Health Education &amp Behavior (HEALTH EDUC BEHAV )

Publisher: Society for Public Health Education, SAGE Publications


A useful tool for academics and practitioners alike, Health Education & Behavior brings you coverage of the vital health issues six times a year - That's 816 pages annually of empirical research articles, case studies, programme evaluations, and review articles with potential practice applications of current scholarly research. Regular features include Perspectives, which offers thoughtful insights into complex subjects, and Program Notes, summarizing innovative programs in health education. Through articles, editorials, and special sections, each issue of HEB covers a wealth of information addressing such varied topics as: Theoretical and practical ways to implement change in health and social behaviour, AIDS, cardiovascular risk reduction, cancer, drug abuse, violence, chronic disease management, stress, social support, the environment, diverse populations of all ages and ethnic groups, empowerment, health care reform, cultural factors, ethics, international health, programme settings such as worksites, hospitals, clinics, communities and schools. Health Education & Behavior explores social and behavioural change as it affects health status and quality of life, as well as examining the processes of planning, implementing, managing, and assessing health education and social-behavioural interventions. HEB is a vital resource for practising health educators and researchers, as well as other health professionals and agencies.

Impact factor 1.54

  • 5-year impact
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  • Eigenfactor
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  • Website
    Health Education & Behavior website
  • Other titles
    Health education & behavior, Health education and behavior
  • ISSN
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  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publisher details

SAGE Publications

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    • Author can archive a post-print version
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    • "as published" final version with layout and copy-editing changes cannot be archived but can be used on secure institutional intranet
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. The family and home environment is an influential antecedent of childhood obesity. The purpose of this study was to pilot test The Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) intervention; a newly developed, theory-based, online program for prevention of childhood obesity. Method. The two-arm, parallel group, randomized, participant-blinded trial targeted mothers with children between 4 and 6 years of age. Measures were collected at baseline, 4 weeks, and 8 weeks to evaluate programmatic effects on constructs of social cognitive theory (SCT) and obesity-related behaviors. Process evaluation transpired concurrently with each intervention session. Results. Fifty-seven participants were randomly assigned to receive either experimental EMPOWER (n = 29) or active control Healthy Lifestyles (n = 28) intervention. Significant main effects were identified for child physical activity, sugar-free beverage consumption, and screen time, indicating that both groups improved in these behaviors. A significant group-by-time interaction was detected for child fruit and vegetable (FV) consumption as well as the SCT construct of environment in the EMPOWER cohort. An increase of 1.613 cups of FVs (95% confidence interval = [0.698, 2.529]) was found in the experimental group, relative to the active control group. Change score analysis found changes in the home environment accounted for 31.4% of the change in child FV intake for the experimental group. Conclusions. Child physical activity, sugar-free beverage consumption, and screen time improved in both groups over the course of the trial. Only the theory-based intervention was efficacious in increasing child FV consumption. The EMPOWER program was robust for inducing change in the home environment leading to an increase in child FV intake (Cohen's f = 0.160).
    Health Education &amp Behavior 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: More than 60% of cancer-related deaths in the United States are attributable to tobacco use, poor nutrition, and physical inactivity, and these risk factors tend to cluster together. Thus, strategies for cancer risk reduction would benefit from addressing multiple health risk behaviors. We adapted an evidence-based intervention grounded in social cognitive theory and principles of motivational interviewing originally developed for smoking cessation to also address physical activity and fruit/vegetable consumption among Latinos exhibiting multiple health risk behaviors. Literature reviews, focus groups, expert consultation, pretesting, and pilot testing were used to inform adaptation decisions. We identified common mechanisms underlying change in smoking, physical activity, and diet used as treatment targets; identified practical models of patient-centered cross-cultural service provision; and identified that family preferences and support as particularly strong concerns among the priority population. Adaptations made to the original intervention are described. The current study is a practical example of how an intervention can be adapted to maximize relevance and acceptability and also maintain the core elements of the original evidence-based intervention. The intervention has significant potential to influence cancer prevention efforts among Latinos in the United States and is being evaluated in a sample of 400 Latino overweight/obese smokers. © 2014 Society for Public Health Education.
    Health Education &amp Behavior 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ecologic models suggest that multiple levels of influencing factors are important for determining physical activity participation and include individual, social, and environmental factors. The purpose of this qualitative study was to use an ecologic framework to gain a deeper understanding of the underlying behavioral mechanisms that influence physical activity adoption among ethnic minority women. Eighteen African American and Hispanic women completed a 1-hour in-depth interview. Verbatim interview transcripts were analyzed for emergent themes using a constant comparison approach. Women were middle-aged (age M = 43.9 ± 7.3 years), obese (body mass index M = 35.0 ± 8.9 kg/m(2)), and of high socioeconomic status (88.9% completed some college or more, 41.2% reported income >$82,600/year). Participants discussed individual factors, including the need for confidence, motivation and time, and emphasized the importance of environmental factors, including their physical neighborhood environments and safety of and accessibility to physical activity resources. Women talked about caretaking for others and social support and how these influenced physical activity behavior. The findings from this study highlight the multilevel, interactive complexities that influence physical activity, emphasizing the need for a more sophisticated, ecologic approach for increasing physical activity adoption and maintenance among ethnic minority women. Community insight gleaned from this study may be used to better understand determinants of physical activity and develop multilevel solutions and programs guided by an ecologic framework to increase physical activity in ethnic minority women. © 2014 Society for Public Health Education.
    Health Education &amp Behavior 12/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective. Education is inversely associated with coronary heart disease (CHD) risk; however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in the education-CHD literature explain the associations between education and CHD risk. Method. The study sample included 346 participants, aged 38 to 47 years (59.5% women), of the New England Family Study birth cohort. Ten-year CHD risk was calculated using the validated Framingham risk algorithm that utilizes diabetes, smoking, blood pressure, total cholesterol, high-density lipoprotein cholesterol, age, and gender. Multivariable regression and mediation analyses were performed. Results. Regression analyses adjusting for age, race/ethnicity, and childhood confounders (e.g., parental socioeconomic status, intelligence) demonstrated that relative to those with greater than or equal to college education, men and women with less than high school had 73.7% (95% confidence interval [CI; 29.5, 133.0]) and 48.2% (95% CI [17.5, 86.8]) higher 10-year CHD risk, respectively. Mediation analyses demonstrated significant indirect effects for reading comprehension in women (7.2%; 95% CI [0.7, 19.4]) and men (7.2%; 95% CI [0.8, 19.1]), and depressive symptoms (11.8%; 95% CI [2.5, 26.6]) and perceived constraint (6.7%, 95% CI [0.7, 19.1]) in women. Conclusions. Evidence suggested that reading comprehension in women and men, and depressive symptoms and perceived constraint in women, may mediate some of the association between education and CHD risk. If these mediated effects are interpreted causally, interventions targeting reading, depressive symptoms, and perceived constraint could reduce educational inequalities in CHD. © 2014 Society for Public Health Education.
    Health Education &amp Behavior 11/2014;
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    ABSTRACT: Objective. Describe a process for designing, building, and evaluating a theory-driven social media intervention tool to help reduce parental concerns about vaccination. Method. We developed an interactive web-based tool using quantitative and qualitative methods (e.g., survey, focus groups, individual interviews, and usability testing). Results. Survey results suggested that social media may represent an effective intervention tool to help parents make informed decisions about vaccination for their children. Focus groups and interviews revealed four main themes for development of the tool: Parents wanted information describing both benefits and risks of vaccination, transparency of sources of information, moderation of the tool by an expert, and ethnic and racial diversity in the visual display of people. Usability testing showed that parents were satisfied with the usability of the tool but had difficulty with performing some of the informational searches. Based on focus groups, interviews, and usability evaluations, we made additional revisions to the tool's content, design, functionality, and overall look and feel. Conclusion. Engaging parents at all stages of development is critical when designing a tool to address concerns about childhood vaccines. Although this can be both resource- and time-intensive, the redesigned tool is more likely to be accepted and used by parents. Next steps involve a formal evaluation through a randomized trial. © 2014 Society for Public Health Education.
    Health Education &amp Behavior 11/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background. Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Method. Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p < .05), more likely to report low health self-efficacy. When unmet medical need due to cost was added to the model, the association between financial hardship and low health self-efficacy was no longer statistically significant. Conclusion. Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy. © 2014 Society for Public Health Education.
    Health Education &amp Behavior 11/2014;
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    ABSTRACT: The few existing economic evaluations of community-based health promotion interventions were reported retrospectively at the end of the trial. We report an evaluation of the costs of the Kin Keeper(SM) Cancer Prevention Intervention, a female family-focused educational intervention for underserved women applied to increase breast and cervical cancer screening by enhancing cancer literacy. The cost analysis was performed from the perspective of a health organization with established community partnerships adding the Kin Keeper family intervention in the future to an existing community health worker program. The cost of delivering the Kin Keeper intervention, including two cancer education home visits, was $151/family. Kin Keeper is an inexpensive educational intervention delivered by community health workers to promote breast and cervical screening, with strong fidelity and quality. Prospecting cost evaluations of community-based interventions are needed for making informed timely decisions on the adaptation and expansion of such programs.
    Health Education &amp Behavior 11/2014;
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    ABSTRACT: Financial barriers can substantially delay medical care seeking. Using patient narratives provided by 252 colorectal cancer patients, we explored the experience of financial barriers to care seeking. Of the 252 patients interviewed, 84 identified financial barriers as a significant hurdle to obtaining health care for their colorectal cancer symptoms. Using verbatim transcripts of the narratives collected from patients between 2008 and 2010, three themes were identified: insurance status as a barrier (discussed by n = 84; 100% of subsample), finding medical care (discussed by n = 30; 36% of subsample) and, insurance companies as barriers (discussed by n = 7; 8% of subsample). Our analysis revealed that insurance status is more nuanced than the categories insured/uninsured and differentially affects how patients attempt to secure health care. While barriers to medical care for the uninsured have been well documented, the experiences of those who are underinsured are less well understood. To improve outcomes in these patients it is critical to understand how financial barriers to medical care are manifested. Even with anticipated changes of the Affordable Care Act, it remains important to understand how perceived financial barriers may be influencing patient behaviors, particularly those who have limited health care options due to insufficient health insurance coverage.
    Health Education &amp Behavior 11/2014;
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    ABSTRACT: Reducing stigma against people living with HIV is key to encouraging HIV testing, which in turn is an important component in the treatment-as-prevention approach. We analyzed nationally representative survey data of participants aged 15 years and older in Namibia (N = 4,300) to determine whether knowledge about HIV and self-efficacy to protect against sexually transmitted HIV would be independently and jointly associated with stigma against people living with HIV, after controlling for demographics. Findings indicated that having less knowledge and feeling less self-efficacy were associated with greater stigma. Our key interaction hypothesis was also supported: stigma among those with lower self-efficacy to reduce risk of sexually transmitted HIV infection was particularly sensitive to the effects of increased knowledge about HIV. Results highlight the importance of enriching knowledge about HIV transmission modes, prevention strategies, and support services among those with low self-efficacy in order to reduce stigma against people living with HIV, and has useful implications for designing anti-stigma campaigns.
    Health Education &amp Behavior 10/2014;
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    ABSTRACT: Introduction. In the United States, one out of every seven low-income children between the ages of 2 and 5 years is at risk for overweight and obesity. Formative research was conducted to determine if preschool children participating in family-style meals consumed the minimum food servings according to U.S. Department of Agriculture dietary guidelines. Method. Participants were 135 low-income children aged 3 to 4 years who attended an urban child care center. Participant's parents completed a Family Demographic Questionnaire to provide information on race/ethnicity, parent's level of education, and household income. Direct observation of children's food and beverage consumption during school breakfast and lunch was collected over 3 consecutive days. Dietary data were assessed using the Nutrition Data System for Research software. Height and weight measurements were obtained to determine risk for obesity. Descriptive statistics were reported by using the Statistical Package for the Social Sciences Version 16. Results. Among 135 participants, 98% identified as Mexican American, 75% lived at or below poverty level, and 24% reported a family history of diabetes. Children consumed less than half of the calories provided between breakfast and lunch and did not consume the minimum recommended dietary food servings. Despite the poor dietary intake, physical measurement findings showed 25% obesity prevalence among study participants. Conclusions. Findings support the need for evidenced-based early childhood obesity prevention programs that provide behavior change opportunities for children, their families, teachers, and menu planners. Family-style meal settings are ideal opportunities for implementing nutrition education strategies to prevent early childhood obesity.
    Health Education &amp Behavior 10/2014;
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    ABSTRACT: Introduction. Research on outcomes of volunteering in later life largely focuses on the health of volunteers. This is in contrast to studies of youth, where attention is directed toward the effects of volunteering on subsequent productive and citizen behaviors. In this study, we examined the effects of volunteering on subsequent social and civic activity of older adults. Method. This study was conducted with volunteers from Experience Corps® (EC), a national program that brings older adults into schools to work with students. Data were derived from a baseline survey of older adults who were new EC volunteers in fall of 2006 and 2007. Follow-up interviews were conducted with 338 volunteers in fall 2010 to capture work, education, and community activities undertaken subsequent to joining EC. Results. Subsequent to joining EC, 16% of volunteers reported that they started a new job, 53% started another volunteer position, 40% started a community activity, and 39% took a class/started educational program. When asked if and how EC participation played a role in their new involvements, 71% said it increased confidence, 76% said it increased realization of the importance of organized activities/daily structure, and more than 40% said they made social connections that led to new involvements. Most reported they were more likely to be involved in advocacy efforts for public education. Discussion. Volunteering among older adults is a means as well as an end-just as it is for young people. Programs can do more to attract and serve older adults by promoting volunteering as a pathway to other engagements, including work, social, and civic activities.
    Health Education &amp Behavior 10/2014; 41(1 Suppl):84S-90S.
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    ABSTRACT: Background. Financial incentives and peer networks could be delivered through eHealth technologies to encourage older adults to walk more. Methods. We conducted a 24-week randomized trial in which 92 older adults with a computer and Internet access received a pedometer, daily walking goals, and weekly feedback on goal achievement. Participants were randomized to weekly feedback only (Comparison), entry into a lottery with potential to earn up to $200 each week walking goals were met (Financial Incentive), linkage to four other participants through an online message board (Peer Network), or both interventions (Combined). Main outcomes were the proportion of days walking goals were met during the 16-week intervention and 8-week follow-up. We conducted a content analysis of messages posted by Peer Network and Combined arm participants. Results. During the 16-week intervention, there were no differences in the proportion of days walking goals were met in the Financial Incentive (39.7%; p = .78), Peer Network (24.9%; p = .08), and Combined (36.0%; p = .77) arms compared with the Comparison arm (36.0%). During 8 weeks of follow-up, the proportion of days walking goals were met was lower in the Peer Network arm (18.7%; p = .025) but not in the Financial Incentive (29.3%; p = .50) or Combined (24.8%; p = .37) arms, relative to the Comparison arm (34.5%). Messages posted by participants focused on barriers to walking and provision of social support. Conclusions. Financial incentives and peer networks delivered through eHealth technologies did not result in older adults walking more.
    Health Education &amp Behavior 10/2014; 41(1 Suppl):43S-50S.
  • Health Education &amp Behavior 10/2014; 41(5):476-84.