Browsing by Subject "health belief model"
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Item Application of the bioecological model and health belief model to self-reported health risk behaviors of adolescents in the united states(2009-05-15) Fleary, Sasha A.Health risk behaviors are responsible for the majority of morbidity and mortality among adolescents. Researchers have identified three sources of risk-taking in adolescents ? dispositional, ecological and biological. The Bioecological Model incorporates these three sources of risk-taking, however it lacks explanatory power. For this reason, this thesis focused on explaining risk perception of health risk behaviors (smoking cigarette, alcohol and marijuana use), and health risk behaviors by integrating the Bioecological Model with a more specific Health Belief Model. The relationship between risk perception and health risk behavior was also investigated as a first step in understanding adolescent decision-making using the Health Belief Model. Adolescents from a suburban Indiana area were asked to complete the Adolescent Health Risk Behavior Survey which assessed egocentrism, self-esteem, social norms, risk perceptions, and the incidence and prevalence of health endangering behaviors. Hierarchical linear regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain risk perception of health risk behaviors. Hierarchical logistic regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain health risk behaviors and to moderate the relationships between risk perception and health risk behaviors. Based on the results, it was confirmed that the Bioecological Model is important in understanding adolescent?s risk perception of health risk behaviors, and their self-reported health risk behaviors. It is also important in understanding the relationship between risk perception and health risk behaviors. Adolescent Variables, Microsystem, and Mesosystem were significant in predicting adolescent risk perception of all health risk behaviors examined, and self-reported smoking cigarette behavior and marijuana use. Adolescent variables and Microsystem were the only systems to predict adolescent self-reported alcohol use. The relationship between risk perception and reported smoking cigarette behavior was moderated by Adolescent Variables, Microsystem and Mesosystem, however for alcohol use the path was moderated by Adolescent Variables and for marijuana use the path was moderated by the Mesosytem. Results of this thesis imply the importance of considering the contribution of Bioecological Model variables when implementing prevention intervention programs specific to adolescent health risk behaviors.Item Relationships between psychosocial factors and adherence to diet and exercise in adults with type 2 diabetes: A test of a theoretical model(2007-05-21) Elizabeth Gressle Tovar; Michele Clark, RN, PhD; Susan Weller, PhD; Regina Lederman, RN, PhD; Hoang Nguyen, PhD; Carrie Jo Braden, RN, PhDIntroduction: Cardiovascular disease (CVD) is the leading cause of premature death among people with diabetes. Diet and exercise adherence are\r\nimportant diabetes self management behaviors that can reduce CVD risk; unfortunately, adherence rates are low among diabetics. Improved understanding of psychosocial factors related to diet and exercise adherence among adults with\r\ntype 2 diabetes can improve strategies to reduce CVD morbidity and mortality in this population.\r\n Purpose: 1) Evaluate psychometrics of the Health Beliefs related to Cardiovascular Disease scale (HBCVD) which measures perceived susceptibility to and severity of heart attack or stroke and perceived benefits of and barriers to\r\ndiet and exercise; 2) Explore relationships between selected bio-psychosocial factors and diet and exercise adherence; and 3) Evaluate the ability of a theoretical model integrating the Health Belief Model (HBM) and Stages of Change Model (SOC) to explain diet and exercise adherence.\r\n Methods: The study design was a descriptive correlational cross section using a convenience sample of 212 adults with type 2 diabetes who completed a series of questionnaires measuring study variables. Outcome variables measured were diet and exercise adherence scores. Predictor/independent variables included knowledge related to CVD risk, cues to action, health beliefs, stage of change, social support, depression, comorbidity, diabetes duration, and\r\nsocioeconomic status. Relationships among model variables were explored using analysis of variance and simple and multiple regression techniques.\r\n Results: The HBCVD demonstrated evidence of validity and reliability, although an improved barriers subscale is recommended. The theoretical model was not supported, although significant paths between model variables were identified. The best model to predict diet included diet stage, susceptibility, self efficacy, social support, and age. The best model to predict exercise included\r\nexercise stage, self efficacy, and social support. Models including HBM and SOC provided greater explanatory power for diet and exercise adherence than either model alone. Susceptibility, barriers, and self efficacy varied significantly across\r\nstages of change. Significant group differences were found among model variables. Participants with depressive symptoms and the least education had lower diet and exercise adherence scores. Younger age and unemployment were also associated with lower diet adherence.\r\n