4: Health behavior change

Question 1

What is health behaviour?

Answer 1

Any activity undertaken by an individualbelieving himself to be healthy, for the purpose of preventing disease or detecting it at an asymptomatic stage

Question 2

What are the scales where health behaviour promotion/interventions can take place?

Answer 2

1. Individual level
2. COmmunity level
3. Population level

Question 3

Does health education work?

Answer 3

Often: not really

• though information is imporatant (and more effective when tailored to people (e..g use condoms insead of abstinence)
• More than just education needed for health behaviour changes

Question 4

Accoriding to learning theory: how does reinforcement lead to unhealthy eating?

Answer 4

• Positive reinforcement:
  
  • Dopamine (feel good), filling an empty void/boredom.
  • Praise for preparing a high-fat meal for the family.
• Negative Reinforcement:
  
  • Avoid painful emotions by comfort eating.

Question 5

How does punishment lead to unhealthy eating?

Answer 5

• Punishment:
  
  • Preparing a low fat meal is criticised.
• Limited/delayed positive reinforcement for healthy eating:
  
  • Efforts at dietary change/weight loss go unnoticed by others; Avoiding future health problems is too remote.

Question 6

What are behavioural modification technics that help with healthy eating?

Answer 6

• Stimulus control techniques:
  
  • Keep ‘danger’ foods out of the house
  • Avoid keeping biscuits in the same cupboard as tea & coffee
  • Eat only at the dining table
  • Use small plates
  • Do not watch TV at the same time as eating.
• Counter conditioning:
  
  • Identify ‘high-risk’ situations/cues (eg stress) and ‘healthier’ responses:
  • Eg Can you think of something other than eating that makes you feel better? Maybe something relaxing or exercise?

Question 7

Explain the use of positive reinforcement in health behaviour

Answer 7

Though not 100% sucessful, there stll can be succes seen (biggest in comparison to punishment etc.)

• Involve significant others to praise healthy eating choices
• Plan specific rewards for successful weight loss
• Vouchers for adherence to healthy eating & weight loss
• Improved self-esteem (positive reinforcement).
• Reduction in symptoms of breathlessness (negative reinforcement).

Question 8

What are the limitations of reinforcement programms?

Answer 8

• Lack of generalization (only affects behaviour regarding the specific trait that is being rewarded).
• Poor maintenance (rapid extinction of the desired behaviour once the reinforcer disappears)
• • Impracticalandexpensive.

Question 9

Does fear arousal work?

Answer 9

No–> when we are scared of something, we tend to look away and also avoid the information

• low to moderate formultations now are more effective

Question 10

Explain the role of social learning in health behaviour

Answer 10

Has a big role (expecially in teenagers)

• e.g. large peer group influence in smoking (+family influence)
• promoting workshop including resisting peer pressure for smoking in role-plays is sucessful

Question 11

What is the expectancy-value principle for health behaviour?

Answer 11

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

Question 12

Which factors influcence the likelyhood to make a health decision (Rosenstock)

(Health believe Model)

Answer 12

The backround of a person influences everything but also

• How suspectible am I to get that outcome? (percieved suspectibility)
• How serious is the outcome? (percieved seriousness)
  
  • Together: feed into percieved threat
• What are the risks and benefits if I do this? (risks and benefits)
• Cues to action (e.g. someone advises me to do something)

Question 13

What is outcome efficacy?

Answer 13

Individuals expectation that the behaviour will lead to a particular outcome

Question 14

What is self-efficacy?

Answer 14

Belief that one can execute the behaviour required to produce the outcome

Question 15

Which factors influcence self-efficacy?

Answer 15

• Mastery experience
• Social learning
• Verbal persuasion or encouragement
• Physiological arousal

Question 16

Explain the Theory of Planned behaviour

Answer 16

The intetntion to persecute a planned behaviour is influenced by

1. Attitute towards the behaviour
   
   1. dependant on the beliefs and the evaluation of the outcome
2. Percieved behavioural control
   
   1. dependant on internal control factors
   2. and external control facors
3. Subjective norm
   
   1. strongly influenced by by beliefs about important others perception of behaviour

Question 17

Explain the Transtheoretical Model (Stages of Change Model)

Answer 17

1. Pre-contemplation
   
   • does not recognise the need for change
   • not actively considering change
2. Conetmplation
   
   • recognised problem and considers change
3. Preparation
   
   • is getting ready to change
4. Action
   
   • is initiating change
5. Maintainance
   
   1. Can go either into
      
      1. relapse or
      2. or permanent change
         
         1. adjusting to change and getting used to new forms to sustain

Question 18

Explain the COM-B model

Answer 18

Three factors influence behavioural change

1. Capability
   
   • influenced by
     
     • physical (skills)
     • psychological (skilly, knowledge)
2. Opportunity
   
   • social (social influences)
   • physical (enviromental resources and context)
3. Motivation
   
   • Reflective (beliefs about outcome, intentions, goals)
   • Automatic ( reinforcement, emotions

Question 19

What is the Bahaviour Change Wheel?

Answer 19

COM-B Wheel = 9 intervention functions and 7 categories of policy (on basis of the COM model)