Midterm 2 Flashcards
Health Behaviours
Activity that people perform to maintain or improve health
Preventing Behaviours (3)
Primary : actions taken to avoid disease or injury
Secondary : actions taken to identify and treat an illness early(to stop or reverse health problem)
Tertiary: actions to retard lasting damage, prevent disability, and rehabilitate
What prompts health behaviours?
Beliefs and attitudes about threat, consequences, importance, benefits, ability and norms
Health Belief Model
Theory that attempts to explain or predict the likelihood of making a specific behaviour choice
Health belief model diagram
In pictures
Core concepts of health belief model
- Perceived Susceptibility
- Perceived Seriousness
- Perceived beliefs (what can I gain by changing behaviours)
- Perceived barriers
- Self Efficacy
- Cues to action (what will give me the final push to change)
What is the likelihood of preventive action based on?
It is based on the combination of perceived threat and the cost-benefit ratio
Theory of Planned Behaviour
People are reasonable, make systematic use of information when deciding how to behave
>Immediate determinant of behaviour is the INTENTION to act or not to act
Diagram of theory of planned behaviour
in pictures
3 Elements of the Theory of Planned Behaviour
- Attitudes
- Subjective Norms
- Perceived behavioural control (self-efficacy)
Competing Goals
Almost always present (losing weight vs enjoying food)
Have to weight the importance of goals
One goal is often more salient than the other
Habits
Automatic behaviours that occur outside of awareness and are triggered by environment/situational cues
Stages of Change (Transtheoretical Model)
- Pre-contemplation - has not thought about change
- Contemplation - aware of problem, considering change
- Preparation - ready and plans to change
- Action - trying to change
- Maintenance - work to maintain behaviour
- Relapse - revert to old habit
Components of the Transtheoretical Model
- It explains why many people do not change behaviour
- Rate of moving through stages is diff for diff people
Goal Pursuit
Implementation Intentions
Build good habits
Self regulation
Monitoring
Motivation Continuum
Controlled –> Autonomous
Extrinsic - introjected - Identified - Integrated - Intrinsic
Implementation Intentions
Specific “If…then” pans
It strengthens the intention-behaviour relationship
Implementation Intentions and Habits
They can help us break bad habits and create new habits
Stages of the motivation continuum
Extrinsic - doing it for someone/thing else
Introjected - because you would feel shame if not
Identified - see that you should do it, it would be good for you
Intrinsic - do it because you want to you and like doing it
How long does it take to create a habit?
Approximately 66 days
Temptation
It is automatic and externally triggered
Using will power to resist temptation
It is effortful, it depletes our resources so it is not something we can do endlessly
What is a better way to resist temptation
It is best to change the environment to decrease the cues and possibilities for temptation
Can also re-evaluate desire
What part do awareness and monitoring play in goal pursuit?
Better monitoring = better progress
Other people’s influence on goal pursuit
Encourage or discourage
Can provide consequences
Modelling
Ways to get people to engage in health behaviours
Primary care settings
Public health campaigns/advertisements
In specific settings
Social engineering
The assumption of educational appeals
That people will change behaviour if they have the correct information
>uses persuasion
Things to consider in educational appeals
Source Message Channel Receiver Destination
Appeals are most persuasive when:
- Colourful and vivid
- Source is credible
- Message is short, clear and direct
- State conclusions explicitly
- Not too extreme
Loss-Framing
Emphasize the costs of a behaviour
> works best for illness detection behaviours
Gain-Framing
Emphasizes benefits from performing behaviour
>works best for behaviours to prevent illness or recover from injury
How do you know which is the best strategy to use?
It depends on the receiver - whether they are approach or avoidance oriented
Fear Appeals
Assumption that by increasing fear, people will change behaviour to reduce fear
Potential problems with fear appeals
Too much fear - undermine behaviour change
Fear alone is not enough
Social Engineering
Modify environment in ways that affect ability to practice health behaviours
What is the recommended level of exercise per week
150 minutes of moderate to high intensity
What are predictors of people who exercise
- Young
- Upper SES
- Educated
- History of exercise
- Urban
- More active in adolescence
Isotonic, isomentric, isokinetic exercise
Builds strength/endurance
Aerobic Exercise
Sustained exercise that stimulated/strengthens heart and lungs
Psychological benefits of exercise
- Increase cog function
- Increase positive mood and well-being
- Reduce stress, anxiety and depression
Barriers to exercise
- lack of time
- too much effort required/too tired
- not enjoyable
- too self conscious
- low self efficacy
- no convenient place
- fear of injury
Why do so many people drop out of exercising?
Initially aversive, few rewards
Lack of knowledge, threatens self esteem
Social comparison
Boring and repetitive
Strategies to improve adherence to exercise
Cognitive-Behavioural strategies - self monitoring - self-reinforcement - goal setting Relapse Prevention Understanding Motivation and Attitudes
How much sleep do we need?
Teenager 8-10h
Young Adult 7-9h
Adult 7-9h
Older Adult 7-8h
Consequences of insufficient sleep
Poorer cog function Decreased mood Worse performance Dampened immune Appetite regulation More accidents More stress --> leads to less sleep
Types of Insomnia
- Difficulty falling asleep
- Multiple awakenings
- Early awakenings
- Unrefreshed sleep
Strategies for getting better sleep
Avoid stimulants close to bed Avoid heavy meals before bed Exercise Avoid napping Comfortable sleep enviro Relaxing bed routine De-stress Only use bed for sleep
Problems with Canada food guide
Ambiguous - how much is 1 serving
Does not take into account junk food
Why is eating healthy a concern?
We have nutritional requirements
Bad diet is linked to diseases
Prevalence of obesity
BMI
kg/m^2
or
(lb/in^2)X703
BMI ranges
Under 18.5 : underweight
18.5-25 : normal
25-30 : over weigh
Over 30: obese
Problem with BMI
It does not distinguish between fat, muscle and bone mass
What causes us to eat too much?
Mindless eating
Mood
Social Network and norms
What is the actual consequence of dieting?
Greater weight gain long term
Alternatives to diets
Mindful eating
Preventing weight gain
Medically supervised approaches
Eating Disorders
Altered consumption of food that impairs health or functioning
Anorexia Nervosa
Restricted intake
Low body weight
Fear of gaining weight
Distorted image of body
Bulimia Nervosa
Binge eating in a short period of time and feel out of control Compensatory behaviours ^ happen once a week for 3 months Self worth dependent on body Disturbance of body image
Binge Eating
At least 3 of: - eating rapidly - eating past full - eating lots when not hungry - eating alone from embarrassment - feeling disgust with self Lack of control Happens at least once a week for 3 months No compensatory behaviours
Prevalence of Anorexia
~0.4% young women
How many people have bulimia
~1-1.5% young females
Prevalence of binge eating
~1.5% women
~0.8% men
Development and course of eating disorders
Usually begin during adolescence and young adulthood
Associated with stressful life event
Treatment of eating disorders
Cognitive behavioural therapy
What leads to drug dependence?
Reinforcement Avoiding withdrawal Substance-related cues Expectancies Individual differences
How many Canadians smoke
14.6%
How many cigarettes on average so people smoke
13.9
Is smoking the greatest cause of preventable death?
Yes
What are illnesses associated with smoking
Cancer
Cardiovascular disease
Respiratory diseases
What are the low-risk alcohol guidelines for women?
No more that 10 drinks/week
No more than 2 drinks/day
No more than 3 drinks on a single occasion
What are the low-risk alcohol guidelines for men?
No more than 15 drinks/week
No more than 3 drinks/day
No more than 4 drinks in a single occasion
Do men or women drink more?
Men
What is problem drinking?
Binge drinking where people get very drunk
What is the typical age range for binge drinking?
18-24
Why do people drink? (4)
Social and Cultural factors
Reinforcement and substance related cues
Psychological factors in heavy drinking
Genetics
Health impacts of drinking
Sleep disorders
Impaired immune
Cognitive impairment
Fetal Alcohol Spectrum Disorder
When can moderate drinking be good for you?
When you are older (over 65)
Prevention strategies for drinking
Social Engineering - Create barrier to buying - Monitor alcohol use - Restrict advertising Education Programs Family Involvement
What are the barriers to change and treatment from alcohol abuse?
Little immediate incentives
Bad habits are enjoyable
Motivational Interviewing
Having a conversation with a person to strengthen their own motivation and commitment to change
What is an important factor when people are trying to quit substance abuse?
They need to work at their own pace and not feel pushed
Abstinence Violation Effect
When people have failed their goal for the day they say “screw it” and completely blow their abstention for that day
Harm reduction for substance reduction
Approach that focuses on the risks and consequences of the substance abuse problem rather than the use itself
What is the average number of times that people use health services each year
On average 5.5 times/year
What populations use health services the most?
Young children and elderly
Women more than men
Non-aboriginal, non-recent immigrants
High SES
Symptoms are:
Subjective evidence of disease or physical disturbance
Illness is :
the subjective sense of feeling unwell that often motivates a patient to consult a physician
Is there much correspondence between perceived symptoms and actual physiological activity
No, there is little correspondence
What des symptom perception depend on?
Individual differences
Situational factors
Beliefs and expectations
What does recognizing illness depend on?
Prior experience
Expectation
Emotions
Lay Referral Network
Non medical professionals that people go to for advice about illnesses (friends, family, internet)
Treatment Delay
Time between noticing a symptom and seeking medical care
Treatment delay intervals
Appraisal Delay (am I ill?) Illness delay (do I need to see a doctor?) Utilization Delay (Is it worth the costs) Medical delay (time from making to getting appointment)
What is treatment delay affected by?
Presence or absence of pain
Life events
Perception of danger
In what ways to people misuse the health care system
Using it for stress or emotional disturbance
Hypochondriacs
Secondary Gain (others are nicer to you when you’re sick
Does taking an active role help with recovery?
Yes, people recover faster, it goes smoother and they exhibit greater treatment adherence
What can make the patient experience less enjoyable?
Interruptions Technical jargon Baby talk and "Elder-speak" Stereotypes Gender of physician
Patients’ factors to the experience
Neuroticism
Anxiety
Knowledge/Language
Attitudes (what they think is important)
What is a problem with the feedback that doctors get>
They get little feedback about treatment success or relationship satisfaction
Most of the feedback is negative
Doctor centred care
All about what the doctor knows, the doctor is always right
Patient-Centred care
What is best for the patient
> has best results
Patient Directed care
The doctor gives the patients whatever they want
Medication Adherence
The degree to which patients carry out prescribe treatments and behaviours
How much to people adhere to prescriptions
15-93%
> Doctors think its higher
What affects medication adherence
Physician communication and style - do they listen to patient
What can improve medication adherence
Doctors give clear instructions and anticipate questions
Involve patient in planning
Involve significant others
