L21 - "We know they are bad for us... Why do we cling to bad health habits?" Flashcards
Three class of factors predicting likelihood of health behaviours
1) Cognitive factors
2) Situation factors
3) Demographic factors
Examples of cognitive factors
1) Vulnerability
2) Cues to action
3) Weighting of benefits and costs
4) Health motivation
5) Perceived Control
6) Self-efficacy
Vulnerability
Cognitive factor; Refers to the perceived threat to an disease, can be divided into two sub-factors:
1) Perceived susceptibility (one’s belief of the likelihood to contract a disease)
2) Perceived severity (one’s perception of the degree of seriousness of the consequence of having the disease)
Cues to action
Cognitive factor; Refers to stimuli that triggers appropriate health behaviours; two kinds of cues:
1) Internal stimuli - Perception of bodily states
2) External stimuli
- stimuli from environment (e.g. TV advert)
- Fear in response to education/information
Weighting benefits and costs of action
Cognitive factor; three components:
1) response effectiveness (belief that health behaviour can reduce threat)
2) Perceived benefits (belief that changing one’s behaviour/adopting new behaviour will reduce threat)
3) Perceived costs (costs involved in changing one’s behaviour/adopting new behaviour - e.g. embarrassment in pap smear)
Health motivation
Cognitive factor; refers to one’s readiness to be concerned about health matters, affected by incentives:
1) Incentives - consequences of behaviour will positively/negatively reinforce a health motivation (e.g. anxiety reduction reinforce smoking; reassurance after negative result reinforce pap smear)
Perceived Control
Cognitive factor; refers to how individual regard their health as controllable by them or not:
1) Internal Control (one’s own health controllable)
2) External Control (one’s own health not controllable by themselves, but under control of powerful others or fate/chance)
Self-efficacy
Cognitive factor; referes to one’s estimate of his/her ability to successfully modify or carry out the desired behaviour
Comparative optimism/optimistic bias
A cognitive factor affecting risk perception towards diseases and consequently health behaviours; refers to how individuals engage in forms of social comparison that reflect best on themselves.
Associated factors:
1) lack of personal experience with the behaviour/problem concerned (low perceived risk)
2) Belief that their own actions can prevent the problems (high self-efficacy)
3) Belief that un-emerged problems are unlikely to emerge in the future
4) Belief that the problem is rare (low perceived susceptibility)
Examples of Situational factors
1) Subjective norms
2) Situation barriers
Subjective norm
Depends on:
1) Perception of social norm
2) Pressure to perform a behaviour
3) Evaluation of whether the individual is motivated to comply with the pressure
Situation barriers
e.g. financial support to adopt new behaviour/change behaviour; time
Examples of Demographic factos
Age, socioeconomic status, gender, education level, marital status, income level
Three classes of health behavioural models
1) Cognition models
2) Social cognition models
3) Transtheorectical Model (TTM)/the stages-of-change model
Example and limitation of cognition models
- Health Belief Model
- The Protection Motivation Model
Limitation: Focus only on the individual rather than the interaction between individual and environment
Example and limitation of social cognition models
- The Theory of Reasoned Action
- The Theory of Planned Behaviour
Limitation: Fail to take into account for habitual behaviours; intention does not necessarily predict actual behaviours
Health Belief Model
- Cognition Model
- Limitation: Focus only on the individual rather than the interaction between individual and environment
FLOW
[Demographic factor] –> [susceptibility, severity, benefits, costs, cues to action, Health motivation, Perceived control] –> [Likelihood of behaviour]

The Protection Motivation Theory
- Cognition Model
- Limitation: Focus only on the individual rather than the interaction between individual and environment
FLOW
[Information] affects:
a) [Threat Appraisal: susceptibility, severity, fear]
b) [Coping Appraisal: Self-efficacy, response effectiveness]
[a,b] jointly affects: [Coping Response: Adaptive (behavioural intentions) or Maladaptive (avoidance, denial)]
affecting [Behaviour]

Theory of Reasoned Action
- Social Cognition Model
- Limitation: Fail to take into account for habitual behaviours; intention does not necessarily predict actual behaviours
FLOW:
[behaviour] is affected by [behaviour intentions] which is jointly affected by [a], [b], [c]
a) [Attitude towards the behaviour]
<– [belief about outcomes; evaluation of outcomes]
b) [Subjective norm]
<– [belief of important’s others’ attitude to behaviour; Motivation to comply with important others]
c) Importance of norm

Theory of Planned Behaviour
- Social Cognition Model
- Limitation: Fail to take into account for habitual behaviours; intention does not necessarily predict actual behaviours
FLOW:
a) [Attitude towards the behaviour]
<– [belief about outcomes; evaluation of outcomes]
b) [Subjective norm]
<– [belief of important’s others’ attitude to behaviour; Motivation to comply with important others]
c) Importance of norm
<– [internal and external behavioural factors]

Transtheorectical Model (TTM) Principles
- Description of processes involved in initiating and maintaining changes
- believe that behavioural change is a process that unfolds over time through stages
- Presents a predictable pathway for behavioural change
Five stages of changes in TTM
1) Pre-contemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance
Pre-contemplation in TTM
No/little consideration of change of the current pattern of behaviour in foreseeable future
Task:
- increase awareness of need for change and concern about current behavioural patterns
- envision possibility of change
Goal:
- Serious consideration of behavioural change
Contemplation in TTM
Examination of current behaviour and potential for change in a risk (reward analysis)
Task:
- analyse pros and cons of current behaviour and behavioural change
Goal:
- Serious consideration of change for this behaviour
Preparation in TTM
Making a commitment to change behaviour; develop a plan and strategy for change
Task:
- increasing commitment and creating a change plan/strategy
Goal:
- implement an action plan in near term
Action in TTM
Implementation of the change plan; taking steps to change current behaviour and create new behavioural pattern
Task:
- Implement strategies for change
- Sustaining commitment in face of difficulties
Goal:
- Successful action to change current patterns
- New pattern established for a significant period of time (e.g. 3-6 months)
Maintenance in TTM
Sustain new behavioural pattern for an extended period of time, consolidate it into the lifestyle
Task:
- sustain change ove time and across different situations
- avoid slips and relapse back to to old behavioural patterns
Goals:
- Long term sustained change of old behaviour
- Establishment of new behavioural pattern
Course of TTM
