Lecture 4 - Health Behaviours

Question 1

What is Health Promotion?

Answer 1

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

Question 2

what is the philosophy for health promotion

Answer 2

Good health is a personal and collective achievement.

Question 3

is there a Role of Behaviours in Disease

Answer 3

• 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

Question 4

what are the Types of Prevention

Answer 4

primary
secondary
tertiary

Question 5

what is involved in primary prevention

Answer 5

Target People Before Disease:
• Diet
• Exercise
• Safety practices 
• etc

Question 6

what is the involved in secondary prevention

Answer 6

Target People at Risk
of Disease to detect and treat early on
• Age
• Gender
• SES
• etc.

Question 7

what is involved in tertiary prevention

Answer 7

target people with disease

–> limit impact of the desease

Question 8

what in an example of primary prevention

Answer 8

education, CBT

Question 9

what in an example of secondary prevention

Answer 9

screening

Question 10

what in an example of tertiary prevention

Answer 10

rehabilitation

Question 11

What are Health Behaviours?

Answer 11

• Behaviours that enhance or maintain health

* Practicing safer sex, sleeping well, healthy eating, not smoking, exercise, etc.

Question 12

define Habits

Answer 12

health behaviours that are firmly established, automatic

Question 13

Those aged 75+ who did 7 habits had health comparable to who

Answer 13

35-44 year olds who only did 3

Question 14

are habits learned behaviour

Answer 14

yes

Question 15

how can we learn habits (what are the learning models)

Answer 15

Classical conditioning
Operant conditioning
Observational learning

Question 16

what is Classical conditioning (summary)

Answer 16

Pavlov, stimulus-response, association, neutral, conditional and
unconditioned stimuli, uncontrollable responses, extinction

Question 17

what is Operant conditioning (summary)

Answer 17

Skinner, reward, punishment, schedules of reinforcement

Question 18

what is Observational learning

Answer 18

Bandura, modelling and imitation

Question 19

give more details for classical conditioning

Answer 19

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).

Question 20

give more details for Operant Conditioning

Answer 20

Type of learning in which voluntary behavior is strengthened if followed by a reinforcement or diminished if followed by a punishment.

Question 21

what are some Barriers to Healthy Behaviours

Answer 21

• 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

Question 22

Why are Interventions in Childhood Needed?

Answer 22

• 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)

Question 23

adolescence is the prime time for what kind of behaviour

Answer 23

Risk Behavior

Question 24

why is adolescence referred to as the ‘window of vulnerability’

Answer 24

Developmental period in which it is most likely to

develop risk behaviours

Question 25

what is the Primary Prevention in Adolescents

Answer 25

1. encourage positive modeling 2. identify opportunities and teachable moments 3. work with emotions

Question 26

What Theories and Models are Used for | Understanding Health Behaviour Change?

Answer 26

3 types; attitude change social cognition transtheoretical

Question 27

what is included in attitude change

Answer 27

* Education * Fear appeals * Message framing

Question 28

what is included in social-cognition

Answer 28

``` • Expectancy-Value Theory • Health Belief Model • Theory of Planned Behaviour • Implementation intentions ```

Question 29

what is included in trans theoretical

Answer 29

stages of change

Question 30

what is the theory of attitude change

Answer 30

* If change people’s attitudes, will change behaviour | * “Health propaganda”

Question 31

what are some examples of attitude change through education

Answer 31

* 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.

Question 32

attitude change through education is most effective when...

Answer 32

Most effective when: • Colourful and vivid • Short, clear, direct • Health threat is new and behaviour easy to adopt

Question 33

Attitude Change Through Education: Limitations

Answer 33

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

Question 34

Attitude Change Through Education: Conclusions

Answer 34

Knowledge is necessary, but not sufficient for behaviour change. Education campaigns important for new health threats.

Question 35

what are Attitude Change Through Fear Appeals

Answer 35

Assumes that if people are afraid that a particular habit is hurting their health, they will change the behaviour to reduce the fear

Question 36

what are some examples of fear appeals

Answer 36

smoking ads

Question 37

what are some limitations of fear appeals

Answer 37

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

Question 38

explain Attitude Change: Message Framing

Answer 38

• 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

Question 39

what are social cognition models

Answer 39

Social and cognitive factors motivate health behaviour change

Question 40

what are the three social cognition models

Answer 40

* Health Belief Model (Rosenstock, 1966) * The Theory of Planned Behavior * Implementation Intentions

Question 41

what is arguably the most influential model in health psychology

Answer 41

Health Belief Model (HBM)

Question 42

Health Belief Model (HBM) says that Health behaviours determined by 2 factors:

Answer 42

1. One's beliefs in a specific health threat: 2. Beliefs that a specific health behaviour can reduce that threat:

Question 43

what are the subcategories of the HBM 'one's beliefs in a specific health threat:'

Answer 43

a) perceived susceptibility | b) perceived severity

Question 44

what re the subcategories in HBM's 'Beliefs that a specific health behaviour can reduce that threat:'

Answer 44

a) Perceived benefits | b) Perceived costs

Question 45

what is the support for HBM

Answer 45

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

Question 46

what is the overall Evaluation of HBM

Answer 46

* 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, ...

Question 47

what is the Theory of Planned Behaviour | TPB

Answer 47

* 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)

Question 48

what is the support for TPB

Answer 48

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.

Question 49

what is the overall evaluation for TPB

Answer 49

* 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?

Question 50

give a summary of this lecture

Answer 50

* 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