(5) Health Behaviour

Question 1

What are learning theories?

Answer 1

How we learn behaviours as a result of association;

behaviours are reinforced by sensations, experiences, or outcomes

E.g. social learning theory, classical/operant conditioning

Question 2

What is classical conditioning?

Answer 2

Uses cues:

Environmental = sights, smells, location

Emotional = anxiety

Behaviour = e.g. drugs/alcohol can trigger behaviour and lead to relapse when quitting

Question 3

How can classical conditioning be used in changing health behaviour?

Answer 3

• avoid cues/change association with cues

- aversive techniques in alcohol misuse

Question 4

What is operant conditioning?

Answer 4

Behaviour shaped by consequences

Behaviour is:

• reinforced = rewarded
• decreases = punished

Question 5

What is social learning theory?

Answer 5

• people learn vicariously (observation/modelling)
• behaviour is goal-directed
• more effective if models are high status or ‘like us’

Question 6

What is the affect of operant conditioning on health related behaviours?

Answer 6

Unhealthy behaviours are immediately rewarding !!

short term rewards

Question 7

What is the affect of social learning theory on health related behaviours?

Answer 7

Influence of family, peers, media figures etc.

-ves: harmful behaviours e.g. drinking, drug use

+ves: peer modelling/education, celebrities in health promotion campaigns

Question 8

What are social cognition models?

Answer 8

How we decide to behave (how we think, feel, and reason about our behaviours)

E.g. cognitive dissonance, theory of planned behaviour, health belief model

Question 9

What is cognitive dissonance theory?

Answer 9

Discomfort when inconsistent beliefs or actions don’t match beliefs

Reduce discomfort by changing beliefs/behaviours

Question 10

What is the affect of cognitive dissonance theory on health related behaviours?

Answer 10

Health promotion:

Providing health information creates mental discomfort and prompts change in behaviour

Question 11

What is the health belief model

Answer 11

(1) beliefs about health threat
- perceived susceptibility
- perceived severity

(2) beliefs about health-related behaviour
- perceived benefits
- perceived barriers

(3) cues to action

} lead to action

Question 12

What is the theory of planned behaviour?

Answer 12

(1) attitude toward behaviour
(2) subjective norm
(3) perceived control

} leads to intention

} leads to behaviour

Question 13

What is the integrated psychological model of behaviour change (COM-B)?

Answer 13

Capability

(1) physical = use rules to reduce opportunity to engage in the behaviour, change physical/social context
(2) psychological = provide an example for people to aspire to or emulate

Opportunity

(1) social = increase knowledge/understanding, use communication to induce positive/negative feelings
(2) physical = create reward/punishment

Motivation

(1) reflective = impart skills
(2) automatic = increase means to increase capability, or reduce barriers to increase opportunity

Question 14

What are the 3 key factors that impact behaviour change (COM)?

Answer 14

Capability

Opportunity

Motivation

Question 15

How does COM relate to patient health related behaviour?

Answer 15

Lack of capability (inadequate knowledge/skills)

Insufficient opportunity

Motivation (desire)

Question 16

What are the key principles of nudge theory?

Answer 16

• focuses on unconscious influences on behaviour

- change behaviour by changing environment

Question 17

What interventions change behaviour based on a nudge approach?

Answer 17

Simple changes to environment to steer decisions in the right direction

For a nudge to be successful, it must:

(i) decrease effort required to make desired choice
(ii) improve our motivation to opt for that choice

Question 18

What are the risks of focusing on individual behaviour?

Answer 18

Determinants of health are complex and may be outside of individual control

Risk of ‘victim blaming’

Single interventions that target a specific behavioural risk have little impact on determinants that actually cause poor health

Question 19

What are the implications for health promotion of focusing on individual behaviour?

Answer 19

(1) behaviour change approach (offering incentives)
(2) strong policy framework that creates a supportive environment (e.g. sugar tax)
(3) empowerment of people to gain more control over making lifestyle decisions

Question 20

Why don’t patients behave in ways that promote health?

Answer 20

Lack of capability (inadequate knowledge/skills)

Insufficient opportunity

Motivation (desire)

Question 21

What are the psychological theories of health-related behaviour suggest approaches to health behaviour change and health promotion?

Answer 21

Learning theories

Social cognition models

Integrated model (COM-B)

Nudge theory