Health promotion: causes, beliefs and measurements

Factors influencing the intention for lung cancer screening in high-risk populations for lung cancer

Objective

Utilizing low-dose computed tomography for lung cancer screening has proven effective in reducing lung cancer mortality among high-risk individuals. This study aimed to investigate the health beliefs, knowledge of lung cancer, and cancer prevention behaviors in adults at high risk for lung cancer, with the goal of identifying predictors influencing their intention to undergo lung cancer screening.

Methods

The study utilized a descriptive cross-sectional design. Online questionnaires, including assessments of lung cancer screening health beliefs, knowledge of lung cancer, cancer prevention behaviors, intention to undergo lung cancer screening, and participant characteristics, were distributed to 186 individuals at high risk of lung cancer through a survey link. The data collection period spanned from April 26 to May 3, 2023. Analytical procedures encompassed descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlations, and hierarchical multiple regression.

Results

The mean score for the intention to undergo lung cancer screening in our study was 3.66 out of 5. The regression model explaining the intention to undergo lung cancer screening accounted for 34.7% of the variance. Significant factors identified included stress level (β = 0.20, P = 0.002), perceived risk (β = 0.13, P = 0.040), self-efficacy (β = 0.35, P < 0.001), and engagement in cancer prevention behavior (β = 0.26, P < 0.001).

Conclusions

Healthcare providers should implement psychological interventions and provide education about cancer screening for high-risk individuals, aiming to enhance their perceived risk and self-efficacy, thus promoting a higher likelihood of undergoing screening.

3D Analysis of Human Movement, Sport, and Health Promotion

This Special Issue, "3D Analysis of Human Movement, Sport, and Health Promotion", aimed to collect studies that assessed motor functions and alterations [...].

Holistic Hypertension Management

Hypertension (HTN) is a major health care problem affecting nearly half of American's adult population. HTN is one of the costliest diagnoses among cardiovascular disease and leads to other major cardiovascular complications, which increase overall morbidity and mortality. Of those diagnosed with HTN in America, only one-fourth of patients are living with well-controlled HTN. This evidenced-based HTN management practice innovation was conducted to explore evidenced-based, holistic nursing practice of a low-sodium dietary approach to stop hypertension (DASH) diet, and exercise alongside antihypertensive medication management in decreasing systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adult patients diagnosed with HTN. This community-based holistic care initiative supports data previously published, which suggests a low-sodium DASH diet, exercise, and antihypertensive medication management are effective in decreasing SBP and DBP. This project supported clinicians seeking to integrate a complementary holistic and traditional approach to HTN management in patients diagnosed with HTN.

The Practice of Physical Activity on Psychological, Mental, Physical, and Social Wellbeing for Breast-Cancer Survivors: An Umbrella Review

(1) Background: The number of breast-cancer patients and survivors is increasing in the last years. Physical activity seems to be a feasible and useful complementary intervention to improve the physical, psychological, and social spheres and decrease some symptoms, especially for survivors. Consequently, the objective of the present umbrella review was to analyze the efficacy of different physical-activity interventions in the physical, mental, and social spheres of breast-cancer survivors. (2) Methods: Systematic reviews and meta-analyses of randomized controlled trials on breast-cancer survivors and physical-activity effects were searched on the electronic databases PubMed, Web of Science, and Scopus till 9 August 2022. The quality of the studies included was evaluated, and the results were narratively analyzed. (3) Results: Physical-activity intervention generally improves the physical, mental, and social spheres of breast-cancer survivors, but the studies included present heterogeneity in the protocols adopted. (4) Conclusions: A well-structured and planned physical-activity intervention is useful for improvements in the physical, mental, and social spheres of breast-cancer survivors, but the studies presented high heterogeneity. Yoga seems to be the most effective physical intervention to complement medical therapy.

The importance of standard operating procedures in physical fitness assessment: a brief review

Background

Physical fitness status is a key aspect of health and, consequently, it is important to create and adopt appropriate interventions to maintain or improve it, and assess it using valid measures. While in other testing contexts, standard operating procedures (SOPs) are commonly and widely adopted, in physical fitness testing, a variety of unstandardized testing protocols are proposed.

Aims

The topic of this review was to evaluate the existing literature on SOPs in physical fitness assessment and to provide guidelines on how SOPs could be created and adopted.

Method

The electronic databases PubMed, Web of Science and Scopus were screened and original, peer-reviewed studies that included SOPs, related to physical fitness, were recorded.

Results

After the inclusion and exclusion criteria screening, a total of six studies were included and these were critically and narratively analyzed.

Conclusions

Standard operating procedures are rarely adopted in the field of physical fitness and a step by step guide has been provided in this manuscript. In the future, it is suggested to follow protocols as a routine, because this is the only way to generalize and contextualize findings.

Effect of Health-Promoting Lifestyle Modification Education on Knowledge, Attitude, and Quality of Life of Postmenopausal Women

Limited knowledge and negative attitudes about menopause among postmenopausal women (PMW) create a multitude of health-related issues leading to impaired quality of life (QOL) among them. This study evaluated the impact of a health-promoting lifestyle education intervention (HPLEI) on knowledge, attitude, and QOL in a group of PMW in Sri Lanka. A quasi-experimental study was conducted with 72 PMW, matched for sociodemographic status of the community from two geographically separated areas in Galle, and they were allocated to intervention (n = 37) and control (n = 35) groups. HPLEI is comprised of health education sessions focused on postmenopausal health management with lifestyle modifications provided only for the intervention group for 8 weeks and follow-up for 6 months. The control group was not given any planned education programme and was allowed to proceed with the usual lifestyle during this period. Knowledge, attitude, menopause-specific QOL (MENQOL), and overall QOL were evaluated in both groups with self-administered questionnaires at the baseline, after 8 weeks of education sessions and at the end of 6 months of follow-up. The mean (SD) ages of the intervention and control groups were 54.6 (4.5) and 56.5 (3.4) (p = 0.06) years, respectively. All evaluated variable scores were not different between the intervention and control groups (p > 0.05) at the baseline. In the intervention group, knowledge (mean ± SD; 21.70 ± 1.05) and attitude (mean ± SD; 44.02 ± 5.33) scores increased at the end (p < 0.001). In the control group, a marginal increase in all dimensions of knowledge scores (mean ± SD; 9.71 ± 2.21) and unchanged attitude scores (mean ± SD; 23.91 ± 7.56) were seen. All MENQOL scores decreased during the follow-up in the intervention group (mean ± SD; 138.51 ± 18.47) (p < 0.001) except the sexual domain (p = 0.32). MENQOL scores were increased in the control group (mean ± SD; 92.05 ± 28.87) (p < 0.001) with time. Overall QOL scores increased (mean ± SD; 74.85 ± 9.71) (p < 0.001) in the intervention group during the study period and in the control group overall QOL (mean ± SD; 51.03 ± 13.61) showed a reduction (p < 0.001) at the end. Health education focused on health-promoting lifestyle modifications was effective in improving knowledge, attitude, MENQOL, and overall QOL of PMW.

The effects of an educational program based on the health belief model on information-motivation-skill-behavioral skills among women living with human immunodeficiency virus

BACKGROUND

Human immunodeficiency virus (HIV) is a kind of behavioral disease in that adopting behavioral changes is the only way to control and stop the epidemic. The aim of this study is to investigate the effect of education base on the health belief model (HBM) on health-seeking behavior among HIV-positive women.

MATERIALS AND METHODS

This study is a paralleled, randomized controlled clinical trial done with control group among HIV-positive women who were registered at the voluntary and counseling testing center of Imam Khomeini hospital in Tehran. Data were gathered by using information obtained from the Motivation-Skill-Behavior questionnaire and demographic data. The women were divided by permuted block and were randomized into two groups. Interventional group participated in six HBM educational classes and used routine counseling guidelines, but the control group used only routine counseling protocol. Data were collected before, immediately after, and 3 weeks after interference among all participants. Data were analyzed by using SPSS software version 16.

RESULTS

According to the results and statistical test, before intervention, the mean score of knowledge was not significantly different in the two groups, but after intervention in the interventional group, test result and follow-up increased statistically significantly (P = 0.000). Both groups had increased mean score of knowledge, and there is significant trend in level of knowledge (interventional group 20.79 ± 1.88, control group: 17.36 ±2.44) and there was a significant increase in mean attitude follow-up score (P < 0.001).

CONCLUSION

According to the result of the present study, counseling base on HBM by trained educator can increase information-motivation-skill-behavior among women living with HIV.

Attitudes and completion of advance care planning: Assessing the contribution of health beliefs about Alzheimer's disease among Israeli laypersons

Objectives

The purpose of this study was to assess laypersons’ attitudes and completion of advance care planning (ACP) and to examine associations with sociodemographic characteristics and health beliefs on Alzheimer's disease.

Methods

A cross-sectional telephone survey was conducted during April and May 2017, with a sample of 514 Israeli adults, aged 18 years and above. A structured, pretested questionnaire assessing participants’ awareness, attitudes, and completion of ACP, as well as health beliefs on Alzheimer's disease (subjective knowledge, susceptibility, and worry), and sociodemographic factors, was used.

Results

Two-fifths of the participants had heard of at least one of the terms: advance directives or durable power of attorney. Overall, participants expressed positive attitudes toward ACP. Results of regression models showed that gender, religiosity, and subjective knowledge of Alzheimer's disease were statistically significant correlates of attitudes toward ACP. Adding health beliefs on Alzheimer's disease doubled the amount of the variance explained, from 3% to 6%.

Significance of results

Our results support the use of cognitive models of health behavior by assessing intra-personal beliefs and knowledge to understand ACP attitudes and completion. Specifically, we demonstrated the importance of knowledge of Alzheimer's disease for ACP attitudes, suggesting the importance of including a module on the topic to ACP interventions.

The Evolutionary Trends of Health Behaviors in Chinese Elderly and the Influencing Factors of These Trends: 2005⁻2014

As China is now facing the severe challenge of rapid population ageing, the health behaviors in Chinese elderly people are of great significance for realizing the goal of “Healthy Ageing” and the construction of a “Healthy China”. Little is known about the evolutionary trends of health behaviors in the Chinese elderly and about the factors influencing these trends; thus, the purposes of this paper are: (1) To describe the classes and evolutionary trends of health behaviors in the Chinese elderly; and (2) to explore the factors that influence the changes in the health behaviors in the elderly in China. Latent class analysis (LCA) is applied in this study to analyze the classes of health behaviors in the Chinese elderly. Growth mixture modelling (GMM) is employed to describe the evolutionary trends of the health behaviors in elderly people in China. In addition, the Bivariate analysis model is adopted to identify the influencing factors of the evolution of health behaviors. The data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2005 to 2014. The results reveal that the health behaviors in the Chinese elderly can be grouped into five classes: Negative, relatively negative, fair, relatively positive, and positive. Approximately 77.2% of the health behaviors in the Chinese elderly have the characteristics of “modified”, with a positive tendency. Moreover, approximately 22.8% of the health behaviors in Chinese elderly people have the characteristics of “non-modified”, with a negative tendency or remaining unchanged. The evolution of the health behaviors in the elderly in China is more affected by economic factors such as timely medical treatment during childhood, pension, occupations before the age of 60 and family income, as well as by self-rated health (SRH) and demographic characteristics such as household registration, age, and education level. Hence, various possible interventions should be made to improve the health behaviors in elderly people.

Health-related behavior of the people who neglect the specific health guidance for metabolic syndrome control

In 2008, Japan introduced a metabolic syndrome screening and intervention program specifically targeting individuals aged 40 to 74 years of age. However, the consultation and follow-up rates for the intervention are still low. The present study aims to identify characteristics of health-related behavior of the people who neglect it. We conducted a group interview targeting public health nurses and qualified dieticians of "A" prefectural branch office of the Japan Health Insurance Association who were regularly involved in performing the intervention. Qualitative content analysis was used to analyze the data, and four themes were extracted: Self-taught practices, Defiance, Hesitation, and Resignation. Our results suggest that the public health advisors recognize the importance of modification of clients' health-related misperception, improve their skills to develop a positive rapport with clients, and be involved in creating a supportive environment conducive to a healthy lifestyle.

Developing community-based health education strategies with family history: Assessing the association between community resident family history and interest in health education

BACKGROUND

Family history (FH) is an underutilized genetically informative tool that can influence disease prevention and treatment. It is unclear how FH fits into the development of community-based health education. This study examines the role that FH plays in perceived threat and health education related to mental and chronic physical conditions in the context of the health belief model.

METHODS

Data were collected from 1,048 adult participants aged 18-90 years. Approximately 76% of participants indicated African-American race/ethnicity and 35% had less than high school level education. Self-report data were collected on FH of four disorders: anxiety, depression, diabetes, and high blood pressure. Interest in receiving information regarding prevention as well as future testing efforts was assessed broadly. A series of logistic regressions examined the association between FH for each of the disorders and interest in receiving information on (1) prevention of diseases in general and (2) testing for diseases in general. These associations were also analyzed after accounting for the influence of perceived threat of conditions.

RESULTS

Interest in receiving general health education was significantly associated with FH of depression (OR = 2.72, 95% CI = 1.74-4.25), anxiety (OR = 2.26, 95% CI = 1.45-3.22), and high blood pressure (OR = 2.54, 95% CI = 1.05-6.12). After adjustment for perceived threat, the magnitude of these associations was reduced substantially. The associations between perceived threat and either interest in receiving information on disease testing or receiving general health education were strong and significant across all conditions (OR = 2.11-3.74).

DISCUSSION

These results provide evidence that perceived threat mediates the association between FH and engagement with health education. Currently available health education programs may benefit from considering the role of FH in an individual's motivation for participation in health education activities alongside other factors.

A model to promote the uptake of male circumcision as an HIV-preventive measure in high HIV and low male circumcision prevalence settings

BACKGROUND

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) remain the leading global burden of disease, especially in Southern Africa. As such, efforts to develop innovative preventive and curative measures continue to be a global priority. Of late, the World Health Organization recognised and recommended mass male circumcision (MC) as an adjunct HIV-preventive measure in 14 selected sub-Sahara African countries. However, despite efforts to promote the uptake of MC in these countries, the uptake remains significantly below set targets.

AIM

The purpose of this article is to describe the process that was followed in developing, describing and evaluating a model to promote the uptake of MC as an HIV-preventive measure in high HIV and low MC settings.

SETTING

The model is designed for all settings of high HIV and low MC prevalence.

METHOD

A theory-generative, qualitative, exploratory, descriptive and contextual research design was used. The process involved four distinct steps, namely concept analysis, description of relationship statements, and description and evaluation of the model using the criteria of clarity, simplicity, generality, accessibility and importance.

RESULTS

The central concept was identified as 'promote the uptake of MC', and three integral constituents were identified for the process, such as transforming men's mindsets about MC, facilitating accessibility and utilisation of MC services, and maintaining a supportive social system. These formed the basis for the model.

CONCLUSION

The model provides a framework of reference for healthcare providers in promoting the uptake of MC as an HIV-preventive measure in high HIV and low MC settings.

Effects of Model-Based Interventions on Breast Cancer Screening Behavior of Women: a Systematic Review

Background: Breast cancer is a great concern for women’s health; early detection can play a key role in reducing associated morbidity and mortality. The objective of this study was to systematically assess the effectiveness of model-based interventions for breast cancer screening behavior of women. Methods: We searched Scopus, PubMed, Web of Science, Science Direct, Cochrane library and Google scholar search engines for systematic reviews, clinical trials, pre- and post-test or quasi-experimental studies (with limits to publication dates from 2000-2017), Keywords were: breast cancer, screening, systematic review, trials, and health model. In this review, qualitative analysis was used to assess the heterogeneity of data. Results: Thirty six articles with 17,770 female participants were included in this review. The Health belief model was used in twenty three articles as the basis for intervention. Two articles used both the Health belief model and the Health Promotion Model, 5 articles used Health belief model and The Trans theoretical Model, 2 used Hthe ealth belief model and Theory planned behavior, 2 used the Health belief model and the Trans theoretical Model, 2 used the Trans theoretical Model, 1 used social cognitive theory, and 1 used Systematic Comprehensive Health Education and Promotion Model. The results showed that model-based educational interventions are more effective for BSE and CBE and mammography screening behavior of women compare to no model based intervention. The Health belief model was the most popular model for promoting breast cancer screening behavior. Conclusions: Educational model-based interventions promote self-care and create a foundation for improving breast cancer screening behavior of women and increase policy makers’ awareness and efforts towards its enhancement breast cancer screening behavior.

Knowledge, beliefs, and perceptions of tuberculosis among community members in Ntcheu district, Malawi

Introduction

The global burden of tuberculosis (TB) remains significantly high, with overreliance on biomedical interventions and inadequate exploration of the socioeconomic and cultural context of the infected population. A desired reduction in disease burden can be enhanced through a broader theoretical understanding of people’s health beliefs and concerns about TB. In this qualitative study, we explore the knowledge, beliefs, and perceptions of community members and people diagnosed with TB toward TB in Ntcheu district, Malawi.

Methods

Using a qualitative phenomenological study design, data were obtained from eight focus-group discussions and 16 individual in-depth interviews. The community’s experiences and perceptions of TB were captured without using any preconceived framework. Adult participants who had had or never had a diagnosis of TB were purposively selected by sex and age and enrolled for the study. Discussions and individual interviews lasting about 60 minutes each were audiotaped, transcribed, and translated into English and analyzed using MaxQDA 10 software for qualitative analysis.

Results

Most participants believed that TB was curable and would go for diagnosis if they had symptoms suggestive of the disease. However, based on their beliefs, individuals expressed some apprehension about the spread of TB and the social implications of being diagnosed with the disease. This perception affected participants’ responses about seeking diagnosis and treatment.

Conclusion

A supportive and collective approach consisting of a combination of mass media, interactive communication campaigns, emphasizing TB symptoms, transmission, and stigma could be useful in addressing barriers to early diagnosis and care-seeking behavior.

Predictors of health-promoting behaviour among older adults with hypertension in Indonesia

OBJECTIVES

This study aimed to determine the predictors of health-promoting behaviour among older adults with hypertension in Bengkulu City, Bengkulu, Indonesia.

METHODS

A cross-sectional study was conducted in 333 older adults with hypertension, who were selected using multistage sampling method. Data were obtained by face-to-face interview with structured questionnaires. The questionnaires used in this study included the Health-Promoting Lifestyle Profile II (HPLP II), Hypertension Knowledge-Level Scale (HK-LS), Self-Rated Abilities for Health Practices Scale (SRAHP), Barriers to Health-promoting Behaviour Scales (BAS), Benefits to Health-Promoting Behaviour Scales (BES), Multidimensional Scale of Perceived Social Support (MSPSS) and Situational Influences Questionnaire (SIQ). Data were analysed by using multiple linear regressions.

RESULTS

The mean and standard deviation (Mean ± SD) of each questionnaire were as follows: HPLP II, 2.55 ± 0.19; HK-LS, 11.83 ± 3.00; SRAHP, 2.00 ± 5.87; BAS, 27.89 ± 2.70; BES, 34.29 ± 2.29; MSPSS, 60.35 ± 8.12; and SIQ, 47.71 ± 6.66. According to the multiple linear regression model, 36.9% of the variation in health-promoting behaviour among older adults with hypertension can be explained by six variables, namely, education, knowledge, self-efficacy, perceived barriers, social support and situational influences (adjusted R 2 = 0.369).

CONCLUSIONS

High and good-quality education will increase the level of health-promoting behaviour, whereas barriers, such as expense and time requirement, can decrease it. Situational influences and support from family and friends can also influence the older adult's attempts to change their health behaviour. Increased self-efficacy will clearly result in improved health-promoting behaviour of older adults with hypertension.

Perceived Risk of Developing Cancer in a Suburban Community in Malaysia

Objective:

To determine the perceived risk of developing cancer in a suburban community in Malaysia.

Methods:

A cross sectional study using a simple random sampling was conducted among residents aged 18 years old and above (n=520) who had never been diagnosed with cancer, in selected households in a suburban area of Pahang state in Malaysia. The study instruments were a validated questionnaire on risk perception, an automatic blood pressure monitor, a weighing scale and a measuring tape. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 and the p value was taken at p <0.05 as significant.

Result:

This study revealed that only 5.0 percent individuals perceived they were at risk cancer, whilst the perceived severity was 41.3 percent. Multivariable analysis showed a significant association only for a family history of cancer (adjusted OR of 4.80; 95% CI = 1.45-15.82) (p=0.010) among this population.

Conclusion:

The perceived risk of developing cancer in the selected suburban community of Pahang state in Malaysia is low as compared to that for other non-communicable diseases in this country, whilst the perceived severity was higher than for other diseases. Thus, considering the importance of correct perceptions for behavioral changes, more health education and promotion is needed to make the community better aware of the actual threat of cancer.

Instrument Development of Integrative Health and Wellness Assessment™

The nurse coach role was developed to address the needs of our nation and the world for health and wellbeing. The Theory of Integrative Nurse Coaching provides a foundation for coaching interventions supporting health promotion, and a framework for the development of the Integrative Health and Wellness Assessment (IHWA) short form. This 36-question Likert-type scale self-reporting tool assists participants in assessing healthy behaviors through a self-reflection process, provides information for the coaching relationship, and may be an outcome measurement. This article describes the history of the IHWA tool and the development and pilot testing of the IHWA short form using guidelines provided by DeVellis. Results of the Kaiser–Meyer–Olkin test yielded a value of .520, and the Bartlett’s test of sphericity was significant. Cronbach’s alpha overall scale internal consistency was .88 ( n = 36). Pilot study results indicate that the scale could be improved through additional revision, and an ongoing study is in progress.

The Effect of a Breastfeeding Motivation Program Maintained During Pregnancy on Supporting Breastfeeding: A Randomized Controlled Trial

BACKGROUND

Exclusive breastfeeding is the recommended breastfeeding method for infants during the first 6 postnatal months.

OBJECTIVE

This study aimed to increase breastfeeding duration and frequency using a breastfeeding motivation program (BMP), which was structurally based on Pender's Health Promotion Model (HPM) and administered during pregnancy and the postnatal period. The study was also designed to determine the BMP effectiveness in supporting exclusive breastfeeding.

MATERIALS AND METHODS

The sample of this randomized controlled trial included 100 pregnant women (50 in the BMP, 50 in the control group) who applied to the pregnancy preparation course in a state hospital located in Usak, western Turkey. Participants in the study were allocated into either the BMP group or control group through systematic sampling and randomization. The BMP was structured based on the HPM and was carried out with the BMP study group four times: during the antenatal period, on the first postnatal day, between the fourth and sixth postnatal weeks, and during the fourth postnatal month. Data were analyzed using the descriptive statistical test, Pearson's chi-square test, independent samples t test, and ANOVA.

RESULTS

The mothers in the BMP group started breastfeeding earlier than the mothers in the control group (97.1%) and had fewer problems with their first breastfeeding experience. The average score of perceived self-efficacy in breastfeeding and the rate of first breastfeeding experience (70.6%) were higher in the BMP group by a statistically significant amount.

CONCLUSION

BMP for breastfeeding, structurally based on Pender's HPM, can help in supporting and maintaining exclusive breastfeeding.

Evaluation of 3 Behavioral Theories for Application in Health Promotion Strategies for Hispanic Women

Hispanic/Latina women often fare poorly when attempting to access the health care that they need in the United States. Using an established criterion, this article analyzes the application of the health belief model (HBM), social cognitive theory (SCT), and health promotion model (HPM) in the context of Hispanic women's limited access to, and use of, health resources to promote their health. An individual's perceptions and the likelihood of taking action are the focus of HBM. SCT is regarded as important sociostructural and personal determinants in the regulation of human behavior. Finally, HPM centers on the unique characteristics and experiences of an individual that motivate him or her toward positive health behavior. The analysis suggests that HPM is a better fit to explore the relationship among sociocultural factors, lifestyle practices, and the positive perceived affect of Hispanic women engaging in healthy behaviors and utilizing health care in the United States. HPM can guide the design of both health-enhancing and disease-prevention strategies that specifically address Hispanic women's unique health needs.

The predictors of glucose screening: the contribution of risk perception

BACKGROUND

The prevention of type 2 diabetes is a challenge for health institutions. Periodic blood glucose screening in subjects at risk for developing diabetes may be necessary to implement preventive measures in patients prior to the manifestation of the disease and to efficiently diagnose diabetes. Not only medical aspects, but also psychological and social factors, such as the perception of risk (the individuals' judgment of the likelihood of experiencing an adverse event) influence healthy or preventive behaviors. It is still unknown if risk perception can have an effect on health behaviors aimed at reducing the risk of diabetes (glucose screening). The objective of study was to identify factors that influence glucose screening frequency.

METHODS

Eight hundred randomized interviews, which were stratified by socioeconomic level, were performed in Mexico City. We evaluated the perception of risk of developing diabetes, family history, health status and socioeconomic variables and their association with glucose screening frequency.

RESULTS

Of the study participants, 55.6% had not had their glucose levels measured in the last year, whereas 32.8% of the subjects reported having monitored their glucose levels one to three times per year and 11.5% had their levels monitored four or more times per year. Risk perception was significantly associated with the frequency of blood glucose screening. Having a first-degree relative with diabetes, being older than 45 years and belonging to a middle socioeconomic level increased the probability of subjects seeing a doctor for glucose screening.

CONCLUSIONS

Glucose screening is a complex behavior that involves the subjects' perception of threat, defined as feeling vulnerable to the development of diabetes, which is determined by the subject's environment and his previous experience with diabetes.

Factors predicting the physical activity behavior of female adolescents: a test of the health promotion model

OBJECTIVES

Physical activity behavior begins to decline during adolescence and continues to decrease throughout young adulthood. This study aims to explain factors that influence physical activity behavior in a sample of female adolescents using a health promotion model framework.

METHODS

This cross-sectional survey was used to explore physical activity behavior among a sample of female adolescents. Participants completed measures of physical activity, perceived self-efficacy, self-esteem, social support, perceived barriers, and perceived affect. Interactions among the variables were examined using path analysis within a covariance modeling framework.

RESULTS

The final model accounted for an R(2) value of 0.52 for physical activity and offered a good model-data fit. The results indicated that physical activity was predicted by self-esteem (β=0.46, p<0.001), perceived self-efficacy (β=0.40, p<0.001), social support (β=0.24, p<0.001), perceived barriers (β=-0.19, p<0.001), and perceived affect (β=0.17, p<0.001).

CONCLUSIONS

The findings of this study showed that the health promotion model was useful to predict physical activity behavior among the Iranian female adolescents. Information related to the predictors of physical activity behavior will help researchers plan more tailored culturally relevant health promotion interventions for this population.

Factors associated with adherence to fecal occult blood testing for colorectal cancer screening among adults in the Republic of Korea

PURPOSE

Repeated participation in fecal occult blood testing (FOBT) is one of the major factors affecting the long-term success of population-based colorectal cancer screening programs. The aim of this study is to explore strong factors linked to repeated participation in FOBT in the prior decade (2002-2011) among adults using the Health Belief Model (HBM) after controlling for other covariates.

METHODS

Data were obtained from South Korean adults, aged 50 years and over, who visited a national health screening center within a magnet hospital (N = 237). A pilot test was conducted to investigate the internal consistency of the HBM instruments and the clarity of survey questions. Sample characteristics and rates of adherence to FOBT screening were examined using means and frequencies. Important factors associated with adherence to FOBT were examined using multivariate logistic regression analysis.

RESULTS

About 44% of the respondents were adherent to FOBT screening over the prior decade. Four out of the six HBM-driven factors (perceived susceptibility, severity, and barriers, and health motivation) were statistically significant. Those with greater levels of susceptibility and health motivation and lower levels of severity and barriers were more likely to adhere to FOBT.

CONCLUSIONS

Health professionals should focus more on the four modifiable HBM-related factors to encourage adults to adhere to FOBT. Intervention programs, which lower perceived severity and barriers and increase susceptibility and health motivation, should be developed and implemented.

Study on situational influences perceived in nursing discipline on health promotion: a qualitative study

Introduction and Objectives. Nurses, as behavioral models, play a key role in health promotion, and their attitudes towards health promotion highly influence their health and performance. The aim of this study is to explore nursing students' perception of studies in nursing discipline as a situational influence on health promotion. Materials and Methods. This study was conducted using directed content analysis, by means of 20 deep semistructured interviews with nursing students. The participants were selected on purposive sampling. Data was analyzed by the qualitative content analysis method. All interviews were recorded, transcribed, and reviewed, and all codes were extracted and summarized. The codes were subcategorized on the basis of centralization and were categorized after review of subcategories, and finally, a theme was determined. Findings. The theme of nursing discipline's situational influence on nursing students' health promotion was revealed. This theme consisted of "choosing the field," "unfavorable environmental factors," "negative impacts of studies in nursing discipline on health," "positive effects of studies in nursing discipline on health", "needs," "attractiveness (aesthetics)," and "coping with negative situational influences in nursing discipline." Conclusion. The perception of studies in nursing discipline as a health-promoting behavior is under influence of social environment. Considering the importance of the students' positive perception of the existing situation, it is essential to pay attention to their attitudes and perceptions so that they can provide better services to patients.

Oral health: locus of control, health behavior, self-rated oral health and socio-demographic factors in Istanbul adults

OBJECTIVES

To determine oral health control beliefs of Istanbul adults using the Multidimensional Oral Health Locus of Control Scale (MOHLCS) after confirming its factorial validity and to examine the relationships between these beliefs, self-rated oral health, oral health behaviors and socio-demographic factors.

MATERIAL AND METHODS

The MOHLCS was administered to a sample of 1200 subjects aged ≥18 years in Istanbul chosen using a quota-sampling method (response 88%). The relationship between the MOHLCS and oral health behaviors, self-rated oral health and socio-demographic factors was assessed after confirming the factorial validity of the MOHLCS.

RESULTS

The MOHLCS demonstrated satisfactory internal reliability. Factor analysis results showed a new four-factor solution, namely Internal, Dentist, Chance, and Socialization agents. Multivariate analysis showed that female gender, younger age, higher socioeconomic status, more frequent daily toothbrushing, and regular dental check-ups were associated with higher Internal beliefs, while older age, lower educational level, lower socioeconomic status, low toothbrushing frequency, and symptom-orientated dental attendance were associated with higher Chance beliefs. Being unmarried and low toothbrushing frequency were associated with lower Dentist beliefs. Males and older subjects had lower Socialization agents beliefs. Internal, Dentist and Chance beliefs were significantly associated with self-rated oral health.

CONCLUSIONS

Compared with the original factor structure, the new factor structure had better goodness of fit for this sample. Self-rated oral health, socio-demographic factors, and oral health behaviors were significantly associated with oral health control beliefs. These beliefs may be useful for planning oral health promotion programs and for formulating advice given by oral health professionals about their patients' oral health behaviors.

Hypertension and the Hmong community: using the health belief model for health promotion

Hmong Americans are a minority population with a hypertensive health problem that is often undiagnosed and not medically managed. Vulnerable populations, such as ethnic minorities, are susceptible to poor health because of their unique perception of disease and treatment. Healthy People 2010 has goals that include promoting quality of life and eliminating health disparities. The Health Belief Model recognizes an individual's perceived susceptibility to disease, perceived severity of disease, perceived benefits of certain behaviors in reducing disease, and perceived barriers, such as cost, to preventive action. Nurses and other health care professionals are in a unique position to promote health in these vulnerable populations by using the Health Belief Model. Health promotion includes identifying barriers, empowering individuals through knowledge, as well as encouraging and educating positive health behaviors.

Supporting mothers in recovery: parenting classes

Drug addiction is a serious issue in today's society. Women are giving birth to infants who are born addicted to illicit drugs, and these mothers are not able to care for their infants safely and competently without training and support. This article examines the prevalence of the problem. It also discusses the possible impact of parenting skills classes, as part of recovery efforts, for women seeking recovery who have recently given birth. Several programs already in place in the U.S have shown positive results for these mothers and their infants. Infants exposed in utero to illicit drugs need to be given all of the resources society can provide in an effort to stop the intergenerational cycle of drug addiction.

Three intervention models for exploring oral health in pregnant minority adolescents

PURPOSE

Maintaining oral health is important for pregnant minority adolescents and their offspring's present and future well-being. The purpose of this article is to identify the scope of oral health problems and describe three models to guide pediatric nursing research and interventions related to oral health in pregnant minority adolescents.

CONCLUSIONS

Identifying and understanding the risks of poor oral health in pregnant minority adolescents will assist those who plan and provide care for this vulnerable population.

PRACTICE IMPLICATIONS

Utilizing more than one model or a combination of models may be necessary for improving oral health outcomes in this population.