Health Behavior Self-efficacy Research Articles

The Influence of Health Literacy among Undergraduates on Health-Promoting Lifestyles mediated by Health Behavior Self-Efficacy: Evidence from Jiangxi Province,China

Purpose This study aims to investigate the relationship between undergraduates' health literacy, health behavior self-efficacy, and health-promoting lifestyles. Method In April 2021, a survey was conducted with 1050 undergraduates from 9 universities in Jiangxi Province, utilizing Health Literacy Scales, Health Behavior Self-efficacy Scales, and Health-Promoting Lifestyle Revision Scales. Results (1) The average health literacy score among undergraduates was (66.17±10.01), with 81.6% of students having high or marginal health literacy. The average score for health-promoting lifestyles was (101.34±16.09), indicating an above-average level. The total score for health behavior self-efficacy was (89.23±18.43), indicating a general level of self-efficacy. (2) Positive correlations were found between undergraduates' health literacy, health behavior self-efficacy, and health-promoting lifestyles (r=0.259 ~ 0.759, P < 0.05). (3) Health behavior self-efficacy was found to mediate the relationship between undergraduates' health literacy and health-promoting lifestyles. Conclusion To promote a healthy lifestyle among undergraduates, it is crucial to not only improve their health literacy but also enhance their health behavior self-efficacy.

Theoretical Mediators of Diabetes Risk and Quality of Life Following a Diabetes Prevention Program for Latino Youth With Obesity.

This study tested self-efficacy and social support for activity and dietary changes as mediators of changes in type 2 diabetes related outcomes following a lifestyle intervention among Latino youth. Latino adolescents (14-16 years) with obesity (BMI% = 98.1 ± 1.4) were randomized to a 3-month intervention (n = 67) that fostered self-efficacy and social support through weekly, family-centered sessions or a comparison condition (n = 69). Primary outcomes included insulin sensitivity and weight specific quality of life. Mediators included self-efficacy, friend, and family social support for health behaviors. Data was collected at baseline, 3-months, 6-months, and 12-months. Sequential path analysis was used to examine mediators as mechanisms by which the intervention influenced primary outcomes. The intervention had a direct effect on family (β = 0.33, P < .01) and friend social support (β = 0.22, P < .001) immediately following the intervention (3-months). Increased family social support mediated the intervention's effect on self-efficacy at 6-months (β = 0.09, P < .01). However, social support and self-efficacy did not mediate long-term changes in primary outcomes (P > .05) at 12-months. Family social support may improve self-efficacy for health behaviors in high-risk Latino youth, highlighting the important role of family diabetes prevention. Fostering family social support is a critical intervention target and more research is needed to understand family-level factors that have the potential to lead to long-term metabolic and psychosocial outcome in vulnerable youth.

Health-Promoting Lifestyle and Its Predictors in Adolescent Survivors of Childhood Cancer.

Background: Cancer survivors are at increased risk of long-term adverse effects related to the disease or treatment. Thus, it is important for cancer survivors to adopt a health-promoting lifestyle (HPL). This study aims to: (1) describe health behavior self-efficacy (HBSE) and HPL of adolescent survivors of childhood cancer, (2) examine the relationships between HBSE, HPL, and various demographic factors, and (3) identify determinants of HPL among adolescent survivors of childhood cancer. Method: A descriptive cross-sectional study was conducted with adolescent survivors of childhood cancer, ranged in age from 11 to 19 years (n = 82). Participants were recruited from pediatric oncology follow-up clinics at two medical centers in southern Taiwan. Data for each participant were collected from questionnaires assessing HBSE and HPL. Results: Only 61% of the adolescent survivors were considered as normal weight. The exercise was the lowest scoring HBSE subscale. Factors associated with better HPL included: education level, HBSE, well-being, and a healthy diet. Specifically, survivors diagnosed with cancer during adolescence exhibited significantly greater self-efficacy with stress management (F = 3.20, p = .04) compared with those diagnosed at pre-school ages. HBSE scores for well-being and a healthy diet were significant predictors of HPL, accounting for 43.8% of the total variance observed. Discussion: Our findings suggest that the age of diagnosis of childhood cancer significantly modulates the frequency of health-promoting behaviors of adolescent survivors. Thus, interventions designed to enhance adolescents' well-being and the management of a healthy diet may enhance HPL in survivors of childhood cancer.

Protocol of a randomized controlled trial to test the effects of client-centered Representative Payee Services on antiretroviral therapy adherence among marginalized people living with HIV

BackgroundClient-Centered Representative Payee (CCRP) is an intervention modifying implementation of a current policy of the US Social Security Administration, which appoints organizations to serve as financial payees on behalf of vulnerable individuals receiving Social Security benefits. By ensuring beneficiaries’ bills are paid while supporting their self-determination, this structural intervention may mitigate the effects of economic disadvantage to improve housing and financial stability, enabling self-efficacy for health outcomes and improved antiretroviral therapy adherence. This randomized controlled trial will test the impact of CCRP on marginalized people living with HIV (PLWH). We hypothesize that helping participants to pay their rent and other bills on time will improve housing stability and decrease financial stress.MethodsPLWH (n = 160) receiving services at community-based organizations will be randomly assigned to the CCRP intervention or the standard of care for 12 months. Fifty additional participants will be enrolled into a non-randomized (“choice”) study allowing participant selection of the CCRP intervention or control. The primary outcome is HIV medication adherence, assessed via the CASE adherence index, viral load, and CD4 counts. Self-assessment data for ART adherence, housing instability, self-efficacy for health behaviors, financial stress, and retention in care will be collected at baseline, 3, 6, and 12 months. Viral load, CD4, and appointment adherence data will be collected at baseline, 6, 12, 18, and 24 months from medical records. Outcomes will be compared by treatment group in the randomized trial, in the non-randomized cohort, and in the combined cohort. Qualitative data will be collected from study participants, eligible non-participants, and providers to explore underlying mechanisms of adherence, subjective responses to the intervention, and implementation barriers and facilitators.DiscussionThe aim of this study is to determine if CCRP improves health outcomes for vulnerable PLWH. Study outcomes may provide information about supports needed to help economically fragile PLWH improve health outcomes and ultimately improve HIV health disparities. In addition, findings may help to refine service delivery including the provision of representative payee to this often-marginalized population. This protocol was prospectively registered on May 22, 2018 with ClinicalTrials.gov (NCT03561103).

Assessment of patients' psychological state and self-efficacy associated with postoperative constipation after thoracolumbar fracture surgery.

ObjectiveWe aimed to explore the relationship among the duration of constipation at 30 days after thoracolumbar fracture surgery, self-efficacy, and anxiety or depression in patients with constipation after thoracolumbar fracture surgery.MethodsIn this descriptive correlational study, 108 patients with thoracolumbar fracture undergoing pedicle screw fixation surgery were recruited from January 2015 to May 2017 in our hospital. From the day of surgery, we conducted a 1-month follow-up investigation. We evaluated the pattern of defecation, stool consistency, and incidence of defecation-related problems using a structured interview. Clinical data were obtained using a patient intake form, and we applied the Health Behavior Self-Efficacy Scale (HBSES), and Hospital Anxiety and Depression Scale (HADS).ResultsApproximately 83.3% of patients experienced postoperative constipation, and most exhibited normal defecation by postoperative day 13. Self-efficacy and anxiety and depression were graded at a medium level in most patients. The average HBSES score was 74.39 ± 11.08, and the mean HADS score was 7.97 ± 4.08. The duration of postoperative constipation was negatively correlated with self-efficacy and positively associated with anxiety or depression.ConclusionsSelf-efficacy, anxiety, and depression are important sociopsychological factors associated with the duration of postoperative constipation.

Factors Affecting Regular Physical Activity in Nursing Students

Objectives This study aimed to investigate the distribution of stages of change of physical activity and identify the influence of self-efficacy for physical activity, stress, and stress-coping style on regular physical activity in nursing students. Methods A cross-sectional survey was conducted at 3 universities in the cities of C, I, and U in Korea. Data on stages of change for physical activity, self-efficacy for physical activity, stress-coping style, stress level, and health behaviors were collected from 209 nursing students. Data were analyzed using ANOVA, chi-square, Pearson’s correlation, and logistic regression analyses. Results The highest proportion (39.2%) of nursing students were at the contemplation stage of change for physical activity. The mean score of self-efficacy was 2.67 out of 5 points. Among the participants’ stress-coping styles, the average number of active coping styles was 4.74 out of 7 points, and passive coping styles was 4.67 out of 7 points. Regular physical activity was related to self-efficacy, stress coping, and stress level. Regression analyses showed that self-efficacy for physical activity (odds=2.30), emotion-focused stress coping (odds=1.65), and stress coping involving seeking social support (odds=1.44) were significant predictors of regular physical activity (R2=0.20). Conclusions The recognition of individual’s self-efficacy, stresscoping styles, and stages of change for physical activity might be a factor in improving regular physical activity among nursing students. While nursing students at the lower stages need more self-efficacy, those at the higher stages require more social support resources in the program for physical activity for nursing students. Key words: Nursing student, Physical activity, Self-efficacy, Stages of change, Stress

Health-promoting lifestyles and their related influences among nursing assistants in nursing homes in China

ObjectiveThe aims are to assess the health-promoting lifestyle status of nursing assistants in nursing homes in China and explore the roles of demographic, health conception, perceived health behavior self-efficacy, and job satisfaction in health-promoting lifestyles. MethodUsing a cross-sectional descriptive design and convenience sampling, 285 nursing assistants from different nursing homes in Hangzhou were investigated using the Health-Promoting Lifestyle Profile II, Self-Rated Abilities for Health Practice Scale, Health Conception Scale, Minnesota Satisfaction Questionnaire, and a demographic questionnaire to measure their health-promoting lifestyle status. The collected data were analyzed using SPSS20.0. ResultsThe total score of health-promoting lifestyles among investigated nursing assistants is 114 (13). Six dimensions are standardized, including interpersonal relations, health responsibility, stress management; nutrition, spiritual growth, and physical activity, listed in descending order of their values. The variables of gender, education, number of care recipients, and religion appear to significantly influence nursing assistants' health-promoting lifestyles (p<0.05). Perceived health behavior self-efficacy, health conception, and job satisfaction are significantly positively correlated with health-promoting lifestyles (p<0.05). Multiple regression analysis revealed that the predictor variables, such as gender, religion, number of care recipients, and perceived health behavior self-efficacy, can explain 48.4% of the variance in health-promoting lifestyles. ConclusionThe level of health-promoting lifestyles is mediocre in nursing assistants in China, with the highest score in interpersonal relations and the lowest score in physical activity. The variables of gender, education, number of care recipients, religion, and perceived health behavior self-efficacy can serve as effective predictors of health-promoting lifestyles.

Association between change in self-efficacy to resist drinking and drinking behaviors among an HIV-infected sample: Results from a large randomized controlled trial

Heavy drinking among HIV-infected individuals is associated with health complications. Health-behavior self-efficacy may be characteristically low among this population or negatively affected by HIV-infected status. We assessed whether self-efficacy to resist drinking increased during brief educational and motivational drinking-reduction interventions within HIV primary care and whether increases in self-efficacy predicted drinking among HIV-infected heavy drinkers. Results indicate that increases in self-efficacy from baseline to end-of-intervention inversely predicted drinking at end-of-intervention and at follow-up. Findings suggest that brief treatment interventions within HIV primary care may promote self-efficacy and that increases in self-efficacy predict initiation and maintenance of drinking reductions among HIV patients.

Rural health behavior at high risk of chronic obstructive pulmonary disease self-efficacy and its influencing factors

Objective To understand the self-efficacy for health behaviors and its influencing factors among investigation of rural chronic obstructive pulmonary disease (COPD) high-risk groups. Methods November 2014 using the general questionnaire, Health Behavior Self-efficacy Scale for 176 over 40 yearsold of high-risk populations in rural COPD self-efficacy and health behavior factors research. Results In rural areas at high risk of health behavior self-efficacy scored (71.75±7.68) points, including nutrition and psychological comfortable highest scores which were (14.86±2.03) points and (19.75±3.03) points. Exercise and health responsibilities lower scored 18.90±2.87 and 18.42±2.52. Multiple regression analysis showed that marital status, education level and income were the main factors affecting rural health behavior at high risk of COPD self-efficacy (β=0.384, 0.297, 0.236,P <0.05). Conclusions COPD risk populations in rural areas at the middle level of health behavior self-efficacy, nurses should be given a lower level of education and income were more concerned to help them improve the health behavior self-efficacy. Key words: Pulmonary disease, chronic obstructive; Population with high risk; Health behavior self-efficacy

Research on the correlation between self-efficacy and perceived health control in patients with diabetes

Objective To investigate the correlation between self-efficacy and perceived health control in patients with diabetes , in order to promote health awareness and patients ’ self-efficacy.Methods From October 2011 to October 2013 , totals of 108 diabetic patients were selected as research subjects .The general information about the patient ’ s self-efficacy, perceived health control and other aspects were investigated and analyzed.Results The total score of patient’s health behavior self-efficacy was （61.76 ±8.39） and the average of each item was （2.37 ±0.93）, which was as the medium level.In the score of diabetics control, the score of external authoritative control was （25.47 ±5.39）, which was relatively high.The score of external control of the fate was （20.13 ±5.82）, which was at the second place.The score of internal control was （19.92 ±7.14）, which was the lowest.Through Pearson linear correlation analysis , the self-efficacy of health behavior was positively related to the internal controls and external authoritative performance （ r=0.517, 0.262, respectively;P〈0.05）, and negatively related to the external control of fate （ r =-0.378, P 〈0.05 ）. Conclusions In nursing care , health education and psychological intervention on health behavior of patients should be strengthened through effective guidance and scientific guidance .The believes of patients on promoting health depends on internal control and external control authorities , so as to improve health behavior self-efficacy, develop good habits ,and improve clinical outcomes . Key words: Diabetes; Self-efficacy; Perceived health control

Patient Activation and Improved Outcomes in HIV-Infected Patients

The Patient Activation Measure (PAM) assesses several important concepts in chronic care management, including self-efficacy for positive health behaviors. In HIV-infected populations, better self-efficacy for medication management is associated with improved adherence to antiretroviral medications (ARVs), which is critically important for controlling symptoms and slowing disease progression. To determine 1) characteristics associated with patient activation and 2) associations between patient activation and outcomes in HIV-infected patients. Cross-sectional survey. 433 patients receiving care in four HIV clinics. An interviewer conducted face-to-face interviews with patients following their HIV clinic visit. Survey data were supplemented with medical record abstraction to obtain most recent CD4 counts, HIV viral load and antiretroviral medications. Patient activation was measured using the 13-item PAM (possible range 0-100). Outcomes included CD4 cell count > 200 cells/mL(3), HIV-1 RNA < 400 copies/mL (viral suppression), and patient-reported adherence. Overall, patient activation was high (mean PAM = 72.3 [SD 16.5, range 34.7-100]). Activation was lower among those without vs. with a high school degree (68.0 vs. 74.0, p < .001), and greater depression (77.6 lowest, 70.2 middle, 68.1 highest tertile, p < .001). There was no association between patient activation and age, race, gender, problematic alcohol use, illicit drug use, or social status. In multivariable models, every 5-point increase in PAM was associated with greater odds of CD4 count > 200 cells/mL(3) (aOR 1.10 [95 % CI 1.01, 1.21]), adherence (aOR 1.18 [95 % CI 1.09, 1.29]) and viral suppression (aOR 1.08 [95 % CI 1.00, 1.17]). The association between PAM and viral suppression was mediated through adherence. Higher patient activation was associated with more favorable HIV outcomes. Interventions to improve patient activation should be developed and tested for their ability to improve HIV outcomes.

The Impact of a Health Promotion Educational Program on Cardiovascular Risk Factors for HIV Infected Women on Antiretroviral Therapy

This study investigates the efficacy of a health promotion educational program on improving cardiovascular risk factors of weight, Body Mass Index, and waist to hip ratio in 76 predominately African American HIV-infected women. The health promotion educational program was the control group (that focused on improving self-efficacy for nutrition, exercise, stress reduction and women’s health behaviors) of a NIH-funded study. The majority of participants was overweight, obese, or at high risk based on waist hip ratio at the beginning of the study. There were no statistically significant improvements in body mass index or waist hip ratio from pre intervention to up to 9 months post intervention. There were significant changes in waist hip ratio and body mass index in both directions (improvement and worsened) for a small group of participants. The health promotion program did not affect significant changes in cardiovascular risk and should be revised, lengthened, and refocused on nutrition, diet, exercise, and long term goal commitments to reduce the high risk for cardiovascular disease in this group.

Relationship between health behaviour self-efficacy and health behavior of older hypertension patients

Objective To explore the relationship between health behavior and health behaviour selfefficacy of older hypertension patients.Methods Totals of 206 older hypertension patients were investigated with health behaviour self-efficacy scale and health behaviour scale and Pearson correlation analysis was used.Results The score of patients' health behaviour self-efficacy and health behavior was (66.24 ± 13.95 ) and (72.25 ± 16.66),respectively.50％ patients had a high level of health behavior self-efficacy,and the score of psychological comfort sub-scale was highest.23.8％ patients had a moderate level of health behaviour,and the score of nutrition dimension was highest.Health behaviour self-efficacy was positively correlated with health behavior (P ＜0.01 ).The relationship between dimensionalities of Health behaviour self-efficacy and that of Health behaviour was significantly positive ( P ＜ 0.01 ).Conclusions It is important to establish effective nursing measures to improve health behaviour self-efficacy of older hypertension patients,so as to improve their health behaviour and life quality. Key words: Hypertension; Health behaviour; Older person; Self-efficacy; Relationship

Self‐efficacy for health‐related behaviors among deaf adults

The purpose of this quasi-experimental, pre-post-test study was to test the effectiveness of the Deaf Heart Health Intervention (DHHI) in increasing self-efficacy for health-related behaviors among culturally deaf adults. The DHHI targets modifiable risk factors for cardiovascular disease. A sample of 84 participants completed time-1 and time-2 data collection. The sign language version of the Self-Rated Abilities Scale for Health Practices (SRAHP) was used to measure self-efficacy for nutrition, psychological well-being/stress management, physical activity/exercise, and responsible health practices. Total self-efficacy scores were significantly higher in the intervention group than in the comparison group at time-2, controlling for scores at baseline (F [1, 81] = 26.02, p < .001). Results support the development of interventions specifically tailored for culturally deaf adults to increase their self-efficacy for health behaviors.

The effects of neuroticism and extraversion on self-assessed health and health-relevant cognition

Previous research suggests that personality traits are related to poorer self-assessed health (SAH) and other health-relevant cognition. In the current study, the effects of neuroticism (N), extraversion (E) and their interaction on a variety of SAH and health cognition variables were examined in 66 male and 69 female participants. Previous relations between N, SAH, and self-reported health behavior were replicated and extended. N was also found to predict poorer health behavior self-efficacy, particularly in the presence of low E. E was positively related to health behavior, health behavior outcome expectancies and likelihood estimates for positive health outcomes. There was a curvilinear effect of E on SAH, such that E was related to higher symptom reports and poorer global health ratings only among individuals high in E. The findings suggest that N and E are reliable predictors of health-relevant cognition.

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.

A randomized clinical trial of a wellness intervention for women with multiple sclerosis

Stuifbergen AK, Becker H, Blozis S, Timmerman G, Kullberg V. A randomized clinical trial of a wellness intervention for women with multiple sclerosis. Arch Phys Med Rehabil 2003;84:467-76. Objective: To examine the effects of a wellness intervention program for women with multiple sclerosis (MS) on health behaviors and quality of life (QOL). Design: Randomized clinical trial. Setting: Community setting in the southwestern United States. Participants: Convenience sample of 113 women with physician-confirmed MS (mean age, 45.79y). Interventions: The 2-phase intervention program included lifestyle-change classes for 8 weeks, then telephone follow-up for 3 months. Participants were followed over an 8-month period. Main Outcome Measures: A series of self-report instruments to measure barriers, resources, self-efficacy for health behaviors, health promotion behaviors, and health-related QOL were completed at baseline, 2 months (after the classes), 5 months (after telephone follow-up), and at 8 months. Principal outcomes measures were health-promoting behaviors (scores on the Health Promoting Lifestyle Profile II) and QOL (scores on the Medical Outcomes Study 36-Item Short-Form Health Survey [lsqb]SF-36[rsqb] scales). Results: Hierarchical linear modeling techniques revealed a statistically significant group by time effect for self-efficacy for health behaviors, health-promoting behaviors, and the mental health and pain scales of the SF-36. Conclusion: These data provide initial support for the positive effects of wellness interventions to improve health behaviors and selected dimensions of QOL for women with MS.

An explanatory model of health promotion and quality of life in chronic disabling conditions.

Although previous studies have examined selected factors influencing health-promoting behaviors or quality of life, the complex interplay of these variables in persons with chronic disabling conditions has not been investigated. To test an explanatory model of variables influencing health promotion and quality of life (Stuifbergen & Rogers, 1997) in persons living with the chronic disabling condition of multiple sclerosis (MS). A sample of 786 persons with MS (630 women and 156 men) completed a battery of instruments measuring severity of illness-related impairment, barriers to health-promoting behaviors, resources, self-efficacy, acceptance, health-promoting behaviors, and perceived quality of life. The proposed model was assessed and modified using the weighted least squares procedure (WLS), which is implemented by LISREL8 (Joreskog & Sorbom, 1993). The initial model was modified to obtain a recursive model with adequate fit, chi2 (8, N = 786) = 77, p < 0.05; GFI = 0.96; IFI = 0.98; CFI = 0.98. The antecedent variables accounted for 58% of the variance in the frequency of health-promoting behaviors and 66% of the variance in perceived quality of life. The effects of severity of illness on quality of life were mediated partially by health-promoting behaviors, resources, barriers, self-efficacy and acceptance. The final model supports the hypothesis that quality of life is the outcome of a complex interplay among contextual factors (severity of illness), antecedent variables (Stuifbergen & Rogers, 1997), and health-promoting behaviors. The strength of direct and indirect paths suggests that interventions to enhance social support, decrease barriers, and increase specific self-efficacy for health behaviors would result in improved health-promoting behaviors and quality of life. Further research using a longitudinal design is needed to clarify the effects of the interaction between health-promoting behaviors and trajectory of illness on quality of life for persons with chronic disabling conditions.

Promoting wellness for women with multiple sclerosis.

There is increasing interest in wellness programs among health care providers and consumers. A unique intervention program was developed to promote wellness for women with multiple sclerosis (MS). Key processes include: provision of accurate knowledge that is specific to health promotion within the context of MS; enhancement of self-efficacy for health behaviors and individualized goal setting and monitoring. Participants have reported positive changes as a result of this two-phase (knowledge/skill building classes and telephone follow-up) intervention.

Predictors of health‐promoting lifestyles in persons with disabilities

Persons with disabilities have been largely overlooked in investigations of health and health behaviors. The primary purpose of this descriptive correlational study was to examine the usefulness of Pender's (1987) Health Promotion Model in explaining the occurrence of health-promoting behaviors among adults with disabilities. Hierarchical multiple regression analyses were used to analyze questionnaire responses from a sample of 117 adults with disabilities. Adults with disabilities were more likely to engage in a health-promoting lifestyle if they had higher specific self-efficacy for health behaviors, higher general self-efficacy, a wellness-oriented definition of health, required less mechanical assistance, and were female. Findings from this study suggest that interventions aimed at enhancing health promotion behaviors among persons with disabilities would be strengthened by addressing perceived ability to master situations, particularly the ability to successfully carry out health-promoting behaviors.