Mass media and health promotion in Indian villages

The role of mass media and other psychosocial factors in forming intentions to acquire health-related information and promotion of actual health behaviors was examined in a field study involving 720 male and female residents in 28 villages of Uttar Pradesh, Bihar, and Madhya Pradesh. It was found that beliefs and attitudes toward health care, as well as some information-related needs, contribute in the formation of intentions. More specifically, the tendency to treat media as a source of stimulation and direction, learning, information, and tension-reduction together with positive attitudes explain 4% of variance in intention. Variance in actual health promotion behaviors and the use of media for health-related information is explained by the general impact of media together with other social factors such as social participation in community, anticipating changes in life situations, and taking initiative by acceptors. Attitude, intention, and behavior are related, but the link between them is mediated by other social factors. In order for mass media to be effective, reinforcement through interpersonal communication as well as change in environment are essential. Excessive reliance upon mass media without the coordinated support of formal and informal systems in the community may not be suitable for the promotion of health behaviors in rural India.     

Health locus of control and self-esteem as related to adolescent health behavior and intentions

A health behavior and attitudes questionnaire was administered to 246 fifth-grade and 265 sixth-grade students during class time. The questions included 20 children's health locus of control (CHLC) items reported by Parcel and Meyer (1978), 17 children's self-esteem (CSE) items modified from those reported by Coopersmith (1967), and questions concerning past and current behavior and future intentions with respect to cigarette smoking, alcohol use, and marijuana use. The results indicate that the relationships between dimensions of children's health locus of control and self-esteem and their behaviors and intentions are not large enough to suggest that intervention programs directed at the prevention of detrimental health behaviors focus on the enhancement of self-esteem or the internal locus of control. An appropriate test of the efficacy of such an approach requires a longitudinal rather than a cross-sectional study, monitoring changes in the levels of self-esteem and health locus of control and associated changes in health behavior.     

Psychological factors associated with maintenance of improved health behaviors in postcoronary patients

Multiple regression analyses of interview data determined whether certain behavioral, personality, and social support variables were associated with maintenance of changes in exercise, weight loss, and smoking cessation for a group of postcoronary patients. The results indicate that the psychological reactions to success or failure at one health behavior change, especially smoking, may affect the ability to maintain changes in other health behaviors. Also, the affective psychological sequelae to heart attacks may disrupt attempts to change health habits or may themselves be alleviated once successful health changes are achieved.     

Behavioral treatment of adult obesity: Attentional controls and a 2-year follow-up

This research included controls for both amount of extra-therapy attention focused on target behaviors and for quality and duration of attention provided during therapy. Two pairs of therapists each conducted one group for each of four experimental conditions: nonspecific therapy, nonspecific therapy + attention prompting, behavior therapy, behavior therapy + positive induction (procedures designed to maximize favorableness of expectancies). Sixty-five obese adults ( OVERWEIGHT = 52%) attended 12 weekly group sessions and 3-month and 2-yr follow-ups. Ratings of expectancies, credibility and therapist characteristics were equivalent in all experimental conditions. Attrition was low (9.7%) and Ss averaged 1–2 lb weight losses per week during treatment, while improving concurrently in eating habits, cardiovascular fitness and adjustment. However, only participants who were in groups conducted by the therapist pair which was rated especially ‘democratic’ maintained average weight losses at the 2-yr follow-up. These results demonstrate the potentially vital role of several ‘nonspecific’ factors in long-term outcomes associated with behavioral treatments for adult obesity.     

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.     

The effects of a brief time perspective intervention for increasing physical activity among young adults

Past research has demonstrated that health behavior is correlated with time perspective: long-term thinkers are more likely than short-term thinkers to engage in health protective behaviors and less likely to engage in health damaging behaviors. To date, however, no research has experimentally demonstrated that time perspective is causally related to health behavior. We designed a brief (three 1/2-h weekly sessions) time perspective intervention to enhance long-term thinking about physical activity and examined its efficacy among two samples of young adults who signed up for fitness classes at a university recreational facility. Participants were assigned to one of three conditions: time perspective intervention, goal-setting control intervention, and no-treatment control. In Study 1, physical activity levels were assessed at preintervention, at postintervention (3 weeks later), and at 10-week follow-up (7 weeks after completion of the intervention). Controlling for preintervention physical activity levels, time perspective participants reported increased levels of physical activity relative to both other groups at postintervention, and relative to the no-treatment group at 10-week follow-up. This study provides the first experimental evidence that the effects of health behavior interventions may be enhanced by increasing participants’ long-term time perspective, and that time perspective is causally associated with health behavior. Study 2 replicated some of the effects of Study 1 using a larger sample, a six-month follow-up interval, and improved measurement of outcome. Together Studies 1 and 2 suggest that time perspective is an important ingredient in interventions designed to promote physical activity.     

Measuring health status and quality of life in HIV and AIDS

Abstract

HIV can diminish quality of life profoundly, and it is important to understand and measure such effects of HIV and its treatments Although the term quality of life is commonly used, “health status” more accurately describes dimensions that are directly health related and that may be affected by traditional interventions. There is a substantial literature on general health status measurement, and several of the most established measures have been applied or adapted for use in HIV infected populations These measures include the Medical Outcomes Study health ratings, the Quality of Well-Being scale, and the Sickness Impact Profile. Cancer-specific measures such as the EORTC Quality of Life Core Questionnaire and the CARES have also been adapted. In the last three years, health status measures for HIV have been completed by several thousand patients, and have generally proved to be reliable and valid indicators of relevant clinical differences such as disease stage, numbers of symptoms, and other psychometic measures of disability and distress. Health status measures were included in a few completed clinical trials, and are being incorporated in a growing number of antiretroviral and antimicrobial studies. Health status measures provide the best way to evaluate psychosocial interventions directly aimed at improving patients' quality of life. Although challenges remain in further developing health status measures for HIV disease and in applying them, measurement of these concepts has proved to be both technically and operationally feasible. Measures of health status and quality of life can play an important role in the evaluation of clinical treatments in research studies, directing clinical treatment, assessing changes in health care delivery, and planning health care services.     

Mechanisms by which childhood personality traits influence adult health status: educational attainment and healthy behaviors.

OBJECTIVE: The purpose of this study was to test a life span health behavior model in which educational attainment and health behaviors (eating habits, smoking, and physical activity) were hypothesized as mechanisms to account for relations between teacher ratings of childhood personality traits and self-reported health status at midlife. DESIGN: The model was tested on 1,054 members of the Hawaii Personality and Health cohort, which is a population-based cohort participating in a longitudinal study of personality and health spanning 40 years from childhood to midlife. OUTCOME: Childhood Agreeableness, Conscientiousness, and Intellect-Imagination influenced adult health status indirectly through educational attainment, healthy eating habits, and smoking. Several direct effects of childhood traits on health behaviors and health status were also observed. CONCLUSION: The model extends past associations found between personality traits and health behaviors or health status by identifying a life-course pathway based on the health behavior model through which early childhood traits influence adult health status. The additional direct effects of personality traits indicate that health behavior mechanisms may not provide a complete account of relations between personality and health.     

Changes in health-promoting behavior following diagnosis with HIV: prevalence and correlates in a national probability sample.

Diet, exercise, smoking, and substance use patterns affect the course of illness and quality of life for people with HIV. In interviews with a national probability sample of 2,864 persons receiving HIV care, it was found that most had made health-promoting changes in one or more of these behaviors since diagnosis. Many reported increased physical activity (43%) and improved diet (59%). Forty-nine percent of cigarette smokers quit or cut down; 80% of substance users did so. Desire for involvement in one's HIV care and information seeking-positive coping were the most consistent correlates of change. Other correlates varied by health practice but included health status, emotional well-being, demographics, and attitudes toward other aspects of HIV care. Most people with HIV improve their health behavior following diagnosis, but more might be helped to do so by targeting these behaviors in future interventions.     

The effects of safety behaviors on health anxiety: an experimental investigation

The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n = 30) or control condition (n = 30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second week-long baseline period. Participants in the control condition monitored their normal use of safety behaviors. Compared to control participants, those in the safety behavior condition reported significantly greater increases in health anxiety, hypochondriacal beliefs, contamination fear, and avoidant responses to health-related behavioral tasks after the safety behavior manipulation. In contrast, general anxiety symptoms did not significantly differ between the two groups as a function of the manipulation. Mediational analyses were consistent with the hypothesis that changes in the frequency of health-related thoughts mediated the effects of the experimental manipulation on health anxiety. These findings suggest that safety behaviors are associated with increases in health anxiety, perhaps by fostering catastrophic thoughts about health. The implications of these findings for the conceptualization of hypochondriasis as an anxiety disorder are discussed.     

Predicting adolescent health complaints by personality and Behaviors

Abstract

In a sample of 97 male adolescents, individual differences in health complaints were predicted by personality traits and by self-reported health/risk behaviors. Anxiety and loneliness were measured at Times 1 and 2, and health locus of control, various behaviors and health complaints were assessed at the end of the two-year study. A causal model was specified, employing anxiety and loneliness as distal predictors, health locus of control and behaviors as proximal predictors of health complaints. It turned out that anxiety was the most powerful single predictor, and that loneliness exerted a direct effect on health locus of control and behaviors and an indirect effect on health complaints. Risk behavior as well as health behavior were related to complaints. Social integration facilitated not only health behavior but also risk behavior.     

Adolescent girls' and boys' weight-related health behaviors and cognitions: associations with reputation- and preference-based peer status.

In this study, the authors examined associations between preference- and reputation-based peer status and weight-related behaviors and cognitions for both adolescent boys and girls. Sociometric measures of peer like-ability and peer-perceived popularity, as well as self-reported measures of body size, dieting behavior, and weight-related cognitions were collected from a sample of 441 adolescents in Grades 11 and 12. Results revealed weight-related cognitions for girls (concerning obesity) and boys (concerning musculature/fitness). Peer-perceived popularity, but not like-ability, was significantly associated with both boys' and girls' body size and dieting. Lower levels of popularity were associated with heavier body shapes for girls and with both thin and heavier body shapes for boys. Findings suggest that peer status is an important source of social reinforcement associated with weight-related behaviors and cognitions.     

Types of inconsistency in health-state utility judgments

In making judgments of health-related quality of life, respondents often compare the relative magnitude of two intervals between health states, such as the interval between normal health and blindness compared to that between normal health and death. We examined two ways of comparing such intervals: person-trade-off (PTO)—in which the judgment concerns matching numbers of people so that two changes are equivalent—and direct judgment of the ratio. Both measures showed ratio inconsistency (a ratio that should be the product of two other ratios is too high) and superadditivity (two ratios that should add to 1 are too high). Some responses in both methods implied that two intervals which should have been different (because they shared a top or bottom point, but differed on the other point) were nevertheless viewed by subjects as being of equal size. These equality responses were more common when death was the bottom (worse end) of both intervals being compared (e.g., the interval between death and blindness is perceived as being the same size as the interval between death and normal health) than when any other condition was at the bottom or when the condition common to the two intervals was at the top. A second experiment indicated that subjects really do consider the intervals to be equal. Our findings argue for giving subjects a chance to reflect on such apparent inconsistencies in practical utility elicitation.     

The dimensionality of cognitive appraisal and its relationship to physical and psychological well-being

In current adjustment models, an individual's appraisal of life events has been included as an important determinant in the stress-illness process. In particular, these events have been defined in terms of a variety of unidimensional concepts, such as desirability, controllability, or as having the potential for threat or challenge. The present study investigated the multidimensional nature of cognitive appraisal and its relationship to physical and psychological well-being. Residents of a Canadian community (N = 184) responded to an extensive survey on life-event stress, appraisal, alcohol consumption, health status, and depression. A principal-axis factor analysis of 19 appraisal dimensions revealed five factors accounting for 60% of the variance: Undesirability/Threat, Gain/Challenge, Need for Information, Familiarity, and Need to Accept. Entered with total number of life events and coping behavior as predicted aspects of well-being.     

Determinants of health knowledge: an investigation of age,gender, abilities,personality, and interests

Ten areas of health knowledge were investigated in 2 studies, 1 of college students (N = 169) and 1 of adults from the community (ages 19-70; N = 176). Measures assessed knowledge of aging, orthopedic/dermatological concerns, common illnesses, childhood/early life, serious illnesses, mental health, nutrition, reproduction, safety, and treatment of illness/disease. Significant gender differences favoring women were found for most areas of health knowledge, especially reproduction and early life. Results showed that cognitive ability accounted for the most variance in health knowledge with nonability (personality and interest traits) and demographic variables accounting for smaller but significant amounts of variance across most knowledge domains.     

Relationships between health behaviors,posttraumatic stress disorder,and comorbid general anxiety and depression

Poor health outcomes associated with posttraumatic stress disorder (PTSD) may reflect engagement in unhealthy behaviors that increase morbidity risk and disengagement in healthy behaviors that decrease morbidity risk. Although research supports this pattern, findings are not definitive, particularly for healthy behaviors. Many studies have not controlled for effects of concurrent generalized anxiety and depression, which might explain conflicting findings. To address this limitation, we used an online cross-sectional research design and multivariate multilevel modelling to evaluate associations between a multitude of health behaviors (i.e. sedentary behavior, sleep quality, physical activity, eating habits, alcohol use and substance use) and PTSD, while adjusting for comorbid generalized anxiety and depression, in a sample of trauma-exposed individuals (N = 246). Our results indicate that PTSD and comorbid generalized anxiety and depression symptoms were differentially associated with specific health constructs. Specifically, sedentary behavior and poor sleep quality were associated with PTSD, whereas low physical activity, poor sleep quality, and unhealthy eating habits were associated with depression. Both increased alcohol and substance use were associated with generalized anxiety. Results from our study highlight the need to conceptualize associations between health behaviors and specific psychological symptoms in a comprehensive manner as part of clinical presentations of PTSD.     

Changes in Developmental Contexts as Predictors of Transitions in HIV-Risk Behaviors Among Young Men Who Have Sex with Men (YMSM)

Emerging adulthood is a transitional time often marked by instability in many areas of life, including residential status, work, school, and romantic relationships. The purpose of this study is to examine transitions in HIV-risk related behaviors among a cohort of ethnically-diverse young men who have sex with men (YMSM) and to reveal how changes in developmental contexts during emerging adulthood might be associated with these behavioral changes. Hidden Markov models were used to examine movement across different stages of behavioral risk-taking over time. Semi-annual surveys were administered across 2 years; analyses included those with at least three of the five waves of data. Results indicated substantial movement at the individual-level transitions. Additionally, high variability in sexual risk, alcohol misuse, and illicit drug-risk behaviors was predicted by age, ethnicity, and correlates of emerging adulthood, such as residential status, work, post-secondary school enrollment, and primary-relationship status. Findings provide evidence of great change in risky behaviors among YMSM during this pivotal time, particularly among those who actively experiment in varying levels of risk-taking. In order to prevent experimental behaviors from evolving into more serious risk, interventions must consider ways to assist YMSM to adjust to life changes brought on by emerging adulthood.     

Coparenting Quality Mediates the Association Between Intimate Partner Violence and Child Behavior Problems in Low-income,Racial and Ethnic Minority Families

Exposure to intimate partner violence (IPV) in the family context has detrimental effects for children’s physical health and psychological adjustment. The current study examined the direct links between IPV and children’s externalizing and internalizing behavior problems and the indirect effect of coparenting quality as reported by a sample of 79 (80% African American, 11% Latina, and 9% Multiracial/Other), low-income mothers of children aged 2–12 years, the majority of whom were not in a romantic relationship (61%) or cohabitating with their child’s biological father (64%). Results indicated that IPV history was directly associated with higher rates of internalizing behaviors, but not with externalizing behaviors. Coparenting quality mediated the association between IPV and child externalizing and internalizing behaviors, when controlling for parent relationship status, such that IPV history was associated with lower levels of coparenting quality, which was associated with higher rates of child behavior problems. Findings highlight the importance of culturally appropriate self-report measures of coparenting and implications of IPV in racially and ethnically diverse low-income families on child adjustment.

     

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.     

Unmitigated communion and health among adolescents with and without diabetes: the mediating role of eating disturbances

The authors examined the implications of unmitigated communion--a focus on others to the exclusion of the self--for psychological and physical health among adolescents with (n = 132) and without (n = 131) diabetes times/during a 1-year period. Unmitigated communion predicted greater psychological distress and lower levels of competence cross-sectionally and longitudinally, controlling for sex, pubertal status, and communion. Health status moderated some longitudinal relations, such that relations held only for adolescents with diabetes. In addition, unmitigated communion was associated with poor metabolic control and predicted a deterioration in metabolic control over the year for adolescents with diabetes. Unmitigated communion also was associated with disturbed eating behavior cross-sectionally and longitudinally, and disturbed eating behavior explained some of the relations of unmitigated communion to psychological but not physical health outcomes.