Chapter 4: What does health protective behavior entail?

Question 1

adherence

Answer 1

that the

patient is following the advice of the expert.

Question 2

compliance

Answer 2

means patient medicine taking behavior which

conforms with doctor’s orders.

Question 3

Concordance

Answer 3

can be defined by a jointly determined agreement between physican
and patient as to what is the appropriate treatment, following the patient having been fully informed of the costs and
the benefits of adhering to their particular treatment.

Question 4

cathecolamines

Answer 4

nordadrenaline and adrenaline

Question 5

Wie lijken er meer te sporten? Mannen of vrouwen?

Answer 5

Mannen

Question 6

mammography

Answer 6

screening for breast cancer

Question 7

distal influences

Answer 7

Examples of distal influences are SES, age,

ethnic origin, gender and personality, indirectly

Question 8

proximal influences

Answer 8

someone’s attitudes and beliefs towards healthrisk and health-protective behavior.

Question 9

Eysenck’s three-factor model

Answer 9

1. Extroversion (outgoing social nature): dimensionally opposite to introversion.
2. Neuroticism (anxious, guilty or worrying) opposite to emotional stability (relaxed and satisfied)
3. Psychoticism (self-centered, aggressive, antisocial) opposite to self-control (kind, predominant, obedient).

Question 10

McCrae and Costa five-factor model

Answer 10

1. Neuroticism
2. Extraversion
3. Openness (to experience)
4. Compliance (agreeableness)
5. Conscientiousness

Question 11

internal locus of control

Answer 11

They take responsibility for their

own actions and believe that they can determine their outcomes.

Question 12

healt locus of control three independent dimensions

Answer 12

1. Internal : strong internal beliefs consider the individual themselves as the prime determinant of their health
   state. Internal beliefs are theoretically associated with high levels of health protective behavior and with
   Bandura ‘s self-efficacy construct.
2. External / chance : strong external beliefs consider that external forces such as happiness or opportunity
   determine the health state of an individual rather than one’s own behavior.
3. Powerful others : strong beliefs on this scale consider that a person’s health status is determined by the
   actions of powerful others such as health and medical professionals

Question 13

self-determination theory

Answer 13

distinguishes between intrinsic and extrinsic motivation. With intrinsic motivation, a
person is motivated to act in a certain way to gain personal satisfaction or rewards, such as a sense of competence.
Extrinsically motivated behavior is due to external rewards, such as the appreciation of peers. There is a relationship
between personality and behavioral motives.§

Question 14

Social Cognition Theory

Answer 14

Health protective and risk behaviors are performed for one reason: people have outcome expectations attached to
them.
According to Bandura, behavior is influenced by three types of expectations: situation-outcome expectations,
outcome expectations and self-efficacy expectations. The Social Cognitive Theory (STC) proposes that these
expectancies may or may not provide lasting incentives to change.

Question 15

unrealistic optimism

Answer 15

Many

people have the idea that they are less likely to get an illness or accident compared to others

Question 16

Health Belief Model

Answer 16

The Health Belief Model is a cognitive model that proposes that the likelihood that a person will engage in particular
health behavior depens on demographic factors, for example SES, gender, age and a number of four beliefs that may
arise as a result of internal or external cue to action. These beliefs encompass perceptions of threat and evaluation of
behavior in question, with cues to action and health motivaiton added at a later date. For example, someone could
have ideas about how obesity affects heart and vascular diseases. In addition, someone may realize that he is
overweight. This may again lead to the idea that health will improve if he fight obesity. A person becomes aware of
the obstacles if he really wants to change his diet. For example, that the partner does not like vegetables at all. The
cues that are of influence may be external, such as watching a cooking program, or internal, such as being out of
breath after walking up a flight of stairs.

Question 17

Criticism of health belief model

Answer 17

The HBM says nothing about how the various components work together, while many studies show that
there is interaction between the components.
 Alleged benefits should be weighed against alleged obstacles, but nowhere does it explain how to make that
calculation.
 The HBM is static, suggesting that beliefs occur simultaneously.
 The HBM attaches great importance to the assumed threat (the severity of a disease), but many studies show
that this does not necessarily have a major impact on actual behavior.
 Social influences receive limited attention in the model.
 Little attention is paid to mood or negative affect.
 The HBM may overestimate the role of threat.

Question 18

Theory of Reasoned Action

Answer 18

The TRA is a model that assumes that behavior is determined by someone’s views, perceptions and expectations
about behavior in a certain social context. The TRA is therefore a social cognitive model. The model assumes that
people focus on a goal and, before taking action, first consider whether they will take a certain action. According to
the TRA, behavior is proximally influenced by intention, which in turn is influenced by attitudes. This results in the socalled outcome expactancy belief, someone’s expectation about the result and the outcome value, a kind of
motivation behind the behavior (‘it is important to become healthy’).
When someone feels social pressure because, for example, his parents want him to stop smoking, this is called
a subjective norm. In the TRA, a person’s attitudes are weighed against subjective norms. Someone who does not feel
like losing weight can eventually do so because there are subjective norms that convince him.

Question 19

Theory of Planned behavir

Answer 19

Developed from the TRA. Houd zich ook meer bezig met uncontrolled behavior, (perceived behavioral control PBC)

Question 20

implementation intentions

Answer 20

Many

people benefit from determining exactly how, when and where they will perform certain behavior

Question 21

The Transtheoretical model (TTM)

Answer 21

Pre-contemplation : The person does not think about changing behavior, does not think he has a problem
and does not intend to change anything in the coming six months.
 Contemplation : There is a realization that something might have to change, but there is no rush. For
example, people start looking for information about the problem or about healthier behavior.
 Preparation : The individual is ready for the change and makes plans, such as a start date (for example within
two months). Motivation and believing in yourself are important in this phase.
 Action : Someone starts with healthy behavior, for example by eating fruit instead of cake. Setting realistic
goals is very important at this stage, as is social support.
 Maintenance: The individual continues with healthy behavior and can resist temptation.
 Termination : The behavior was good for a while, but now the individual has the idea of falling back into
unhealthy behavior.
 Relapse : Falling back in the old behavior or going back one phase.

Question 22

The Precaution Adoption Process Model (PAPM)

Answer 22

. Stage 1 ( unaware ): People are not aware of a possible health hazard. You see this especially when new
diseases or risks are discovered. For example, when the HIV virus was just discovered, many people
continued to have unsafe sexual contact because they thought it would not happen to them and that the risk
of AIDS would be very small.
2. Stage 2 ( unengaged ): People are now aware of the risk, but there is unrealistic optimism . People mistakenly
think optimistically about the danger of behavior and the associated risks. For example, it is thought that it is
not bad to have unsafe sex a few times, often because people from the area show the unhealthy behavior
more often.§
3. Stage 3 ( consoderation ): People are considering whether something should happen and whether they are
willing to change things.
4. Stage 4 ( decide not to act ): Although people are aware of the risks, it can happen that someone decides not
to change their behavior.
5. Stage 5 ( decide to act ): Making the decision to take action (which does not mean that action is actually
taken).
6. Stage 6 (action): In this phase, action is taken to reduce the risk.
7. Stage 7 ( final stage ): This phase is not always reached by everyone. It is also questionable how long the new
behavior will be sustained.

Question 23

The Health Action Process Approach (HAPA)

Answer 23

This model also consists of phases, but the people behind this have also thought of the transition between intention
and behavior. The belief in own abilities and action plans play a major role in this model.
Awareness of the risk content and personal aspects that contribute to this are an important factor in the motivation
phase.
When someone’s intentions have been formed, it is time to make concrete plans. Just as with the implementation
intentions, it is about where, when and how questions. It is important to adhere to the formed intentions. It is again
important here to believe that behavior can be maintained, even though it may be difficult. For example, a person
who started eating healthier would not have thought of a birthday where unhealthy food is abundant. When
someone has given in to the temptation, the recovery phase comes, in which healthy behavior is resumed.
Although this model is relatively young, the research results are positive. Research into preventive breast
examinations shows that phase-specific belief in one’s own abilities is a good predictor of future behavior