Health Beliefs and Cognitions Flashcards
What is health behaviour? (ref?)
Any activity undertaken for the purpose of preventing or detecting disease, or for improving health and wellbeing (Connor & Norman, 2005)
Give examples of health impairing behaviours
smoking, alcohol use, high fat intake
Give examples of health enhancing behaviours
exercising, eating fruit and veg, condom use (primary prevention) Medication adherence (secondary and tertiary prevention)
What are the two assumptions of health behaviour pattern (HBP) research?
- An important proportion of the preventable mortality and morbidity is due to behaviour
- HBPs are modifiable
Based on the Alameda County Study (N=7,000) which took place over 10 years, which 7 behaviour patterns predict mortality? (ref?)
- Not smoking
- Moderate alcohol intake
- 7-8 hours sleep
- Regular exercise
- Maintaining healthy weight
- Avoiding snacks
- Eating breakfast
(Breslow & Engstrom, 1980)
Which factors were assessed by the UK population study? (ref?)
Not smoking, being physically active, moderate alcohol use and plasma vitamin levels indicating 5+ fruit and veg a day (Khaw et al., 2008)
What were the findings of the UK population study?(ref?)
After 11years 200,000 people were followed up and those who had performed all 4 behaviours studied were 4x more likely to be alive than those doing none of them. (Khaw et al., 2008). This was controlling for age, gender, BMI and SES.
Describe Yates et al’s (2008) study and their findings.
They studied more than 2000 70yo men over 20 years and found that:
- The average healthy 70 year old had a 54% change of living to 90
- This was reduced to 44% for those with sedentary lifestyle
- 26% if obese
- 22% if a smoker
In what four ways do health behaviours affect health?
- Direct biological benefits (e.g. exercise increases cardiovascular functioning)
- Protection against health risks (e.g. condoms and STI’s)
- Facilitation of early disease detection (help seeking)
Facilitation of treatment (adherence)
What are the six categories of predictors of health behaviour and who identified them?
Cummings et al (1980)
- Knowledge about disease
- Perception of threat
- Accessibility of care
- Attitudes to health care
- Social network characteristics
- Demographics
Some of the predictors of health behaviours are more _________ through ________ than others.
Modifiable/targeted health promotion
Social cognition models (SCMs) were developed to identify ______________.
Modifiable cognitive predictors of behaviour
Good ______________ is essential if SCMs are to provide targets for HP.
Predictive validity.
Model 1: Health beliefs model (ref?)
Becker (1974)
Describe the model diagram on card 5.
See card 5.
HBM as a predictive model: Outline the findings of Janz and Becker (1984)
Review of 18 prospective studies looking at the significance ratios for each of the HBM predictors and behaviour.
Severity = 65% (11/17)
Susceptibility = 82% (14/17)
Benefits = 81% (13/16)
Barriers = 100% (11/11)
- There were very few studies of cues to action and health motivation and therefore no support.
HBM as a predictive model: Outline the findings of Harrison et al (1992)
Meta-analytic review of 234 studies, only 16 met criteria for including the four major constructs and reliability checks revealed weak operationalisations.
Sample weighted average correlations:
Severity = 0.08
Susceptibility = 0.05
Benefits = 0.13
Barriers = -0.21
- Only 0.25-4.4% of behaviour variance explained by the HBM. However this study used extremely harsh inclusion criteria and potentially undermined combined effects.
HBM based interventions: Describe the study on persuading A&E asthma patients to visit their GP (PICO)
P = 74 patients presenting with asthma at A&E
I = 1. Health beliefs assessed 2. HBM advice given (susceptibility to asthma, seriousness of asthma and benefits of visiting the GP to obtain treatment and avoid complications)
C = group just advised to go to GP with no supporting information
O = % who made and who kept GP appointment
- Active group were both significantly more likely to make and keep GP appointment.
HBM based interventions: Describe the study on increasing compliance in ER patients using clinical and telephone intervention based on the HBM
P = 842 ER patients
I = 1. Routine care, 2. Hospital HBM intervention, 3. Telephone HBM intervention, 4. Combined intervention
O = % who scheduled/kept a GP appointment
Results: 1. 33%/24%, 2. 76%/59%, 3. 85%/59%, 4. 85%/68%
- This was a well conducted, effective HBM intervention
HBM overview: Health beliefs predict health behaviours but are __________.
Weak predictors
HBM overview: Can the model be improved?
Maybe by considering intention as a measure of health motivation, attributions and self efficacy.
HBM overview: The HBM has inspired many ____________.
Effective interventions.
Model 2: Theory of Reasoned Action/Theory of Planned behaviour (ref?)
(Fishbein, 1963/Azjen, 1991)
TRA: Attitudes depend on ___________ and ____________
- Beliefs about action outcomes
2. Evaluation of those outcomes