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At least 19 recordsLinked to original sources
PubMedDate not supplied

Direct-to-consumer advertising: public perceptions of its effects on health behaviors, health care, and the doctor-patient relationship.

PURPOSE: To determine public perceptions of the effect of direct-to-consumer advertising (DTCA) of prescription medications on health behaviors, health care utilization, the doctor-patient relationship, and the association between socioeconomic status and these effects. METHODS: Cross-sectional survey of randomly selected, nationally representative sample of the US public using computer-assisted telephone interviewing. MAIN OUTCOME MEASURES: numbers and proportions of respondents in the past 12 months who, as a result of DTCA, requested preventive care or scheduled a physician visit; were diagnosed with condition mentioned in advertisement; disclosed health concerns to a doctor; felt enhanced confidence or sense of control; perceived an effect on the doctor-patient relationship; requested a test, medication change, or specialist referral; or manifested serious dissatisfaction after a visit to a doctor. RESULTS: As a result of DTCA, 14% of respondents disclosed health concerns to a physician, 6% requested preventive care, 5% felt more in control during a physician visit; 5% made requests for a test, medication change, or specialist referral, and 3% received the requested intervention. One percent of patients reported negative outcomes, including worsened treatment, serious dissatisfaction with the visit, or that the physician acted challenged. Effects of DTCA were greater for respondents with low socioeconomic status. CONCLUSIONS: DTCA has positive and negative effects on health behaviors, health service utilization, and the doctor-patient relationship that are greatest on people of low socioeconomic status. The benefits of DTCA in terms of encouraging hard-to-reach sections of the population to seek preventive care must be balanced against increased health care costs caused by clinically inappropriate requests generated by DTCA.

Advertising↗
PubMedDate not supplied

Health behaviors, health status, and access to and use of health care: a population-based study of lesbian, bisexual, and heterosexual women.

BACKGROUND: There is a dearth of validated information about lesbian and bisexual women's health. To better understand some of these issues, we used population-based data to assess variations in health behaviors, health status, and access to and use of health care based on sexual orientation. METHODS: Our study population was drawn from a population-based sample of women, the 1997 Los Angeles County Health Survey. Participants reported their sexual orientation and these analyses included 4697 women: 4610 heterosexual women, 51 lesbians, and 36 bisexual women. We calculated adjusted relative risks to assess the effect of sexual orientation on important health issues. RESULTS: Lesbians and bisexual women were more likely than heterosexual women to use tobacco products and to report any alcohol consumption, but only lesbians were significantly more likely than heterosexual women to drink heavily. Lesbians and bisexual women were less likely than heterosexual women to have health insurance, more likely to have been uninsured for health care during the preceding year, and more likely to have had difficulty obtaining needed medical care. During the preceding 2 years, lesbians, but not bisexual women, were less likely than heterosexual women to have had a Papanicolaou test and a clinical breast examination. CONCLUSIONS: In this first population-based study of lesbian and bisexual women's health, we found that lesbians and bisexual women were more likely than heterosexual women to have poor health behaviors and worse access to health care. These findings support our hypothesis that sexual orientation has an independent effect on health behaviors and receipt of care, and indicate the need for the increased systematic study of the relationship between sexual orientation and various aspects of health and health care. Arch Fam Med. 2000;9:1043-1051

Adult↗
PubMed2003

Quantifiable impact of the contract for health and wellness: health behaviors, health care costs, disability, and workers' compensation.

Current literature about the long-term impacts of corporate health and wellness programs has brought to light new evidence about the cost savings associated with health-promotion interventions. A critical element in these initiatives is attracting the participation of employees at risk for high benefits use. This study presents evidence that suggests accomplishing this task has economic savings implications to large employers. A health and wellness intervention program offered at GlaxoSmithKline, entitled the Contract for Health and Wellness, is examined. Focusing on a group of 6049 employees, the study examines the impact on health behaviors and on integrated health benefits use of this continuously employed population from 1996 to 2000. Total benefits costs are examined for participants and nonparticipants, and the annual savings associated with the isolated impact of the program are, on average, $613 per participant. Reductions in disability costs accounted for the majority of these savings.

Adult↗
PubMed2005

[Socioeconomical status, health behaviors and health status of French adolescents: Health Behavior in School-aged Children (HBSC) survey].

BACKGROUND: The impact of living conditions on health is not well known, but health inequalities observed in adults seem partly determined by behaviours and health status at an earlier stage, and more particularly during adolescence. So, our aim was to study adolescents' health and their health behaviours function to family socioeconomic status. METHODS: We analysed French data from the international survey "Health Behavior in School-aged Children" carried out in a representative sample of adolescents aged 13 and 15 years in 1998. A self-administered questionnaire was completed by the adolescents who answered questions concerning their health, health behaviours, and their families' socio-economic status. RESULTS: Adolescents from blue-collar families were more numerous to report to be in "fairly good health" or "not very good health" (OR = 1.40, CI 95% = 1.12-1.74) and to be overweight or obese (OR = 1.85, CI 95% = 1.25-2.24) than those from executive families. They were also more numerous to have bad health behaviours than those from executive families. CONCLUSION: This study has established that, in adolescents, differences in health, health behaviours, types of consumption and physical activities depended on the families' socio-economic status.

Adolescent↗
PubMedDate not supplied

Stages of change of smoking cessation: relationships with other health behaviors.

Health behaviors are often intercorrelated, suggesting that these behaviors may be manifestations of underlying attitudes toward health. Changes in these attitudes may cause simultaneous changes in several health behaviors. As individuals progress among the stages of change of one health behavior, such as smoking cessation, they may make changes in other health behaviors as well. This study evaluated the hypothesis that subjects in the later stages of change of smoking cessation would practice more healthful behaviors than subjects in the early stages of change. Subjects were 929 respondents in the California Behavioral Risk Factor Surveillance Study who were current smokers or had quit smoking within the past year. Subjects in the more advanced stages of smoking cessation showed more healthful levels of alcohol use and exercise than subjects in the earlier stages. These results suggest that people may make improvements in several health behaviors concurrently. If so, lifestyle-based health promotion programs may be able to take advantage of shifts in attitudes toward health behavior to modify several health behaviors simultaneously.

Female↗
PubMed1994

Health behavior and health status: concepts, methods, and applications.

Reviewed current conceptualizations of how health behavior and health status are linked. Although many health providers assume a near perfect relationship between health behavior and health status, empirical verification of this assumption has been difficult. For many diseases, the link between health behavior and health status is weak, nonexistent, or untested. Problems associated with the definition, conceptualization, and measurement of both health behavior and health status are discussed. The impact of treatment effectiveness (i.e., inert, weak, and strong treatments; treatments with linear versus nonlinear health-behavior relationships; and the effect of under- and overtreatment) on health behavior and health status linkages is illustrated.

Diabetes Mellitus, Type 1↗
PubMed1990

Demonstration of replicable dimensions of health behaviors.

Health behaviors are known to be multidimensional, but the precise number of dimensions involved and their behavioral content have not been clearly established. Using convergence of factor analyses of 40 health behaviors across two samples as the criterion for identifying both the number and content of health behavior dimensions, the present study showed that individual differences in health behavior can be conceptualized in terms of a hierarchical model. At the most general level, health behaviors formed two broad categories or dimensions, preventive behavior and risk taking behavior. Preventive behavior included two empirically distinct subsets of behaviors, wellness maintenance behaviors and accident control behaviors. Risk taking behavior included subsets comprised of traffic-related risk taking and risk taking through exposure to hazardous substances. This hierarchical model is consistent with important theoretical distinctions in health behavior research, can accommodate the findings of prior studies, and should provide a useful framework for formulating research questions regarding antecedents and consequences of individual differences in health behaviors. Brief scales are proposed for use as reference measures in future studies of health behaviors.

Adolescent↗
PubMed2006

[Latent factors generating health behavior and health consciousness].

PURPOSE: The purpose of the present study was to explore structural relationships among health behavior and health consciousness and to delineate latent factors underlying them. METHODS: Data used in this study were obtained from a mail survey conducted by Toshima City Government, Tokyo, in 2002. The subjects were 3,000 community residents, living in the city, ranging in age from 20 to 79 years. The response rate was 54.3%. The data for 1,301 respondents without missing observations were analyzed. A second-order factor model utilizing 23 items of health behavior and health consciousness as observed indicators was developed for the analysis. RESULTS: Covariance structure analysis showed that a model consisting of 23 observed indicators, 9 latent first-order factors, and one second-order factor fitted well and explained the structure of health behavior and health consciousness: the 23 items of health behavior and health consciousness were indicatives of the latent second-order factor named Health-oriented Attitude. The second-order factor score was significantly higher in respondents willing to participate in programs of public health agencies than in those not willing. CONCLUSION: The results imply that reinforcement of the health-oriented attitude may bring about improved health consciousness and practice of health behavior. They also suggest the necessity to reconsider traditional programs of public health agencies because persons with a weak health-oriented attitude are less likely to participate.

Activities of Daily Living↗
PubMed2004

Preventive health behaviors, health-risk behaviors, physical morbidity, and health-related role functioning impairment in veterans with post-traumatic stress disorder.

An examination of the relationships between health behaviors (preventive and risk-related), physician-diagnosed medical problems, role-functioning impairment because of physical morbidity, and post-traumatic stress disorder was conducted on a large cohort of consecutive treatment-seeking cases (N = 826) presenting to an outpatient Veterans Affairs post-traumatic stress disorder clinic. Results revealed that the sample rates of several medical conditions were markedly elevated when compared with general population rates for men of comparable age. The rates of smoking and other behavioral risk variables were greater than rates among men in the general population. Moreover, the majority of the sample did not engage in preventive health behaviors such as exercise and medical screening at levels consistent with health care guidelines. Physical role functioning indices of the SF-36 reveal greater role-functioning impairment because of physical morbidity in this psychiatric sample relative to the age adjusted general population norms. The health care implications of these data are discussed, as are areas for future research.

Aged↗
PubMedDate not supplied

Regulatory compliance issues in behavioral health.

Behavioral health as a discipline has grappled with regulatory compliance issues on its own, tending to be isolated from other specialties and to benefit little from the mistakes and solutions of the rest of medicine. The most common problems with behavioral health regulatory compliance have to do with documentation, billing and coding, treatment plans, and medical necessity. Regulatory compliance is inextricably linked to quality of care. Providers can assess their compliance efforts by asking themselves a series of questions and, most important, by assessing the quality of the care they provide. Sound research and outcomes-based practice are the best ways to improve outcomes in behavioral health treatment and will be the most effective methods for aligning practice with regulations.

Education, Continuing↗
PubMed2005

Explaining US racial/ethnic disparities in health declines and mortality in late middle age: the roles of socioeconomic status, health behaviors, and health insurance.

Pervasive health disparities continue to exist among racial/ethnic minority groups, but the factors related to these disparities have not been fully elucidated. We undertook this prospective cohort study to determine the independent contributions of socioeconomic status (SES), health behaviors, and health insurance in explaining racial/ethnic disparities in mortality and health declines. Our study period was 1992-1998, and our study population consists of a US nationally representative sample of 6286 non-Hispanic whites (W), 1391 non-Hispanic blacks (B), 405 Hispanics interviewed in English (H/E), and 318 Hispanics interviewed in Spanish (H/S), ages 51-61 in 1992 in the Health and Retirement Study. The main outcome measures were death; major decline in self-reported overall health (SROH); and combined outcome of death or major decline in SROH. Crude mortality rates over the 6-year study period for W, B, H/E and H/S were 5.8%, 10.6%, 5.8%, and 4.4%, respectively. Rates of major decline in SROH were 14.6%, 23.2%, 22.1% and 39.4%, for W, B, H/E and H/S, respectively. Higher mortality rates for B versus W were mostly explained by worse baseline health. For major decline in SROH, education, income, and net worth independently explained more of the disparities for all three minority groups as compared to health behaviors and insurance, reducing the effect for B and H/E to non-significance, while leaving a significant elevated odds ratio for H/S. Without addressing the as-yet undetermined and pernicious effects of lower SES, public health initiatives that promote changing individual health behaviors and increasing rates of insurance coverage among blacks and Hispanics will not eliminate racial/ethnic health disparities.

Black or African American↗
PubMed2001

Religious attendance increases survival by improving and maintaining good health behaviors, mental health, and social relationships.

Several recent prospective analyses involving community-based populations have demonstrated a protective effect on survival for frequent attendance at religious services. How such involvement increases survival are unclear. To test the hypothesis that religious attendance might serve to improve and maintain good health behaviors, mental health, and social relationships, changes and consistencies in these variables were studied between 1965 and 1994 for 2,676 Alameda County Study participants, from 17 to 65 years of age in 1965, who survived to 1994. Measures included smoking, physical activity, alcohol consumption, medical checkups, depression, social interactions, and marital status. Those reporting weekly religious attendance in 1965 were more likely to both improve poor health behaviors and maintain good ones by 1994 than were those whose attendance was less or none. Weekly attendance was also associated with improving and maintaining good mental health, increased social relationships, and marital stability. Results were stronger for women in improving poor health behaviors and mental health, consistent with known gender differences in associations between religious attendance and survival. Further understanding the mechanisms involved could aid health promotion and intervention efforts.

Adolescent↗
PubMed2003

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.

Aged↗
PubMed2003

Relationship between oral health behaviors and general health behaviors in a Japanese adult population.

OBJECTIVE: The aim of this study was to analyze the relationship between oral health behaviors and general health behaviors in adults. METHODS: A total of 2,467 adults (1,208 men and 1,259 women aged 20-59 years) who consulted dentists in Chiba City were administered a questionnaire. RESULTS: Women, older participants, and those living with family had better health behaviors than the other subjects studied. Additive indices for oral and general health behaviors were significantly correlated. Toothbrushing frequency was significantly correlated with five items of general health behavior (smoking, drinking, exercise, eating breakfast, and having medical check-ups). Having dental check-ups was significantly correlated with having medical check-ups. There was a negative correlation between dental flossing and drinking. CONCLUSIONS: Of all oral health behaviors examined, toothbrushing frequency was the most predictive indicator of general health behavior.

Adult↗
PubMed1993

The Human Genome Project and health behavior and health education research.

The Human Genome Project (HGP) is a multinational initiative to map and sequence the human genome. This major biological research effort, estimated to take 15 years and cost $3 billion, should have significant implications for public health generally, and for health behavior and health education research in particular. It is anticipated that the HGP research will lead to expanded (1) newborn genetic disease screening, (2) prenatal diagnoses and (3) trait carrier screening. The HGP also is likely to lead to presymptomatic screening of people with late onset genetic diseases, as well as screening for genetic-based susceptibility for common disease morbidity and mortality mediated by either or both life style and environmental factors. These potential developments have raised ethical, legal and social questions, and have highlighted the fact that research is needed on individual, organizational, population and governmental use of and response to these developments. Central to the expanding role of genetics in public health will be health behavior and education research. Such research could contribute to an effective and humane applied human genetics.

Ethics, Medical↗