Health Behaviour

Question 1

Generic model of health promotion

Answer 1

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

Question 2

Examples of health bevahiours

Answer 2

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

Question 3

Examples of Patient compliance and adherence

Answer 3

Preventative health behaviours
Keeping medical appointments
Self care actions
Taking med
Parents administering med to children

Question 4

What is non adherence

Answer 4

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)

Question 5

What affects patient adherence

Answer 5

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

Question 6

Leys model of compliance

Answer 6

Understanding + memory = satisfaction = compliance

Question 7

Stantons model of adherence

Answer 7

Doctor communication
Increased knowledge and satisfaction
Patients beliefs, locus of control, perceived social support
= adherence

Question 8

Information motivation and strategy model (martin)

Answer 8

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

Question 9

What is strategy

Answer 9

Provide written instructions
Sign a behavioural contract
Link to support groups
Empowerment and self care

Question 10

What is health promotion

Answer 10

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

Question 11

Health belief model

Answer 11

Susceptibility of benefits
Of seriousness
Of susceptibility
Of barriers

Cues to action
Motivation

Question 12

Theory of planned behaviour

Answer 12

Attitude towards behaviour
Subjective norm
Perceived behavioural control

Question 13

COM-B model

Answer 13

Capability + motivation + opportunity = influence behaviour

Question 14

Effectiveness of different stratergies for reducing alcohol misuse

Answer 14

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

Question 15

How can we address inactivity through health promotion

Answer 15

Interventions with the nhs
Community based interventions
National/ gov actions

Question 16

What is information is regards to IMS model (martin)

Answer 16

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

Question 17

What is motivation in regards to IMS model (martin)

Answer 17

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

Question 18

What does capability stand for in the COM-B model

Answer 18

Individuals psychological and physical capacity to e engage in the activity
Having necessary knowledge and understand and physical capability

Question 19

What does motivation stand for in the COM-B model

Answer 19

Brain processes that energise and direct behaviour
Not just goals and conscious decision making
Habitual process and emotional responding

Question 20

What does oppurtunity stand for in the COM-B model

Answer 20

Factors that lie outside the individual that make behaviour possible
E.g. financial and material resoruces

Question 21

How can we address physical inactivity through health promotion

Answer 21

Interventions with the nhs
CBM
National actions

Question 22

What are NHS interventions

Answer 22

–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)

Question 23

Community based interventions

Answer 23

•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…..

Question 24

Governmental interventions

Answer 24

•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

Question 25

General approaches to health promotion

Answer 25

•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

Question 26

Types of prevention

Answer 26

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

Question 27

Types of prevention for type 2 diabetes

Answer 27

•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

Question 28

Health promotion in diverse communities

Answer 28

•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

Question 29

Summary: implications for practice

Answer 29

•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