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Health Orientation

Definition

Health orientation is an individual-differences concept defined as an individual's motivation to engage in healthy attitudes, beliefs, and behaviors (Dutta, Bodie, & Basu, 2008). Essentially, health orientation represents individuals' inclinations toward their own health, and is important in understanding the extent to which individuals are willing to take responsibility for their own health (Moorman & Matulich, 1993). A person that is highly oriented toward their health is motivated to search, attend, and comprehend health information as well as perform health behaviors. Health orientation is conceptualized "as an intrinsic interest rather than an interest that is prompted by situational factors in the environment" (Dutta-Bergman, 2005a, p. 4). Thus, the greater an individual's interest in health-related issues, the stronger the likelihood of the individual engaging in health-related behaviors.

Research on individuals' motivations about their health attitudes and behaviors has shown that health motivations vary within and across populations, and that this variance can explain significant variance in health behaviors (MacInnis, Moorman, & Jaworski, 1991; Moorman & Matulich, 1993; Park & Mittal, 1985).

Suggested Measure

Dutta-Bergman (2004) measured four indicators of health orientation:
1) health consciousness
2) health information orientation
3) health oriented beliefs, and
4) healthy activities

Health consciousness (α = .72).

  1. Living life in the best possible health is very important to me
  2. Eating right, exercising, and taking preventive measures will keep me healthy for life
  3. My health depends on how well I take care of myself
  4. I actively try to prevent disease and illness
  5. I do everything I can to stay healthy

Responses were measured on a 1 to 5 scale with 1 representing "strongly disagree" and 5 representing "strongly agree."

Health information orientation (α = .87).

  1. I make a point to read and watch stories about health
  2. I really enjoy learning about health issues
  3. To be and stay healthy it's critical to be informed about health issues
  4. The amount of health information available today makes it easier for me to take care of my health
  5. When I take medicine, I try to get as much information as possible about its benefits and side effects
  6. I need to know about health issues so I can keep myself and my family healthy
  7. Before making a decision about my health, I find out everything I can about this issue
  8. It's important to me to be informed about health issues

Responses were measured on a 1 to 5 scale with 1 representing "strongly disagree" and 5 representing "strongly agree."

Health-oriented beliefs (α = .82).

  1. Eating a diet that is low in fat
  2. Eating lots of fruits, vegetables and grains
  3. Drinking plenty of water every day
  4. Taking vitamins and mineral supplements regularly
  5. Exercising regularly
  6. Not smoking cigarettes
  7. Not drinking alcohol or drinking in moderation
  8. Maintaining a healthy body weight

Responses were measured on a 1 to 5 scale based on how important participants thought that each behavior was for their overall health

Healthy activities.

  1. Eating a diet that is low in fat
  2. Eating lots of fruits, vegetables and grains
  3. Drinking plenty of water every day
  4. Taking vitamins and mineral supplements regularly
  5. Exercising regularly
  6. Not smoking cigarettes
  7. Not drinking alcohol or drinking in moderation
  8. Maintaining a healthy body weight

Participants marked each behavior that they currently perform, with a yes/no format. Responses to the activities were summed to constitute the healthy activities variable.

Gould (1988, 1990) developed a 9-item Health Consciousness Scale that aligns conceptually with Dutta's health consciousness subscale above in that is purports to tap a dispositional attitude about one's health (α = .92).

  1. I reflect about my health a lot.
  2. I'm very self-conscious about my health.
  3. I'm generally attentive to my inner feelings about my health.
  4. I'm constantly examining my health.
  5. I'm alert to changes in my health.
  6. I'm usually aware of my health.
  7. I'm aware of the state of my health as I go through the day.
  8. I notice how I feel physically as I go through the day.
  9. I'm very involved with my health.

Responses were collected on a 4-point scale, where 1=describes you very little to 4=describes you very well.

Rationale for selection

These items were chosen because they represent a range of contexts in which health orientation has been reliably measured. The measure (and subscales) chosen can be adapted to a particular health context under study.

Reliability

The subscales above show reliabilities ranging from .72 (health consciousness) to .87 (health information orientation). The last subscale, health behaviors, is a summative index of dichotomous responses.

Use of Measure (with examples)

Dutta-Bergman (2005b) measured health orientation using the four subscales found in Dutta-Bergman (2004). Analyzing data from the Porter Novelli HealthStyles database (Porter Novelli, 1999), he found the way patients were oriented toward their health impacted the extent to which they actively participated in their physician-patient relationships. Patients who were actively oriented toward health, sought out health information, held strong health beliefs, and participated in a variety of healthy activities were also more likely to actively participate in the doctor–patient relationship, and were more satisfied with that relationship than patients who were less actively oriented toward the own health. Dutta argues that this research suggests the need for tailoring the health care providers' communicative styles depending on the health orientation of the patient.

Basu and Dutta (2008) also analyzed the HealthStyles database (Porter Novelli, 1999) and found that health information orientation and health information efficacy were positively correlated with community participation, which was linked to prevention orientation, health beliefs, and health behaviors.

Additional Commentary

Subsequent research has utilized one or more subscales, depending on the research question of interest. For example, Basu & Dutta (2008) measured both health information orientation (similar to 8-item health information orientation subscale above), prevention orientation (similar to 5-item health consciousness subscale above), and health oriented beliefs (identical to health oriented beliefs above, identical α). He found that these health indexes were positively correlated with measures of community participation (e.g., wrote a letter to the local paper, worked for a political party, etc.) and that the health indexes were positively correlated with each other.

Dutta and Feng (2007) measured health orientation with two subscales: orientation toward preventative behaviors (similar to 5-item health consciousness subscale above, α = .74) and health information orientation (similar to 8-item health information orientation subscale above, α = .88). Only health orientation was a positive predictor of online community participation, measured as participation in an online discussion group on health.

Dutta (2007) found that people who reported to learn health information from different kinds of TV programs (e.g., news/magazine, talk shows, soap operas) tended to be higher across the four health orientation indexes from Dutta (2004).

Okeefe, Boyd, and Brown (1998) measured health orientations (used as separate items in a regression) attempting to determine which information channels individual reported learning the most information about preventative health care. They found that health orientations predicted learning from print media (magazine and newspaper articles) and personal media (books about health, health professionals, brochures, posters, newsletters, computer sources, and family and friends) equally well. Health orientations were less predictive (although significantly and positively) of learning about health from television. The health orientation items were:

  1. Having visited a health care provider for a routine checkup in the last 12 months
  2. How much would you say you worry about coming down with a serious, life-threatening illness (1-5)?
  3. In general, would you say your health is excellent, very good, good, fair, or poor?
  4. Overall, how interested are you in keeping up with the latest information on how to prevent illness and maintain good health (1-5)?
  5. Considering all the places you get information—television and radio, newspapers, community organizations, the mail, talking with other people—how much have you heard or read in the past 6 months about how to prevent illness and maintain good health (1-5)?

Rimal, Flora, and Schooler (1999) measured what they called "overall health orientation" as a ranking of 6 items: knowledge about health, diet self-efficacy, dietary behavior, exercise self-efficacy, exercise behavior, and smoking behavior. Significant predictors of overall health orientation were information seeking, interpersonal communication about exercises, and exposure to health booklets. They analyzed two cross sections of survey data from the Stanford Five-City Project. The overall index had an α of .56. They acknowledge the low α and note that it should not be surprising given the nature of the six items. For instance, they argue that while it may be reasonable for someone to rank high on all behaviors, it is not likely that others would rank low on all behaviors. Such variability would likely reduce the internal consistency of the index. They found that overall health orientation was positively predicted by interest in cardio-vascular disease, interpersonal communication about diet and exercise, information seeking, and health booklets, and negatively predicted by perceived risk.

Snell, Johnson, Lloyd, and Hoover (1991) tested a 50-item health orientation scale with ten subscales (5 items each. Examples of subscales are personal health consciousness, health anxiety, motivation for healthiness, etc.). Responses to each item was recorded on a 5-point Likert scale. Cronbach's α of each subscale ranged from .69 to .92.

Other indexes of health orientation exist, although they conceptually deviate from the ones proposed above. Further, their scales are available from the authors (e.g., Kreitler & Kreitler, 1991; Roden, 2004; Tai & Tam, 1997) and in some cases, require payment or permission (e.g., Cash, 2000).

References

Basu, A. & Dutta, M.J. (2008).

The relationships between health information seeking and community participation: The roles of health information orientation and efficacy.
Health Communication, 23, 70-79.

Cash, T. (2000).

User's manuals for the Multidimensional Body-Self Relations Questionnaire, the Situational Inventory of Body-Image Dysphoria, and the Appearance Schemas Inventory. Available from the author at http://www.body-images.com.

Dutta, M.J. (2007).

Health information processing from television: The role of health orientation.
Health Communication, 21, 1-9.

Dutta, M.J., Bodie, G.D., & Basu, A. (2008).

Health disparity and the racial divide among the nation's youth: Internet as a site for change? In A. Everett (Ed.),
Learning race and ethnicity: Youth and digital media (pp. 175-198). The John D. and Catherine T. MacArthur Foundation Series on Digital Media and Learning. Cambridge, MA: The MIT Press.

Dutta, M.J. & Feng, H. (2007).

Health orientation and disease state as predictors of online health support group use.
Health Communication, 22, 181-189.

Dutta-Bergman, M. (2004).

Primary sources of health information: Comparison in the domain of health attitudes, health cognitions, and health behaviors.
Health Communication, 16, 273-288.

Dutta-Bergman, M. (2005a).

Psychographic profiling of fruit and vegetable consumption: The role of health orientation.
Social Marketing Quarterly, 11, 1-20.

Dutta-Bergman, M. (2005b).

The relation between health-orientation, provider-patient communication, and satisfaction: An individual-difference approach.
Health Communication, 18, 291-303.

Gould, S. J. (1988).

Consumer attitudes toward health and health care: A differential perspective.
Journal of Consumer Affairs, 22(1), 96-118.

Gould, S. J. (1990).

Health consciousness and health behavior: the application of a new health consciousness scale.
American Journal of Preventive Medicine, 6(4), 228-37.

Kreitler, S. & Kreitler, H. (1991).

The psychological profile of the health-oriented individual.
European Journal of Personality, 5, 35-60.

MacInnis, D. J., Moorman, C., & Jaworski, B. (1991).

Enhancing and measuring consumers' motivation, opportunity, and ability to process brand information from ads.
Journal of Marketing, 55, 32–53.

Moorman, C., & Matulich, E. (1993).

A model of consumers' preventive health behaviors: The role of health motivation and health ability.
Journal of Consumer Research, 20, 208–228.

O'Keefe, G.J., Boyd, H.H., & Brown, M.R. (1998).

Who learns preventive health care information from where: Cross-channel and repertoire comparisons.
Health Communication, 10, 25-36.

Park, C. W., & Mittal, B. (1985).

A theory of involvement in consumer behavior: Problems and issues. In J. Sheth (Ed.),
Research in consumer behavior (pp. 201–231). Greenwich, CT: JAI.

Porter Novelli. (1999).

HealthStyles syndicated survey data. Washington, DC: Author.

Rimal, R.N., Flora, J.A., & Schooler, C. (1999).

Achieving improvements in overall health orientation: Effects of campaign exposure, information seeking, and health media use.
Communication Research, 26, 322-348.

Roden, J. (2004).

Validating the revised Health Belief Model for young families: Implications for nurses' health promotion practice.
Nursing and Health Sciences, 6, 247-259.

Snell, W.E., Johnson, G., Lloyd, P.J., & Hoover, M.W. (1991).

The health orientation scale: A measure of psychological tendencies associated with health.
European Journal of Personality, 5, 169-183.

Tai, S.H.C. & Tam, J.L.M. (1997).

A lifestyle analysis of female consumers in greater China.
Psychology & Marketing, 14, 287-307.