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Health Psychology Sem2Yr2 Flashcards

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1
Q

How can health psychology be defined?

A

The application of psychology to the study of health and ill-health

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2
Q

What are the different types of research methods in psychology?

A
  • Randomised control trials
  • Qualitative ideographic approaches
  • meta-analysis and systematic reviews
  • Case studies
  • Questionnaire-based surveys
  • Clinical observation
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3
Q

What are some historical health beliefs?

A
  1. In the early middle ages, people believe health was a punishment from god or evil spirits entering the soul
  2. People believed they had little control over their health
  3. Priests were health medics by exorcising evil spirits
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4
Q

Why was Descartes (1685-1650) important to health psychology?

A

Proposed dualism - the interaction of mind and body
Believed that the brain and body were made up of material matter
The mind was non-material
The interaction occurred through the Pineal gland
Made it more acceptable to do autopsies because the sole had left the body

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5
Q

What is the biological approach in health psychology?

A

When advances in medical research developed in the 19th century, health psychology was seen from a more medical perspective
Health was considered the normal state and ill-health was when external bodies entered the body

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6
Q

Who developed the germ theory of how microorganisms caused illnesses?

A

Pasteur (1864)

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7
Q

How can health be defined?

A

Historically viewed as the absence of disease.

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8
Q

Who did the biomedical model?

A

Papas, Belar, & Rozensky, 2004

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9
Q

What is the biomedical model?

A

Views health from the perspective of medicine and biology

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10
Q

What is the holistic definition of health?

A

Considers health as environment, lifestyle, and behavioural choices

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11
Q

What is the biopsychosocial model?

A

Considering health psychology from the perspective of psychology, biology and sociology.

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12
Q

According to the biopsychosocial model, answer these questions:
1. What causes illness?
2. Who is responsible for illness?
3. How should illness be treated?
4. Relationship between health and illness?
5. Relationship between mind and body?
6. Role of psychology in health?

A
  1. Multifaceted
  2. Patients, not necessarily passive
  3. Holistic treatment of whole person
  4. Continuum
  5. Separate with interaction
  6. Psychological consequence to illness but also contributes to aetilogy.
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13
Q

According to the biomedical model, answer these questions:
1. What causes illness?
2. Who is responsible for illness?
3. How should illness be treated?
4. Relationship between health and illness?
5. Relationship between mind and body?
6. Role of psychology in health?

A
  1. External disease invading the body or internal
    involuntary changes
  2. The patients are victims
  3. Physiological medicine
  4. Separate
  5. Separate
  6. Psychological consequence, not cause
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14
Q

Who developed the biopsychosocial model?

A

Engel (1977)

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15
Q

What is the definition of health risk behaviour?

A

Any behaviour with a frequency or intensity that increases the risk of disease or injury

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16
Q

What is the definition of health-enhancing behaviour?

A

Activities that may help to prevent disease/detect diseases and disability at an early stage, promote and enhance health, or protect from risk of injury

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17
Q

What are cohort studies?

A

They help us determine the association between behaviours and health status

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18
Q

What are RCTs and dose-response studies?

A

Refine the detail and complexities of these associations

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19
Q

What are the 6 key determinants of health?

A
  • Physical activity
  • Diet
  • Smoking
  • Alcohol consumption
  • Attending screenings
  • Sexual health
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20
Q

According to Weller et al (2009), are men or women more willing to engage in screenings?

A

Women

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21
Q

What demographics are less likely to attend screening?

A
  • Lower-income
  • Lower levels of education
  • Socially deprived backgrounds
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22
Q

What demographics are more likely to smoke?

A
  • Unmarried
  • Unemployed
  • Lower-level of education
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23
Q

What percentage of adults drink over the recommended weekly guidelines?

A

19%

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24
Q

What are the demographics for sexual health?

A
  • Young people have the highest rates of sexual diseases
  • Young women are more likely to be diagnosed with an STD
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25
Q

What does it mean by determinants of health?

A

Factors that influence the health of individuals/communities

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26
Q

What are health inequalities?

A

Differences in health outcomes that may be deemed unfair

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27
Q

What is the ecological model of public health? (Mcleroy, Bibeau, Steckler, & Glanz (1988))

A

Individual - Attitudes, knowledge, and skills
Interpersonal - Family, friends, social networks
Organisational - Organisations, social institutions
Community - relationships among organisations
Public policy - National, state, local laws

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28
Q

What does evidence suggest that are perceptions determine?

A
  • Respond to perceived symptoms
  • Make decisions regarding help seeking behaviour
  • Make decisions regarding adhering to medical advice
  • Function in terms of well-being
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29
Q

What individual factors contribute to our perceptions of health and our health related behaviour?

A
  • Culture
  • Lifespan development
  • Gender
  • Personality
  • Attitudes
  • Fears
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30
Q

How does age effect our perception of health?

A
  • Lack of understanding
  • experiences of health in ourselves and others
  • Health expectations
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31
Q

How does culture effect our perception of health?

A

Differences between collectivist and individualist cultures.
- Do people view health as an individual or collective responsibility?

Acceptance of alternate therapies

Concepts such as mental health vs spiritual possession

~Obesity : Western societies appropriateness of fast food, food convenience and portion sizes have contributed to the obesity epidemic.
~Hypertension : Western societies associate this with processed foods high in salt. African cultures associate it with stock cubes.

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32
Q

How does gender effect our perception of health?

A

Men contact health services less often

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33
Q

What is the health belief model? (HOCHBAUM, ROSENSTOCK
& KEGELS (1950S); BECKER
& ROSENSTOCK (1988)

A

It is a COGNITIVE MODEL that assumes behaviour is as a result of rational processing of the costs and benefits the behaviour

Originally used to understand how perceptions of health could influence health behaviours and response to treatment in chronically ill patients

New demographics of the model:
Perceived susceptibility
Perceived severity
Costs of behaviour
Benefits of behaviour
–>Lead to behavioural intention
Cues to action
Health motivation
Perceived control/self-efficacy

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34
Q

What is the effect of educational intervention based on the health belief model on promoting self care behaviours of type-2 diabetes patients?
(Shabibi et al. (2017)) - study

A

Rationale - Need for patients to understand how to self-manage their condition, they should be made to understand the severity of their condition

Intervention using the principles of HMB

4 - 60 min sessions in a month (once per week)
session 1 - intro about diabetes, symptoms, complications, ways to prevent
session 2 - knowledge of self-care aspects: food care, regular drug use, physical activities
session 3 - healthy diet and proper nutrition
session 4 - testing blood sugar with practical demonstrations

6 questions on perceived susceptibility
6 questions on perceived benefits
5 questions on perceived severity
7 questions on perceived barriers
10 questions on self-efficacy

tested with t-tests

CONCLUSIONS
- health interventions can be beneficial for altering health perceptions

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35
Q

Evaluation of Health Belief Model

A

Has been used in numerous health contexts - safe sex, dental visits, exercise

There is contradictory research between relationship with behavioural interventions and low perceived severity and susceptibility.

Focuses on behaviour intention not actual behaviour

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36
Q

What is protection motivation theory? ROGERS (1983); ROGERS AND PRENTICE-DUNN (1997)

A

Theory is designed to explain reducing health risk behaviour - smoking and unprotected sex

  • Proposes that health risk reducing behaviour happens when an individual has high protection motivation
37
Q

What is protection motivation?

A

It is as a result of combining two cognitive appraisals - threat appraisal and cognitive appraisal

38
Q

What is threat appraisal?

A

they relate to the perception of a health risk behaviour - smoking

39
Q

What is coping appraisal?

A

Relate to perceptions and consideration of the risk reducing behaviour

40
Q

What is the extended parallel process model? (Witte 1992, 1998)

A

This attempts to explain when increasing risk perceptions will/will not increase risk reducing behaviour

Places more importance on fear than the protection motivation theory

Comprises threat and efficacy
- threat happens first so without threat, efficacy appraisal will not occur

41
Q

What is efficacy appraisal?

A

Depending on efficacy appraisal, people will engage in either: danger control or fear control

42
Q

What is danger control?

A

Being motivated to address perceived threat/danger and adopt risk reducing behaviour

43
Q

What is fear control?

A

Relates to strategies to reduce the fear arousal e.g., denial, defensive avoidant, reactance

44
Q

Why is it important to understand the determinants of a behaviour?

A
  • Can target interventions to make more appealing to people
  • Can understand when is best to intervene
  • Better identify strategies to use to help individuals change their behaviour.
45
Q

What are the 2 main forms of models?

A

Stage theories - Assumes that changing behaviour requires individuals to go through stages.
Social cognition models - Specify the cognitive determinants of behaviours

46
Q

What are stage models?

A

Stage models identify stages that people move through during behaviour change.
Stages are different and people can only be in one stage at once.
They are helpful for determining where in a process of behaviour change an individual is so we can consider how to help them move on or an appropriate time to intervene.

47
Q

What are the 4 properties of stage theory (Weintstein, Rothman & Sutton, 1998)?

A
  • A classification system to define the stages
  • An order to the stages
  • Common barriers should face people at the same stage
  • Different barriers to change for different stages
48
Q

What is the transtheoretical model of behaviour change? (PROCHASKA & DICLEMENTE, 1984; PROCHASKA & VELICIER, 1997)

A

The theory is made up of:
stages of change - identify an individuals position in terms of behaviour change.
processes of change -Identifies a way to help individual move through the stages
temptation - The urge to relapse to previous behaviour when facing difficult periods

49
Q

What are the stages of change?

A

PRECONTEMPLATION: No participation in the behaviour with no intention of changing behaviour
CONTEMPLATION: No participation in the behaviour but intends to change in the next 6 months (not 30 days)
PREPARATION: Intention to participate in the near future (30 days)
ACTION: Engaged in regular participation for less than 6 months.
MAINTANANCE: Been engaged in regular participation for more than 6 months

50
Q

What is decision balance?

A

Identifying barriers and facilitators for changing the behaviour

51
Q

What is self-efficacy?

A

How confident an individual is that they can carry out a behaviour to achieve a desired outcome

52
Q

What is the COGNITIVE process of change?

A
  1. Consciousness raising - seek information to increase understanding of behaviour
  2. Dramatic relief - Stimulating an emotional reaction
  3. Environmental re-evaluation - Consideration of impact of behaviour on environment/others
  4. Self re-evaluation - Assessing self-image
  5. Self-liberation - Making a commitment to change and believing its possible
53
Q

What is the BEHAVIOURAL process of change?

A
  1. Social-liberation - Taking advantage of alternative lifestyles and opportunities
  2. Helping-relationships - Accepting the support of others
  3. Contingency management - Rewarding oneself/being rewarded/achieving goals
  4. Stimulus control - Removing unhelpful triggers and substituting with positive cues
  5. Counterconditioning - Identifying substitute behaviours to implement instead of negative ones
54
Q

What was the research for Transtheoretical model? (Kirk, MacMillan, & Webster (2010))

A

Physical activity with people with diabetes type 2 or/and cardiovascular disease.

Participant identified their stage of change for physical activity.
Provided measures of self-efficacy.

Using TTM, results showed:
Consciousness raising increased from contemplation to action
 Self-liberation increased from contemplation to maintenance
 Helping relationships increased from preparation to
maintenance
 Counter conditioning increased from contemplation to
preparation, action and maintenance
 Reinforcement management increased from contemplation and
preparation to maintenance

55
Q

Name some evaluation points for Transtheoretical model.

A

TTM is one of the most extensively applied models of behaviour change
yet receives large amount of criticism
 Successfully acknowledges individual differences
 Most research is cross-sectional therefore cause and effect between SoC,
self-efficacy and DB is difficult
 Time frames suggested lack any meaningful basis and no account of past
behaviour
 Conflicting research to support the variance in processes of change at
different levels
 Some suggest that weaknesses of model can be attributed to weak RM
focusing on aspects of the model rather than entire model

56
Q

What is theory of planned behaviour? (Ajzen & Fishbein, 1980)

A

It is developed from the Theory of Reasoned Action.
Suggests that individuals decisions to engage in a behaviour are:
- Rational and goal directed
- Determined by a persons belief about the behaviour in a social context, social perceptions and expectations

57
Q

Explain the research for theory of planned behaviour - Hassandra et al. (2011)

A

Wanted to explore how the TPB variables, parental attitudes, and parental smoking behaviour predicts adolescents intentions to smoke at different ages
(elementary 7-12)
(junior high 13-15)
(senior high 16-18)

763 Greek students ages 10-18 discussed their attitudes, subjective norms and intentions to smoke.
525 parents reported on smoking attitudes and current smoking behaviours.

RESULTS:
Students views on smoking were mostly negative but scores gradually increased with age.
Attitudes and Perceived Behavioural Control predicted intention to smoke in all ages but had stronger relations with 16-18 years than 7-15.
Subjective norms had no significant relationship with intention.
Parents attitudes predicted intentions to smoke in 7-12 years only.
No relationship between parents smoking
behaviour and smoking intentions of students

58
Q

What does the theory of planned behaviour model look like?

A

Demographics, personality, and experience impacts attitudes, subjective norms, and perceived behavioural control which poor into behaviour intentions.

59
Q

Briefly give evaluation for the theory of planned behaviour model.

A

 Applied successfully to predict a wide range of health related behaviours
 Generally predicting 40-50% of variance in intention; 19-38% actual
behaviour
 Research consistently supports the role of attitudes and PBC for
predicting behavioural intention (Armitage & Connor, 2001)
 Role of social norms are less conclusive; may be too broad and not
account fully for contribution of disperse social groups or moral pressure
 The indirect relationship of attitudes and SNs predicting behaviour
suggests additional variables must translate intentions into behaviour
 No consideration of the potential reverse relationships that may exist.
For example, behaviour may shape attitudes etc.

60
Q

What is health promotion?

A

“Any event, process or activity that facilitates the protection
or improvement of the health status of individuals, groups,
communities or populations” (Marks et al., 2005, p393)
-Interventions
-Public policy
-Advertisement/posters/leaflets raising awareness

61
Q

According to Marks et al., (2005) what are the 3 main approaches to health promotion?

A

Behaviour change approach
Self-empowerment approach
Collective action / Community development approach

62
Q

What determines whether a health promotion campaign is successful?

A

Whether the communication is effective at changing attitudes.
Whether the modified attitudes are effective for changing behaviour

63
Q

What is the Behaviour Change Approach?

A

Considers -
Individuals cognitions/attitudes
Individuals perceptions of society
Individuals perceptions of access to facilities

It considers ways to help the individual change their cognitions in a way to facilitate their behaviour change

64
Q

What are fear appeals?

A

They’re a health promotion technique for encouraging behaviour change.

They aim to generate an emotional reaction to -
heighten awareness to a particular message
motivate a change in attitudes
motivate a change in behaviour

65
Q

How effective are fear campaigns according to Witte & Allen (2000)?

A

In a meta-analysis, it was suggested that:
strong fear appeals increase perceived susceptibility and severity.
strong fear campaigns are more persuasive than weak campaigns
strong fear alongside support of self-efficacy result in the greatest likelihood of adaptive behaviour change
strong fear alongside weak support of self efficacy result in increased likelihood of maladaptive coping such as avoidance.

66
Q

What is the self-empowerment approach?

A

Based on the belief that health promotion works most effectively when the
individual is in control of their social and internal environment.
Psychological empowerment relates to an individuals ability to make
decisions and have control over her or his personal life and health decisions.
It is becoming increasingly popular because it fits with the move to create
responsible citizens who take control of their own health (Jacobs, 2015).

67
Q

What is collective action/community development?

A

It emphasises the relationship between individual health status and the social/health context that the individual is in.
It is based on the assumption that individual health status is dependant on the environment and so promotion activity targets these societal issues rather than the individuals themselves.
People act collectively to change their social environment.

68
Q

What are the modern application and approaches?

A

Health promotions needs to adapt to the needs of society and its target audience.
Therefore whilst traditional approaches may have used poster campaigns and
television adverts continue we also see development of other tactics
 Social media campaigns
 Use or reality TV / soaps to communicate and raise awareness

69
Q

What is the Elaboration Likelihood Model? Petty & Cacioppo (1996)

A

This model attempts to identify the cognitive processes i9nvolved in processing persuasive communication.
DUAL ROUTE - Routes differ based on the level of effort required to process the argument or information being conveyed.
Understanding how these routes work enable conscious thought about how to design health promotion to target either route.

70
Q

How does the Elaboration Likelihood Model work?

A

There is a persuasive message - two routes of either motivation and ability to process information.
If YES - CENTRAL ROUTE: Reader fully engaged and using cognitive effort. (cognitive effort) Attitude to change, persistent, long-lasting, harder to change. (consequence)
If NO - PERIPHERAL ROUTE: Limited engagement and reader uses heuristics to make brief judgements. (cognitive effort) Attitude to change, Temporary short term change, susceptible to change. (consequence)

71
Q

What is the Elaboration Likelihood Model peripheral route?

A

It can be effective in the short term.
Often the route used if the receiver is short of time to
receive the message (i.e., a poster campaign)

Overtime -
- Emotion dissipates
- Feelings about the source can change
- Cues become disassociated form the message

72
Q

What is the Elaboration Likelihood Model central route?

A

For this route, the receiver must have the motivation to receive the message:
There must be relevance of the message to the receiver
There must be accountability for a behavioural decision

The receiver must have the ability to process the information:
Intellectual understanding of the message
Strength of argument
Ability to elaborate with few distractions

73
Q

How does communication work in health promotion?

A

Sender - where/who is the message coming from
Receiver - who is being targeted and why
Message - what are you trying to communicate
Medium - in what format you choose to deliver the message
Noise - distortion or disturbance to the message

74
Q

What is prospect theory in message framing? (Tversky & Kahneman; 1981)

A

People consider their prospects in decision making.
Persuasive to the framing of the message.

75
Q

What is positive/gain framing in message framing?

A

Emphasises the benefits of taking action/adopting a behaviour

76
Q

What are loss frame appeal in message framing?

A

Emphasis the cost of not taking an action

77
Q

What is the effectiveness of message framing?

A

Research is contradictory regarding the effectiveness of negative versus positive framing.
It is based on content of the message and message recipients beliefs.

78
Q

How does message framing work according to prospect theory (Tversky & Kahneman, 1981)?

A

Positive messages make people risk adverse (encourages people to avoid risk)
Negative framed messages make people risk seeking (Encourages people to take that risk - is it worth the risk?)

79
Q

How does persuasive communication work?

A

Explicit recommendations or courses of action are more persuasive.
Languages used Changing third person to second person (Burnkrant & Unnava, 1989).
Posing questions draws the reader in and encourages elaboration.
Statistics can be useful to convey generalisations or emphasise the magnitude of the problem

80
Q

What are some limitations for reviews exploring the effectiveness of health? - Michie & Abraham, 2004

A
  • Methodological flaws limiting assessment of effectiveness
  • Lack of theoretical approaches
  • Lack of adequate description about the intervention (Michie et al., 2011)
81
Q

What is intervention mapping? (Kok et al., 2004 and Bartholomew et al., 2006)

A

It proposes a series of processes that should aid in the development of interventions.
Stages are non-linear - designers should move back and forth between stages.
Stages are cumulative and so information from one should feed another.

82
Q

What are the 6 steps of intervention mapping? (Kok et al., 2004)

A
  1. Needs assessment - identify a target at-risk group and the behaviour that needs changing.
  2. Definition of objectives - specifying the behaviour that the intervention is going to focus on and the determinants and beliefs around this behaviour.
  3. Selection of theory based methods - the theoretical concepts that can best help explain the relevant determinants of the behaviour
  4. Programme design - Putting theoretical techniques into a practical plan.
  5. Adoption and implementation - Identifying people/organisations will adopt the intervention and run it, developing training courses
  6. Evaluation - Conducting research to discover whether the intervention was successful
83
Q

What is self-determination theory (Deci & Ryan,1985)?

A

Concerned with the processes involved in behavioural regulation and their associated cognitive, affective, and behavioural outcomes.
Our motivation is not a binary concept.
Motivation lies on a continuum where the drive to engage increasingly becomes more self-determined.

84
Q

What is behavioural regulation?

A

How our behaviour is motivated

85
Q

What is continuum of regulation?

A

No motivation - motivated as a result of external source - motivated to avoid guilt - motivated because you identify with the values of the behaviour - motivated internally by pleasure.

86
Q

Who associated amotivation with a lower likelihood to engage in behaviour?

A

Standage et al., 2003

87
Q

What are the inherent psychological needs?

A

Autonomy - The need to feel volitional in our decisions and have control over our behavioural choices.
Competence - The need to feel that we can effect change / are good at what we choose to do.
Relatedness - The need to feel accepted and connected to others.

88
Q

What is the taxonomy of strategies outlined by Miche et al., 2011 for physical activity behaviour change?

A
  • Providing information
  • Rewards and shaping
  • Using prompts or cues
  • Environmental restructuring to make environment more supportive
  • Fear arousal
  • Barrier identification
  • Follow-up prompts
  • Self-talk
  • Imagery
  • Relapse prevention
  • Motivational interviewing
  • Time management
  • Action planning
  • Goal setting
  • Self-monitoring
  • Providing feedback
89
Q

What is the intention behaviour gap?

A

Many strategies are about helping people to develop intention or the volition to change their behaviour.
The difference between having the intention to change the behaviour and the decision to actually do it is known as the intention behaviour gap (Sniehotta, Scholz, & Schwarzer, 2005)

Psychology (6 decks)

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