Thesis (D.N.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / This study investigated of the capacity of self-efficiency (SE) and the Health Belief Model (HBM) to predict diabetes self care. Research questions derived from Bandura's Social Cognitive Theory asked the associations between SE, HBM, and their interaction on reported self care (SC). / 2031-01-01

No description available.

No description available.

No description available.

From the viewpoint of the public, academic work is relatively autonomous, stable, and stress-free as opposed to other professions. However, as the societal environment evolves, high satisfaction is no more an absolute consequence of academic work. Even in comparison to other professionals, the academics experienced longer working hours and heavier occupational stress; hence the events of ¡§Karoshi¡¨ among university academics happened from time to time. Actually, the reason resulting in ¡§Karoshi¡¨ has been proved related to health behavior, and the health behavior also has been proved associated with health belief. Following this concept, a study based upon ¡§health belief model¡¨ was carried out to investigate the health belief, health behavior, and health status of university academics, respectively, and the possible relationships among the aforementioned health related concepts. In total, 4,000 subjects were selected from among the 43,050 or so university academics nationwide based on stratified sampling approach. Data were collected through survey questionnaires which include personal demographics, health belief, health behavior, and health status information. From June through August 2004, 1,778 questionnaires returned with a response rate of 44.45%. SPSS was used for descriptive analysis and basic hypothesis test, and then the software package AMOS was used for structural equation modeling examination. Compared to the general population with the same age, the health status of university academics was worse in both physical and psychological function. Further, it was found that the factor work significantly contributed to each component of health belief (i.e. perceived susceptibility, perceived seriousness, perceived barriers, and perceived benefits). In terms of health behavior, although the academics had no unhealthy habits (i.e. smoking or excessive drinking), the average working hour after 10 pm was more than one hour and one in three teachers didn¡¦t take exercise regularly, which altogether are definitely harmful to health. The structural equation modeling showed that an academic¡¦s health belief would influence his/her health behavior and then influence the health status indirectly. In other words, positive health belief will lead to healthy status in the long run, and negative health belief will conduce to unhealthy status. To sum up, the issue on improving the health status of academics is on edge and the responsibility for taking this issue would be shouldered by teamwork¡X individuals, educational authorities, and public health agencies. An academic should try his/her best to improve the health; the educational authorities should assess the job loading on academic population from time to time and draw up a better educational system; and finally, the public health agency should play the role of information disseminator and catalyst for strengthening the health belief and then improving the health behavior and health status among the academics.

Despite strong evidence that screening for Colorectal cancer (CRC) can reduce cancer incidence and mortality, screening adherence remains low. Racial differences in CRC incidence and mortality are well documented in the literature. Racial differences in CRC screening use remain mixed with most studies using race as an independent variable and focusing on racial differences in CRC screening rates. Few studies have examined correlates of CRC screening use, stratifying by race. The purpose of this study was to determine if there are racial differences in correlates of CRC screening, using the Health Belief Model as the theoretical framework. Data analyzed in this study came from the 2003 Health Information National Trends Survey (HINTS) of the National Cancer Institute. White (n=1988) and non-white (562) respondents age ≥50 years, without a history of cancer were interviewed by phone. Multivariable logistic regression was used to identify correlates of FOBT and endoscopy adherence stratified by race and screening test. Independent variables included age, gender, education, income, insurance status, regular care visit frequency, perceived risk of CRC, family history of cancer, CRC knowledge, cancer worry, perceptions of screening benefits, and perceptions of expense as a barrier. Predictors of adherence to FOBT for whites included being older and having at least 1 regular car visit. Predictors of FOBT adherence for non-whites included having health insurance. Endoscopy adherence for whites was significantly associated with being older, being female, and agreeing with perceptions of benefits to CRC screening. Predictors of endoscopy adherence for non-whites included being older, and disagreeing with perceptions of benefits to CRC screening. Such differences, if confirmed in future studies, may inform race-specific interventions to increase CRC screening utilization.

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are ailments that have a social and political impact in the U.S. Since their discovery more than three decades ago, there has been an intense focus on eradicating these deadly diseases. Although there has been a lot of progress in the fight against HIV and AIDS, there are communities still disproportionately affected by it. Based on data from the Center for Disease Control and Prevention (CDC), one such community is young adults age 20 to 24 (CDC, 2016a). These young adults are at the focal center of the HIV/AIDS epidemic for various reasons; yet, this group is often overlooked in HIV literature and prevention/intervention strategies. Additionally, this community is known for inconsistent condom use, although there have been countless public service announcements (PSAs) and interventions promoting the use of condoms as a means of preventing not only unwanted pregnancy but the contraction of sexual transmitted infections (STIs) including HIV/AIDS. The aim of the current study was to test a comprehensive moderated mediation model and assess factors associated with condom use among early young adults age 18 to 24 above and beyond known variables such as age, gender, and ethnicity/race. These variables included participants’ age of sexual debut, number of lifetime sexual partners, perceived threat of contracting STIs and HIV/AIDS, and exposure to cues to action as predictors of condom use. The decision to expand the study to assess condom use among early young adults (18 -24) as opposed to focusing exclusively on young adults (20 -24) was based on early young adults being less likely to be tested for HIV compared to other age groups (CDC, 2008). For the moderated mediation model, I drew on the health belief model (HBM) and tested whether 1) the relationship between sexual debut and condom use was mediated by number of lifetime sexual partnerships, and 2) the relationships between sexual debut and the mediator were moderated by perceived threat, and whether the relationships between the mediator and condom use was moderated by perceived threat and cues to action. The full model was not supported. The implication of this study is that more current research is needed to understand early young adults and their condom use, as they are a community that is most vulnerable to HIV/AIDS and a key component in the fight against this disease.

The purpose of this study was to compare the health profiles of women seeking residential treatment for substance abuse with women in the community. These 2 data sets consisted of a total of 621 participants. An additional aim of the present study was to examine whether these health profiles differ between the monosubstance abusing and polysubstance abusing women within the treatment group. There were a total of 257 participants in this group. All analyses controlled for the effects of age, insurance, marital status, employment and race/ethnicity. Binary logistic regressions were used to compare between and within the specified groups on the following variables: asthma, dyslipidemia, diabetes, Hepatitis B vaccination, HIV testing, hypertension, Pap smear testing, mental health problems, overweight/obesity and smoking. A follow-up analyses examined whether differences in the variables could be explained by the effects of specific control variables. Results suggested that differences in four outcomes might be explained by a single or smaller number of specific control variables. The overall results revealed that age was one of the strongest predictors of differences between the treatment and community group. When we controlled for age, marital status, low socioeconomic status (insurance, employment) and ethnicity we found that only two variables were significantly different. Women in residential showed significantly more smoking and mental health symptoms than were found in the community sample. There were no significant differences in the health profiles of polysubstance substance abusing than were found in monosubstance abusing women. The findings of the present study indicate that women seeking treatment are individuals with similar health disorders and health maintaining behaviors as the general population of women. However, women seeking treatment have significant increases in mental health disorders and smoking. Older age was related to increases in the odds of having dyslipidemia, diabetes, hypertension, and decreases in the odds of being immunized for Hepatitis B, tested for HIV, and having a Pap test in the last year. Due to anticipated-age related disorders, screening for dyslipidemia, diabetes, and hypertension should be provided for older women seeking admission to treatment. Substance abuse treatment centers for women should provide for mental health services and offer smoking cessation.

I Sverige genomförs årligen 35 000 - 40 000 aborter. Kvinnor i åldersgruppen 20-24 är de som utför allra flest och risktaganden i sexuella sammanhang är betydligt större än vad det tidigare har varit. Litteraturstudiens syfte var att beskriva unga kvinnor sexuella riskbeteenden och deras attityder till abort. Systematiska sökningar gjordes i Cinahl, PubMed och PsycINFO och artiklar som motsvarade syftet granskades kritiskt. Slutligen valdes 11 vetenskapliga artiklar som bearbetades och analyserades. Utifrån syftet delades resultatet upp i två delar. Under riskbeteenden framkom följande underteman: alkohol gör unga kvinnor mer riskbenägna, liberala attityder till sex, inkonsekvent användande av preventivmedel, upplevda nackdelar med preventivmedel samt brist på information om preventivmedel och sexualkunskap. Dessa teman beskriver på olika sätt de sexuella riskbeteenden som visat sig finnas hos unga kvinnor idag. Unga kvinnors attityder till abort delades upp i två underteman: abort som ett accepterat alternativ samt blandade känslor kring en oplanerad graviditet och beslut om abort. Abort sågs som en självklar rätt men även rädsla att ångra sitt beslut uttrycktes. Preventiva insatser vad gäller oönskade graviditeter är ett ansvar som åligger hälso- och sjukvården. Sjuksköterskan kan i sin profession använda sig av motiverande samtal. Det vilar också ett ansvar på hälso- och sjukvården att erbjuda en god abortvård samt möjlighet till återhämtning där sjuksköterskan spelar en viktig roll vid samtal och stöd. / Every year implements 35,000 to 40,000 abortions in Sweden. The most are performed by women aged 20-24 and risk-taking in sexual context is much more common than before. The aim of this study was to describe young women´s sexual risk behaviors and their attitudes toward abortion. Systematic searches were made in Cinahl, PubMed and PsycINFO and articles that corresponded the aim was critically reviewed. Finally 11 research articles were selected and after that they were processed and analyzed. Based on the purpose the result was divided in two parts. To risk behaviors following subthemes revealed: alcohol makes young women more willing to take risks, liberal attitudes to sex, inconsistently use of contraception, perceived disadvantages of contraception and lack of information about contraception and sex education. These themes describe the sexual risk behaviors that exist in young women today. About young women's attitudes to abortion two subthemes were emerged: abortion as accepted alternative and mixed feelings about an unplanned pregnancy and the decision on abortion. Abortions were seen as a natural right, but also fear of regretting their decision was expressed. Preventions of unwanted pregnancies are a responsibility of health and medical care. Nurses can in their profession use motivational interviewing. The health sector also has a responsibility to offer a good abortion care and allow for recovery. The nurse plays a particularly important role in the support.

Women smokers with heart disease (HD) are at increased risk for negative health effects. At the time of invasive cardiovascular (CV) interventions is a critical opportunity to make lifestyle changes to reduce future CV interventions. The purposes of this study guided by the Health Belief Model were to determine which factors predict smoking cessation (SC) in women following an invasive CV procedure and to explore assistance received with SC. A correlational, prospective design was used. Data were collected from women smokers at the time of an invasive CV intervention and three months later. Instruments measured commitment to stop smoking, perceived threat of HD and future interventions, cessation self efficacy, barriers to SC, benefits of SC, cues to action, and motivation. Analyses included Chi-square, t-tests, and multiple, hierarchical, and logistic regression. On average women (N = 76) were middle-aged (M = 55.9 ± 8.0 yrs), smoked M = 15.3 ± 9.8 daily cigarettes and smoked for M = 33.6 ± 10.2 years. At baseline, fewer perceived barriers to SC, high cessation self-efficacy, and being more autonomously motivated to quit smoking explained 67 % of variance in commitment to stop smoking, F (6, 67) = 19.37, p < .001. At 3 months, only 8 (n = 54) women had quit smoking. Women smoked fewer daily cigarettes (M = 10.6 ± SD = 8.5) at 3 months compared to time of procedure (M = 15.3 ± 9.8), t(51) = 3.43, p < .01. Higher baseline cessation self-efficacy and lower HD threat were predictors of SC at three months, X2 (4, N=54) = 18.67, p = .001. At the three month follow up, the most common barrier to SC was anxiety (24%) and cigarette cravings (24%). While women were highly committed and confident they could quit, they reported receiving little help from their health care provider (HCP) other than simple advice to quit smoking. Most women undergoing an invasive CV procedure were unable to quit smoking even with a high desire to do so. Referrals for assistance from HCP to decrease anxiety and nicotine dependence and to address ongoing challenges to SC are needed.