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There is a growing interest in this country in primary prevention as a means to prevent morbidity and mortality and lower health care costs (Woolf, 1999) Evidence-based primary prevention methods such as smoking cessation, exercise, and lowering cholesterol and blood pressure can prevent significantly more deaths than do mainstream tertiary prevention techniques such as the use of ACE inhibitors, b-blockers, aspirin, and warfarin in patients with cardiovascular disease (Woolf, 1999) Primary prevention (eg, stopping smoking and becoming physically active) is also superior to secondary prevention (eg, mammography) for decreasing mortality risk in breast cancer (Woolf, 1999) Thus, isolating psychosocial factors that predict the adoption and maintenance of health behavior changes at the earliest time is a major mission of behavioral scientists and organizations such as the National Institutes of Health (NIH).

It has become clear, however, that bringing about and, especially, sustaining such behavior changes can be difficult and complex for most people Health psychologists have been able to make a significant contribution through behavioral research that identifies psychosocial variables associated with the adoption and maintenance of specific health activities These variables include cancer risk behaviors such as smoking, excessive exposure to ultraviolet rays, unprotected sexual behaviors, and obesity and overeating (eg, L Glanz, Lew, Song, & Cook, 1999; Rock et al, 2000) Psychosocial factors associated with engaging in these types of risk behaviors include, but are not limited to, an individual s: cognitive appraisals of self-worth, current health status, perceived susceptibility to disease, general outlook toward the future, the health protective effects of ceasing the risk behaviors, and the personal efficacy for making behavior changes (Becker, Maiman, Kirscht, Haefner, & Drachman, 1977; McCann et al.

, 1995; Rosenstock, 1974; Turk & Meichenbaum, 1989); repertoire of coping strategies for dealing with internal and external forces that perpetuate the practice of the behaviors; available external resources for gaining the tangible informational, spiritual, and emotional support necessary to make.

extended network (labeled social integration) in a randomly selected sample of 50-year-old men in Sweden The men were followed for six years Both attachment and social integration were lower in men who contracted coronary artery disease, and the associations remained signi cant after controlling for other risk factors Pulmonary Disease One study has examined the role of social support in pulmonary disease Grodner and colleagues (1996) studied both satisfaction with support and the number of persons in the support network as predictors of forced expiratory volume (FEV), maximum oxygen uptake during a treadmill test, exercise endurance, perceived breathlessness, and perceived fatigue Participants were enrolled in a rehabilitation program The association of baseline social support with sixyear mortality was also assessed Results indicated that the number of network members was predictive or there was improvement in perceived breathlessness after the rehabilitation, but support satisfaction was not associated with indices of improvement.

When you get ready to build a file, Acrobat prompts you for the index filename. By default the text you type in the Index Title field is listed in the File name field in the Save Index File dialog box. This dialog box opens when you click the Build button in the Catalog dialog box (see the section Building the index later in this chapter). In most cases where you supply a name as a description in the Index Title, you ll want to change the filename to a name consistent with standard DOS conventions (that is, eight-character maximum with a three-character maximum extension). Make this change when you are prompted to save the file. If you see an index name grayed out, the index is not available to your Acrobat viewer. You may have moved the index file to another location on your hard drive, deleted the file, or tried to search an index on a CD-ROM that is not mounted. In order to bring back the index and make it available to your viewer you need to delete the grayed out index name by clicking the Remove button and then add the file or rebuild and Add the file in the Index selection dialog box.