Study on Public Health Behavior against the Background of COVID-19 Pandemic - Based on Bandura Reciprocal Determinism

Objective To explore the factors influencing public health behaviors in China in the context of COVID-19 pandemic,and to propose suggestions and countermeasures for enhancing public health behaviors.Methods A public health behavior system based on Bandura’s reciprocal determinism was constructed,and public health behavior was analyzed from the perspective of the interaction of health awareness,health behavior and environment.Results and Conclusion The public health behavior was analyzed through the public health behavior system based on Bandura’s reciprocal determinism,and the results and conclusions were draw.The public can be urged to develop better health beliefs and form better health behaviors by strengthening publicity and interventions,improving personal awareness,and increasing government investment.

Social Determinants of Health Behaviors in Primary School Children：A Cross-sectional Study of both Migrant and Resident Children in Beijing,China

Childhood risky behaviors always result in adverse health outcomes. These behaviors are greatly affected by social environment and individual factors. However, few studies explored the social determinants of schoolchildren＇s health behaviors. In this cross-sectional study, the social determinants of health behaviors were examined among both migrant and resident students in Beijing, China. Data of 967 children from six urban and suburban primary schools were analyzed using multiple linear regression analysis. The results showed that less than 60% of children performed some healthy behaviors, although their health knowledge was generally good. Children＇s health behavior scores were greatly determined by school characteristics, health knowledge, demographic characteristics, and family context. Therefore, improving health education and conditions in primary schools is the priority to promote children＇s healthy behaviors, especially for disadvantaged children.

Emotions,Perceptions and Health Behaviors of Adult Congenital Heart Disease Patients during COVID-19 in New York City

Background:Adults with congenital heart disease(ACHD)have increased prevalence of mood and anxiety disorders.There are limited data regarding the influence of the COVID-19 pandemic on the mental health and health behaviors of these patients.Objective:The purpose is to evaluate the perceptions,emotions,and health behaviors of ACHD patients during the COVID-19 pandemic.Methods:In this cross-sectional study of ACHD patients,we administered surveys evaluating self-reported emotions,perceptions and health behaviors.Logistic regressions were performed to determine the adjusted odds of displaying each perception,emotion and health behavior based on predictor variables.Results:Ninety-seven patients(mean age 38.3 years,46.4%female,85.6%moderate or complex lesion)completed the survey.The majority of patients reported feeling moderately or very sad(63.1%),and 48.4%of patients identified themselves as feeling moderately or very anxious.The majority of patients perceived their risk of COVID-19 as moderate or high.Females were more likely to report feeling sad and anxious(95%CI 1.06–10.96,p-value 0.039,and 95%CI 1.44–15.30,p-value=0.012,respectively),and were associated with higher odds of having a perceived increased risk of COVID-19(95%CI 1.33–10.59,p-value 0.012).There was no association between ACHD anatomic or physiologic classification and perceptions,emotions and health behaviors.Conclusions:Females were more likely to report feeling sad,anxious and an increased risk of COVID-19 in comparison to males.These findings indicate the need for mental health support and promotion of health behaviors during the pandemic amongst all ACHD patients,regardless of underlying condition.

Promoting Health Behavior Change in Canada: A Quality Improvement Project Integrating Prevention and Wellness in Frontline Care

Background: The critical need for Health Behaviour Change (HBC) for preventative care has been highlighted by the COVID-19 pandemic. This quality improvement project assessed the effectiveness and acceptability of Fountain of Health HBC tools as a minimal intervention for primary and secondary prevention among Canadian clinicians and their patients. Methods: Clinicians received HBC education and tools (paper tools and app-based) to assist their patients in setting a S.M.A.R.T (Specific, Measurable, Action-oriented, Realistic, Time-limited) goal at baseline and assessed four weeks later. Primary outcome measures were: 1) patient self-report of success at goal attainment;2) patient self-reported evaluation of change in well-being and health attitudes;and 3) clinician experience and engagement. Results: A total of 2184 clinicians received HBC education. Of these, 759 clinicians registered to participate in the project. 961 patients set S.M.A.R.T. HBC goals using either the paper tools (PT) or the app format. Patient data revealed nearly all patients (89% of PT users and 90% of app users) at least partially succeeded in attaining their goal at a four-week follow-up. Most patients (85% of PT and 80% of app users) also reported improvement in their well-being. A significant difference in health beliefs and attitudes was found in both PT (p < 0.001) and app users (p = 0.003). Conclusions: HBC is challenging. Educating and providing clinicians with HBC tools as a minimal intervention was found to be a successful health prevention strategy to improve patient well-being and health attitudes, and achieve S.M.A.R.T. goals. Results show HBC tools, education, and support for clinicians are both acceptable and effective for HBC in frontline care. These findings are relevant and timely given greater reliance on virtual care in the wake of the COVID-19 pandemic. Further research with rigorous methodology is needed to implement programs to achieve sustainable HBC to promote health on a large scale.

Exploring the Influences of Continuous Self-Management Education on the Self-Care Skills and Health Behavior of Patients with PICC Intubation

Objective:To analyze the effects of continuous self-management education on the selfcare ability and health behavior of patients with tumor through peripherally inserted central venous catheters(PICC).Methods:The period from August 2018 to August 2020 was used as the research time range,and the random number table method was used as the basis for grouping.80 patients with malignant tumors who regularly performed fixed catheter maintenance care in the PICC clinic of our hospital were admitted in the experimental group(given PICC specialist nursing,and implemented continuous self-management education),and 80 patients with PICC tube malignant tumors discharged from the superior hospital during this time range served as the control group(return to the original catheterization hospital from time to time or perform catheter maintenance care in the nursing clinic of our hospital).The self-care ability scores,health behavior scores,and complications during intubation between both groups were analyzed.Results:(1)There was no significant difference in self-care ability score and healthy behavior score between groups before the intervention,P>0.05;the self-care ability score and health behavior score of the research group were better than the control group after intervention,P<0.05;(2)After investigation,the incidence of complications in the research group(2.50%)was lower than that of the control group(10.00%),but there was no difference between the groups,P>0.05.Conclusion:Continuous self-management education has good effects on improving the self-care ability of tumor patients with PICC intubation.It can urge patients to maintain good health behaviors and reduce complications.It is worthy of promotion.

Health behaviors of Korean adults with hepatitis B:Findings of the 2016 Korean National Health and Nutrition Examination Survey

AIM To assess the frequencies of five health-related behaviors(smoking, alcohol consumption, body weight, sleep dura-tion, and physical activity) in Korean adults with chronic hepatitis B.METHODS Data were obtained from the 2016 Korean National Health and Nutrition Examination Survey. In total, 5887 subjects(2568 males, 3319 females) over 19 years old were enrolled in this study. Interviews were performed to obtain information on demographic characteristics and medical conditions. A self-administered questionnaire and medical examination were used to assess the smoking history, alcohol use, physical activity, sleep duration, and body weight of the subjects. Chronic hepatitis B was diagnosed based on detection of hepatitis B surface antigen(HBs Ag). The subjects were categorized into HBs Ag positive and negative groups, and a complex sampling analysis was conducted to compare the health behaviors between these groups.RESULTS Among males, the current smoking rate in the HBs Ag positive group was higher than that in the negative group(45.5% vs 38.5%). In the positive group, the rates of monthly and high-risk alcohol use were 70.4% and 17.6% in males and 45.9% and 3.8% in females, respectively. The rate of alcohol use was similar between the two groups [P = 0.455(males) and P = 0.476(females)]. In the HBs Ag positive group, 32.3% and 49.9% of males and 26.5% and 49.6% of females were overweight and physically inactive, respectively. High-risk alcohol consumption and physical inactivity were significantly associated with self-perceived health status.CONCLUSION Our data demonstrate that a large proportion of Korean adults with chronic hepatitis B have poor health behaviors. Further studies are needed to confirm our results.

The effect of self-employment on health, access to care, and health behavior

The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions;access-to-care measures such as a barrier to obtaining necessary health care;and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.

Availability and Equality of Health Services: The Reduction of the Influence of Social Class on Obstetric Health Behavior in Northern Bangladesh

The present study attempts to examine the influence of social class (in terms of educational qualification, the occupation of the husband and monthly family income of the respondents) on obstetric health behavior (in terms of antenatal care or ANC visits, the intake of iron tablets, tetanus toxoid vaccination of mother, types of birth attendant, sources of information about obstetric health) in some suburban places of northern Bangladesh. Mix methods have been executed to conduct the present study. A total of one hundred and twenty-five (125) women who gave birth within the last two years have been selected through purposive sampling. Besides ten (10) case studies and five (5) key informants analysis have been performed in this study. As all the variables;both dependent and independent;used in this study are categorical, the Chi-square test has been used to assess the relationship between social class and obstetric health behavior. In this study, a significant association has been found between taking of iron tablets and occupation of the husband (P = 0.026);taking of iron tablets and educational qualification (P = 0.029);vaccination of mother (TT) and educational qualification (P = 0.004), whereas the association of other variables regarding social class and obstetric health behavior has been found insignificant. So the present study shows that the influence of social class on obstetric health behavior has been significantly reduced. It is evidenced that nowadays the effect of social class on obstetric health behavior has significantly faded by the availability, equality-based health services, and services through satellite clinics in the study area. Stakeholders and concerned authorities should give top priority to the findings while developing strategies to improve the condition of maternal health of Bangladesh to acquire the aims of reducing maternal mortality to less than 70 deaths per 100,000 live births.

Identifying and Measuring Multilevel Influences on College-Aged Athletes’ Multiple Health Behavior: A Pilot Study

The current study gathered preliminary data relative to the influences on intercollegiate athletes’ multiple health behavior. A secondary objective was to inform future measurement of identified factors. A sample of 20 intercollegiate athletes participated in an open-ended survey, followed by a corresponding focus groups (≈90-minute). Qualitative data were gathered relative to the factors impacting athletes’ excessive alcohol intake, fruit and vegetable consumption (FVC), and maintenance of physical activity after college. In general, participating athletes reported influences within their social and physical environments (friends, bar accessibility, etc.) as the leading enablers of their excessive alcohol intake, while individual level influences were the most salient reasons not to drink excessively (responsibilities, health, etc.). Individual characteristics (taste preference, health, and expense) and the physical environment (availability and accessibility) were reported as the most salient levels of influence on athletes’ FVC. And when anticipating future maintenance of physical activity, athletes mostly reported individual level influences (outcome expectation, intrinsic motivation, etc.), with mention of family and friend influences. An in-depth comparison of current outcomes to similar research among young adult and athlete populations is provided, including validated measurement scales and future research suggestions. Current results provide an essential foundation for progressive research examinations among similar populations.

Gender differences of health behaviors and quality of life of Koreans with asthma

Purpose: The purpose of this study was to explore gender differences in health-behaviors and quality of life (QOL) in Koreans with asthma. Methods: Participants, selected from the 2009 Korean National Health and Nutritional Examination Survey VI, included 305 individuals (men = 128, women = 177) with asthma and over 19 years old. Health behaviors were measured by questions about disease management, health choices, and functional and psychological status. QOL was measured with the European Quality of Life-5D (EQ-5D). Results: In health behaviors, 51.3% of women and 37.7% of men suffered from wheezing at rest. About 41% of men and 10% of women were smokers. One half of the participants were not taking medication and this was not significantly different by gender. The number of women with symptoms of depression was significantly higher than men. The EQ-5D index score of women was significantly lower than that of men. Conclusion: Women with asthma were more likely to have psychological problems and discomfort than men. Understanding gender differences in asthma is important to the development of effective, tailored asthma management strategies to cope with symptoms and improve health behaviors and QOL for people with asthma.

Health behavior after intrahepatic cholestasis of pregnancy

Background: Pregnancy is an opportunity to adopt favorable health behaviors. We studied whether intrahepatic cholestasis of pregnancy (ICP) promotes favorable health behavior in later life. Design: A prospective controlled cohort study. The method was a questionnaire survey in 2010 among 575 women with ICP and 1374 controls, all having delivered between the years 1969 and 1988 in Tampere University Hospital in Finland. Questionnaires were sent to 544 ICP patients and 1235 controls. Responses were received from 1178 (response rate 66.2%). The main outcome measures concerning recent or current health behavior were smoking, alcohol consumption, physical activity, body mass index (BMI) and special diet. Results: Current smoking was less common in the ICP group than among controls (10.5% vs 15.7%, p = 0.017). Assessed by smoking pack years there was a similar difference: in the ICP group 11.7% of women had at least 10 smoking pack years compared to 18.0% of the controls (p = 0.006). Recent alcohol consumption did not separate the two groups. The groups did not differ as to reported physical activity assessed in MET units. Fewer ICP women had had BMIs of 30 or more during pregnancy compared with controls (18.8% vs 25.1%, p = 0.023). In other points of life the BMI differences were not statistically significant. Weight-loss diet and gallbladder diet were more common in the ICP group (6.3% vs 3.6%, p = 0.044, and 3.0% vs 1.3%, p = 0.038). Conclusions: Having developed ICP two to four decades earlier seemed to constitute an effective intervention for smoking habits but not for other aspects of health behavior.

Understanding the Sociocultural Health Belief Model Influencing Health Behaviors among Saudi Stroke Survivors

Understanding patients’ beliefs of stroke, especially that cultural model which influences the medical management, is important. Professionals normally hold medical knowledge only about stroke, rather than the patients’ perceptions, which leads to limitations in cultural competency. Little is known about Saudi stroke survivors’ beliefs and behaviors related to their strokes. Methods: A qualitative methodology was used to collect in-depth information from stroke survivors. From March 2010 to October 2014, 45 stroke survivors were recruited from outpatient rehabilitation clinic at King Fahad Medical City (KFMC-RH), during their follow-up treatments. Results: Thematic content analysis yielded four major themes of the causes of stroke: medical, cultural, psychological and environmental. Three major themes were determined regarding stroke interventions: medical, lifestyle and behavioral, as well as cultural interventions. Stroke is most likely to be associated with a wide range of cultural beliefs by stroke survivors, leading them to cultural behaviors and management. All of these cultural interventions were typically used as an adjunct rather than an alternative to medical care. Conclusions: Health professionals need to be aware that cultural beliefs and their management are common problems for stroke survivors undergoing rehabilitation in a hospital. This study could be one step forward to help health professionals become culturally competent when working with stroke survivors in a rehabilitation setting in Saudi Arabia.

The Effectiveness of Hyperlipidemia Prevention Intervention Designed to Affect Behavior Change: Focus on Changes in Health Behavior

Hyperlipidemia prevention intervention for behavior change was conducted on subjects in their 30s and 40s to evaluate changes in health behavior and investigate the effectiveness of these changes, with respect to early prevention and improvement of disease. Subjects were middle-aged individuals aged 30 - 49, suffering from serum lipid abnormalities. Intervention designed to affect behavior change was implemented for 3 weeks in 11 employees (nine males, two females) at five workplaces. Intervention mainly consisted of improving self-efficacy. The study’s purpose was explained and the written consent was obtained from subjects. Subjects filled questionnaires (characteristics, history of present illness, health behavior, self-efficacy scale for prevention of hyperlipidemia, etc.) both before and after intervention. Subjects recorded their physical activity using accelerometers and dietary intake photographically. Each subject created realistic behavior goals and recorded their progress using self-monitoring charts. Data were analyzed using descriptive statistics;therefore, pre- and post-intervention data were compared. Physical activity and achievement rate of goals during the first week and over the next 2 - 3 weeks were compared. Health behavior scores showed modification of behavior in a desirable direction after intervention compared with those before intervention. No significant difference in self-efficacy before and after intervention was observed. However, the subscale for diet was significantly higher after intervention compared with that before intervention. Steps, total calories, and activity calories were increased in the second and third weeks compared with those in the first week. Three weeks of intervention resulted in health behavior changing in a desirable direction. We infer that intervention in the form of self-monitoring using accelerometers that make physical activity visible was effective in leading to behavior change.

Adherence in CABG Patients: An Empirical Test of a Health Behavior Model

To benefit from a Coronary Artery Bypass Graft Surgery (CABG), patients must adhere to their therapeutic regimen. To test the extent of which the Information-Motivation-Behavioral Skills (IMB) model constructs explain the variability in adherence behaviors in CABG patients, and also to examine the relationship between the IMB model constructs, CABG patients (N = 152) were randomly assigned to either an intervention group, or a standard care control group. They completed pretest measures, and were reassessed later. Although perfect replication of the IMB model’s predicted pathways was not achieved in this study, support for several of these pathways was demonstrated. The estimated model for adherence-demonstrated good fit of the data. Motivation was a significant predictor of adherence behavior in CABG patients. These findings suggest that IMB model-based intervention that improves motivation can enhance adherence. Therefore, CABG patients’ education programs should mainly target motivation in order to affect adherence behavior.

Integrating the health belief model into health education programs in a clinical setting

The article demonstrates that health belief model(HBM)-based health education in hypertensive patients effectively improves blood pressure control and medication adherence at 3 months and 6 months.The HBM addresses perceived barriers,benefits,susceptibility,severity,and self-efficacy,leading to better health behaviors.HBM-based education has been effective in various contexts,including managing chronic diseases,promoting cancer screenings,and preventing infectious diseases.However,the model has limitations,such as cultural applicability and addressing complex health behaviors influenced by environmental factors.Future research should integrate HBM with other theories and conduct longitudinal studies to assess long-term impacts.Despite these limitations,HBM-based education significantly improves patient outcomes,highlighting its potential in health education and promotion when appropriately adapted and implemented.This reinforces the model's value in designing effective health interventions and advancing public health.

Investigation of the Oral Health Status of Patients Based on Rehabilitation Nursing

Objective: To investigate the current situation of knowledge, attitude, and practice (KAP) of oral health among rehabilitation nursing patients, and provide some reference for implementing oral health intervention measures for rehabilitation nursing patients. Method: A total of 231 nursing patients in the rehabilitation department of a tertiary hospital in this city from January 2023 to October 2023 were selected as the research subjects. Their oral health knowledge, attitudes, and behaviors were investigated, and the oral health behavior habits of patients with different genders, education levels, and disease situations were compared. Result: The total awareness rate of oral health knowledge among patients was 73.16%, and the average score of oral health knowledge was 6.58 ± 1.25 points. The overall positive rate of oral health attitude among patients is 55.70%, and the average score of oral health attitude is 5.01 ± 1.04 points. The average score for oral health behavior is 16.87 ± 5.23 points. Only 8.48%, 3.3%, 1.3%, 2.6%, and 0.87% of patients seek timely medical treatment for bleeding tooth roots, gum swelling and pain, gum bleeding, tooth pain, and dental calculus, respectively;Only 5.19% of people change their toothbrush every 3 months, and only 10.39% use the vertical brush method to brush their teeth. The scores of oral health knowledge, attitudes, and behaviors of patients are related to age, educational level, disease type, and smoking situation. The oral health knowledge and attitude scores of elderly patients were lower than those of younger patients, and the difference was statistically significant (P P P P P < 0.05). Conclusion: The oral health status of rehabilitation nursing patients is not optimistic, with a moderate level of oral health knowledge, weak awareness of oral health, and a low qualification rate of oral health behaviors. Strengthening oral health education for rehabilitation nursing patients and incorporating oral health care procedures into rehabilitation nursing procedures is of great significance.

A Cross-sectional Study of Health-related Behaviors in Rural Eastern China

Objective This study examined the status of health-related behaviors among rural residents and the factors influencing the practice of such behaviors. Methods One thousand and ninety subjects aged 15 years or over in a rural community, Anhui Province, China were surveyed. A questionnaire was used to collect information on the health knowledge, attitude and behavior of the subjects. Information on health behavior included smoking, drinking, dietary habits, regular exercises, sleeping pattern and oral health behavior. Results The prevalence of smoking and drinking in the male subjects was 46.5% and 46.9%, respectively. There was a positive significant association between smoking and drinking. Only 8.3% of all subjects ate three regular meals a day regularly. Among subjects who ate two meals a day, 89.7% did not have breakfast. Only 1.7% of subjects took part in regular exercise. About 85% of subjects slept 6 to 8 h per day. Only 38.4 % of the respondents had the habit of hand washing before eating and after using the lavatory. 79.3% of the subjects brushed their teeth every day, and among them, only 10.6 percent brushed their teeth twice a day Further analyses showed that 64.8% of subjects had 3-5 items of positive health behaviors out of 8 items and only 16.9% had six or more items. Logistical regression analyses suggested that better health behavior was affected by sex, age, years of education, income and health knowledge. Conclusion The status of health behaviors among rural residents was generally poor. It is thus urgent to reinforce health education in rural communities in China.

Multidimensional health literacy profiles and health-related behaviors in the elderly:A cross-sectional survey

Objectives:To investigate health literacy profiles using a multidimensional tool in the elderly,analyze the factors related to health literacy,and explore the relationships between health literacy and health-related behaviors.Methods:A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha,Hunan Province,between June 2020 and August 2020.We used the Health Literacy Questionnaire(HLQ)to assess the elderly’s health literacy.Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire.Latent profile analysis,Pearson’s chi-squared and ordinal logistic regression were used to analyze the data.Results:The median age of the 440 respondents was 68 years.The participants had the lowest scores in the“appraisal of health information”subscale(2.22±0.52),followed by“navigating the healthcare system”subscale(2.89±0.81)of HLQ.Based on the analysis of three profiles,respondents who were 60 e74 years(OR=2.06,95%CI:1.23e3.42,P=0.006),living in urban areas(OR=3.28,95%CI:2.17e4.94,P<0.001),with secondary education or above(OR=2.86,95%CI:1.92e4.27,P<0.001),and having health insurance(OR=1.89,95%CI:1.02e3.51,P=0.042)were significantly associated with health literacy.Statistically significant associations were found between health literacy level and health-related behaviors,including medical service-seeking behavior(χ^(2)=25.14,P<0.001),exercising regularly(χ^(2)=34.08,P<0.001),and taking a medical examination in the past 12 months(χ^(2)=24.76,P<0.001).Conclusion:The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings.It revealed the relationships of sociodemographic character-istics,including age,education level and residence,with health literacy.These findings emphasized the importance of health literacy in promoting health behaviors,guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.

Pandemic prevention and personality psychology: Gender differences in preventive health behaviors during COVID-19 and the roles of agreeableness and conscientiousness

One of the greatest public health crises in recent times,the COVID-19 pandemic,has come with a myriad of challenges in terms of health communication and public cooperation to prevent the spread of the disease.Un-derstanding which are the key determinants that make certain individuals more cooperative is key in effectively tackling pandemics and similar future challenges.In the present study(N=800),we investigated whether gen-der differences in compliance with preventive health behaviors(PHB)at the onset of the COVID-19 pandemic could be established,and,if so,whether the personality traits of agreeableness and conscientiousness could help explain this presumed relationship.Consistent with our theorizing,we found women to score higher than men on agreeableness and conscientiousness,and to be more willing to comply with a set of PHB.Importantly,both per-sonality traits were found to mediate the gender-compliance link.This means that women’s greater compliance levels with PHB could,at least in part,be attributed to their higher agreeableness and conscientiousness scores.A greater understanding of the determinants of PHB in terms of gender and associated personality traits may help identify options for developing more effective communication campaigns,both in terms of communication channel selection and message content.

Family Health History and Behavioral Change among Undergraduate Students: A Mixed Methods Study

Background: We examined family health history (FHH) as a public health intervention tool in undergraduate students. We hypothesized that the FHH assignment would positively relate to students’ FHH knowledge and health and healthcare-seeking behavioral change. Methods: Health professional students’ (n = 103) pre/post-test surveys and research papers were collected in 2011-2012, from a mid-western and southern university in the United States of America, using mixed methods research. Results: The majority of students were aged 18 - 30, women, White, had healthcare access and health insurance, and awareness of the term FHH. Significant logistic regression relationships existed between: 1) helping students understand important strengths and weaknesses in their health and quality of life and outcomes of talking with family and doctors about FHH;and 2) improving students’ understanding of what they needed to do to maintain their health and the outcome statement “FHH tells you about inherited genes.” Key themes from the research papers included actions and FHH and proposed behavioral changes. Conclusions: Quantitative findings supported the relationship between students’ assignment evaluation and knowledge change, while qualitative findings supported relationships between assignment evaluation and knowledge and behavioral change. This study highlights regional differences in students’ FHH and the need to address family support barriers to behavioral change.