Health behaviour and the COM-B model Flashcards
What is health
A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
Out of date due to- ageing population, ability to manage chronic health conditions
Huber proposed shifting emphasis of health towards the ability to adapt and self-manage in the face of social, physical and emotional challenges
Behavioural factors
Account for around 50% of premature deaths from the 10 leading causes
Health behaviour- any activity undertaken for the purpose of preventing or detecting disease or for improving health/wellbeing
They can have positive and negative health effects
Positive (protective) HB can be defined as activities that may help to prevent disease, detect disease and disability at an early stage, promote and enhance health, or protect from risk of injury
Negative (risky) HB- activities undertaken by people with a frequency or intensity that increases risk of disease or injury
HB- behaviours people engage in that affect their health
Number of health behaviours
7 baseline negative HB predicted mortality
Lack of exercise
Snacking between meals
Smoking
Sleep
Skipping breakfast
Regularly drinking more than 5 units of alcohol
Over/underweight
People over 75 who did the opposite of all this had the health of people aged 35-44 year olds who did less than 3
Preventing cancer/CVD
Not smoking
Being physically active
Drinking moderately
Eating 5 or more servings of fruit and veg a day
Health behaviour in the modern world
The concept of health behaviour is fluid
Health behaviours are not equally important, but vary in their influence across time and across different populations e.g. covid
Strength of the evidence relating behaviours with health outcomes is variable
May do health behaviours for appearance reasons
Important health behaviours in the modern world
Diet- only 28% of adults eat 5 a day
Exercise- 80% of adolescents and 27% of adults do not meet recommended levels of physical activity
Smoking- 8 million adults in UK smoke- highest rates among 25-34 year olds
Sexual behaviour- 47% of sexually active young people do not use a condom when sleeping with someone for the first time
Alcohol- 25-28% of adult drinkers binge on alcohol on their heaviest drinking days
16-24 year olds- less likely to drink but binge when they do
Types of behaviour change
Initiate new behaviour- wear face mask
Stop an existing behaviour- stop smoking
How a behaviour is formed- reduce number of smoking
What do we need to consider
Our motivational concerns in life are food water air reproduction etc
Challenging the behaviours that are motivated by these systems can be difficult
Condom use, energy seeking behaviour- eating habits- energy conservation behaviour- exercise
Biopsychosocial approach
Biology- heritable component to smoking initiation and body weight
Some behaviours have a physiological response- release dopamine, endorphins that can reinforce the behaviour
Disabilities may impact a persons ability to carry out exercise
Symptoms give clues as to what health behaviour to change
Social
Early socialisation- observational learning- brushing teeth
Culturally valued or discouraged behaviour- alcohol
Peer pressure in adolescence
Socioeconomic status- lack of resource
Legislative laws- seat belt use, drink driving
Psychological
Emotion
Stress- smoking, drinking
Fear- avoidance of healthcare- dentist
Disgust- fear avoidance- blood tests
Cognition
Attitudes/beliefs
COM-B model
Capability, opportunity, motivation- behaviour
Capability
Physical capability
Psychological capability- knowledge of how illness works
Opportunity
Environment that enables behaviour
Physical- close proximity to gym, available cycle lanes
Social opportunity- people around you are engaging in a behaviour, reminds you to do something, support
Motivation
Mechanisms that activate or inhibit behaviour
Reflective motivation- evaluations- beliefs about what is good or bad- drinking responsibly,
Plans -planning to wake up early
Automatic motivation- emotional reactions, desires
Anticipated pleasure at the prospect of eating cake
