Health promotion for women with physical disabilities: A pilot study.

Objective: To pilot test a health promotion intervention for women with physical disabilities. Design: Pre- and postintervention questionnaires. Participants: Two groups of women with physical disabilities (n=15). Intervention: Seven-session weekly workshop intervention grounded primarily in social-cognitive theory. Setting: Disability and rehabilitation settings. Main Outcome Measures: Indicators of health status. Results: Statistically significant positive changes between pre- and postintervention scores on measures of self-efficacy for dietary behaviors, medical decision making, social interaction, physical functioning, impact of physical limitation on role activities, and vitality. Conclusion: Women with disabilities who participate in this health promotion intervention may exhibit improvements on indicators of health status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining social-cognitive determinants of intention and physical activity among Black and White adolescent girls using structural equation modeling.

Structural equation modeling was used to evaluate components within the theories of reasoned action (TRA), planned behavior (TPB), and self-efficacy (SET) for understanding moderate and vigorous physical activity among 1,797 Black and White adolescent girls. Modest to strong support was provided for components of TPB and SET; weak support was provided for components of TRA. Perceived behavioral control was related to vigorous physical activity. Self-efficacy was related to moderate and vigorous physical activity, and it accounted for the effect of intention on physical activity. The observed relationships were similar between Black and White girls. Self-efficacy and perceived behavioral control are independent influences on physical activity among Black and White adolescent girls and warrant study as potential mediators in physical activity interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitude, social influence, and self-efficacy among Chinese participants of chronic disease self-management program: A latent growth curve modeling study.

Objectives: This study aimed to examine temporal relationships among psychological parameters (readiness to change, changes in self-efficacy [SE], social norm [SN], attitude [AT]) and two self-management behaviors: cognitive symptom management (CSM) and tangible help-seeking (TH) by constructing latent growth change models. Method: This was a longitudinal study of 60 Chinese participants with various chronic diseases who completed a 6-week chronic disease self-management program. Psychological and behavioral variables were assessed at the beginning of the 1st, 4th, and 6th week of the program. Results: Latent growth change curve analysis revealed that, in the early stages of engagement in CSM, SE was a key determinant of behavior. During the 6-week period, changes in SE were influenced directly by both SN and AT. When engaging in TH, SE influenced the behavior with direct and indirect effect from AT and SN. Readiness for change, on the other hand, appeared to be more associated with psychological rather than behavioral changes. This study revealed different underlying change mechanisms for two types of self-management behaviors. Conclusion: The findings shed light on program modifications that could further strengthen the therapeutic effects of the program. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The instability of health cognitions: Visceral states influence self-efficacy and related health beliefs.

Objective: To determine how visceral impulses, such as hunger and drug craving, influence health beliefs. Design: The authors assessed smokers' self-efficacy and intentions to quit while in a randomly assigned state of cigarette craving or noncraving (Study 1), and assessed dieters weight-loss beliefs while hungry or satiated (Study 2). Main outcome measures: Self-efficacy, smoking cessation, weight-loss goals. Results: The authors found, in both the context of smoking and weight-loss, that participants in a cold (e.g., satiated) state had different health beliefs than participants in a hot state (e.g., hungry). Specifically, in Study 1, the authors found that smokers who experienced cigarette craving had lower self-efficacy than did satiated smokers. Consequently, smokers who craved a cigarette had less intention to quit smoking in the future compared with satiated smokers. In Study 2, the authors found that hungry dieters had less self-efficacy than did satiated dieters. This difference led hungry dieters to form less ambitious future weight-loss goals and view prior weight-loss attempts with more satisfaction. Conclusion: These findings contribute to our understanding of the nature of health beliefs and reveal that health beliefs are more dynamic than previously assumed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms, social support, and personal health behaviors in young men and women.

This study investigated the relationship of depressive symptoms, social support, and a range of personal health behaviors in 2,091 male and 3,438 female university students from 16 countries. Depressive symptoms and social support were measured using the short Beck Depression Inventory and the Social Support Questionnaire; 9 personal health behaviors were also assessed. After the authors took age, social support, and clustering by country into account, depressive symptoms were significantly associated with lack of physical activity, not eating breakfast, irregular sleep hours, and not using a seat belt in both men and women, and additionally with smoking, not eating fruit, and not using sunscreen among women. Low social support was independently associated with low alcohol consumption, lack of physical activity, irregular sleep hours, and not using a seat belt in men and women. Bidirectional causal pathways are likely to link health behaviors with depressed mood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interaction between physical environment, social environment, and child characteristics in determining physical activity at child care.

Objective: To investigate the association between the child-care environment and physical activity of 2- and 3-year-olds. Based on an ecological view of environmental influences on health behavior, we hypothesized that the social and physical environment, as well as child characteristics (age and gender), would show independent and interactive effects on children's physical activity intensity. Design: Observations of physical activity intensity were performed among children (N = 175) at 9 Dutch child-care centers. Aspects of the child-care environment were assessed using the validated Environment and Policy Assessment and Observation (EPAO) Instrument. Multilevel linear regression analyses examined the association of environment and child characteristics with children's activity intensity. Moderation was tested by including interaction terms in the analyses, with subsequent post hoc analyses for significant interaction terms. Main Outcome Measure: Observed child physical activity intensity, measured with the Observational System for Recording Physical Activity in Children—Preschool Version. Results: A large proportion of the observed activities were classified as sedentary, while far fewer observations were classified as moderate or vigorous. Activity opportunities in the physical environment (assessed using EPAO) and prompts by staff and peers were significantly and positively related to physical activity intensity, while group size was negatively related to activity intensity. The influence of the physical environment was moderated by social environment (peer group size), while the social environment in turn interacted with child characteristics (age and gender) in determining activity intensity. Conclusion: Our findings are in line with the ecological perspective regarding environmental influences on behavior, and stress the importance of incorporating the child-care environment in efforts to prevent childhood overweight and obesity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Barrier self-efficacy and physical activity over a 12-month period in men and women who do and do not attend cardiac rehabilitation.

Objectives: Two primary objectives were to examine (a) changes in physical activity (PA) over a 12-month period in people living with cardiac disease who did not attend cardiac rehabilitation (CR), and (b) the role of barrier self-efficacy in explaining these changes from a gender perspective. A secondary objective was to examine whether attending CR (or not) moderated the gender-barrier self-efficacy relationship with PA. Design and Setting: Participants (N=801) completed a questionnaire in the hospital and at 2, 6, and 12 months after hospitalization, as well as a telephone-administered 7-day PA recall at 2, 6, and 12 months. Main Outcome Measures: PA and barrier self-efficacy. Results: Hierarchical linear modeling showed significant declines in PA over time, which were especially pronounced for women. Moreover, the association between barrier self-efficacy and PA became significantly weaker over time, especially for women. This trend was similar for participants who did and did not attend CR. Conclusion: Interventions that focus on increasing barrier self-efficacy in people living with heart disease after hospitalization will likely equally benefit men and women in the short term but may disproportionately benefit men in the longer term regardless of participation in CR. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regret intensity, diurnal cortisol secretion, and physical health in older individuals: Evidence for directional effects and protective factors.

Two studies were conducted to examine the associations between life regrets and health-relevant variables among older adults. Study 1 explored whether intense experiences of regret would be associated with a health-relevant biological process (i.e., diurnal cortisol secretion) and acute physical problems (N = 183). In Study 2, a group of 103 older adults was followed over a period of 3 months, and changes in cold symptoms and sleep problems were examined. Study 2 incorporated an experimental manipulation, targeted at engaging participants in adaptive social- cognitive processes through writing. The results of Study 1 showed intense life regrets to be associated with a larger volume and a steeper morning rise of cortisol secretion and with higher levels of acute physical symptoms. Study 2 demonstrated that levels of regret intensity generally declined only in the experimental group, whereas certain aspects of regret intensity remained stable in the control group. In addition, the intervention evidenced a beneficial effect on the association between initial regret intensity and increased sleep problems over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived social support, psychological adjustment, and functional ability in youths with physical disabilities.

Objective: To examine the relationship between perceived social support and psychological adjustment and functional ability in youths with physical disabilities. Participants: Thirty-seven youths with neuromuscular disease and 33 with spina bifida. Measures: Demographic and disability-related questions, Child Health Questionnaire, Functional Disability Inventory, and Multidimensional Scale of Perceived Social Support. Results: Social support from family, but not from friends, was significantly associated with better psychological adjustment. Significant interactions emerged between family support and age, as well as between friend support and gross motor functioning, in the prediction of functional ability. Conclusions: Social support appears to play an important role in psychological adjustment and functional ability in this population, and the nature of this role may be moderated, to some extent, by age and gross motor functioning. Future research and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood physical abuse, attachment, and adult social support: Test of a mediational model.

This study examined the mediating role of attachment on the relationship between childhood physical abuse and perceived social support in adulthood. The 2 underlying dimensions of attachment, view of self and view of other, were both hypothesized to be potential mediators. Young adults, with and without a history of childhood physical abuse, completed a series of questionnaires inquiring about past abuse experiences and current levels of attachment and social support. Results indicated a robust mediational effect. Namely, both attachment variables were significant mediators in the relationship between childhood physical abuse and social support. In addition, the mediation occurred across all sources of social support, that is, social support from family/close friends, peers, and authority figures. Theoretical and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood abuse and current health problems among older adults: The mediating role of self-efficacy.

Objectives: Child abuse has negative consequences on health functioning and the self-concept. Prior studies have garnered support for these relationships in younger adults; yet few studies have looked at the effects of abuse on health in older adults and the psychosocial variables, specifically self-efficacy, that may influence the abuse-health relationship. Methods: Data obtained from the Physical Health and Disability Study were used to explore the impact of child abuse on current medical problems among older adults who were screened on physical disability status (N = 1396, Mean age = 67, SD = 10.2). The study was conducted in South Florida and used a multiethnic sample that is representative of the general population in this area. Results: Child abuse was associated with the number of current medical problems and disability. Child abuse was also related to lower self-efficacy, and self-efficacy explained the relationship between abuse and the number of health problems. Conclusions: There are far-reaching effects of child abuse on older adults' health and self-concept. Health care providers and gerontologists need to be aware that child abuse is a lifelong risk factor for increased disability and specific health problems, especially among the elderly. Future research should examine treatments designed to increase self-efficacy, especially among those who experienced child abuse, and observe any positive effects on health functioning. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A longitudinal study of social competence among children of alcoholic and nonalcoholic parents: Role of parental psychopathology, parental warmth, and self-regulation.

This study tested a conceptual model predicting children's social competence in a sample of children with alcoholic and non-alcoholic parents. The model examined the role of parents' alcohol diagnoses, depression, and antisocial behavior at 12–18 months of child age in predicting parental warmth/sensitivity at 2 years of child age. Parental warmth/sensitivity at 2 years was hypothesized to predict children's self-regulation and externalizing behavior problems at 3 years. Parenting, self-regulation, and behavior problems were expected to predict social competence in kindergarten. Structural equations modeling was supportive of this model. Fathers' alcohol diagnosis was associated with lower warmth/sensitivity. Lower maternal warmth/sensitivity at 2 years was predictive of lower child self-regulation at 3 years. Parenting, self-regulation, and externalizing behavior problems were predictive of social competence in kindergarten, although associations varied by reporter (parents or teacher). There was a direct association between fathers' alcohol diagnosis and father reports of social competence, and between fathers' depression and teacher reports of social competence. The study elucidates developmental processes in predicting social competence and the role of fathers' alcoholism and associated risk factors in this process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical activity after cardiac rehabilitation: Evidence that different types of self-efficacy are important in maintainers and relapsers.

Objective: To test whether maintenance self-efficacy predicts physical activity among individuals who maintain an active lifestyle and whether recovery self-efficacy predicts physical activity among those who relapse to a less active lifestyle. Study Design and Participants: In a longitudinal study, data were collected from 114 participants 4-10 days after a myocardial infarction (MI), 2 weeks after rehabilitation (2 months after MI), and 8 months after MI. Results: In a subgroup of participants who maintained regular activity at 8 months after MI, maintenance self-efficacy predicted physical activity. Among participants who had relapsed by 8 months after MI, recovery self-efficacy predicted physical activity. Conclusions: Those who conduct interventions among cardiac rehabilitation patients should aim to increase recovery self-efficacy among those patients who are at risk for relapse and to increase maintenance self-efficacy among those patients who are likely to maintain their level of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mediating roles of perceived social support and resources in the self-efficacy-suicide attempts relation among African American abused women.

The authors examined whether self-efficacy among African-American abused women decreased their risk of suicide through the mediating influences of perceived social support from friends, perceived social support from family, and perceived effectiveness for obtaining material resources. The sample consisted of 100 women who presented to a hospital following a suicide attempt and 100 women who presented to the same hospital for nonemergency medical problems. Results revealed that the association between self-efficacy and suicide attempt status was partially accounted for by the mediating roles of perceived social support from friends and family, and perceived effectiveness at obtaining resources. Findings suggest that interventions to increase abused women's self-efficacy should focus on increasing their capacity to obtain social and material resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of self-efficacy on behavior change and weight change among overweight participants in a weight loss trial.

Despite considerable clinical interest, attempts to link perceived self-efficacy with successful weight control have had mixed success. Definitive data on prospective associations between self-efficacy and weight loss are particularly sparse. This study examined relationships between self-efficacy beliefs, weight control behaviors, and weight change among individuals participating in a weight loss trial (N = 349, 87% women). Cross-sectionally, eating and exercise self-efficacy beliefs were strongly associated with corresponding weight loss behaviors. Self-efficacy beliefs prospectively predicted weight control behavior and weight change during active treatment but not during follow-up. Mediational models indicate that people's weight control behaviors mediate the impact of self-efficacy on weight change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of social support and problematic support on optimism and depression in chronic illness: A prospective study evaluating self-esteem as a mediator.

The present study focused on the mechanism through which social and problematic support affects psychological adjustment in chronic illness. The authors hypothesized that self-esteem would mediate the relations between social and problematic support and adjustment. Eighty-six end-stage renal disease patients were assessed twice for social support, problematic support, and self-esteem. Adjustment was assessed twice by depression and optimism. Mediational analyses indicated that social support operated through self-esteem to influence optimism cross-sectionally and prospectively and depression cross-sectionally. Social support was associated with high self-esteem, which in turn increased optimism and was related to decreased depression. Problematic support was unrelated to self-esteem obviating mediational analysis. Disaggregating social support into subscales showed that belonging support predicted decreases in depression, and both tangible and belonging support predicted increases in optimism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facial disfigurement in patients with head and neck cancer: The role of social self-efficacy.

This study investigated the moderating role of social self-efficacy (i.e., the belief that one is capable of exercising control over the reactions and openness of other people) with respect to the link between facial disfigurement and psychological and n = 76) as well as their physicians. In line with the hypotheses, the results revealed that the degree of facial disfigurement, as judged by patients as well as their physicians, was positively related to psychological distress and distress in reaction to unpleasant behavior of others, but only when patients did not feel self-efficacious in social encounters. Furthermore, social self-efficacy mitigated the positive link between facial disfigurement as judged by patients and social isolation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Resources for health: Differential effects of optimistic self-beliefs and social support according to socioeconomic status.

Objective: This study examined whether socioeconomic status (SES) determines the degree to which psychological and social resources such as optimistic self-beliefs and social support affect health. Design: We used data from the representative German Ageing Survey (N = 2,454, aged 40–85 years). Structural equation modeling was employed to examine whether relationships between psychological (self-esteem, control beliefs, optimism) and social resources (perceived emotional and informational support, network size) and health differ between education and income groups. Main Outcome Measures: Self-reported physical health, functional health, and subjective health. Results: Psychological resources positively affected health in all groups but were stronger predictors of functional and subjective health in low compared to higher educated participants. A higher level of social resources was associated with better functional and subjective health mainly in the low-income group. Social resources were particularly important for financially disadvantaged older people. Conclusion: Our results provide evidence for differential effects of optimistic self-beliefs and social support on health depending on whether individuals are challenged by low incomes or low education. Future research, especially aimed at intervention, should consider that different aspects of SES have differential meanings and that the impact of health-protective factors may vary according to SES facet. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive mediation of rape's mental, physical and social health impact: Tests of four models in cross-sectional data.

Four nested, theoretically specified, increasingly complex models were tested representing cognitive mediation of rape's effects on mental, physical, and social health. Data were cross-sectional (N = 253 rape survivors). Outcomes were standardized assessments of social maladjustment, physical, and psychological symptoms, including posttraumatic stress disorder (PTSD). The best-fitting model was not fully cognitively mediated. Personological and rape characteristics influenced the level of self-blame experienced and the intensity of maladaptive beliefs about self and others. Self-blame and maladaptive beliefs predicted psychological distress, which strongly influenced all health outcomes. Self-ratings of rape memory characteristics contributed little to predicting postrape distress. The model accounted for 56% of the variance in general distress, including 91% of psychological symptom severity; 54% of PTSD symptoms; 65% of social maladjustment; and 17% of physical symptoms. Longitudinal replication is planned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risky families: Family social environments and the mental and physical health of offspring.

Risky families are characterized by conflict and aggression and by relationships that are cold, unsupportive, and neglectful. These family characteristics create vulnerabilities and/or interact with genetically based vulnerabilities in offspring that produce disruptions in psychosocial functioning (specifically emotion processing and social competence), disruptions in stress-responsive biological regulatory systems, including sympathetic-adrenomedullary and hypothalamic-pituitary-adrenocortical functioning, and poor health behaviors, especially substance abuse. This integrated biobehavioral profile leads to consequent accumulating risk for mental health disorders, major chronic diseases, and early mortality. In conclusion, the authors state that childhood family environments represent vital links for understanding mental and physical health across the life span. (PsycINFO Database Record (c) 2010 APA, all rights reserved)