Relationship between health self-efficacy and health care education

Researchers: Katie Cossette, MSOT/S’15

Stacey Dahm, MSOT/S’15

Stephanie Flower,

MSOT/S’15

Susan Goedeken, MSOT/S’15

Merissa Harkema, OTD/S’16

Problem

Poor health behaviors are a significant contributor to illness and mortality.

• 3 out of the 4 leading causes of death are heavily influenced by daily choices and behaviors (Hoyert & Xu, 2012)

• 1 million deaths per year in the U.S. can be attributed to tobacco use, sedentary lifestyle, unhealthy diet and alcohol use (Glanz, Rimer, & Viswanath, 2008)

How can we address poor health behaviors?

Health self-efficacy: a person’s belief that she or he can successfully perform activities which will influence her or his health

• Preliminary evidence suggests that education and knowledge can lead to higher health self-efficacy (Hawkes & Holm, 1993)

Who has high health self-efficacy? Do people working in healthcare fields believe they can change their state of health?

Purpose: To determine if the health self-efficacy of healthcare students and practitioners is significantly different from that of adults studying and working in other fields.

Importance: Health care providers play an influential role in the health behaviors of their clients.

Hypothesis: Adults working or studying in the field of healthcare will have higher health self-efficacy than adults working and studying in other fields.

Purpose and Hypothesis

Methods: Subjects

Participants: 154 individuals took the survey,137 were included in the study, recruited via Facebook and email

• Demographics: • Age: 20-35 years old, mean age 23.84 years

N Age Mean (SD) % Female

Student Health Care 58 22.67 (1.49) 86

Student Non-Health Care 22 22.59 (3.26) 74

Worker Health Care 14 25.14 (4.56) 79

Worker Non-Health Care 43 24.98 (4.18) 70

Methods: Outcome Measures

Outcome Measures: Health-Specific Self-Efficacy Scales by Schwarzer and Renner• Measures health self-efficacy related to nutrition (5 questions), physical exercise (5 questions) and alcohol resistance (3 questions)

For Physical Exercise the survey asks: How certain are you that you could overcome the following barriers?

I can manage to carry out my exercise intentions…• Even when I have worries and problems• Even when I feel depressed• Even when I feel tense• Even when I am tired

Answers on an ordinal scale: very uncertain (1), rather uncertain (2), rather certain (3), very certain (4)

Statistical Analysis

To compare aggregate means across groups:

• Independent measures T-test– compare means between individuals in HC and individuals not in HC

• 1-way ANOVA and Tukey’s Post-hoc test—compare means between four groups: HC student, HC worker, Non HC student, Non HC worker

To compare the three components (nutrition, exercise, alcohol resistance) between individuals in HC and individuals not in HC:

• Mann-Whitney U non-parametric test

Results: Aggregate Health Self-efficacy

M SDSignificanc

e

Health Care (72)39.0

6 5.98 0.001Non Health Care (65)

35.68 5.86

Independent T-test between Health Care and Non-Health Care Groups

Post hoc Tukey test: Significant difference between HC Student and NonHC Worker, p=0.026

Health Care Non Health Care

33

34

35

36

37

38

39

40

Independent Samples T-test

Mean Health Self-Efficacy Score

Nutrition Exercise Alcohol

HC NonHC HC NonHC HC NonHC

Mean Rank 78.96 57.97 74.3 63.1373.1

3 64.42Significanc

e 0.002 0.099 0.185

Results: Comparison between components of health self-efficacy

Mann Whitney U Test

Results: Comparison between components of health self-efficacy

HC NonHC HC NonHC HC NonHCFood Exercise Alcohol

Results of Mann-Whitney U Test

Mean Rank

** p<0.05

Discussion

• Hypothesis Supported• Individuals in the health care field have higher

health self-efficacy• Support for Social Cognitive Theory (Bandura,

2004)• Core determinants of self-efficacy:

• Knowledge• Outcomes expectations

• Active vs. passive information gathering• Active correlated with high SE re: physical

activity (Hirvonen et. al, 2012)

Limitations

• Convenience Sample: friends, family• High proportion of females• Possible response bias• Survey may not have addressed all health behaviors

Clinical Implications

• Health self-efficacy linked with behavior

• Clinicians are aware of potential differences in health self-efficacy between themselves and their clients

Future Research

• Difference in actual health behaviors of population?• Causality?

• Knowledge high self-efficacy?• People with high self-efficacy choose health care?

Summary / Conclusions

• There is a significant difference in overall health self-efficacy between those in the health care field and individuals who work and study in other fields

• Nutrition was the only area of significant difference

• The largest difference in health self-efficacy was between health care students and non-health care workers