Health Behaviour Flashcards
Generic model of health promotion
Persuasion via health education: changes perceptions on susceptibility, severity and benefits
Changing the environment to encourage people to change behaviour e.g. cycle lanes/ street lighting/ “safe” parks/ providing facilities for NHS staff to exercise…cues for action, benefits, subjective norm
Changing the law either to force people to change behaviour e.g. seat belts/non-smoking environments OR to make unhealthy behaviours expensive e.g. tobacco/alcohol/sugar taxation…barriers, benefits, cues for action, subjective norm
Examples of health bevahiours
Visiting the doctor
•Exercise
•Smoking
•Drinking alcohol
•Self examination
•Eye tests
•Reckless driving
•Using sun screen
•Protected sexual intercourse
•Teeth and gum care
•Compliance to treatment/advice
•Taking medication
•Taking vitamins
•Diet
•Sleep patterns
•Illicit drug use
•Wearing a seat belt
•Wearing cycling helmet
•Immunisations
Examples of Patient compliance and adherence
Preventative health behaviours
Keeping medical appointments
Self care actions
Taking med
Parents administering med to children
What is non adherence
Describes the failure of patient to follow recommend health behaviours and treatment advice given by clinician
Non compliance
Not becaue they dont have intention - intentions are loosely associated with actual behaviour (Webb)
What affects patient adherence
Treatment - comply with some and not others
Condition - varies by condition
Beliefs - effectiveness of treatment
Good predictor of long term adherence
Complex regimens have low adherence
Intrusive treatments lower adherence
Expense
Asymptomatic conditions
Leys model of compliance
Understanding + memory = satisfaction = compliance
Stantons model of adherence
Doctor communication
Increased knowledge and satisfaction
Patients beliefs, locus of control, perceived social support
= adherence
Information motivation and strategy model (martin)
Info - patients don’t understand what theyre meant to do
Motivation - patients are not motivated to carry out their treatment recommendation
Strategy - patient do not have a workable strategy for following treatment recommendations
What is strategy
Provide written instructions
Sign a behavioural contract
Link to support groups
Empowerment and self care
What is health promotion
Process of enabling people control over and to improve their health. Social and environmental interventions.
Supports gov, communities and individuals with coping with health challenges
Building health public policies, create supporting environments and strengthening community and actions and personal skills
Health belief model
Susceptibility of benefits
Of seriousness
Of susceptibility
Of barriers
Cues to action
Motivation
Theory of planned behaviour
Attitude towards behaviour
Subjective norm
Perceived behavioural control
COM-B model
Capability + motivation + opportunity = influence behaviour
Effectiveness of different stratergies for reducing alcohol misuse
Little effective = education and public info
Moderate effectiveness = advertising control
Effective = limiting availability through taxes and other influences on price
Alcohol specific sales outlet
Limiting hours of the day and sale
Regulation of drinking environments
Social norm interventions with students
How can we address inactivity through health promotion
Interventions with the nhs
Community based interventions
National/ gov actions
What is information is regards to IMS model (martin)
Communicat info effectively
Build trust and encourage patients to be involved in decision making
Patients share why and how they will carry out treatments
Listen to concerns and give full attention
What is motivation in regards to IMS model (martin)
Help patients believe efficacy
Elicit, listen and discuss negative attitudes
Help build commitment to adherence and belief in themselves
Role of patents social system in supporting or contraindicating treatment
What does capability stand for in the COM-B model
Individuals psychological and physical capacity to e engage in the activity
Having necessary knowledge and understand and physical capability
What does motivation stand for in the COM-B model
Brain processes that energise and direct behaviour
Not just goals and conscious decision making
Habitual process and emotional responding
What does oppurtunity stand for in the COM-B model
Factors that lie outside the individual that make behaviour possible
E.g. financial and material resoruces
How can we address physical inactivity through health promotion
Interventions with the nhs
CBM
National actions
What are NHS interventions
–GPs/practice nurses identify people who are inactive and encourage them to do more physical activity
–Refer to “exercise referral scheme”
–Provision of supervised exercise (cardiac rehabilitation) for people who have heart disease
SUCEPTIBILITY, MOTIVATION, BARRIERS (HBM)
–Provide facilities for NHS staff to exercise
SUBJECTIVE NORM, CUE FOR ACTION (TPB)
Community based interventions
•More pedestrian crossings/lollipop people – crossing guards
•Cycle lanes, pavements
•Street lighting
•“Safe” parks
•Improve availability of public transport and safety
•Subsidise leisure centres/children’s play places
•Walking groups…..
Governmental interventions
•FACILITATING:
–Allow councils to spend money on road safety schemes
–Provide resources in councils budget for leisure centres etc
•TAXATION
–Tax work-place car parking spaces/company cars/petrol/road use to encourage use of public transport; congestion charge
–Make gym membership tax free
General approaches to health promotion
•Change determinants of behaviour:
–Promote/ sustain desirable habits
–Infrastructure (e.g. food provision, education)
–Economic incentives
–Regulatory change to reinforce behaviour
–Large numbers of people influenced
–Expensive/ difficult to implement
•Focus on individuals at risk
–Education/ motivational strategies
–Some success, not good at sustained long term change
Types of prevention
PRIMARY PREVENTION
Aims to prevent the onset of disease
SECONDARY PREVENTION
Aims to minimise the consequences of disease after it has arisen by detection and treatment to prevent worsening
TERTIARY PREVENTION
Aims to prevent death or permanent disability once a disease has become established
Types of prevention for type 2 diabetes
•Primary prevention
–Education and encourage population to undertake physical activity and eat sensibly
•Secondary prevention
–Support dieting activities and exercise, good management of diabetes to prevent complications, good blood pressure control and cholesterol lowering to prevent heart disease
•Tertiary prevention
–Treat kidney and eye problems, heart disease that are the consequences of diabetes; amputations from injury to neuropathic foot
Health promotion in diverse communities
•Generic campaigns may have different effects on different sectors of society
•May also have unexpected negative consequences; e.g. promoting cooking with fresh vegetables has cost implications
•Important to understand awareness, attitudes, perceptions and beliefs of those targeted and at risk
Summary: implications for practice
•Unhealthy behaviour is not simply due to lack of education, information, or motivation
•Important for doctors to understand people’s health beliefs and the contexts of their behaviour
•Health beliefs differ between cultures
•Also important to be advocates and lobby for environment level changes, including legislative change
