Search results

Contextual to the recognition of the complex interplay between health and behavioral aspects, integrated behavioral health (IBH) has emerged. Although this model is becoming popular in the Western world, its presence in the global context is not promising. This paper aims to explore the need for IBH in India and address its barriers to implementation and possible solutions.

We analyzed the case of IBH and its potential implications for India using the current evidence base, authors' reflections and experience of implementing similar programs.

This paper identifies contextual factors, including increased instances of non-communicable diseases and psychosocial and cultural determinants of health, that necessitate the implementation of IBH programs in India. The key features of different IBH models and their applicability are outlined. The current status of IBH and potential challenges in implementation in India in terms of human resources and other factors are delineated. We also discuss the potential models for implementing IBH in India.

Integrating behavioral health in primary care is considered an effective and sustainable model to promote health and well-being across various target populations. Towards this end, this paper is the first to discuss the contextual factors of IBH in India. It is a significant addition to the knowledge base on IBH and its possible implementation barriers and strategies in low- and middle-income countries.

Since health behaviors of elderly Asian Americans are often underreported, the study, based on the health behavioral model (Andersen’s model), was to examine if there is a reciprocal relationship between healthcare utilization and health outcomes, and how social characteristics play their role in this relationship between US-born and foreign-born elderly Asian Americans.

Using structural equation modeling, this research examined the proposed hypotheses which consisted of direct and indirect effects among health outcomes, healthcare utilization and social characteristics, as well as the disparities of the effects between US-born and foreign-born elderly Asian Americans (65 + ). A sample size of elderly Asian Americans was divided into a US-born group (N = 1,305) and a foreign-born group (N = 4,902) from the National Health Interview Survey (NHIS) 1998–2012. Health outcomes consisted of current health status and health change. Healthcare utilization included general doctor visit, ER, and mental health professional visit. Social characteristics of population included predisposing characteristics (such as age, sex, marital status, and region of residency) and enabling resources (such as education, family size, and family income).

Results from the study indicated that first, there was a reciprocal relationship between health outcomes and healthcare utilization for both groups. Second, predisposing characteristics had a direct effect on health outcomes, and enabling resources had an indirect effect on health outcomes via healthcare utilization. In addition, living in the West had both direct and indirect effects on health outcomes. Third, regarding disparities of the effects between both groups, the US-born elderly are more likely to attain health benefits from healthcare utilization and their social characteristics than the foreign-born. As a result, the interactive relationship between health outcomes, healthcare utilization, and social characteristics, as well as disparities of healthcare outcomes through health utilization and social characteristics for elderly Asian Americans is highlighted.

First, due to the design of NHIS, this research was limited to fully present the needs and more characteristics of elderly Asian Americans. This shows the great need for a large scale, representative study for health behaviors of elderly Asian Americans. Second, in the dataset, the study was limited to explore health behaviors of elderly Asian Americans into each Asian ethnic subgroup. Since the culture of Asian Americans is heterogeneous, it is recommended that future research can explore differences and commonalities of the health behaviors between Asian subgroups. Third, based on the health behavioral model and the design of the dataset, this study was limited to illustrate variations of life experiences between both groups. These differences regarding their needs and desires for healthcare services and health outcomes can become an important foundation for service providers and policy makers to provide appropriate services that improve the quality of the later lives of elderly Asian Americans.

First, the study applied the health behavioral model and proved that the effect of healthcare utilization and social characteristics on health outcomes is greater for the US-born elderly Asian Americans than for the foreign-born. Second, this study confirmed that the healthcare services in US society are still beneficial for the health outcomes of elderly Asian Americans. Third, the study found that when family is used to explain the social behaviors of elderly Asian Americans, researchers need to be more careful to identify various family factors in accordance to its dynamics, such as interpersonal relationship, material supply, and emotional support.

The purpose of this paper is to identify how need for service, enabling factors and pre-disposing characteristics influences access to service. In addition, the authors seek to examine the moderating influence of pre-disposing variables on the relationship between insurance and health services utilization.

The authors utilize data from a major metropolitan hospital in the USA to test and extend the behavioral model of health care.

Results indicate that insurance and pre-disposing variables have a direct impact on type of health service utilization. However, the insurance effect is found to vary by demographic factors.

This paper is limited to secondary data. Future work can incorporate both attitudinal and behavioral measures to obtain a more comprehensive evaluation of services access.

The research offers a tactical framework for management to segment consumer markets more effectively.

Through the framework, management will have the requisite knowledge to target segmented populations based on need, insurance, and pre-disposing variables which will help improve access to services and clinical outcome.

The findings of this paper will serve as a basis for future research exploring the influence of insurance on access to services.

The aim of this paper is to study the association between health consciousness, health belief model and intention to engage in healthy activities in addition to use restaurants.

An electronic questionnaire was distributed through social media and university website including questions on demographic variables and Likert scaled aspects of health consciousness, health belief model and behavioral intention to practice healthy habits and use fast-food restaurants.

A total of 92 Palestinian adults participated in this study. Age 28.5 ± 9.7 years. Of the studied group, 28.6% were males, body mass index = 24.4 ± 4.1 kg/m². Average health consciousness was 12.3 ± 3.1, health belief model (susceptibility = 10.4 ± 6.8, severity = 12.7 ± 7.2, benefit = 28.1 ± 5.3 and barriers = 17.8 ± 6.8) and for behavioral intention = 21.1 ± 6.4. In final regression models, only benefit was significantly associated with health consciousness (B = 0.18 ± 0.07, p = 0.012) and behavioral intention B = 0.26 ± 0.13, p = 0.05). Only barrier and severity were associated significantly with number of using restaurants weekly (0.04 ± 0.02, p = 0.03) and (0.05 ± 0.02, p = 0.004), respectively.

Health belief model partially explained use of restaurants and healthy lifestyle among Palestinians. This is a cross-sectional design and future clinical trials are needed.

To the best of the authors’ knowledge, this is the first study to address the role of health belief model and health consciousness in improving dietary style and habits.

The purpose of this paper is to explore the “active ingredients” of integrated behavioral health care (IBHC) from the perspective of Karen refugee participants in an IBHC intervention.

This paper is based on in-depth, semi-structured interviews with participants (n=40) who have received an IBHC intervention for one year. These qualitative data are supplemented by descriptive quantitative data from those same participants.

This research suggested that IBHC increased awareness and access to behavioral health services, and that IBHC may be especially amenable to treating complex health conditions. The research also found that IBHC provided a point of regular contact for patients who had limited time with their primary care providers, which helped to enhance access to and engagement with health care.

IBHC has the potential to meet the complex needs of Karen resettled refugees living in an urban setting in the USA.

IBHC is a promising approach to help meet the mental health needs of refugees in the USA. There are, however, gaps in knowledge about the “active ingredients” of IBHC. This paper helps fill these gaps by studying how IBHC works from the perspective of a group of Karen refugees; these are critical perspectives, missing in the literature, which must be heard in order to better address the complex conditions and needs of resettled refugees.

To determine gendered patterns of preventive medical care (physical and dental/optical) use among pan-ethnic U.S. Asian and Latino adults.

Using National Latino and Asian American Study (2004) data, we apply Andersen’s (1995) Behavioral Model of Health Services Use to assess how preventive care use among Asian and Latino men and women varies as a function of predisposing, enabling, and need-based characteristics. We explore whether adjustment for these factors mediates gender disparities in both physical and dental/optical check-ups, and test whether certain factors operate differently among men versus women.

A higher proportion of women reported a routine care visit last year, especially among Latinos. Adjusting for predisposing, enabling, and need-based factors explained the gender difference in reporting a dental/optician check-up, but not a physical check-up, among both Asian and Latino adults.

Our findings illustrate how gender patterns in routine care use differ by race/ethnicity, and highlight the fundamental importance of enabling characteristics (especially health insurance and having a regular doctor) for shaping routine care use between men and women, both Asian and Latino. Limitations of this chapter are that the data are cross-sectional and were collected before the implementation of the Affordable Care Act, and measures are self-reported.

This chapter focuses on Asian and Latinos because they represent the fastest growing minority populations in the United States, yet few studies have evaluated gender differences in preventative health care use among these groups.

Health-seeking behaviors (HSB) for infertility are influenced my multiple factors. The Behavioral Model of Health Services Utilization states that enabling resources and predisposing factors are essential in predicting HSB, and this study examined the relationship between state-level mandates that insurance providers cover infertility service on the rates of HSB for infertility among a nationally representative sample of women.

This study used data from the National Survey of Family Growth, identified 15 states with state-level mandates as enabling resources, and used sociodemographic characteristics as predisposing resources. Using discrete-time event-history analyses, and retrospective accounts of infertility HSB, these variables were examined to determine if residing in a state with state-level insurance mandates would increase the likelihood of HSB for infertility.

Results indicated an impact of state-level mandates on HSB for infertility. Specifically, the rates of HSB for infertility were higher among women residing in states with state-level mandates.

A limitation in this research stems from a data restriction that forced identifying a place-of-residence before or after 2000. To overcome this, multiple analyses, and a nested model comparison were tested to measure the effect of state-level mandates on HSB.

The comparative analysis of the rates of HSB for women residing in states with state-level mandates has not been considered before, and the results provide further detail into the infertility experience for women and their partners.

Using Andersen’s (1968) behavioral model of health services use as a guiding conceptual framework, this study examined how receipt of family-centered care relates to the perceived family challenges for families of children with autism spectrum disorder (ASD).

Data from the 2009–2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) were analyzed for 812 parents of children with ASD.

Multiple regression analyses provided substantive statistical evidence that a child’s race, the adequacy of a family’s insurance, and the stability of child’s health care needs significantly contributed to predicting his or her receipt of family-centered care. Further results suggested a relationship between receipt of family-centered care and the perception of challenge for these families; families receiving family-centered care perceive fewer challenges and feel less unmet need for child health services.

Family-centered professionals provide critical voices in the development of policies and programs geared toward improving the health outcomes of children with ASD and their families.

The COVID-19 outbreak reached a critical stage when it became imperative for public health systems to act decisively and design potential behavioral operational strategies aimed at containing the pandemic. Isolation through social distancing played a key role in achieving this objective. This research study examines the factors affecting the intention of individuals toward social distancing in India.

A correlation study was conducted on residents from across Indian states (N = 499). Online questionnaires were floated, consisting of health belief model and theory of planned behavior model, with respect to social distancing behavior initially. Finally, structural equation modeling was used to test the hypotheses.

The results show that perceived susceptibility (PS), facilitating conditions (FC) and subjective norms are the major predictors of attitude toward social distancing, with the effect size of 0.277, 0.132 and 0.551, respectively. The result also confirms that the attitude toward social distancing, perceived usefulness of social distancing and subjective norms significantly predict the Intention of individuals to use social distancing with the effect size of 0.355, 0.197 and 0.385, respectively. The nonsignificant association of PS with social distancing intention (IN) (H1b) is rendering the fact that attitude (AT) mediates the relationship between PS and IN; similarly, the nonsignificant association of FC with IN (H5) renders the fact that AT mediates the relationship between FC and IN.

The results of the study are helpful to policymakers to handle operations management of nudges like social distancing.

The research is one of its kind that explores the behavioral aspects of handling social nudges through FC.

Adherence is a critical factor for success, for both the health of the customer and the financial outcomes of the firm. Central to the success of adherence behavior is the co-productive role of the customer which is determined by service perceptions as well as individual attributes. Based on social cognition theory, the aim of this paper is to examine the factors that influence past adherence behavior, and whether past adherence behavior predicts future intentions.

The model was tested using structured equation modeling on a sample of 771 weight-loss customers.

The authors show how service quality influences role clarity, which leads to increases in self-efficacy. The study also demonstrates the role of emotional intelligence (EI) in increasing efficacious beliefs. Past adherence behavior was found to predict future intentions.

This study was undertaken with a single service industry, and based on data which was collected at a single point in time. Limitations associated with common method bias inherent in cross-sectional designs, as well as limitations related to the use of self-report measures are acknowledged.

The findings suggest that interventions to promote health outcomes should target customer skills in service consumption. By providing quality interactions, providers can increase customer role clarity which produces efficacious beliefs. Interventions should also address EI training in customers given its role in influencing self-efficacy.

The simultaneous examination of traditional service factors and socio-cognitive factors contributes to theory by considering the individual health and organizational outcomes of these factors. The finding of a direct path between past adherence behavior and future intentions provides a unique insight into the prediction and control of behavior in a number of domains.