Browsing by Subject "Health Promotion"
Now showing 1 - 16 of 16
- Results Per Page
- Sort Options
Item Bandura's Social Cognitive Concepts and Physical Activity of People with Multiple Sclerosis: A Hierarchical Regression Analysis(2013-12-30) Gaylord, Kathryn Lee; Chiu, Chung-Yi; Froehlich-Grobe, Katherine; Rose, LindseyBACKGROUND: Social Cognitive Theory (SCT), developed by Alfred Bandura, is a theory often employed for health promotion. This theory focuses on a set of determinants, examining how each operates, and translating information about the determinants into health practices. The combination and interaction of the primary determinants of SCT (perceived self-efficacy, outcome expectations, goals, and perceived facilitators and barriers) not only determine, but also influence the health behaviors individuals engage in. Through the use of this theory, determinants to change and adoption of a new behavior can be assessed, and individual treatment plans may be developed to effectively focus on the most influential targets for behavioral change. Multiple Sclerosis, a chronic and debilitating health problem estimated to affect hundreds of thousands of individuals in the United States, often leads to individual suffering and an overall decreased quality of life. Currently, there is no cure for MS, so symptom management and a decrease in debility remain a critical area of focus for health professionals working with MS patients. While there is no cure for this disorder, physical activity has been shown to alleviate multiple symptoms of MS such as mobility impairment, fatigue, pain, and depression, which then improves the quality of one’s life. Furthermore, there is strong empirical evidence to support the use of SCT as an efficacious treatment approach for employing health promotion practices. The purpose of this study is to extend previous findings by examining how various SCT concepts relate to physical health, mental health, stage of change for exercise, and action planning and coping planning for exercise. Additionally, the present study examines how disability affects self-efficacy thereby impacting physical activity. SUBJECTS: A total of 214 individuals (185 females [86%] and 29 males [14%] with self-reported MS recruited from the National Multiple Sclerosis Society and a neurology clinic of a university teaching hospital in the Midwest participated in the current study. The average age among participants was 46.97 years (SD = 9.92). Around 36% of participants were retired due to MS, and approximately 72% of participants reported being treated for secondary health problems (e.g., overweight, high blood pressure, and diabetes). METHOD: Participant demographic data were gathered from self-reports and include age, gender, ethnicity, marital status, years since onset of MS, secondary health issues, education level, vocational status, occupation, area of residence, current and past rehabilitation services received, source of income, total income, access to physical exercise in community, and changes in health practice since onset of MS. SCT concepts were assessed using the following measures: Action Self-Efficacy Scale-Physical Exercise (ASES-PE), Outcome Expectancy Scale-Physical Exercise (OES-PE), Health/Safety Risk Perceptions Scale (HRPS), Health/Safety Expected Benefits Scale (HEBS), Barriers to Health Promoting Activities for Disabled Persons Scale (BHADP), the Action Planning and Coping planning Scale-Physical Exercise (APCPS-PE), the Physical Activity Stages of Change Instrument (PASC). Participant disability and health were assessed using the following measures: Minimal Record of Disability (MRD) and the MOS Short form Health Survey (SF-12v2). The present study used a hierarchical regression analysis to examine associations between various domains and a set of social cognitive concepts (self-efficacy, knowledge of health and risk benefits, and outcome expectancy). RESULTS: There were several significant findings when examining the four domains of action planning and coping planning, stage of change, physical health, and mental health. Results indicated action planning and coping planning was predicted by action self-efficacy (R2 = 45%, ß = .45, p < .001), outcome expectancy (R2 = 45%, ß = .20, p < .01), risk perception (R2 = 45%, ß = .14, p < .05), and perceived barriers (R2 = 16%, ß = -.14, p < .05). Results indicated that stage of change was predicted by action planning and coping planning (R2 = 28%, ß = .26, p < .01). When “physical health” was the outcome variable, it was predicted by age (R2 = 8%, ß = -.20, p < .01), severity of disability (R2 = 14%, ß = -.28, p < .01), action self-efficacy (R2 = 22%, ß = -.16, p < .05), and outcome expectancy (R2 = 22%, ß = .27, p < .01). Lastly, when “mental health” was the outcome variable, it was predicted by age (R2 = 6%, ß = .18, p < .05), perceived barriers (R2 = 11%, ß = -.23, p < .01), outcome expectancy (R2 = 18%, ß = -.25, p < .01), and action self-efficacy (R2 = 18%, ß = .22, p < .05). DISCUSSION: The research findings support the applicability of Bandura’s Social Cognitive Theory as a model for exercise or physical activity for people with MS. This study found unique relationships between physical health and action self-efficacy, and mental health and outcome expectancy (with both relationships having a negative correlation). The current study includes a unique subset of the MS population who are well-educated, affluent, and report greater access to services and who expressed the negative correlate between action self-efficacy and physical health. The aforementioned factors are supposed to support physical health. However, the current group has high action self-efficacy to exercise, and given that they likely have good knowledge about exercise benefits to MS and good environmental support to engage in exercise, their motivation has likely surpassed, and is greater than, their experienced physical health, such as suffering pain and fatigue, which decreases physical health. Furthermore, it may be that the participants in the current study have good knowledge about how physical activity benefits their MS symptoms and progress management; consequently, they have high intention to push themselves to engage in exercise even though they may have experienced pain and fatigue, both of which have affected physical health significantly. Additionally, considering that high outcome expectations of a behavior may lead to stress and anxiety, such stress may decrease mental health, particularly if the positive effects of an activity (such as exercise) are not experienced as soon as and as much as expected. Examining the social cognitive, physical health, and mental health domains provides a well-rounded and empirical basis for employing health promotion efforts in clinical work with persons with MS. Rehabilitation professionals may help persons with MS implement physical activity through the use of SCT, which may improve their mobility impairment, pain, fatigue, and depression. The present study’s findings enable clinicians and rehabilitation professionals to better create and customize treatment to best meet individual patients’ needs and improve their overall quality of life.Item Baseline Assessment of Adolescent Reproductive and Sexual Health in Yantaló, San Martin, Peru(2016-04-01) Murarka, Shivani; Johnson, AndreaBACKGROUND: The term “adolescent fertility rate” refers to the number of births per 1000 in girls ages 15-19. In July 2013, the adolescent fertility rate in rural Yantaló, Peru, was nearly 10%, almost double the national rate of 5.2% in 2012 (World Bank). Adolescent pregnancy remains a major contributor to maternal and child mortality and to the cycle of ill-health and poverty world-wide (WHO). In Yantaló, many young mothers are forced to terminate their schooling in order to care for their children, giving them fewer opportunities for financial independence in a society with a strong machismo culture. OBJECTIVE: To gain a better understanding of the adolescent sexual and reproductive health education and practice in Yantaló and the potential interventions that could be made to decrease the adolescent fertility rate. METHODS: This study involved numerous methods of data collection that were then evaluated and presented to the local community. We started by conducting oral interviews with 19 local authorities, who played different roles in the community, to gain a deeper understanding of the issues surrounding adolescent sexual and reproductive health in the region. We then conducted 218 written surveys with high school students ages 11-19 to investigate their baseline reproductive health knowledge, religious values, family life, and their preferences regarding avenues of receiving sexual health information and sexual health classes. We also evaluated the proposed national curriculum on sexual health. All of this data was then used to create suggestions regarding interventions to improve the adolescent fertility rate in Yantaló, and this information was presented to local authorities. RESULTS: Analysis of the study revealed that there were many components that contributed to the high adolescent fertility rate in Yantaló and many potential areas for intervention were made apparent. Data from oral interviews pointed to a strong machismo culture, rampant misconceptions regarding sexual health and contraceptive methods, insufficient outreach programs, and a general lack of coordination between local entities as reasons for the high number of adolescent pregnancies. The surveys of the adolescents revealed that they lacked basic reproductive health knowledge but were eager to learn more, especially from local clinicians and their mothers and fathers, despite admitting having difficulty communicating openly about sexual health with their parents. Although the proposed national curriculum was analyzed, the school in Yantaló admitted that it only followed the guidelines loosely, which made it an ineffective tool to evaluate sexual health education in the region. CONCLUSION: Yantaló is similar to many other rural communities in South and Central America in that it has a strong traditional, machismo culture that influences much of the adolescent sexual health practices. Like much of Peru, Yantaló also has access to trained healthcare providers and free contraceptive care, but misconceptions and a lack of education regarding sexual health limits access. This research emphasized the importance collaboration within the community to utilize the existing infrastructure of the village to increase education of adolescents and encourage communication between providers, parents, and adolescents to improve adolescent sexual health and reduce the burden of unwanted teenage pregnancy. This practice could be easily translatable to numerous other communities that struggle with the same inefficiencies.Item Clinical exercise prescription: no pain, no gain?(2000-11-30) Leach, Steven L.Item Ethics large and small: moral considerations in response to childhood obesity(2022-03-08) Hester, D. MicahObesity in the U.S. has been described as an epidemic, and in response to such rhetoric, individuals, healthcare providers, public health officials, even state legislatures, and courts have proposed initiatives or enacted consequences either to encourage better eating habits, discourage poor eating habits, or even punish poor nutritional practices. All these actions raise ethical concerns for public health and individual patient care. This talk will explore a number of these issues and will suggest that certain state-based responses do not merit ethical scrutiny, but individual provider directiveness in regards to nutritional counseling, especially with parents of overweight children, is warranted.Item Health maintenance for adults(1984-04-12) Kirk, Lynne M.Item The kitchen as a lab: translating food into clinical science through culinary medicine(2018-08-03) Albin, Jaclyn LewisItem [News](1981-06-25) Harrell, AnnItem [News](1984-04-30) Williams, AnnItem [News](1985-03-28) Bosler, Tommy JoyItem [News](1984-08-30) Weeter, DeborahItem [News](1980-08-15) Spiegel, RichardItem [News](1983-04-20) Floyd, CarolItem [News](1980-02-28) Spiegel, RichardItem [News](1984-02-17) Rutherford, SusanItem [News](1983-03-23) Harrell, AnnItem Why?(2023-01-06) Butler, Javed