2. Health behaviour change Flashcards
What is the number one cause of preventable illness and death?
Smoking
On average, how many years younger do cigarette smokers die than non-smokers?
10 years younger
What proportion of men and women are overweight or obese?
- 7/10 men
* 6/10 women
Why are we getting fatter?
- Genetic predisposition to have a higher weight
- Medical conditions (e.g. thyroid conditions) can contribute)
- Social factors, contributing to how much we can afford to eat
- Societal influences - emotional eating
What are the 5 modern day killers?
- Dietary excess
- Alcohol
- Lack of exercise
- Smoking
- Unsafe sexual behaviour
What is health behaviour?
- Any activity for the purpose of preventing disease, or detecting it at an asymptomatic stage
- Undertaken by an individual believing themselves to be healthy
At what 3 levels are behaviour change interventions often offered at?
1) Population level e.g. NHS nationwide programmes - cervical screening
2) Community level e.g. weight-loss programme in a London borough
3) Individual level
What type of health education works and doesn’t work?
- Campaigns now focus on positive emotions e.g. confidence, lack of judgement etc.
- Earlier campaigns focused on negative emotions e.g. guilt, shame and embarassment
- This didn’t work
What are the cues for unhealthy eating?
- Visual (sweets at checkout)
- Auditory (ice cream van)
- Olfactory
- Locatory (couch)
- Time (end of TV programme)
- Emotional
Give examples of the following which encourages eating food:
• Positive reinforcement
• Negative reinforcement
• Punishment
- +ve R - praise for preparing a high-fat meal for the family
- -ve R - avoid painful emotions by comfort eating
- P - preparing a low far meal is criticised
What are stimulus control techniques for over-eating?
- Keep danger foods out of the house
- Keep biscuits in a different cupboard to tea + coffee
- Only eat at the dining table
- Use small plates
- Do not watch TV at the same time as eating
Give a question as an example of counter conditioning for over-eating
Can you think of something other than eating that makes you feel better?
What is contingency management?
Operant conditioning by stimulus control and positive reinforcement
What are naturally occurring reinforcers to controlling food intake?
- Positive - improved self-esteem
* Negative - reduction in symptoms of breathlessness
How are incentives effective at reducing smoking compared to encouraging weight loss?
Smoking cessation schemes are most effective, and weight-loss are the least effective
What are the limitations of reinforcement programmes?
- Does not improve overall health behaviour - lack of generalisation
- Poor maintenance - once reinforcer is removed => rapid extinction of desired behaviour
- Impractical and expensive
When teaching on the negative effects of certain health habits, is it better to induce no, low or high fear?
Low fear - will have the highest change in behaviour (but not no fear at all)
Who has the greatest influence of adolescent smoking?
Best friends, followed by peer groups
Using the flu vaccine as an example, give quotes as examples of the following in the Health Beliefs Model: • susceptibility • seriousness • benefits • costs • cues
• Susceptibility - “a lot of people I know have got flu
symptoms”
• Seriousness – “It’s not something to really worry
about”
• Benefits – “The vaccination will stop me getting sick”
• Costs - “The injection will be painful and it
might make me ill for a while”
• Cues – “Doctor strongly advises to have it”
Give examples of how you can use the health beliefs model for smoking cessation, by exploring the following:
• cues to action
• perceived susceptibility and severity
• perceived benefits and barriers
- Cues - “has anything made you think about giving up smoking?”
- Susceptibility and severity - “how do you think it’s affecting your health?” + “what would it be like if you got cancer?”
- Benefits and barriers - “what are the pros and cons of it for you?” + “is anything stopping you from quitting?”
What is outcome efficacy?
Individuals expectation that the behaviour will lead to a particular outcome
What is self efficacy?
Belief that one can execute the behaviour required to produce the outcome
What 4 factors influence self-efficacy?
- Mastery experience - if engaged with a behaviour successfully before
- Social learning
- Verbal persuasion or encouragement
- Physiological arousal - being nervous weakens self-efficacy
In the theory of planned behaviour, what was postulated to be the main predictor for behaviour?
Intention
In the theory of planned behaviour, what was initially thought to influence intention, and what 2 factors have been added to this influence?
• Attitudes to behaviour
- Perceived behavioural control
- Subjective norm
What are the stages in the transtheoretical model?
(• Pre-contemplation) • Contemplation • Preparation • Action • Maintenance • Relapse
Which stage of the transtheoretical model is a patient in if they say that they love to smoke and have no intention of quitting?
Pre-contemplation
Which stage of the transtheoretical model is a patient in if they say that they are worried about their health due to smoking?
Contemplation
Which stage of the transtheoretical model is a patient in if they begin to research resources and are referred to a smoking cessation programme?
Preparation stage
Which stage of the transtheoretical model is a patient in if they try to reduce smoking?
Action stage
Which stage of the transtheoretical model involves providing patients with support?
Maintenance
