Adopting Health Belief Models Flashcards

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1
Q

What are Health Behaviours?

A
  • Activities undertaken to prevent or detect disease
  • Activities undertaken to improve well-being
  • Use of medical services or self-directed behaviour
  • Restrict a behaviour or add a behaviour
  • Episodic or long-term
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2
Q

why or why not? health behaviours

A
  • Fear
  • Benefits
  • Costs
  • Peer pressure / family pressure
  • Social / cultural / religious norms
  • Learned behaviour
  • Confidence
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3
Q

The Importance of Health Behaviour Models

A
  • understanding and predicting health behahiour decisions
  • explain adherence and non-adherence
  • generate research
  • guide practitioners in promoting healthy behaviours
  • design interventions to improve adherence
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4
Q

Continuum Theories

A
  • one-size-fits-all’ approach
  • First class of theories developed
  • Single set of factors used to explain adherence
  • Applies equally to all regardless of motivation to change
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5
Q

Continuum Theories (4 types)

A
  1. Health Belief Model
  2. Behavioral theory
  3. The Theory of Planned Behaviour
  4. Social Cognitive Theory
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6
Q

Health Belief Model

A
  • (Becker & Rosenstock, 1984)
  • Beliefs are an important contributor to health behaviour
  • Beliefs about the disorder/disease and about health-enhancing behaviours
  • Rational decisions are made on cost-benefit analysis
  • -Susceptibility
  • -Severity
  • -Benefits
  • -Barriers
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7
Q

Limitations of the Health Belief Model

A
  • Relationship between variables is unclear
  • Poor predictor of adherence for risk reduction behaviours linked to socially determined or unconscious motivations
  • Important determinants omitted e.g. social influence and positive/negative effects of behaviour
  • Needs to include sociopsychological factors
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8
Q

Behavioural Theory

A
  • Based on principles of operant conditioning (B.F. Skinner, 1953)
  • Focuses on the environment and teaching skills to manage adherence
  • Positive reinforcement
  • Negative reinforcement
  • Punishment
  • Antecedents (internal and external) and consequences influence behaviour
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9
Q

Behavioural Theory: Behaviour Change

A
  • Patterns and habits are often resistant to change
  • Need help establishing changes
  • Cues – written reminders, phone calls, self-reminders
  • Rewards – extrinsic (material, compliments); intrinsic (feel healthier, increased self-esteem)
  • Contingency contracts – written, established at start of treatment
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10
Q

Behavioural Theory: strengths

A
  • Predicts that adherence will be difficult

- Recognises that people need help establishing changes

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11
Q

Behavioural Theory: limitations

A
  • Limited by its focus on external influences of behaviour
  • Lacks an individualised approach
  • Does not consider less conscious factors e.g. acceptance of diagnosis
  • Does not consider the person’s perception of the rewards
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12
Q

The Theory of Planned Behaviour

A
  • Information is used to decide how to behave
  • Think about outcomes before taking action
  • Choose to act / not to act
  • Intention is an immediate determinant of behaviour
  • Intention is shaped by three factors
    1. Attitude Toward Behaviour
    2. Subjective Norm
    3. Perceived Behavioural Control
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13
Q

Theory of Planned Behaviour: limitations

A
  • Assumes behaviours are under volitional control
  • Assumes intention will actually lead to enacting the behaviour
  • Does not consider the impact of past behaviour on current behaviour
  • Components need to be directly relevant to -behaviour
  • Structural barriers need to be taken into account
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14
Q

Social Cognitive Theory

A
  • Social origins of behaviour + cognitive processes influence behaviour
  • Self-Efficacy + Outcome Expectations predicts behaviour
  • You must believe that your behaviour will bring about a valuable outcome AND that you have the ability to successfully carry out the behaviour
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15
Q

Social Cognitive Theory: Self-Efficacy Theory

A

A person’s belief in their ability to initiate difficult behaviours predicts the likelihood of achieving them

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16
Q

Social Cognitive Theory: Outcome Expectations

A

The belief that a specific behaviour will produce a valuable outcome

17
Q

Self – Efficacy

A
  • Feeling you have control over your behaviour

- Confident you can perform the necessary behaviour to achieve the desired outcome

18
Q

Sources of self-efficacy

A
  1. Performance
  2. Vicarious experience
  3. Verbal persuasion
  4. Physiological arousal states
19
Q

Social Cognitive Theory: Observational Learning

A
  • Learning can occur in the absence of direct reinforcement through observing models
  • Use of role models to shape cultural attitudes and behaviour
20
Q

Social Cognitive Theory: strengths

A
  • Good predictor of adherence

- Components incorporated into most other health behaviour models

21
Q

Social Cognitive Theory: limitations

A
  • omits other facotrs that also influence motivation e.g. stigma
  • variables are difficult to operationalise
  • The wide-range of focus may make it difficult to base interventions on this model
22
Q

Stage Theories

A
  • People pass through a series of discrete stages as they attempt to change their behaviour
  • Describes the process of behaviour change
  • Different stages → different variables are important
  • Different stages → different interventions
  • Interventions tailored to the specific stage
23
Q

Stage Theories (3 types)

A
  1. The Transtheoretical Model
  2. The Precaution Adoption Process Model
    The Health Action Process 3. Approach
24
Q

The Transtheoretical Model

A
People progress through 5 stages in making behavioural changes
1. Precontemplation
No intention of changing
2. Contemplation
Aware of problem
Thoughts about change
3. Preparation
Thoughts and Action
4. Action
Make overt changes in behaviour
5. Maintenance
Sustain changes
Resist temptation
(Relapse
Resume old behaviour)
-Can relapse to a previous stage / first stage
-Relapse is a learning experience
25
Q

The Transtheoretical Model: strengths

A
  • Generated the most research
  • Identified that interventions need to be tailored according to the stage of -change a person is in
  • Good predictor of smoking cessation
  • Good predictor of ongoing behaviours e.g. diet and exercise
26
Q

The Transtheoretical Model: limitations

A
  • The number of stages and processes make it very complex
  • Interventions may be complicated and costly
  • People don’t always progress through stages in orderly way
  • No allowance made for people unaware of the risk
  • Non-stage matched interventions may be just as effective
  • May be more appropriate for behaviours that do not need to be changed urgently
27
Q

The Precaution Adoption Process Model

A

Susceptibility beliefs – change over time; linked to the different stages

  1. Unaware of personal risk
  2. Optimistic bias – aware of the risk but don’t believe they are at risk
  3. Acknowledge own susceptibility and that taking precautions is a good idea (no decision to act yet)
  4. Decide to take action
  5. Decide that action is unnecessary
  6. Have already taken precautions to decrease risks
  7. Maintaining the precautions if needed
28
Q

The Precaution Adoption Process Model: Strengths

A
  • Identifies the need to tailor interventions to the different stages
  • Identifies the importance of awareness interventions
  • Good predictor of behaviours requiring awareness of risk
  • Identified that barriers to health behaviours change from stage to stage
29
Q

The Precaution Adoption Process Model: limitations

A
  • Little research generated (except optimistic bias)
  • Unclear if the 7 stages represent different categories
  • Omits several important factors e.g. social, psychological, self-efficacy
  • Model may be too complex
30
Q

The Health Action Process Model

A

Stage 1 – Motivational Phase:The intention to adopt preventative measures or change risk behaviour is formed
3 beliefs necessary:
1. perceive personal risk
2. have favourable outcome expectations
3. action self-efficacy
BUT intention is not enough to produce lasting changes

Stage 2 – Volitional Phase
-Attempt to make changes
-Persist with changes over time
-Need to plan the behaviour change and plan for setbacks
Maintenance self-efficacy – confidence that you can keep up the behaviour
Relapse self-efficacy– confidence that you will resume the behaviour after a relapse

31
Q

The Health Action Process Model: strengths

A
  • Recognises that intention does not necessarily result in a particular behaviour being enacted
  • Incorporates some of the most important aspects of continuum theories and stage theories
  • Fewer stages make it less complex
  • Identifies several forms of self-efficacy
  • Highlights the importance of planning
32
Q

The Health Action Process Model: limitations

A

not yet studied widely but propositions supported

-omits important social factors