助推手卫生的行为干预策略

保持手卫生是感染防控的重要策略,但是如何提高其依从性成为预防传染性疾病和减少医疗机构获得性感染的一大挑战。以行为科学为基础的手卫生助推干预以更“隐性”的方式将洗手转变为一种可自动触发的行为习惯,弥补了以知识分享和健康宣教为主的传统手卫生干预策略的诸多局限性。基于影响机制的不同,手卫生助推干预策略可分为提供决策信息、优化决策选项、影响决策结构、提醒决策方向4个大类的框架体系。多模式助推策略的有效性也已在实践中得到印证,但目前还非常缺乏在中国社会文化情境下开展的助推洗手行为的干预研究,今后可尝试基于行为科学理论有针对性地在医院、学校和社区等公共场所开展此类干预研究和实践,为感染防控、疾病预防和改善公共健康做出相应的贡献。     

Keeping adolescents safe from harm: management strategies of African-American families in a high-risk community

In this study, we investigated changes in parents' use of restrictive and promotive management strategies from early to middle adolescence. We also examined the antecedents of these changes and their effects on adolescents' achievement and mental health. Longitudinal data included 50 African American adolescents and their parents living in a low-income school district. There were three major findings. First, parents, on average, used less restrictive and promotive management strategies from early to middle adolescence. Second, parents who experienced increased depressive symptoms reported using more restrictive management strategies from early to middle adolescence. Third, adolescents whose parents increased their use of restrictive management strategies experienced more anger and lower grade point averages, whereas adolescents whose parents increased their use of promotive management strategies experienced less anger, higher grade point averages, and less absences from early to middle adolescence. These findings suggest that increasing parents' use of promotive rather than restrictive management strategies may be more beneficial in supporting the academic achievement and mental health of adolescents living in high-risk neighborhoods.     

Parent-adolescent health conversations as action: Theoretical and methodological issues

Abstract

A qualitative research method based on action theory is proposed and illustrated for use in health psychology and health promotion research. Action refers to the goal-directed and intentional behaviors of individual and groups. Action theory has the advantage of using the perspectives provided by manifest behavior, internal processes, and social meaning in the analysis of action. In this article, the actions under consideration are the health-related conversations of parents and their adolescent children. The approach is premised on an understanding of health promotion as a family task constructed through actions such as conversations between family members. Health conversations in two parent-adolescent dyads are used to illustrate the method. The analysis includes the identification of goals, functional steps, and elements and their relation to the family health promotion project. Specific attention is paid to data gathering and analysis issues and their implications for health promotion research.     

Environment and Physical Activity Dynamics: The Role of Residential Self-selection

OBJECTIVES: Within the socio-ecologic framework, diet and physical activity are influenced by individual, interpersonal, organizational, community, and public policy factors. A basic principle underlying this framework is that environments can influence an individual's behavior. However, in the vast majority of cross-sectional and even the few longitudinal studies of this relationship, the question of whether individuals select their area of residence based on physical activity-related amenities is ignored. In this paper, we address a critical methodological issue: self-selection of residential location, which is generally not accounted for, and can significantly compromise research on the relationship between environmental factors and physical activity behaviors. METHOD: We define and discuss the problem of residential self-selection in the study of neighborhood influences on health and health behavior, review methods used to control for residential self-selection in the literature, and present our strategy for addressing this potentially important source of bias. CONCLUSION: Existing research has built our understanding of residential self-selection bias, but important gaps remain. Our strategy uses data from a longitudinal cohort study linked to contemporaneous environmental measures to create a multi-equation model system to simultaneously estimate residential choice, environmental influences on physical activity, and downstream health outcomes such as obesity and clinical cardiovascular disease risk factor measures.     

Health promotion from the perspective of social cognitive theory

Abstract

This article examines health promotion and disease prevention from the perspective of social cognitive theory. The areas of overlap with some of the most widely applied psychosocial models of health are identified. The models of health promotion and disease prevention have undergone several generational changes. We have shifted from trying to scare people into health, to rewarding them into health, to equipping them with self-regulatory skills to manage their health habits, to shoring up their habit changes with dependable social supports. These transformations have evolved a multifaceted approach that addresses the reciprocal interplay between self-regulatory and environmental determinants of health behavior. Social cognitive theory addresses the socio structural determinants of health as well as the personal determinants. A comprehensive approach to health promotion requires changing the practices of social systems that have widespread detrimental effects on health rather than solely changing the habits of individuals. Further progress in this field requires building new structures for health promotion, new systems for risk reduction and greater emphasis on health policy initiatives. People's beliefs in their collective efficacy to accomplish social change, therefore, play a key role in the policy and public health approach to health promotion and disease prevention.     

The Structure of Problem and Positive Behavior Among American Indian Adolescents: Gender and Community Differences

Using Problem-Behavior Theory as a framework, the latent structure of problem and positive behaviors was examined within a sample of 1,894 American Indian adolescents. Support was found for a two-factor second-order structure in which problem behaviors (antisocial behavior, alcohol use, drug use, and risky sexual behavior) and positive behaviors (school success, cultural activities, competencies, and community-mindedness) represented two relatively uncorrelated aspects of behavior. Hierarchical multiple regressions demonstrated that the positive behaviors construct contributed significant incremental construct validity in the statistical prediction of psychosocial outcomes, over and above the problem behaviors. In addition, the fit of the structure was examined across gender and the four participating communities. The importance of the inclusion of positive behaviors is discussed from the standpoint of both prevention/promotion activities and the communities' perceptions. Further recommendations are made for deeper understandings of community concerns and strengths in conducting preventive/promotive research efforts.     

A Social Ecological Approach to Investigating Relationships Between Housing and Adaptive Functioning for Persons with Serious Mental Illness

This paper seeks to advance mental health—housing research regarding which factors of housing and neighborhood environments are critical for adaptive functioning, health, and recovery for persons with serious mental illness (SMI). Housing and neighborhood environments are particularly important for persons with SMI because of the prevalence of poor housing conditions among this population. Most mental health—housing research has been limited by a focus on problems in environments and functioning. The paper seeks to expand the mental health—housing research agenda to consider protective factors that promote community integration and adaptive functioning. We provide an account of how social ecology theory transformed a research program, from examining individual risk factors to investigating the functioning of persons in the contexts of their housing and neighborhood experiences. The resulting housing environment framework—physical aspects of housing and neighborhoods, social environment of neighborhoods, and interpersonal relationships tied to housing—allows for identification of opportunities for health promotion and facilitation of participation in community-based settings. This program of research draws upon several methods to understand the social experience of persons with SMI living in community settings—survey research, qualitative interviews, Geographic Information Systems, participatory research, and visual ethnography. In this paper, we present how social ecology theory was instrumental in the development of new housing environment measures, the selection of appropriate research methods, and framing research questions that are building a new empirical base of knowledge about promoting adaptive functioning, health, and recovery for persons with SMI living in community settings.     

Psychologists in Academic Health Settings: Key Contributors to Dynamic Interplay Among Research, Clinical Practice, and Policy Domains

Psychologists in academic health systems are in a unique position to impact the dynamic interplay among research, clinical practice, and policy domains. In addition to their specialty expertise in psychopathology, particular types of physical illness and disease, and health promotion, psychologists have substantial knowledge of human behavior, refined scientific skills, knowledge and experience in the effective delivery of clinical services, strengths in written expression, and a collaborative orientation. This combination of strengths makes psychologists extremely well-suited for (a) interdisciplinary efforts to develop and implement evidence-based assessment and intervention strategies with biological, psychological, behavioral, and social components, and (b) leadership and advocacy efforts that impact the quality and availability of health care services.     

Motivational interviewing in health promotion: it sounds like something is changing.

Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been applied in public health, medical, and health promotion settings. This article provides an overview of MI, outlining its philosophic orientation and essential strategies. Major outcome studies are reviewed, nuances associated with the use of MI in health promotion and chronic disease prevention are described, and future directions are offered.     

Technology’s influence on physical activity and exercise science: the present and the future

Background and purpose. Research and application in the physical activity and exercise area are increasingly impacted by technology. The exponential growth of World Wide Web access and the proliferation of personal computers highlight the importance of this development. The purpose of this article is to discuss the current impact of technology on different aspects of physical activity interventions and potential future applications.Methods. Relevant literature is reviewed within each of the areas being discussed.Results and conclusions. Technology has contributed to a secular decline in physical activity; however, it allows a) the proactive recruitment of large populations, b) the individualization of interventions on a large scale, and c) the delivery of activity promoting interventions to large populations via differing channels. Support is emerging for individualized interactive physical activity interventions delivered to large samples. Yet-untested areas where technology may have a beneficial impact on physical activity adoption and maintenance are interactive TV and virtual reality. With the increased focus on environmental strategies, technology could also be used to modify home environments to facilitate incorporating physical activity into everyday life. Technology is also increasing its role in the business of physical activity/exercise. For example, web-based health sites are now listed on the stock market. Health and fitness centers are adopting high-tech entertainment capabilities to serve each client. Combining the individualized technology used in the adoption and maintenance research with the existing infrastructures in health and fitness centers could increase adherence within these centers. Currently, however, there is limited research and utilization of this technology for the promotion of physical activity and exercise at the population level.     

Smoking research: basic research, intervention, prevention, and new trends

Smoking is a behavior that is influenced by a variety of factors that cut across methodologies, disciplines, and content areas within health psychology. The present article is designed to show the diversity and richness of smoking research by examining smoking from four perspective: basic laboratory research, intervention, prevention and deterrence, and new directions in smoking research. Methodologies that were derived from such varied sources as psychopharmacology, behavioral pharmacology, behavior therapy, clinical psychology, public health and health promotion, and social and developmental psychology have been used to study the smoking problem. The subject populations in these investigations ranged from animal models, to the individual smoker attempting to quit, to communities involved in health promotion and public health approaches. Future research should seek to provide new and improved examples of interdisciplinary research within the field of health psychology to multidisciplinary approaches from the basic and applied sciences.     

Sexual behavior in young adulthood: a population-based twin study.

OBJECTIVE: With behavior genetic analyses of data from young adult twins, we evaluated theoretical perspectives that differentially emphasize biological dispositions, social/cultural factors, or universal pathways to explain individual differences in sexual behaviors. DESIGN: We fit biometric sex limitation models to three aspects of sexual behavior reported by 4,925 Finnish twins ages 23-27. MAIN OUTCOME MEASURE: From a postal questionnaire, we obtained self-report information on initiation/abstinence of sexual intercourse, onset age, and number of sexual partners. RESULTS: Genetic and non-shared environmental influences were significant for all three measures. There were trends for common environmental influences on initiation and, in females, age at first intercourse. Some differential effects in males and females were found. Results comparing onset age and number of partners among experienced twins from pairs concordant and discordant for initiation found genetic and environmental influences on initiation/abstinence overlapped those found for the other aspects of sexual behavior. CONCLUSIONS: These results document genetic variation in individual differences in sexual behavior of young adults. Incorporating genetic dispositions into integrated models of sexual behavior will facilitate more effective health promotion and risk taking intervention.     

Serious,Minor, and Non-Delinquents in Early Adolescence: The Impact of Cumulative Risk and Promotive Factors. The TRAILS Study

This study uses a social-ecological approach to the development of delinquency. The authors emphasize that a balance between eliminating risk and enhancing protection across domains is essential in reducing problems and promoting competence. The cumulative risk and promotive effects of temperament, family and school factors in preadolescence were examined on different groups of delinquents (based on self-report) in early adolescence. Data from the first two waves of the TRAILS study (N = 2,230) were used. The results provide evidence for a compensatory model that assumes main effects of risk and promotive factors on problem behavior. Accumulation of risks in preadolescence promoted being a serious delinquent in early adolescence, with the strongest effects for temperament. Accumulation of promotive effects decreased being a delinquent and supported being a non-delinquent. Furthermore, evidence is found for a counter-balancing effect of cumulative promotive and risk factors. Exposure to more promotive domains in the relative absence of risk domains decreased the percentage of serious delinquents. Our results did not support a protective model. Implications for prevention and intervention are discussed.     

The impact of a rural or urban context in eating awareness and self‐regulation strategies in children and adolescents from eight European countries

Complex relationships exist between eating behaviour and personal and environmental factors. Rural and urban geographic contexts seem to play a role in eating behaviour, and therefore deserve a deeper study. A healthy eating behaviour and the conditions that promote it are a major issue in the promotion of adolescent health. The study aims to investigate the associations between the area of residence (urban vs. rural), self‐regulation strategies (TESQ‐E) and eating behaviours among children and adolescents. A total of 11,820 adolescents (50.6% girls) participated in the study, with a mean age of 13.30 years (SD= 2.13). Nine countries (The Netherlands, United Kingdom, Poland, Portugal, Denmark, Romania, Germany, Finland and Belgium) completed a questionnaire in the school context, asking about the use of self‐regulation strategies, eating behaviour awareness/care and sociodemographic questions such as age, gender and residential area. Both areas of residence (urban vs. rural) are associated with eating awareness/care in Romania and Portugal, controlling for age, gender and self‐regulation strategies. In some European countries at least, and most probably around the world, health promotion should focus on an ecological approach that includes the understanding of the effect of both environmental factors and personal skills on eating behaviour/awareness.     

Toward a comprehensive model of physical activity

Background and purpose. Despite the widely acknowledged public health burden and years of individually based intervention approaches, physical inactivity remains a growing concern among industrialized nations. Interventions aimed at changing individual dispositions that increase physical activity generally result in small changes in behavior that dissipate within weeks. Correlational research testing theories and models focusing on these same individual dispositions explain, at best, 20–40% of the variance in physical activity. As a result, recent calls have been made for consideration of broader, multilevel, ecological approaches to physical activity promotion. The purpose of this article is to define a comprehensive model for understanding physical activity and consider future directions for research.Methods. Relevant literature is reviewed within each of the areas being discussed.Results and conclusions. Ecological models incorporate both intra- and extra-individual influences that may impact on individual physical activity. However, the role of extra-individual factors has not been clearly defined in current ecological models of physical activity. We present the theoretical background of ecological models of health behavior, and define an ecological model for physical activity promotion. This model portrays physical activity behavior as being influenced by interplay between environmental settings and biological and psychological factors. Further testing of this and existing ecological models of physical activity is recommended.     

Introduction to the special section on dissemination: dissemination research and research dissemination: how can we close the gap?

One of the greatest challenges facing health promotion and disease prevention is translating research findings into evidence-based public health and clinical practices that are actively disseminated and widely adopted. Despite the tremendous strides made in developing effective disease prevention and control programs, there has been little study of effective dissemination of evidence-based programs to and adoption by community, public health, and clinical practice settings. This special section provides a venue in which to highlight exemplary dissemination research efforts while also identifying limitations in research to date and framing important future research questions. This issue establishes a resource for investigators interested in dissemination research, with relevance to health psychology. In this sense, it can serve as a benchmark by which to examine subsequent progress. The 6 articles reflect the state of the science in dissemination research for the promotion and adoption of health behavior change interventions.     

Exploring gene-environment interactions: socioregional moderation of alcohol use.

Examples of gene-environment interaction in human behavioral data are relatively rare; those that exist have used simple, dichotomous measures of the environment. The authors describe a model that allows for the specification of more continuous, more realistic variations in environments as moderators of genetic and environmental influences on behavior. Using data from a population-based Finnish twin study, the authors document strong moderating effects of socioregional environments on genetic and environmental influences on adolescent alcohol use, with nearly a five-fold difference in the magnitude of genetic effects between environmental extremes. The incorporation of specific environmental measures into genetically informative designs should prove to be a powerful method for better understanding the nature of gene-environment interaction and its contribution to the etiology of behavioral variation.     

中国国民心理健康素养的现状与特点

本研究以系统的全国抽样调查方式, 了解我国国民心理健康素养现状。结果显示, 我国成年公众的心理健康素养总体处于中偏低水平; 其发展水平在地域、人口学分布上比较均衡; 在结构上, 公众心理健康素养的发展表现出心理健康维护和促进的素养高于心理疾病应对的素养, 自助的素养高于助人的素养两个特点。调查还发现, 个体心理健康素养中, 知识观念部分个体差异较大, 态度和习惯部分个体差异较小; 在心理健康素养的社会性影响因素方面, 社会经济地位是所考察变量中效应最大的因素, 且其对素养的知识观念方面影响较大, 对素养的态度习惯方面影响较小。调查结果提示, 要充分认识心理健康素养提升任务的艰巨性; 在实践策略上, 宜以提升心理疾病应对的素养作为当前的工作重点和突破口。     

Categories of environmental scenes

Environmental scenes are the settings in which human action occurs; since they constrain behavior, they are of interest to social, personality, and environmental psychologists. Scenes can also be viewed as a spatial generalization of objects, as well as the spatial contexts in which objects appear. As such, they are studied in perception and memory. Previous approaches to characterizing environments have relied on scaling techniques to yield a manageable number of dimensions or attributes by which environments can be compared. In contrast, the present research demonstrates development of a taxonomy of kinds of environmental scenes, where perceived attributes are obtained as a byproduct. A basic or preferred level of categorization in the taxonomy is also identified, based on measures of cognition, behavior, and communication. The basic level, for example, school, home, beach, mountains, corresponds to the level commonly used in the study of scene schemas in perception, memory, and environmental psychology, as well as to the level apparently most useful in other domains of knowledge concerned with environments, for example, architecture and geography.