Conceptualizing Psychological Wellness Care Utilization Making Use Of The Wellness Perception Product1984170

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Conceptualizing Psychological Well Being Care Utilization Working With The Overall Health Belief Design

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The HBM (Rosenstock, 1966, 1974), located in a sociocognitive viewpoint, was initially designed within the fifties by social psychologists to elucidate the failure of some individuals to work with preventative health and fitness behaviors for early detection of illnesses, client reaction to indicators, and medical compliance (Janz & Becker, 1984 ; Kirscht, 1972; Rosenstock, 1974). The theory hypothesizes that people are likely to engage inside of a given healthrelated behavior to the extent that they (a) perceive that they could contract the illness or be susceptible to the problem (perceived susceptibility); (b) believe that the problem has really serious consequences or will interfere with their daily functioning (perceived severity); (c) believe that the intervention or preventative action will be effective in reducing signs and symptoms (perceived benefits); and (d) perceive few barriers to taking action (perceived barriers). All four variables are thought to be influenced by demographic variables for example race, age, and socioeconomic status. A fifth original factor, cues to action, is frequently neglected in studies of the HBM, but nevertheless provides an important social factor related to psychological wellbeing care utilization. Cues to action are incidents serving as a reminder of the severity or threat of an illness. These may perhaps include personal experiences of signs or symptoms, including noticing the changing shape of a mole that triggers an individual to consider his or her risk of skin cancer, or external cues, such as a conversation initiated by a physician about smoking cessation. In addition, Rosenstock, Strecher, and Becker (1988) added components of social cognitive theory (Ba ndura, 1977a, 1977b) to the HBM. They proposed that one's expectation about the ability to influence outcomes (selfefficacy) is an important component in understanding health and fitness behavior outcomes. Thus, believing one is capable of quitting smoking (efficacy expectation) is as crucial in determining whether the person will actually quit as knowing the individual's perceived susceptibility, severity, benefits, and barriers.

Across diverse religious orientations, beliefs in a spiritual cause of mental illness have been associated with preference for treatment from a religious leader rather than a mental health and fitness professional (Chadda et al., 2001; Cinnirella & Loewenthal, 1999). For people who interpret psychological distress signs and symptoms as spiritually based, a religious leader might be viewed as a more beneficial provider than a traditional psychological wellbeing professional. Some clients prefer to see clergy for psychological health and fitness concerns. Some psychologists have formed relationships in between religious organizations and psychological overall health providers to foster collaboration and access to many treatment options for community members (McMinn, Chaddock, & Edwards, 1998). Benes, Walsh, McMinn, Dominguez, and Aikins (2000) describe a design of clergypsychology collaboration. Employing Catholic Social Services as a medium through which collaboration took place, psychologists, priests, religious school teachers, and parishioners collaborated through a continuum of treatment beginning with prevention (public speaking about mental wellness topics, parent training workshops) through intervention (1800 access numbers, support groups, and counseling services). The authors note that bidirectional referralsnot simply clergy referring to cliniciansand a sharing of techniques and expertise are keys to the success of these types of programs. Providing care to men and women through the source that they consider most credible or accessible is an innovative strategy for increasing perceived treatment benefits and decreasing barriers

Approximately 71% (Lipscomb et al., 2004; Thompson et al., 2004) of folks report looking to their primary care physician for mental health and fitness information, treatment, and referrals. However, many physicians lack the appropriate knowledge to identify mental health conditions (Hodges, Inch, & Silver, 2001). After examining five decades (19502000) of articles evaluating the adequacy of physician training in detecting, diagnosing, and treating psychological health, Hodges et al. (2001) offer several suggestions for improving primary care physicians' training to effectively identify patients with psychological wellbeing issues. Beyond learning the diagnostic criteria for the major disorders and providing appropriate medications when needed, however, physicians also need to be aware that they can act as a "cue to action" while in the patient seeking psychotherapy. These types of cues would alert the patient that his or her indicators of distress or depression had reached critical levels and that the trusted family physician believes additional treatment is needed.

ations for this sort of intensification of the perceptions. Examples of intervention strategies that can serve as individual or systemlevel "cues to action" will be reviewed within each domain of the model. In addition, where appropriate, the discussions will highlight how sociodemographic factors like age, sex, and ethnicity impact the perceived threat from the disorder and the expectations for the benefits of therapy. The model we discuss assumes that the individual seeking therapy is autonomous in this decision making. That is, it is not directly applicable to those who are required to seek therapy by the judicial system, a spouse, or their place of employment, nor does it address children's mental well being care utilization. We will address some of these issues briefly later in our discussion.

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