Background: Health-related Habits (HrH) are a major priority in healthcare. However there is little agreement on whether exercise, diet, smoking or dental hygiene are better described as lifestyles, habits or behaviors, and on what is their hierarchical relationship. This research is aimed at representing the basic concepts which are assumed to constitute the conceptual framework enabling us to interpret and organize the field of HrH. Methods: A group of 29 experts with different backgrounds agreed on the definition and hierarchy of HrH following an iterative process which involved framing analysis and nominal group techniques. Results: Formal definitions of health-related behavior, habit, life-style and life-style profile were produced. In addition a series of basic descriptors were identified: health reserve, capital, risk and load. Six main categories of HrH were chosen based on relevance to longevity: diet/exercise, vitality/stress, sleep, cognition, substance use and other risk. Attributes of HrH are clinical meaningfulness, quantifiability, temporal stability, associated morbidity, and unitarity (non-redundancy). Two qualifiers (polarity and stages of change) have also been described. Conclusions: The concepts represented here lay the groundwork for the development of clinical and policy tools related to HrH and lifestyle. An adaptation of this system to define targets of health interventions and to develop the classification of person factors in ICF may be needed in the future.
References
[1]
Horder, T. Health with happiness. Br. Med. J. 1937, 2, 858–859, doi:10.1136/bmj.2.4008.858.
[2]
Lalonde, M. A New Perspective on the Health of Canadians (Lalonde report 1973–1974); Minister of Supply and Services: Ottawa, ON, Canada.
[3]
Kilmer, G.; Roberts, H.; Hughes, E.; Li, Y.; Valluru, B.; Fan, A.; Giles, W.; Mokdad, A.; Jiles, R. Surveillance of certain health behaviors and conditions among states and selected local areas-behavioral risk factor surveillance system (BRFSS), United States, 2006. MMWR Surveill. Summ. 2008, 57, 1–188.
[4]
Hart, T.L.; Craig, C.L.; Griffiths, J.M.; Cameron, C.; Andersen, R.E.; Bauman, A.; Tudor-Locke, C. Markers of sedentarism: The joint Canada/U.S. survey of health. J. Phys. Act. Health 2011, 3, 361–371.
[5]
Hamer, M.; Kivimaki, M.; Steptoe, A. Longitudinal patterns in physical activity and sedentary behaviour from mid-life to early old age: A substudy of the Whitehall II cohort. J. Epidemiol. Community Health. 2012, 12, 1110–1115, doi:10.1136/jech-2011-200505.
[6]
U.S. Department of Health and Human Services (HHS). Healthy People 2010: Understanding and Improving Health; U.S. Government Printing Office (GPO): Washington, DC, USA, 2000.
[7]
McCartney, G.; Hanlon, P. What can health professionals contribute to the challenge of sustainability? Public Health 2009, 123, 761–764, doi:10.1016/j.puhe.2009.09.008.
[8]
Grandes, G.; Sanchez, A.; Sanchez-Pinilla, R.O.; Torcal, J.; Montoya, I.; Lizarraga, K.; Serra, J. Effectiveness of physical activity advice and prescription by physicians in routine primary care: A cluster randomized trial. Arch. Intern. Med. 2009, 169, 694–701, doi:10.1001/archinternmed.2009.23.
[9]
Jansink, R.; Braspenning, J.; van der Weijden, T.; Niessen, L.; Elwyn, G.; Grol, R. Nurse-led motivational interviewing to change the lifestyle of patients with type 2 diabetes (mild-project): Protocol for a cluster, randomized, controlled trial on implementing lifestyle recommendations. BMC Health Serv. Res. 2009, 9, doi:10.1186/1472-6963-9-19.
[10]
Grandes, G.; Sanchez, A.; Cortada, J.M.; Balague, L.; Calderon, C.; Arrazola, A.; Vergara, I.; Millan, E. Is integration of healthy lifestyle promotion into primary care feasible? Discussion and consensus sessions between clinicians and researchers. BMC Health Serv. Res. 2008, 8, doi:10.1186/1472-6963-8-213.
[11]
Sanchez, A.; Grandes, G.; Cortada, J.M.; Pombo, H.; Balague, L.; Calderon, C. Modelling innovative interventions for optimising healthy lifestyle promotion in primary health care: “Prescribe vida saludable” Phase I research protocol. BMC Health Serv. Res. 2009, 9, doi:10.1186/1472-6963-9-103.
[12]
Korhonen, I.; Mattila, E.; Ahtinen, A.; Salminen, J.; Hopsu, L.; Lappalainen, R.; Leino, T. Personal health promotion through personalized health technologies—Nuadu experience. IEEE Eng. Med. Biol. Soc. 2009, 1, 316–319.
[13]
Roma-Ferri, M.T.; Palomar, M. Analysis of health terminologies for use as ontologies in healthcare information systems. Gac. Sanit. 2008, 22, 421–433.
[14]
Moner, D.; Maldonado, J.A.; Angulo, C.; Bosca, D.; Perez, D.; Abad, I.; Reig, E.; Robles, M. Standardization of discharge reports with the iso 13606 norm. IEEE Eng. Med. Biol. Soc. 2008, 1470–1473.
[15]
Buetow, S.; Kiata, L.; Liew, T.; Kenealy, T.; Dovey, S.; Elwyn, G. Patient error: A preliminary taxonomy. Ann. Fam. Med. 2009, 7, 223–231, doi:10.1370/afm.941.
[16]
Kilic, O.; Dogac, A. Achieving clinical statement interoperability using r-mim and archetype-based semantic transformations. IEEE Trans. Inf. Technol. Biomed. 2009, 13, 467–477, doi:10.1109/TITB.2008.904647.
[17]
Salvador-Carulla, L.; Walsh, C.O.; Alonso-Trujillo, F.; Gómez, R.; de Teresa, C.; Cabo-Soler, J.R.; Cano, A.; Ruiz, M. eVITAL: A preliminary taxonomy and electronic toolkit of health-related habits and lifestyle. Sci. World J. 2012, doi:10.1100/2012/379752.
Alonso-Trujillo, F.; Walsh, C.O.; Salvador-Carulla, L. eVITAL group. Methodology for the development of a taxonomy and toolkit to evaluate health related habits and lifestyle (eVITAL). BMC Res. Notes 2010, 3, 1–5, doi:10.1186/1756-0500-3-1.
[20]
International Classification of Functioning, Disability And Health (ICF); WHO: Geneva, Switzerland, 2001.
[21]
World Health Organization. Health Promotion Glossary; WHO: Geneva, Switzerland, 1998.
[22]
Noncommunicable Diseases and Mental Health Cluster. Noncommunicable Disease Prevention and Health Promotion Department. Aging and Life Course. Active aging: A policy framework; WHO: Geneva, Switzerland, 2002.
Mezzich, J.E.; Salloum, I.M.; Cloninger, C.R.; Salvador-Carulla, L.; Kirmayer, L.J.; Banzato, C.E.; Wallcraft, J.; Botbol, M. Person-centred integrative diagnosis: Conceptual bases and structural model. Can. J. Psychiatry 2010, 55, 701–708.
[25]
Prochaska, J.O.; DiClemente, C.C. Stages and processes of self-change of smoking: Toward an integrative model of change. J. Consult. Clin. Psychol. 1983, 51, 390–395.
[26]
Prochaska, J.O.; Velicer, W.F. The transtheoretical model of health behavior change. Am. J. Health Promot. 1997, 12, 38–48, doi:10.4278/0890-1171-12.1.38.
[27]
Prochaska, J.O.; Butterworth, S.; Redding, C.A.; Burden, V.; Perrin, N.; Leo, M.; Flaherty-Robb, M.; Prochaska, J.M. Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion. Prev. Med. 2008, 46, 226–231, doi:10.1016/j.ypmed.2007.11.007.
[28]
Salvador-Carulla, L.; Gibert, K.; Ochoa, S. Definition of “Functional dependency”. Implications for health and social policy. Aten. Primaria 2010, 42, 344–345, doi:10.1016/j.aprim.2009.08.001.
[29]
Bowman, J.L. Stoicism, Enkrasia and Happiness; iUniverse Inc.: Bloomington, IN, USA, 2011.
[30]
Bertholet, N.; Cheng, D.M.; Palfai, T.P.; Samet, J.H.; Saitz, R. Does readiness to change predict subsequent alcohol consumption in medical inpatients with unhealthy alcohol use? Addict. Behav. 2009, 34, 636–640, doi:10.1016/j.addbeh.2009.03.034.
[31]
Wright, J.A.; Velicer, W.F.; Prochaska, J.O. Testing the predictive power of the transtheoretical model of behavior change applied to dietary fat intake. Health Educ. Res. 2009, 24, 224–236.
[32]
Seeman, T.E.; Singer, B.H.; Ryff, C.D.; Dienberg Love, G.; Levy-Storms, L. Social relationships, gender, and allostatic load across two age cohorts. Psychosom. Med. 2002, 64, 395–406.
Reig Redondo, J. eSalud en la Europe de las Regiones: Conferencia de alto Nivel Sobre Aspectos de Políticas de eSalud, Málaga, 10–12 Mayo 2006; Available online: http://archivo.revistaesalud.com/index.php/revistaesalud/article/viewArticle/65 (accessed on 6 May 2013).
[35]
Sedentary Behaviour Research Network. Letter to the editor: Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl. Physiol. Nutr. MeTab. 2012, 37, 540–542, doi:10.1139/h2012-024.
[36]
McEachan, R.R.; Lawton, R.J.; Conner, M. Classifying health-related behaviours: Exploring similarities and differences amongst behaviours. Br. J. Health Psychol. 2010, 15, 347–366.
[37]
Michie, S.; Ashford, S.; Sniehotta, F.F.; Dombrowski, S.U.; Bishop, A.; French, D.P. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychol. Health 2011, 26, 1479–1498, doi:10.1080/08870446.2010.540664.
[38]
Sweet, S.S.; Fortier, M.S. Improving physical activity and dietary behaviours with single or multiple health behaviour interventions? A synthesis of meta-analyses and reviews. Int. J. Environ. Res. Public Health. 2010, 7, 1720–1743, doi:10.3390/ijerph7041720.
[39]
Good Health Adds Life to Years. Global Brief for World Health Day 2012; WHO: Geneva, Switzerland, 2012.
[40]
Giannangelo, K.; Millar, J. Mapping SNOMED CT to ICD-10. Stud. Health Technol. Inform. 2012, 180, 83–87.
[41]
Geyh, S.; Müller, R.; Peter, C.; Bickenbach, J.E.; Post, M.W.; Stucki, G.; Cieza, A. Capturing the psychologic-personal perspective in spinal cord injury. Am. J. Phys. Med. Rehabil. 2011, 90, 79–96, doi:10.1097/PHM.0b013e318206c695.
[42]
Paviot, B.T.; Madden, R.; Moskal, L.; Zaiss, A.; Bousquet, C.; Kumar, A.; Lewalle, P.; Rodrigues, J.M. Development of a new international classification of health interventions based on an ontology framework. Stud. Health Technol. Inform. 2011, 169, 749–753.
