BELIEF MODELS Flashcards
1
Q
Kasl and Cobb 1966
Health Behaviours
A
behaviours which aim to prevent disease
2
Q
Kasl and Cobb 1966
Illness Behaviours
A
behaviours aimed to seek remedy
ie doctors
3
Q
Kasl and Cobb 1966
Sick Role Behaviours
A
Behaviours in order to get better
ie medicine
4
Q
Matarazzo 1984
behavioural pathogens
A
health impairing
ie smoking
5
Q
Matarazzo 1984
behavioural immunogens
A
health protective
ie health check
6
Q
Kasl Cobb/Matarazzo
what are health behaviours overall
A
behaviours which determine the health status of an individual
7
Q
What do the social cognitive models of health behaviour propose overall
A
look at the predictors and precursors of health
beh governed by expectancies, incentives and social cognitions
based on SEU -
beh is the consequence of weighted percieved costs and benefits
humans are rational information processors
8
Q
what are the three main social cognitive models of health behaviour
A
health belief model
protection motivation theory
theory of planned behaviour
9
Q
health belief model by..
A
rosenstock 1966
10
Q
what does the health belief model predict overall
A
the likelihood that a health behaviour is performed
11
Q
core beliefs of the health belief model
A
susceptability severity costs + beneftis cues to action health motivations percieved control
12
Q
HBM susceptability
A
percieved likelihood of contracting disease
13
Q
HBM severity
A
illness severity - how bad is the illness percieved to be
14
Q
HBM cost and benefits
A
cost: neg consequences ie social/financial
benefit: pos consequences ie better health
15
Q
HBM cues to action
A
internal (ie symptom) or external cues (ie advice)
16
Q
HBM health motivation
A
revised HBM (becker and rosenstock 1987) concern over health and problems
17
Q
HBM control
A
revised HBM (becker and rosenstock 1987) percieved control over disease severity
18
Q
studies assessing the role of HBM
A
Budd, hughes and smith 1996 (meds)
Norman and Brian 2005 (BSE)
19
Q
Budd Hughes and Smith 1996 HBM
AIM
A
can HBM predict antipsychotic medication compliance in schizophrenic population
20
Q
Budd Hughes and Smith 1996 HBM
MEDTHOD
A
20 compliant and non complaint schiz
HBM Q and health locus of control scale
21
Q
Budd Hughes and Smith 1996 HBM
CLASSIFICATION
A
compliant: took meds when offered to them, went to every appt etc
non compliant: rarely took meds, refused to attend etc
22
Q
Budd Hughes and Smith 1996 HBM
RESULTS - COMPLIERS
A
believed themselves more susceptable to relapse
percieved relapse as more severe
believed medication benefit and prevent relapse
23
Q
Budd Hughes and Smith 1996 HBM
RESULTS - NON COMPLIERS
A
did not believe themselves susceptible to relapse
24
Q
Budd Hughes and Smith 1996 HBM
REULTS - problems
A
compliance due to mental state? - controlled for
discrepancy in compliance definition compared to other studies - strict, therefore large difference and may explain maximised diff between groups
- construct not reliably defines across studies - generalisable?
25
Norman and Brian 2005 HBM
| types of compliance
infrequent
appropriate
excessive
26
Norman and Brian 2005 HBM
| infrequent BSE compliance
unlikely to detect early
27
Norman and Brian 2005 HBM
| appropriate BSE compliance
detect early
| monthly checks
28
Norman and Brian 2005 HBM
| excessive BSE compliance
hinder early detection
- more checks but less thorough
- identify more benign - increase anxiety - check MORE
29
Norman and Brian 2005 HBM
| additional constructs
subconstructs of percieved barriers
- practical (time/expense) and psychological (pain/embarassment) (sheeran and abraham 1996)
self efficacy (rosenstock, stretcher and becker 1988)
30
Norman and Brian 2005 HBM
| AIM
HBM predict BSE at 9m follow up
role of SE?
role of worries(psych) or past?
can HBM be extended?
31
Norman and Brian 2005 HBM
| METHOD
RCT - high risk breast cancer women
T1 (control and exp) - HBM Q, clinic (exam, advise, genetic assessment and option for annual review)
(only exp) - specialist geneticist consultation and risk assessment
T2 - follow up Q
32
Norman and Brian 2005 HBM
| FINDINGS - infrequent > appropriate and excessive
T1 BSE predictive of T2 BSE
discriminated by SE, psych barriers, and percieved benefits
- higher SE barriers, higher emotional barriers and lower percieved benefits
HBM TO BE EXTENDED: INCLUDE SE AND EMOTIONAL COMPONENTS
33
Norman and Brian 2005 HBM
| FINDINGS - PAST
past BSE strongest predictor of group membership
**barriers/benefits still strong when past controlled for
- habitual?
- shape future beliefs? -determine cog?
34
Norman and Brian 2005 HBM
| FINDINGS - excessive>infreq/appropriate
SE, cancer worries and percieved severity most powerful
(lower SE barriers, high anxiety and high severity)
cause hypervigilance
35
Norman and Brian 2005 HBM
| FINDINGS- problems
fail to distinguish proficiency from frequency (is there a difference in knowledge about disease/BSE and ones motives/psychological factors?)
no cues to action
- monthly prompts increase BSE in all groups?
- influence of environ cues ie when/where performed
36
Protection motivation theory by..
Rogers 1975
37
PMT overall predicts
likelihood protective health behaviours are performed
- positive inclinations
expansion of HBM
including an affective component
38
PMT core beliefs
```
severity
susceptibility
response efficacy
self efficacy
fear
```
39
PMT severity
percieved seriousness of illness/disease
40
PMT susceptibility
percieved likelihood will contract the disease
41
PMT response efficacy
how influential beh is in determining outcome
42
PMT self sefficacy
belief in own ability to perform behaviour
43
PMT fear
emotional response to disease prospect
44
PMT
| threat appraisal
perceptions of severity and vulnerability
- severity
- susceptability
- fear
45
PMT
| coping appraisal
beleifs about outcome
- RE
- SE
46
PMT
| influence of what sources?
```
environmental sources (ie persuasion)
interpersonal sources (ie past exp)
determines coping mechanisms
```
47
PMT
| coping mechanisms
adaptive (perform good beh)
| maladaptive (deny/avoid) `
48
PMT studies
orbell and sheeran 1998
| norman et al 2003
49
Orbell and Sheeran 1998 PMT
| AIM
can PMT predict motivations to attend cervical screening?
| can PMT predict uptake and distinguish groups in 1 year?
50
Orbell and Sheeran 1998 PMT
| actors and abstainers
inclined actors
inclines abstainers
disinclined actors
disinclined abstainers
51
Orbell and Sheeran 1998 PMT
| inclined actors
act consistent with intentions
52
Orbell and Sheeran 1998 PMT
| disinclined actors
no intent
| act inconsistently - still perform
53
Orbell and Sheeran 1998 PMT
| incline abstainers
intent but dont act in line with intention
54
Orbell and Sheeran 1998 PMT
| disinclined abstainers
no intent, no beh
55
Orbell and Sheeran 1998 PMT
| METHOD
T1 - all abstainers
- assess willingness to attend screening
- measure objective risk
T2 - follow up
- screening behaviour 1 year on
56
Orbell and Sheeran 1998 PMT
| RESULTS - TIME 1
38% inclined
predicted by:
high percieved susceptability, low percieved barriers, high SE to overcome barriers, high percieved benefits ('peace of mind' - reassurance>detection)
less likely to use avoidant coping
57
Orbell and Sheeran 1998 PMT
| RESULTS - FOLLOW UP
24% have screening
- 43% of these initially inclined
- 12% initially disinclined
58
Orbell and Sheeran 1998 PMT
| RESULTS - predictors of screening uptake
high motivation to perform, high objective risk, high percieved susceptibility, low worry about cervical cancer (easily curable), higher perception that problems will be detectable
59
Orbell and Sheeran 1998 PMT
| RESULTS- PMT efficiency at predicting
PMT not entirely mediate effect of variables and obective risk on behaviour
worry and response efficacy still sig mediate PMT when willingness included
- other factors missing
could NOT distinguish inclined abstainers
- dont know what processes lead an initial intent/willingness into an action
60
Orbell and Sheeran 1998 PMT
| kuhl 1985 eval - intent to action
no insight into how inclinations lead to performan
kuhl distinguished:
choice motivations - desicions to pursue
executive motivations - processes translate decision to action
- need o develop an account for underlying processes to aid understanding
61
Orbell and Sheeran 1998 PMT
| RESULTS - eval
willlingness not intent - similar, but empirically and conceptually different
62
Orbell and Sheeran 1998 PMT
| RESULTS - application
different methods of intervention to envourage health behaviour uptake among different groups
disinclined abstaines distringuised by motivational variables - motivational intervention
disinclined actors highlight risk and disease
63
Norman et al 2003 PMT
| AIM
can PMT predict parental adherence to eyepatching child everyday for 2 months to improve eye defect?
64
Norman et al 2003 PMT
| intentions to eyepatch
belief that not adhering has neg consequences
believe eyepatching is effective
confident in own ability to eyepatch child
65
Norman et al 2003 PMT
| 2 month follow up adherence
high adherence predicted by
percieved neg consequences is not adhere
lower perception that eyepatching may be a barrier in everyday life
66
Norman et al 2003 PMT
| past beh
past not sig influence PMT
BUT sig predict follow up adherence
partially mediated by percieved costs/barriers
67
Norman et al 2003 PMT
| application
clinicians should emphasise neg consequences of not adhering nd explore means of improving daily life with eyepatch
68
Theory of Planned behaviour by...
Ajzen 1986
69
TPB beliefs and cognitions
outcome beliefs and evals = attitude to beh
social att. beliefs and motivation to comply = subjective norms
internal.external control factors = PBC (= beh)
= intent = behaviour
70
TPB
| attitudes to beh
pos or neg evals
| belief in outcome and importance of outcome to self
71
TPB
| subjective norms
percieved norms and pressures to conform
| motivations to conform
72
TPB
| PBC
```
internal control (skill/ability - SE)
external contorl (obstacles/opportunity)
- ones abiity to carry out the behaviour
```
thought to mediate behaviour irrespective of intent
ie can intent but no opportunity so no beh
73
TPB mediation hypothesis
Atttiudes, subjective norms and PBC mediate the development of intentions which mediate the performance of behaviour
74
TPB sufficiency hypothesis
all other bio, social, enviorn, econ, medical, cultural influences mediated via TPB
75
TPB studies
Armitage 2005
| Schifter and Ajzen 1985
76
Armitage 2005 TPB
| AIM
can TPB predict participation over 12 weeks of physical activity
- improve prev (sheeral et al 2001) where not look at annual behaviours, but weekly, frequent beh in everyday life (exerecise)
+ influence of past?
77
Armitage 2005 TPB
| METHOD
pps sign up to refurbished gym that not prev attend
TPB Q baseline and follow up
- self reported activity at 3 months
- actual gym attendence
78
Armitage 2005 TPB
| RESULTS - predictive validity
TPB sig predict exercise intention and actual activity
majority maintain in first 5 weeks but in gradual decline
survival rate about 5 weeks plateu (greater maintenance)
30% attend each week for 12 weeks
relapse in 61% in those who experience prior attendence lapse
79
Armitage 2005 TPB
| RESULTS - past
accumulated past sig predicts future
beh in first 5 weeks sig determines attendence > 5 weeks
PBC only covariate - habit?
80
Armitage 2005 TPB
| RESULTS - past and cognition
successful beh performance = greater intent and beh
| unsuccessful performance undermine intent and beh
81
Armitage 2005 TPB
| RESULTS - application
interventions to change PBC control beliefs
- set subgoals for personal mastery?
observation modelling
relax techniques for anxiety or affect reg improvement
82
Schifter and Ajzen 1985 TPB
| AIM
can TPB predict weight loss intent and actual weight loss?
83
Schifter and Ajzen 1985 TPB
| weight loss intent and beh discrepancy
intent to lose weight likely to reflect personal and social desireability factors, percieved ease etc
BUT actual weight loss likely to be largely influenced by motivational factors ( opportunity/time/resources) and percieved control over realistic weight loss constraints (managing hunger etc, warding off cravings etc)
84
Schifter and Ajzen 1985 TPB
| METHOD
T1 + T2 weigh and TPB Q
T2 = 6 weeks later
expect: 4.5kg loss
85
Schifter and Ajzen 1985 TPB
| RESULTS
58% lose weight
maintenance unknown, not equally successful
mean loss of 0.76kg (not much)
intent weak correlation with weight lost
BUT those with stronger intentions and higher percieved SE we more likely to lose more weight
86
Schifter and Ajzen 1985 TPB
| Results explanation
high PBC more likely to conistently attempt loss - even if inaccurate perceptions of ability
- not mediated by intentions - PBC reflection of past success
PBC marginally predictive of loss but likely to be other influences
TPB constructs predictive of intent but insufficient to predict actual behaviour
87
HBM habit criticism
HBM focus on conscious information processing and ignores automatic health behaviours
88
HBM external factors criticism
HBM focuses on the individual and ignores the role of social and environmental factors
89
HBM core beliefs criticism
does explain relationship between core beliefs, measurements of core beliefs, and how the core beleifs interact with one another ( linearly? multifactorially?)
ignores role of affect, SE or outcome expetancies
90
PMT predicting PM and predicting beh criticism
Armitage and connor
variables that predict protection motivation (intent to perform pos health behaviour) may differ from the variables that ultimately predict ones actual behaviour
**majority of PMH crticisms are 'typical' (habit/social or environ/conscious processeors)
91
TPB pro
Attempts to adress social and environmental influences on intent and behaviour which HBM and PMT fail to addres
92
TPB population criticsm
McEachan et al 2011
TPB sig less predictive ofintent and beh when not use longditudinal design, uni students or when measures are objective and not self report
- not accomodating across diff pop/measures/designs
93
sc model criticism - rationality
assumes humans are rational decision makers, tend to exclude affect and anticipation of outcomes
94
TPB predictive validity critcism
doesnt provide a full account
needs to be extended
sufficiency hypothesis is falsifiable
- sniehotta et al 2013- age, SES, physical and mental health sig predict physical activity when TPB controlled for
95
predictors of behaviour unconsidered by SC models
| sneihotta et al 2013
```
habit
self determination
anticipated regret
identity
self reg (ie planning )
+ reinforcement, beh outside conscious awareness may mediate beh without intent or PBC
```
96
utility of TPB criticism
| sniehotta et al 2013
TPB useless in creating new interventions or research paradigms
does not offer any new information compared to newer theories and extensions
97
connoer 2014 tpb on sneihotta et al 2013 commentary
sniehotta misplaces and unsupported
| extend not reject TPB
98
mceachan et al 2011 meta TPB
| connor 2014
attitude and PBC large ES in predicting intentions
intent and PBC med-large ES in predicting beh
variables are some of the key predictors in intent and beh - good pragmatics (ogden 2003) although leaves a lot unexplained
99
connoer and sparks 2005 TPB subconstructs
| connor 2014
can tease apart TPB constructs and increase predictive power
attitudes: affective or cognitive
PBC: self efficacy or control
norms: injunctive or desciptive
- TPB variables have depth and can be explores more
100
Connor 2014 main TPB problem
there does exist variables not covered by TPB or SC models
BUT only important dependent on who is being assesed, who is the assesor (aim) and what behaviour is being assessed
- thus researchers want broad predictive theory BUT clinicians want specific target intervention theory
101
can TPB be conceptually tested?
| orbell 2003 criticism
where TPB fails to predict the outcome or variance is left unexplained, tendency to provide alt explanations
ie diff pop, probs in variable operationalisation or due to the beh
therefore seemingly unfalsifiable and technically not testable
102
ogden 2003 synthetic truth
theory definitions are determined via empirical tests and explorations
103
ogden 2003 analytic truth
theory constructs are determined as a consequence of definition as opposed to actual discrepancy in research
104
ogden 2003
| TPB synthetic or analytic
'different' cognitions ie PBC and intent are measured similarly in practice
"can you do this" / "will you do this"
self reports likely contaminated by subjective cognitions
ANALYTIC
105
ogden 2003 create or access cog
pps unknown beh - questionned about attitudes
FORM attitudes? self report - desireability influence?
may CREATE than access
