Don P. Haefner

Selected Psychosocial Models and Correlates of Individual Health-Related Behaviors

RELATIVELY LOW LEVELS of public participation in screening, immunization, and other preventive health programs have been extensively documented,21 50 55, 91 as have the generally poor rates of individual compliance with prescribed medical therapies.42, 52, 81, 86 Over the past two decades, hundreds of research reports and review articles have been published reflecting the desire to both discover and better under-

Psychosocial determinants of immunization behavior in a swine influenza campaign.

A prospective design was used to study factors which predisposed individuals to receive vaccination in response to the anticipated outbreak of swine influenza in the fall and winter of 1976. Data were obtained from a telephone survey of 286 adults in Oakland County, Michigan. Predictor variables included Health Belief Model (HBM) variables as well as measures of behavioral intention, social influence, physicians advice, socioeconomic status and past experience with flu shots. In multivariate analysis, over 40 per cent of the variance in inoculation behavior was explained by the predictors used. Path analysis revealed that most of the HBM variables’ influence on behavior was mediated through behavioral intention. While behavioral intention was an important predictor of inoculation behavior, other psychosocial factors played a significant role in explaining variance in the dependent variable.

Alameda County redux: replication in Michigan.

This article describes an attempt to reproduce, in Michigan, cross-sectional findings concerning the relationship between health habits and health status previously obtained in Alameda County, California by Belloc and Breslow. Data for this study were gathered by a telephone interview of a state-wide sample of 3,259 adult Michigan residents. The ridit (relative to an identified distribution) analyses presented include a comparison of findings from the Michigan and Alameda County studies. In Michigan, as in Alameda County, health status was found to be associated with various health practices, both individually and in combination. Consistent relationships were found between physical health status and individual health practices regarding hours of sleep, eating breakfast, eating between meals, cigarette smoking, weight for height, and physical activity. Physical health status was also linked to the overall number of health practices individuals engaged in. When the confidence interval for each ridit value was taken into account, however, only some of the findings proved statistically reliable.

The Health Belief Model and Preventive Dental Behavior

I n 1961, Kegeles published a seminal article I dealing with applications to dental health behavior of the generalized ’*Health Belief Model” developed by himself, Rosenstock, and Hochbaum. In tha t article, Kegeles set forth four perceptual factors deemed crucial in determining whether a person would seek dental care on a periodic basis. The variables were: (1) susceptibility the belief that dental disease can happen to oneself; (2) severity the perception that the consequences of the disease might be clinically severe or might interfere with things considered by the individual to be extremely important; (3) salience the feeling tha t doing something about the disease is more important than doing other things; and ( 4 ) benefits beliefs about which practices to follow together with the belief that following such practices is more beneficial than not doing so. Subsumed under the benefits variable was the subsidiary factor of perceived barriers or costs of the action, i.e., situational and psychological deterrents to taking preventive health action. In the article, Kegeles interpreted the results of various studies as being consistent with the role of the above-mentioned health beliefs in accounting for dental health behavior. He wisely noted, however, that further research needed to be done on the topic and cautioned that “the research needed should not consist merely of surveys of existent attitudes and beliefs. It must, instead, demonstrate (1) the relation of attitudes, motives, and beliefs to subsequent behavior; (2) the effects of changing certain attitudes and beliefs on dental behavior; and (3) the effect of changing dental behavior on attitudes and beliefs.” I Over a dozen years have passed since publication of that article. During those years, published studies in the dental area bearing on the Health Belief Model have trebled. The research ranges from experiments to surveys, from retrospective to prospective studies, from investigations performed in the United States to those conducted in other countries, from original research explicitly designed to measure particular health beliefs to reanalyses of data originally obtained for other purposes. What has been the thrust of this research, and what are its implications? The focus of this paper will be on studies concerning the hypothesized relationship between health beliefs and preventive

Impact of a negative breast biopsy on subsequent breast self-examination practice

Abstract Women who practice breast-self examination (BSE) occasionally detect breast lumps that are ultimately biopsied and found to be benign. This research examined the impact of a negative breast biopsy on subsequent BSE practice. A total of 655 women comprised three study groups: 83 women who discovered their breast problem by BSE; 179 women whose lump was identified by an individual/procedure in the health care system; and 393 women with no history of breast problems. Telephone interviews determined BSE practice for 6-month intervals prior to, and after, the benign biopsy experience. Among previously-regular practitioners, 21% of the self-discovered group and 16% of those whose lump was discovered in the health care system reduced their BSE practice below the recommended monthly interval following the benign biopsy. In contrast, among initiallynonregular practitioners, 29% of the self-discovered group, and 25% of the health care system group subsequently became regular BSE practitioners. Possible explanations are offered for these opposite shifts in BSE regularity, and some practical suggestions are provided for health care professionals who counsel women following a benign biopsy experience.