L6/7- Health behaviour

Question 1

health related behaviours

Answer 1

‘Anything that can promote good health or lead to illlness’ 
•	Drinking 
•	Smoking 
•	Drug use 
•	Taking exercise 
•	Safe sex behaviour 
•	Taking up screening activities

Question 2

Why are we concerned about behaviour?

Answer 2

• 1/3 of all disease burden in developed world due to tobacco, alcohol BP, cholesterol and obesity
• Behaviour risk include: tobacco us, physical inactivity and unhealthy diet
• Responsible for 80% of CVD

Question 3

theories to help understand health related behaviours

Answer 3

1) Learning theories
2) Social cognition models
3) Integrative model

Question 4

learning theories

Answer 4

a. Classical conditioning
b. Operant conditioning
c. Social Learning theory

Question 5

social cognition models

Answer 5

a. Cognitive dissonance theory
b. Health belief model
c. Theory of planned behaviour

Question 6

integrative

Answer 6

COM-B

Question 7

classical conditioning (learning theory)

Answer 7

• Environmental cues- sights, smells, location, people e.g. signal expectation of drug/ alcohol
• Cues may be emotional (e.g. anxiety)
• Cues with connection to using drug/alcohol can trigger behaviour and lead to relapse when quitting (e.g. drinking with friends could trigger smoking or drug use)

Question 8

example of classical conditioning

Answer 8

e.g. Dog- salvation response experiment

 how you can learn new associations through new pairings

Question 9

classical conditioning and changing behaviour

Answer 9

Involves avoiding cues/change association with cues
• E.g. Aversive techniques in alcohol misuse= pair behaviour with unpleasant response
• Alcohol + medication to induce nausea (nausea is result of medication and loopholes but comes to be associated with alcohol)

Question 10

operate conditioning (learning theory)

Answer 10

• People/ animal act on the environment and behaviour shaped by consequence
  • E.g. trying out new behaviour and seeing what the outcomes is

Question 11

• Behaviour reinforced (increases) if its:

Answer 11

o Rewarded

o Punished

Question 12

• Behaviour decrease if

Answer 12

o Punished
o Reward taken away
E.g. Skinners Rat experiment- lever pressing

Question 13

operant conditioning and healthy related behaviours

Answer 13

• Explains why we do things and for our health- immediately rewarding e
• The problem is… Unhealthy behaviour is rewarding .g. nicotine rush
• Driven by short term rewards and avoiding short term negative consequences (withdrawal)
• E.g. using financial incentive for smoking cessation

Question 14

limitation of operant conditioning

Answer 14

Short term affect, moral and ethical issues

Question 15

limitation of classical and operant conditioning

Answer 15

• Based on simple-stimulus response associations
• No account of cognitive processes, knowledge, belief, memory, attitudes etc
• No account of social context

Question 16

social learning theory (learning theory)

Answer 16

• Built on operant theory
• People can learn vicariously (observation/modeeling)
• Behaviour is goal-directed

Question 17

• People are motivated to perform behaviours:

Answer 17

o That are valued

o That they believe they can enact (self-efficacy)

Question 18

We can learn what behaviours are rewarded and how likely it is we can perform behaviour, from observing others

Answer 18

o Modelling more effective if model high status (parent or celeb) or like us (would be achievable for even me) (value/ability)

Question 19

Social learning theory and healthy related behaviours

Answer 19

• Influence of family, peers, media figures, celebrities, as role models
• Harmful behaviours e.g. drinking, drug use, unsafe sex
• Celebrity behaviours will influence society

Question 20

cognitive dissonance theory (social cognition model)

Answer 20

• Discomfort when hold inconsistent beliefs or actions events dont match
• Reduce discomfort by changing beliefs or behaviours
  o E.g. UFO cult- Festinger (1957)- when the world didn’t end, they changed their beliefs e.g. they had save the world

Question 21

health promotion and cognitive dissonance theory

Answer 21

Providing health info (usually uncomfortable) creates mental discomfort and can prompt change in behaviour

Question 22

health belief model (social cognition model)

Answer 22

• If we want to understand peoples behaviour we need to understand their beliefs in health threats

e.g. Convincing people to use condoms:
- Thinking about the risk of a sexual transmitted infection
o e.g. will have perceived belief regarding benefits
o E.g. range of barriers
 Not having one

Question 23

theory of planned behaviour (social cognition model)

Answer 23

Starts from the assumption that the strongest predictor of behaviour is intention
• Attitude toward behaviour
• Subjective norm- what are my friends doing?
• Perceived control- self efficacy? Can i do this behaviour

Question 24

Theory of planned behaviour is a good predictor of

Answer 24

intentions but poor predictor of behaviour
• Problem is translating intentions into behaviours
• Implementation intentions

Question 25

Addressing the problems of interventions to change behaviour

Answer 25

• Multiple and poorly-integrated models of behaviour, suggest diff targets for behaviour change

–> therefore need for an integrated approach

Question 26

• NICE says: intervention to change health-related behaviours have

Answer 26

variable and modest effects

Question 27

• Impact of intervention depends on

Answer 27

the type of behaviour, the population being targeted and the context

Question 28

name a model which reprints an integrated approach to intevrentions

Answer 28

COM-B modle

Question 29

COM-B demonstrates the barriers to behaviour change

Answer 29

• Lack capability (inadequate knowledge and/or skills)
• Insufficient opportunity
• Motivation (desire) at key movements to engage in healthy behaviour is lacking
• Because healthy behaviours are usually different, boring or unpleasant while unhealthy are enjoyable or meet immediate needs

Question 30

types of capability

Answer 30

• Physical and psychological capability: knowledge, skill, strength, stamina

Question 31

types of motivation

Answer 31

• Reflective and automatic motivation: plans, evaluations, desires and impulses

Question 32

types of opportunity

Answer 32

: time, resources, cues/prompts

Question 33

COM-B can be found right in the centre of the

Answer 33

Behaviour change wheel

Question 34

If we are going to be developing behaviour change mechanisms, we need to:

Answer 34

• Specify the behaviour to be changed
• Understand the nature of the behaviour and underpinning influences - behavioural diagnosis
• Choose behaviour change techniques matched to diagnosis- prescription

Question 35

example of intervention development

Answer 35

• Psychological capability
  o Knowledge (risk of STIs and about condom sizes and types
• Motivation
  o Beliefs about consequences (impact on pleasure)
  o Difficulty using condoms in the heat of the moment

Result: Digital intervention created: personal, tailored interactive website

Question 36

nudge theory

Answer 36

Based on the idea that 80% of human behaviour is automatic

Question 37

choice architecture

Answer 37

• People responding to cues in the environment that unconsciously shape their choices

Question 38

• Nudge involves making simple changes to the choice architecture to steer decision in the right direction
  o e.g.

Answer 38

placing a fruit bowl on the front counter in a school canteen to encourage children to buy more fruit

Question 39

for nudge to be successful

Answer 39

o Must decrease the effort required to make the desired choice
o Improve our motivation to opt for that choice

Question 40

Evidence suggests that nudging alone

Answer 40

is a weak way of improving population health. Therefore, must be used with other interventions : targeting automatic behaviours and also peoples beliefs