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At least 19 recordsLinked to original sources
PubMed1999

Radon-smoking synergy: A population-based behavioral risk reduction approach.

BACKGROUND: Radon and cigarette smoking have a synergistic, multiplicative effect on lung cancer rates. Smokers, and perhaps nonsmoking residents, of smoking households are at increased risk for lung cancer even when radon levels are relatively low. A behavioral risk reduction strategy emphasizing smoking cessation is proposed and data are presented from pilot studies and a short-term evaluation of a randomized intervention trial. METHODS: Pilot studies, including radon testing, interviews, questionnaires, and focus groups, led to a three-arm randomized intervention trial comparing two kinds of written materials and telephone counseling. Smoking households were recruited by offering free radon test kits through an electric utility companies billing system. Three-month follow-up data were obtained by mail and phone. RESULTS: Of an estimated 2,600 smoking households in the utility district, 1,220 requested a radon test kit, and 714 were randomized into three treatment conditions. Brief phone counseling (up to two short calls) significantly increased smoking quit rates, compared to written materials only, and was also related to other risk reduction behaviors (e.g., household ban on smoking). CONCLUSIONS: Offering free radon testing through a public utility billing system is an effective recruitment tool for reaching households at risk due to radon-smoking synergy. Brief telephone counseling is superior to written materials in reducing smoking and encouraging indoor smoking bans. Methods are needed to better inform smokers of their additional risk from exposure to even low levels of radon.

Adult↗
PubMedDate not supplied

Risk behavior, perceptions of HIV risk, and risk-reduction behavior among a small group of rural African American women who use drugs.

HIV/AIDS is a health crisis for African Americans. African American women are exposed to HIV primarily through sexual behavior, which is an increased risk for women who use drugs. The study design was a mixed method consisting of an ethnography with ongoing participant observation and in-depth interviews and a questionnaire. The purpose of the questionnaire component was to explore drug use, sexual behavior, health history, and perceptions. The questionnaire was administered at months 6 and 18. Data for this report were derived from the first questionnaire with 30 respondents. The majority of respondents (82.7%) used polysubstances consisting of cocaine, marijuana, and alcohol. Between 33% and 50% exchanged sex for drugs or money, with less than half ever using condoms. About 37% perceived that they had no risk of acquiring HIV, whereas 52% perceived a 25% chance. The pattern of HIV testing in which 33% of the women were tested 10 times or more was unexpected because of the low perception of risk. The principal conclusion was that there is great need to intervene with prevention efforts targeting rural women who use drugs in an attempt to curb increasing rates of sexually transmitted infections including HIV.

Adolescent↗
PubMedDate not supplied

Smoking in pregnancy: patient and provider risk reduction behavior.

OBJECTIVE: To describe the range of risk reduction behaviors among women who continue to smoke after learning of their pregnancy, including reduced tobacco use, eventual cessation, and sustained abstinence as well as the patient-reported smoking cessation-promoting behaviors of prenatal care providers. METHODS: This research is part of a larger prospective, community-based study conducted to assess the association between maternal stress and birth outcomes and infant health and development. Over a 2-year period, from February 2000 to November 2001, women receiving prenatal care at a consortium of public health centers in Philadelphia, Pennsylvania, were consecutively recruited (n = 1,451) completing interviews at their initial prenatal visit and again 3 to 4 months following their delivery. Smoking rates during pregnancy were determined from responses given during the first postpartum interview, at 3 to 4 months postpartum. RESULTS: Of the 1,451 women interviewed at 3 to 4 months postpartum, 24.9 percent indicated smoking during their pregnancy. Of these antenatal smokers, 89.0 percent reported reducing their cigarette consumption during pregnancy. However, only 25.4 percent attained abstinence during their pregnancy. Among women who achieved abstinence during their pregnancy, 21.7 percent were still not smoking at the time of the postpartum interview. Antenatal smokers reported that prenatal care providers asked about their smoking (90.6%) and advised about quitting (76.5%). However, only 27.9 percent were given referrals to smoking cessation programs. CONCLUSION: While cessation was achieved by only a quarter of antenatal smokers, almost 90 percent reduced their cigarette consumption. Prenatal care providers identified and provided cessation advice to the majority of women who were smoking but they did not follow through with material assistance in the form of referrals to smoking cessation programs.

Adult↗
PubMed1991

Sexual risk reduction behaviors among young heterosexual adults.

Although young, sexually-active heterosexuals have always been at risk for contracting sexually transmitted diseases, the recent appearance of Acquired Immunodeficiency Syndrome (AIDS) has increased the possible peril of sexual experimentation. Currently, behaviors to reduce the risk of contracting AIDS are being widely advocated. The present study examines predictors of self-reported risk reduction behaviors in a sample of 188 young, sexually-active heterosexuals. Three factors (perceptions of personal vulnerability, sexual behaviour history, and homophobia) were hypothesized to predict levels of worry about contracting a sexually transmitted disease. Worry, in turn, was hypothesized to predict behavior change. Structural equation modeling provided support for these predictions, but found somewhat different patterns for women and men. For both sexes, higher levels of worry were a significant predictor of risk reduction behavior implementation. For women only, more extensive sexual behavior histories significantly predicted levels of worry. In contrast, for men only, perceptions of personal vulnerability and homophobia were significant predictors of worry. Results suggest that gender plays an important role in understanding cognitive predictors of sexual risk reduction behaviors.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

AIDS beliefs in young women: are they related to AIDS risk-reduction behavior?

Little is known about the relationship between AIDS beliefs and AIDS risk-reduction behavior, especially in young heterosexual adults. This study explores young women's beliefs and behavior regarding AIDS. The results of this exploratory study indicate that college women generally see AIDS as serious, do not see themselves as susceptible, and are uncertain if AIDS beliefs influence their contraceptive behavior. Higher susceptibility scores are consistently correlated with AIDS risk-reduction behavior, and women who believe that AIDS affects their contraceptive use are more likely to use condoms. Implications for practice and strategies to increase susceptibility in women at risk are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Psychological factors influencing cardiovascular risk reduction behavior in low and middle income African-American women.

Cardiovascular disease is the number one cause of death for women, especially, African-American women in the United States. In fact, it is reported that each year, 39% of all deaths in women are from coronary heart disease (CHD). Further, 1 out of every 5 women in the United States have some form of cardiovascular disease (CVD). In 1998, 500,037 women died from CVD. In 1997, the morality for CHD for females was 236,468; representing 491 of all deaths for this disease. Among women, African-American women have a death rate for CHD almost four times higher than their White counterparts. Several factors influence the risks for African-American women. African-American women are more likely to be obese and to participate in lower rates of cardiovascular risk reduction behavior (diet control, exercise, weight management) than Caucasian women. Few studies explore psychological factors influencing African-American women's participation rates in cardiovascular risk reduction behavior. The purpose of this study was to explore the role of psychological factors (self-concept, self-efficacy to diet and exercise, and stress) on cardiovascular risk reduction behavior in low and middle-income African-American women. A questionnaire measuring self-concept, self-efficacy to diet and exercise, and stress was self-administered by middle-income women and investigator administered to low-income women. Findings revealed that self-efficacy to diet and exercise were positively correlated with cardiovascular risk reduction behavior in both groups. Additionally, middle-income women with higher levels of self-concept and lower body mass index were more likely to participate in the risk reduction behavior. Findings have implications for tailoring cardiovascular risk reduction interventions to African-American women of varying socioeconomic status (SES).

Adult↗
PubMed1998

Cognitive appraisal and cardiac risk reduction behavior following coronary angioplasty.

Clinicians express concern that because percutaneous transluminal coronary angioplasty (PTCA) is minimally invasive and yields rapid symptom relief, patients with successful PTCA may be too optimistic about their future health status, may no longer perceive heart disease as a threat to health, and thus, may view cardiac risk-reduction behaviors as unnecessary. This study examined the relationship between patients' cognitive appraisal of PTCA (treatment appraisal and heart disease threat) and subsequent participation in cardiac risk-reduction behavior 2 weeks following hospital discharge. The sample included 58 subjects with successful PTCA. The majority were older, married, Caucasian men who reported participation in cardiac risk-reduction behavior (not smoking, exercising regularly, and following a low fat/low sodium diet) following PTCA. Although heart disease threat was a significant negative predictor of psychological well-being, it did not predict self-reported participation in cardiac risk-reduction behavior.

Adult↗
PubMed1991

Psychosocial predictors of gay men's AIDS risk-reduction behavior.

Used psychosocial variables derived from the health belief model (Rosenstock, 1974), Bandura's (1986) self-efficacy framework, and protection motivation theory (Rogers, 1984) to predict self-reported AIDS risk-reduction behaviors in a sample of 389 homosexual men who participated in the Multicenter AIDS Cohort Study in Los Angeles and who knew their HIV antibody status. Hierarchical multiple regression analyses showed that self-efficacy, perceived risk, response efficacy, and prior sexual behavior accounted for approximately 70% of the variance in the total number of sexual partners and the number of anonymous partners over a 6-month interval, controlling for demographic variables, HIV antibody status, and presence of a primary partner. A logistic regression analysis showed that barriers to change predicted increased unprotected anal receptive intercourse over a 6-month interval, controlling for prior behavior. The relation of health beliefs to risk-reduction behavior was substantially different for HIV-seropositive men without primary partners than for other groups of gay men. Implications for interventions are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Motivating HIV positive women to adhere to antiretroviral therapy and risk reduction behavior: the KHARMA Project.

Women comprise the fastest growing group of persons with AIDS. They are often diagnosed later in the disease, when antiretroviral therapy (ART) is strongly indicated. Antiretroviral therapy has transformed the course of HIV/AIDS to a treatable, chronic illness. This article provides a profile of women with HIV/AIDS and describes ART. Selected research related to adherence and motivation is summarized. Psychosocial and economic concerns specific to women, ART, adherence, and motivation are presented. The article reviews challenges for risk reduction behaviors for HIV+ women, such as sexual activity and substance abuse. The authors discuss the Keeping Health and Active with Risk reduction and Medication Adherence (KHARMA) Project, a research project in progress that was designed to promote adherence to both ART and risk reduction behaviors in HIV+ women. The study includes two groups: a motivational group intervention based on motivational interviewing and a health promotion program control group tailored to the needs of HIV+ women. A description of the tailored intervention and project update is included.

Adult↗
PubMed2005

Enhanced counseling for women undergoing BRCA1/2 testing: impact on subsequent decision making about risk reduction behaviors.

The authors evaluated the impact of an enhanced counseling intervention, designed to promote well-informed decision making for follow-up risk reduction options for ovarian cancer, among high-risk women undergoing BRCA1/2 testing (N = 77). Following standard genetic counseling, participants received either an enhanced counseling session--designed to help participants anticipate their reactions to possible test outcomes and plan for postresult consequences--or a general health information control session. One week after disclosure of test results, women in the enhanced counseling group experienced a greater reduction in avoidant ideation, suggesting more complete processing of risk feedback. At the 6-month follow-up, intervention respondents reported seeking out more information about prophylactic oophorectomy and were more likely to have actually undergone preventive surgery. The results indicate that the use of enhanced counseling can play an important role in decision making about risk reduction behaviors following BRCA1/2 testing.

Comprehension↗
PubMed2005

Influence of partner participation on sexual risk behavior reduction among HIV-positive Zambian women.

Sexual risk behavior interventions in sub-Saharan Africa focus predominantly on individual and couples counseling. This cognitive-behavioral group intervention was adapted from an urban US context to urban Zambia. Preliminary data analyses assessed the influence of partner participation on sexual risk behavior among HIV-positive Zambian women. Female participants (n=180) attended four group intervention sessions and received sexual behavior skill training and male and female condoms; male partners (n=152) were randomly assigned to high- or low-intensity gender-concordant group intervention sessions. Sexual risk behavior, strategies, attitudes, and knowledge were assessed at baseline, 6, and 12 months. At baseline, 19% of males reported using alcohol before sex, 10% reported using alcohol to cope, and negative coping was associated with sexual risk behavior. In contrast, 1% of women reported using alcohol before sex, and 15% used alcohol as an HIV-coping strategy. Consistent barrier use was reported by 48% of women and 74% of men. After intervention, female high intensity participants reported higher rates of condom use (F=5.68, P=.02), more positive condom attitudes, safer sex intentions, and less alcohol use. These findings highlight the influence of male partners in implementation of effective risk reduction interventions.

Adult↗
PubMed2003

Encouraging HIV risk-reduction behaviors and testing with people experiencing homelessness.

In keeping with the Cafés philosophy of reciprocal transformation, the students and guests both were effected and changed by the encounter. The guests actively participated in the intervention, discussed HIV risk-reduction behaviors, and shared their knowledge with others. Participation in the onsite HIV testing project increased, and the guests, Café staff, and the program coordinator of the agency providing HIV testing expressed gratitude for the student intervention. The students were effected as well. Although all of the students had seen people who were homeless, none had had a sustained encounter with this population. Most students entered the experience uneasy. Some were fearful or had negative stereotypical impressions. As the students spent time with the guests and shared stories, they grew more at ease, and a feeling of connection developed. The students began to know more about the guests in terms of place, family, and abilities, not just their 'homeless' label. The students commented: Having been raised in an upper middle class environment most of my life, spending time in this type of community is something that I had little experience with. [I have a] greater awareness of the [need] for serving as an advocate. Through interaction at the Café [my] stereotypes of the homeless were proven incorrect. I know I will not take my own life and my living situation for granted ever again. The intervention provided experiences [that] cannot be measured. ...relationships were formed and hearts touched. I don't want to leave. I want to come back. These comments suggest the students had their eyes opened in new ways and left with a deeper connection to and understanding of the guests and people living at the edges of society.

Adult↗
PubMed2006

Personality traits, perceived risk, and risk-reduction behaviors: a further study of smoking and radon.

Personality traits and risk perceptions were examined as predictors of changes in smoking behavior. Participants (N = 697) were part of a randomized controlled trial of interventions to reduce exposure to the combined hazard of radon and cigarette smoke. Participants with higher perceived risk at baseline for the combination of smoking and radon were more likely to have a more restrictive household smoking ban in place at 12-month follow-up (p < .05). Risk perceptions also predicted reductions in the total number of cigarettes smoked in the home for participants in the video intervention who had high or moderate levels of extraversion (p < .01). Greater perceived risk predicted whether highly or moderately conscientious women quit smoking (p < .05). The moderating effects of personality traits should be considered when evaluating risk-reduction interventions.

Female↗
PubMed2006

Risk reduction behaviors and provider communication following genetic counseling and BRCA1 mutation testing in an African American kindred.

Little is known about the impact of cancer genetic counseling and testing on health behaviors in racial and ethnic subgroups. This prospective observational study examined use of risk reduction strategies following BRCA1 counseling and testing. Participants were female members of an African American kindred who received genetic education, counseling and testing (n = 40) and completed a 1-year follow-up interview. Mutation carriers were more likely to opt for breast (100%, 7/7) and ovarian (25%; 1 of 4) cancer surveillance than prophylactic surgery. Following genetic counseling, 71% (5/7) of the BRCA1 carriers who opted for surveillance reported having a mammogram within the year following receipt of their genetic test results. Ovarian cancer screening among mutation carriers increased from 0% at baseline to 25% (one of four) at 1 year. Compared to noncarriers (23%, 7/30), carriers (70%, 7/10) were more likely to discuss their BRCA1 test results with their primary health care providers. Surveillance for breast cancer was preferred to prophylactic surgery and chemoprevention as a way to reduce risk for these cancers. Our data indicate that patient-provider communication about BRCA1 test results is suboptimal.

Adult↗
PubMedDate not supplied

A conceptual explanation of risk-reduction behavior and intervention development.

This study used a new conceptual model of health behavior to examine a specific risk-reduction response. Known to be at risk for fetal abnormalities because of maternal age, 203 women were examined for their acceptance or rejection of an amniocentesis test on the basis of individual characteristics and external significant factors. The multivariate approach to analysis offered a fuller explanation for nonuse of prenatal diagnosis than was previously available. In addition to specific client factors, environmental factors such as financial support for the procedure, multiple information sources, social support, and aspects of the client-provider interaction were determined to be important in explaining client acceptance or rejection of the test. More importantly, the study demonstrated the advantages of using a conceptual model to direct the development of interventions.

Abortion, Induced↗
PubMed2004

Cancer risk-reduction behaviors of breast cancer survivors.

Using secondary data analysis, the aim was to determine if postmenopausal women, who have survived breast cancer, have adopted healthy nutritional and physical activity behaviors recommended in the American Cancer Society guidelines as cancer risk-reduction strategies, and in guidelines for prevention of other chronic diseases or for improving general health. From their personal health history, women who have survived breast cancer would be likely candidates to adopt healthy behaviors recommended as cancer risk-reduction strategies or for prevention of other chronic diseases. A secondary aim was to determine the perceived general health and affective state of these women. These breast cancer survivors had a high perception of their general health, a positive affective state, and have adopted some healthy lifestyle behaviors, but they are not fully adhering to the ACS nutrition and physical activity guidelines or other health related guidelines for cancer risk reduction or prevention of other chronic diseases.

Adult↗
PubMed1991

HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis.

BACKGROUND AND PURPOSE: Peer norms influence the adoption of behavior changes to reduce risk for HIV (human immunodeficiency virus) infection. By experimentally intervening at a community level to modify risk behavior norms, it may be possible to promote generalized reductions in HIV risk practices within a population. METHODS: We trained persons reliably identified as popular opinion leaders among gay men in a small city to serve as behavior change endorsers to their peers. The opinion leaders acquired social skills for making these endorsements and complied in talking frequently with friends and acquaintances. Before and after intervention, we conducted surveys of men patronizing gay clubs in the intervention city and in two matched comparison cities. RESULTS: In the intervention city, the proportion of men who engaged in any unprotected anal intercourse in a two-month period decreased from 36.9 percent to 27.5 percent (-25 percent from baseline), with a reduction from 27.1 percent to 19.0 percent (-30 percent from baseline) for unprotected receptive anal intercourse. Relative to baseline levels, there was a 16 percent increase in condom use during anal intercourse and an 18 percent decrease in the proportion of men with more than one sexual partner. Little or no change was observed among men in the comparison cities over the same period of time. CONCLUSIONS: Interventions that employ peer leaders to endorse change may produce or accelerate population behavior changes to lessen risk for HIV infection.

Community Participation↗
PubMedDate not supplied

The feasibility of behavioral risk reduction in primary medical care.

This prospective study evaluated changes in patients' health-risk behavior one year after preventive intervention by primary care physicians. The trial used a quasiexperimental design with 2,218 adults (1,409 study subjects and 809 controls) at five multispecialty, group practice sites in three regions of the United States. Pre- and postintervention surveys showed that the treated study patients with behavioral risks were more likely to report positive changes than were controls in regard to beginning regular exercise (P = .02), using auto seat belts, (P less than .001), losing weight (P = .05), decreasing alcohol intake (P = .01), and to performance of monthly breast self-examination by women (P less than .001). The smoking cessation rate was greater among the treated study group compared with the controls, although the change was not significantly different. Greater behavioral risk changes also occurred among the total study group (treated and untreated) in comparison with the control group. An additive index of these behavioral risks showed greater reduction among the treated and the total group of study patients compared with controls. These initial results suggest that clinical preventive services, which include risk factor education and counseling by primary care physicians, can improve short-term health-related behavior of patients.

Adolescent↗