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The Role of Self-Efficacy in Predicting Adherence/Compliance to Health Behavior Regimens

Description: The purpose of the present study was to investigate the relationship between Self-Efficacy Theory (Bandura, 19 77) and adherence to health behavior prescription. A self report Self-Efficacy Questionnaire was developed to assess levels of efficacy. Dietary adherence was determined by self report as well as body composition assay and measurement of body weight. Levels of exercise compliance were assessed by self report in addition to a treadmill test.
Date: May 1985
Creator: Cline, Mark H. (Mark Holley)
Partner: UNT Libraries

Towards Resistance Detection in Health Behavior Change Dialogue Systems

Description: One of the challenges fairly common in motivational interviewing is patient resistance to health behavior change. Hence, automated dialog systems aimed at counseling patients need to be capable of detecting resistance and appropriately altering dialog. This thesis focusses primarily on the development of such a system for automatic identification of patient resistance to behavioral change. This enables the dialogue system to direct the discourse towards a more agreeable ground and helping the patient overcome the obstacles in his or her way to change. This thesis also proposes a dialogue system framework for health behavior change via natural language analysis and generation. The proposed framework facilitates automated motivational interviewing from clinical psychology and involves three broad stages: rapport building and health topic identification, assessment of the patient’s opinion about making a change, and developing a plan. Using this framework patients can be encouraged to reflect on the options available and choose the best for a healthier life.
Date: August 2015
Creator: Sarma, Bandita
Partner: UNT Libraries

Validity of the Health Belief Model as a Predictor of Activity in Younger and Older Adults

Description: The present investigation assessed Health Belief Model (HBM) variables and a measure of physical activity for both younger and older adults. Results of discriminant analyses suggest HBM variables and physical activity can predict age-group membership with 89% accuracy. The younger sample (n = 88; M= 21.5 years) was significantly more anxious about aging, perceived more barriers to exercise, less control from powerful others, and more social support than the older sample (n = 56; M = 71.8 years). For the younger sample, those who perceived more benefits of exercise, had social support, were male, and were less anxious about aging were more active. For the older sample, those who perceived more benefits of exercise were more likely to be active.
Date: August 1993
Creator: Weigand, Daniel A. (Daniel Arthur)
Partner: UNT Libraries

Factors Affecting Exercise Adherence among Participants, Nonparticipants and Dropouts of a Worksite Health and Fitness Program

Description: This study examines the relationship between exercise adherence and several factors: self-motivation; attitudinal commitment; predisposing, enabling, and reinforcing (PER) factors; and barriers related to exercise. The sample (N=431) consists of employees at Texas Instruments, Incorporated in Dallas, Texas. The sample was placed into six comparison groups: high adherers, low adherers, nonparticipants who exercise, nonparticipants who do not exercise, dropouts who exercise and dropouts who do not exercise. Using a one-way ANOVA, the results show significance (p<.01) among the groups for: self-motivation and barriers. Attitudinal commitment and PER factors did not show significance. The results can be applied to worksite health programs to increase exercise adherence among employee populations.
Date: August 1994
Creator: Orsak, Katherine Cecil
Partner: UNT Libraries

Threat to Health or Exuberant Well-Being: Which Best Explains Wellness Behavior?

Description: Because of the high and rapidly increasing cost of health care, wellness has become a significant issue for both health care practitioners and the general public. This research examines the issue of wellness and seeks to develop a model that identifies the factors that are most significant in explaining why people engage in wellness activities. A questionnaire was mailed to a sample (n = 499) randomly selected from the general population of the United States. Predictor variables are the demographic variables of age, income, education and gender together with the cognitive variables of self-actualization, benefits of wellness behavior, health locus of control and threat to health. Dependent variables are the health-seeking behaviors of exercise, stress management, nutrition, health responsibility and social support. Canonical correlation, t-tests, regression and analysis of variance are used to analyze the data. Chapter one presents two existing health models. The first presents prevention or threat to health and the second proposes self-actualization as motivating wellness behavior. The research model combines the two models. Chapter two presents relevant studies in the literature regarding use of multivariate models in consumer behavior, dimensions of wellness and empirical findings of wellness-related research. Chapter three presents the research hypotheses, research design and techniques of analysis. Chapter four presents analysis of the data and results of statistical tests. Conclusions and limitations of the research are discussed in chapter five along with recommendations for further research. The study finds threat to health as the strongest driver of wellness behavior followed closely by self-actualization thus supporting the study model. Results indicate that older persons and females perform more wellness behaviors than do younger individuals and males. Two 3-way interactions were found: (1) Income, age and marital status; (2) Education, age and marital status. Internal locus of control was not found to influence wellness behavior.
Date: August 1996
Creator: Murrow, Jimmie L. (Jimmie Lorraine)
Partner: UNT Libraries

AIDS and Aging: Are the Eldery Becoming the New At-Risk Population?

Description: This dissertation breaks new ground. It examines the perceptions of older adults towards AIDS prevention. Using the National Health Interview Survey, 1988: AIDS Knowledge and Attitudes Supplement, a modified Health Belief Model is developed. Despite the low number of older adults 55+ with AIDS, some extenuating circumstances increase their risk of AIDS contraction. Older adults have lower levels of knowledge about AIDS, weaker immune systems and receive more blood transfusions. Societal influences include educational neglect at the hands of physicians, healthcare workers and social service personnel. The first stage of the dissertation involved establishing older adults as an at-risk population through an extensive literature review. Next, the data was described utilizing frequencies, correlations and factor analysis. Frequencies clearly indicated that older adults in the data set had low levels of AIDS knowledge and did not view themselves at risk for AIDS contraction. Correlations between the variables were minimal. A modified Health Belief Model was developed and tested. Multiple regression determined that minimal variation in the two dependent variables, "Perceived Effectiveness of Effective Methods to Prevent AIDS Contraction" and "Perceived Effectiveness of Ineffective Methods to Prevent AIDS Contraction" was accounted for by the independent variables. Although F ratios allowed rejection of the two null hypotheses, beta weights were low. Adjusted R^2's accounted for only 21% and 16% respectively of the variation in the dependent variables. Finally, discrepancies in the model were determined and recommendations made for further research. Most health belief models concentrate on individual social-psychological variables. Due to AIDS' societal consequences, it is proposed that societal providers of education: physicians, social service workers and healthcare personnel need to be included in the model. Recommendations were made for additional research into sexual behavior of older adults and exploration of available training of physicians, healthcare and social service professionals. Finally, recommendations were ...
Date: August 1994
Creator: Allen, Annette Marie
Partner: UNT Libraries

High-Risk Sexual Behaviors of Young Adults: AIDS Prevention

Description: The Health Belief Model was used to study HIV/AIDS beliefs of 419, 18 to 24 year old, never married, sexually active, heterosexual college students and predict their AIDS preventive behaviors from a larger sample of 662 college students. The structural properties of the scales used were evaluated using confirmatory factor analysis. Recent preventive behaviors were predicted in a LISREL Structural Equation Modeling analysis.
Date: August 1994
Creator: Bloodgood, Martha Madden
Partner: UNT Libraries

Spirituality, health locus of control, and wellness in organizational health promotion and wellness programs

Description: The relationship between an individual's level of spirituality, health locus of control, and participating in wellness activity was investigated. The relationship between spirituality, health locus of control on physical health was also investigated. The research question was based on prior studies that reported people who are more spiritual are healthier. Does their spirituality lead to increased levels of health, or are individual's who are more spiritual more likely to proactively take control of their health and engage in health promoting behaviors? One hundred and fifteen male and female employees completed The Spiritual Involvement and Beliefs Scale (SIBS), a spirituality measure, The Multidimensional Health Locus of Control Scale, a measure of locus of control related to health and healthcare, and The Center for Disease Control's (CDC) Health Risk Appraisal, a self-report measure of participation in health behaviors. Physical measures of health were obtained by obtaining Body Mass Index, blood pressure readings, and a cholesterol screening. The current study looked at level of spirituality (internal, external), level of health locus of control (internal, powerful other, chance) and participation in wellness/health promoting behaviors and health. Correlational analyses were performed on the relationship between spirituality and health locus of control. Hierarchical multiple regressions were performed on the internal spirituality and internal health locus of control to examine the relationship between spirituality, health locus of control and positive health behaviors and level of physical health. Stepwise discriminant function analysis using spirituality and health locus of control as predictor variables for the health-behavior criterion variables were performed. Discussion of the results, limitations of the current study and recommendations for future research were presented.
Date: August 2001
Creator: Gauthier, Janine E.
Partner: UNT Libraries

Exploratory Analysis of Social E-health Behavior

Description: Extant literature has documented well that people seek health information via the internet as patients and consumers. Much less, however, is known about interaction and creation behaviors in the development of new online health information and knowledge. More specifically, generalizable sociodemographic data on who engages in this online health behavior via social media is lacking in the sociological literature. The term “social e-health” is introduced to emphasize the difference between seeking behaviors and interaction and creation behaviors. A 2010 dataset of a large nationally representative and randomly sampled telephone survey made freely available from the Pew Research Center is used to examine social e-health behavior according to respondents’ sociodemographics. The dependent variable of social e-health behavior is measured by 13 survey questions from the survey. Gender, race, ethnicity, age, education, and income are used as independent variables. Logistic regression analysis was used to determine the odds of engagement in social e-health behavior based on the sociodemographic predictors. The social determinants of health and digital divide frameworks are used to help explain why socioeconomic variances exist in social e-health behavior. The findings of the current study suggest that predictable sociodemographic patterns along the dimensions of gender, race, age, education, and income exist for those who report engaging in social e-health behavior. This study is important because it underscores the fact that engagement in social e-health behavior is differentially distributed in the general U.S. population according to patterned sociodemographics.
Date: May 2014
Creator: Acadia, Spencer
Partner: UNT Libraries

Designing a Social Marketing Plan to Promote Hispanic Participation at Prostate Cancer Screenings

Description: Prostate cancer is the most commonly occurring cancer and the second leading cause of cancer death for men in the United States. Because early prostate cancer is frequently without symptoms and data on how to prevent prostate cancer is lacking, early detection has the greatest potential for decreasing mortality. Studies have shown Hispanics/Latinos to be less likely than whites or African-Americans to utilize prostate cancer screening exams. The purpose of this descriptive study was to design a social marketing plan which could be used as a model to promote Hispanic/Latino participation at prostate cancer screenings. Information obtained through medical and marketing literature review, the author's experiences serving on the promotion committee of a community-sponsored prostate cancer screening project, and interviews with 51 Hispanic/Latino prostate cancer screening participants is described and incorporated into a guide with recommendations for future program planners.
Date: December 1995
Creator: Zimmerman, Suzanne M. (Suzanne Marie)
Partner: UNT Libraries

Breast Cancer Screening Health Behaviors in Older Women

Description: Health beliefs of 221 postmenopausal women were assessed to predict the Breast Cancer Screening Behaviors of breast self-examination (BSE) and utilization of mammography. Champion's (1991) revised Health Belief Model (HBM) instrument for BSE, which assesses the HBM constructs of Seriousness, Susceptibility, Benefits, Barriers, Confidence and Health Motivation, was utilized along with her Barriers and Benefits instrument for mammography usage. Ronis' and Harel's (1989) constructs of Severity-Late and Severity-Early were evaluated along with Cuing and demographic variables. These exogenous latent constructs were utilized in a LISREL path model to predict Breast Cancer Screening Behavior.
Date: August 1994
Creator: Hammond, Marsha V.
Partner: UNT Libraries

The Role of Acculturation in the Health Belief Model for Mexican-Americans with Type II Diabetes

Description: Diabetes has alarming prevalence rates not only in the U.S., but also worldwide. Ethnicity plays a large role with Hispanic-Americans having one of the highest prevalence rates. Diabetes is a complicated disease that requires significant lifestyle modifications. The health belief model (HBM) has been investigated as a theory to explain behavior change. However, little research has been done to determine its utility to Mexican-Americans. In the current study, participants were Mexican-American adults (N = 66) with type II diabetes who were recruited from family medicine clinics. Self-report questionnaires included the General Acculturation Index (GAI) and the Multidimensional Diabetes Questionnaire (MDQ). Participants had the option to complete them in either Spanish or English. Laboratory values were collected from medical charts. A MANCOVA indicated that two variables were significant, perceived severity (PS) and misguided support behaviors (MSB), p < .05. With respect to the HBM, PS was identified as a component of an individual's perception, acculturation was a modifying factor, and MSB was a component of the likelihood to change factors. These three affected glycemic control. Odds ratios determined that individuals with better glycemic control had less perceived severity and less misguided supportive behavior. Individuals with the least acculturation were more likely to have best glycemic control. Significant results were found for each of the three main columns of the model suggesting that the HBM has utility for the Hispanic-American population with type II diabetes. Results suggest that health care personnel should be aware of the ramifications of patients' perceived severity of their illness as well as the amount the "nagging" type support they receive from friends and family on glycemic control. This awareness can lead to the development of interventions aimed at improving glycemic control and the quality of life in Mexican-Americans with diabetes. Specifically, programs focused on incorporating the family ...
Date: August 2007
Creator: Bereolos, Nicole Margaret
Partner: UNT Libraries

Organizational Identity, Health Identity, and Motivation: a Symbolic Interactionist Approach to the Understanding of Heath Behaviors in Work Settings

Description: Identity is an important determinant of behavior. This paper proposed an identity model as one way of understanding those factors related to the perceived probability or willingness of a worker to participate in health promotion programming at the worksite. Part of a larger study on employee wellness, this study took place in the municipal complex of a small city in the southeastern United States. A stratified cross sectional sample of 150 employees was selected utilizing a systematic random sampling methodology. Structured interviews were conducted with 129 participants resulting in a response rate of 92% after adjusting for those people no longer employed by the city. In order to test the identity model developed by this author, descriptive analysis, simple multiple regression analysis and path analysis were utilized. The dependent variable, perceived willingness to participate in health promotion programming, was examined in relationship to commitment to one's health identity, commitment to one's organizational identity, tendency to comply with health initiatives, and the forms of supervisory power utilized to enact employee compliance. The descriptive analysis revealed that subjective health status is moderately and positively associated with commitment to one's health identity, that individuals can be strongly committed to a negative/destructive health identity, and that both the family and physician play important roles as health advice givers. The path analysis revealed that commitment to one's organizational identity, commitment to one's health identity, and tendency to comply with health initiatives are significantly and positively associated with willingness to participate in health promotion programming, accounting for 25% of the variance in the dependent variable. In contrast, the forms of supervisory power were not shown to be related to the dependent variable. In conclusion, the identity model appears to be a useful tool for the understanding of health attitudes and behaviors within a work setting.
Date: May 1989
Creator: Weber, Linda R. (Linda Roberta)
Partner: UNT Libraries

Ethnic Identity, Gay Identity and Sexual Sensation Seeking: HIV Risk-taking Predictors Among Men of Color Who Have Sex with Men

Description: This study examined relationships among ethnic identity, gay identity, sexual sensation seeking, and HIV risk-taking behaviors among 302 men of color recruited from gay bars, bathhouses, community agencies, and the 1998 United States Conference on AIDS. The sample included 24% African American, 28% Latino, 25% Asian/ Pacific Islander, 19% Caucasian, 1% American Indian, and 3% other ethnicity. Logistic regression analysis identified sexual sensation seeking, having an undefined gay identity, being in a sexually exclusive relationship, not being HIV seronegative, and length of stay in the country (for those born overseas) as significant predictors of unprotected anal intercourse (insertive and penetrative) among men of color who have sex with men.
Date: August 1999
Creator: Géliga-Vargas, Jesús A.
Partner: UNT Libraries

Topical content in sexuality education and sexual health outcomes.

Description: Secondary analysis of data from the National Longitudinal Study of Adolescent Health is used to examine possible explanatory variables for sexual health outcomes. Linear and logistic regression analyses were conducted to examine the relationship between sexual health outcomes and topical content in sexuality education, controlling for race, biological sex, low socioeconomic status, and religiosity. Results indicated increasing topical content in sexuality education had a positive effect on knowledge acquisition and confidence, but no statistically significant effect on engagement in sexual risk behavior or likelihood of reporting sexual coercion. Control variables were significant predictors and overall model fit was low, indicating topical content in sexuality education is minimally important in creating adolescent sexual behavior. Further exploration of differing aspects of sexuality education is suggested.
Date: December 2007
Creator: Cudhea, Maia Christine
Partner: UNT Libraries

An Integrative Model of eHealth Communication: a Study of 18-30 Year Old College Students

Description: eHealth is commonly defined as health services and information provided through the Internet and related technologies. Health educators have taken advantage of Internet and social media venues to disseminate health information essential to health risk management, disease prevention, and disease management and did not have a validated theoretical model to explain their experiences. The goal of this study was to create and test an integrated model of eHealth communication specific to 18-30 year old college students based on five research questions that identified and confirmed the factors most highly correlated with the presentation of health information on Internet or social media venues that improve eHealth literacy and provoke eHealth behavioral intention among college students. A sample of over 1400 18-30 year old college students was surveyed about their general and health information related use of the Internet and social media. As a result of exploratory factor analysis and subsequent structural equation modeling, the proposed theoretical model was revised and tested for statistical power. Two revised integrative models of eHealth communication, one for Internet and one for social media, were developed and validated. The model for social media shows statistically significant paths throughout the model; however, the model for the Internet reveals that the path between two constructs and Online Health Behavior are not statistically significant and is worthy of further examination. This study has important practical implications for eHealth educators, organizations dedicated to informing the public about specific diseases or health promotion techniques, health practitioners seeking improved strategies for effective eHealth message design, and to health information professionals.
Date: August 2014
Creator: Prybutok, Gayle
Partner: UNT Libraries

Improving the Definition of Exercise Maintenance: Evaluation of Concepts Related to Adherence

Description: Physical activity has been demonstrated in the literature as an effective way to reduce the risk for development of chronic disease. The Transtheoretical Model (TTM) of behavior change has been developed as a means to predict and facilitate movement into healthier lifestyle behaviors. The model is centered on "stages of change", which describe a continuum of readiness to engage in a health behavior change. Stages contain temporal, qualitative, and quantitative characteristics. This was a six-month study that evaluated the effectiveness of stage-matched (theorized to be pertaining only to the maintenance stage of change) vs. generic (theorized to be pertaining to anyone, regardless of stage) newsletters in assisting subjects to attain the Maintenance stage of change. It also sought to identify further qualitative characteristics that can differentiate between the Action and Maintenance stages of change. Results indicated that monthly stage-matched newsletters were no more effective in helping subjects reaching Maintenance than were the generic newsletters. Exerciser self-schema was related to stages of change, but those relationships differed from baseline to six-month follow-up, indicating development of exerciser self-schema during the study period. Implications of this are discussed. Other concepts discussed included "structure" of change process, in that three new scores were developed and correlated with self-efficacy as well as intercorrelated. Motivation was also evaluated and compared across levels of success at adhering to exercise during a three-month period. Limitations of the study and implications are discussed.
Date: August 2002
Creator: Wilcox, Susan E.
Partner: UNT Libraries

Health message framing : motivating cardiovascular risk factor screening in young adults.

Description: As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of framing effects could be conducted. Sixteen (11.2%) of the 143 participants who participated in Part 1 of the experiment participated in Part 2 (i.e., attended a risk factor screening appointment). Multiple regression analysis revealed risk index, age, and powerful others health locus of control as significant predictors of screening intention. Gender was the only demographic or health related variable that was significantly related to screening outcome, such that women were more likely to get screened than men. Limitations and recommendations are discussed.
Date: August 2008
Creator: Link-Malcolm, Jessica
Partner: UNT Libraries

Peer Networks and Health Risk Behaviors Among Adolescents

Description: Adolescence is a time of great exploration and change. During this time, youth are transitioning both biologically and sexually into adults. Adolescents are also testing the boundaries of self-reliance and making choices about their personal relationships. Not surprisingly, aggressive urges are often driven by peers in pursuit of some form of identity (Masten 2004). Peers can have both positive and negative effects on the wellbeing on youth. Peer groups can provide emotional, physical, and social support to youth during a time of immense change (Parker and Asher 1987; Gest, Graham-Berman, and Hartup 2001). Peers can also model delinquent and risk-taking behaviors that have lasting health, social, and economic consequences throughout the life course. In an effort to understand the role of friendships in adolescent health, social scientists have increasingly focused on adolescent network structures within schools and the role various positions and peer group formations influence behaviors such as alcohol and cigarette use, violent and serious delinquency, and sexual risk-taking. While informative, peer networks studies have yet to adequately address how peer network structures based on immigrant generation and types of marginalized social positions influence health risk behavior engagement among adolescents. In three studies, I address the dearth of research in these areas, using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). The first study investigates the influence of generational peers on alcohol misuse among immigrant youth. Testing hypotheses derived from sociological theories of generations regarding race/ethnicity, gender, and immigrant generation, findings from this study demonstrate generational ties are inversely related to alcohol misuse for immigrants and these effects depend partly on race/ethnicity and gender. The second study investigates the effects of specific network forms of social isolation on heavy episodic drinking and cigarette use among adolescents. The central finding from this study is that ...
Date: May 2015
Creator: Niño, Michael David
Partner: UNT Libraries