Social Support Networks and Self-Efficacy of Peruvian Women Diagnosed with Cancer: A Biocultural Analysis of Health Behavior Constructs

Thesis (Ph.D.)--University of Washington, 2016-06

The role of self-efficacy in predicting rule-following behaviors in shelters for homeless youth: A test of the theory of planned behavior

Through a prospective study of 70 youths staying at homeless-youth shelters, the authors tested the utility of I. Ajzen's (1991) theory of planned behavior (TPB), by comparing the constructs of self-efficacy with perceived behavioral control (PBC), in predicting people's rule-following behavior during shelter stays. They performed the 1st wave of data collection through a questionnaire assessing the standard TPB components of attitudes, subjective norms, PBC, and behavioral intentions in relation to following the set rules at youth shelters. Further, they distinguished between items assessing PBC (or perceived control) and those reflecting self-efficacy (or perceived difficulty). At the completion of each youth's stay at the shelter, shelter staff rated the rule adherence for that participant. Regression analyses revealed some support for the TPB in that subjective norm was a significant predictor of intentions. However, self-efficacy emerged as the strongest predictor of intentions and was the only significant predictor of rule-following behavior. Thus, the results of the present study indicate the possibility that self-efficacy is integral to predicting rule adherence within this context and reaffirm the importance of incorporating notions of people's perceived ease or difficulty in performing actions in models of attitude-behavior prediction.

Acculturation and Diabetes Self-management of Cuban Americans: Is Age a Protective Factor?

Migration to the United States has been linked to obesity and poor diet quality. We investigated the relationship among diabetes self-management, diet, age and acculturation factors for 182 Cuban-Americans (Females = 110, Males = 72) with type 2 diabetes recruited from a randomized mailing list in South Florida. Inadequate glycemic control (β = 0.257), BMI (β = 0.251), total fat intake (β = 0.251), and smoking (β = 0.200), were positively associated, while understanding of overall diabetes care (β = -0.165), was negatively associated with migration (N = 162, adj.R2 = 0.286, F = 14.65, p < 0.001). These associations suggest that effective diabetes education targeting acculturation issues is lacking.

The Self as a Moral Basis: Do Our Own Patterns of Behavior Affect our Moral Attributions?

To determine which actions are morally acceptable, psychologists typically focus on decision making within existing moral paradigms. However, this fails to comment upon individual and social processes, such as attribution, that determine morality. To address these processes, this study had participants respond to morally-charged scenarios by rating the immorality of an actor who did not tip a waiter (n = 125), was partial to infidelity (n = 128), and texted while driving (n = 128). Participants also completed an empathy measure, and provided their own frequency of engaging in certain behaviors, including those featured in the scenarios. Immorality ratings were compared to the participants’ own frequency of the scenario action (hypothesized to lower ratings), as well as empathy and outcome severity (both hypothesized to increase ratings). Findings were assessed in three regressions, one per scenario. Behavioral similarity predicted immorality ratings in each (p ≤ .03), empathy predicted ratings only for not tipping a waiter (p = .04), while outcome severity was un-predictive in each scenario. Theoretical implications, directions for future research, and limitations of the study are discussed.

Prosocial behavior and self-concept of Spanish students of Compulsory Secondary Education

This study analyzed the relationship between prosocial behavior and self-concept dimensions in a sample of 2022 Spanish students (51.1% males) of Compulsory Secondary Education. The prosocial behavior was measured with the Prosocial Behavior scale of the Teenage Inventory of Social Skills (TISS) and the self-concept was measured with the Self-Description Questionnaire-II (SDQ-II). Logistic regression analyses revealed that prosocial behavior is a positive and significant statistically predictor of high scores on the following self-concept dimensions: physical ability, parent relations, same-sex relations, opposite-sex relations, verbal, school, trustworthiness, and self-esteem. Those results were found in males, females and every Compulsory Secondary education year. However, prosocial behavior is not a significant statistically predictor of high scores on physical appearance, math, and emotional stability.

Self-affirmation before exposure to health communications promotes intentions and health behavior change by increasing anticipated regret

Health-risk information can elicit negative emotions like anticipated regret that may positively affect health persuasion. The beneficial impact of such emotions is undermined when target audiences respond defensively to the threatening information. We tested whether self-affirming (reflecting on cherished attributes) before message exposure can be used as strategy to enhance the experience of anticipated regret. Women were self-affirmed or not before exposure to a message promoting fruit and vegetable consumption. Self-affirmation increased anticipated regret and intentions reported following message exposure and consumption in the week after the intervention; regret mediated the affirmation effect on intentions. Moreover, results suggest that anticipated regret and intentions are serial mediators linking self-affirmation and behavior. By demonstrating the mediating role of anticipated regret, we provide insights into how self-affirmation may promote healthy intentions and behavior following health message exposure. Self-affirmation techniques could thus potentially be used to increase the effectiveness of health communication efforts.

Changing the servicescape : The influence of music, self-disclosure and eye gaze on service encounter experience and approach-avoidance behavior

The purpose of this thesis is to investigate and understand the effect of a servicescape’s ambient and social conditions on consumers’ service encounter experience and their approach/avoidance behavior in a retail context. In three papers, with a total sample of over 1600 participants (including 550 actual consumers) and seven experiments, the author investigates the effect of music (ambient stimuli), employees’ self-disclosure (verbal social stimuli) and employees’ gazing behavior (nonverbal social stimuli) on consumers’ service encounter experience and approach/avoidance behavior in a retail store. Paper I comprised two experiments, and the aim was to investigate the influence of music on emotions, approach/avoidance behavior. Paper II comprised two experiments, and the aim was to investigate the effect of frontline employees’ personal self-disclosure on consumers’ reciprocal behavior. Paper III comprised three experiments, and the aim was to investigate the influence of employee’s direct eye gaze/ averted eye gaze on consumer emotions, social impression of the frontline employee and encounter satisfaction in different purchase situations. The results in this thesis show that music affects consumers in both positive and negative ways (Paper I). Self-disclosure affects consumers negatively, in such a way that it decreases encounter satisfaction  (Paper II) and, finally, eye gaze affects consumers by regulating both positively – and in some cases also negatively – consumers’ social impression of the frontline employee and their encounter satisfaction (Paper III). The conclusions of this thesis are that both ambient and social stimuli in a servicescape affect consumers’ internal responses, which in turn affect their behavior. Depending on the purchase situation, type of retail, and stimuli, the internal and behavioral responses are different.

[the Perception Of Behavior Related To Mindfulness And The Brazilian Version Of The Freiburg Mindfulness Inventory].

Mindfulness is a practice and a form of consciousness which has been the basis for innovative interventions in care and health promotion. This study presents mindfulness, describes and discusses the process of cultural adaptation of The Freiburg Mindfulness Inventory (FMI) to Brazilian Portuguese. From the original version of this pioneering instrument for assessing mindfulness two translations and two back-translations were made. These were evaluated by a committee of 14 experts (Buddhists, linguists, health professionals), who helped to create two versions for the first pre-test, based on which suggestions were made by a sample of 41 people of the population through interviews. Considering the difficulties in understanding the concepts that are unfamiliar to the Brazilian culture, a new version was prepared with additional explanations, which underwent a further evaluation of the experts and a second pre-test with 72 people. This process aimed at addressing the limitations and challenges of evaluating mindfulness in a country of western culture through a self-report instrument based on Buddhist psychology. With appropriate levels of clarity and equivalence with the original instrument, the Freiburg Mindfulness Inventory adapted for Brazil is presented.

Beliefs Related To Adherence To Oral Antidiabetic Treatment According To The Theory Of Planned Behavior.

to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.

Changes in parents' and self-reports of behavioral problems in Brazilian adolescents after behavioral treatment with urine alarm for nocturnal enuresis

PURPOSE: Compare parents' reports of youth problems (PRYP) with adolescent problems self-reports (APSR) pre/post behavioral treatment of nocturnal enuresis (NE) based on the use of a urine alarm. MATERIALS AND METHODS: Adolescents (N = 19) with mono-symptomatic (primary or secondary) nocturnal enuresis group treatment for 40 weeks. Discharge criterion was established as 8 weeks with consecutive dry nights. PRYP and APSR were scored by the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR). RESULTS: Pre-treatment data: 1) Higher number of clinical cases based on parent report than on self-report for Internalizing Problems (IP) (13/19 vs. 4/19), Externalizing Problems (EP) (7/19 vs. 5/19) and Total Problem (TP) (11/19 vs. 5/19); 2) Mean PRYP scores for IP (60.8) and TP (61) were within the deviant range (T score ≥ 60); while mean PRYP scores for EP (57.4) and mean APSR scores (IP = 52.4, EP = 49.5, TP = 52.4) were within the normal range. Difference between PRYP' and APSR' scores was significant. Post treatment data: 1) Discharge for majority of the participants (16/19); 2) Reduction in the number of clinical cases on parental evaluation: 9/19 adolescents remained within clinical range for IP, 2/19 for EP, and 7/19 for TP. 3) All post-treatment mean scores were within the normal range; the difference between pre and post evaluation scores was significant for PRYP. CONCLUSIONS: The behavioral treatment based on the use of urine alarm is effective for adolescents with mono-symptomatic (primary and secondary) nocturnal enuresis. The study favors the hypothesis that enuresis is a cause, not a consequence, of other behavioral problems.

Self-medication: initial treatments used by patients seen in an ophthalmologic emergency room

OBJECTIVE: This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients' use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS: We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS: The sample included 561 subjects, 51.3% males and 48.7% females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5% reported self-medicating; 29.4% used a homemade preparation (13.9% referred to an industrialized product like boric acid as a homemade preparation), and 11.1% used a manufactured product. The most frequently used products included a boric acid solution (53.3%), a normal saline solution (35.7%), herbal infusions (6.1%) and breast milk (4.8%). Viral conjunctivitis was the most frequent diagnosis (24.4%), followed by the presence of a corneal foreign body (7.4%). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION: Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries.

Surface dental enamel lead levels and antisocial behavior in Brazilian adolescents

Lead poisoning has been reportedly linked to a high risk of learning disabilities, aggression and criminal offenses. To study the association between lead exposure and antisocial/delinquent behavior, a cross-sectional study was conducted with 173 Brazilian youths aged 14\201318 and their parents (n = 93), living in impoverished neighborhoods of Bauru-SP, with high criminality indices. Self-Reported Delinquency (SRD) and Child Behavior Checklist (CBCL) questionnaires were used to evaluate delinquent/antisocial behavior. Body lead burdens were evaluated in surface dental enamel acid microbiopsies. The dental enamel lead levels (DELL) were quantified by graphite furnace atomic absorption spectrometry (GFAAS) and phosphorus content was measured using inductively coupled plasma optical emission spectrometry (ICP-OES). Logistic regression was used to identify associations between DELL and each scale defined by CBCL and SRD scores. Odd ratios adjusted for familial and social covariates, considering a group of youths exposed to high lead levels (\2265 75 percentile), indicated that high DELL is associated with increased risk of exceeding the clinical score for somatic complaints, social problems, rule-breaking behavior and externalizing problems (CI 95 per cent). High DELL was not found to be associated with elevated SRD scores. In conclusion, our data support the hypothesis that high-level lead exposure can trigger antisocial behavior, which calls for public policies to prevent lead poisoning

Exact time-dependent solutions for a self-regulating gene

The exact time-dependent solution for the stochastic equations governing the behavior of a binary self-regulating gene is presented. Using the generating function technique to rephrase the master equations in terms of partial differential equations, we show that the model is totally integrable and the analytical solutions are the celebrated confluent Heun functions. Self-regulation plays a major role in the control of gene expression, and it is remarkable that such a microscopic model is completely integrable in terms of well-known complex functions.