Enhancing health knowledge,health beliefs,and health behavior in Poland through a health promoting television program series

This study examined the impact of a health promoting television program series on health knowledge and the key factors of the health belief model (HBM) that have led people to engage in healthy behavior (exercising, losing weight, changing eating habits, and not smoking/quitting smoking). Using data from a posttest comparison field study with 15) viewers and 146 nonviewers in Poland, we found that hierarchical regression analysis showed stronger support for the HBM factors of efficacy, susceptibility, seriousness, and salience in their contribution toward health behavior among television viewers compared with nonviewers. Cues to action variables (including television viewing) and health knowledge boosted efficacy among viewers. Without the advantage of receiving health information from the television series, nonviewers relied on their basic disease fears on one hand, and interest in good health on the other to take steps toward becoming healthier. A health promoting television series can increase health knowledge and enhance health beliefs, which in turn contribute to healthy behaviors.     

Enhancing Health Knowledge,Health Beliefs,and Health Behavior in Poland through a Health Promoting Television Program Series

This study examined the impact of a health promoting television program series on health knowledge and the key factors of the health belief model (HBM) that have led people to engage in healthy behavior (exercising, losing weight, changing eating habits, and not smoking/quitting smoking). Using data from a posttest comparison field study with 151 viewers and 146 nonviewers in Poland, we found that hierarchical regression analysis showed stronger support for the HBM factors of efficacy, susceptibility, seriousness, and salience in their contribution toward health behavior among television viewers compared with nonviewers. Cues to action variables (including television viewing) and health knowledge boosted efficacy among viewers. Without the advantage of receiving health information from the television series, nonviewers relied on their basic disease fears on one hand, and interest in good health on the other to take steps toward becoming healthier. A health promoting television series can increase health knowledge and enhance health beliefs, which in turn contribute to healthy behaviors.     

Towards an Effective Health Interventions Design: An Extension of the Health Belief Model

Introduction

The recent years have witnessed a continuous increase in lifestyle related health challenges around the world. As a result, researchers and health practitioners have focused on promoting healthy behavior using various behavior change interventions. The designs of most of these interventions are informed by health behavior models and theories adapted from various disciplines. Several health behavior theories have been used to inform health intervention designs, such as the Theory of Planned Behavior, the Transtheoretical Model, and the Health Belief Model (HBM). However, the Health Belief Model (HBM), developed in the 1950s to investigate why people fail to undertake preventive health measures, remains one of the most widely employed theories of health behavior. However, the effectiveness of this model is limited. The first limitation is the low predictive capacity (R² < 0.21 on average) of existing HBM’s variables coupled with the small effect size of individual variables. The second is lack of clear rules of combination and relationship between the individual variables. In this paper, we propose a solution that aims at addressing these limitations as follows: (1) we extended the Health Belief Model by introducing four new variables: Self-identity, Perceived Importance, Consideration of Future Consequences, and Concern for Appearance as possible determinants of healthy behavior. (2) We exhaustively explored the relationships/interactions between the HBM variables and their effect size. (3) We tested the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model.

Methods:

To achieve the objective of this paper, we conducted a quantitative study of 576 participants’ eating behavior. Data for this study were collected over a period of one year (from August 2011 to August 2012). The questionnaire consisted of validated scales assessing the HBM determinants – perceived benefit, barrier, susceptibility, severity, cue to action, and self-efficacy – using 7-point Likert scale. We also assessed other health determinants such as consideration of future consequences, self-identity, concern for appearance and perceived importance. To analyses our data, we employed factor analysis and Partial Least Square Structural Equation Model (PLS-SEM) to exhaustively explore the interaction/relationship between the determinants and healthy eating behavior. We tested for the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model and investigated possible mediating effects.

Results:

The results show that the three newly added determinants are better predictors of healthy behavior. Our extended HBM model lead to approximately 78% increase (from 40 to 71%) in predictive capacity compared to the old model. This shows the suitability of our extended HBM for use in predicting healthy behavior and in informing health intervention design. The results from examining possible relationships between the determinants in our model lead to an interesting discovery of some mediating relationships between the HBM’s determinants, therefore, shedding light on some possible combinations of determinants that could be employed by intervention designers to increase the effectiveness of their design.

Conclusion:

Consideration of future consequences, self-identity, concern for appearance, perceived importance, self-efficacy, perceived susceptibility are significant determinants of healthy eating behavior that can be manipulated by healthy eating intervention design. Most importantly, the result from our model established the existence of some mediating relationships among the determinants. The knowledge of both the direct and indirect relationships sheds some light on the possible combination rules.     

Formative research on adolescent and adult perceptions of risk factors for breast cancer

This study uses the Health Belief Model (HBM) as a framework to guide formative research of the lay public's perceptions of risks associated with breast cancer. Data were collected from adolescent females and adult females across four counties in Michigan, US. Ten focus groups (N=91) were conducted and analyzed with a coding scheme based on the HBM. Participants' responses to focus group questions (N=5168 thought units) reveal beliefs about severity, susceptibility, and efficacy pertaining to breast cancer, nutrition, activity, environment, and the role of government and industry. Chi-squares examined the distribution of statements across categories between adult females and adolescent females. Results revealed that both adolescent and mother groups recognized gender and heredity as relevant risk factors related to susceptibility, and detection as a strategy to decrease severity of breast cancer through early treatment. Beliefs about environmental factors were characterized by uncertainty for both groups. Also, while adolescent girls communicated more about efficacy issues, mothers focused significantly more than adolescent girls on the role of government and industry in breast cancer prevention and treatment. Representative qualitative thought units are included based on their frequency, salience, and relevance to HBM message design guidelines. Formative research is the first phase in the development of health campaigns, informing the creation of health messages for target audiences.     

Health Blief Model-based intervention to improve nutritional behavior among elderly women

BACKGROUND/OBJECTIVESNutrition is a determinant factor of health in elderly people. Independent living in elderly people can be maintained or enhanced by improvement of nutritional behavior. Hence, the present study was conducted to determine the impact of Health Belief Model (HBM)-based intervention on the nutritional behavior of elderly women.SUBJECTS/METHODSCluster-random sampling was used to assess the sample of this clinical trial study. The participants of this study attended a 12-week nutrition education program consisting of two (2) sessions per week. There was also a follow-up for another three (3) months. Smart PLS 3.5 and SPSS 19 were used for structural equation modeling, determination of model fitness, and hypotheses testing.RESULTSThe findings indicate that intervention had a significant effect on knowledge improvement as well as the behavior of elderly women. The model explained 5 to 70% of the variance in nutritional behavior. In addition, nutritional behavior was positively affected by the HBM constructs comprised of perceived susceptibility, self-efficacy, perceived benefits, and barriers after the intervention program.CONCLUSIONThe results of this study show that HBM-based educational intervention has a significant effect in improving nutritional knowledge and behavior among elderly women.     

Health salience: reclaiming a concept from the lost and found

This paper describes development of a new measure to assess one dimension of health motivation, the salience of health concerns. The new, five-item, measure was administered to 578 women as part of a larger investigation examining the determinants of exercise and calcium consumption. The study used a cross-sectional survey research design. Data were analyzed separately for premenopausal and menopausal women, allowing us to cross-validate our findings in two independent samples. Our findings suggest that the new measure has many desirable psychometric properties. It is internally consistent (Cronbach's alpha = 0.85 and 0.86 for premenopausal and menopausal women, respectively). For both samples, factor analysis revealed that over 60% of the total item variance was explained by a single underlying factor. All factor loadings exceeded 0.74. The measure also correlated in predictable ways with measures of other health beliefs, differentiated among women in different stages of change with respect to exercise and calcium consumption, and discriminated between women on the basis of their information-seeking behavior. We discuss the potential applications of this new measure in future research. Hopefully, the measure will facilitate research on the role that health salience plays in the behavior change process.     

The impact of family history of breast cancer on women's health beliefs, salience of breast cancer family history, and degree of involvement in breast cancer issues.

Prior investigations have employed the Health Belief Model (HBM) to predict health care utilization and cancer screening behaviors. The HBM is expanded in the current investigation to include issue involvement with breast cancer and salience of breast cancer family history. Differences in the constructs of this expanded HBM, as they relate to mammography screening, between women with positive and negative family histories of breast cancer were assessed in 378 women. Perceived benefits and barriers were found to be similar for women with positive and negative family histories of breast cancer. However, susceptibility, cues to action, salience of family history, and issue involvement were found to be more relevant for women with a positive family history of breast cancer. These findings have implications for interventions directed at increasing compliance with recommendations for breast cancer screening.     

Gesundheitskompetenztraining für Menschen in Langzeitarbeitslosigkeit

Among the long-term unemployed ill health is often a hindrance to successful reintegration in the job market. In a quasi-experimental controlled study we examined the effects of a health promotion intervention program tailored to the specific needs of the long-term unemployed combining individual sessions based on motivational interviewing and participatory group sessions including physical activity. Over a period of 3 months the participants of the intervention group (n?=?179) showed more improvement compared to the control group (n?=?108) in terms of motivation for lifestyle changes towards more physical activity and healthier nutrition. Participants of the intervention group developed an intention to act significantly more often (active lifestyle: odds ratio 4.44; 95% CI: 2.00-9.83; healthy nutrition: odds ratio 3.94; 95% CI: 1.55-10.00) and actually implemented a behavior change significantly more often (active lifestyle: odds ratio 2.77; 95% CI: 1.35-5.71; healthy nutrition: odds ratio 4.34; 95% CI: 1.92-9.78). In terms of smoking and alcohol consumption no significant intervention effects were detected. The results of the study show the effectiveness of the described health promotion program regarding a lifestyle change towards more healthy nutrition and more physical activity.     

Using the Health Belief Model to Explain Clinic Appointment-Keeping for the Management of a Chronic Disease Condition

Broken appointments have untoward repercussions for patients' health and well-being. Although the literature on missed appointments has been largely atheoretical, several studies have tested the Health Belief Model (HBM) in this context. Those studies have found HBM dimensions are not predictive of keeping appointments for the management of a chronic condition. Given several limitations that characterize these studies, questions can be raised about the validity of this conclusion. This study investigated the utility of HBM for explaining appointment-keeping for Systemic Lupus Erythematosus (SLE), a potentially fatal chronic disease. A questionnaire, operationalizing HBM dimensions and exhibiting acceptable psychometric properties, was developed for this research and administered to 153 SLE patients enrolled at an outpatient clinic of a major teaching hospital. In addition to measuring intention to keep appointments, data were abstracted from medical records regarding actual appointment-keeping during 12 months prior to and 6 months following questionnaire completion. Regression analysis indicated that general health motivation and perceived severity of SLE were uniquely associated in the theoretically predicted direction with, respectively, intent and the percentage of scheduled appointments kept (PSAK) during the 12 month retrospective period. Perceived costs was associated in the expected direction with intent, 12 month retrospective and 6 month prospective PSAK. Typical of HBM research the effect sizes uncovered were modest in magnitude. Questions for future investigation are discussed.     

A meta-analysis of the effectiveness of health belief model variables in predicting behavior

The Health Belief Model (HBM; Rosenstock, 1966) was constructed to explain which beliefs should be targeted in communication campaigns to cause positive health behaviors. The model specifies that if individuals perceive a negative health outcome to be severe, perceive themselves to be susceptible to it, perceive the benefits to behaviors that reduce the likelihood of that outcome to be high, and perceive the barriers to adopting those behaviors to be low, then the behavior is likely for those individuals. A meta-analysis of 18 studies (2,702 subjects) was conducted to determine whether measures of these beliefs could longitudinally predict behavior. Benefits and barriers were consistently the strongest predictors. The length of time between measurement of the HBM beliefs and behavior, prevention versus treatment behaviors, and drug-taking regimens versus other behaviors were identified as moderators of the HBM variables' predictive power. Based on the weakness of two of the predictors, the continued use of the direct effects version of the HBM is not recommended.     

The Health Belief Model

The objective of this discussion is to show how the Health Belief Model (HBM) can be applied to family planning in general, and in particular to the use or nonuse of contraception among sexually active young females. Katatsky has argued that the HBM should be used to guide family planning research, but the shortcoming of her article is that she fails to go into detail regarding how the specific concepts of the HBM would be useful. The attempt in this is made in this discussion to go beyond Katastky's general statement. Her main argument for use of the HBM is that it focuses on the role of motivating factors in the prevention of health problems. This is particularly relevant in understanding the birth control practices of teenagers, for whom motivational factors are more important than lack of knowledge in inhibiting the use of contraception. The HBM assumes that motivation is a necessary condition for action. The 2 major components of motivation in the HBM are perceived susceptibility and perceived severity. In the family planning area, perceived susceptibility refers to the perceived risk of becoming pregnant and is an important factor explaining the use or nonuse of contraception particularly among adolescents. Lack of perceived susceptibility to pregnancy can result in risk taking, but risk taking itself can lead to lowered feelings of susceptibility. The HBM assumes that the more serious a health problem is viewed, the more likely one is to take preventive action against it. Research has consistently shown that contraceptive effectiveness rates for couples who have definitely decided not to have any more children is considerably higher than for those couples who only want to delay the next pregnancy. Research with unmarried women has shown that those who have high educational and career goals are more likely to practice effective contraception than those who give priority to motherhood over a career. According to the HMB, before taking preventive health actions, persons weigh the perceived benefits of the health action against the cost of taking the proposed actions. There are major costs of using contraceptives that are not method specific. These include the reluctance to plan ahead for sexual intercourse and the cost of admitting to others that one is sexually active. Other costs are method specific. The final major concept of the HBM is a cue to action that stimulates preventive behavior. Cues could be internal (coming from within the individual) or external (coming from others). An internal cue could be a delayed menstrual period.     

Factors Influencing Healthy Eating Habits Among College Students: An Application of the Health Belief Model

Poor eating habits are an important public health issue that has large health and economic implications. Many food preferences are established early, but because people make more and more independent eating decisions as they move through adolescence, the transition to independent living during the university days is an important event. To study the phenomenon of food selection, the heath belief model was applied to predict the likelihood of healthy eating among university students. Structural equation modeling was used to investigate the validity of the health belief model (HBM) among 194 students, followed by gender-based analyses. The data strongly supported the HBM. Social change campaign implications are discussed.     

Application of the Health Belief Model to Teach Complementary Feeding Messages in Ethiopia

In Ethiopia many women do not practice appropriate complementary feeding (CF). The Health Belief Model (HBM) asserts that change in behavior is determined after consideration of severity, benefit, and barriers to change. This study examined the effectiveness of 3 months of HBM-based education compared to the traditional (didactic) method on CF practices of mothers, with no education as control, using three randomized groups. One hundred sixty-six mother-infant (6–18 months) pairs were recruited. At baseline and after intervention, knowledge, perceptions, and practices about CF and related areas were determined. It was only diet diversity that increased significantly in the HBM group (from 3.05 ± 0.94 food groups to 3.79 ± 0.82, p < .05) while the other two groups had no change. Improvements in food groups were most noticeable as legumes & nuts (from 35.6% use to 83.9% in HBM group). Thus, nutrition education about diet diversity improvement needs to be conducted promotes behavior change.     

A psychosocial perspective in the explanation of patients' drug-taking behavior

The goal of this study was to examine the applicability of the Health Belief (HBM) and Theory of Reasoned Action (TRA) models in predicting drug-taking compliance behavior among female patients with uncomplicated urinary tract infections. Thirty-eight percent of the respondents were compliant, 25% finished all of their medication, but missed one or more doses during the course of therapy, and 37% did not finish all of their medication as directed. Two HBM and three TRA variables had a statistically significant relationship with compliance: barriers and benefits (HBM) and belief strength, outcome evaluation, and behavioral intention (TRA). HBM variables explained 10% of the variance in the compliance variable. Adding the TRA variables to the model explained an additional 19% of the variance. Social influence variables (normative expectations, motivation to comply, and subjective norms) had a significant influence in the prediction of behavioral intention, but not in the prediction of compliance behavior. Suggestions for improving compliance based on these findings include: simplification of drug therapy by customizing and simplifying the regimen, continued patient reminders of the therapy's value, and benchmarks for patients to evaluate the success or failure of therapy. A frank and open discussion from the start of therapy about its complexity, the medication's side effects, time and fiscal constraints, and other factors which may modify patients' perception of the likelihood of compliance is an important key to improving patients' compliance behavior.     

The Effect of Educational Program on Increasing Cervical Cancer Screening Behavior among Women in Hamadan, Iran: Applying Health Belief Model

Background: The systematic application of Pap test helps early diagnosis and effective treatment of cervical cancer. This study was conducted to assess the effect of education on health beliefs and practice of women eligible for Pap test using Health Belief Model (HBM). Methods: This quasi-experimental study was conducted in Hamadan City, the west of Iran, in 2010 using before-after design. In this study, 70 women aged 16 to 54 years participated voluntarily who had never done Pap test until the date of the study. The volunteers were divided into several small groups. For each group, 2-hour training session was held twice. The data collection tool was a self-administered multi-choice questionnaire that was developed based on HBM constructs. Health beliefs and practice of the target group were evaluated pre-intervention and four months later. Results: Our findings indicated that education based on HBM was effective and could enhance the participants' knowledge significantly and improve the HBM constructs including perceived susceptibility, severity, benefits, and barriers. The training program enhanced the practice from zero before intervention to 81.4% after that. The results of the present study revealed that increase in knowledge had effect on the HBM constructs. Furthermore, there was a significant relationship between knowledge and both age and educational level. Conclusion: Health education based on HBM can enhance women's knowledge of cervical cancer, change their health beliefs and improve their behaviors regarding screening programs like Pap test.     

Nutrition knowledge, attitude, and behavior of Taiwanese elementary school children

The purpose of this study is to understand nutrition knowledge, attitude, and behavior in Taiwanese elementary school children, and the relationship of these various components. The results indicated that children's knowledge was fair in nutrition basics, but poor in 'the physiological function of nutrients', 'relationships between diet/nutrients and disease', and 'the daily serving requirement for different food groups'. Children in general valued the importance of nutrition, but they did not concern the health benefit of foods in food selections. Their dietary quality was not satisfactory, and the diet of most children did not meet the recommended serving requirements for milk, vegetable, fruit, and cereals and grains groups. Positive relationships were found among nutrition knowledge, attitude, caring- about-nutrition behavior and dietary quality score. The restraint or disinhibited eating behavior of 4th to 6th graders was not serious, but a large number of children already performed some self-controlling practices to avoid obesity, but not frequently. One fourth of the students skipped meals, especially breakfast, and one quarter of 4th to 6th graders prepared their own breakfast; which may have some impact on children's diet quality. A gap was found between nutrition knowledge, attitude and eating behavior, especially vegetable and fruit consumption, indicating that the attitude toward eating for health was not strong in this age group. Future nutrition education for school children should not only include food serving requirements of food groups, but also apply appropriate theories to improve the motivation for healthy eating.     

Health beliefs and physical activity behavior in adults with multiple sclerosis

BackgroundUnderstanding how health beliefs intersect with physical activity in people with multiple sclerosis (MS) is an important step in developing effective activity promotion programs.ObjectiveThe purpose of the study was to employ the Health Belief Model (HBM) to assess the health beliefs of adults with MS and examine the relationship between health beliefs and physical activity behavior.MethodParticipants with MS (N = 384) completed a web-based survey assessing the following HBM constructs: perceived susceptibility and seriousness of negative health outcomes, perceived benefits and barriers to physical activity, cues to action, and self-efficacy. Self-reported physical activity was also surveyed.ResultsParticipant perceptions of susceptibility to negative health outcomes were focused more on physical conditioning and functioning rather than on general health conditions. The most important HBM predictors of physical activity were self-efficacy and perceived benefits of exercise. Even when controlling for the significant effects of disability level on physical activity, self-efficacy and perceived benefits remained robust exercise predictors.ConclusionIndividuals with MS believe they can benefit from physical activity and remain healthy even in the context of their disease. They also acknowledge the fact that their disability levels limit their exercise capabilities. Given that self-efficacy and perceived benefits of activity are important determinants of physical activity, health promotion efforts should be directed at these modifiable factors.     

The Impact of Family History of Breast Cancer on Women's Health Beliefs,Salience of Breast Cancer Family History,and Degree of Involvement in Breast Cancer Issues

ABSTRACT

Prior investigations have employed the Health Belief Model (HBM) to predict health care utilization and cancer screening behaviors. The HBM is expanded in the current investigation to include issue involvement with breast cancer and salience of breast cancer family history. Differences in the constructs of this expanded HBM, as they relate to mammography screening, between women with positive and negative family histories of breast cancer were assessed in 378 women. Perceived benefits and barriers were found to be similar for women with positive and negative family histories of breast cancer. However, susceptibility, cues to action, salience of family history, and issue involvement were found to be more relevant for women with a positive family history of breast cancer. These findings have implications for interventions directed at increasing compliance with recommendations for breast cancer screening.     

运动和营养知识态度行为对大学生健康生活方式的影响

了解国内在校大学生健康生活行为、营养知识态度行为及课余体育锻炼情况,为提出相应的改善建议提供参考.方法 采用横断面调查研究的方法,选取国内4所综合性院校2 261名在校大学生进行问卷调查.结果 大学生健康生活方式自评标准化得分为65.7分,8个维度标准化得分在50~ 70分之间,其中“运动锻炼”维度标准化得分最低,仅为52.1分.营养知识、态度及行为(KAP)得分分别为(10.5±3.6),(20.8±4.2),(18.3±3.7)分.Logistic回归分析显示,营养KAP得分、每次体育锻炼的强度、认为体育锻炼对人的全面健康的重要程度、在校期间每周参加体育锻炼的次数(体育课除外)、是否愿意参加体育锻炼、现在对课余体育锻炼的态度与健康生活方式自评总得分均呈正相关(P值均<0.05).结论 大学生健康生活方式自评得分较低,营养知识得分相对较低,多数学生营养态度较好,但转化为行为的动力不足;课余体育锻炼现状较好的大学生健康生活方式自我评价更高.     

Predicting Young Adults’ Intentions to Get the H1N1 Vaccine: An Integrated Model

Young adults 19 through 24 years of age were among the populations that had the highest frequency of infection from the 2009 H1N1 pandemic. However, over the 2009–2010 flu season, H1N1 vaccine uptake among college students nationwide was around 8%. To explore the social cognitive factors that influenced their intentions to get the H1N1 vaccine, this study compares the predictive power of the theory of planned behavior (TPB), the health belief model (HBM), and an integrated model. The final model shows that several HBM variables influenced behavioral intentions through the TPB variables. The results suggest that even though the TPB seemed a superior model for behavior prediction, the addition of the HBM variables could inform future theory development by offering health-specific constructs that potentially enhance the predictive validity of TPB variables.