medical education, and the assessment of future physicians' health preventive perceptions and behaviors is a critical step in the process. We conducted a cross-sectional survey of 512 medical students enrolled during the 1992-1993 academic year. Outcome measures were self-reported health behaviors and ratings of the importance of prevention. Overall, results indicated that the preponderance of respondents are engaging in healthy behaviors; however, some high-risk behaviors, such as drinking and driving and possible binge drinking, were reported by at least 15% of the respondents. Significant differences were detected regarding students' perceptions; a linear decreasing trend was noted with first-year students rating the importance of prevention the highest and fourth-year students rating it the lowest. Additionally, this study attempted to correlate health behaviors with perceptions. The results show significant relationships between student-reported behaviors and corresponding perceptions. Even though this cohort is healthy overall, some students are engaging in behaviors that are not conducive to maintaining a healthy lifestyle. It is important to identify and address negative health behaviors in this population, not only in terms of personal health, but also in its effect on their interaction with future patient populations. The attrition of interest in prevention during undergraduate medical training is cause for concern; future clinical practice will be strongly motivated by their perceptions. Medical schools should identify health issues and assess preventive health perceptions among students in order to facilitate the adoption of preventive practices by future physicians. Medical Subject Headings (MeSH): health promotion, prevention, medical students, health behavior.

Adult↗

[An epidemiological study of health behavior and health consciousness in smoking behavior modification].

Among health enhancement activities which have been promoted at various worksites smoking cessation is the most common but is seldom very successful. Smoking cessation programs have almost always neglected individual background factors. The main purpose of this study is to evaluate the factors critical to behavior modification with respect to smoking cessation at worksites. Five hundred and sixty-five chemical factory workers responded to questionnaires on their smoking behavior lifestyle, drinking habits, opinions on smoking, opinions on quitting smoking, knowledge about the effects of smoking on health, and type A behavior pattern. Two hundred thirty two male smokers (age 20-58) were chosen for the smoking cessation program, which was administered during the periodical health examinations. One year after receiving the anti-smoking education their smoking behaviors were again surveyed. Fifteen employees had quit smoking and 79 had reduced consumption by more than 10 cigarettes per day. A principal component analysis was performed in order to extract factors from the numerous items on the questionnaire. Principal component scores were compared between the group that had stopped smoking or had cut back by more than 10 cigarettes per day (Responsive Group) and the rest of the smokers (Unresponsive Group). Principal component scores, which appear to be related to levels of individual health consciousness and levels of regular exercise, were significantly higher in the responsive group than in the unresponsive group. No significant differences were noted between the two groups for principal component scores for knowledge of effects of smoking on health, drinking habits, opinions on smoking, opinions on quitting smoking, and type A behavior.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Socioeconomic differences in health: how much do health behaviors and health insurance coverage account for?

As evidence accumulates that both unhealthy behaviors and inadequate access to health care are responsible in part for poor health, there is a tendency to attribute the differences in health status between the poor and the affluent to the higher prevalence of unhealthy behaviors and inadequate access to health care among people of low socioeconomic status (SES). The purpose of this study is to determine quantitatively how much health behaviors and health insurance coverage account for the SES disparity in health. The study employed secondary analysis of data collected through the Kentucky Behavioral Risk Factor Surveillance System for 2000. After adjusting for health behaviors and health insurance coverage, the differences in health among different levels of SES (measured by education and income) remained strong and significant. Health behaviors and health insurance coverage accounted for 10-16% of the socioeconomic differences in health.

Adolescent↗

Behavioral health in multiracial adolescents: the role of Hispanic/Latino ethnicity.

OBJECTIVES: The purpose of the present study was twofold: (1) to determine whether adolescents who self-identify as multiracial have more adverse health behaviors than their monoracial counterparts, and (2) to examine whether the health behaviors of adolescents who are multiracial and Hispanic are more similar to those who identify as monoracial Hispanic or those who are multiracial and non-Hispanic. METHODS: Secondary analyses of data in a subsample from the Youth Risk Behavior Survey of 3,704 (27.2%) adolescents who identified as Hispanic/Latino only, multiracial Hispanic, or multiracial non-Hispanic were conducted. Regression analyses were conducted using SUDAAN for the complex sampling to test for differences in health behaviors (i.e., smoking, exercise, substance abuse, and suicide risk) among the three ethnicity/race groups. RESULTS: Each health behavior scale yielded significant between-group differences according to ethnic/racial identity: Hispanic/Latino adolescents scored significantly lower than both multiracial groups on the measure of cigarette smoking, lower than multiracial Hispanic adolescents on the substance abuse scale, and lower than multiracial non-Hispanic adolescents on the measure of exercise. The multiracial Hispanic group was also at marginally increased risk for suicide compared to the Hispanic/Latino group. CONCLUSIONS: The results support the hypothesis that multiracial Hispanic adolescents have more behavioral health problems than monoracial Hispanic adolescents. The second hypothesis--that multiracial Hispanic adolescents are more similar to multiracial non-Hispanic adolescents--was also supported. The implications of these findings for the classification of Hispanic adolescents in terms of ethnicity and race in relation to health behaviors are discussed.

Adolescent↗

Influences of personality and coping variables on health behaviors and health outcomes.

Many health problems begin with behavior: taking risks or failing to take proper precautions. Psychosocial processes of several types underlie such behaviors. It follows that research on health can benefit from considering psychosocial processes as well as biological ones. This article focuses on two general domains of psychological influences on health--personality and coping. Several approaches to the domain of personality are described, along with several issues involved in the conceptualization of coping. Examples of research on how these phenomena relate to health behaviors and health outcomes are presented.

Adaptation, Psychological↗

[Health risk behaviors, health status self-assessment and stress perception among industrial workers].

OBJECTIVE: To identify the prevalence and association among health risk behaviors, stress perception, and health status self-assessment among industrial workers. METHODS: A cross-sectional study was performed using a questionnaire previously tested in a pilot study in the State of Santa Catarina, Brazil. Data on smoking, alcohol consumption, fruit and vegetables intake, physical activity, stress perception, and self-assessment of health status were available for 4,225 workers (67.5% males and 32.5% females). Subjects were selected using a 3-stage cluster sampling (5% error margin). Statistical analysis was performed using Chi-square, and logistic regression analysis (p<0.05). RESULTS: The mean age was 29.7 years old (SD=8.6). The prevalence of smokers was 20.6%, higher among males (23.1%) than females (15.6%). The proportion of heavy drinkers was high (57.2% among males and 18.8% among females). Almost half of the subjects (46.2%) reported no leisure-time physical activity (67% females and 34.8% males). Approximately 14% of subjects reported high levels of stress and difficulty to cope with daily tasks. About 15% of the workers perceived their health status as regular or poor. Gender, age, marital status, number of children, educational level and economic status were significantly associated with the prevalence of health risk behaviors. CONCLUSIONS: Despite the limitations of cross-sectional studies, based on self-report assessments, the study results suggest a high prevalence of alcohol consumption and physical inactivity during leisure time. The observed association between gender and health risk behavior suggests that both sexes engage in risk behaviors: for men these behaviors are direct or active (smoking, alcohol consumption) and for women, they are more indirect or passive (physical inactivity, stress).

Adult↗

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

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.

Environmental Exposure↗

[Prevalence of physical diseases, health behavior and health care utilization in single homeless men: a cross sectional study].

OBJECTIVE: The aim of this cross-sectional study was to establish the prevalence of physical diseases, the subjective evaluation of their own health and health care utilization in the actually homeless and a comparison group of formerly homeless. METHODS: A representative sample of 82 homeless and 37 formerly homeless was studied. Instruments were a physical examination and a standardized interview. The latter included parts of the assessment of the German cardiovascular disease prevention study and the questionnaire "Funktionseinschränkungen" (functional impairments) by Potthoff (1982). RESULTS: Disease prevalence was high. The main diagnoses fell within the categories of defective dental status (over 80%), ophthalmologic diseases (over 60%) and diseases of the liver and musculoskeletal system (over 40% each). Morbidity in the formerly homeless was even higher. In both groups the subjective evaluation of their own health was unrealistically positive. Risk factors for cardiovascular diseases were high. Health care utilization was mainly acute. CONCLUSIONS: The medical care of the homeless in standard medical services is insufficient and could be improved by especially tailored projects which should include education about risk factors. Formerly homeless continue to show high disease prevalence.

Adult↗

Internet use among people living with HIV/AIDS: association of health information, health behaviors, and health status.

The telecommunications revolution provides open access to health information that can inform and empower people living with chronic illnesses. However, many people living with HIV may not access the Internet and are not benefiting from available health information. This study investigated Internet access among people living with HIV/AIDS and its relation to health. Results of a survey of men (n = 175) and women (n = 84) living with HIV/AIDS recruited from infectious disease clinics and community-based AIDS services showed that 51% (n = 116) of participants reported ever using the Internet, of which 59% (n = 68) had used the Internet to access health-related information. As expected, Internet users were significantly more likely to be better educated and of higher incomes. Internet users, including those who used the Internet for general purposes and those who reported health-related use, also demonstrated significantly greater knowledge of HIV disease and greater confidence in their ability to adhere to medications. Persons who used the Internet for general purposes were more likely to have an undetectable viral load compared to persons who had not used the Internet. The disparities in Internet use identified in this study suggest that individuals who access the Internet, particularly for health information, are among the better resourced and healthier persons living with HIV/AIDS.

Adult↗

[Effect of health behavior on health status--social medicine problems in family practice management].

Health counselling as a part of the family doctor's practice includes the influence of health behaviour on the state of health. Health behaviour is transmitted by relational persons within everyday social groups. It depends on the scale of values and norms of behaviour within a group and is modified by individual needs. Vital social contacts (family and relational persons) have a higher value than health and serve-depending on the structure of personality-as a motivation of a health-promoting lifestyle. The family doctors strategies of intervention are aimed at winning relational persons, group leaders and local personalities to encourage health promotion and thus achieving that a healthful lifestyle is supported by the public opinion and becomes the social standard.

Germany, East↗

Health behaviors and health status of older women with schizophrenia.

The authors interviewed 43 women with schizophrenia who were 40 to 70 years of age about their health status, preventive health care, addictive behaviors, and comorbid medical conditions. Data were compared with those for age-matched samples from the general population. Thirty women in the study sample (71 percent) were overweight or obese, compared with 38 percent in the general population. Twenty-seven (63 percent) smoked cigarettes. Twenty-six women (62 percent) had received a mammogram in the past two years, compared with 86 percent in the general population. Rates of routine physical examinations and Pap tests did not differ markedly between the study sample and the general population. These results highlight the health impairments of older women who have schizophrenia.

Adult↗