Relationship between health selfefficacy 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 and Hypothesis
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.
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
Independent T-test between Health Care
and Non-Health Care Groups
Health Care (72)
Non Health Care
(65)
M
39.06
SD
5.98
Significance
0.001
Independent Samples T-test
40
39
38
37
35.68
5.86
Mean Health
Self-Efficacy
Score
36
35
34
Post hoc Tukey test: Significant difference
between HC Student and NonHC Worker,
p=0.026
33
Health Care
Non Health Care
Results: Comparison between
components of health self-efficacy
Mann Whitney U Test
Nutrition
Mean Rank
Significance
Exercise
Alcohol
HC
NonHC
HC
NonHC
HC
NonHC
78.96
57.97
74.3
63.13
73.13
64.42
0.002
0.099
0.185
Results: Comparison between
components of health self-efficacy
*
Results of Mann-Whitney U Test
*
Mean Rank
HC NonHC
Food
HC NonHC
Exercise
HC NonHC
Alcohol
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