Health Behavior

Objective: To investigate the self-care practices of Malaysian adults with diabetes and sub-optimal glycaemic control. Methods: Using a one-to-one interviewing approach, data were collected from 126 diabetic adults from four settings. A 75-item questionnaire was used to assess diabetes-related knowledge and self-care practices regarding, diet, medication, physical activity and self-monitoring of blood glucose (SMBG). Results: Most subjects had received advice on the importance of self-care in the management of their diabetes and recognised its importance. Sixty-seven subjects (53%) scored below 50% in their diabetes-related knowledge. Subjects who consumed more meals per day (80%), or who did not include their regular sweetened food intakes in their daily meal plan (80%), or who were inactive in daily life (54%), had higher mean fasting blood glucose levels ( p = 0.04). Subjects with medication non-adherence (46%) also tended to have higher fasting blood glucose levels. Only 15% of the subjects practiced SMBG. Predictors of knowledge deficit and poor self-care were low level of education ( p = <0.01), older subjects ( p = 0.04) and Type 2 diabetes subjects on oral anti-hyperglycaemic medication ( p = <0.01). Conclusion: There were diabetes-related knowledge deficits and inadequate self-care practices among the majority of diabetic patients with suboptimal glycaemic control. Practice implications: This study should contribute to the development of effective education strategies to promote health for adults with suboptimal diabetes control.

Objective: Posttraumatic stress disorder (PTSD) has been linked to reduced heart rate variability (HRV), which is in turn a risk factor for cardiovascular disease and death. Although hyperarousal and anxiety are thought to underlie this association, behavioral health risks, including smoking, alcohol dependence, obesity, and sleep disturbance, represent potential mechanisms linking PTSD and HRV. Methods: To test this hypothesis, short-term laboratory-based and 24-hour ambulatory measures of HRV were collected from 227 young adults (18Y39 years), 107 of whom were diagnosed as having PTSD. Latent variable modeling was used to assess the relationship of PTSD symptoms with HRV along with potential behavioral health mediators. Results: PTSD symptoms were associated with reduced HRV (A = j0.21, p = .002). However, this association was reduced in models that adjusted for cigarette consumption and history of alcohol dependence and was rendered nonsignificant in a model adjusting for sleep disturbance. Independent mediation effects were deemed significant via bootstrapping analysis. Together, the three behavioral health factors (cigarette consumption, history of alcohol dependence, and sleep disturbance) accounted for 94% of the shared variance between PTSD symptoms and HRV. Abdominal obesity was not a significant mediator. Conclusions: These results indicate that behavioral factorsVspecifically smoking, alcohol overuse, and sleep disturbanceVmediate the association between PTSD and HRV-based indices of autonomic nervous system dysregulation. Benefits from psychiatric and psychological interventions in PTSD may therefore be enhanced by including modification of health behaviors. Key words: posttraumatic stress disorder, heart rate variability, cigarette smoking, alcohol dependence, sleep disturbance. PTSD = posttraumatic stress disorder; HRV = heart rate variability; SNS = sympathetic nervous system; PNS = parasympathetic nervous system; CAPS = Clinician Administered PTSD Scale; DTS = Davidson Trauma Scale; MDD = major depressive disorder; SDNN = standard deviation of all normal R-R intervals; TR index = triangular index; LF power = low-frequency power; HF power = highfrequency power; RRSD = standard deviation of normal-to-normal R-R intervals; RMSEA= root mean square error of approximation; CFI = comparative fit index; SRMR = standardized root mean square residual; CI = confidence interval.

The Transtheoretical Model (TTM) has gained widespread popularity and acceptance, yet little is known about its effectiveness as a basis for health behavior intervention. A systematic review was conducted in order to evaluate the effectiveness of TTM interventions in facilitating health-related behavior change. Thirty-five electronic databases, catalogues, and internet resources were searched for relevant studies. In addition, the bibliographies of retrieved references were scanned for further relevant publications and authors were contacted for further information where necessary. Thirty-seven randomized controlled trials, targeting seven health-related behaviors, satisfied the inclusion criteria. Overall, the methodological quality of trials was variable, and there was limited evidence for the effectiveness of stage-based interventions as a basis for behavior change or for facilitating stage progression, irrespective of whether those interventions were compared with other types of intervention or with no intervention or usual care controls. The theoretical and practical implications of these findings are discussed.

To determine (i) the extent to which recommended lifestyle healthy behaviors are adopted and the existence of positive attitudes to health; (ii) the relative influence of socio-demographic variables on multiple healthy lifestyle behaviors and positive attitudes to health; (iii) the association between healthy lifestyle behaviors and positive attitudes to health. Two distinct healthy behavioral measures were developed: (i) healthy lifestyles based on physical activity, no cigarette smoking, no/moderate alcohol drinking, maintaining a &quot;healthy&quot; weight and having no sleeping problems and (ii) positive health attitudes based on having positive emotional attitudes, such as: self-perceived good health status, being calm, peaceful and happy for most of the time, not expecting health to get worse and regular health check-ups. A composite healthy lifestyle index, ranging from 0 (none of behaviors met) to 5 (all behaviors met) was calculated by summing up the individual&#39;s scores...

Background: To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. Methods: A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. Results: The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (χ 2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. Conclusion: In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.

Purpose: The purpose of this article is to provide nurse practitioners (NPs) with an evidence-based counseling strategy for motivating patients to adopt healthier cardiovascular lifestyles and reduce their cardiovascular disease (CVD) risk. A comprehensive overview of motivational interviewing (MI), framed within the context of the transtheoretical model of change (TTM), demonstrates how primary care NPs can utilize this counseling approach to optimize cardiovascular outcomes in their patients. Data sources: Published original research and review articles in scholarly journals on the following topics: MI; advice giving; counseling techniques; TTM; CVD; quality NP care. Conclusions: Although the major risk factors for CVD are largely preventable, CVD rates are increasing to epidemic proportions. Traditional advice giving to decrease CVD risk is minimally effective. MI combined with TTM is an effective counseling technique, which motivates patients who are resistant and ambivalent to change. MI is an appropriate, evidence-based strategy to promote cardiovascular health. Implications for practice: NPs working in primary care can integrate MI with TTM into ongoing patient encounters to facilitate positive behavior changes in their patients over time. Thus, NPs can play a key role in decreasing the growing burden of CVD in North America. Cardiovascular disease (CVD) is a significant cause of morbidity and mortality in North America, affecting one in three Americans (American Heart Association [AHA], 2009; Centers for Disease Control [CDC], 2009). Most risk factors for CVD, including cigarette smoking, hypertension, dyslipidemia, diabetes, metabolic syndrome, atherogenic diet, obesity, and physical inactivity, are modifiable (AHA, 2009; Grundy, 2007). Poor diet and physical inactivity are especially important behaviors to address because they frequently lead to the more complex risk factors of obesity, diabetes, and metabolic syndrome (Jansink et al., 2009; Smith, van der Ploeg, & Buffart, 2008). While most risk factors for CVD can be prevented or reduced by lifestyle modification, the traditional approach of advice giving to stimulate behavior change is often ineffective and rarely results in sustained behavior change (Brodie & Inoue, 2004; Cifuentes et al.,

A central component of the primary health care approach in developing countries has been the development and utilization of community-based health workers (CHWs) within the national health system. While the use of these front line workers has the potential to positively influence health behavior and health status in rural communities, there continues to be challenges to effective implementation of CHW programs. Reports of high turnover rates, absenteeism, poor quality of work, and low morale among CHWs have often been associated with weak organizational and managerial capacity of government health systems. However, no systematic research has examined the contribution of work-related factors to CHW job performance. The research reported in this paper examines the relative influence of reward and feedback factors associated with the community compared to those associated with the health system on the performance of CHWs. The data are drawn from a broader study of health promoters (CHW...

The Paddington Alcohol Test (PAT) has evolved over 15 years as a clinical tool to facilitate emergency physicians and nurses giving brief advice and the offer of an appointment for brief intervention by an alcohol nurse specialist. Previous work has shown that unscheduled emergency department re-attendance is reduced by 'making the connection' between alcohol misuse and resultant problems necessitating emergency care. The revised 'PAT (2009)' now includes education on clinical signs of alcohol misuse and advice on when to request a blood alcohol concentration. B. Clinical Signs C. Blood Alcohol Concentration

Background: Suboptimal adolescent human papillomavirus (HPV) vaccine rates in the US highlight the need for catch-up vaccination. When teenagers enter college, there may be a shift in healthcare decision-making from parents and guardians to the students themselves. Little is known about factors influencing college students' healthcare decision-making processes. Study design: We evaluated HPV vaccine decision-making among 18-to-26-year-old college students through a self-administered, anonymous, cross-sectional survey. This survey was distributed to a sample of men and women in classroom settings at two universities. Categorical data comparisons were conducted using Chi-square and Fisher's exact tests. Multivariate Poisson regression was used to model initiation of HPV vaccine and compute prevalence ratios while controlling for key influential covariates at the 0.05 alpha level. Results: A total of 527 students participated (response proportion = 93.1%). Overall, 55.8% of participants received the HPV vaccine. Encouraging conversations with doctors and/or parents/guardians were identified as one of the most influential factors to increase vaccine uptake. Among students who received encouragement from both a doctor and parent, 95.8% received the vaccine. Campaigns about cancer prevention were viewed as more influential than those that focus on preventing genital warts. Approximately one-third of students indicated they didn't know where to get the HPV vaccine. Women were more likely to report that their parents would not let them get the HPV vaccine compared to men (26.7% vs. 2.3%). The majority of students (77.3%) indicated their parents were sometimes, equally, or mostly involved in making decisions about receiving vaccines (other than flu). Conclusion: Students' decision-making is greatly influenced by their parents; therefore, interventions for this population should work to increase students' control over decision-making while also addressing parental concerns.

The present study was designed to determine the prevalence of broken appointments of female and male patients scheduled for third, fourth, and fifth year dental students. Data was obtained from computers used for patient scheduling at two campuses of the dental college. The proportion of broken appointments at these facilities was computed using the X2 -test to determine a difference between males and females. Results showed that male patients (14.9%) had a higher proportion of broken appointments than female patients (12.4%). Such differences among gender was statistically significant (p=4.218). The highest percentage of broken appointments was during December of 2001. Thirty four percent of these broken appointments were in the Restorative Clinic at the Darraiyah Campus (DUC) serving primarily male patients and 24% in the Removable Partial Denture Clinic at the Malaz Campus (MUC) serving only female patients. It was concluded the percentage of broken appointment s is considered to...

Objectives. Current evidence shows that type 2 diabetes (T2D) can be prevented by lifestyle changes and medication. To meet the menacing diabetes epidemic, there is an urgent need to translate the scientific evidence regarding prevention of T2D into daily clinical practice and public health. In Finland, a national programme for the prevention of T2D has been launched. The programme comprises 3 concurrent strategies for prevention: the population strategy, the high-risk strategy and the strategy of early diagnosis and management. The article describes the implementation strategy for the prevention programme for T2D. Methods. The implementation project, FIN-D2D, is being conducted in 5 hospital districts, covering a population of 1.5 million, during the years 2003-2007. The main actors in the FIN-D2D are primary and occupational health care providers. Results. The goals of the project are (1) to reduce the incidence and prevalence of T2D and prevalence of cardiovascular risk factor levels; (2) to identify individuals who are unaware of their T2D; (3) to generate regional and local models and programmes for the prevention of T2D; (4) to evaluate the effectiveness, feasibility and costs of the programme; and (5) to increase the awareness of T2D and its risk factors in the population and to support the population strategy of

Few comprehensive studies exist that evaluate the nutrient intake and health indicators of college-aged students. This article describes the University of New Hampshire's Young Adult Health Risk Screening Initiative and examines results from participants evaluated from September 2005 through July 2007. This cross-sectional study included 1,701 students who enrolled in an introductory nutrition course, met age requirements (18 to 24 years), agreed to participate, and completed related assessments. All evaluation components were built into the semester-long course design, thus minimizing participant burden. Anthropometric measurements, blood lipids, blood glucose, and blood pressure were measured directly by research staff. Online dietary intake was self-reported and evaluated using a software program. Health risk data indicate high rates of overweight (33%), elevated low-density lipoprotein cholesterol (53%), and elevated systolic (47%) and diastolic blood pressures (39%). Less than 30 minutes of physical activity per day was reported by 28% of respondents. The majority of males (94%) and females (73%) exceeded sodium guidelines. Although females were less likely to be overweight than males, few met recommended intakes for vitamin D (26%), calcium (25%), potassium (35%), iron (31%), and folate (32%). Undergraduate and graduate dietetics students assisted with biological assessments, data entry, and record maintenance. Data inclusion rates ranged between 84% and 94% for various measurements. The methods employed in this study could be modified by institutions interested in profiling the health status of students. Results have led to an enhanced understanding of the nutrition practices and health status of this population and will serve to inform university programs and policies.

Background This study sought to assess the diet quality of individuals living with HIV/AIDS who were receiving antiretroviral therapy in São Paulo, Brazil. Methods This cross-sectional study involved 56 HIV-infected adults. Demographic and anthropometric data were collected, and diet quality was measured using the Healthy Eating Index (HEI), modified for Brazilians, which included ten components: adequacy of intake of six different food groups, total fat, cholesterol, dietary fibre and dietary variety. Results Among the individuals assessed, 64.3% of the participants had a diet needing improvement, while 8.7% had a poor diet. The overall HEI score was 68.3 points (SD = 14.9). Mean scores were low for fruits, vegetables, dairy products and dietary fibre; and high for meats and eggs, total fat and cholesterol. The overall HEI score was higher among individuals who were not overweight (P = 0.003), who were also more likely to achieve dietary goals for dairy products (P = 0.039) and grains (P = 0.005). Conclusion Most of these adults living with HIV/AIDS had diets that required improvement, and being overweight was associated with poorer diet quality. Nutritional interventions aimed at maintaining healthy body weight and diet should be taken into account in caring for HIV-infected people.

Introduction: This correlational study developed and tested theory to better understand positive health practices (PHPs) in middle adolescents. It tested theoretic relationships postulated between PHPs and (a) social support (SS), (b) optimism, and (c) loneliness, and between SS and the variables of optimism and loneliness. Optimism and loneliness were tested as possible mediators in the relationship between SS and PHPs. Method: A convenience sample of 204 middle adolescents was obtained. Participants completed a demographic sheet and four instruments. Results: There were statistically significant positive relationships between SS (r ϭ .44) and optimism (r ϭ .54) with PHPs. There was a statistically significant negative relationship between loneliness (r ϭ Ϫ.39) and PHPs. There was a statistically significant positive relationship between optimism (r ϭ .63) and SS. There was a statistically significant negative relationship between loneliness (r ϭ Ϫ.76) and SS. Optimism was found to partially mediate the relationship between SS and PHP; loneliness did not. Discussion: Findings contribute to a more comprehensive knowledge base regarding health practices in middle adolescents.

The latest socio-economical changes have had a great impact on the perception of health issues. The definition of health according to the WHO is often citied here as a kind of postulate of psychical, psychological and sociological well being. Health education takes an important part in propagating ideas of promoting and protecting health and also shaping life skills. Health education especially affects schools but it also has an impact on family and local community. Contemporary definitions of health education underline that it is also a process of learning how to take care of one&#39;s own health and that of others&#39;. This attitude to health corresponds with the changing health problems affecting society. Despite implementing many programs and actions promoting health and preventing diseases on a world and European scale, there still exist many problems in this area. They are particularly due to disproportionate access to medical help and technological development resulting from...

Lifestyle factors (eg, smoking, diet) and compliance with screening recommendations play a role in cancer risk, and emerging technologies (eg, new vaccines, genetic testing) hold promise for improved risk management. However, optimal outcomes from cancer control efforts require better preparation of health professionals in risk assessment, risk communication, and implementing health behavioral change strategies that are vitally important to cancer control. Although physician assistants (PAs) are substantively engaged in cancer-related service delivery in primary care settings, few models exist to facilitate integration of cancer control learning experiences into the curricula used in intense, fast-paced, 24- to 30-month PA training programs.

Objective: To assess the prevalence of risk factors and risk for cardiovascular disease and Type 2 diabetes in employees with sedentary occupations enrolled in a workplace health-promotion program. Methods: Participants (n = 762) were recruited from ten Melbourne workplaces, participating in a physical activity program. Demographic, behavioral, biomedical, and physical measurements were collected. Results: The majority of employees were not meeting recommended guidelines for physical activity (62%), fruit intake (70%), vegetable intake (86%), body mass index (58%), or waist circumference (53%). Most had intermediate (53%) or high (7%) risk of developing Type 2 diabetes. Conclusions: The majority of Australian adults in sedentary occupations were not meeting guidelines for a number of chronic disease risk factors and a substantial proportion were unaware of their increased risk. This study supports the potential of chronic disease risk factor detection and intervention programs in the workplace.

Background: Although research shows that religious involvement is associated with a wide range of individual health behaviors, it has yet to be determined whether the effect of religious involvement extends to an overall pattern of regular health practices that may constitute a lifestyle.Purpose: Building on prior research, we test whether religious individuals tend to engage in healthier lifestyles than individuals who are less religious.Methods: Using data collected from a statewide probability sample of 1,369 Texas adults, we estimate a series of ordinary least squares regression models to assess the net effect of religious involvement on overall healthy lifestyle scores.Results: The results of our study indicate that religious individuals do tend to engage in healthier lifestyles, and this pattern is similar for men and women and across race/ethnic groups. We also find some evidence to suggest that the association between religious involvement and healthy lifestyles may be less pronounced in old age.Conclusions: Assuming that religious involvement is associated with healthier lifestyles, additional research is needed to account for these patterns. Future studies should also consider whether healthy lifestyles may serve as a mechanism through which religious involvement might favor health and longevity.

Although socioeconomic status is a major contributing factor to health disparities, the mechanisms through which socioeconomic status influences health remain unclear. The purpose of the present study was to evaluate an a priori conceptual model of the pathways between socioeconomic status and modifiable health risk factors in a sample of 399 African Americans seeking smoking cessation treatment. A latent variable modeling approach was utilized to characterize the interrelationships among socioeconomic status, neighborhood disadvantage, social support, negative affect/perceived stress, and three specific modifiable risk factors (i.e., overweight/obesity, insufficient physical activity, at-risk drinking). Findings indicated that neighborhood disadvantage, social support, and negative affect/perceived stress function as pathways linking socioeconomic status and modifiable risk factors among African American smokers, and negative affect/perceived stress appears to play a key mediating role. Policy, community, and individual-level interventions may attenuate the impact of socioeconomic status on health by targeting intermediate psychosocial, environmental, and behavioral pathways.

Cost-effectiveness analyses are important tools in efforts to prioritise interventions for obesity prevention. Modelling facilitates evaluation of multiple scenarios with varying assumptions. This study compares the cost-effectiveness of conservative scenarios for two commonly proposed policy-based interventions: front-of-pack &#39;traffic-light&#39; nutrition labelling (traffic-light labelling) and a tax on unhealthy foods (&#39;junk-food&#39; tax). For traffic-light labelling, estimates of changes in energy intake were based on an assumed 10% shift in consumption towards healthier options in four food categories (breakfast cereals, pastries, sausages and preprepared meals) in 10% of adults. For the &#39;junk-food&#39; tax, price elasticities were used to estimate a change in energy intake in response to a 10% price increase in seven food categories (including soft drinks, confectionery and snack foods). Changes in population weight and body mass index by sex were then estimated ba...

Over the past decade, motivational interviewing has been used by health professionals to promote health behavior changes and help individuals increase their motivation or "readiness" to change. This paper describes a preliminary study used to evaluate the feasibility of motivational interviewing as a component in a school-based obesity prevention program, New Moves. New Moves is a program for inactive adolescent high school girls who are overweight or at risk for becoming overweight due to low levels of physical activity. Throughout the 18-week pilot study, 41 girls, aged 16-18 participated in an all-girls physical education class that focused on increasing physical activity, healthy eating and social support. Individual sessions, using motivational interviewing techniques, were also conducted with 20 of the girls to develop goals and actions related to eating and physical activity. Among the participants, 81% completed all seven of the individual sessions and girls set a goal 100% of the time. Motivational interviewing offers a promising approach as a component for school-based obesity prevention programs and was demonstrated to be feasible to implement in school settings and acceptable to the adolescents.

OBJETIVO: Analisar a idade e o uso do preservativo na iniciação sexual de adolescentes brasileiros em dois períodos: 1998 e 2005. MÉTODOS: Amostras representativas da população urbana brasileira foram entrevistadas em inquérito domiciliar por duas pesquisas, realizadas em 1998 e 2005. Dentre os entrevistados, 670 jovens (16 a 19 anos) sexualmente ativos foram selecionados para o estudo, 312 de 1998 e 358 de 2005. Para análise dos dados ponderados foram utilizados o teste qui-quadrado de Pearson e o teste exato de Fisher (α<5%). RESULTADOS: Em 2005, 61,6% dos jovens entrevistados tinham iniciado-se sexualmente, cuja idade média foi 14,9 anos, sem diferenças signifi cativas para os jovens entrevistados em 1998. O uso de preservativo na primeira relação sexual aumentou signifi cativamente em relações estáveis (48,5% em 1998 vs. 67,7% em 2005) e casuais (47,2% em 1998 vs. 62,6% em 2005) em quase todos os segmentos. Persistiram as diferenças relacionadas à iniciação sexual e ao uso de preservativos segundo gênero, cor da pele e escolaridade, tal como observado em 1998. A diminuição no uso de preservativo entre os jovens que se iniciaram sexualmente antes dos 14 anos, em todos os contextos de parceria, foi expressiva na região Sudeste e entre os mais escolarizados. CONCLUSÕES: Como em outros países, observou-se tendência à estabilização da idade da iniciação sexual entre jovens de 15 a 19 anos. O adiamento do início da vida sexual, mais freqüente entre os jovens mais escolarizados, deve ser tema discutido no planejamento da educação dos adolescentes para a sexualidade e prevenção das IST. Quanto à diminuição da vulnerabilidade ao HIV, é relevante e signifi cativo o incremento no uso de preservativo na iniciação sexual. ABSTRACT OBJECTIVE: To analyze age and condom use at fi rst sexual intercourse among Brazilian adolescents at two periods: 1998 and 2005. METHODS: Representative samples of the Brazilian urban population were interviewed during a household survey for two studies, carried out in 1998 and 2005. Interviewees included 670 sexually active young people (aged 16 to 19) who were selected for the study, 312 in 1998 and 358 in 2005.

Because of the increased emphasis on prevention and early detection of cervical cancer, we studied the effects of 2 educational methods on the knowledge, attitude, and practice, as regards prevention of cervical cancer, of women high school teachers in Tabriz. This study was a semiexperimental research. Samples were 129 female teachers divided in 3 groups: experimental 1 (educated by pamphlets), experimental 2 (educated by a lecture and flash cards), and control group (not manipulated). After doing pretest in the 3 groups, investigators used 2 educational methods for experimental groups. Data regarding the knowledge and attitude of 3 groups were gathered after 14 days and data regarding practice were gathered after 2 months. Chi-square and 1-way ANOVA were used for data analysis. Before education, knowledge, attitude, and practice of the 3 groups were the same, but after education there were significant differences in mean scores of knowledge and attitude of 2 experimental groups as compared with the control group and also between the 2 experimental groups (P &amp;amp;amp;lt; .001). Education by lecture and flash cards was more effective than by pamphlets. In regard to Pap smear practice, there was a significant difference between the 2 experimental groups as compared with the control group (P = .001), but there was no significant difference between the 2 experimental groups. Therefore, educational methods were effective on knowledge, attitude, and practice of teachers regarding prevention of cervical cancer and education by lecture and flash cards was more effective than by pamphlets in increasing knowledge and inducing a positive attitude but the 2 educational methods had the same effect on practice of teachers.

Adolescence is a critical time for developing lifelong healthy behaviors, including active lifestyles. Participation in sport and physical activity, however, declines during adolescence, and few studies have comprehensively identified why, particularly among rural girls. This article identifies a range of independent and interacting factors that influence sport and physical activity participation of rural adolescent girls. The socioecological model of health was used to guide four focus group discussions with Grade 7 girls (n = 34). The results showed that adolescent girls were positively influenced when sports or physical activities were fun, when they involved being with friends, and when they were supported by families and teachers through role modeling and positive feedback. A range of intrapersonal and organizational factors affected perceived self-competence, particularly the coeducational nature of school physical education classes and peer teasing, which supported social comparisons of skill level. In promoting sport and physical activity to rural adolescent girls, focus must be directed on developmentally appropriate activities that are fun, offering opportunities for single-sex classes, and generating cultural changes that encourage noncompetitive and selfreferencing activities.

Background-Self-efficacy and the use of self-regulatory strategies are consistently associated with physical activity behavior. Similarly, behavioral inhibition and cognitive resource allocation, indices of executive control function, have also been associated with this health behavior.

The social and economic burden of osteoporosis is important since it concerns a continuously aging population, while the disease is silent until the emergence of fractures. Aim of the study was to assess female population knowledge about osteoporosis risk factors and to identify the risk factors of the studied population. A sample of 99 (aged: 61.59+/-9.61 years) women under treatment for osteoporosis or osteopenia answered the questionnaire provided by their pharmacists and were included in the study&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s analysis. Various parameters on osteoporosis awareness and risk factor knowledge of the population sample studied were analyzed. It was revealed that 96% of the participants knew osteoporosis definition and sources of this knowledge were one or more of the following: doctors (86.3%), mass media (20%) and friends or relatives (13.7%). It was found that the older age was associated with less knowledge (OR=0.93, CI: 0.88-0.97, p=0.004), and higher education with increased knowledge (OR=1.68, CI: 1.10-2.55, p=0.014) about osteoporosis. 56.4% of the participants were aware of at least one osteoporosis risk factor. In multivariate analysis, it was revealed that the participants who referred increased milk products consumption in childhood (OR=3.72, CI: 1.34-10.36, p=0.012) and current performance of physical activity (OR=13.06, CI: 3.22-53.05, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) were more likely to be informed about osteoporosis risk factors; age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;61 years was associated with decreased knowledge of risk factors (OR=0.27, CI: 0.09-0.82, p=0.018). This study implies that a higher degree of participant&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s health education may result in the avoidance of osteoporosis risk factors. Increasing knowledge of osteoporosis should be a priority for future intervention programs in order to promote specific behavioural strategies for osteoporosis prevention.

The current study investigated biopsychosocial resilience in an older adult caregiver. A case study was selected for in-depth exploration of resilience in caregiving identified through biopsychosocial (i.e., salivary cortisol) methods. An exemplar of a woman caring for an adult child dying from a genetic disease is presented in the context of multiple stressors. Significant stress was found to be buffered by cognitive reframing and acceptance of interpersonal limits. Early experiences in caregiving for others with terminal illnesses provided a frame of reference, and difficult family dynamics added a layer of complexity. During periods identified as stressful, cortisol levels rose outside of normal bounds. The study implications are that mixed-methods (i.e., biopsychosocial) studies yield important results on individual differences within similar contexts. [Res Gerontol Nurs. 2015; 8(1):29-38.].

There is limited information about African American students attending Historically Black Colleges and Universities (HBCUs) in the areas of health behavior, health knowledge, and attitudes. To fill this gap, a comprehensive examination of first-year students was undertaken at a consortium of HBCUs. A non-random sample of 1,115 freshmen were administered a survey that assessed several domains including: (1) demographics, (2) general health, (3) smoking habits, (4) disease risk, (5) weight perception, (6) physical activity, (7) perceived stress, (8) eating habits, (9) social support, (10) personal/family medical history, (11) leadership, (12) domestic violence, (13) substance use, and (14) sexual behavior. In general, most students knew about health behaviors and disease risk. Areas that warrant further exploration include physical activity, sexual behavior, and drug use. The analyses provide key information for health education and prevention.

To address major societal challenges and enhance cooperation in research across Europe, the European Commission has initiated and facilitated 'joint programming'. Joint programming is a process by which Member States engage in defining, developing and implementing a common strategic research agenda, based on a shared vision of how to address major societal challenges that no Member State is capable of resolving independently. Setting up a Joint Programming Initiative (JPI) should also contribute to avoiding unnecessary overlap and repetition of research, and enable and enhance the development and use of standardised research methods, procedures and data management. The Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub (KH) is the first act of the European JPI 'A Healthy Diet for a Healthy Life'. The objective of DEDIPAC is to contribute to improving understanding of the determinants of dietary, physical activity and sedentary behaviours. DEDIPAC KH is a multi-disciplinary consortium of 46 consortia and organisations supported by joint programming grants from 12 countries across Europe. The work is divided into three thematic areas: (I) assessment and harmonisation of methods for future research, surveillance and monitoring, and for evaluation of interventions and policies; (II) determinants of dietary, physical activity and sedentary behaviours across the life course and in vulnerable groups; and (III) evaluation and benchmarking of public health and policy interventions aimed at improving dietary, physical activity and sedentary behaviours. In the first three years, DEDIPAC KH will organise, develop, share and harmonise expertise, methods, measures, data and other infrastructure. This should further European research and improve the broad multi-disciplinary approach needed to study the interactions between multilevel determinants in influencing dietary, physical activity and sedentary behaviours. Insights will be translated into more effective interventions and policies for the promotion of healthier behaviours and more effective monitoring and evaluation of the impacts of such interventions.

Shipping companies were surveyed to evaluate the effect of public health measures during the influenza A (H1N1) pandemic of 2009 on ship and port operations. Of 31 companies that operated 960 cruise, cargo, and other ships, 32% experienced health-screening measures by port health authorities. Approximately a quarter of ports (26%) performed screening at embarkation and 77% of shipping companies changed procedures during the early stage of the pandemic. Four companies reported outbreaks of pandemic influenza A (H1N1) 2009 on ships, which were ultimately stopped through infection control practices. Public health measures did not interfere substantially with port and ship operations with the exception of some port authorities that delayed embarking and disembarking procedures in a few ships. However, in the shipping companies&#39; experience, measures were inconsistent between port health authorities. Access to antiviral drugs and pandemic vaccine was not provided in all ports. Current...

This study evaluates the prevalence of mental/emotional distress and its specific correlates among people living with HIV/AIDS (PLWHA) in 20 jail systems across the United States. Of the 878 PLWHA jail detainees, 52% had high levels of mental/emotional distress, defined by the composite Addiction Severity Index score. High mental/emotional distress was found to be associated with the inmate living in a city with lower income inequality, lower health ranking, and higher degree of danger. Proximate variables included being female, bisexual orientation, poorer physical health, and increased severity of substance abuse. Inmates in jails with accredited health services and those satisfied with family support had lower mental/emotional distress scores. These findings indicate the need for expanded mental health assessment of PLWHAs entering jail.

Background: Public awareness-raising campaigns targeting alcohol use during pregnancy are an important part of preventing prenatal alcohol exposure and Fetal Alcohol Spectrum Disorder. Despite this, there is little evidence on what specific elements contribute to campaign message effectiveness. This research evaluated three different advertising concepts addressing alcohol and pregnancy: a threat appeal, a positive appeal promoting a self-efficacy message, and a concept that combined the two appeals. The primary aim was to determine the effectiveness of these concepts in increasing women's intentions to abstain from alcohol during pregnancy. Methods: Women of childbearing age and pregnant women residing in Perth, Western Australia participated in a computer-based questionnaire where they viewed either a control or one of the three experimental concepts. Following exposure, participants' intentions to abstain from and reduce alcohol intake during pregnancy were measured. Other measures assessed included perceived main message, message diagnostics, and potential to promote defensive responses or unintended consequences. Results: The concepts containing a threat appeal were significantly more effective at increasing women's intentions to abstain from alcohol during pregnancy than the self-efficacy message and the control. The concept that combined threat and self-efficacy is recommended for development as part of a mass-media campaign as it has good persuasive potential, provides a balance of positive and negative emotional responses, and is unlikely to result in defensive or unintended consequences. Conclusions: This study provides important insights into the components that enhance the persuasiveness and effectiveness of messages aimed at preventing prenatal alcohol exposure. The recommended concept has good potential for use in a future campaign aimed at promoting women's intentions to abstain from alcohol during pregnancy.

The aim of this study was to assess lycopene intake in daily food rations of women (n = 725) from the Lower Silesia region. The data on the lycopene intake were collected using 24-hour recall and diet history questionnaire. The intake of lycopene was not too low. The average lycopene contents in the daily food rations of 725 women from Lower Silesia region was 7.5 mg. The highest lycopene intake was found in the food daily rations of women with BMI &gt; 30. In examined group of women low knowledge on the importance of the role of lycopene in health was noticed. Educational interventions are required to inform women and to increase lycopene intake among them.

The development and implementation of worksite health and wellness programs (WHWPs) in the United States (US) holds promise as a means to improve population health and reverse current trends in non-communicable disease incidence and prevalence. However, WHWPs face organizational, economic, systematic, legal, and logistical challenges which have combined to impact program availability and expansion. Even so, there is a burgeoning body of evidence indicating WHWPs can significantly improve the health profile of participating employees in a cost effective manner. This foundation of scientific knowledge justifies further research inquiry to elucidate optimal WHWP models. It is clear that the development, implementation and operation of WHWPs require a strong commitment from organizational leadership, a pervasive culture of health and availability of necessary resources and infrastructure. Since organizations vary significantly, there is a need to have flexibility in creating a customize...

Physical education (PE) classes provide opportunities for children to be active. This study examined the associations between specific environmental characteristics (teacher characteristics; class size, duration and location; and lesson context) and elementary school-aged children&#39;s moderate-to-vigorous activity (MVPA) during PE. Environmental characteristics and student activity levels were measured in 211 third-, fourth-, and fifth-grade PE classes in 74 Texas public schools using SOFIT direct observation. Students engaged in less than half their PE class time in MVPA (38%), while approximately 25% of class time was spent in classroom management. Percent time in MVPA was significantly higher in outdoor classes compared with indoors (41.4% vs. 36.1%, P = .037). Larger (P = .044) and longer (P = .001) classes were negatively associated with percentage of MVPA and positively correlated with time spent in management (P &lt; .001). Findings suggest that children&#39;s activity may ...

Background: Measurement of social cognitive variables is often restricted to long-term and health-related outcomes. A more comprehensive measurement of cognitive determinants would enable evidence-based design of health behavior interventions with a focus on the most relevant targets. The purpose of this study was to examine the relative impact of different social cognitive determinants on fruit and vegetable (FV) and fast food consumption. Methods: Finnish male conscripts (N = 855, age M = 20) filled in questionnaires on social cognitive factors when entering the military service, and on food consumption frequency after two months. The data were analysed using structural equation modeling. Results: Physical well-being expectation and bad taste expectation were most strongly related to both FV and fat avoidance intentions. Perceived weight gain risk predicted fat avoidance intention, whereas perceived risk for other health problems predicted FV intention. Social self-efficacy was associated with FV intention only. Consumption of both FV and fast food was predicted by action planning and intention. Conclusions: A more careful evaluation of subtypes of social cognitions sheds light on the specific content behind motivation. Such understanding might help in designing more effective intervention messages.

This explorative study assesses perceptions of mental health and help-seeking behavior among adults in Vietnam. Methods included questionnaires (200) and focus group discussions (eight). Respondents were often unable to name specific mental illnesses. Frequently mentioned symptoms of mental illness were talking nonsense, talking/laughing alone and wandering. Pressure/stress and studying/thinking too much were often identified causes. Most respondents showed a preference for medical treatment options, often in combination with family care. The results show that perceptions of mental health and help-seeking behaviour are influenced by a lack of knowledge and a mix of traditional and modern views.

For a variety of purposes it is increasingly necessary to establish the health needs of local populations. Following a critique of existing proxies of need, this paper presents and evaluates an alternative which draws upon epidemiological evidence concerning the age, sex and social class distribution of morbidity in order to estimate the prevalence of specific conditions in designated populations. By way of demonstrating the insights to be gained through the use of these indicative prevalence rates, the paper considers the treatment of ischaemic heart disease in a sample of 539 practices and presents evidence regarding the significance of deprivation and rurality in determining health service use relative to needs. r