4)Health Behaviours Flashcards
What are health-related behaviours?
Anything that may promote good health (exercise, healthy diet, safer sex behaviour, screening activities) or lead to illness (smoking, drinking, drug use)
What are the 2 broad categories of theories used to help understand people’s HRBs?
- Learning theories
2. Social cognition models
What are learning theories?
Look at HOW we learn behaviours as a result of (often unconscious) association. And how this can be reinforced through its association with sensations, experiences or outcomes.
Name the 2 types of conditioning used in learning theories
Classical conditioning- association
Operant conditioning- reinforcement
Outline use of classical conditioning in humans
- environmental cues ie sights, smells, location, people signal expectation of drug/alcohol
- cues can be emotional ie anxiety (associate the internal emotional state with the behaviour)
- cues with a connection to drug/alcohol use can trigger behaviour and lead to relapse when quitting
How can CC be utilised to change behaviours?
- avoid cues/change the association with the cues (else will continue to evoke a maladaptive behavioural response)
- aversive techniques= pair behaviour with an unpleasant response (use of disulfiram in chronic alcoholics)
Outline operant conditioning
Behaviour is dependent on the consequences of behaviour (reward or punishment)
- reinforced (increases) if rewarded or punishment removed
- behaviour decreases if it is punished or a reward is taken away.
Consequences must be observed within a short time of the behaviour in order for an association to be formed
How does operant conditioning relate to health behaviour?
- unhealthy behaviours drug-takin, alcohol, cooking, chocolate and unsafe sex) are immediately rewarding
- we are driven by short term rewards & avoiding short term negative consequences
Outline some limitations of conditioning theories
- classical/operant conditioning based on simple stimulus-response associations
- no account of cognitive processes, knowledge, beliefs, memory, attitudes, expectations etc
- no account of social context (surrounded by other people, yet this influence is ignored)
What is involved in Social Learning theory
People learn through vicarious re-inforcement (through observing the behaviour of role models and the consequences of this behaviour)
Example: Bandura’s Bobo Doll study
Describe the use of SLT
- behaviour is goal-directed
- people are motivated to perform a behaviour if it is valued(rewarded) and they believe they can execute the behaviour (have the self-efficacy)
- modelling behaviours are more effective when role models are of high status or like us (in terms of value/ability)
How does SLT impact health-related behaviour?
- influence of family, peers, media figures, celebrities as role models
- harmful behaviour(modelled by media/films) ie drinking, drug use and unsafe sex, without consequence
Positives
- peer modelling/education (effective in health promotion)
- celebrities in health promotion campaigns
What do social cognition models do?
Look at how we decide to behave in particular ways (cognitions underlying behaviour)
Look at how people think, feel and reason about their behaviours
What is involved in cognitive dissonance theory?
Used in health promotion when providing heath information that makes people feel uncomfortable, creates mental discomfort and can prompt change in behaviour.
- discomfort arises when we hold inconsistent beliefs/conflict with external information
- reduce discomfort by changing beliefs or behaviour
Eg introduction of graphic images of health issues on cigarette packaging
Outline the Health Belief Model
- developed to explain why people engage with preventative health measures ie breast screening
- action influenced by beliefs about health threat (perceived susceptibility/perceived severity) and beliefs about health related behaviours (perceived benefits/perceived barriers)
- cues in the environment prompt action (use of service) ie condom machine in the toilets at a bar
Outline the Theory of Planned Behaviour
Intentions may lead to behaviour (what do I think? What do other people think? Can I do it?). Influenced by:
- complex range of +ve/-ve attitudes toward behaviour
- subjective norm(what people around us think/do, social influence/peer pressure)
- Perceived control (self efficacy- Do we have control over behaviour? Resources/ abilities)
Outline limitations of Theory of Planned Behaviour
- the theory is a good predictor of intentions but a poor predictor of behaviour (as intentions do not always lead to behaviour/action)
What are the 3 core factors that cause people to behave in ways that do not promote health?
- Lack of capability (inadequate knowledge/skills)
- Insufficient opportunity (lack time/resources)
- Motivation at key moment to engage healthy behaviour is lacking (healthy behaviours are usually difficult, boring or unpleasant; whilst unhealthy behaviour satisfy our immediate needs)
Outline the 4 elements of the COM-B model
Capability
Motivation
Opportunity
Behaviour
What does the C stand for?
Capability
Can be physical and psychological capabilities: knowledge, skill, strength, stamina
What does M stand for?
Motivation
Reflective (plans/goals-thoughts about behaviour) and automatic (emotional response/desires-in the moment):
Plans, evaluations, desires, impulses
What does the O stand for?
Opportunity
Physical and social opportunity:
Time, resources, cues/prompts, environment, social support
How can the COM-B model be used in healthcare?
Identify the barriers and target strategies that will effectively alleviate the barrier.
Ie modelling, enablement, coercion, incentivisation, education
What is the behaviour change wheel?
Includes the sources of behaviour, intervention functions AND policy categories imparted by the government
What are the key influences on behaviour in terms of intervention development?
- psychological capability= knowledge
- motivation (more significant barrier)= beliefs about consequences
What is Nudge theory?
-focus on unconscious influences on behaviour
- change behaviour by changing the environment, using positive reinforcement, using messaging and indirect suggestions.
Thus ‘nudging’ them towards positive health related behaviours.
What is nudge theory based on?
Around 80% of all human behaviour is automatic; people responding to cues in the environment unconsciously shape choices= choice architecture.
What are the 2 requirements for a successful nudge?
Must:
A) decrease the effort required to make the desired choice
B) improve out motivation to opt for that choice
Implications for health promotion: requires application of a comprehensive strategy with which core components?
- A behaviour change approach (ie incentives for weight loss- on its own insufficient, must be used in conjunction with other methods)
- Strong policy framework that creates a supportive environment (at national level- ie fruit in schools- starting habits in early childhood)
- Empowerment of the people to win control over making healthy lifestyle decisions (particularly people in lower SES)
