Predictors of intention to reduce stroke risk among people at risk of stroke: An application of an extended health belief model.

Purpose: To examine predictors of intention to reduce stroke risk in a sample of at risk individuals through the application of an expanded Health Belief Model (HBM). Research Method: Predictors included stroke knowledge, demographic variables, beliefs about stroke derived from the HBM, and measures of subjective norm and self-efficacy. The dependent variable was intention to reduce stroke risk. Two hundred and seventy six surveys were distributed to participants at three site types: bowling clubs, senior citizens clubs and retirement villages. One hundred and one surveys were returned yielding a response rate of 37%, and data from 76 of these respondents was used for further analysis. Results: With regard to exercise intention, a pattern of significant correlations between HBM variables, subjective norm and self-efficacy was observed. Results of multiple hierarchical regression analyses showed that perceived benefits of undertaking exercise, and self-efficacy in relation exercise were the two most important determinants of exercise intentions. Conclusions: Findings suggest that health beliefs may play an important role in stroke prevention. Practice Implications: Stroke education and prevention programs that selectively target beliefs about the perceived benefits of, and self-efficacy related to, exercise to reduce stroke risk may prove most efficacious.

[1]  W. Rosamond,et al.  Determinants of Use of Emergency Medical Services in a Population With Stroke Symptoms: The Second Delay in Accessing Stroke Healthcare (DASH II) Study , 2000, Stroke.

[2]  I. Ajzen,et al.  Prediction of goal directed behaviour: Attitudes, intentions and perceived behavioural control , 1986 .

[3]  C. Wai,et al.  Utility of the Health Belief Model in predicting compliance of screening in patients with chronic hepatitis B , 2005, Alimentary pharmacology & therapeutics.

[4]  C. Kilo,et al.  The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. , 1987, Journal of consulting and clinical psychology.

[5]  S. Juvela,et al.  Lifestyle-associated risk factors for acute brain infarction among persons of working age. , 1997, Stroke.

[6]  S. Y. Fung,et al.  Factors associated with breast self-examination behaviour among Chinese women in Hong Kong. , 1998, Patient education and counseling.

[7]  G. Chapman,et al.  Cholesterol control, medication adherence and illness cognition. , 2002, British journal of health psychology.

[8]  N L Greengold,et al.  Prevention of a first stroke: a review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. , 1999, JAMA.

[9]  H. Adriaanse,et al.  In search of factors responsible for noncompliance among tuberculosis patients in Wardha District, India. , 1992, Social science & medicine.

[10]  C. Nigg,et al.  Barriers to exercise behavior among older adults: a focus-group study. , 2005, Journal of aging and physical activity.

[11]  G. Donnan,et al.  The Avoid Stroke as Soon as Possible (ASAP) general practice stroke audit , 2002, The Medical journal of Australia.

[12]  K. Sullivan,et al.  Toward the Development of the Cerebrovascular Attitudes and Beliefs Scale (CABS): A Measure of Stroke-Related Health Beliefs , 2007, Topics in stroke rehabilitation.

[13]  G. Auld,et al.  Expanded health belief model predicts diabetes self-management in college students. , 2001, Journal of nutrition education.

[14]  Stephen L. Brown,et al.  The Health Belief Model and Compliance with CPAP Treatment for Obstructive Sleep Apnoea , 2001, Behaviour Change.

[15]  V. Champion.  The relationship of breast self-examination to health belief model variables. , 1987, Research in nursing & health.

[16]  Gabriele Oettingen,et al.  The emergence and implementation of health goals , 1998 .

[17]  D. Rutter,et al.  Do health beliefs predict health behaviour? An analysis of breast self-examination. , 1986, Social science & medicine.

[18]  P. Gollwitzer.  Implementation intentions: Strong effects of simple plans. , 1999 .

[19]  K. White,et al.  The nature and predictors of stroke knowledge amongst at risk elderly persons in Brisbane, Australia , 2006, Disability and rehabilitation.

[20]  W. Miller,et al.  Motivational Interviewing: Preparing People to Change Addictive Behavior , 1991 .

[21]  Charles Abraham,et al.  The health belief model , 2005 .

[22]  E. Roth,et al.  Physical activity and exercise recommendations for stroke survivors: an American Heart Association scientific statement from the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical , 2004, Circulation.

[23]  L. Aiken,et al.  The health belief model and adolescents with insulin-dependent diabetes mellitus. , 1992, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[24]  A. Burns.  The expanded health belief model as a basis for enlightened preventive health care practice and research. , 1992, Journal of health care marketing.

[25]  S. Straus,et al.  New evidence for stroke prevention: scientific review. , 2002, JAMA.

[26]  V. Champion.  Attitudinal variables related to intention, frequency and proficiency of breast self-examination in women 35 and over. , 1988, Research in nursing & health.

[27]  G. DeFriese,et al.  Knowledge of risk among patients at increased risk for stroke. , 1997, Stroke.

[28]  C. Warlow,et al.  Perceptions and knowledge of stroke among surviving patients with stroke and their carers. , 1994, Age and ageing.

[29]  Paul Norman,et al.  An application of an extended health belief model to the prediction of breast self-examination among women with a family history of breast cancer. , 2005, British journal of health psychology.

[30]  I. Rosenstock,et al.  Social Learning Theory and the Health Belief Model , 1988, Health education quarterly.

[31]  N. Ali.  Prediction of Coronary Heart Disease Preventive Behaviors in Women: A Test of the Health Belief Model , 2002, Women & health.

[32]  C. Braden,et al.  Utility of health belief model as a guide for explaining or predicting breast cancer screening behaviours. , 2001, Journal of advanced nursing.

[33]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .

[34]  F. Mold,et al.  Qualitative Studies of Stroke: A Systematic Review , 2004, Stroke.

[35]  M. W. Linn,et al.  Health Beliefs, Compliance, and Control of Diabetes Mellitus , 1985, Southern medical journal.

[36]  Peter Moyer,et al.  Recommendations for the Establishment of Stroke Systems of Care: Recommendations From the American Stroke Association’s Task Force on the Development of Stroke Systems , 2005, Circulation.

[37]  A. Bandura.  Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[38]  P. Gollwitzer.  Goal Achievement: The Role of Intentions , 1993 .

[39]  David Gill,et al.  Predicting health behavior , 1997 .

[40]  D L Streiner,et al.  The health belief model: predicting compliance and dropout in cardiac rehabilitation. , 1990, Medicine and science in sports and exercise.

[41]  P. Werner.  Knowledge about symptoms of Alzheimer's disease: correlates and relationship to help‐seeking behavior , 2003, International journal of geriatric psychiatry.

[42]  I. Ajzen.  The theory of planned behavior , 1991 .

[43]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[44]  R. Wikoff,et al.  Fishbein's Model of Reasoned Action and Compliance Behavior Of Hypertensive Patients , 1992, Nursing research.

[45]  L. Wallace.  Osteoporosis prevention in college women: application of the expanded health belief model. , 2002, American journal of health behavior.

[46]  P A Wolf,et al.  Primary prevention of ischemic stroke: A statement for healthcare professionals from the Stroke Council of the American Heart Association. , 2001, Circulation.

[47]  G. Hankey.  Stroke: how large a public health problem, and how can the neurologist help? , 1999, Archives of neurology.

[48]  B. Turkoski,et al.  Developing realistic treatment standards in today's economic climate: stroke survivor education. , 1999, Journal of advanced nursing.

[49]  Stroke Knowledge and Misconceptions Among Survivors of Stroke and a Non-Stroke Survivor Sample , 2005, Topics in stroke rehabilitation.

[50]  I. Ajzen,et al.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[51]  K. Sullivan,et al.  Development and Validation of the Stroke Knowledge Test , 2004, Topics in stroke rehabilitation.

[52]  T E Miller,et al.  Changes in knowledge, attitudes, and behavior as a result of a community-based AIDS prevention program. , 1990, AIDS education and prevention : official publication of the International Society for AIDS Education.