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The extensive physical remodeling of a psychiatric admissions ward was conducted to investigate the relationship between ward design and patient behavior. This paper presents an analysis of important changes in the ward social system, including staff role relationships, distribution of power, and communication styles, which were generated by the physical changes and mediated the effects on patient behavior. The social system impacts are conceptualized as operating through a time-ordered process of environmental change involving four phases-petrification, unfreezing, resistance, and personalization. Psychological issues underlying the translation of environmental change into change at the level of the ward social system are discussed. Finally, comparisons are drawn between interventions based on environmental strategies and those based on organizational development techniques.

The purpose of this study was to employ cognitive mapping and behavioral mapping strategies in conjunction, using the behavioral data to lend both credence and elucidation to the cognitive mapping findings. Cognitive maps of a university campus were collected from 104 students enrolled in an undergraduate psychology class. We predicted that both observed and reported behavior patterns in the environment would be directly related to those spatial areas which were emphasized or excluded in the cognitive maps and to subjective distortions in mapping. The study's findings provided strong support for the proposed hypotheses.

Purpose. The present study investigated an unexplored health behavior pathway: the association between living with a smoker and physical inactivity. Design. The study performed an analysis of cross-sectional data from the second wave of the Survey of Midlife Development in the United States (2004–2006). Subjects. The sample included 1050 women and 945 men, ages 30 to 84 years (mean, 56.5 years). Measures. In addition to control variables, survey items indexed presence of a smoker in the respondent's home, and physical inactivity and low health commitment on the part of the respondent. Analysis. Analysis employed multiple logistic regression analyses, controlling for sociodemographic factors as well as health restrictions on physical activity and respondents current smoking status. Results. Living with a smoker was linked to 56% higher odds of physical inactivity. Low health commitment mediated this association. Living with a smoker was linked to lower health commitment (B = .31), and low health commitment was linked in turn to increased odds of physical inactivity (odds ratio, 1.36). Conclusions. The increased health risk among individuals living with a smoker is assumed to be a function of exposure to secondhand smoke. We demonstrate an unexplored behavioral pathway involving a link between living with a smoker and physical inactivity. These findings suggest that household smoking bans may have broad health behavior effects beyond reducing smoking.

This study investigated the effect of visual distraction on reaction time to a target stimulus in a simulated traffic environment. Subjects viewed slides of simulated roadside signs, some of which included a traffic stop sign. Reaction time was measured to their "stop" or "go" response. As predicted, the number and color of distractors, as well as the proximity of distractors to the target stop sign, all had significant effects on reaction time: In addition, all two-way interactions between the distractor dimensions were statistically significant. Practical suggestions for reducing visual distraction in the traffic environment are discussed.

Purpose: We hypothesized that living with a smoker would be positively associated with general and central adiposity among middle-aged and older women. Design: Prospective across up to 8 years. Setting: Women's Health Initiative Observational Study. Sample: A total of 83 492 women (age 50-79 at baseline). Measures: The predictor was living with a smoker at baseline. Outcomes were clinic-assessed obesity and high waist circumference, examined cross-sectionally at baseline and prospectively at year 3 and (for self-reported obesity) year 8. Analysis: All analyses used logistic regression and controlled for sociodemographic factors and participants' current smoking; prospective analyses also adjusted for baseline obesity or high waist circumference. Results: Living with a smoker was associated (1) cross-sectionally with obesity (n = 82 692, odds ratio [OR] = 1.38, P < .001) and a high waist circumference (n = 83 241, OR = 1.41, P < .001) and (2) prospectively with obesity (n = 68 753, OR = 1.22, P < .001) and a high waist circumference (n = 68 947, OR = 1.22, P < .001) 3 years later and obesity (n = 38 212, OR = 1.21, P < .001) 8 years later. Conclusion: These results document an essentially unrecognized health risk associated with living with a smoker. For practitioners, these findings underscore the need for innovative household-level interventions for families living with a smoker integrating established smoking and obesity prevention efforts.

Purpose. To examine the relationship between the presence of smokers in the workplace and smokers in the home and current smoking status among employed men and women. Design. Analysis of data from the second wave of the nationally representative Survey of Midlife Development in the United States (2004–2006). Subjects. Sample of 627 currently employed men and women, aged 34 to 82 (M = 51), who had been regular cigarette smokers at some time. Measures. Survey items indexing presence of smokers in the respondents' immediate work area and home and their current smoking status. Analysis. Multiple logistic regression analyses, controlling for age, gender, education, race, and job type. Results. Examined together, smokers in the workplace (OR = 2.83) and smokers in the home (OR = 6.09) were uniquely associated with current smoking status. Moreover, smokers in the home reduced the association between smokers in the workplace and current smoking. The presence of smokers in the workplace was associated with a more than fourfold increase in current smoking among respondents with no smokers in the home, but was unrelated to current smoking among respondents with smokers in the home. Conclusions. Failure to consider the presence of smokers in the home significantly limits the potential impact of workplace smoking interventions.

Purpose. This study examined the relationship between depressive symptoms and cigarette smoking in a large sample of American workers. Methods. We used data from the National Survey of Midlife Development in the United States. Seventy percent of individuals completed a telephone survey. The present study focused on 2593 individuals working for pay. Measures included depressive symptoms, job level, and current smoking status. Results. In a logistic regression analysis, depressive symptoms significantly predicted smoking status among workers (p < .01). In follow-up x2 analyses, the link between depressive symptoms and smoking was consistent across gender (p < .01) and job levels (p < .01). Discussion. Depressive symptoms among workers present an underlying obstacle to the success of worksite smoking cessation efforts. Findings highlight the need for increased cooperation between workplace mental health and medical health promotion programs and for tailoring smoking cessation programs to depressed workers. Limitations include self-report cross-sectional data and an underrepresentation of minority group members and individuals of low socioeconomic status.