Health psychology

Question 1

What is health psychology?

Answer 1

Health psychology emphasises the role of psychological factors in the cause, progression and consequences of health and illness
Aims to put theory into practice by promoting healthy behaviours and preventing illness

Question 2

What are the three health behaviours?

Answer 2

Health Behaviour
Illness Behaviour
Sick role Behaviour

Question 3

What is a health behaviour?

Answer 3

A behaviour aimed to prevent disease (e.g. eating healthily)

Question 4

What is an illness behaviour?

Answer 4

A behaviour aimed to seek remedy (e.g. going to the doctor)

Question 5

What is a sick role behaviour?

Answer 5

Any activity aimed at getting well (e.g. taking prescribed medications; resting)

Question 6

What are some health damaging behaviours?

Answer 6

Smoking , alcohol & substance abuse, risky sexual behaviour, sun exposure, driving without a seatbelt

Question 7

What are some health promoting health behaviour?

Answer 7

Taking exercise, healthy eating , attending health checks, medication compliance, vaccinations

Question 8

What are some examples of health promotion campaigns?

Answer 8

‘Everyone enjoys a drink, no one enjoys a drunk.’
Change 4 Life Campaign, “5 a day”
Stoptober, Movember

Question 9

What are perceptions of risks influenced by?

Answer 9

Lack of personal experience with problem
Belief that preventable by personal action
Belief that if not happened by now, its not likely to 4. Belief that problem infrequent

Question 10

What are the NICE guidance on behaviour change?

Answer 10

Planning interventions

2. Assessing the social context
3. Education and training
4. Individual-level interventions
5. Community-level interventions
6. Population-level interventions
7. Evaluating effectiveness
8. Assessing cost-effectiveness

Question 11

How can doctors help individuals change their health behaviours?

Answer 11

Work with your patient’s priorities
• Aim for easy changes over time
• Set and record goals
• Plan explicit coping strategies
• Review progress regularly (this really matters)
• Remember the public health impact of lots of you making small differences to individuals

Question 12

What are some models and theories of behaviour change?

Answer 12

Health belief model (HBM)

2. Theory of Planned Behaviour (TPB)
3. Stages of change /transtheoretical model (TTM)
4. Social norms theory
5. Motivational interviewing
6. Social marketing
7. Nudging (choice architecture)
8. Financial incentives

Question 13

In the health belief model, individuals will change if they….?

Answer 13

Believe they are susceptible to the condition in question (e.g. heart disease)
Believe that it has serious consequences
Believe that taking action reduces susceptibility
Believe that the benefits of taking action outweigh the costs

Question 14

What is bad about the health behaviour model?

Answer 14

Alternative factors may predict health behaviour, such as outcome expectancy (whether the person feels they will be healthier as a result of their behaviour) and self-efficacy (the person’s belief in their ability to carry out preventative behaviour)
As a cognitively based model, HBM does not consider the influence of emotions on behaviour
HBM does not differentiate between first time and repeat behaviour
Cues to action are often missing in HBM research

Question 15

In the theory of planned behaviour, intention is determined by…..?

Answer 15

A persons attitude to the behaviour
The perceived social pressure to undertake the behaviour,
or subjective norm
A persons appraisal of their ability to perform the
behaviour, or their perceived behavioural control

Question 16

What bridges the gap between behaviour and behaviour intention?

Answer 16

Perceived control
Anticipated regret
Preparatory actions
Implementation intentions
Relevance to self

Question 17

What is bad about the theory of planned behaviour?

Answer 17

Criticisms include the lack of a temporal element, and the lack of direction or causality (Schwarzer, 1982)
• TPB is a “rational choice model”. Doesn’t take in to account emotions such as fear, threat, positive affect, all of which might disrupt “rational” decision making
• Model does not explain how attitudes, intentions and perceived behavioural control interact
• Habits and routines - which Simon (1957) referred to as “procedural rationality” - bypass cognitive deliberation and undermine a key assumption of the model
• Assumes that attitudes, subjective norms and PBC can be measured
• Relies on self-reported behaviour

Question 18

What are the good things about the health behaviour model?

Answer 18

Longest standing model of behaviour change
• Successful for a range of health behaviours (breast self-examination, vaccinations, diabetes management, adherence to medication, cancer screening)
• Perceived barriers have been demonstrated to be the most important factor for addressing behaviour change in patients

Question 19

What are the good things about the theory of planned behaviour?

Answer 19

Rational choice model
• Attitudes, subjective norms, PBC are the major determinants of intentions
• TPB can predict intentions for a wide range of health behaviours (smoking, self-examination, abortion, diet, condom use)
• Takes in to account the importance of social pressures and norms as well as perceived control
• Useful for predicting people’s intentions but not as successful for actual behaviours – techniques to bridge the gap between intentions and behaviours

Question 20

What are the stage models of health behaviour and what are they?

Answer 20

Transtheoretical model, or stages of change model.
Stage theories see individuals located at discrete ordered stages, rather than on a continuum.
• Each stage denotes a greater inclination to change outcome, typically behaviour, than the previous one.

Question 21

What are the stages in the transtheoretical model?

Answer 21

Precontemplation – no intention of giving up smoking
• Contemplation – beginning to consider giving up, probably at some ill-defined time in the future
• Preparation – getting ready to quit in the near future
• Action – engaged in giving up smoking now
• Maintenance – steady non-smoker,
i.e. state of change reached

Question 22

What are the advantages of the transtheoretical model?

Answer 22

Acknowledges individual stages of readiness (tailored interventions)
• Accounts for relapse
• Temporal element (although arbitrary)

Question 23

What are the disadvantages of the transtheoretical model?

Answer 23

Not all people move thorough every stage, some people move backwards and forwards or miss some stages out completely
• Change might operate on a continuum rather than in discrete stages
• Doesn’t take in to account values, habits, culture, social and economic factors

Question 24

What does motivational interviewing involve?

Answer 24

A counselling approach for initiating behaviour change by resolving ambivalence

Question 25

What does the ‘nudge’ theory involve?

Answer 25

‘Nudge’ the environment to make the best option the easiest –e.g. opt-
out schemes such as pensions, placing fruit next to checkouts

Question 26

What are some transition points that would be a good time to try and change health behaviours?

Answer 26

leaving school,
• entering the workforce
• becoming a parent
• becoming unemployed
• retirement and bereavement