Children's Health Beliefs Research Articles

Understanding Treatment Adherence With the Health Belief Model in Children With Cystic Fibrosis.

Children's health beliefs are significantly related to their adherence; however, pediatric literature has rarely tested health-related theories as a whole. The goal of the present study was to evaluate the use of the health belief model (HBM) in understanding children's adherence, both globally and to individual treatment components. Thirty-three patient-parent dyads completed questionnaires regarding health beliefs and adherence to medical regimens. Multiple linear regressions found a significant relationship among the HBM variables and reports of global adherence for children and parents. For children, the HBM variables were significantly related to adherence to aerosol medications, aerosol antibiotics, metered dose inhalers, and vitamins. For parents, the HBM variables were significantly related to children's adherence to airway clearance, oral antibiotics, and vitamins. Paired sample t tests found children and parents had significantly discrepant heath beliefs. These findings provide further support for the HBM in evaluating pediatric adherence, with evidence that barriers and cues to action may be targets for early intervention. Future research using this model to identify a comprehensive way to assess, understand, and elicit change in the adherence to medical regimens for youth with chronic illness would be beneficial.

Parental influence on models of primary prevention of cardiovascular disease in children.

Lifestyle behaviors such as overeating and physical inactivity contribute significantly to CVD, the leading cause of morbidity and mortality among adults globally. CVD risk factors that begin in children often track into adulthood. Parents are believed to influence the health behaviors of their children. To review the literature on parental influence on children's health beliefs and behaviors, particularly eating and exercise behaviors as indicators of CV health, school-based CVD risk reduction programs, and racial/ethnic, gender and socioeconomic considerations for models of primary prevention of CVD in children. Seventeen studies that included parents as either a source of information, change agent or participant in a CVD risk reduction intervention were identified searching the Medline, CINAHL and PsycINFO databases from 1980 through 2002. Children's lifestyle health beliefs and behaviors are significantly influenced by positive parental modeling and involvement in exercise and healthy eating; parental influence on children's behavior lasts beyond adolescence; parents are effective teachers of health habits at home when prompted by health educators; and parental influences vary by ethnicity/race, socioeconomics and gender. A broader base of knowledge that is socioculturally sensitive must be developed about what parents and children believe is healthy, how parents model beliefs and behaviors for their children, and how to build self-efficacy for positive health behaviors.

Understanding young children's health beliefs and diabetes regimen adherence.

Previous studies of chronic illness management in children have focused mainly on parents' health beliefs. However, children's health beliefs also can be an important factor in predicting adherence. Indeed, children 6 to 10 years old spend most waking hours away from home, are under less parental supervision, and are becoming more responsible for their own care. The purpose of this study was to develop a pictorial, multi-item instrument to measure dimensions of the Health Belief Model (HBM) and self-efficacy (SE), designed specifically for children with diabetes, thus making it possible to examine both the parent's and child's health beliefs; to explore the relationship between their beliefs; and to examine the extent to which these beliefs are predictors of adherence and metabolic control.

Development and Change of Young Adults' Preventive Health Beliefs and Behavior: Influence from Parents and Peers

A longitudinal data set is employed to explore the sources of stability and change in young adults' health beliefs and behavior concerning drinking, diet, exercise, and wearing seat belts. There is substantial change in the performance of health behaviors during the first three years of college, and peers have a strong impact on the magnitude of that change. In total, however, parents are much more important than peers as sources of influence over these beliefs and behaviors. Of the various social influence processes considered, the direct modeling of behavior appears to be the most important avenue of influence for both parents and peers. These data, along with previous papers in our research program, suggest a pattern of gradually increasing parental influence on their children's health beliefs and behavior while the children are living at home, and the persistence of that influence at least through the college years.

A Children??s Health Belief Model

The classic Health Belief Model (HBM) was adapted to explain children's expected medicine use for five common health problems. To evaluate this Children's Health Belief Model (CHBM), 270 urban preadolescents, stratified by socioeconomic status, grade level, and sex, and their primary caretakers (93% mothers) were individually interviewed. Analyses were performed in two steps. First, regression analysis evaluated the influence of the child's primary caretaker on the child's expected medicine use. Individual differences in children's motivations, perceived benefits and threats, and expectations to take medicines were partially explained by caretakers' perceptions of these children. Second, path analysis evaluated hypothesized causal relationships in the CHBM, accounting for 63% of the adjusted variance in children's expected medicine use. Two readiness factors, perceived severity of illness and perceived benefit of taking medicines, had the highest path coefficients, with illness concern and perceived vulnerability to illness accounting for a smaller, but significant, portion of the variance. Cognitive/Affective variables, notably children's health locus of control, contributed to indirect paths between demographic and readiness factors. The CHBM appears to be a promising model for studying the development of children's health beliefs and expectations.

The effect of health beliefs and feelings of self efficacy on self management behavior of children with a chronic disease

This study is among the first to examine the value of chronically ill children's health beliefs, self-efficacy beliefs, experiences of hospitalization, and participation in a health education program in predicting self-management behavior. Data were collected from a random sample of 214 children with asthma being served by any of four NYC hospitals. As measured, perceived self-efficacy, prior hospitalization and participation in a health education program had modest predictive value for self-management while measures of perceived severity of asthma attacks and beliefs in the benefits of self-management techniques in controlling the disease failed to predict subsequent use of self-management techniques. We conclude that (1) the Health Belief Model may not be useful in predicting the behavior of children because of their developmental status, or (2) the measures used in the present study did not adequately tap the health belief constructs.

Origins and stability of children's health beliefs relative to medicine use

Two hundred and seventy urban school children and their primary caretakers (93% mothers) were interviewed in Washington, D.C., about their health beliefs and behaviors relative to medicine use and expected medicine use for common health problems to test hypotheses about the development of children's health beliefs and behaviors. Results indicated that mothers have a stronger influence on health related orientations of children than previously indicated and that these orientations are relatively stable by school age. Strong similarities were observed between primary caretakers and their children in a health belief based model to predict expected medicine use, and significant correlations between primary caretakers and children were observed for almost three-fourths of the variables in the model; correlations were not higher between mothers and older children than between mothers and younger children, nor were means of variables closer to those of mothers for older than for younger children. Most model variables were stable for children over a 3 year period, and measurement in the earlier period predicted medicine use and expected medicine use 3 years later. Only weak developmental affects were suggested, primarily by perceived vulnerability to illness, a powerful predictor in adult representations of the Health Belief Model, but relatively weak in children's representations.

Parental and Child Health Beliefs and Behavior

Personal interviews concerning health beliefs and behaviors were conducted with a parent and child in each of 250 households. Index scores were constructed for parental and child health beliefs, and these scores were entered, along with demographic variables, in a series of multiple regression analyses predicting child health beliefs and behaviors. The age of the child was the variable most highly associated with three of four child health behaviors and four of six child health beliefs. The children's snacking between meals and cigarette smoking were related to several parental behaviors and, to a lesser extent, parental health beliefs. The children's health beliefs were less predictable than were their health behaviors, and the observed significant relationships were with parental health beliefs and demographics. The implications for the design of health education programs are discussed.

Dimensions of children's health beliefs.

Health beliefs interviews were conducted with 250 children aged 6-17 years. A factor analysis of the items resulted in six correlated factors which were interpreted as 1) specific health concerns, 2) general health concerns, 3) perceived parental concern, 4) perceived general susceptibility, 5) perceived susceptibility to specific conditions, and 6) perceived seriousness of and susceptibility to disease. Factor scores were computed and two-way analyses of variance (by age and sex of child) were conducted on six sets of factor scores. No significant sex differences or sex by age interaction effects were noted. Younger children scored significantly higher on "specific health concerns" and "perceived general susceptibility," while older children scored significantly higher on "perceived parental concern." Tests of differences among variances showed a tendency for the variability to be greater among younger children. The results are interpreted as providing partial support for a model of children's health beliefs and as a basis for further operationalization of concepts which are central to an understanding of motivated health behavior. Implications for practice are discussed.

Children's Health Beliefs and Acceptance of a Dental Preventive Activity

In a study of participation in a school-based preventive dental program, the relationship between children's beliefs about health and their participation did not follow predictions of the Health Belief Model. Further, perceived efficacy was the only belief altered by an introduction to the program, despite the fact that some children participated in group discussions designed to change other health beliefs as well. The similarity of these data to other data on health beliefs of children and adults is cited. It is suggested that health beliefs are difficult to change and are often unrelated to behavior. It is also suggested that health beliefs and behavior might be parallel developments in the individual that need not be causally related.

Some Correlates of Children's Health Beliefs and Potential Health Behavior

Predictions that perceived vulnerability to health problems is (1) inversely related to potential health behavior in persons with high degrees of perceived internal control, (2) directly related to potential health behavior in persons with low perceived internal control, and (3) inversely related to perceived internal control in persons for whom health is salient, were all confirmed by a study of 108 children, aged 7 to 18, conducted at a summer camp. The results highlight the importance of an interplay of factors in determining health-related behavior, and are consistent with the health-belief model. THE salience of health, perceptions of vulnerability to health problems, and perceptions of internal control over environmental events form a set of related elements whose implications for potential health behavior are the focus of this study. The obstacles encountered by health professionals and social scientists who attempt to shape or modify specific health behaviors attest to the importance of increasing understanding of developmental aspects of health-relevant behavior. Although most behavioral and psychological studies of health behavior have attempted to influence specific behavioral acts (e.g., smoking reduction, presymptomatic screening, dieting) through systematic variation of the content and format of messages or the underlying motivational state of the target, this study will, in contrast, explore health-relevant behavior as it exists naturally, without experimental manipulation. The salience of health. Confronted with a direct question about the value he attaches to health, the average person is likely to reply that he considers health to be very important, and that good health