Health Education & Behavior

While we have several hallmarks of a mature profession, does this include a well-articulated Philosophy of Health Education? High-order questions should be important to both practitioners and researchers in health education. This address outlines why it is important for us to have a philosophy of health education, an approach that we could take in such a project, and brief illustrations of how one's philosophy of health education impacts our work. Studying philosophy is a discipline unto itself. The suggestion is made for us to take a systematic look at fundamental questions about who we are, what areas of the human condition we choose to affect, why (and in what way) we do the things we do, and what difference we are making. If using a traditional philosophical framework of inquiry, three major and important areas of questioning would be examined, falling in the areas of epistemology, ethical and moral discourse, and governance and justice. Discovering a philosophy of health education understandably could be far a field from one's research agenda. However, if the profound statement that, of all the functions that a public health department provides, health education quite possibly could be the most essential service in a democratic society is true, then it is important for us, on balance, to get it right, thus giving a strong rationale for us to discover our own brand, as opposed to a borrowed, philosophy of health education.

To understand factors influencing fruit and vegetable (F&V) consumption in children, the authors studied the association between F&V consumption in mothers and children in a sample of 1,106 boys and girls in Grades 4-6 in 24 elementary schools in low-income, multiethnic neighborhoods in Montreal, Canada. Approximately 10% of girls and 19% of boys reported not having eaten any vegetables in the week prior to questionnaire administration; 53% of girls and 63% of boys did not consume whole fruits daily. Each unit increase in F&V consumption in mothers was associated with a 10% to 20% increase in F&V consumption in children. Interventions to improve F&V consumption should aim to improve awareness among parents of the importance of fruits and vegetables and of the impact of their own behavior on their children's F&V consumption.

Obesity is a growing global concern. Examining dietary habits of individuals can facilitate the development of important prevention approaches, which are needed to decrease the incidence of obesity and other related diseases and improve quality of life indices. Because food preferences and dietary habits vary across cultures, it is essential that prevention programs are based on specific populations. Using both ethnographic and quantitative methods, food-consumption patterns were investigated among 1,125 children in the Commonwealth of the Northern Mariana Islands. Differences were observed related to food frequency, age of children, and grade level. Exploratory factor analyses suggested that the individual foods were best organized into food-consumption groups that reflected cultural characteristics rather than more commonly referenced food organizational systems. In addition to developmental differences in food consumption patterns, results suggest that the ethnicity of parents may play a role in the diet of children.

This article presents findings from a qualitative study of 53 low-income women who were smokers at the onset of pregnancy. Study participants were interviewed during pregnancy to document smoking trajectories and factors contributing to, or undermining, harm reduction and quit attempts. Thirty percent of women quit smoking completely, 43% engaged in sustained harm reduction, and 26% reduced their smoking levels intermittently. Case studies of women are presented to illustrate reasons for quitting, harm reduction practices, and factors influencing relapse and smoking continuation. Women's motivations to quit are highlighted. Moral identity as a mother was found to be a key motivating factor behind women's quit attempts. Future programs targeting this population would do well to acknowledge moral identity as an issue and recognize the challenges of quitting for women with limited social support and little control over their immediate environment.

This study evaluates the impact of a school-based intervention program on aggressive behavior among junior high school students in Japan. One hundred and four seventh-graders were enrolled in the program and completed Time 1, Time 2, and Time 3 surveys. The program was implemented in two classes between Time 1 and Time 2 surveys (the first treatment group) and in two other classes between Time 2 and Time 3 surveys (the delayed treatment group). The program included four weekly lessons related to problem solving, stress management, and communication. The initial intervention group reported a significant increase in appropriate relationships with classmates. Aggressive behavior significantly decreased from Time 1 to Time 3 in both groups and from Time 2 to Time 3 in the delayed treatment group, but no treatment group effect was noted. Additional modification of the program may be needed to achieve decreases in aggressive behavior.

Narrative is the basic mode of human interaction and a fundamental way of acquiring knowledge. In the rapidly growing field of health communication, narrative approaches are emerging as a promising set of tools for motivating and supporting health-behavior change. This article defines narrative communication and describes the rationale for using it in health-promotion programs, reviews theoretical explanations of narrative effects and research comparing narrative and nonnarrative approaches to persuasion, and makes recommendations for future research needs in narrative health communication.

Measurement of specific behaviors involved in weight management is essential to understanding the behavior change process. This study presents measures of common behavioral objectives for weight management interventions. The relationships between these measures and conventional outcomes of weight management are described. Data are from a survey of 407 adults in the rural Midwest ages 23 to 88. Analyses involved bivariate and multivariate statistical tests. Relationships were stronger when limited to diet or physical activity outcomes as opposed to body mass index or waist circumference. Diet-related strategies were more strongly correlated with diet-related outcomes than physical activity-related outcomes and vice versa. Measures of social interactions and self-monitoring for both diet and physical activity were consistently related to outcomes. The measures show promise as reliable and valid indicators of behavior that could be useful in the evaluation of interventions. Intervention studies are needed to further characterize their value and sensitivity to change over time.

This study evaluates the ability of a safer sex televised public service announcement (PSA) campaign to increase safer sexual behavior among at-risk young adults. Independent, monthly random samples of 100 individuals were surveyed in each city for 21 months as part of an interrupted-time-series design with a control community. The 3-month high-audience-saturation campaign took place in Lexington, KY, with Knoxville, TN, as a comparison city. Messages were especially designed and selected for the target audience (those above the median on a composite sensation-seeking/impulsive-decision-making scale). Data indicate high campaign exposure among the target audience, with 85%-96% reporting viewing one or more PSAs. Analyses indicate significant 5-month increases in condom use, condom-use self-efficacy, and behavioral intentions among the target group in the campaign city with no changes in the comparison city. The results suggest that a carefully targeted, intensive mass media campaign using televised PSAs can change safer sexual behaviors.