181523 A latent variable structural path model of health behaviors after spinal cord injury

Tuesday, October 28, 2008: 9:00 AM

James S. Krause, PhD , College of Health Professions, Medical University of South Carolina, Charleston, SC
Karla S. Reed , College of Health Professions, Medical University of South Carolina, Charleston, SC
John J. McArdle, PhD , Department of Psychology, University of Southern California, Los Angeles, CA
Jennifer Coker, MPH , College of Health Professions, Medical University of South Carolina, Charleston, SC
Background: We developed a latent behavioral model by identifying the factor structure of health behaviors and their relationships with biographic, injury, and educational characteristics.

Design: Survey

Methods: 1388 adults with traumatic spinal cord injury (SCI) of at least one year duration participated. Risk and protective health behaviors were measured by selected items from the Behavioral Risk Factor Surveillance System, the CAGE, and a SCI health survey.

Results: Latent variable structural equation modeling was used to identify the underlying factors and model the relationship of the factors with biographic, injury, and educational characteristics. After a random split of the participant sample, 7 common factors were clearly indicated by the exploratory factor analysis and were cross-validated using confirmatory factor analysis. They included: (a) healthy nutrition, (b) unhealthy nutrition, (c) fitness, (d) smoking, (e) alcohol use, (f) prescription medications, and (g) SCI healthy activities. Although education level was positively correlated with protective dimensions and negatively correlated with risk dimensions, other characteristics were not as consistently related to either risk or protective domains. For instance, participants with the most severe injuries were lower on smoking and alcohol but higher on psychotropic medications; age was positively correlated with healthy nutrition and negatively correlated with alcohol and tobacco use but also negatively correlated with fitness.

Conclusion: The results suggest that risk and protective behaviors should be evaluated on multiple dimensions. It is important rehabilitation professionals look at patterns of health behaviors and the potential consequences in order to promote health and prevent secondary complications.

Learning Objectives:
1. Identify the two primary components of structural equation modeling – the measurement model and the latent model. 2. List three protective behavioral dimensions that may become the focus of interventions. 3. List three risk behavioral dimensions that may be the focus of interventions.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an author on the accepted manuscript of the same topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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