Index

A

Adaptation, 31

Adherence, in clinical interventions, 192– 194

Administrative strategies, 246

Adolescents with chronic disease, 212–218

family therapy for, 217–218

interventions affecting family relationship quality and functioning, 215–217

psychoeducational interventions for, 212–215

Adrenal steroids, 44

Adult weight gain, 96–97

Adults with chronic disease, interventions for, 218–219

Advantage, relative, of innovations, 305– 306

Adverse social interactions, 150–151

Advocacy Institute, 346

Affliction, disproportionate, of sexually transmitted infections, 110–112

Agency for Health Care Policy and Research (AHCPR), 335–336

Alcohol consumption, 102–107

early data on, 19

maldistribution in, 106

negative health effects, 103–104

positive health effects, 104–105

quantifying net public health benefit, 105–107

socioeconomic factors in, 102–103

Allostasis and allostatic load, 4–5, 41–42

in the autonomic nervous system, 45

patterns of long-term harm associated with, 46

Alzheimer’s disease, 211

American Academy of Pediatrics, 115

American Cancer Society, 107, 117, 119, 203

American College of Obstetricians and Gynecologists, 117

American Heart Association, 115

Heart Partners program, 308

American Medical Association, 115, 117

American Psychiatric Association, 22

American Psychological Association, 281

American Stop Smoking Intervention Study (ASSIST), 203, 308



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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Index A Adaptation, 31 Adherence, in clinical interventions, 192– 194 Administrative strategies, 246 Adolescents with chronic disease, 212–218 family therapy for, 217–218 interventions affecting family relationship quality and functioning, 215–217 psychoeducational interventions for, 212–215 Adrenal steroids, 44 Adult weight gain, 96–97 Adults with chronic disease, interventions for, 218–219 Advantage, relative, of innovations, 305– 306 Adverse social interactions, 150–151 Advocacy Institute, 346 Affliction, disproportionate, of sexually transmitted infections, 110–112 Agency for Health Care Policy and Research (AHCPR), 335–336 Alcohol consumption, 102–107 early data on, 19 maldistribution in, 106 negative health effects, 103–104 positive health effects, 104–105 quantifying net public health benefit, 105–107 socioeconomic factors in, 102–103 Allostasis and allostatic load, 4–5, 41–42 in the autonomic nervous system, 45 patterns of long-term harm associated with, 46 Alzheimer’s disease, 211 American Academy of Pediatrics, 115 American Cancer Society, 107, 117, 119, 203 American College of Obstetricians and Gynecologists, 117 American Heart Association, 115 Heart Partners program, 308 American Medical Association, 115, 117 American Psychiatric Association, 22 American Psychological Association, 281 American Stop Smoking Intervention Study (ASSIST), 203, 308

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Anger, 65 associated with susceptibility to diseases, 4 Anti-tobacco interventions, government level, 339–345 Anxiety, 67 Arousal, and memory modulation, 49–51 Assessing outcomes, 275–278 choice of outcome measures, 275–276 outcome measurement, 276–278 ASSIST. See American Stop Smoking Intervention Study Atherosclerosis, 63 Autonomic nervous system, 62 allostasis in, 45 B Behavior definition of, 3, 20–21 health-related interventions affecting individual, 9–11 Behavior change, 333–335 maintaining, 334–335 models of, 183–191 producing, 333–334 Behavioral disease factors anger, 65 anxiety, worry, and hope, 67 in cardiovascular health and disease, 64–67 depression, 66–67 hostility, 64–65 vital exhaustion, 65–66 Behavioral factors affecting health, 27, 37– 178 Behavioral intervention studies, of individuals, lessons from, 209 Behavioral interventions, funding supporting long-duration efforts for, 16, 348 Behavioral risk factors, 5–6, 87–137, 197–200 addressing, 197–200 alcohol consumption, 102–107 disease screening practices, 113–121 family and, 211 obesity, physical activity, and diet, 92– 102 sexual practices, 107–113 tobacco use, 87–92 unemployment, 155–156 Behavioral variables, integrating into interdisciplinary research, 16, 348 Bereavement, health and immunity effects of, 57 Biobehavioral factors in health and disease, 4–5, 39–86 brain as interpreter, regulator, and target, 47–51 cardiovascular health and disease, 61–67 defining, 20 developmental trajectories, 68–70 factors influencing long-term effects of stress, 57–61 immune system function in health and disease, 51–57 stress, health, and disease, 40–47 Biological risk factors, 27, 37–178 Biological variables, interdisciplinary research into integrating, 16, 348 Biosocial factors in health and disease, defining, 20–21 Blood cholesterol, screening for high, 115– 116 Bogalusa Heart Study, 70 Bone mineral density, 100 Bootheel Heart Health Project, 203 Brain function arousal and memory modulation, 49–51 as interpreter, regulator, and target, 47– 51 neurotransmitters, experience, and behavior, 48–49 Breast cancer screening, 119–120 British Regional Heart Study, 155 Buffering, positive social relations providing, 146 C Calcium intake, 100–101 Canadian Ministry of Health, 243

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Cancer, 99–100 addressing psychosocial risk factors for, 195–196 depression linked with, 66 diet linked with, 100 sexually transmitted infections and, 110 Cancer screening breast, 119–120 cervical, 117 colorectal, 117–118 prostate, 118–119 Cannon, Walter, 40 Capital. See Social capital Capitated financing, for managed-care organizations, 303 Cardiac arrhythmia, 276 Cardiovascular disease, 98–99 cardiovascular health and, 61–67 effect of social isolation on risk of, 24 produced by chronic social stress, 62 stress and cardiovascular function in, 61–63 Caregivers interventions for, 219–220 of relatives with progressive dementia, 7 CATCH. See Child and Adolescent Trial of Cardiovascular Health Catecholamines, 44 CBA. See Cost/benefit analysis CD4 cells, 148 CEA. See Cost-effectiveness analysis Centers for Disease Control and Prevention, 256 Cervical cancer screening, 117 Change assumptions about, 253 behavioral, 333–335 organizational, 242–243 theories of, 252–254 Chemical work hazards, 12 Child and Adolescent Trial of Cardiovascular Health (CATCH), 208 Children, stress in, 68–70 Children with chronic disease, 212–218 family therapy for, 217–218 interventions affecting family relationship quality and functioning, 215–217 psychoeducational interventions for, 212–215 Cholesterol screening, 116 CHPGP. See Community Health Promotion Grant Program Chronic disease, 10 interventions for adults and elderly, 218–219 interventions for children and adolescents, 212–218 Chronic social stress, cardiovascular disease produced by, 62 Cigarette-smoking early data on, 19 measuring the public health burden of, 88–89 primary prevention of, 91–92 Civic association membership, density of, 164 Classic conditioning, 184–186 Clinical interventions, 192–200, 335–338 addressing behavioral risk factors, 197– 200 addressing psychosocial risk factors, 194–197 adherence in, 192–194 cost-effectiveness of, 337 evaluating, 279–281, 337–338 on individuals, 192–200 need for research on practice, 200 in tobacco use, 335–338 Clinical research findings, presentation to consumers, 297–298 Cognitive social learning model, 186–187 Cognitive theory, 187 Cohesion. See Social cohesion “Collective efficacy,” 165 Colorectal cancer screening, 117–118 Committee on Health and Behavior, 2, 20, 27 report organization, 33 task statement of, 27–31 underlying assumptions of, 27

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Communicating risk information, to consumers , 294–297 Communities and health, 13–14, 250–254 community-level constructs, 252 geography versus identity and action, 252 interventions for, 13–14, 241–273 Communities of identity, 251 Community-based group dissemination, 304–307 community and organizational readiness for, 305–306 of effective community interventions, 304–305 of interventions in tobacco use, 338–339 research on, 306–307 Community-based participatory research, 285–288 Community Health Promotion Grant Program (CHPGP), 204 Community Intervention Trial (COMMIT) for Smoking Cessation, 203, 205, 308 Community-level interventions, 13–14, 254–258 concurrent, 17, 348–349 East Side Village Health Worker Partnership, 256–257 evaluating, 282–283 lessons from community change interventions, 257–258 Tenderloin Senior Organizing Project, 255–256 theories of change for, 252–254 Community socioeconomic standing, effects on mortality and morbidity, 8 Community-wide trials, 201–205 large-scale studies, 201–203 small-scale studies, 203–204 Conceptualization of SES, 143–145 general susceptibility versus disease specificity, 144 reverse causation and social selection, 145 Concurrent interventions at multiple levels, individual, family, community, and society, 17, 348– 349 Conditioning, 184–186 Constraints on health, governmental and societal, 260 Constructs, community-level, 252 Consumer dissemination, 294–300 for communicating risk information, 294–297 for presentation of clinical research findings, 297–298 for shared decision making, 298–300 Continuous-improvement models, 199 Coping facilitated by optimism, 59 with long-term effects of stress, 24, 58– 60 psychosocial aspects of, 31, 333 Coronary Artery Risk Development in Young Adults, 162 Coronary heart disease addressing psychosocial risk factors for, 196–197 hostility linked to, 5 Coronary Primary Prevention Trial (CPPT), 297 Corticotropin-releasing hormone (CRH), 48–49 Cost/benefit analysis (CBA), 293 Cost-effectiveness, 337 Cost-effectiveness analysis (CEA), 291– 293 Counseling, promoting primary prevention measures, 9 CPPT. See Coronary Primary Prevention Trial CRH. See Corticotropin-releasing hormone Current Concepts of Positive Mental Health, 23 Cytokines, pleiotropy of, 55

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences D Decision making, shared with consumers, 298–300 “Demand/control” model, 152 Dementia, caregivers of relatives with, 7, 220 Depression, 66–67 associated with susceptibility to diseases, 4–5 linked with cancer, 66 “subsyndromal,” 22 Deprivation, relative, 160–161 Determinants of health, model of, 25–26 Developmental links, 68–70 Diabetes mellitus, addressing psychosocial risk factors for, 194–195 Diagnostic thresholds, changing, 3 Diet, 92–102 and adult weight gain, 96–97 early data on, 19 prevalence and trends, 93–95 weight and disease, 97–102 Dietary Guidelines Advisory Committee, 97 Dietary Guidelines for Americans, 103 Direct political power, versus relative, 163 Discrimination, social inequalities of, 161– 163 Disease. See also individual disease conditions Disease factors. See also Transmission associated with susceptibility, 4 biobehavioral, 39–86 in cardiovascular health and disease, behavioral, 64–67 psychosocial, 64–67 Disease management, families and, 210–211 Disease screening practices, 113–121 breast cancer screening, 119–120 cervical cancer screening, 117 colorectal cancer screening, 117–118 primary versus secondary prevention, 114–115 prostate cancer screening, 118–119 screening for hypertension and high blood cholesterol, 115–116 screening for sexually transmitted diseases, 120–121 Disproportionate affliction, of sexually transmitted infections, 110–112 Dissemination, 274–327 to community-based groups, 304–307 to consumers, 294–300 through interorganizational linkages, 307–309 through organizations, 301–304 Distribution, of medical care, 141 Drinking, 102–107 linked with smoking, 6 negative health effects, 103–104 positive health effects, 104–105 quantifying net public health benefit, 105–107 socioeconomic factors in, 102–103 DSM-IV, 22 E East Side Village Health Worker Partnership (ESVHWP), 256–257 Ecological approach, to healthy behavior research, 28–29 Economic adversity, relational strengths protecting against, 7 Educational interventions, 195 promoting primary prevention measures, 9 Effective clinical interventions, 280–281 Effective community interventions, disseminating to community-based groups, 304–305 Effectiveness, intervention studies including measures determining, 17, 349 Elderly with chronic disease, interventions for, 218–219 Electronic medication monitors, 193 Emotions, writing about, 60 Employee health behaviors. See also Job-related risk factors; Worksite trials changing, 244–245 Endocrine effects, on the immune system, 53

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Engineering strategies, 246 Enhancing Recovery in Coronary Heart Disease (ENRICHD) trials, 197 Environmental risk factors, 245–249 Environments constraining individual health choices, 7 toxic, 141 Ergonomic work hazards, 12 ESVHWP. See East Side Village Health Worker Partnership Evaluating clinical interventions, 279– 281, 337–338 for efficacy and effectiveness, 280–281 evidence-based medicine, 279–280 Evaluating intervention research, 274–327 cost-effectiveness evaluation, 291–293 disseminating, 294–309 Evaluating interventions, 275–291 clinical, 279–281 community-level, 282–289 governmental, 290–291, 343–345 outcomes of, 275–278 Evaluation design, 284 Evaluation models, 309 Evidence-based medicine, 279–280 Evidence hierarchies, 279 Excise taxes, 343 Extinction, versus original learning, 185– 186 F Families and health, 11–12, 209–211 families and disease management, 210– 211 family and behavioral risk factors, 211 health-related interventions for, 11–12, 183–240 models and interventions, 183–240 models of behavior change, 183–191 Family interaction interventions, 211–221 for adults and elderly with chronic disease, 218–219 for caregivers, 219–220 for children and adolescents with chronic disease, 212–218 concurrent, 17, 348–349 family therapy, 217–218 relationship quality and functioning, 215–217 Family intervention studies, lessons from, 220–221 Fecal occult blood test (FOBT), 117–118 “Fight or flight,” 40 Findings and recommendations, 16–18, 348–350 application of research results, 347 behavior change, 333–335 for concurrent interventions at multiple levels, 17, 348–349 for funding supporting long-duration efforts, 16, 348 interactions among risk factors, 331– 333 for interdisciplinary research, 16, 348 intervention in tobacco use, 335–347 for intervention studies, 16, 17, 348, 349 for program planners and policy makers, 17–18, 349–350 for resource allocation to health promotion and disease prevention, 17, 349 5-A-Day Campaign, 261 Flexible sigmoidoscopy, 117–118 FOBT. See Fecal occult blood test Food, affordability of, 259 “Force field analysis,” 243 FORECAST model, 309 Funding supporting long-duration efforts, for behavioral and psychosocial interventions, 16, 348 G Gender, and long-term effects of stress, 60 General Social Surveys, 164 Geography, versus identity and action, 252 Gini coefficient, 158–159

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Government interventions, assessing, 290–291 Government level anti-tobacco interventions, 339–345 evaluation studies, 343–345 media campaigns, 340–342 tobacco taxes, 343 Governmental constraints on health, 260 Guide to Clinical Preventive Services, 114 H HBM. See Health belief model Health biological, behavioral, and social factors affecting, 37–178 definition of, 3, 21–25, 27 measurement of, 21–25 model of determinants of, 25–26 Health and Behavior: Frontiers of Research in the Biobehavioral Sciences (1982 report), 19–20, 331 updating, 27 Health behaviors, changing employee, 244–245 Health belief model (HBM), 187–188 Health Care Financing Administration, 291 Health care systems, resource allocation to health promotion and disease prevention by, 17, 349 Health communication campaigns, 261–262 Health-enhancing behaviors, promoting with positive social relations, 147 Health-related interventions, 8–15, 179–327 for communities, 13–14, 241–273 evaluating and disseminating intervention research on, 274–327 for families, 11–12, 183–240 for individuals, 9–11, 183–240 for organizations, 12–13, 241–273 for society, 14–15, 241–273 Health targets, 260–261 Healthy behavior research ecological approach to, 28–29 program planners and policy makers modifying societal conditions to enable, 17–18, 349–350 Healthy diet, linked with physical activity, 6 Healthy People, 19, 260, 331 Healthy People 2000, 261 Healthy People 2010, 261 Heart Partners program, 308 Hemoglobin A1C, 216–217 High blood cholesterol, screening for, 115–116 HIV importance of behavior to health, 20 psychological states associated with, 20 Homeostasis, 40 Hope, 67 a component of psychological well-being, 5 Hostility, 64–65 associated with susceptibility to diseases, 4 linked to coronary heart disease, 5 HPA axis, 48–49, 52–53, 63 HSPP. See Hutchinson Smoking Prevention Project Human capital, underinvestment in, 160 Hutchinson Smoking Prevention Project (HSPP), 207, 339, 346 Hypertension, 219 screening for, 115–116 I Identity. See Communities of identity Immune system, 44 effects on the nervous system, 53–55 function in health and disease, 51–57 integrated with other physiological systems, 4 neural and endocrine effects on, 53 stress and function of, 55–57 Immunity, neuroendocrine regulation of, 54

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Improving Prevention through Organization, Vision, and Empowerment (IMPROVE) trials, 199 Individual interventions, 183–240 clinical, 192–200 lessons from behavioral studies of, 209 models and, 183–240 population-based, 200–208 Individuals concurrent interventions for, 17, 348– 349 environments constraining health choices of, 7 families and health, 209–211 models of behavior change for, 183–191 Inequalities, 157–165 in people and places, 157–161 in race, and discrimination, 161–163 in social cohesion and social capital, 163–165 Inflammatory responses, effect on nervous system, 53–55 Innovations, relative advantage of, 305– 306 Interactions, among risk factors, 331–333 Interdisciplinary research, into integrating biological, psychological, behavioral, and social variables, 16, 348 Interorganizational linkages, 307–309 Interpersonal trust, level of, 164 Intersections, of health and behavior, 25– 27 Intervention case study on tobacco, 15, 335–347 clinical intervention, 335–338 community-based intervention, 338– 339 government level intervention, 339– 345 practical solutions, 345–347 Intervention research, 274–327 behavioral, lessons from, 209 cost-effectiveness evaluation of, 291– 293 dissemination of, 294–309 including measures determining effectiveness, 17, 349 into modifying social and psychological factors, 16, 348 Interventions, 8–15 in chronic disease, 212–219 educational, 195 evaluating, 275–291 legal, 290–291 psychosocial, 195–196 targeted at family interactions, 211–221 targeted at individuals, 191–209 targeted at organizations, 243–250 Isolation. See Social isolation J Job-related risk factors, 152–153, 156 job strain, 152–153 threat of job loss, 156 Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, 115 K Kaiser Family Foundation, 204 L Learning, original, versus extinction, 185– 186 Learning and conditioning model, 184– 186 Legal interventions, 290–291 Life expectancy, 61 Life Skills Training (LST) program, 207 Life stress, 51 Lifespan and lifecourse development, 32 Lifestyle Heart Trial, 192 Lipid Research Clinics Coronary Primary Prevention Trials, 192 Long-term effects of stress, early development influence on, 46–47

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Long-term resources, establishing and maintaining, through positive social relations, 149 LST. See Life Skills Training program M Maintaining behavior change, 334–335 Managed-care organization, 303 Management. See Disease management Marital discord, health and immunity effects of, 56 Material conditions, 141 distribution of medical care, 141 toxic physical environments, 141 Measurement of health, 21–25 positive health concept, 23–25 time dimension of, 23 Measurement of SES, 143–145 general susceptibility versus disease specificity, 144 reverse causation and social selection, 145 Media campaigns, government level anti-tobacco interventions, 340–342 Medical care, distribution of, 141 Medical practices, dissemination through, 303–304 Medication regimens, nonadherence to, 19, 333 Memory modulation, arousal and, 49–51 Memory processes, 50 Minnesota Heart Health Program (MHHP), 201–202, 208 Models of behavior change, 183–191 cognitive social learning, 186–187 health belief model, 187–188 learning and conditioning, 184–186 social action theory, 190 stages-of-change model/ transtheoretical model, 188–190 theory of reasoned action, 188 Models of determinants of health, 25–26 Models of health-related interventions for individuals and families, 183–240 for organizations, communities, and society, 241–273 Models of planned change, 243 Modulation, of memory with arousal, 49–51 Morbidity data, 21 Mortality data, 21 MRFIT. See Multiple Risk Factor Intervention Trial Multi-drug-resistant tuberculosis, 193 Multiple Risk Factor Intervention Trial (MRFIT), 139, 143, 191–192 Musculoskeletal health, 100–102 Myocardial infarction, vital exhaustion a predictor of, 65 N National Cancer Institute (NCI), 117, 203, 261, 275, 302, 308, 339 National Health and Nutrition Examination Study, 70 National Heart, Lung, and Blood Institute (NHLBI), 202, 275 National Institute for Dental Research (NIDR) , 307 National Institutes of Health, 27 National Longitudinal Mortality Study (NLMS), 139 National Opinion Research Center, 164 National Surveys of Worksite Health Promotion Activities, 205 Natural killer-cell cytotoxicity (NKCC), 57 Negative health effects, of alcohol consumption, 103–104 Negative social relations, 149–151 adverse interactions, 150–151 isolation, 149–150 Nervous system, effects of inflammatory and immune responses on, 53–55 Neural effects, on the immune system, 53 Neurobiology, advances in, 48 Neuroendocrine regulation, of immunity, 54

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Neuroendocrine responses, 42 Neurotransmitters, experience and behavior, 48–49 NHLBI. See National Heart, Lung, and Blood Institute NIDR. See National Institute for Dental Research NKCC. See Natural killer-cell cytotoxicity NLMS. See National Longitudinal Mortality Study NNH. See Number needed to harm NNT. See Number needed to treat North Karelia Project, 201 Number needed to harm (NNH), calculating, 298 Number needed to treat (NNT), calculating, 297–298 Nurses Cohort Study, 98 O Obesity, 92–102 adult weight gain, 96–97 defining, 22, 93–94 prevalence and trends, 93–95 socioeconomic factors in, 95–96 weight and disease, 97–102 Objectives for the Nation, 260 Observability, of innovations, 306 Occupational risk factors, 151–157 job strain, 152–153 retirement, 156–157 threatened job loss, 156 unemployment, 153–156 Occupational safety and health (OSH) programs, 12, 245–246 OD. See Organizational development Operant-conditioning theory, 184–187 Optimism a component of psychological well-being, 5 coping facilitated by, 59 Organisation for Economic Co-operation and Development (OECD), 156 Organizational change interventions, potential targets for, 247 Organizational development (OD), 242–243 Organizational dissemination, 301–304 through medical practices, 303–304 through schools, 301–302 Organizational interventions, 12–13, 241–273 changing employee health behaviors, 244–245 communities and health, 250–254 community-level interventions, 254–258 lessons from, 250 organizations and health, 241–243 reducing environmental risk factors, 245–249 society and health, 258–260 society-level interventions, 260–264 Organizational readiness, in disseminations to community-based groups, 305–306 Organizations and health, 241–243 organizational culture, 242–243 planned-change models, 243 Original learning, versus extinction, 185–186 Osteoarthritis, 101 Outcome measurement, 275–278 choice of measures, 275–276 Outcomes assessment, 22 Overweight. See Obesity P Panel on Cost-Effectiveness in Health and Medicine, 278 Pap smear, 117 PAR. See Participatory action research PARR. See Physical Activity for Risk Reduction Project Participatory action research (PAR), 249 Pawtucket Heart Health Program (PHHP), 201–202 People, social inequalities of, 157–161 Pessimistic thinking, 5 PHHP. See Pawtucket Heart Health Program

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Physical activity, 92–102 and adult weight gain, 96–97 linked with healthy diet, 6 prevalence and trends, 93–95 weight and disease, 97–102 Physical Activity for Risk Reduction (PARR) Project, 204 Physical environments, toxic, 141 Physical morbidity, from unemployment, 155 Physical work hazards, 12 Physiological processes, altering with positive social relations, 147–149 Pittsburgh Sleep Quality Index, 157 Place, social inequalities of, 157–161 Planned-change models, 243 Pleiotropy, of cytokines, 55 Policy makers, modifying societal conditions to enable healthy behavior and social relationships, 17–18, 349–350 Population-based interventions, 200–208 community-wide trials, 201–205 by individual, 200–208 school trials, 206–208 worksite trials, 205–206 Positive health, 3, 23–25 components of, 23 difficulty assessing, 24 Positive health effects, of alcohol consumption, 104–105 Positive social interactions, 146–149 altering physiological processes, 147–149 buffering, 146 establishing and maintaining long-term resources, 149 promoting health-enhancing behaviors, 147 Postintervention assessment, 217 PPIP. See Put Prevention Into Practice program Practice in clinical interventions, need for research on, 200 Preintervention assessment, 217 Prenatal stress, handling, 46 Prevalence of obesity, 93–95 of sexually transmitted infections, 108 Preventing Tobacco Use Among Young People, 92 Prevention of cigarette-smoking, primary, 91–92 primary versus secondary, 114–115 of sexually transmitted infections, 112–113 Primary prevention, versus secondary, 114–115 Produce for Better Health Foundation, 261 Producing behavior change, 333–334 Program planners, modifying societal conditions to enable healthy behavior and social relationships, 17–18, 349–350 Prostate cancer screening, 118–119 Psychoeducational interventions, 212–215 Psychological factors, intervention studies into modifying, 16, 348 Psychological variables, interdisciplinary research into integrating, 16, 348 Psychological well-being, hope and optimism as components of, 5 Psychoneuroimmunology, 20 Psychosocial aspects of coping, 31 Psychosocial disease factors anger, 65 anxiety, worry, and hope, 67 in cardiovascular health and disease, 64–67 depression, 66–67 hostility, 64–65 vital exhaustion, 65–66 Psychosocial interventions, 195–196 funding supporting long-duration efforts for, 16, 348 Psychosocial risk factors, 142–143, 194–197 for cancer, 195–196 for coronary disease, 196–197 for diabetes mellitus, 194–195 psychosocial context, 142

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences relationship to health-related behaviors and biological risk factors, 143 Psychosocial work hazards, 12–13 Public health burden of cigarette-smoking, measuring, 88–89 national concern about consequences of tobacco use, 20 quantifying net benefit of alcohol consumption, 105–107 Public health interventions, 14 Public health systems, resource allocation to health promotion and disease prevention by, 17, 349 Purpose in life, having a sense of, 24 Put Prevention Into Practice (PPIP) program, 304 Q QALY. See Quality-adjusted life year Quality-adjusted life year (QALY), measuring by, 276–278, 293, 337 Quantifying net public health benefit, of alcohol consumption, 105–107 R Race, social inequalities of, 161–163 Randomized clinical trials (RCTs), 279– 282 RCTs. See Randomized clinical trials Readiness for dissemination, with community-based groups, 305–306 Reasoned action, theory of, 188 Recommendations. See Findings and recommendations Regulatory approaches, 262 Relapse rates, 193 Relational strengths, protecting against economic adversity, 7 Relative advantage, of innovations, 305–306 Relative political power, versus direct, 163 Relaxation training, 197 Religious belief, 165–166 Research evidence hierarchy, 279 Research findings. See also Studies presentation to consumers, 297–298 Resilience, 31 differential, 5 and long-term effects of stress, 57–58 Resource allocation to health promotion and disease prevention, by public health and health care systems, 17, 349 Retirement, 156–157 Reverse causation, in the conceptualization and measurement of SES, 145 Risk factors, 3–8 behavioral, 5–6, 87–137, 197–200 biobehavioral, 4–5 environmental, 245–249 interactions among, 331–333 job-related, 152–153, 156 psychosocial, 142–143, 194–197 social, 6–8, 138–178 Risk information, communicating to consumers, 294–297 Risk ratio information, communicating, 297 Robert Wood Johnson Foundation, 27 Robin Hood index, 159 S Schools dissemination through, 11, 301–302 trials in, 206–208 Screening. See Disease screening practices Second-hand smoke, consequences of, 90 Secondary prevention, versus primary, 114–115 Sedentary lifestyles, 96 early data on, 19 “Self,” distinguishing from “nonself,” 52 Self-control, 27 Self-regard, having high, 25 Self-regulation, 186–187 Selye, Hans, 40

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Serotonin system, 48–49 SES. See Socioeconomic status Sexual practices, 107–113 contributing factors that affect transmission, 108–110 Sexually transmitted diseases and cancer, 110 disproportionate affliction of, 110–112 prevalence of, 108 prevention of, 112–113 screening for, 120–121 SFCP. See Stanford Five City Project Shared decision making, involving consumers, 298–300 Sigmoidoscopy, 117–118 Smoking, 26, 87–92 benefits of ceasing, 92 consequences of second-hand smoke, 90 factors associated with, 5, 258 linked with drinking, 6 major related diseases, 89–90 measuring the public health burden of, 88–89 primary prevention of, 91–92 socioeconomic factors in, 90–91 SMR. See Standard mortality ratio Social-Action Theory, 190–191 Social capital, social cohesion and, 163–165 Social Cognitive-Learning Theory, 190 Social cohesion erosion of, 160 and social capital, 163–165 Social factors affecting health, 14–15, 27, 37–178 intervention studies into modifying, 16, 348 occupational factors, 151–157 religious belief, 165–166 social inequalities, 157–165 social networks and social support, 145–151 and socioeconomic status, 139–145 Social inequalities, 157–165 in people and places, 157–161 in race, and discrimination, 161–163 in social cohesion and social capital, 163–165 Social influences, on long-term effects of stress, 60–61 Social interactions adverse, 150–151 positive, 146–149 Social isolation, 149–150 effect on risk of cardiovascular disease, 24 Social Learning Theory, 187 Social networks and social support, 7–8, 145–151 negative social relations, 149–151 positive social relations, 146–149 Social patterning, 6 Social relationships high quality, 23–24 program planners and policy makers modifying societal conditions to enable improved, 17–18, 349–350 Social risk factors, 6–8, 138–178 large scale studies of, 19 Social selection, in the conceptualization and measurement of SES, 145 Social stress, cardiovascular disease produced by chronic, 62 Social variables, interdisciplinary research into integrating, 16, 348 Societal conditions, program planners and policy makers modifying, 17–18, 349–350 Societal constraints on health, 260 Society and health, 258–260 governmental and societal constraints on health, 260 and health-related interventions, 14–15, 241–273 Society-level interventions, 260–264 addressing socioeconomic status and health, 262–264 concurrent, 17, 348–349 health communication campaigns, 261–262 health targets, 260–261 regulatory approaches, 262

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences Socioeconomic status (SES), 139–145, 332 and alcohol consumption, 102–103 conceptualization and measurement of, 143–145 and health, 262–264 material conditions affecting, 141 and obesity, 95–96 psychosocial risk factors from, 142–143 and smoking, 90–91 Stages-of-Change Model, 188–190 Standard mortality ratio (SMR), 153–154 Stanford Five City Project (SFCP), 201–202 Stanford Three Community Study, 201–202 Stress factors, 31, 40–47, 57–61 allostasis and allostatic load, 41–42 and cardiovascular function, 61–63 coping with, 58–60 early development influence on long-term effects of, 46–47 gender, 60 and immune system function, 55–57 and resilience, 57–58 social influences, 60–61 Stress in children, 68–70 Stress management, 197 Stress mediators, protective and damaging effects of, 42–46 Stress response, 40–41 and development of allostatic load, 43 Studies boundaries of present, 31–33 disseminating to community-based groups, 306–307 generalizing current, 2 of health-related interventions, 274–327 large-scale, 201–203 small-scale, 203–204 Substance abuse, 31 early data on, 19 Susceptibility to diseases anger associated with, 4 depression associated with, 4 general, versus disease specificity, 144 hostility associated with, 4 vital exhaustion associated with, 4 Symptoms, varieties of, 22–23 Systems theory, 242 T T cells, 57 Taxes, on tobacco, 343 Technology Assessment Panel, 334 Telephone tracking, 218, 303 Tenderloin Senior Organizing Project (TSOP), 255–256 Theories of change, for community-level interventions, 252–254 “Theory-based evaluation,” 254 Theory of Reasoned Action, 188 Thresholds, changing diagnostic, 3 Time dimension of health, 23 Tobacco Institute, 344 Tobacco taxes, 343 Tobacco use, 87–92 benefits of smoking cessation, 92 consequences of second-hand smoke, 90 major smoking-related diseases, 89–90 measuring the public health burden of cigarette-smoking, 88–89 national concern about public health consequences of, 20 primary prevention of cigarette-smoking, 91–92 socioeconomic factors in, 90–91 Toxic physical environments, 141 Transmission, sexual practices that affect, 108–110 Transtheoretical Model, 188–190 Trends in obesity, 93–95 Trialability, of innovations, 306 TSOP. See Tenderloin Senior Organizing Project Tuberculosis, multi-drug-resistant, 193 Type A behavior, 64

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Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences U Unemployment, 153–156 biological and behavioral risk factors from, 155–156 physical morbidity from, 155 U.S. Department of Health and Human Services, 205 U.S. Epidemiologic Catchment Area, 156 U.S. National Longitudinal Mortality Study, 154 U.S. Preventive Services Task Force, 113, 115, 117–120, 304 U.S. Public Health Service, 113, 346 V Village Health Workers (VHWs), 257 Vital exhaustion, 65–66 associated with susceptibility to diseases, 4 predictor of myocardial infarction, 65 W Weight and disease, 6, 97–102. See also Obesity cancer, 99–100 cardiovascular disease, 98–99 musculoskeletal health, 100–102 Well-being measures of, 22 psychological, hope and optimism as components of, 5 WHO. See World Health Organization WHP. See Working Healthy Project Willpower, 27 Working Healthy Project (WHP), 206 Working Well trial, 205–206 Worksite trials, 205–206 World Health Organization (WHO), 21, 88, 261, 263 Worry, 67 Writing about emotions, 60