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The purpose of this study was to examine the relationship between adolescents' perceptions of their parents' encouragement to lose weight and physical activity habits (i.e., exercise habits and sedentary behaviors) and their own physical health-related fitness (HRF) and psychological well-being. Results of structural equation modeling revealed both similarities and differences between boys and girls. Specifically, parental sedentary behavior and encouragement to lose weight related to girls HRF. Among boys, only encouragement to lose weight related to HRF. When inspecting the relationship between HRF and psychological well-being, HRF related to body satisfaction, but not depressive symptoms, among both boys and girls. Results of this study highlight the complex influence that parental perceptions have during adolescent development.

It has been well established, in the literature, the association between low health literacy rates and poor health outcomes. With the increase of technology dependence, more people are using the internet to look up health information. Research has shown that shared decision making between providers and patients can improve patients' health outcomes. This research aims to examine whether electronic health (eHealth) literacy impacts patient-provider relationships. This research will also examine how geography specifically state residency impacts eHealth literacy rates. Data collected from a national sampling of online health and medical information users who participated in the Study of Health and Medical Information in Cyberspace (N=710) is used to construct structural equation models from SPSS AMOS v. 20.0. After path analysis, the results shown that white males with higher education were more likely to have higher eHealth literacy rates and that eHealth literacy rates are associated with better self-care, higher patient satisfaction and increased trust in provider. Also, state residency does not have an impact on eHealth literacy rates. eHealth literacy will be significant in patient-provider relationships. Program development should be established on focusing on eHealth literacy across the lifespan. Also, it will be important to review federal policy on technology disbursements in order to achieve national goals on eHealth literacy rates.

One of the challenges fairly common in motivational interviewing is patient resistance to health behavior change. Hence, automated dialog systems aimed at counseling patients need to be capable of detecting resistance and appropriately altering dialog. This thesis focusses primarily on the development of such a system for automatic identification of patient resistance to behavioral change. This enables the dialogue system to direct the discourse towards a more agreeable ground and helping the patient overcome the obstacles in his or her way to change. This thesis also proposes a dialogue system framework for health behavior change via natural language analysis and generation. The proposed framework facilitates automated motivational interviewing from clinical psychology and involves three broad stages: rapport building and health topic identification, assessment of the patient’s opinion about making a change, and developing a plan. Using this framework patients can be encouraged to reflect on the options available and choose the best for a healthier life.

eHealth is commonly defined as health services and information provided through the Internet and related technologies. Health educators have taken advantage of Internet and social media venues to disseminate health information essential to health risk management, disease prevention, and disease management and did not have a validated theoretical model to explain their experiences. The goal of this study was to create and test an integrated model of eHealth communication specific to 18-30 year old college students based on five research questions that identified and confirmed the factors most highly correlated with the presentation of health information on Internet or social media venues that improve eHealth literacy and provoke eHealth behavioral intention among college students. A sample of over 1400 18-30 year old college students was surveyed about their general and health information related use of the Internet and social media. As a result of exploratory factor analysis and subsequent structural equation modeling, the proposed theoretical model was revised and tested for statistical power. Two revised integrative models of eHealth communication, one for Internet and one for social media, were developed and validated. The model for social media shows statistically significant paths throughout the model; however, the model for the Internet reveals that the path between two constructs and Online Health Behavior are not statistically significant and is worthy of further examination. This study has important practical implications for eHealth educators, organizations dedicated to informing the public about specific diseases or health promotion techniques, health practitioners seeking improved strategies for effective eHealth message design, and to health information professionals.

Extant literature has documented well that people seek health information via the internet as patients and consumers. Much less, however, is known about interaction and creation behaviors in the development of new online health information and knowledge. More specifically, generalizable sociodemographic data on who engages in this online health behavior via social media is lacking in the sociological literature. The term “social e-health” is introduced to emphasize the difference between seeking behaviors and interaction and creation behaviors. A 2010 dataset of a large nationally representative and randomly sampled telephone survey made freely available from the Pew Research Center is used to examine social e-health behavior according to respondents’ sociodemographics. The dependent variable of social e-health behavior is measured by 13 survey questions from the survey. Gender, race, ethnicity, age, education, and income are used as independent variables. Logistic regression analysis was used to determine the odds of engagement in social e-health behavior based on the sociodemographic predictors. The social determinants of health and digital divide frameworks are used to help explain why socioeconomic variances exist in social e-health behavior. The findings of the current study suggest that predictable sociodemographic patterns along the dimensions of gender, race, age, education, and income exist for those who report engaging in social e-health behavior. This study is important because it underscores the fact that engagement in social e-health behavior is differentially distributed in the general U.S. population according to patterned sociodemographics.

As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of framing effects could be conducted. Sixteen (11.2%) of the 143 participants who participated in Part 1 of the experiment participated in Part 2 (i.e., attended a risk factor screening appointment). Multiple regression analysis revealed risk index, age, and powerful others health locus of control as significant predictors of screening intention. Gender was the only demographic or health related variable that was significantly related to screening outcome, such that women were more likely to get screened than men. Limitations and recommendations are discussed.

Abstract not available.

Diabetes has alarming prevalence rates not only in the U.S., but also worldwide. Ethnicity plays a large role with Hispanic-Americans having one of the highest prevalence rates. Diabetes is a complicated disease that requires significant lifestyle modifications. The health belief model (HBM) has been investigated as a theory to explain behavior change. However, little research has been done to determine its utility to Mexican-Americans. In the current study, participants were Mexican-American adults (N = 66) with type II diabetes who were recruited from family medicine clinics. Self-report questionnaires included the General Acculturation Index (GAI) and the Multidimensional Diabetes Questionnaire (MDQ). Participants had the option to complete them in either Spanish or English. Laboratory values were collected from medical charts. A MANCOVA indicated that two variables were significant, perceived severity (PS) and misguided support behaviors (MSB), p < .05. With respect to the HBM, PS was identified as a component of an individual's perception, acculturation was a modifying factor, and MSB was a component of the likelihood to change factors. These three affected glycemic control. Odds ratios determined that individuals with better glycemic control had less perceived severity and less misguided supportive behavior. Individuals with the least acculturation were more likely to have best glycemic control. Significant results were found for each of the three main columns of the model suggesting that the HBM has utility for the Hispanic-American population with type II diabetes. Results suggest that health care personnel should be aware of the ramifications of patients' perceived severity of their illness as well as the amount the "nagging" type support they receive from friends and family on glycemic control. This awareness can lead to the development of interventions aimed at improving glycemic control and the quality of life in Mexican-Americans with diabetes. Specifically, programs focused on incorporating the family may lead to improved psychosocial and educational outcomes since familial relationships are crucial in this population.

Physical activity has been demonstrated in the literature as an effective way to reduce the risk for development of chronic disease. The Transtheoretical Model (TTM) of behavior change has been developed as a means to predict and facilitate movement into healthier lifestyle behaviors. The model is centered on "stages of change", which describe a continuum of readiness to engage in a health behavior change. Stages contain temporal, qualitative, and quantitative characteristics. This was a six-month study that evaluated the effectiveness of stage-matched (theorized to be pertaining only to the maintenance stage of change) vs. generic (theorized to be pertaining to anyone, regardless of stage) newsletters in assisting subjects to attain the Maintenance stage of change. It also sought to identify further qualitative characteristics that can differentiate between the Action and Maintenance stages of change. Results indicated that monthly stage-matched newsletters were no more effective in helping subjects reaching Maintenance than were the generic newsletters. Exerciser self-schema was related to stages of change, but those relationships differed from baseline to six-month follow-up, indicating development of exerciser self-schema during the study period. Implications of this are discussed. Other concepts discussed included "structure" of change process, in that three new scores were developed and correlated with self-efficacy as well as intercorrelated. Motivation was also evaluated and compared across levels of success at adhering to exercise during a three-month period. Limitations of the study and implications are discussed.

The relationship between an individual's level of spirituality, health locus of control, and participating in wellness activity was investigated. The relationship between spirituality, health locus of control on physical health was also investigated. The research question was based on prior studies that reported people who are more spiritual are healthier. Does their spirituality lead to increased levels of health, or are individual's who are more spiritual more likely to proactively take control of their health and engage in health promoting behaviors? One hundred and fifteen male and female employees completed The Spiritual Involvement and Beliefs Scale (SIBS), a spirituality measure, The Multidimensional Health Locus of Control Scale, a measure of locus of control related to health and healthcare, and The Center for Disease Control's (CDC) Health Risk Appraisal, a self-report measure of participation in health behaviors. Physical measures of health were obtained by obtaining Body Mass Index, blood pressure readings, and a cholesterol screening. The current study looked at level of spirituality (internal, external), level of health locus of control (internal, powerful other, chance) and participation in wellness/health promoting behaviors and health. Correlational analyses were performed on the relationship between spirituality and health locus of control. Hierarchical multiple regressions were performed on the internal spirituality and internal health locus of control to examine the relationship between spirituality, health locus of control and positive health behaviors and level of physical health. Stepwise discriminant function analysis using spirituality and health locus of control as predictor variables for the health-behavior criterion variables were performed. Discussion of the results, limitations of the current study and recommendations for future research were presented.

The goal of this study was to determine relationships between health information behaviors and population health as well as their relationships with particular facets of urban ecology.

The purpose of the present study was to investigate the relationship between Self-Efficacy Theory (Bandura, 19 77) and adherence to health behavior prescription. A self report Self-Efficacy Questionnaire was developed to assess levels of efficacy. Dietary adherence was determined by self report as well as body composition assay and measurement of body weight. Levels of exercise compliance were assessed by self report in addition to a treadmill test.

Identity is an important determinant of behavior. This paper proposed an identity model as one way of understanding those factors related to the perceived probability or willingness of a worker to participate in health promotion programming at the worksite. Part of a larger study on employee wellness, this study took place in the municipal complex of a small city in the southeastern United States. A stratified cross sectional sample of 150 employees was selected utilizing a systematic random sampling methodology. Structured interviews were conducted with 129 participants resulting in a response rate of 92% after adjusting for those people no longer employed by the city. In order to test the identity model developed by this author, descriptive analysis, simple multiple regression analysis and path analysis were utilized. The dependent variable, perceived willingness to participate in health promotion programming, was examined in relationship to commitment to one's health identity, commitment to one's organizational identity, tendency to comply with health initiatives, and the forms of supervisory power utilized to enact employee compliance. The descriptive analysis revealed that subjective health status is moderately and positively associated with commitment to one's health identity, that individuals can be strongly committed to a negative/destructive health identity, and that both the family and physician play important roles as health advice givers. The path analysis revealed that commitment to one's organizational identity, commitment to one's health identity, and tendency to comply with health initiatives are significantly and positively associated with willingness to participate in health promotion programming, accounting for 25% of the variance in the dependent variable. In contrast, the forms of supervisory power were not shown to be related to the dependent variable. In conclusion, the identity model appears to be a useful tool for the understanding of health attitudes and behaviors within a work setting.

Prostate cancer is the most commonly occurring cancer and the second leading cause of cancer death for men in the United States. Because early prostate cancer is frequently without symptoms and data on how to prevent prostate cancer is lacking, early detection has the greatest potential for decreasing mortality. Studies have shown Hispanics/Latinos to be less likely than whites or African-Americans to utilize prostate cancer screening exams. The purpose of this descriptive study was to design a social marketing plan which could be used as a model to promote Hispanic/Latino participation at prostate cancer screenings. Information obtained through medical and marketing literature review, the author's experiences serving on the promotion committee of a community-sponsored prostate cancer screening project, and interviews with 51 Hispanic/Latino prostate cancer screening participants is described and incorporated into a guide with recommendations for future program planners.

The Health Belief Model was used to study HIV/AIDS beliefs of 419, 18 to 24 year old, never married, sexually active, heterosexual college students and predict their AIDS preventive behaviors from a larger sample of 662 college students. The structural properties of the scales used were evaluated using confirmatory factor analysis. Recent preventive behaviors were predicted in a LISREL Structural Equation Modeling analysis.

This study examines the relationship between exercise adherence and several factors: self-motivation; attitudinal commitment; predisposing, enabling, and reinforcing (PER) factors; and barriers related to exercise. The sample (N=431) consists of employees at Texas Instruments, Incorporated in Dallas, Texas. The sample was placed into six comparison groups: high adherers, low adherers, nonparticipants who exercise, nonparticipants who do not exercise, dropouts who exercise and dropouts who do not exercise. Using a one-way ANOVA, the results show significance (p