L6/7- Health behaviour Flashcards
health related behaviours
‘Anything that can promote good health or lead to illlness’ • Drinking • Smoking • Drug use • Taking exercise • Safe sex behaviour • Taking up screening activities
Why are we concerned about behaviour?
- 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
theories to help understand health related behaviours
1) Learning theories
2) Social cognition models
3) Integrative model
learning theories
a. Classical conditioning
b. Operant conditioning
c. Social Learning theory
social cognition models
a. Cognitive dissonance theory
b. Health belief model
c. Theory of planned behaviour
integrative
COM-B
classical conditioning (learning theory)
- 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)
example of classical conditioning
e.g. Dog- salvation response experiment
how you can learn new associations through new pairings
classical conditioning and changing behaviour
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)
operate conditioning (learning theory)
- People/ animal act on the environment and behaviour shaped by consequence
• E.g. trying out new behaviour and seeing what the outcomes is
- Behaviour reinforced (increases) if its:
o Rewarded
o Punished
- Behaviour decrease if
o Punished
o Reward taken away
E.g. Skinners Rat experiment- lever pressing
operant conditioning and healthy related behaviours
- 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
limitation of operant conditioning
Short term affect, moral and ethical issues
limitation of classical and operant conditioning
- Based on simple-stimulus response associations
- No account of cognitive processes, knowledge, belief, memory, attitudes etc
- No account of social context
social learning theory (learning theory)
- Built on operant theory
- People can learn vicariously (observation/modeeling)
- Behaviour is goal-directed
- People are motivated to perform behaviours:
o That are valued
o That they believe they can enact (self-efficacy)
We can learn what behaviours are rewarded and how likely it is we can perform behaviour, from observing others
o Modelling more effective if model high status (parent or celeb) or like us (would be achievable for even me) (value/ability)
Social learning theory and healthy related behaviours
- Influence of family, peers, media figures, celebrities, as role models
- Harmful behaviours e.g. drinking, drug use, unsafe sex
- Celebrity behaviours will influence society
cognitive dissonance theory (social cognition model)
- 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
health promotion and cognitive dissonance theory
Providing health info (usually uncomfortable) creates mental discomfort and can prompt change in behaviour
health belief model (social cognition model)
- 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
theory of planned behaviour (social cognition model)
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
Theory of planned behaviour is a good predictor of
intentions but poor predictor of behaviour
• Problem is translating intentions into behaviours
• Implementation intentions
Addressing the problems of interventions to change behaviour
- Multiple and poorly-integrated models of behaviour, suggest diff targets for behaviour change
–> therefore need for an integrated approach
- NICE says: intervention to change health-related behaviours have
variable and modest effects
- Impact of intervention depends on
the type of behaviour, the population being targeted and the context
name a model which reprints an integrated approach to intevrentions
COM-B modle
COM-B demonstrates the barriers to behaviour change
- 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
types of capability
• Physical and psychological capability: knowledge, skill, strength, stamina
types of motivation
• Reflective and automatic motivation: plans, evaluations, desires and impulses
types of opportunity
: time, resources, cues/prompts
COM-B can be found right in the centre of the
Behaviour change wheel
If we are going to be developing behaviour change mechanisms, we need to:
- 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
example of intervention development
- 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
nudge theory
Based on the idea that 80% of human behaviour is automatic
choice architecture
- People responding to cues in the environment that unconsciously shape their choices
- Nudge involves making simple changes to the choice architecture to steer decision in the right direction
o e.g.
placing a fruit bowl on the front counter in a school canteen to encourage children to buy more fruit
for nudge to be successful
o Must decrease the effort required to make the desired choice
o Improve our motivation to opt for that choice
Evidence suggests that nudging alone
is a weak way of improving population health. Therefore, must be used with other interventions : targeting automatic behaviours and also peoples beliefs
