Conditional health threats: health beliefs, decisions, and behaviors among adults.

We combined the health belief model with the theory of subjective expected utility to derive hypotheses about the relations among health beliefs and preventive decisions. The central implication of this combination of theories is the importance of conceptualizing, measuring, and communicating about health threats in ways that are clearly conditional on action. It is important to distinguish, for example, between how susceptible to a disease a person thinks he or she would be if that person were and were not to take a preventive action. An experimental study of judgments about a hypothetical preventive action was conducted to test many of the theoretically derived hypotheses. A correlation study of dental flossing behavior was conducted to test the hypotheses as they apply to overt behavior rather than to judgment. Results of both studies supported most of the tested hypotheses, especially those related to the conditional conceptualization of health threats. Implications for theory, research methods, and practical applications are discussed.     

Physical activity: the relative associations with cognitive and affective risk beliefs

Abstract

Objective: The role of affectively oriented risk beliefs in explaining health behaviors has not been examined in the context of physical activity or in diverse study populations. We evaluated whether affective risk beliefs account for unique variance in physical activity intentions and behavior above and beyond that accounted for by cognitive risk beliefs.

Design: A cross-sectional survey of socio-demographically diverse US residents (N?=?835; 46.4% no college training; 46.7% minority racial/ethnic ancestry; 42.6% men).

Main outcome measures: Physical activity intentions and behavior.

Results: Hierarchical linear regressions showed that affective risk beliefs accounted for variance in physical activity intentions beyond that predicted by socio-demographics and cognitive risk beliefs (F-change ps<.001). Specifically, intentions were higher among people with higher anticipated regret (ps<.001) and with higher absolute feelings of risk (ps<.05) or worry (ps<.05). There was an indirect relationship between perceived absolute likelihood and intentions through anticipated regret and feelings of risk. Neither cognitive nor affective risk beliefs accounted for variance in physical activity behavior (F-change ps>.05), but unsurprisingly, behavior was positively associated with physical activity intentions (p<.001).

Conclusion: Future interventions could target affective risk beliefs—particularly anticipated regret—to increase intentions, and then add other intervention components to bridge the intention–behavior gap.     

The relationship between instrumental and expressive traits,health behaviors,and perceived physical health

Relations between instrumental and expressive traits, health behaviors, and self-reported physical health were examined among young adults. Individuals (169 men, 167 women) completed two measures of instrumental and expressive traits, the Bem Sex Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ). Ethnic background of the sample included 72% European Americans, 13% Latin Americans, 6% Asian Americans, 5% African Americans, less than 1% Native American, and 4% did not specify a particular category. Expressive traits from the BSRI, and expressive and instrumental traits from the PAQ were associated with health behaviors, after controlling for neuroticism. Neuroticism explained 43% of the variance in perceived physical health. Separation of individuals into four groups on the basis of instrumental and expressive traits showed that androgynous individuals reported significantly better health practices than other individuals providing support for the androgyny model.     

The role of social cognition models in predicting attendance at health checks

Abstract

The present study sought to apply the Health Belief Model and the Theory of Planned Behaviour to the prediction of attendance at health checks. In addition, the way in which patients were invited to the health checks and the effect this had on both the uptake of the service and the role of cognitive factors in predicting attendance was analysed. Based in a single general practice, 818 patients were either sent an invitation letter which included an appointment time or they were sent an open invitation to contact the practice to make their own appointment time. Prior to the commencement of the programme health belief questionnaires were sent to patients. The results of the study firstly showed that letters offering patients an appointment produced a much higher attendance rate (70%) than letters containing an open invitation (37%). Secondly, through stepwise discriminant function analyses, the predictors of attendance behaviour were found to vary according to how patients were invited. For patients sent an appointment, attenders were found to be more likely than non-attenders to place a high value on their health, to believe that their health is influenced by powerful others, that certain referent groups would advise them to attend, that attending would lead to positive outcomes and that motivational barriers would not prevent them from attending. For patients sent an open invitation, intention to attend and perceived control were found to be independent predictors of attendance behaviour. These results suggest that attendance at health checks may not be a homogeneous behaviour such that the beliefs which distinguish attenders and non-attenders may be seen to vary according to the way in which the service is offered.     

The impact of rape on women's sexual health risk behaviors.

This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N=102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and/or drugs during sex. The 2nd cluster (moderate risk) reported increases in frequency of sexual activity and number of partners but mitigated that risk with increased condom use. Survivors in the 3rd cluster (low risk) indicated that their sexual health behaviors had become much less risky postrape. An ecological model predicting cluster membership revealed that individual-level and contextual factors predict patterns of risk behaviors.     

Dimensions of acculturation: associations with health risk behaviors among college students from immigrant families

In the present study, we examined a bidimensional model of acculturation (which includes both heritage and U.S. practices, values, and identifications) in relation to hazardous alcohol use, illicit drug use, unsafe sexual behavior, and impaired driving. A sample of 3,251 first- and second-generation immigrant students from 30 U.S. colleges and universities completed measures of behavioral acculturation; cultural values (individualism, collectivism, and self-construal); ethnic and U.S. identity; and patterns of alcohol and drug use, engagement in potentially unsafe sexual activities, and driving while (or riding with a driver who was) intoxicated. Results indicate that heritage practices and collectivist values were generally protective against health risk behaviors, with collectivist values most strongly and consistently protective. Nonetheless, heritage identifications were positively associated with sexual risk taking for Hispanics. U.S. practices, values, and identifications were not consistently related to risk behavior participation. Results are discussed in terms of bidimensional approaches to acculturation, the immigrant paradox, and implications for counseling practice.     

Success strivings and their relationship to affective work behaviors: gender differences.

Gender differences in the importance of six life success dimensions and their relationships to job satisfaction, job involvement, and propensity to stay on the job were examined among 756 working women and men in southeast Florida. Results showed that the female participants rated family relationships, personal fulfillment, and security as more important success measures than their male counterparts did, and they rated status/wealth as less important. Professional fulfillment and security were not significantly different. The relationships between measures of success and work behaviors also varied significantly by gender, even after controlling for demographic and job position variables.     

Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997-2005.

OBJECTIVE: Beliefs about HIV treatment effectiveness and the impact of HIV treatments on HIV transmission risks were initially related to sexual risk-taking in the late 1990s when multidrug HIV treatments first became available. This study examined changes in beliefs about the effects of HIV treatment for preventing HIV transmission and their association to sexual risk behaviors between the years 1997 and 2005. DESIGN: Anonymous surveys were administered to a convenience sample of gay and bisexual men attending a large community event in Atlanta, Georgia in 1997 (N = 498) and again at the same community event in 2005 (N = 448). Analyses were performed for men living with HIV/AIDS and for men who have not been diagnosed with HIV/AIDS. MAIN OUTCOME MEASURES: Rates of unprotected anal intercourse in the previous 3 months. RESULTS: There were significant increases in high-risk sexual practices that coincided with increased beliefs that HIV treatments can reduce the chance of transmitting HIV. However, optimistic beliefs about the health benefits of HIV treatments decreased over the 8 years and were not related to risk behaviors. CONCLUSIONS: Beliefs about how HIV treatments impact HIV infectiousness remain associated with HIV transmission risk behavior and interventions targeting at-risk as well as HIV-positive men who have sex with men must directly address these beliefs and perceptions.     

Beyond smile dynamics: mimicry and beliefs in judgments of smiles

The judgment that a smile is based on "true," usually positive, feelings affects social interaction. However, the processes underlying the interpretation of a smile as being more or less genuine are not well understood. The aim of the present research was to test predictions of the Simulation of Smiles Model (SIMS) proposed by Niedenthal, Mermillod, Maringer, and Hess (2010). In addition to the perceptual features that can guide the judgment of a smile as genuine, the model identifies the conditions that the judgments rely on: (a) the embodiment of the facial expression and its corresponding state, and (b) beliefs about the situations in which genuine smiles are most often expressed. Results of two studies are consistent with the model in that they confirm the hypotheses that facial mimicry provides feedback that is used to judge the meaning of a smile, and that beliefs about the situations in which a smile occurs guides such judgments when mimicry is inhibited.     

Associations between multiple health risk behaviors and mental health among Chinese college students

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95%CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.     

Assessment of irrational health beliefs: relation to health practices and medical regimen adherence.

The purpose of the present research was to provide initial validation of the 20-item Irrational Health Belief Scale (IHBS). Study 1 included 392 undergraduate psychology students. Results from Study 1 suggested that the IHBS total score is internally consistent and stable over an 18-month time period. Greater health-related cognitive distortion (higher IHBS scores) was associated with weaker internal health locus of control beliefs, lower positive affectivity, stronger chance health locus of control beliefs, and greater negative affectivity. Most important, greater cognitive distortion was uniquely and significantly associated with a less positive pattern of health practices. Study 2 involved 107 individuals with Type I diabetes mellitus. Results indicated that higher IHBS scores were significantly associated with both objective (hemoglobin HbA1) and self-reported diabetic regimen adherence independent of trait neuroticism and conscientiousness.     

Black and white adolescent mothers' child-rearing beliefs and behaviors

A convenience sample of 99 Black and 63 White adolescent mothers participated in a study of child-rearing beliefs and behaviors. Attitudes toward child-rearing were assessed using a scale developed for low-income, Black adolescent mothers. The HOME was used by trained observers to record parenting behavior. The Black and White samples were comparable in terms of income, employment status, educa tion, and age. Black mothers were more likely than White mothers to advocate some authoritarian child-rearing techniques. Black and White mothers with desirable attitudes toward parenting and positive parenting behaviors exceeded the number expected on the basis of chance alone. Overall, Black mothers were not as punitively oriented in either words or deeds as depicted in sociological analyses. The results of this analysis point to the importance of recognizing diversity in parental attitudes and behavior both between and within racial groups in the broader context of the changing role of adolescent mothers in our society.     

Individual differences in self-assessed health: an information-processing investigation of health and illness cognition.

In 2 studies, the relation between measures of self-assessed health (SAH) and automatic processing of health-relevant information was investigated. In Study 1, 84 male and 86 female undergraduate students completed a modified Stroop task. Results indicated that participants with poorer SAH showed enhanced interference effects for illness versus non-illness words. In Study 2, 27 male and 30 female undergraduate students completed a self-referent encoding task. Results offered a conceptual replication and extension of Study 1 by confirming the specificity of the relation between SAH measures and automatic processing of health (vs. negative or positive general trait) information. These studies provide evidence that individual differences in SAH are reflected in schematic processing of health-relevant information.     

Health beliefs and breast examination behaviors: Analyses of linear structural relations

Abstract

A survey of 619 Detroit-area women was conducted in order to understand why women do or do not perform breast self-examination and obtain or not obtain professional breast examinations. The survey assessed these behaviors and women's beliefs about (a) their susceptibility to breast cancer, (b) the seventy or seriousness of breast cancer, (c) the benefits of breast examinations and (d) the costs or disadvantages of the examinations. Separate sets of questions measured seventy of breast cancer when it is treated (a) late (seventy-late) and (b) promptly (seventy-early). Predictions were derived by combining the health belief model with the theory of subjective expected utility. Path analysis supported most predictions of the combined theory. As predicted, high severity-late increased perceived benefit, high seventy-early decreased benefit, and perceived benefit mediated the effects of seventy on behavior. Implications for understanding health decisions, measuring health beliefs, and modifying health behaviors are discussed.     

The relationship of depression to health risk behaviors and health perceptions in Korean college students

The purpose of this study was to investigate the relationship of depression to health risk behaviors and health perceptions in Korean college students. The sample consisted of 434 students, ranging in age from 18 to 28 years, who were attending four universities in Korea. Data were collected using the Beck Depression Inventory, the Symptom Pattern Scale, and the Short Form Health Survey. Results indicate that the students were mildly depressed. The prevalence of alcohol consumption during the previous month was 84.6% and for smoking it was 33.6%. The majority of the students reported a low occurrence of symptoms of psychological distress and evaluated their health as either very good or good. The level of depression predicted alcohol consumption, symptom pattern, and physical health. Students who were more depressed reported more symptoms and perceived their health as worse compared with those who were less depressed. The students who were less depressed drank more alcohol. Depression did not predict smoking.     

Beyond risk and ambiguity: Deciding under ignorance

In this study, we examined the neural basis of decision making under different types of uncertainty that involve missing information: ambiguity (vague probabilities) and sample space ignorance (SSI; unknown outcomes). fMRI revealed that these two different types of uncertainty recruit distinct neural substrates: Ambiguity recruits the left insula, whereas SSI recruits the anterior cingulate cortex, bilateral inferior parietal cortex, and the lateral orbitofrontal cortex. The finding of unique activations for different types of uncertainty may not necessarily be predicted within the reductive approach of modern theories of decision making under uncertainty, because these theories purport that humans reduce more complicated uncertain environments to subjectively formed less complicated ones (i.e., SSI to ambiguity). The predictions of the reductive view held only for ambiguityaverse individuals and not for ambiguity-tolerant individuals. Consequently, theories of decision making under uncertainty should include individual tolerance for missing information and how these individual differences modulate the neural systems engaged during decision making. Supplemental materials for this article may be downloaded from http://cabn.psychonomic-journals.org/content/supplemental.     

Predicting attendance at health screening: Organizational factors and patients' health beliefs

The present study firstly considers the effectiveness of two invite methods. Three hundred and twenty-five patients aged between 30 and 50 were invited to attend a general health check either by letter or opportunistically during a routine consultation After six months the two invite methods had similar attendance rates, although the opportunistic method produced fewer patients at screening and was biased in favour of females. The study also examined the health beliefs of attenders (n = 98) and non-attenders (n = 33) who had been sent questionnaires based on the health belief model prior to the commencement of the screening programme. Discriminant analysis revealed attenders to be more likely to report cutting back on everyday activities when ill and to believe in the seriousness of high blood pressure and weight problems. Non-attenders were found to be more worried about the screening appointment. These findings have important implications for those who plan screening services.     

Embodied cognition and social consumption: Self-regulating temperature through social products and behaviors

Extant embodied cognition research suggests that individuals can reduce a perceived lack of interpersonal warmth by substituting physical warmth, and vice versa. We suggest that this behavior is self-regulatory in nature and that this self-regulation can be accomplished via consumptive behavior. Experiment 1 found that consumers perceived ambient temperature to be significantly lower when eating alone compared to eating with a partner. Experiment 2 found that consuming a cool (vs. warm) drink led individuals to generate more socially-oriented attributes for a hypothetical product. Experiment 3 found that physically cooler individuals desired a social consumption setting, whereas physically warmer individuals desired a lone consumption setting. We interpret these results within the context of self-regulation, such that perceived physical temperature deviations from a steady state unconsciously motivate the individual to find bodily balance in order to alleviate that deviation.