2. Health beliefs and behaviours Flashcards
Define health behaviour?
Any activity undertaken by an individual believing himself to be healthy, for the purpose of preventing disease or detecting it at an asymptomatic stage”
how can we help people adopt health behaviours?
- population level e.g NHS nationwide programmes for specific populations - community level e.g. weight-loss programme offered in a london borough - individual level: e.g. direct implementation of intervention with a patient
what does learning theory involve?
cues e.g. for unhealthy eating: - visual: fast food signs, sweets at checkout - auditory: ice cream bell - olfactory: smell of baked bread - location: couch/car - time: evening/events - emotional: bored/stressed
does fear arousal work?
targeting fear can be useful, but is not effective in changing behaviours all the time if enough fear is not aroused people don’t engage with the message at all
what is involved in the health beliefs model?
The health belief model attempts to explain and predict health behaviours. It suggests that the likelihood of someone making health behaviour change is determined by their perceived susceptibility to adverse outcomes and the perceived severity of those outcomes along with the perceived benefits and barriers to making a change. These are modified by characteristics of the individual and the presence of a trigger or cue to action.
- perceived susceptibility: e.g. “a lot of people i know have flu symptoms” - perceived seriousness: e.g. “its not something to worry about” - perceived benefits: e.g. “i won’t get sick” - perceived costs/barriers: e.g. “the injection will be painful and may make me ill” - cues to action: doctor advises it - background variables: age, sex, ethnicity (see diagram)
For example, the decision to get a flu vaccine:
- 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/barriers - “The injection will be painful and it might make me ill for a while”
- Cues – Doctor strongly advises to have it.
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
Outcome efficacy – Individuals expectation that the behaviour will lead to a particular outcome
Efficacy expectancy – Belief that one can execute the behaviour required to produce the outcome (Bandura 1977)
what factors influence self-efficacy?
1. mastery experience: if we have engaged with a behaviour before (and successfully) we are more likely to have higher levels of self-efficacy
2. social learning: surrounding yourself with people who have already made the change you wish to make
3. verbal persuasion/encouragement: particularly from SOs
4. physiological arousal: if we are nervous about performing a behaviour, self-efficacy is often weaker
what were the early stages of the theory of planned behaviour referred to and what was it about?
the theory of reasoned action intention was the main predictor for behaviour, intention would be influenced by attitudes to the behaviour
what does the theory of planned behaviour involve?
The Theory of Planned Behaviour is based on the idea that a person’s intention is the key determinant in predicting behaviour. The intention is influenced by the individual’s pros and cons towards the behaviour which form the attitude, and what the person believes others important to them think about the behaviour and their motivation to adhere to those beliefs. It also acknowledges the importance of self-efficacy or perceived behavioural control.
Theory of planned behaviour is a theory that links one’s beliefs and behaviour.
This is similar to the HBM but added dimension of subjective norm – i.e. what society/friends/certain individuals (opinions that you may value) may think
This model can also be used when discussing behavioural change to patients = explore their attitudes and perceptions
Subjective norm is the beliefs about important people’s attitudes towards the behaviour. This could be the beliefs you have about your parents attitude towards smoking cessation. Do you (as the patient) believe your parents find this important?
there are 2 factors other than ‘attitudes towards behaviour’ that are involved: 1. perceived behavioural control - the perception of being able to manage the behaviour (e.g. if friends are doing dry Jan you might think you should resist any peer pressure to go out and drink) 2. subjective norm - norms that are established amongst our SOs about a particular topic
describe how you would promote smoking cessation using the theory of planned behaviour
- explore attitudes towards smoking: what do you think about smoking? is it good or bad for you? - explore the norms of SOs: what do your family/friends think? - explore whether they intend to quit - explore how much control they think they have: do you think you can quit?
what are the stages in the transtheoretical model?
- PRE-CONTEMPLATION: does not recognise the need for change or is not actively considering change 2. CONTEMPLATION: recognises problem and is considering change 3. PREPARATION: is getting ready to change 4. ACTION: is initiating change 5. MAINTENANCE: is adjusting to change and is practicing new skills and behaviour to sustain change 6. PERMANENT EXIT or RELAPSE: either leaves the model or relapses which starts the cycle again (–> contemplation)
What approaches help people to adopt health behaviours?
Smoking Education in Schools (Nutbeam et al, 1995)
Effect of positive reinforcement (Kegels et al, 1978)
Effect of negative reinforcement (Janis & Fesbach, 1953)
What is the expectancy value theory?
The potential for a behaviour to occur in any specific situation is a function of the expectancy that the behaviour will lead to a particular outcome and the value of that outcome” (Rotter 1954)
