Health Beliefs and Behaviour

Question 1

What is health behaviour?

Answer 1

Any activity undertaken by an individual believed to be healthy for preventing disease or detecting it at an asymptomatic stage e.g. Alameda study.

Question 2

What are some changes in behaviourally inspired causes of death?

Answer 2

Circulatory diseases have gone from 14% of deaths in 1900 to 29% of deaths in 2012

Causes of death in smokers in 50% of cases is due to the smoking
- Smoking is the number 1 cause of preventable illness and death (on average, smokers die 10 years younger than non-smokers)

7/10 men and 6/10 women in the UK are overweight.
- Due to – complex reasons, increased calorie intake, auto-dependency (cars, etc.)

• 5 modern day killers include – dietary excess, alcohol, lack of exercise, smoking and unsafe sexual behaviour

Question 3

What can behavioural change interventions be targeted at?

Answer 3

• Population – e.g. smoking ban
• Community – e.g. spin classes
• Individual – e.g. healthy eating adverts

*Smoking education in schools – study found that smoking education wasn’t enough to change the smoking behaviour

Question 4

When is health education most effective?

Answer 4

Education is most effective for discrete/ once off behaviours – e.g. getting a child vaccinated

Tailored messages to a particular audience are most effective – e.g. condom use to teenagers

People need more than knowledge to change a habitual lifestyle behaviour – e.g. social support

Question 5

According to learning theory, what are some cues for unhealthy eating?

Answer 5

senses (visual, auditory, olfactory), location, time/events and emotion

Question 6

How do positive reinforcement, negative reinforcement and punishment affect unhealthy eating habits?

Answer 6

Positive reinforcement

• dopamine, boredom alleviation, praise for high-fat meal for family
• Delayed positive reinforcement for healthy eating (effects take too long to have an effect)
• Efforts at dietary change go unnoticed by others (no positive reinforcement)

Negative reinforcement
- avoid painful emotions by comfort eating

Punishment
- preparing a low-fat meal is criticised

Question 7

What are behavioural modification techniques?

How can this be applied to unhealthy eating?

Answer 7

Stimulus control techniques – no “danger” foods in house, eat only at dining table, smaller plates, etc

Counter conditioning – identify “high-risk” situations (e.g. stress) and make healthier responses

Contingency management – encourage partners to praise healthy eating, plan rewards for successful weight loss

Naturally occurring reinforcers – improved self-esteem, reduction in symptoms (e.g. breathlessness)

Question 8

What are the limitations of reinforcement programmes?

Answer 8

• Lack of stimulus generalisation – only behaviour affected was regarding the specific trait being rewarded
• Poor maintenance – rapid extinction of behaviour once primary reinforcer disappeared
• Impractical and expensive

Question 9

What did studies find about fear arousal methods?

Answer 9

high levels of fear had negative effects on reducing bad behavioural effects

Question 10

What did studies find about the effect of friends on altering behaviour

Answer 10

friends had a strong effect

• Adolescents are particularly susceptible
• Best friends have the greatest effect/influence
• Training to avoid peer pressure into smoking had a significant effect on reducing numbers of new smokers

Question 11

What is expectancy-value principle?

Answer 11

The potential for a behaviour to occur is a function of the EXPECTANCY (that the behaviour will lead to a specific outcome) and the VALUE of that outcome

Question 12

What is the health beliefs model?

Answer 12

*look at diagram in slides

The stimuli pathway to induce a change in behaviour

perceived susceptibility and perceived seriousness lead to a perceived threat -> likelihood of behavioural change

perceived benefits vs perceived costs/barriers -> likelihood of behavioural change

cues to action (e.g Angelina Jolie getting double mastectomy)-> perceived threat -> likelihood of behavioural change

Question 13

What is outcome efficacy?

Answer 13

individual expectation that behaviour will lead to the outcome

Question 14

What is self efficacy?

What factors influence self efficacy?

Answer 14

individual belief that one can execute the behaviour required

Influencing factors include:

• Mastery experience – goal-related success
• Social learning – observational (modelling) learning
• Verbal persuasion/encouragement
• Physiological arousal – breathlessness is worrying

Question 15

What is the theory of planned behaviour?

How can this be applied to smoking cessation?

Answer 15

• diagram in slides

beliefs about outcome (expectancy) and evaluation of outcome (value) -> attitude toward behaviour -> intention -> behaviour

beliefs about important other’s attitudes towards the behaviour -> subjective norm -> intention -> behaviour

internal control factors (e.g self-efficacy) and external control factors (e.g perceived costs/barriers) -> perceived behavioural control -> intention and behaviour

• smoking:
• Explore attitudes towards smoking
• Explore norms of important people around
• Explore whether they intend to quit
• Explore how much self-efficacy they have

Question 16

What is the transtheoretical model (stages of change)?

Answer 16

The model begins with pre-contemplation to enter the cycle -> contemplation -> preparation -> action -> maintenance -> permanent exit/ relapse (relapse -> contemplation)

*The behaviour may often go around the cycle a few times before the individual permanently exists the cycle and thus the unwanted behaviour