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HEALTH > BELIEF MODELS > Flashcards

BELIEF MODELS Flashcards

1
Q

Kasl and Cobb 1966

Health Behaviours

A

behaviours which aim to prevent disease

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2
Q

Kasl and Cobb 1966

Illness Behaviours

A

behaviours aimed to seek remedy

ie doctors

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3
Q

Kasl and Cobb 1966

Sick Role Behaviours

A

Behaviours in order to get better

ie medicine

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4
Q

Matarazzo 1984

behavioural pathogens

A

health impairing

ie smoking

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5
Q

Matarazzo 1984

behavioural immunogens

A

health protective

ie health check

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6
Q

Kasl Cobb/Matarazzo

what are health behaviours overall

A

behaviours which determine the health status of an individual

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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

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8
Q

what are the three main social cognitive models of health behaviour

A

health belief model
protection motivation theory
theory of planned behaviour

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9
Q

health belief model by..

A

rosenstock 1966

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10
Q

what does the health belief model predict overall

A

the likelihood that a health behaviour is performed

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11
Q

core beliefs of the health belief model

A 
susceptability
severity
costs + beneftis
cues to action
health motivations
percieved control
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12
Q

HBM susceptability

A

percieved likelihood of contracting disease

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13
Q

HBM severity

A

illness severity - how bad is the illness percieved to be

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14
Q

HBM cost and benefits

A

cost: neg consequences ie social/financial
benefit: pos consequences ie better health

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15
Q

HBM cues to action

A

internal (ie symptom) or external cues (ie advice)

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16
Q

HBM health motivation

A 
revised HBM (becker and rosenstock 1987)
concern over health and problems
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17
Q

HBM control

A 
revised HBM (becker and rosenstock 1987) 
percieved control over disease severity
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18
Q

studies assessing the role of HBM

A

Budd, hughes and smith 1996 (meds)

Norman and Brian 2005 (BSE)

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19
Q

Budd Hughes and Smith 1996 HBM

AIM

A

can HBM predict antipsychotic medication compliance in schizophrenic population

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20
Q

Budd Hughes and Smith 1996 HBM

MEDTHOD

A

20 compliant and non complaint schiz

HBM Q and health locus of control scale

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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

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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

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23
Q

Budd Hughes and Smith 1996 HBM

RESULTS - NON COMPLIERS

A

did not believe themselves susceptible to relapse

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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?

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25
Q

Norman and Brian 2005 HBM

types of compliance

A

infrequent
appropriate
excessive

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26
Q

Norman and Brian 2005 HBM

infrequent BSE compliance

A

unlikely to detect early

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27
Q

Norman and Brian 2005 HBM

appropriate BSE compliance

A

detect early

monthly checks

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28
Q

Norman and Brian 2005 HBM

excessive BSE compliance

A

hinder early detection

  • more checks but less thorough
  • identify more benign - increase anxiety - check MORE
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29
Q

Norman and Brian 2005 HBM

additional constructs

A

subconstructs of percieved barriers
- practical (time/expense) and psychological (pain/embarassment) (sheeran and abraham 1996)

self efficacy (rosenstock, stretcher and becker 1988)

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30
Q

Norman and Brian 2005 HBM

AIM

A

HBM predict BSE at 9m follow up
role of SE?
role of worries(psych) or past?
can HBM be extended?

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31
Q

Norman and Brian 2005 HBM

METHOD

A

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

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32
Q

Norman and Brian 2005 HBM

FINDINGS - infrequent > appropriate and excessive

A

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

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33
Q

Norman and Brian 2005 HBM

FINDINGS - PAST

A

past BSE strongest predictor of group membership
**barriers/benefits still strong when past controlled for

  • habitual?
  • shape future beliefs? -determine cog?
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34
Q

Norman and Brian 2005 HBM

FINDINGS - excessive>infreq/appropriate

A

SE, cancer worries and percieved severity most powerful
(lower SE barriers, high anxiety and high severity)
cause hypervigilance

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35
Q

Norman and Brian 2005 HBM

FINDINGS- problems

A

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
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36
Q

Protection motivation theory by..

A

Rogers 1975

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37
Q

PMT overall predicts

A

likelihood protective health behaviours are performed
- positive inclinations
expansion of HBM
including an affective component

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38
Q

PMT core beliefs

A 
severity
susceptibility
response efficacy
self efficacy
fear
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39
Q

PMT severity

A

percieved seriousness of illness/disease

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40
Q

PMT susceptibility

A

percieved likelihood will contract the disease

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41
Q

PMT response efficacy

A

how influential beh is in determining outcome

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42
Q

PMT self sefficacy

A

belief in own ability to perform behaviour

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43
Q

PMT fear

A

emotional response to disease prospect

44
Q

PMT

threat appraisal

A

perceptions of severity and vulnerability

  • severity
  • susceptability
  • fear
45
Q

PMT

coping appraisal

A

beleifs about outcome

  • RE
  • SE
46
Q

PMT

influence of what sources?

A 
environmental sources (ie persuasion)
interpersonal sources (ie past exp)
determines coping mechanisms
47
Q

PMT

coping mechanisms

A

adaptive (perform good beh)

maladaptive (deny/avoid) `

48
Q

PMT studies

A

orbell and sheeran 1998

norman et al 2003

49
Q

Orbell and Sheeran 1998 PMT

AIM

A

can PMT predict motivations to attend cervical screening?

can PMT predict uptake and distinguish groups in 1 year?

50
Q

Orbell and Sheeran 1998 PMT

actors and abstainers

A

inclined actors
inclines abstainers
disinclined actors
disinclined abstainers

51
Q

Orbell and Sheeran 1998 PMT

inclined actors

A

act consistent with intentions

52
Q

Orbell and Sheeran 1998 PMT

disinclined actors

A

no intent

act inconsistently - still perform

53
Q

Orbell and Sheeran 1998 PMT

incline abstainers

A

intent but dont act in line with intention

54
Q

Orbell and Sheeran 1998 PMT

disinclined abstainers

A

no intent, no beh

55
Q

Orbell and Sheeran 1998 PMT

METHOD

A

T1 - all abstainers

  • assess willingness to attend screening
  • measure objective risk

T2 - follow up
- screening behaviour 1 year on

56
Q

Orbell and Sheeran 1998 PMT

RESULTS - TIME 1

A

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
Q

Orbell and Sheeran 1998 PMT

RESULTS - FOLLOW UP

A

24% have screening

  • 43% of these initially inclined
  • 12% initially disinclined
58
Q

Orbell and Sheeran 1998 PMT

RESULTS - predictors of screening uptake

A

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
Q

Orbell and Sheeran 1998 PMT

RESULTS- PMT efficiency at predicting

A

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
Q

Orbell and Sheeran 1998 PMT

kuhl 1985 eval - intent to action

A

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
Q

Orbell and Sheeran 1998 PMT

RESULTS - eval

A

willlingness not intent - similar, but empirically and conceptually different

62
Q

Orbell and Sheeran 1998 PMT

RESULTS - application

A

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
Q

Norman et al 2003 PMT

AIM

A

can PMT predict parental adherence to eyepatching child everyday for 2 months to improve eye defect?

64
Q

Norman et al 2003 PMT

intentions to eyepatch

A

belief that not adhering has neg consequences
believe eyepatching is effective
confident in own ability to eyepatch child

65
Q

Norman et al 2003 PMT

2 month follow up adherence

A

high adherence predicted by
percieved neg consequences is not adhere
lower perception that eyepatching may be a barrier in everyday life

66
Q

Norman et al 2003 PMT

past beh

A

past not sig influence PMT
BUT sig predict follow up adherence
partially mediated by percieved costs/barriers

67
Q

Norman et al 2003 PMT

application

A

clinicians should emphasise neg consequences of not adhering nd explore means of improving daily life with eyepatch

68
Q

Theory of Planned behaviour by…

A

Ajzen 1986

69
Q

TPB beliefs and cognitions

A

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
Q

TPB

attitudes to beh

A

pos or neg evals

belief in outcome and importance of outcome to self

71
Q

TPB

subjective norms

A

percieved norms and pressures to conform

motivations to conform

72
Q

TPB

PBC

A 
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
Q

TPB mediation hypothesis

A

Atttiudes, subjective norms and PBC mediate the development of intentions which mediate the performance of behaviour

74
Q

TPB sufficiency hypothesis

A

all other bio, social, enviorn, econ, medical, cultural influences mediated via TPB

75
Q

TPB studies

A

Armitage 2005

Schifter and Ajzen 1985

76
Q

Armitage 2005 TPB

AIM

A

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
Q

Armitage 2005 TPB

METHOD

A

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
Q

Armitage 2005 TPB

RESULTS - predictive validity

A

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
Q

Armitage 2005 TPB

RESULTS - past

A

accumulated past sig predicts future

beh in first 5 weeks sig determines attendence > 5 weeks
PBC only covariate - habit?

80
Q

Armitage 2005 TPB

RESULTS - past and cognition

A

successful beh performance = greater intent and beh

unsuccessful performance undermine intent and beh

81
Q

Armitage 2005 TPB

RESULTS - application

A

interventions to change PBC control beliefs
- set subgoals for personal mastery?
observation modelling
relax techniques for anxiety or affect reg improvement

82
Q

Schifter and Ajzen 1985 TPB

AIM

A

can TPB predict weight loss intent and actual weight loss?

83
Q

Schifter and Ajzen 1985 TPB

weight loss intent and beh discrepancy

A

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
Q

Schifter and Ajzen 1985 TPB

METHOD

A

T1 + T2 weigh and TPB Q
T2 = 6 weeks later
expect: 4.5kg loss

85
Q

Schifter and Ajzen 1985 TPB

RESULTS

A

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
Q

Schifter and Ajzen 1985 TPB

Results explanation

A

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
Q

HBM habit criticism

A

HBM focus on conscious information processing and ignores automatic health behaviours

88
Q

HBM external factors criticism

A

HBM focuses on the individual and ignores the role of social and environmental factors

89
Q

HBM core beliefs criticism

A

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
Q

PMT predicting PM and predicting beh criticism

A

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
Q

TPB pro

A

Attempts to adress social and environmental influences on intent and behaviour which HBM and PMT fail to addres

92
Q

TPB population criticsm

A

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
Q

sc model criticism - rationality

A

assumes humans are rational decision makers, tend to exclude affect and anticipation of outcomes

94
Q

TPB predictive validity critcism

A

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
Q

predictors of behaviour unconsidered by SC models

sneihotta et al 2013

A 
habit
self determination
anticipated regret
identity
self reg (ie planning )
\+ reinforcement, beh outside conscious awareness may mediate beh without intent or PBC
96
Q

utility of TPB criticism

sniehotta et al 2013

A

TPB useless in creating new interventions or research paradigms
does not offer any new information compared to newer theories and extensions

97
Q

connoer 2014 tpb on sneihotta et al 2013 commentary

A

sniehotta misplaces and unsupported

extend not reject TPB

98
Q

mceachan et al 2011 meta TPB

connor 2014

A

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
Q

connoer and sparks 2005 TPB subconstructs

connor 2014

A

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
Q

Connor 2014 main TPB problem

A

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
Q

can TPB be conceptually tested?

orbell 2003 criticism

A

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
Q

ogden 2003 synthetic truth

A

theory definitions are determined via empirical tests and explorations

103
Q

ogden 2003 analytic truth

A

theory constructs are determined as a consequence of definition as opposed to actual discrepancy in research

104
Q

ogden 2003

TPB synthetic or analytic

A

‘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
Q

ogden 2003 create or access cog

A

pps unknown beh - questionned about attitudes
FORM attitudes? self report - desireability influence?
may CREATE than access

HEALTH (5 decks)

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