Browsing by Subject "Health Behavior"

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    Augmenting the Health Belief Model to Promote Knee Massage as Self-Management Among Individuals with Knee Osteoarthritis: A Roadmap for Future Research and Intervention Development
    (2023-08) Nemati, Raheleh; Munk, Niki; Kaushal, Navin; Keith, NiCole; Naugle, Kelly
    Self-administered massage is a form of self-management that has been shown to alleviate symptoms among individuals with knee osteoarthritis. However, existing interventions have yielded inconsistent results in terms of promoting the practice of self-administered massage, highlighting a critical gap in the application of a theoretical or conceptual model. The current study utilized an expanded health belief model that integrates constructs from the theory of planned behavior aimed to identify the behavioral determinants associated with the practice of self-administered knee massage. An observational study was designed to address the objectives using an online survey. A total of 268 participants with knee osteoarthritis completed the survey. Data regarding the clinical characteristics of participants, including the year of diagnosis, chronicity of pain, affected knee(s), and the intensity of pain in terms of current, average, and worst levels, were collected. Structural equation modeling was used to test the predictive validity of the proposed model. The model revealed self-administered massage behavior to be predicted by intention (β = .21, p < .014). Intention was predicted by cues (β = .29, p <.001), task self-efficacy (β = .29, p <.001), affective attitudes (β = .14, p =.011), perceived severity (β = .27, p <.001), and perceived facilitators (β = .22, p <.001), but not response self-efficacy, instrumental attitudes, or barriers. Intention mediated the effects between cues (β = .06, 95% CI .025, .129) and perceived severity (β = .06, 95% CI .014, .127) and behavior. Model determinants were found to mediate between age and behavior (β = -.16, 95% CI -.224, -.093). Interventions aimed at promoting self-administered massage should focus on enhancing individuals' perception of the severity of their knee OA progression and their confidence in performing the massage by teaching them the common massage techniques.
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    Educational disparities in health behaviors among patients with diabetes: the Translating Research Into Action for Diabetes (TRIAD) Study
    (BioMed Central, 2007-10-29) Karter, Andrew J.; Stevens, Mark R.; Brown, Arleen F.; Duru, O. Kenrik; Gregg, Edward W.; Gary, Tiffany L.; Beckles, Gloria L.; Tseng, Chien-Wen; Marrero, David G.; Waitzfelder, Beth; Herman, William H.; Piette, John D.; Safford, Monika M.; Ettner, Susan L.; Cellular and Integrative Physiology, School of Medicine
    Background Our understanding of social disparities in diabetes-related health behaviors is incomplete. The purpose of this study was to determine if having less education is associated with poorer diabetes-related health behaviors. Methods This observational study was based on a cohort of 8,763 survey respondents drawn from ~180,000 patients with diabetes receiving care from 68 provider groups in ten managed care health plans across the United States. Self-reported survey data included individual educational attainment ("education") and five diabetes self-care behaviors among individuals for whom the behavior would clearly be indicated: foot exams (among those with symptoms of peripheral neuropathy or a history of foot ulcers); self-monitoring of blood glucose (SMBG; among insulin users only); smoking; exercise; and certain diabetes-related health seeking behaviors (use of diabetes health education, website, or support group in last 12 months). Predicted probabilities were modeled at each level of self-reported educational attainment using hierarchical logistic regression models with random effects for clustering within health plans. Results Patients with less education had significantly lower predicted probabilities of being a non-smoker and engaging in regular exercise and health-seeking behaviors, while SMBG and foot self-examination did not vary by education. Extensive adjustment for patient factors revealed no discernable confounding effect on the estimates or their significance, and most education-behavior relationships were similar across sex, race and other patient characteristics. The relationship between education and smoking varied significantly across age, with a strong inverse relationship in those aged 25–44, modest for those ages 45–64, but non-evident for those over 65. Intensity of disease management by the health plan and provider communication did not alter the examined education-behavior relationships. Other measures of socioeconomic position yielded similar findings. Conclusion The relationship between educational attainment and health behaviors was modest in strength for most behaviors. Over the life course, the cumulative effect of reduced practice of multiple self-care behaviors among less educated patients may play an important part in shaping the social health gradient.
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    Effects of Proximity to Supermarkets on a Randomized Trial Studying Interventions for Obesity
    (American Public Health Association, 2016-03) Fiechtner, Lauren; Kleinman, Ken; Melly, Steven J.; Sharifi, Mona; Marshall, Richard; Block, Jason; Cheng, Erika R.; Taveras, Elsie M.; Department of Pediatrics, IU School of Medicine
    OBJECTIVES: To determine whether proximity to a supermarket modified the effects of an obesity intervention. METHODS: We examined 498 children aged 6 to 12 years with a body mass index (BMI) at or above the 95th percentile participating in an obesity trial in Massachusetts in 2011 to 2013. The practice-based interventions included computerized clinician decision support plus family self-guided behavior change or health coaching. Outcomes were 1-year change in BMI z-score, sugar-sweetened beverage intake, and fruit and vegetable intake. We examined distance to the closest supermarket as an effect modifier. RESULTS: Distance to supermarkets was an effect modifier of 1-year change in BMI z-score and fruit and vegetable intake but not sugar-sweetened beverage intake. With each 1-mile shorter distance to a supermarket, intervention participants increased their fruit and vegetable intake by 0.29 servings per day and decreased their BMI z-score by -0.04 units relative to controls. CONCLUSIONS: Living closer to a supermarket is associated with greater improvements in fruit and vegetable intake and weight status in an obesity intervention.
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