Healthy Living Flashcards
Becker - Theories of Health Belief
Asthma compliance.
> AIM To use the HBM to explain mothers’ adherence to to a drug regime for their asthmatic children.
> SAMPLE 111 mothers responsible for administering atshma medication to their children. Mothers: ages 17-54.
Children: ages 9 months - 17 years.
> PROCEDURE Mothers interviewed for 45 mins each.
- Perception of child’s susceptibility to asthma
- Susceptibility of seriousness
- How much child’s asthma has interfered with child’s education and caused embarrassment
- Interfered with mothers activities.
- Faith in doctors and medication.
> RESULTS
POSITIVE compliance to medication:
- Mothers who perceived susceptibility to asthma attacks and perceived seriousness.
- Mothers who reported that their child’s asthma interfered with their and their child’s daily activities.
NEGATIVE compliance to medication:
- Disruption of daily activities, inaccessibility to chemists, child complaining.
- Demographic variables that correlated with compliance - marital status and education.
> CONCLUSION The HBM is a useful model to predict and explain different levels of compliance with medical regimes.
> EVALUATION
- Interviews subject to bias - Social desirability, lying, embarrassment etc…)
- Generalisable sample - large in size and age range however no representation of fathers.
- High in validity due to blood tests confirming adherence.
- High in eco valid. as child already had asthma.
Rotter - Theories of Health Belief
Internal and External Locus of Control.
> SAMPLE - 6 pieces of research into individual perceptions of ability to control outcomes based on reinforcement.
> PROCEDURE Review article
- Information gathered by previous research and analysed by Rotter.
> RESULTS Results from study consistently showed p’s who felt they had more control over the situation are more likely to show behaviours that would enable them to cope with potential threats, than participants who thought that chance or non-controllable forces determined the effects of the behaviours on their health.
> CONCLUSION - LOC affects many of our behaviours
> SYNOPTIC LINK - James et al (1965) found that male smokers who gave up w/o relapse had a higher level of internal LOC than those who did not quit. Interestingly no difference for female smokers - indicating that other factors (eg weight gain) were influential in giving up smoking.
> EVALUATION Reductionist - it reduces the explanation of why people do/don’t adopt healthy lifestyles down to just 2 variables (internal / external LOC) - eg. whether or not a person adopts a healthy lifestyle is probably dependant on a wide number of variables.
Bandura - Theories of Health Belief
Analysis of self efficacy theory on behavioural change.
> AIM To assess self-efficacy of patients undergoing systematic desensitisation in relation to their behaviour w previously phobic objects.
> SAMPLE
10 snake-phobic patients
replied to an ad in newspaper
9f, 1m. (aged 19-57)
> PROCEDURE Controlled quasi experiment
PRE-TEST ASSESSMENT:
- Each assessed for avoidance towards a boa constrictor, then fear arousal assessed w/ oral rating (1-10), then efficacy expectations (how much they felt they would be able to perform different behaviours w/ snakes)
SYSTEMATIC DESENSITISATION:
- Standard desensitisation programme followed - patients introduced to a series of events w/ snakes (imagining looking at a picture - holding a live one) - each stage taught in relaxation.
POST-TEST ASSESSMENT:
- Again measured on same scales/measures as pre-test to compare how their efficacy had changed and whether it enabled their behaviours to change.
> RESULTS Higher levels of post-test self efficacy found to correlate w/ higher levels of interaction w/ snakes.
> EVALUATION All 3 theories can be accused of being reductionist - because it ignores other key influences on our behaviour.
- Natural exp. - cause and effect cannot be found - cannot see if the naturally occuring IV had an effect on the DV.
- Sample size - not generalisable - small sample - more female
- Sample - collected from newspaper - meaning they had time on their hands - could be biased.
Cowpe - Methods of Health Promotion
MEDIA CAMPAIGNS
Chip pan fires
> AIM To test effectiveness of an advertising campaign which demonstrated a procedure, provided information challenged perceptions about lack of ability to cope and encouraged preventative actions.
> SAMPLE People living in TV areas
> PROCEDURE Campaigns shown on TV.
- Two 60 second commercials:
- INATTENDANCE: initial cause of the fire .
- OVERFILLING: actions required to put it out
- Real-time and slow-motion sequences to heighten the effect.
- Three areas were shown reminders in another year.
- Number of reported chip-pan fires analysed for each area
> RESULTS
- Net decline in each area over the 12 month period of the campaign was between 7% and 25%.
- Largest reduction during the campaign:
Tyne Tees: reduction of 33% during, 17% over the next six months, 15% over the following 15 weeks.
- If there was an ‘overlap’ of TV commercials, areas showed less impact -> reduced impact of seeing the campaign more than once.
Questionnaires:
- increase in awareness from 62% before the campaign to 96% after the campaign.
- Mentioning of chip pan fires increased from 12% before the campaign to 28% after the campaign.
> CONCLUSION Advertising shows effectiveness by the reduction in chip-pan fires. The behaviour change is seen most during the campaign and reduces as time after the end of the campaign. Viewers are less likely to be influenced by the campaign if overexposed to it, as in the overlap areas.
> EVALUATION Natural experiment used, cannot establish cause and effect.
High in ecological validity this is as individuals were shown live broadcasting television adverts which they are likely to normally watch at their own homes.
Dannenberg - Methods of Health Promotion
LEGISLATIONS
Law on bike helmets on effect of wearing them.
> AIM To review the impact of the passing of a law requiring cycle helmet wearing in children.
> SAMPLE Children from 47 schools in Howard Country, Maryland, USA.
- MONTOMERY County: already using the campaign - BALTIMOR County: not doing anything (control)
- HOWARD County: legislation aged 9-10, 12-13, 14-15
> PROCEDURE Natural experiment
- Questionnaires containing a 4 point Likert scale on:
- Bicycle use
- Helmet ownership and use
- Awareness of law
- Sources of info about helmet
- Peer pressure
-> parents asked to help children complete: consent was obtained.
> RESULTS Response rates: 41 and 53%
- Participants asked about use 1 year previously and on their most recent bike ride
- Usage increased:
- Howard county: 11.4 to 37,%
- Montgomery: 8.4% to 12.6%
- Baltimore: 6.7% to 11.1%
- Awareness of the law in Howard country: 87% and 38% of those had worn their helmet on the last ride as apposed to 14% of the children who didn’t know there was a law
> CONCLUSION Legislation in Howard Country showed a large increase in reported cycle helmet wearing.
- The slight rise in the area where there was an educational campaign was not significantly different from the area where there wasn’t a campaign.
- Passing legislation has more effect than education campaigns alone, and educational campaigns are not necessarily effective at all in increasing health behaviours.
> EVALUATION High in reliability, as a second study was conducted and proved to show similar results to Danneberg’s.
- The questionnaire could be biased as parents were asked to help therefore they might have answered that there child does wear a helmet (even if not) as they wouldn’t want to be seen as bad parents and the fear of being prosecuted.
- Sample not representative of general population as only school children used - doesn’t give any statistics for the older generations which might be more likely to cycle.
Janis + Feshbach - Methods of Health Promotion
FEAR AROUSAL
Effects of fear arousal.
> AIM To investigate the consequences on emotions & behaviour of fear appeals in communications.
> SAMPLE - A 9th grade freshman class
- Aged 14 - 15 yrs
- Divided into 4 groups (incl a control)
> PROCEDURE Lab exp. Independent measures.
- Showed fear-arousing material then collected data on emotional reactions + changes in dental practice through questionnaires.
- Each ppt in one of 4 lectures
- 1 = Strong fear appeal - Emphasis on painful consequences eg tooth decay & gum disease, v direct appeal eg ‘this could happen to you’.
- 2 = Moderate appeal - Little info on consequences, statements more factual.
- 3 = Minimal fear arousal - Info on tooth growth and function.
- 4 = Control - Lecture on the human eye.)
> RESULTS
- Amount of knowledge on dental hygiene did not differ between the 3 groups - so all lectures had conveyed the required information.
- Strong fear appeal seen in a more positive light - Students more likely to agree it was interesting and should be given to all schools in Connecticut. However also reported higher levels of dislike (eg. slides were too unpleasant)
- Changes in dental hygiene (measured by comparing no. of recommended dental practices eg. brushing for 3 mins) shown before lecture & 1 week after:
- Strong fear appeal group showed net increase in conformity of 8%
- Moderate showed net increase of 22%
- Weak showed increase of 36%
- Control showing 0% change
- Diff between strong and control insignificant.
> CONCLUSION
- Fear appeals can be helpful in changing behaviours, but important to keep level of fear just right.
- Minimal was most effective
- The use of strong fear appeals did increase emotional arousal + positive feedback - Which means it will be good in some situations (eg. getting people to donate)
- But relatively low arousal is likely to be optimal for promoting health
> EVALUATION
Ethical issues – Psychological harm in the strong fear arousal group. However it is worthwhile if people stop drink-driving or give up smoking. If they give up such behaviours perhaps the ends have justified the means.
- Sample cannot be generalised to the general population as students were used.
- Laboratory experiment was used therefore cause and effect can be established this means that it could be said that the independent variable had an effect on the dependent variable.
- This study has high scientific credibility.
Bulpitt - Features of Adherence to Medical Regimes
Importance of well-being in hypertensive patients.
> AIM To review research on adherence in hypertensive patients.
> PROCEDURE
Review article - Research identifying problems with taking drugs for high blood pressure.
- Research was analysed to identify the physical and psychological effects of drug treatment on a persons life. These included work, physical well-being hobbies ect.
> RESULTS
- Anti-hypertension medication can have made side effects:
- Sleepiness
- Dizziness
- Lack of sexual functioning
- Work and hobbies being cut
- 8% of males discontinued treatment because of sexual problems (Curb et al)
- 15% of patients had withdrawn from taking medication due to side effects (Medical Research Council)
> CONCLUSION When the costs of taking medication, such as side effects, outweigh the benefits of treating a mainly asymptomatic problem such as hypertension, there is less likelihood of the patient adhering to their treatment.
> EVALUATION
- V low control when reviewing articles and past research.
Lustman - Features of Adherence to Medical Regimes
Use of fluoxetine in treatment for depression in diabetes.
> AIM To assess the efficacy of the anti-depressant Fluoxetine in treating depression by measuring glycemic control.
> SAMPLE 60 patients with type 1 or type 2 diabetes and diagnosed with depression
> PROCEDURE
- Patients were randomly assigned to either the Fluoxetine or placebo group.
- Patients were assessed for depression using psychometric tests and their adherence to their medical regimen was measured by measuring their GHb levels, which indicated their glycemic control.
> RESULTS
- Patients given Fluoxetine reported lower levels of depression.
- They also had lower levels of GHb (nearer to normal) which indicated their improved adherence.
> CONCLUSION
- Measuring GHb in patients with diabetes indicates their level of adherence to prescribed medical regimes.
- Greater adherence was shown by patients who were less depressed, and previous research has suggested that reducing depression may improve adherence in diabetic patients.
> EVALUATION
- Objective, scientific method of confirming/measuring adherence to their medical regimens.
Watt - Features of Adherence to Medical Regimes
Improving adherence to taking medication for asthma.
> AIM To see if using a Funhaler can improve children’s adherence to taking medication for asthma.
> SAMPLE
- 32 Australian children (10 boys, 22 girls)
- Aged 1.5 to 6 years.
- All been diagnosed with asthma and prescribed drugs.
- The parents gave informed consent.
> PROCEDURE
- Each child was given a Breath-a-Tech to use for one week.
- The parents were given a questionnaire to complete.
- The second week, the children used the Funhaler, and the parents were given a questionnaire with matched questions at the end of the second week.
- The Funhaler has incentive toys (spinner and whistle) which function best when the child uses the deep breathing pattern that endures the effective inhalation of the medication.
> RESULTS - 38% more parents were found to have medicated their children the previous day when using the Funhaler, compared to the existing treatment.
> CONCLUSION Previous research had given reasons for non-adherence in children with asthma such as boredom, forgetfulness and apathy. The Funhaler set out to remedy this by reinforcing correct usage of the inhaler with a spinner and a whistle. This did improve adherence to the medication. So by making the medical regime fun, adherence, certainly in children, can be improved.
> EVALUATION
- Questionnaires subject to bias– could reduce validity
