Behavioral science in diabetes. Contributions and opportunities.
OBJECTIVE: To summarize the current status of behavioral research and practice in diabetes and to identify promising future directions. RESEARCH DESIGN AND METHODS: We review behavioral science contributions to diabetes in self-management and patient empowerment, interventions with children and adolescents, and special problems including blood glucose awareness training and complications such as depression. We also identify emerging areas in which behavioral science stands to make significant contributions, including quality of life, worksite and community programs, interventions using new information technologies, and translation research evaluating practical programs in representative settings. We then discuss the gap between the generally encouraging research on behavioral contributions to diabetes and the infrequent incorporation of such contributions in practice. Suggestions are made for how to close this gap, including ways to increase understanding of behavioral issues, opportunities for funding of key research and implementation questions, and how behavioral science principles can become more integrated into diabetes organizations and care. CONCLUSIONS: Changes are required on the part of behavioral scientists in how they organize and present their research and on the part of potential users of this knowledge, including other health professions, organizations, and funding agencies. Integrating behavioral science advances with other promising genetic, medical, nutritional, technology, health care, and policy opportunities promises not only to broaden our understanding of diabetes but also to improve patient care, quality of life, and public health for persons with diabetes. (+info)
Gross anatomy of the head and neck and neuroscience in an integrated first-year medical school curriculum.
The curriculum for first year medical students at the University of Cincinnati has changed. Beginning in the fall of 1998, material in the first year was presented in an Integrated Educational Program. The goal of this program was to provide students with an understanding of the normal structure, function, and development of the human body. The purpose of this report is to discuss the unique integration that occurs in a block offered during the Spring Quarter. The two components of this block are Gross Anatomy of the Head and Neck and Brain and Behavior I. Brain and Behavior I is a new offering combining neuroanatomy, neurophysiology, neurology, and a psychiatry/behavioral component. The unique combinations offered in this block are logical, educationally sound, and have been enthusiastically received by both the students and faculty. (+info)
Behavioral sampling techniques for feedlot cattle.
Continuous observations are an accurate method for behavioral measurements but are difficult to conduct on large numbers of animals because of extensive labor requirements. Thus, we sought to develop methods of behavioral data collection in feedlot cattle production systems that reasonably approximated continuous sampling. Standing, lying, feeding, drinking, and walking behaviors were examined from 224 h of continuous video from 64 heifers. Experiment 1 (n = 24 heifers) compared continuous behavioral sampling techniques (Continuous) with scan sampling using intervals of 1, 5, 10, 15, 30, and 60 min and time sampling (a technique for the periodic recording of behavior) for the first 10 min out of every 60 min. Means for each scan sampling method did not differ in estimated percentage of duration of behaviors (P > 0.05) from continuous sampling, except for scan sampling with a 60-min interval. Scan sampling with a 60-min interval differed from more frequent scan sampling intervals for all behaviors except lying. Scan sampling with short intervals (1 and 5 min) was correlated highly with Continuous for all behaviors. The longer the scan interval, the lower the correlations, especially for behaviors with short duration. Time sampling was not an accurate technique for measuring the sampled behaviors. Focal animal sampling (using continuous sampling of individuals) indicated that one heifer was representative of the entire pen of 10 animals (Continuous) for all maintenance behaviors except drinking. Scan sampling methods (1-, 5-, 10-, and 15-min intervals) were accurate methods of behavioral sampling for feedlot cattle, but scan intervals of 30 or 60 min were less accurate and less precise. Time sampling was not an accurate method because it overestimated standing and underestimated lying behaviors. Experiment 2 (n = 40 heifers) investigated the number of focal animals required to accurately represent continuous behavioral sampling for all animals. Focal animal sampling was accurate for most behaviors using as few as 1 animal out of 10 but was not an accurate method for drinking behavior unless 40% of the animals in the pen were observed. Estimates of sample sizes needed for experimental protocols are provided. Behavioral means, standard deviations, and coefficients of variation are presented along with estimates of required sample sizes. These results validate accurate, precise, and efficient methods for quantifying feedlot cattle behavior. (+info)
Citation trends of applied journals in behavioral psychology 1981-2000.
One variable with which to evaluate scientific journals is how often their articles are cited in the literature. Such data are amenable to longitudinal analysis and can be used as a measure of a journal's impact on research within a discipline. We evaluated multiple citation measures for a number of applied journals in behavioral psychology from 1981 to 2000. The results indicate a relatively consistent impact across these journals, with some evidence of growth. (+info)
Grounding a new information technology implementation framework in behavioral science: a systematic analysis of the literature on IT use.
Many interventions to improve the success of information technology (IT) implementations are grounded in behavioral science, using theories, and models to identify conditions and determinants of successful use. However, each model in the IT literature has evolved to address specific theoretical problems of particular disciplinary concerns, and each model has been tested and has evolved using, in most cases, a more or less restricted set of IT implementation procedures. Functionally, this limits the perspective for taking into account the multiple factors at the individual, group, and organizational levels that influence use behavior. While a rich body of literature has emerged, employing prominent models such as the Technology Adoption Model, Social-Cognitive Theory, and Diffusion of Innovation Theory, the complexity of defining a suitable multi-level intervention has largely been overlooked. A gap exists between the implementation of IT and the integration of theories and models that can be utilized to develop multi-level approaches to identify factors that impede usage behavior. We present a novel framework that is intended to guide synthesis of more than one theoretical perspective for the purpose of planning multi-level interventions to enhance IT use. This integrative framework is adapted from PRECEDE/PROCEDE, a conceptual framework used by health planners in hundreds of published studies to direct interventions that account for the multiple determinants of behavior. Since we claim that the literature on IT use behavior does not now include a multi-level approach, we undertook a systematic literature analysis to confirm this assertion. Our framework facilitated organizing this literature synthesis and our analysis was aimed at determining if the IT implementation approaches in the published literature were characterized by an approach that considered at least two levels of IT usage determinants. We found that while 61% of studies mentioned or referred to theory, none considered two or more levels. In other words, although the researchers employ behavioral theory, they omit two fundamental propositions: (1) IT usage is influenced by multiple factors and (2) interventions must be multi-dimensional. Our literature synthesis may provide additional insight into the reason for high failure rates associated with underutilized systems, and underscores the need to move beyond the current dominant approach that employs a single model to guide IT implementation plans that aim to address factors associated with IT acceptance and subsequent positive use behavior. (+info)
Integrating behavioral and social science into a public health agency: a case study of New York City.
In the last century, both the health and life expectancy of Americans improved dramatically. These gains were primarily the result of advances in public health. But the approaches used may not be adequate to achieve the next level of improvements in health. Because health exists in the context of social, environmental, community, religious, political, and other spheres, ecological approaches that incorporate behavioral and social science theory and methodologies may provide the best avenue for advancing health in the 21st century. In 1999, the New York City Department of Health (NYCDOH) undertook the task of integrating behavioral and social science into its public health practice. The experience serves as a case study on the integration process at a public health agency. (+info)
Use of social and behavioral sciences by public health departments in major cities.
Individual behavior and social contexts are critical determinants of health. We surveyed commissioners or their designees in 22 departments of health serving US cities of at least 500,000 people to examine their use of scientific approaches to influence individual behavior and social contexts. Each department used behavioral or social science in its work, but only four departments were judged to have integrated these approaches throughout their operations, using both centralized and decentralized structures. Degree of integration was unrelated to collaboration with universities or communities but was related to use of explicit theories. Behavioral and social sciences were employed most frequently in the areas of HIV/AIDS and maternal and child health and in the service of changing individual behavior rather than larger contexts, although across departments many health problems and approaches were involved. Commissioners generally found the approaches valuable, but articulated barriers to more widespread adoption. (+info)
The role of social and behavioral science in public health practice: a study of the New York City Department of Health.
Studies over the last decade have demonstrated the effectiveness of public health interventions based on social and behavioral science theory for many health problems. Little is known about the extent to which health departments are currently utilizing these theories. This study assesses the application of social and behavioral science to programs in the New York City Department of Health (NYCDOH). Structured open-ended interviews were conducted with executive and program management staff of the health department. Respondents were asked about the application of social and behavioral sciences within their programs, and about the benefits and barriers to increasing the use of such approaches. Themes related to the aims of the study were identified, a detailed coding manual developed, narrative data were coded independently by two investigators (kappa.85), and data analyzed. Interviews were conducted with 61 eligible individuals (response rate 88%). The most common applications of social and behavioral science were individual-level behavior change to prevent HIV transmission and community-level interventions utilizing community organizing models and/or media interventions for health promotion and disease prevention. There are generally positive attitudes about the benefits of utilizing these sciences; however, there are also reservations about expanded use because of resource constraints. While NYCDOH has successfully applied social and behavioral sciences in some areas of practice, many areas use them minimally or not at all. Increasing use will require additional resources. Partnerships with academic institutions can bring additional social and behavioral science resources to health departments and benefit researchers understanding of the health department environment. (+info)