Impact of a video-based intervention to improve the prevalence of skin self-examination in men 50 years or older: the randomized skin awareness trial. The image of four diseases held by the urban Jewish population of Israel. Increasing screening mammography in asymptomatic women: evaluation of a second-generation, theory-based program. Randomised controlled trial of the use of a modified postal reminder card on the uptake of measles vaccination Cost-effectiveness comparison of five interventions to increase mammography screening. A two-step intervention of increase mammography among women aged 65 and older. Increasing attendance at colorectal cancer screening: testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults. Using A Pharmacy-Based Intervention To Improve Antipsychotic Adherence Among Patients With Serious Mental Illness A behavioural intervention to reduce persistence of bacterial vaginosis among women who report sex with women: results of a randomised trial An application of the health belief model to patient education and compliance: acute otitis media. Motivational interviewing (MINT) improves continuous positive airway pressure (CPAP) acceptance and adherence: a randomized controlled trial. Impact of a pharmacist consult clinic on a hospital-based geriatric outpatient clinic in Singapore. Enhancing the effectiveness of community stroke risk screening: a randomized controlled trial. Compliance in acute and chronic patients receiving a health belief model intervention in the emergency department.
OBJECTIVE To improve the proportion of men 50 years or older who conduct a thorough whole-body skin self-examination ( SSE ) , because these men are at increased risk of being diagnosed as having thick melanomas and dying of melanoma . DESIGN R and omized trial of a video-based intervention to increase whole-body SSE compared with brochures-only control . SETTING Men from an Australian population register . PARTICIPANTS The study included 930 men 50 years or older . INTERVENTION The men were r and omly assigned to receive either written material s only ( control ) or written material s along with a DVD or video and 2 postcard reminders ( intervention ) . Telephone interviews were conducted at baseline and at 7 and 13 months . MAIN OUTCOME MEASURE The proportion of men who conducted a whole-body SSE with the help of 2 mirrors and /or a person to assist with difficult-to-see areas . RESULTS Compared with baseline ( 10 % ) , by 13 months both groups had increased their whole-body SSE behaviors similarly ( 36 % intervention and 31 % control ) ( P = .85 ) . At 7 months , the intervention group was significantly more likely to examine at least 1 part of their back ( P < .001 ) and to examine a greater number of body sites ( P < .001 ) . At 7 months , the proportion of men conducting any SSE increased by 28 % in the intervention group compared with 13 % in the control group ( P < .001 ) , but at 13 months , the prevalence of any self-examination ( 83 % vs 80 % ) was again similar . CONCLUSION While men 50 years or older are responsive to appropriately targeted intervention material s to increase their SSE behaviors , the addition of a video or DVD to written material s had only a transient advantage for optimal SSE practice s. TRIAL REGISTRATION anzctr.org.au Identifier : 12608000384358 Abstract This study has applied the Semantic Differential for Health technique , developed by Jenkins , in a study of the images of cancer , heart disease , mental illness and cholera  held by a r and om sample ( N = 1770 ) of the Israeli Jewish adult urban population in 1971 . Six scales were used to represent the dimensions of seriousness , control , personal susceptibility , and salience . The data show that the images of these four diseases vary considerably from each other , with cancer being the most anxiety-providing , while mental illness is most mysterious and distant . The image of heart disease is not radically different from that of cancer , yet nonetheless is significantly less pessimistic . The possible fatal consequences of cholera are recognized , but in overall terms the image held is one of confidence . Analysis of the disease images held by age-sex and ethnicity education subgroups leads to the unanticipated conclusion that , despite a number of specific differences , in overall terms the disease images are not distributed differentially along these demographic lines . Some of the possible implication s of the findings for action by health authorities are discussed Two theory-based programs to increase mammography screening rates among asymptomatic women were implemented and evaluated in the community . One program ( E ) was based on the Health Belief Model ( HBM ) ; the second program ( EP ) added exercises adapted from the social psychology of compliance . Program impact on screening among 295 primarily Caucasian , middle-class women was evaluated against untreated controls ( C ) over a 6-month period . Both programs led to increases in HBM components ( Perceived Susceptibility , and Perceived Benefits ) and Intentions to obtain a mammogram . Screening rates 2 to 3 times higher were observed in the EP and E over C conditions ; EP and E did not differ . A mediational model of compliance illustrated the interplay of HBM components in the compliance process OBJECTIVE To determine whether rewording postal reminder cards according to the “ health belief model ” , a theory about preventive health behaviour , would help to improve measles vaccination rates . DESIGN A r and omised controlled trial , with blind assessment of outcome status . Parents of children due for their first measles vaccination were r and omised to one of two groups , one receiving the health belief model reminder card , the other receiving the usual , neutrally worded card . The proportion of children subsequently vaccinated in each group over a five week period was ascertained from clinical ( provider based ) records . SETTING A local government operated public vaccination clinic . PARTICIPANTS Parents of 259 children due for measles vaccination . MAIN RESULTS The proportion of children vaccinated in the health belief model card group was 79 % compared with 67 % of those sent the usual card ( 95 % CI , 2 % to 23 % ) , a modest but important improvement . CONCLUSION This study illustrates how the effectiveness of a minimal and widely practised intervention to promote vaccination compliance can be improved with negligible additional effort BACKGROUND Mammography is the primary method used for breast cancer screening . However , compliance with recommended screening practice s is still below acceptable levels . This study examined the cost-effectiveness of five combinations of physician recommendation and telephone or in-person individualized counseling strategies for increasing compliance with mammography . METHODS There were 808 participants who were r and omly assigned to one of six groups . A logistic regression model with compliance as the dependent variable and group as the independent variable was used to test for significant differences and a ratio of cost to improvement in mammogram compliance evaluated the cost-effectiveness . RESULTS Three of the interventions ( in-person , telephone plus letter , and in-person plus letter ) had significantly better compliance rates compared with the control , physician letter , or telephone alone . However , when considering costs , only one emerged as the superior strategy . The cost-effectiveness ratios for the five interventions show that telephone-plus-letter is the most cost-effective strategy , achieving a 35.6 % mammography compliance at a marginal cost of $ 0.78 per 1 % increase in women screened . CONCLUSIONS A tailored phone prompt and physician reminder is an effective and economical intervention to increase mammography . Future research should confirm this finding and address its applicability to practice OBJECTIVES This study evaluated a two-step intervention for mammography screening among older women . METHODS Four hundred and sixty women , identified from physician practice s , were r and omized to a control or a two-step intervention ( physician letter and peer counseling call ) group . Women in the intervention group who obtained a mammogram received a grocery coupon . RESULTS Over the 12 months of the study , more women in the intervention group than in the control group obtained mammograms ( 38 % vs 16 % ) . The most dramatic difference was in the higher odds that women in the intervention group would obtain a mammogram within 2 months ( odds ratio = 10.5 ) . CONCLUSIONS The intervention significantly increased screening mammography . Future efforts must be multifaceted and incorporate the unique concerns of older women This article describes a trial of a psychoeducational intervention design ed to modify negative attitudes toward flexible sigmoidoscopy screening and thereby increase screening attendance . The intervention material s addressed the multiple barriers shown to be associated with participation in earlier studies . Adults ages 55 - 64 ( N = 2,966 ) , in a " harder-to-reach " group were r and omized either to receive an intervention brochure or to a st and ard invitation group .  Attitudes and expectations were assessed by question naire , and attendance at the clinic was recorded . Compared with controls , the intervention group had less negative attitudes , anticipated a more positive experience , and had a 3.6 % higher level of attendance . These results indicate that psychoeducational interventions can provide an effective means of modifying attitudes and increasing rates of screening attendance Background : Similar to patients with other chronic disorders , patients with serious mental illness ( SMI ) are often poorly adherent with prescribed medications . Objective : We conducted a r and omized controlled trial examining the effectiveness of a pharmacy-based intervention ( Meds-Help ) in increasing antipsychotic medication adherence among Department of Veterans Affairs ( VA ) patients with SMI . We also examined the impact of Meds-Help on psychiatric symptoms , quality of life , and satisfaction with care . Methods : We enrolled 118 patients from 4 VA facilities with schizophrenia , schizoaffective , or bipolar disorder who were on long-term antipsychotics but had antipsychotic medication possession ratios ( MPRs ) < 0.8 in the prior year . Patients were r and omized to usual care ( UC ; n = 60 ) or the pharmacy-based intervention ( Meds-Help ; n = 58 ) . We reassessed adherence at 6 and 12 months , at which time patients completed Positive and Negative Symptom Scales ( PANSS ) , Quality of Well-being Scales ( QWB ) , and Client Satisfaction Question naires ( CSQ-8 ) . Results : Prior to enrollment , Meds-Help and UC patients had mean antipsychotic MPRs of 0.54 and 0.55 , respectively . At 6 months , mean MPRs were 0.91 for Meds-Help and 0.64 for UC patients ; at 12 months , they were 0.86 for Meds-Help and 0.62 for UC patients . In multivariate analyses adjusting for patient factors , Meds-Help patients had significantly higher MPRs at 6 and 12 months ( P < .0001 ) . There were no significant differences between groups in PANSS , QWB , or CSQ-8 scores , but power to detect small effects was limited . Conclusions : Congruent with prior studies of patients with other disorders , a practical pharmacy-based intervention increased antipsychotic adherence  among patients with SMI . However , SMI patients may require additional care management components to improve outcomes Objectives Bacterial vaginosis ( BV ) is common in lesbians , and treatment fails in up to 28 % . Risks include sexual behaviours that transmit vaginal fluid . The authors measured efficacy of a behavioural intervention to reduce sexual transfer of vaginal fluid between female sex partners in reducing BV persistence . Methods Women aged 16–35 years with BV who reported sex with women ( prior year ) were eligible . Participants were r and omised to intervention ( motivational interviewing design ed to reduce sharing of vaginal fluid on h and s or sex toys post-treatment , by provision of condoms , gloves and water-based lubricant ) or control ( general STI education ) arms . All were treated with vaginal metronidazole and underwent computer-assisted self-interview to ascertain sexual behaviours , with test-of-cure at 30 days . Results Of 129 women with BV , 108 ( 84 % ) were eligible ; 89 ( 69 % ) agreed to enrol . 43 were r and omised to control and 46 to intervention ; 81 ( 91 % ) returned for test-of-cure . BV persisted in 12 ( 27.9 % ) of 43 women in intervention and 8 ( 21.1 % ) of 38 women in control arms ( p1/40.6 ) . Digital-vaginal sex was common post-treatment ( 50 % intervention and 68 % control ) ; women r and omised to the intervention were less likely to report receptive digital-vaginal sex without gloves than control ( 31 % vs 61 % ; p1/40.01 ) , without reported lower frequency of other sexual practice s. Shared vaginal use of sex toys was infrequent . Conclusions Although the intervention effected a significant increase in glove use during digital-vaginal sex post-BV treatment , this was not associated with reduction in BV persistence . Shared use of vaginal sex toys was infrequent , suggesting that other mechanisms promote BV in lesbians This study made use of concepts from the health belief model to test the influence of educational intervention on patient attitude and subsequent sick-role behavior . The hypothesis tested was as follows : Mothers of pediatric patients in an experimental group ( N-29 ) receiving specially design ed education about otitis media , would consequently acquire greater awareness of their children 's susceptibility to the disease , the possibility of its serious effects , and the benefits of treatment than a comparable control group ( N-30 ) not receiving the educational intervention . It was further hypothesized that patient compliance would be higher in the experimental group . Experimental group health beliefs changed in a significant , positive direction with respect to illness susceptibility and severity , the benefits of treatment , and patient modifying factors . Control group attitudes did not significantly change . Compliance rates for both groups were very high ; 91.8 % compliance was noted for experimental subjects and 85.6 % for controls . This may reflect the additional time and attention given all those participating in the study OBJECTIVE Adherence to continuous positive airway pressure ( CPAP ) therapy for obstructive sleep apnoea ( OSA ) is poor . We assessed the effectiveness of a motivational interviewing intervention ( motivational interview nurse therapy [ MINT ] ) in addition to best practice st and ard care to improve acceptance and adherence to CPAP therapy in people with a new diagnosis of OSA . METHOD One hundred six Australian adults ( 69 % male ) with a new diagnosis of OSA and a clinical recommendation for CPAP treatment were recruited from a tertiary sleep disorders center . Participants were r and omly assigned to receive either 3 sessions of a motivational interviewing intervention ( MINT ; n = 53 ; mean age = 55.4 years ) or no intervention ( control ; n = 53 ; mean age = 57.74 years ) . The primary outcome was the difference between the groups in objective CPAP adherence at 1-month , 2-month , 3-month , and 12-month follow-ups . RESULTS Fifty ( 94 % ) participants in the MINT group and 50 ( 94 % ) participants in the control group met all inclusion and exclusion criteria and were included in the primary analysis . The number of hours of CPAP use per night in the MINT group at 3 months was 4.63 hr and was 3.16 hr in the control group ( p = .005 ) . This represents almost 50 % better adherence in the MINT group relative to the control group . Patients in the MINT group were substantially more likely to accept CPAP treatment . CONCLUSIONS MINT is a brief , manualized , effective intervention that improves CPAP acceptance and objective adherence rates compared to st and ard care alone INTRODUCTION We study the impact of a pharmacist consult clinic on the care of elderly out patients based on the Health Belief Model that the perceived benefits ( improvement in medication knowledge , clinical status and perception ) and attached barriers ( cost and number of medication and adverse drug reactions ) can influence health behaviour ( medication compliance ) . MATERIAL S AND METHODS A r and omised controlled study of 136 eligible patients with risk factors for non-compliance , using Zelen 's design , was conducted in a hospital-based geriatric outpatient clinic from November 2001 to June 2002 . All patients were assessed for outcome variables at baseline and 2 months later . RESULTS One hundred and twenty-six patients were included in the intention-to-treat analysis . There were 104 pharmacist interventions with a physician acceptance rate of 76 % . There was a significant improvement in medication knowledge with regards to indication ( P = 0.03 ) and the composite dose , frequency and indication score ( P = 0.06 ) , as well as a decrease in residual adverse drug reactions that persisted at month 2 and cost avoidance of dollars 387.28 over 2 months . There was no significant difference in perception , clinical status or decrease in number of medications . The intervention group showed an improvement in adjusted compliance ( odds ration [ OR ] = 2.52 ; 90 % confidence interval [ CI ] , 1.09 to 5.83 ) based on the ordered logistic regression model . Perception of severity of illness at baseline ( OR = 1.30 ; 90 % CI , 1.04 to 1.62 ) , number of medication remembering methods ( OR = 1.87 ; 90 % CI , 1.08 to 3.25 ) and the use of routine habits ( OR = 4.48 ; 90 % CI , 1.51 to 13.28 ) and medication aids ( OR = 3.68 ; 90 % CI , 1.04 to 13.06 ) significantly affected compliance . CONCLUSION The addition of a pharmacist consult clinic to the management of selected geriatric out patients can improve compliance , with the attendant benefits of improving medication knowledge , cost avoidance and reducing residual adverse drug reactions Stroke risk factors are routinely assessed in community screening programs ; however , the rate of patient follow-up for health care once risk factors are identified is known to be low . This study was conducted to test the effectiveness of a brief behavioral telephonic intervention in an ongoing community stroke prevention screening program on health care seeking for stroke risk . A total of 227 participants with 2 or more stroke risk factors were r and omly allocated to either an attention control arm or a behavioral intervention arm . The control group received st and ard information on risk and advice , whereas the intervention group received a brief Health Belief Model telephonic intervention design ed to motivate care-seeking . The effect of treatment on the participants who completed a health care visit for stroke risk concerns was assessed using logistic regression . Cox survival analysis was used to compare time to physician visit between the 2 groups . Participants in the intervention arm were 1.85 times more likely to visit a primary care physician than controls . At 3 months , 69.2 % of subjects in the intervention arm and 52.9 % of those in the controls arm reported a new primary care visit after screening ( P = .02 ) , with 56.0 % in the intervention arm and 38.4 % in the control arm reporting a primary care visit specifically to discuss the stroke screening results ( P < .01 ) . Our data indicate that the brief , low-cost , motivational intervention effectively promoted adherence to screening advice and merits further testing We compared  compliance behavior in acute ( n = 670 ) and chronic ( n = 172 ) patients visiting the Emergency Department ( E.D. ) of an acute care , private hospital ; compliance was operationalized as scheduling or keeping a follow-up referral appointment originating in the Emergency Department . The purpose s of the study were to assess demographic and illness experience differences among patients and to assess the relative impact of a Health Belief Model Intervention on compliance in acute versus chronic patients . Within the acute and chronic categories patients were r and omized into four experimental groups to test the efficacy of the HBM intervention . Although chronic patients were generally more compliant than acute patients , the HBM interventions were equally effective in increasing compliance in both groups . Chronic patients were older , more likely to have had previous treatment for an illness , and more likely to regard the potential consequences of their illness as serious ; these factors were associated with greater compliance
Lack of adherence to health-promoting advice challenges the successful prevention and management of many conditions .
The Health Belief Model ( HBM ) was developed in 1966 to predict health-promoting behaviour and has been used in patients with wide variety of disease .
The HBM has also been used to inform the development of interventions to improve health behaviours .
Several review s have documented the HBM 's performance in predicting behaviour , but no review has addressed its utility in the design of interventions or the efficacy of these interventions .
The HBM has been used continuously in the development of behaviour change interventions for 40 years .