20 - Health Behaviours Flashcards
What internal/personal factors influence health?
Knowledge about risk Attitudes/beliefs Circumstances e.g. finances, time, stress Physiology/genetics
What external factors influence health?
Social support Social norms Media Laws & regulation Environment Healthcare system
How have causes of deaths changed over the years?
Switched from infectious diseases to non-communicable diseases (e.g. cancer, heart disease) Deaths more concentrated in the older ages
What are the top 5 causes for premature death?
- Cancer 2. Cardiovascular disease 3. Other 4. Respiratory disease 5. Liver disease
What are the cancer risk factors?
- Smoking, exposure to another person’s cigarette smoke - Drinking more than 1 unit of alcohol a day - Eating less than 5 portions of fruit and vegetables - Eating red or processed meat once a day or more - BMI over 25 - Getting sunburnt more than once as a child - Infection with HPV (Human Papillomavirus) - Doing less than 30 mins of moderate physical activity 5 times a week - Being over 70 - Having a close relative with cancer
What improved the transmission of infectious diseases?
- Clean water - Immunisation - Better hygiene
What is needed to improve health conditions today?
Health behaviours (laws; education campaigns; screening)
What are examples of behavioural pathogens?
- Smoking, drinking (heart disease, cancer) - Sex, contraception (HIV, STD) - Stress (immune system response, CVD)
What are examples of behavioural immunogens?
- Exercise (e.g. 20 minutes walking a day; stairs) - Balanced diet (e.g. 5 a day) - Immunisation (e.g. polio, TB, MMR) - Screening (e.g. breast, cervical, cholesterol)
How can health behaviours be changed?
Information on health risk
When using fear appeals, what must they do to be effective?
Increase people’s self-efficacy (i.e. confident that they can change) I.e. how to do it not just what to do
What are fear appeals?
Persuasive messages that arouse fear
What are reasons people keep their lifestyle behaviours?
Habit; fun; rebellious; friends; enjoyable; relaxing; happy; risk perceptions of health/ illness.
What are reasons people change their lifestyle behaviours?
External restrictions; not well; friends/ family; other changes lifestyle; values/ risk perception changes.
What are the societal causes for premature death?
Working class, ethnic minority, northern UK, male, MH, disability
What is purpose of health behaviour models?
- Outline psychological responses relevant to health - Are used to predict, explain and change behaviour - Offer explicit hypotheses regarding determinants and processes underlying behaviour - Allow us to build on and further behavioural science
How are psychological determinants involved in behaviour?
Are conceived of as proximal determinants of behaviour and assumed to mediate the influence of interventions Assumed to be more open to modification than other factors (e.g. personality) Intervention –> Psych construct –> Behaviour –> Health
I.e. target pyschological constructs in order to target behaviour
What is the COM-B Model?
The Capability, Opportunity, Motivation, Behaviour (COM-B) model Implies behaviour occurs as an interaction between these 3 necessary conditions
What is ‘capability’?
Psychological or physical ability to enact the behaviour Includes things like knowledge, physical and mental skills, mobility, and strength
What is motivation?
Reflective and automatic mechanisms that activate or inhibit behaviour Intentions and evaluations (‘reflective’ motivation), and desires, emotions and habits (‘automatic’ motivation)
What is opportunity?
Physical and social environment that enables the behaviour
What is the COM-B Model used for?
This model seeks to aid our understanding of barriers and facilitators of behaviour through categorising them as related to our capability, opportunity or motivation. If one or more of the factors are deficit, then it is less likely behaviour change will occur.
Use the COM-B model in regards to trying to increase physical activity
M - Do people want to do this? O - Easier by improving cycle routes or access to gym facilities C - Providing cycling proficiency
What did Ajzen and Madden come up with?
The Theory of Planned Behaviour
What is the Theory of Planned Behaviour?
Motivational theory
Behavioural change determined by attitude, subjective norms and perceived behavioural control
What are the strengths of the Theory of Planned Behaviour?
- Identifies constructs and behaviour to change, not the disease
- Links beliefs to behaviour
- Has been shown to predict behaviour well (but better at intentions)
- Identifies potential targets for health promotion intervention
- Can be used to study the population and identify specific beliefs
- Highlights the importance of society (norms)
What are the weaknesses of the Theoery of Planned Behaviour?
- Intention-behaviour gap
- Perceived Behavioural Control is both a proxy for actual control and a measure of confidence in one’s own ability
- Superior prediction over other models may be only due to better definition of constructs (causality?)
- Provide only targets for behaviour change, not methods for change
- Assume that people are rational and deliberative
What was Bandura’s theory on behaviour?
Social Congition Theory –> behaviour governed by: expectancies about behaviour and self-efficacy, incentives or consequence behaviour, social cognitions – people representations of the social world
What are the limits of health behaviour models?
- Causality rarely tested
- Assumes that people are rational and deliberative, what about impulsive health actions?
- Provides only targets for behavioural change, not methods for change
What are habits?
Relatively automatically triggered actions formed through a repetition in a consistent context
Can be used to help people learn healthy behaviours
What are the benefits of habit-based interventions?
- Require less engagement or motivation
- Less time-consuming to explain
- Easier to implement
- Promotes long-term maintenance
What are individual interventions?
Advice / empowerment e.g. Ten Top Tips
What are organisational interventions?
Work place/ school responsibility for health workforce, e.g. messages in lifts, parking restrictions, smoking support on campus, buying bike schemes, showers
What are community interventions?
Skills and resources set up by communities (e.g. walking buses, running groups).
What are societal interventions?
Laws, taxation, nudges
What is ‘nudging’?
A technique that alters a person’s decision-making context without removing options or changing the incentives in order to promote choice and behaviour in accordance to their own preferences, such as choosing healthy food over unhealthy food in a supermarket
What are the individual / organisation / societal interventions for hand washing?
Individual:
- Knowledge, skills, motivation, beliefs, attitudes, risk perception, intention, social norms, self-efficacy
Organisation:
–Posters, anti-bacterial gel at doorways, on belts, etc
–Monitoring
Society:
–Guidelines, patient safety
Who came up with the habit formation theory?
Lally et al
What is the habit formation theory?
Habits formed through repetition
