Individual Health Behaviors Research Articles

SENTIDO DE COHERENCIA E INTELIGENCIA EMOCIONAL: EFECTO EN LA ANSIEDAD SOCIAL DE ESTUDIANTES UNIVERSITARIOS

Abstract.SENSE OF COHERENCE AND EMOTIONAL INTELLIGENCE: EFFECT ON SOCIAL ANXIETY OF COLLEGE STUDENTSThe aim of the study was to describe a sample of college students two key variables in health behaviors of individuals, such as the Antonovsky Sense of Coherence (SOC) (1971), and Perceived Emotional Intelligence (IEP) Mayer and Salovey (1990). In the sample of students possible cases of social phobia (FS) that may exist and trends to anxiety and social avoidance are analyzed. With these data, it aims to investigate the possible relationship between the SOC and the Social Phobia, and between it and the IEP. Outcomes among patients with Social Phobia and cases that did not, obtaining significant differences in mean SOC IEP and, these being lower in cases of FS were compared.Keywords: Emotional Intelligence, Sense of Coherence, Social Anxiety.Resumen.El objetivo del estudio ha sido describir en una muestra de estudiantes universitarios dos variables fundamentales en las conductas de salud de las personas, como son, el Sentido de Coherencia de Antonovsky (SOC) (1971), y la Inteligencia Emocional Percibida (IEP) de Mayer y Salovey (1990). En la muestra de estudiantes se analizan los posibles casos de Fobia Social (FS) que puedan existir y las tendencias a la ansiedad y evitación social. Con estos datos, se pretende indagar en la relación que pueda existir entre el SOC y la Fobia Social, y entre ésta y la IEP. Se compararon los resultados entre los casos con Fobia Social y los casos que no la tenían, obteniendo diferencias significativas en las medias de IEP y SOC, siendo éstas inferiores en los casos de FS.Palabras Clave: Inteligencia Emocional, Sentido de Coherencia, Ansiedad Social.

Study protocol for a randomised controlled trial of brief, habit-based, lifestyle advice for cancer survivors: exploring behavioural outcomes for the Advancing Survivorship Cancer Outcomes Trial (ASCOT)

IntroductionPositive health behaviours such as regular physical activity and a healthy diet have significant effects on cancer outcomes. There is a need for simple but effective behaviour change interventions with...

Multiple health behaviours among mothers and partners in England: Clustering, social patterning and intra-couple concordance

Research on multiple health behaviours is increasing but little is known about parental behaviours and how they covary. Our study investigates cigarette smoking, alcohol intake, fruit and vegetable (F&V) consumption and physical activity among mothers and co-resident partners in England. Using the UK Household Longitudinal Study, we examined (i) clustering of health behaviours using observed-expected ratios and latent class analysis (ii) socio-demographic correlates of the derived latent classes and (iii) intra-couple concordance of individual health behaviours and their latent classes. We identified five latent classes for mothers and partners: Never smoked drinkers (28% of mothers; 29% of partners), Abstainers (25%; 17%), Drinkers and ex-smokers (19%; 26%), Unhealthy low frequency drinkers (18%; 16%) and Unhealthiest behaviour group (11%; 12%). These had distinctive social profiles. Never smoked drinkers were more likely than those in other groups to be white and socially advantaged: married, older, and with higher educational qualifications and incomes. Abstainers were non-smokers who never or occasionally drank, and were disproportionately drawn from ethnic minority groups and middle/lower income families. Drinkers and ex-smokers were the most physically active group and were more likely to be socially advantaged. Unhealthy low frequency drinkers were more likely to be disadvantaged and have a limiting long-standing illness. The Unhealthiest behaviour group had the highest proportion of smokers, heavy smokers and binge drinkers and the lowest F&V intake and physical activity levels. They were largely white and socially disadvantaged: younger, non-married and with lower educational levels. Mothers and their partners typically shared the same risk behaviours, and 44 per cent of partners and mothers belonged to the same latent class. Our findings point to the potential for a broadening of research and policy perspectives, from separate behaviours to combinations of behaviours, and from individuals to the domestic units and communities of which they are part.

Child oral health in migrant families: A cross-sectional study of caries in 1-4 year old children from migrant backgrounds residing in Melbourne, Australia.

Early Childhood Caries (ECC) is the most common, preventable disease of childhood. It can affect children's health and wellbeing and children from migrant families may be at greater risk of developing ECC. To describe ECC in children from migrant families, and explore possible influences. Cross-sectional analysis of caries data collected as baseline data for an oral health promotion study. The analysis sample included 630 1-4 year-old children clustered within 481 Iraqi, Lebanese and Pakistani families in Melbourne, Australia. Child participants received a community-based visual dental examination. Parents completed a self-administered questionnaire on demographics, ethnicity, and oral health knowledge, behaviour and attitudes. Child caries experience. Bivariate associations between oral health behaviours and ethnicity were tested for significance using chi-square. Multivariate logistic regression analyses were performed to identify associations with ECC, adjusting for demographic variables and accounting for clustering by family. Overall, 34% of children in the sample experienced caries (both non-cavitated and cavitated). For all caries lesions, parent' length of residence in Australia, consumption of sweet drinks and parental education remained as independent predictors of child caries experience. Adding sugar to drinks was an additional risk factor for cavitation. Ethnicity was associated with some individual oral health behaviours suggesting cultural influences on health, however the relationship was not independent of other predictors. Culturally competent oral health promotion interventions should aim to support migrant families with young children, and focus on reducing sweet drink consumption.

Impact of Game-Inspired Infographics on User Engagement and Information Processing in an eHealth Program.

BackgroundOnline interventions providing individual health behavior assessment should deliver feedback in a way that is both understandable and engaging. This study focused on the potential for infographics inspired by the aesthetics of game design to contribute to these goals.ObjectiveWe conducted formative research to test game-inspired infographics against more traditional displays (eg, text-only, column chart) for conveying a behavioral goal and an individual’s behavior relative to the goal. We explored the extent to which the display type would influence levels of engagement and information processing.MethodsBetween-participants experiments compared game-inspired infographics with traditional formats in terms of outcomes related to information processing (eg, comprehension, cognitive load) and engagement (eg, attitudes toward the information, emotional tone). We randomly assigned participants (N=1162) to an experiment in 1 of 6 modules (tobacco use, alcohol use, vegetable consumption, fruit consumption, physical activity, and weight management).ResultsIn the tobacco module, a game-inspired format (scorecard) was compared with text-only; there were no differences in attitudes and emotional tone, but the scorecard outperformed text-only on comprehension (P=.004) and decreased cognitive load (P=.006). For the other behaviors, we tested 2 game-inspired formats (scorecard, progress bar) and a traditional column chart; there were no differences in comprehension, but the progress bar outperformed the other formats on attitudes and emotional tone (P<.001 for all contrasts).ConclusionsAcross modules, a game-inspired infographic showed potential to outperform a traditional format for some study outcomes while not underperforming on other outcomes. Overall, findings support the use of game-inspired infographics in behavioral assessment feedback to enhance comprehension and engagement, which may lead to greater behavior change.

Everett Appointed Head of New SAMHSA Office

Back to table of contents Previous article Next article Professional NewsFull AccessEverett Appointed Head of New SAMHSA OfficeVabren WattsVabren WattsSearch for more papers by this authorPublished Online:14 Sep 2016https://doi.org/10.1176/appi.pn.2016.9b3AbstractAnita Everett, M.D., and her staff will focus on expanding innovative, science-supported approaches to behavioral health.This month APA President-Elect Anita Everett, M.D., assumed a new position as the chief medical officer at the Substance Abuse and Mental Health Services Administration (SAMHSA).Anita Everett, M.D., says having a psychiatrist on SAMHSA’s leadership team will help to advance the nation’s behavioral health system.Everett is now responsible for organizing and leading the newly created Office of the Chief Medical Officer, which is expected to provide valuable input into strategic initiatives, policy directions, and legislative issues to ensure that medically researched and clinically approved practices are incorporated in the development and implementation of SAMSHA programs and activities. Additionally, the office will play a key role in representing SAMHSA’s clinical perspectives, particularly when collaborating with other Department of Health and Human Services entities and federal agencies. “Having a psychiatrist as a member of the leadership team at SAMHSA will enable psychiatrists to join other mental health and public health professionals in guiding the federal component of our nation’s behavioral health system,” Everett told Psychiatric News. “I’m really excited about the new position.” One of Everett's first tasks will be to hire staff for the new office, including one policy analyst, one nurse practitioner, and a second physician. Everett also mentioned that she will begin the process of seeking government funding opportunities to promote effective treatment and prevention of mental illness and substance use disorders. Everett told Psychiatric News that her desire to contribute firsthand to healthy community, social justice, and public services is what led her to this position and has driven her professional career. “I have worked in virtually every aspect of the profession of psychiatry—including private, public, and academic institutions, as well as inpatient and outpatient services, and services for substance use disorders, geriatric, children, and persons with developmental disabilities.”Prior to taking on the role as SAMHSA’s chief medical officer, Everett served as the division director of Johns Hopkins Community and General Psychiatry, Bayview Campus, in Baltimore, where her research focused on health behavior of individuals with long-term mental illnesses living in urban and underserved areas. From 1999 to 2003, Everett served as inspector general to the Office of the Governor in the Department of Mental Health in Virginia, completing more than 80 inspections of institutions licensed to provide mental health services within the state. Everett has also been involved in multiple international projects such as working as a consultant with the Ministries of Health in the implementation of government-operated mental health services in Iraq and Afghanistan. Everett was elected president-elect of APA in February and will assume the office of president at the conclusion of the APA Annual Meeting in San Diego in May 2017. She has held numerous leadership roles within the organization, which include trustee-at-large on the APA Board of Trustees and chair of the APA Task Force on Healthcare Reform 2015. “As practicing psychiatrists, we have the opportunity to be a catalyst for positive change in the lives of the patients we serve,” Everett told Psychiatric News. “As active members of APA, we have the opportunities to be part of a catalyst for positive change on a larger scale.” Everett said that psychiatrists know more today than ever before about causes and treatments of behavioral health conditions and must continue to find ways to increase access to effective treatment and prevention.“Our nation’s behavioral health system is very complex,” said Everett. “We cannot let that deter us from making a difference. As suggested as a tactic in the approach to complex tasks: ‘A journey of a thousand miles begins with the first step,’” Everett concluded. ■ ISSUES NewArchived

Predictors of the Health-Promoting Behaviors of Nepalese Migrant Workers.

Health-promoting behaviors assist individuals to prevent disease, promote health, increase longevity, and enjoy a better quality of life. A number of interpersonal, social, and environmental factors have been shown to influence health-promoting behaviors. Little empirical evidence exists about the predictors of health-promoting behaviors among migrant workers. This study uses Pender's health promotion model to describe and identify the predictors of health-promoting behaviors in Nepalese migrant workers in Korea. A cross-sectional research design was used. Nepalese migrants who had been working in South Korea (n = 169) for over 6 months were surveyed between July and December 2012. Self-efficacy was measured using the Perceived Health Competence Scale, the Health-Promoting Lifestyle Profile II was used to measure health-promoting lifestyle behaviors, and perceived health status was measured using a single-item question. Descriptive statistics, correlation analysis, and multiple regression analysis were used to analyze data. Spiritual activity was the highest reported health-promoting behavior, whereas physical activity was the least practiced behavior. Self-efficacy was the only significant predictor of health-promoting behavior. The results of this study suggest that future health-promoting interventions should enhance the self-efficacy of target populations for individual health behaviors. Factors such as working conditions, culture, and economic background that may affect the health-promoting behaviors of migrant workers must be considered when planning nursing interventions. Multicultural nursing structures and policies are needed to reach out proactively to all adult migrant groups.

A multilevel analysis of lifestyle variations in symptoms of acute respiratory infection among young children under five in Nigeria.

BackgroundNigeria has the second highest estimated number of deaths due to acute respiratory infection (ARI) among children under five in the world. A common hypothesis is that the inequitable distribution of socioeconomic resources shapes individual lifestyles and health behaviors, which leads to poorer health, including symptoms of ARI. This study examined whether lifestyle factors are associated with ARI risk among Nigerian children aged less than 5 years, taking individual-level and contextual-level risk factors into consideration.MethodsData were obtained from the nationally representative 2013 Nigeria Demographic and Health Survey. A total of 28,596 surviving children aged 5 years or younger living in 896 communities were analyzed. We employed two-level multilevel logistic regressions to model the relationship between lifestyle factors and ARI symptoms.ResultsThe multivariate results from multilevel regressions indicated that the odds of having ARI symptoms were increased by a number of lifestyle factors such as in-house biomass cooking (OR = 2.30; p < 0.01) and no hand-washing (OR = 1.66; p < 0.001). An increased risk of ARI symptoms was also significantly associated with living in the North West region and the community with a high proportion of orphaned/vulnerable children (OR = 1.74; p < 0.001).ConclusionsOur findings underscore the importance of Nigerian children’s lifestyle within the neighborhoods where they reside above their individual characteristics. Program-based strategies that are aimed at reducing ARI symptoms should consider policies that embrace making available basic housing standards, providing improved cooking stoves and enhancing healthy behaviors.

Integrating worksite health protection and health promotion: A conceptual model for intervention and research

There is increasing recognition of the value added by integrating traditionally separate efforts to protect and promote worker safety and health. This paper presents an innovative conceptual model to guide research on determinants of worker safety and health and to inform the design, implementation and evaluation of integrated approaches to promoting and protecting worker health. This model is rooted in multiple theories and the premise that the conditions of work are important determinants of individual safety and health outcomes and behaviors, and outcomes important to enterprises such as absence and turnover. Integrated policies, programs and practices simultaneously address multiple conditions of work, including the physical work environment and the organization of work (e.g., psychosocial factors, job tasks and demands). Findings from two recent studies conducted in Boston and Minnesota (2009–2015) illustrate the application of this model to guide social epidemiological research. This paper focuses particular attention on the relationships of the conditions of work to worker health-related behaviors, musculoskeletal symptoms, and occupational injury; and to the design of integrated interventions in response to specific settings and conditions of work of small and medium size manufacturing businesses, based on a systematic assessment of priorities, needs, and resources within an organization. This model provides an organizing framework for both research and practice by specifying the causal pathways through which work may influence health outcomes, and for designing and testing interventions to improve worker safety and health that are meaningful for workers and employers, and responsive to that setting's conditions of work.

The Perils of Integrating Wellness and Safety and Health and the Possibility of a Worker-Oriented Alternative.

In response to the article by Michael B. Lax, MD entitled "The perils of integrating wellness and safety and health and the possibility of a worker-oriented alternative," the National Institute for Occupational Safety and Health (NIOSH) provides updated information on the current focus and priorities and addresses concerns raised regarding the Total Worker Health® initiative. Many of the concerns and criticisms in the report echo those NIOSH publicly shares on a regular basis. The theory and practice of Total Worker Health (TWH) continues to evolve in response to valuable stakeholder input like that provided by Dr. Lax. In 2015, NIOSH updated the TWH concept to emphasize the main focus of TWH is the primacy of traditional health protection which prioritizes employer responsibilities for the organization of work over individual worker health behaviors. NIOSH acknowledges the past lack of "fit" between theory and practice in some publications of TWH-funded grantees as Dr. Lax points out. NIOSH is hopeful that the solicitation of new research, which is now underway, will clarify the work-centered priorities for TWH-funded research. Based on input from Dr. Lax and other stakeholders, NIOSH looks forward to contributing more effectively to protecting and promoting worker safety and health in the new twenty-first century world of work.

Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM) - a Pan Canadian cohort study.

BackgroundThe Canadian Alliance for Healthy Hearts and Minds (CAHHM) is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services) with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes.Methods/DesignParticipants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity), cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI) of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition.DiscussionCAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3310-8) contains supplementary material, which is available to authorized users.

개인 건강행태 및 지역보건의료 수준과 치료순응의 관계: 지역사회 건강조사 바탕으로

연구목적: 본 연구는 의사로부터 고혈압으로 진단받은 사람들을 대상으로 개인 건강행태 및 지역 보건의료수준이 치료순응에 미치는 영향을 파악하고자 실시하였다. 고혈압 치료순응은 고혈압 약물치료율로 조작적 정의를 하였다. 정의는 의사에게 고혈압을 진단받은 30세 이상 사람 중 현재 혈압 조절약을 한 달(30일)에 20일 이상 복용하고 있는 사람의 분율로 정의하였다. 연구방법: 2010년도 지역사회건강조사대상 만 19세 이상 성인 229,229명을 대상으로 개인특성에 따른 고혈압 치료순응지표의 차이 비교는 카이제곱 검정을 사용하였으며, 개인 및 지역수준 변수를 고려한 고혈압 치료순응의 관련지표의 지역 간 변이 파악은 다수준 로지스틱회귀분석 실시하였다. 통계 프로그램은 SPSS 18.0과 HLM 7(hierarchical linear model)을 이용하였다. 연구결과: 개인 건강행태 및 지역 보건의료수준이 고혈압 치료순응에 미치는 관련성 연구에서 건강행태 및 지역의 보건의료수준에 따라, 치료순응에 미치는 영향이 크다는 것을 알 수 있었다. 결론: 본 연구에서는 지역보건의료 수준의 변수들의 교차비가 높지는 않았지만, 개인수준의 변이에 초점을 맞춘 기존연구와는 달리 지역보건의료수준의 변이를 찾을 수 있었다는데 의의가 있었으며, 추후 많은 연구에서 지역수준을 고려한 다수준 분석이 필요할 것으로 사료된다. Objective: This study was conducted in order to investigate the effects of individual patient behavior regarding the health and medical care level on their therapeutic compliance for people diagnosed with high blood pressure by a physician, in order to evaluate the impact of treatment compliance. In this study, the therapeutic compliance was defined as the hypertension drug cure rate. The current blood pressure controls were persons about 30 years of age diagnosed with high blood pressure by their doctor one month fraction of the people who take more than 20 days (30 days). Methods: The data was analyzed by using the X2-test for different comparisons of the therapeutic compliance in the individual characteristics and using a two-stage multilevel logistic regression to identify the community variance of the related index of high blood pressure therapeutic compliance using the data from 229 adults over the age of 19 in a community health survey conducted in 2010. The Spss 18.0 statistical program was used with HLM 7 (hierarchical linear model) Results: It was found that the rate of therapeutic compliance was affected by the individual health behavior and health and medical care levels. Conclusion: In this study, although the odds ratio of the variable region of the high level of health care, I was able Unlike previous studies and focuses on the personal level of variation found variations in the local health care level was a significant. More studies on multilevel analysis are needed in the future considering regional level data.

Linked Lives: Dyadic Associations of Mastery Beliefs With Health (Behavior) and Health (Behavior) Change Among Older Partners.

Mastery beliefs are known to contribute to healthy aging. However, it is an open question whether individual mastery-health associations impact the health of close long-term partners. We applied actor-partner interdependence models to 4-wave, 6-year longitudinal dyadic data from married and cohabitating partners in the Health and Retirement Study (N = 1,981 partners; age at baseline: M = 67 years, SD = 8.93, range 50-94 years). Higher individual mastery beliefs were associated with better individual physical health and health behaviors. Higher mastery beliefs were associated with subsequent increases in light physical activity. Having a partner with higher levels of mastery was uniquely associated with fewer functional limitations, better self-rated health, and more physical activity. Actor × Partner interaction effects for functional limitations indicated multiplicative associations of actor and partner mastery with health. Of note, mastery-health associations for individuals and their partners were invariant across age, gender, education, employment status, perceived stress over one's own and partner's health, and cognition. Findings suggest that partner mastery beliefs matter for the health (behaviors) of older adults. We discuss possible mechanisms underlying partner interrelations in mastery and health, their age invariance, and consider implications arising from our results.

The effect of metropolitan-area mortgage delinquency on health behaviors, access to health services, and self-rated health in the United States, 2003–2010

The recent housing crisis offers the opportunity to understand the effects of unique indicators of macroeconomic conditions on health. We linked data on the proportion of mortgage borrowers per US metropolitan-area who were at least 90 days delinquent on their payments with individual-level outcomes from a representative sample of 1,021,341 adults surveyed through the Behavioral Risk Factor Surveillance System (BRFSS) between 2003 and 2010. We estimated the effects of metropolitan-area mortgage delinquency on individual health behaviors, medical coverage, and health status, as well as whether effects varied by race/ethnicity. Results showed that increases in the metropolitan-area delinquency rate resulted in decreases in heavy alcohol consumption and increases in exercise and health insurance coverage. However, the delinquency rate was also associated with increases in smoking and obesity in some population groups, suggesting the housing crisis may have induced stress-related behavioral change. Overall, the effects of metropolitan-area mortgage delinquency on population health were relatively modest.

Evaluating the effectiveness of a family empowerment program on family function and pulmonary function of children with asthma: A randomized control trial

BackgroundEmpowerment can be an effective strategy for changing an individual's health behaviours. However, how to empower whole families to manage their children's asthma is a challenge that requires innovative nursing intervention based on family-centred care. AimsTo evaluate the effectiveness of a family empowerment program on family function and pulmonary function of children with asthma compared to those receiving traditional self-management only. DesignA randomized control trial. MethodsSixty-five families were recruited from one asthma clinic in a medical centre in Taiwan. After random assignment, 34 families in the experimental group received the family empowerment program consisting of four counselling dialogues with the child and its family. We empowered the family caregiver's ability to manage their child's asthma problems through finding the problems in the family, discovery and discussion about the way to solve problems, and enabling the family's cooperation and asthma management. The other 31 families received the traditional care in asthma clinics. The Parental Stress Index and Family Environment Scale of family caregivers, and pulmonary function, and asthma signs of children with asthma were collected at pre-test, 3-month post-test, and one-year follow-up. We utilized the linear mixed model in SPSS (18.0) to analyze the effects between groups, across time, and the interaction between group and time. ResultsThe family empowerment program decreased parental stress (F=13.993, p<.0001) and increased family function (cohesion, expression, conflict solving, and independence) (F=19.848, p<.0001). Children in the experimental group had better pulmonary expiratory flow (PEF) (F=26.483, p<.0001) and forced expiratory volume in first second (FEV1) (F=7.381, p=.001) than children in the comparison group; however, no significant change in forced expiratory volume in first second (FEV1)/forced vital capacity (FVC) was found between the two groups. Sleep problems did not show significant changes but cough, wheezing, and dyspnoea were significantly reduced by family caregiver's observations. ConclusionWe empowered families by listening, dialogues, reflection, and taking action based on Freire's empowerment theory. Nurses could initiate the families’ life changes and assist children to solve the problems by themselves, which could yield positive health outcomes.

Early childhood social disadvantage is associated with poor health behaviours in adulthood

Background: Individual health behaviours are considered important risk factors for cardiometabolic diseases. These behaviours may be socially patterned by early exposure to social disadvantage, but few studies have prospectively tested this hypothesis empirically.Aim: This study investigated whether childhood social disadvantage was associated with likelihood of engaging in less healthy behaviours 40 years later.Subjects and methods: Prospective data were analysed from the New England Family Study, a 2005–2007 adult follow-up of a cohort initiated in 1959–1966 (n = 565). Childhood social environment (age 7 years) was assessed using a cumulative index of socioeconomic and family stability factors. Logistic regression models evaluated associations between social disadvantage and each health-related behaviour and obesity in adulthood.Results: Relative to low disadvantage, higher disadvantage was associated with 3.6-fold greater odds of smoking (95% CI = 1.9–7.0), 4.8-fold greater odds (in women only) of excess alcohol consumption (95% CI = 1.6–14.2) and 2.7-fold greater odds of obesity (95% CI = 1.3–5.5), but was not associated with unhealthy diet or physical inactivity.Conclusion: These findings suggest childhood social disadvantage may contribute to adult cardiometabolic disease by predisposing children to adopt certain unhealthy behaviours. If replicated, such findings may support intervention strategies that target social environmental factors and behavioural pathways that are established early in life.

Cognitive-Motivational Influences on Health Behavior Change in Adults with Chronic Pain.

The primary aim was to assess the psychological factors that influence engagement in health behaviors in individuals with chronic pain using a new measure, the Behavioral Engagement Test for Chronic Pain (BET-CP). A secondary aim was to determine preliminary psychometric properties of the BET-CP. Participants were 86 adults with chronic musculoskeletal pain recruited from University of Florida pain clinics and the community. Participants completed a battery of self-report instruments online, including the BET-CP and measures of related constructs. Items on the BET-CP assessed motivation, self-efficacy, outcome expectations, and the symptom benefit required to engage across four health behaviors: exercise, diet, sleep, and pain self-management (e.g., relaxation and activity pacing). Participants reported modest expectations of pain-related symptom improvement if they practiced the health behaviors (22-26% improvement), but they required twice that (47-54% improvement) to make it worth their while to commit to practicing them. Participants expected to get the most symptom relief from relaxation and activity pacing, but they were most confident and motivated to eat a healthy diet. In a subsample of participants who provided data for psychometric analysis, the BET-CP demonstrated strong test-retest reliability across 7 days and adequate convergent validity. While patients with musculoskeletal pain have outcome expectancies that are nearly in line with research on behavioral pain treatments, their stringent requirements for symptom benefit may impede engagement in the health behaviors recommended for their pain-related symptoms. Additional psychometric study with larger sample sizes is needed to further validate the BET-CP.

Poverty dynamics in Germany: Evidence on the relationship between persistent poverty and health behavior

Previous studies have found poverty to be related to lower levels of health due to poor health behavior such as unhealthy eating, smoking or less physical activity. Longer periods of poverty seem to be especially harmful for individual health behavior. Studies have shown that poverty has a dynamic character. Moreover, poverty is increasingly regarded as being a multidimensional construct and one that considers more aspects than income alone. Against this background this paper analyzes the relationship between health behavior and persistent spells of income poverty as well as a combined poverty indicator using data of the German Socio-Economic Panel (2000–2010). Next to cross-sectional logistic regression models we estimate fixed-effects models to analyze the effect of persistent poverty on dietary behavior, tobacco consumption, and physical activity.Cross-sectional results suggest that persistent poverty is related to poor health behavior, particularly regarding tobacco consumption and physical activity. Results also show that multidimensional and dynamic aspects of poverty matter. Complementary panel analyses reveal negative effects for the combined poverty indicator only for dietary behavior in the total sample. However, by analyzing the sample by gender we identify further effects of persistent poverty on health behavior. The analyses show that not only do individuals in poverty but also those in precarious situations show health-damaging behavior more often.

Health Ballistics

Health Ballistics aims to quantify preventive health measures in relation to their health impact on an individual's productive lifespan, and in turn for a societally beneficial impact. An uninformed individuals behaviors will significantly affect their overall Health Wealth Commodity and are based upon the notion that what an individual does not know will with high probability lead to unhealthy monetary savings decision further empowering already established poor health outcome trajectories. The current theory emphasized the necessity for intensified focus on only a few health variables, as only a few variables indeed affect an individual's health trajectory with extreme weight at any moment. By calculating the highly probable and realistic health outcomes of an individual's health behavior based on these variables, a monetary savings can be retrospectively associated with the preventive measures utilized to obtain the health outcomes observed and in turn, prospectively associated to calculate statistically predictable individual health behavior and chronic diseases.

Health, education, and retirement over the prolonged life cycle: a selective survey of recent research

This issue of the Vienna Yearbook of Population Research contains a selection of papers that were presented at the conference ‘Health, Education, and Retirement over the Prolonged Life Cycle’, which was organised by the Vienna Institute of Demography of the Austrian Academy of Sciences and held in Vienna in November 2013. The conference was devoted to the socio-economic causes and consequences at both the individual and the societal level of the unprecedented increase in life expectancy over the past few decades. At the micro level, a better understanding is needed regarding the extent to which the increase in human life expectancy has been shaped by individual health behaviour, rather than by other socio-economic influences, and through which channels this happened. Conversely, it is important to understand better how the prolongation of the life cycle will shape individual behaviour. The conference focused on behaviour relating to health, education, and the supply of labour. Although generally perceived as a positive development, the increase in life expectancy also poses policy challenges for social security and the cohesion of society, given that different social groups benefit from rising longevity to varying degrees. Important questions have been raised about the macro consequences of the prolongation of the individual life cycle, not least because having an understanding of the underlying mechanisms will be crucial for assessing the extent to which retirement, health, and educational policies need to be reformed. The recognition that the design of reforms should be guided by an awareness of the potential effects