Poor Health Behaviors Research Articles

The Impact of Stress on Pressure Ulcer Wound Healing Process and on the Psychophysiological Environment of the Individual Suffering from them.

Introduction:The occurrence of a pressure ulcer constitutes a major psychological and physiological burden and it has been linked with a reduced quality of life and increased stress of the individual.Objective:The main objective was to investigate the impact that stress has on pressure ulcer healing process and on the psychophysiological environment of the individual suffering from them.Method:The scientific literature was reviewed through Cinahl, Pub-med, EBSCO, Medline and Google scholar. The articles were chosen due to their direct correlation with the objective under study and their scientific relevance.Results:Increased stress has been demonstrated to increase the glucocorticoids levels affecting negatively the production of wound healing cytokines (IL1α, IL1β and TNFα). Matrix metalloproteases has been identified to be unregulated in occasions of increased stress in acute wounds. Stress has also been correlated with poor health behaviors that may not have a direct link on the wound healing process, although they can in part explain or enhance some of the effects of stress on wound healing.Conclusion:The correlation between stress and wound healing in acute wounds has been thoroughly investigated and its negative effects have been established. The presence of a pressure ulcer can have a detrimental impact on the stress level of an individual although further investigation is needed to establish the role of stress in chronic wounds such as pressure ulcers.

Prevalence of and factors associated with dental anxiety among medical and dental students of the Northern State Medical University, Arkhangelsk, North-West Russia

ABSTRACTThe objective was to assess the prevalence of and factors associated with dental anxiety (DA) in medical and dental students in North-West Russia. This cross-sectional study included 422 medical and 285 dental undergraduate Russian students aged 18–25 years from the Northern State Medical University in Arkhangelsk. Corah’s Dental Anxiety Scale (DAS) was applied to measure DA. Information on socio-demographic and socioeconomic factors, oral health behaviour and general and oral health was obtained from a structured, self-administered questionnaire. A clinical examination was performed to assess caries experience, Simplified Oral Hygiene Index, and Gingival Index. DAS score ≥13 was found in 13.7% and 2.2% of medical and dental students, respectively. Female sex (incidence rate ratio [IRR] = 1.11, p = 0.013), lower education of mother (IRR = 1.13, p = 0.001), and poor self-assessed oral health (IRR = 1.15, p < 0.001) were associated with DA in medical students. Corresponding factors in dental students were female sex (IRR = 1.16, p = 0.001), irregular dental visits (IRR = 1.19, p = 0.001), infrequent tooth-brushing (IRR = 1.17, p = 0.007), pain in mouth (IRR = 1.09, p = 0.031) and number of missing teeth (IRR = 1.13, p = 0.007). The prevalence of high DA was lower in dental students than in medical students. DA was associated with sex, mother’s education, poor oral health behaviour and self-assessed and clinically assessed oral health.

Assessment of access and utilization of adolescent sexual and reproductive health services in Lagos State, 2013

Introduction : adolescents represent a large proportion of the world population. Their health impacts on the overall health of the world as they transit into adulthood. In Nigeria, limited access to effective health education programmes and friendly sexual and reproductive health services are major contributory factors to poor sexual and reproductive health knowledge and behavior among the young people. The objectives of the study were to determine the level of awareness, access and factors that affect utilization of the Adolescent Sexual and Reproductive Health services in the state. Method : we conducted a cross-sectional descriptive study between April and August 2013 among adolescents in Lagos State schools. Respondents were selected using a multi-stage sampling technique and data was collected with a semi-structured interviewer administered questionnaire. Test of associations was done using chi square. Results : a total of 413 respondents were selected, 226 (54.7%) were male. In all, 48 (11.6%); male 28 (12.4%), females 20 (10.7%) had had sexual intercourse. Mean age at sexual debut was 11.7 ± 3.3 years. Twenty-two (5.3%) respondents had more than one sexual partners. Twenty-eight (6.8%) had ever used condoms. Only 8 (16.7%) of those who ever used condoms, used it consistently while 18 (4.4%) had never used condoms. Twelve (2.9%) reported ever having sexually transmitted infection. Only 132 (32%) of the sampled adolescents were aware of adolescent sexual and reproductive health services in the state. Parents and teachers were the major sources of information on the centres providing the services. Only 42 (10.2%) of the respondents ever accessed the adolescent sexual and reproductive health center in the state and services accessed include HIV counselling and testing STI treatment and prevention. Factors that significantly affected utilization were awareness, cost of care and societal disapproval (p-values Conclusion : utilization of the existing adolescent reproductive and health services was low among the school adolescents in Lagos State. Awareness, cost of care and societal disapproval were found to account for the poor utilization. Mass media campaign should be engaged for improved awareness and behavioral change in the society and reduction in service fee will improve utilization of adolescent sexual and reproductive health services in Lagos State.

Targeting Diet and Physical Activity: Reaching Homeless Adults through Customized Interventions

Over six percent of the American population experience homelessness in their lifetime, and poor health is commonplace among individuals experiencing this condition. Homelessness is a risk factor for both acute and chronic diseases; homeless populations experience an age-adjusted mortality rate 3-4 times greater than the general population. In fact, despite the high prevalence of poor health behaviors and the well-documented disparities in health care outcomes among homeless adults, interventions for this population are scarce, likely due to the fact that they are challenging to implement. Consequently, there are few published interventions on diet/physical activity interventions targeting this population to date. Health-eStrides, a novel randomized pilot lifestyle intervention for 32 transitional shelter residents, took place at The Bridge in Dallas, Texas. This paper reports on the lessons learned and approaches for intervening in this vulnerable population. Participants were randomized into either the experimental arm or control arm of the study. The experimental arm included a 4-week shelter-based diet, physical activity intervention, tailored educational newsletters, and supplemental fruits and vegetables; the control arm was not given any additional resources and compensated for completing assessments at the conclusion of the study. 71% of participants reported that the intervention was “extremely/very helpful” for both increasing daily intake of fruits and vegetables and for increasing physical activity. Based on this intervention, this paper discusses barriers and facilitators for lifestyle improvements among homeless adults. This intervention demonstrated the effectiveness of customized lifestyle interventions in improving health care outcomes for homeless adults and affirms the need for more research and innovation on this vulnerable population, especially in terms of long-term and sustainable solutions.

Health behaviours of young mothers: Implications for health promotion and cancer prevention.

Objective:Evidence suggests that younger mothers engage in poorer health behaviours, resulting in increased cancer risk. We aimed to better understand the health behaviours of younger mothers and the factors that influence their lifestyle choices, in order to improve cancer prevention within this population.Methods:A multiple focus group, photo-elicitation-aided approach was used, in which young mothers (n = 27; aged 16–24 years) were provided with cameras and asked to capture ‘a week in your life’. Photographs were developed and participants invited to an initial focus group where photographs were used to elicit discussion, exploring participants’ health behaviours. Data were thematically analysed particularly identifying themes relating to barriers and facilitators of positive health behaviours. Participants were later invited to participate in a second focus group, to explore and validate identified themes further.Results:Themes emerged from the data relating to (1) the mothers’ personal perceptions of health, (2) health-related behaviours and (3) beliefs about cancer and its causes. Barriers to positive health behaviours included a lack of money, childcare and cookery skills; facilitators included the social media, commercial weight loss programmes and local community organisations.Conclusion:Study findings provide insight into the health behaviours and life choices of young mothers. They help illustrate health perceptions in relation to cancer risk, providing an understanding of how their daily routine and circumstance influence young women’s decisions and lifestyle behaviour choices and highlighting barriers to, and facilitators of, positive health behaviours. Data hold potential to inform future health-related research among young mothers, particularly relating to cancer prevention intervention.

The Cost of Caring: Economic Vulnerability, Serious Emotional Distress, and Poor Health Behaviors Among Paid and Unpaid Family and Friend Caregivers.

This study examined differences between paid and unpaid family/friend caregivers to better understand the consumer-driven caregiving workforce. We compared economic vulnerability, unhealthy behavior, and serious emotional distress for 475 paid and 10,500 unpaid family/friend informal caregivers from the 2009 California Health Interview Survey. We then estimated whether caregiver status moderated the relationship between economic vulnerability and health outcomes. Compared to unpaid family/friend caregivers, paid family/friend caregivers had a 27% greater risk ( p = .002) of economic vulnerability. Among all family/friend caregivers, the probabilities of serious emotional distress and unhealthy behaviors increased by >100% and 28% for those with the greatest compared to the least economic vulnerability, and caregiver type did not moderate these relationships. To address economic and health vulnerabilities of paid informal caregivers, policy makers might increase wages in consumer-driven programs. These changes could prove beneficial to both paid informal caregivers and their care recipients, while reducing long-term inefficiencies in consumer-driven programs.

Associations between self-rated health, sickness behaviour and inflammatory markers in primary care patients with allergic asthma: a longitudinal study

Allergic asthma is a chronic inflammatory disorder associated with elevated levels of immunoglobulin E (IgE), serum eosinophilic cationic protein (S-ECP), plasma eosinophil-derived neurotoxin (P-EDN) and fraction of exhaled nitric oxide (FENO). Poor self-rated health and sickness behaviour has repeatedly been associated with inflammatory markers, but the nature of this relationship in chronic inflammatory disease is not known. Likewise, such findings largely rely on cross-sectional investigations. Self-rated health (How would you rate your general state of health?), sickness behaviour (mean rating of satisfaction with energy, sleep, fitness, appetite and memory), IgE, S-ECP, P-EDN, and FENO were assessed in 181 non-smoking primary care patients with asthma in a 1-year longitudinal study. Associations between repeated measurements were calculated using mixed regression models and Spearman’s correlations for change scores. Poor self-rated health was associated with high levels of seasonal IgE (p = 0.05) and food IgE (p = 0.04), but not total IgE or inflammatory markers. An increase over 1 year in perennial IgE was associated with a worsening of self-rated health (ρ = 0.16, p = 0.04). Poor self-rated health was associated with more pronounced sickness behaviour (p < 0.001), and a worsening in sickness behaviour was associated with a worsening of self-rated health over time (ρ = 0.21, p = 0.007). The study corroborates the importance of sickness behaviour as a determinant of self-rated health by showing that these factors co-vary over a 1-year period in a group of patients with allergic asthma. The importance of specific IgE for perceived health in primary care patients with mild to moderate asthma needs further investigation.

Health and healthcare disparities among U.S. women and men at the intersection of sexual orientation and race/ethnicity: a nationally representative cross-sectional study

BackgroundResearch has shown that sexual minorities (SMs) (e.g. lesbian, gay, and bisexual individuals), compared to their heterosexual counterparts, may engage in riskier health behaviors, are at higher risk of some adverse health outcomes, and are more likely to experience reduced health care access and utilization. However, few studies have examined how the interplay between race and sexual orientation impacts a range of health measures in a nationally representative sample of the U.S. population.MethodsTo address these gaps in the literature, we sought to investigate associations between sexual orientation identity and health/healthcare outcomes among U.S. women and men within and across racial/ethnic groups. Using 2013–2015 National Health Interview Survey data (N = 91,913) we employed Poisson regression with robust variance to directly estimate prevalence ratios (PR) comparing health and healthcare outcomes among SMs of color to heterosexuals of color and white heterosexuals, stratified by gender and adjusting for potential confounders.ResultsThe sample consisted of 52% women, with approximately 2% of each sex identifying as SMs. Compared to their heterosexual counterparts, white (PR = 1.25 [95% confidence interval (CI): 1.08–1.45]) and black (1.54 [1.07, 2.20]) SM women were more likely to report heavy drinking. Hispanic/Latino SM women and men were more likely to experience short sleep duration compared to white heterosexual women (1.33 [1.06, 1.66]) and men (1.51 [1.21, 1.90). Black SM women had a much higher prevalence of stroke compared to black heterosexual women (3.25 [1.63, 6.49]) and white heterosexual women (4.51 [2.16, 9.39]). White SM women were more likely than white heterosexual women to be obese (1.31 [1.15, 1.48]), report cancer (1.40 [1.07, 1.82]) and report stroke (1.91 [1.16, 3.15]. White (2.41 [2.24, 2.59]), black (1.40[1.20, 1.63]), and Hispanic/Latino SM (2.17 [1.98, 2.37]) men were more likely to have been tested for HIV than their heterosexual counterparts.ConclusionsSexual minorities had a higher prevalence of some poor health behaviors, health outcomes, and healthcare access issues, and these disparities differed across racial groups. Further research is needed to investigate potential pathways, such as discrimination, in the social environment that may help explain the relationship between sexual orientation and health.

Infant Mortality Lessons Learned from a Fetal and Infant Mortality Review Program.

Marion County Public Health Department (MCPHD) FIMR staff identified and reviewed 22 fetal and infant deaths to Indianapolis Healthy Start program participants between 2005 and 2012. Trained FIMR nurses completed 13 of 20 maternal interviews and compiled case summaries of all deaths from the MCPHD FIMR database.. Results Case review teams identified a total of 349 family strengths, 219 contributing factors, and made 220 recommendations for future pregnancies. FIMR deliberation values for Healthy Start program participant deaths were similar to other infant deaths in Marion County during the same time period. Common themes that emerged from the reviews included lack of social support, absence of paternal involvement, substance abuse, non-compliance, and poor health behaviors leading to chronic health conditions that complicated many pregnancies. Conclusions A number of the infant deaths in this review could have been prevented with preconception and inter-conception education and by improving the quality and content of prenatal care.

Peer norms moderate the association between mental health and sexual risk behaviors among young men living in Dar es Salaam, Tanzania

BackgroundYoung men living in Dar es Salaam's informal settlements face environmental stressors that may expose them to multiple determinants of HIV risk including poor mental health and risky sexual behavior norms. We aimed to understand how these co-occurring risk factors not only independently affect men's condom use and sexual partner concurrency, but also how they interact to shape these risk behaviors. MethodsParticipants in the study were male members of 59 social groups known as “camps” in Dar es Salaam, Tanzania. We assessed moderation by changes in peer norms of the association between changes in symptoms of anxiety and depression and sexual risk behaviors (condom use and sexual partner concurrency) among 1113 sexually active men. Participants nominated their three closest friends in their camp and reported their perceptions of these friends' behaviors, attitudes, and encouragement of condom use and concurrency. Anxiety and depression were measured using the HSCL-25, and condom use and sexual partner concurrency were assessed through self-report. ResultsPerceptions of decreasing condom use among friends (descriptive norms) and decreasing encouragement of condom use were associated with lower levels of condom use. Perceptions of increasing partner concurrency and acceptability of partner concurrency (injunctive norms) among friends were associated with higher odds of concurrency. Changes in perceived condom use norms (descriptive norms and encouragement) interacted with changes in anxiety symptoms in association with condom use such that the negative relationship was amplified by norms less favorable for condom use, and attenuated by more favorable norms for condom use. ConclusionsThese results provide novel evidence of the interacting effects of poor mental health and risky sexual behavior norms among a hard to reach population of marginalized young men in Dar es Salaam. Our findings provide important information for future norms-based and mental health promotion interventions targeting HIV prevention in this key population.

Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia.

Introduction:Intergenerational cycles of poverty, violence and crime, poor education and employment opportunities, psychopathology, and poor lifestyle and health behaviours require innovative models of health care delivery to break them. We describe a programme of research informed service development targeting vulnerable families in inner metropolitan Sydney, Australia that is designed to build and confirm a “Theory of Neighbourhood Context, Stress, Depression, and the Developmental Origins of Health and Disease (DOHaD)”. We describe the development of an intervention design and business case that drew on earlier realist causal and programme theoretical work.Methods:Realist causal and programme theory were used to inform the collaborative design of initiatives for vulnerable families. The collaborative design process included: identification of desirable and undesirable outcomes and contextual factors, consultation forums, interagency planning, and development of a service proposal.Results:The design elements included: perinatal coordination, sustained home visiting, integrated service model development, two place-based hubs, health promotion and strengthened research and analysis capability.Conclusions:We demonstrate here the design of interventions for vulnerable families in Sydney utilising translational research from previous realist causal and program theory building to operational service design. We have identified the importance of our earlier analysis of underlying causal mechanisms and related programme mechanisms for identifying the elements for the full intervention design. The application of theory added rigour to the design of the integrated care initiatives. In applying the theory to the local situation the analysis took into account: the role of the local agencies; evidence of program effectiveness; determinants and outcomes for local children and their families; the current deployment of service resources; and insights from front-line staff and interagency partners.

Factors associated with smoking behaviour change in UK military personnel.

Research in the UK civilian population suggests that poor mental health outcomes are associated with smoking behaviour. In the UK military population, smoking cessation is associated with deployment in the reserve forces. However, little is known about the links between mental health outcomes and smoking initiation and cessation in the UK military. The aim of this longitudinal study was to examine change in mental health and military factors associated with smoking initiation and cessation in a representative sample of UK military personnel. Data were collected between 2003 and 2009; 5138 regular and reserve military personnel were included in the analyses. The results showed that smoking initiation was associated with symptoms of psychological distress, symptoms of probable post-traumatic stress disorder (PTSD), relationship breakdown and deployment. These findings are consistent with existing research in civilian populations showing links between poor mental health and smoking behaviour. Furthermore, our finding that deployment is associated with smoking initiation is also in line with research from the US military and UK reserves.

Oral health beliefs and behavior among young adults in Appalachian Kentucky

ABSTRACTWe used communication infrastructure theory to investigate oral health beliefs and behavior among young adults in Appalachian Kentucky. We conducted 7 focus groups with 67 participants who reported poor oral health behavior, but this was not necessarily the result of poor oral health knowledge. Participants identified several sociocultural factors affecting their oral health, including lack of oral health prioritization among older generations, and risky health behaviors that competed with good oral health. These sociocultural factors create a context in which standard oral health recommendations are commonly seen as excessive. Participants described various responses to the poor oral health in the region, including fatalism and a distrust of dentists, and that oral healthcare professionals may be using potentially problematic communication tactics. Practical implications for designing effective oral health promotion campaigns in the region and theoretical implications for developing social-contextual frameworks of oral health promotion are discussed.

Perceived neighborhood safety related to physical activity but not recreational screen-based sedentary behavior in adolescents

BackgroundA growing proportion of adolescents have poor cardiovascular health behaviors, including low levels of physical activity and high levels of sedentary behavior, thus increasing the likelihood of poor heart health in later years. This study tested the hypothesis that low perceived neighborhood safety would be associated with low levels of physical activity and high levels of recreational sedentary behavior in high-school students.MethodsUsing cross-sectional, weighted data from the 2015 Pennsylvania (USA) State and Philadelphia city Youth Risk Behavior Survey, multivariable logistic regression modeling was used to examine the association between perceived neighborhood safety, and physical activity levels and recreational screen-based sedentary behavior time respectively, while controlling for potential confounders.ResultsAfter adjustment for other significant correlates of physical activity, students with low perceived neighborhood safety had a 21% reduced odds of being physically active on 5 or more days of the last week as compared to those who felt safe (p = 0.044). Perceived safety was not related to sedentary behavior; but sports team participation emerged as a strong correlate of low screen-based sedentary behavior (OR = 0.73, p = .002).ConclusionThese data add to a growing body of work demonstrating the importance of perceived safety with physical activity levels in youth. Sports team participation may be a viable target to reduce screen-based sedentary time.

Close relationships and the management of chronic illness: Associations and interventions.

Self-management of a chronic illness involves not only monitoring symptoms, adhering to medication regimens, and keeping medical appointments but also making and maintaining difficult lifestyle changes. This article highlights correlational and intervention research suggesting family members are influential in children's and adults' illness management. The argument is made that a dyadic approach to chronic illness management that targets the influence of close relationships may yield more sustainable effects on patient behavior than has been achieved in the past. In particular, dyadic approaches aimed at helping patients and family members to find ways to collaborate in goal setting for these behaviors is recommended. Such dyadic interventions may also benefit family members who are ill or are at risk because of poor health behaviors. (PsycINFO Database Record

Physical health promotion in patients with functional psychoses receiving community psychiatric services: Results of the PHYSICO-DSM-VR study

ObjectivesPsychotic patients have poorer health behaviours, including poor diets and sedentary lifestyles increasing their risk for obesity, diabetes, hypertension, and dyslipidaemia, and tend to have a shorter life expectancy as compared to nonpsychiatric populations. Lifestyle intervention programmes that target modifiable risk factors in such patients have produced uneven results. The objective was to evaluate the efficacy of a package of health promotion strategies to improve diet and physical exercise in psychotic patients. Our hypothesis was that a pre- to post-treatment improvement in physical activity and dietary habits would occur in the group receiving intervention. MethodThis randomised controlled trial was carried out in four psychiatric services. The intervention included psychoeducation sessions on diet and physical activity and regular participation in walking groups (experimental group). The control group received routine treatment. The primary outcome was an improvement of at least one World Health Organization recommendation on diet and exercise. ResultsOf a total of 326 subjects recruited, 169 were randomly assigned to the experimental group and 157 to the control group. An improvement in one or more World Health Organization criteria over baseline was observed in 25.4% of experimental group subjects and in 12.2% of control group subjects (odds ratio 2.46, 95% confidence interval 1.22–4.97; p=0.01). ConclusionsA statistically significant proportion of the sample achieved post-treatment improvement in lifestyle habits, especially as regarded increased physical activity. A post-intervention reduction in lifestyle variability was also noted. Interventions directly addressing dietary habits may be desirable in psychotic patients.

WORK LIMITING HEALTH AND DIVORCE BEHAVIOR: A RETROSPECTIVE ANALYSIS WITH SIPP DATA

In this paper, we consider the role of all work limiting health conditions on divorce behavior but we distinguish between less (exogenous) predictable versus more (endogenous) predictable shocks. We divide the reported health conditions in the 2004 Survey of Income and Program Participation (SIPP) into those that appear to arrive randomly conditional on age for married men and women versus those that appear to be more predictable. The six work limiting health conditions that appear to arrive largely exogenously are cancer, carpal tunnel syndrome, deafness or serious trouble hearing, paralysis, thyroid trouble and tumor cyst or growth. How the onset of work limiting conditions then affects divorce is studied across different demographic groups. The primary result of the study is that the onset of health problems that are unpredictable generally does not increase the likelihood of divorce while the divorce behavior is closely related to the onset or evolution of a broader, arguably endogenous set of health conditions. However, the patterns of response are shown to vary by race and ethnicity. For example, the onset of health conditions that do appear to be statistically related to demographic factors known to correlate with poor health behaviors appear to be associated with a statistically significant increase in the probability of divorce particularly among minority (Black and Hispanic) groups. The data used in the study are drawn from the SIPP, particularly from the topical module on “work disability history”, and the retrospective histories are used to construct a panel over the individuals’ lives. The primary estimation method is a panel linear probability model with fixed-effects.

Combined influence of poor health behaviours on the prevalence and 15-year incidence of age-related macular degeneration

We aimed to establish the collective influence of four lifestyle practices (physical activity, diet, smoking and alcohol consumption) on the prevalence and incidence of AMD. At baseline, 2428 participants aged 49+ with complete lifestyle and AMD data were examined, and of these, 1903 participants were re-examined 15 years later. AMD was assessed from retinal photographs. A health behaviour score was calculated, allocating 1 point for each poor behaviour: current smoking; fruits and vegetables consumed <4 serves daily; <3 episodes of physical activity per week; and >2 alcoholic drinks per day. Cross-sectional analysis showed that participants who engaged in all 4 poor health behaviours (n = 29) versus those who did not engage in unhealthy behaviours (reference group; n = 677) had greater odds of any and late AMD: multivariable-adjusted OR, 5.14 (95% CI, 1.04–25.45) and OR 29.53 (95% CI 2.72–321.16), respectively. A marginally non-significant association was observed between increasing number of poor health behaviours and 15-year incidence of early AMD (multivariable-adjusted P-trend = 0.08). Our data suggests that motivating patients with AMD to eat better, exercise more, limit alcohol intake and avoid smoking seems advisable to decelerate the development or worsening of existing AMD.

Erratum to: Poor Health Behaviors Prior to Laparoscopic Sleeve Gastrectomy Surgery

Erratum to: Poor Health Behaviors Prior to Laparoscopic Sleeve Gastrectomy Surgery

Erratum to: Poor Health Behaviors Prior to Laparoscopic Sleeve Gastrectomy Surgery.

Erratum to: Poor Health Behaviors Prior to Laparoscopic Sleeve Gastrectomy Surgery.