New Horizons in Health An Integrative Approach (2001) / Chapter Skim
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Interventions
Interventions
Pages 148-163
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From page 148... ...
interventions designed to decrease health risk behaviors, such as alcohol and substance abuse or smoking, or to increase health-promoting behaviors, such as exercise and following a healthy diet; (2) interventions aimed at facilitating effective coping with chronic or life-threatening diseases and conditions, including cancer, HIV/AIDS, asthma, diabetes, arthritis, and stroke; (3)
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From page 149... ...
When underlying causes of illness, such as low socioeconomic status are widely distributed in segments of the population, small changes at the population level are likely to have significant effects on overall population-level health. Indeed, many of the new social risk factors, including poverty and social isolation, are better addressed at the family, organizational, or population level than at the level of the individual.
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From page 150... ...
DHHS, 1994~. A meta-analysis of school interventions aimed at reducing smoking found that effect sizes were largest for interventions that focus on social reinforcement for the target behavior, moderate for those with either a developmental orientation or a focus on changing social norms as a way to influence the target behavior, and small for interventions with a health education focus (Bruvold, 1993~.
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From page 151... ...
Like smoking cessation, there is a portfolio of interventions designed to change other risk behaviors, including diet, physical inactivity, and alcohol and substance use. Many of these interventions are important both to prevent illness in the healthy and to prevent recurrence or delay illness progression in those who are managing chronic illness, such as coronary heart disease.
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From page 152... ...
Considerable evidence supports the effectiveness of cognitive behavioral therapy for reducing bulimia nervosa, showing roughly 80 percent reduction in binge-purge episodes and 50 to 60 percent of patients achieving complete remission (Craighead and Agras, 1991~. Medically prescribed and supervised physical activity forms the keystone of cardiac rehabilitation, and regular exercise by patients with coronary artery disease is associated with reductions in mortality from all cardiovascular causes except sudden death (Naughton,1992~.
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From page 153... ...
Although measures of the effectiveness of separate components in this program are not available, exit interviews with program participants indicate that they find the social intervention component to be especially helpful. Families have been targeted in programs aimed at changing health risk behaviors of children.
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From page 154... ...
Key targets for these workplace-based interventions include smoking cessation, improvement in diet, and physical activity (Sorensen et al., 1998~. Other current lines of workplace research having potential to inform work site interventions are studies of stress and health risks in repetitive work and supervisory monitoring work (Lundberg and Tohansson, 1999)
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From page 155... ...
, and awareness of this discrimination among patients living with chronic conditions such as HIV and cancer motivates many to choose not to disclose their status, even to health care providers (Chesney and Smith, 1999~. Past medical and psychosocial interventions have focused largely on the standard risk factors for chronic illness, such as inactivity, smoking, and unhealthy diet.
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From page 156... ...
Biobehavioral strategies could be extended to interventions directed at coping with chronic conditions and recovery from acute illness. The behavioral interventions discussed in this chapter have been manual based but often delivered by professionals to individuals or groups, either separately or within work sites or schools.
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From page 157... ...
underscores the importance of grounding intervention programs in solid science and of approaching tobacco control via multipronged strategies (e.g., educational programs, media advertising, counseling, social support, pharmacotherapies for nicotine dependence, cigarette taxes, prohibition against smoking in public places)
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From page 158... ...
There are four common features of population-level interventions that make traditional randomized control trials difficult, if not impossible: 1. The program contains multiple interventions acting simultaneously.
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From page 159... ...
The complexity of such intervention programs suggests that what is deemed effective should be installed initially and that one or more components should be adjusted at regular intervals, based on outcome indices. It should be recognized that intervention programs will seldom if ever be based on complete understanding of mechanisms at all levels described in this report.
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From page 160... ...
Williams DA. 1998 "Sampling of empirically supported psychological treatments from health psychology: Smoking, chronic pain, cancer, and bulimia nervosa" Journal of Consulting and Clinical PsycI7ology 66/1:89112.
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From page 161... ...
1993 "Survival of breast cancer patients receiving adjunctive psychosocial support therapy: A 10-year follow-up study" Journal of Clinical Oncology 11/1:66-69. Herzog TA, Abrams DB, Emmons KM, Linnan LA, Shadel WG.
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From page 162... ...
1999 "Interactive versus noninteractive interventions and dose-response relationships for stage-matched smoking cessation programs in a managed care setting" HealtI7 Psychology 18/1:21-28. Vernon SW 1999 "Risk perception and risk communication for cancer screening behaviors: A review" Journal of tI7e National Cancer Institute Monographs 25:101-118.
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From page 163... ...
1995 "Criteria for determining an optimal cigarette tax: The economist's perspective" Tobacco Control 4:380-386. Wenger NK, Forelicher ES, Smith LK, and the Cardiac Rehabilitation Guideline Panel of the Agency for Health Care Policy and Research.
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