Lecture 4 - Health Behaviours Flashcards
What is Health Promotion?
WHO definition
• process of enabling people to increase control over,
and to improve, their health
• focus not only on individual behaviour, but also a wide range of social and environmental interventions
what is the philosophy for health promotion
Good health is a personal and collective achievement.
is there a Role of Behaviours in Disease
• Acute disorders declined
• Preventable disorders increased (e.g.,
cardiovascular disease, diabetes)
• Nearly 50% of deaths in Canada are caused by modifiable behaviours (e.g., smoking, poor diet, physical inactivity)
• Changing BEHAVIOURS is now the key
what are the Types of Prevention
primary
secondary
tertiary
what is involved in primary prevention
Target People Before Disease: • Diet • Exercise • Safety practices • etc
what is the involved in secondary prevention
Target People at Risk of Disease to detect and treat early on • Age • Gender • SES • etc.
what is involved in tertiary prevention
target people with disease
–> limit impact of the desease
what in an example of primary prevention
education, CBT
what in an example of secondary prevention
screening
what in an example of tertiary prevention
rehabilitation
What are Health Behaviours?
- Behaviours that enhance or maintain health
* Practicing safer sex, sleeping well, healthy eating, not smoking, exercise, etc.
define Habits
health behaviours that are firmly established, automatic
Those aged 75+ who did 7 habits had health comparable to who
35-44 year olds who only did 3
are habits learned behaviour
yes
how can we learn habits (what are the learning models)
Classical conditioning
Operant conditioning
Observational learning
what is Classical conditioning (summary)
Pavlov, stimulus-response, association, neutral, conditional and
unconditioned stimuli, uncontrollable responses, extinction
what is Operant conditioning (summary)
Skinner, reward, punishment, schedules of reinforcement
what is Observational learning
Bandura, modelling and imitation
give more details for classical conditioning
Type of learning in which a response (drooling) that is naturally elicited by a stimulus (food) becomes elicited by a different formerly neutral stimuli (bell).
give more details for Operant Conditioning
Type of learning in which voluntary behavior is strengthened if followed by a reinforcement or diminished if followed by a punishment.
what are some Barriers to Healthy Behaviours
• Little incentive for good behaviour in the short-term
• Once established, poor habits are hard to change
Particular importance to target childhood and adolescence in interventions
Why are Interventions in Childhood Needed?
- Poor health habits in early life have consequences many decades later
- Healthy lifestyle habits may easiest and most lastingly formed in childhood through pure association and repetition (classical conditioning), reinforcement learning, and observational learning. (eating, exercising, dental hygiene)
adolescence is the prime time for what kind of behaviour
Risk Behavior
why is adolescence referred to as the ‘window of vulnerability’
Developmental period in which it is most likely to
develop risk behaviours
what is the Primary Prevention in Adolescents
- encourage positive modeling
- identify opportunities and teachable moments
- work with emotions
What Theories and Models are Used for
Understanding Health Behaviour Change?
3 types;
attitude change
social cognition
transtheoretical
what is included in attitude change
- Education
- Fear appeals
- Message framing
what is included in social-cognition
• Expectancy-Value Theory • Health Belief Model • Theory of Planned Behaviour • Implementation intentions
what is included in trans theoretical
stages of change
what is the theory of attitude change
- If change people’s attitudes, will change behaviour
* “Health propaganda”
what are some examples of attitude change through education
- Canadian Food Guide
- Accident Prevention Posters
- Education in physical education classes at school
- Sex education at school
- Public service announcements risk of Hepatitis B while traveling
- Diabetes workshops
- Etc.
attitude change through education is most effective when…
Most effective when:
• Colourful and vivid
• Short, clear, direct
• Health threat is new and behaviour easy to adopt
Attitude Change Through Education: Limitations
Limited success:
• They try to be attention-grabbing
– Not easy in an over-stimulated world! Messages get lost
• Information not necessarily accurate
• Information not necessarily received accurately
• Might lead to increased knowledge but not necessarily to behaviour change
—Particularly for complex or difficult behaviours
Attitude Change Through Education: Conclusions
Knowledge is necessary, but not sufficient for behaviour change.
Education campaigns important for new health threats.
what are Attitude Change Through Fear Appeals
Assumes that if people are afraid that a particular habit is hurting their health, they will change the behaviour to reduce the fear
what are some examples of fear appeals
smoking ads
what are some limitations of fear appeals
Effects found to be weak (meta-analysis, 2009) • Too much fear may not work
• Effects might only be short-lasting
• Fear alone may not be enough
• Recommendations/advice for action may be needed
explain Attitude Change: Message Framing
• Prospect theory: Kahneman & Tversky, 1979
• Different presentations of risk information changes people’s
perspectives and actions
• Only prospect of loss makes people engage in difficult/high cost behaviour
• For easy behaviours (e.g. sunscreen use), prospect of gains should be emphasized
what are social cognition models
Social and cognitive factors motivate health behaviour change
what are the three social cognition models
- Health Belief Model (Rosenstock, 1966)
- The Theory of Planned Behavior
- Implementation Intentions
what is arguably the most influential model in health psychology
Health Belief Model (HBM)
Health Belief Model (HBM) says that Health behaviours determined by 2 factors:
- One’s beliefs in a specific health threat:
- Beliefs that a specific health behaviour can
reduce that threat:
what are the subcategories of the HBM ‘one’s beliefs in a specific health threat:’
a) perceived susceptibility
b) perceived severity
what re the subcategories in HBM’s ‘Beliefs that a specific health behaviour can
reduce that threat:’
a) Perceived benefits
b) Perceived costs
what is the support for HBM
Large body of research showing that the HBM predicts health behaviours to a certain extent:
• Dental care
• Breast examination • Dieting in obesity
• Sexual behaviour
• Smoking
what is the overall Evaluation of HBM
- Health beliefs alone are modest determinant of people’s intentions to take preventative health measures
- There are so many factors beyond beliefs that determine how a person will act
- E.g. intention, planning, norms, self-efficacy, motivation, knowledge, …
what is the Theory of Planned Behaviour
TPB
- Health behaviour is direct result of a behavioural intention
- Behavioural intentions are determined by:
- Attitudes to a specific action
- Subjective Norms
- Perceived Behavioural Control (PBC)
what is the support for TPB
Useful for understanding health behaviour change
• Links beliefs to behaviour
• Fine-tuned picture of intentions for a particular health behaviour
Research evidence
• Testicular examinations, weight loss, speeding, self- harm, condom use, sunscreen use, oral contraceptive use, soft drink consumption, breast cancer screening, exercise, AIDS related risk behaviours, etc.
what is the overall evaluation for TPB
- Despite support for the TPB, it is still not very good at explaining long-term behaviour change
- Does not talk about the intention-behaviour link: what actually gets people to do what they intend to do?
give a summary of this lecture
- Education campaigns have their role particularly for new health threats
- HBM and TPB have some prediction but
- Mostly for intention
- Do not address the intention-behavior gap
