17 - Models in Health Psychology Flashcards
What is health?
There is no one correct definition of what health is, but we can agree that it is a complex, multifaceted concept extending beyond the pure biological aspects of an individual’s functioning
What is health psychology?
Health psychology is an interdisciplinary field concerned with the application of psychological knowledge and techniques to health, illness, and health care.
What are the two models of health and illness?
Biomedial (most common)
Biopsychological
Describe the biomedical model of illness
Most common
Symptoms of illness considered to have underlying pathology.
Removal of pathology»_space; restored health
May be mechanic, too reductionist – ignores the fact that different people respond in different ways to illness because of differences (e.g. personality, social support, cultural beliefs)
Describe the biopsychological model of illness
Psychological and social factors can add to biological or biomedical explanations and understanding of health and illness
Increases understanding and explanations of health and illness.
Diseases and symptoms can be explained by a combination of physical, social, cultural, and psychological factors
Why are models of health behaviour important?
To explain and predict why people engage in health risk or enhancing behaviours
Can provide targets for intervention, promotion and education
What are the three types of models of behaviour change
Stage Based Model of behaviour change
Social Cognitive Models of behaviour change
Models of behaviour change focusing on Past Intentional Behaviour
Describe the transtheoretical model
Stage model of behaviour change - individuals can be at ‘discrete ordered stages’, each one denoting a greater inclination to change
Provides a framework for explaining how behaviour change occurs as individuals move through stages of motivational readiness
Makes 2 broad assumptions:
- People move through -
Processes involved at each stage differ
5-7 stages; pre-contemplation, contemplation, preparation, action, maintenance, termination, relapse
not linear and you can start and re-enter at any stage
Implication; different intervations and different stages of health behaviour change
What are the criticisms for the transtheoretical model of behaviour change?
An individual may be in several stages of change at one time
Perhaps too much focus on motivation and intention- past behaviour is a more powerful predictor of future behaviour
Participants stage of change may not be predictive of success of intervention
Doesn’t consider social aspects of health behaviour, severity of illness/disease/outcome, characteristics of the individual
In the transtheoretical model, what interventions should be used at each stage?
Pre-contemplation; Individuals more likely to be using denial, may report lower self-efficacy and more barriers to change
Contemplation; More likely to seek information and may report reduced barriers and increased benefits- although may still underestimate their susceptibility
Preparation; People start to set their goals and priorities, and some will make concrete plans. Motivation and self-efficacy are crucial if action is to be elicited
Action; Realistic goal setting is crucial if action is to be maintained. Use of social support is important to receive reinforcement of change
Maintenance; Can be enhanced by self-monitoring and reinforcement
Describe the health belief model
The HBM is a social cognitive model that attempts to explain and predict health behaviours by focusing on the attitudes and beliefs of individuals
Readiness to take health action is determined by four factors;
- Perceived severity or seriousness of disease
- Perceived susceptibility of the disease
- Perceived benefits of health action
- Perceived barriers to performing action
Revisions included; demographic and psychosocial variables and cues to action
What are the criticisms of the health belief model?
Static model- does not allow for staged or dynamic process of change in beliefs which later models show
Assumption that individuals are rational information processors and decision-makers, which is not always the case
Limited account of social influences on behaviour
Describe the theory of planned behaviour model
Behaviour is thought to be determined by intention (readiness to perform behaviour)
Intention is influenced by;
- Attitude towards behaviour (outcome expectancies and evaluations)
- Subjective norm (normative beliefs and motivation to comply)
- Perceived behavioural control (affects intention and behaviour directly)
What are the strengths and criticisms of the planned behaviour model of health behaviour?
- The theory of planned behaviour addresses many of the criticisms of the health belief model (more social and behavioural)
- The relationship between variables is well defined
- Includes consideration of the social influences on behaviour
- Considers whether the individual feels able to perform the behaviour
- However…prediction of behaviour from TPB variables is significantly lower than the prediction of intention -> IBG (intention-behaviour gap)
What is the intention-behaviour gap?
- Although intentions are an important part of predicting future behaviour— not all intentions are translated into behaviour
- The inconsistency between strong behavioural intentions and subsequent behaviour has resulted in a theoretical ‘intention behaviour’ gap
- There are two main approaches to addressing the intention behaviour gap
• Adding extra variables (e.g. to the theory of planned behaviour- moral norm, self-regulation, habit)
• Developing new models to explain post-intentional behaviour
What are post-intentional models of health behaviour?
- Some researchers have developed new models to explain what happens after you form an intention to perform a behaviour
- Focus on post intentional behaviour
o Health Action Process Approach (HAPA)
o Temporal Self-Regulation Theory
Describe Health Action Process Approach to health behaviour
attempts to fill the ‘intention-behaviour gap’ by highlighting the role of self-efficacy and action plans
Requires motivation (intention) and volition (action)
Motivation phase; self-efficacy and outcome expectancies are predictors of goal intention. Perceptions of threat severity and personal susceptibility only affect motivation phase.
Volition phase; planning needs to occur. self-efficacy involved; initiative self-efficacy, coping/maintenance SE, recovery SE
What are some criticisms of the HAPA health behaviour model?
The body of literature applying HAPA to behaviour is still limited
Too rational? - emotion may be neglected
The social and environmental influences are not considered as directly affecting behaviour, but rather as cognitions
Describe the Temporal Self-Regulation Theory model of health behaviour
Addresses criticisms of theory of planned behaviour adds variables to explain intention-behaviour gap
Novel; incorporates behioural pre-potency (habits) and individual differences in self-regulatory capacity (moderate IBG)
Health behaviour is determined by three factors;
- Intention strength (function of connectedness beliefs and temporal proximity)
- behavioural pre-potency
- self-regulatory capacity
Combination of last two determines likelihood that intentions will be translated into behaviour and each has direct influences on behaviour itself
Describe behavioural pre-potency
Behavioural pre-potency examines the strength of past performance in similar contexts.
It is thought to represent a quantifiable value reflecting frequency of past performance and/or presence of cues to action in the environment
Describe self-regulatory capacity
Self-regulation includes impulse control/management of short term desires. Composed primarily of executive functioning resources through the prefrontal cortex.
Executive functioning refers to the ability of an individual to exert control over cognition, emotion, behaviour, and physiology.
Describe the criticisms of the temporal self-regulation theory model of health behaviour
o The body of research using temporal self-regulation theory is small (but growing!)
o We are still trying to find good ways to measure self-regulation and behavioural pre-potency
o It is unclear whether the model is better than the theory of planned behaviour (but it seems likely)
