PSY306 Health psychology Morrison Ch 5

Question 1

According to WHO what are the leading risks of death globally?

Answer 1

High blood pressure (13% of deaths)
Tobacco use (9%)
High blood glucose (6%) 
Physical inactivity (6%)
Overweight or obese (5%)

Question 2

Define health behaviour

Answer 2

Behaviour performed by an individual, regardless of his/her perceived health status, with the purpose of protecting, promoting or maintaining his/her health.

Question 3

What is the difference between a behavioural pathogen and behavioural immunogen?

Answer 3

Behavioural pathogens: a behavioural practice thought to be damaging to health e.g., smoking (health-risk behaviour)
Behavioural immunogens: a behavioural practice thought to be health protective behaviours e.g., Exercise (health protective behaviour)

Question 4

What are the seven key indicators (that are multiplitive and cumulative) associated with health and longevity found in the Alameda county study?

Answer 4

• sleeping 7–8 hours a night;
• not smoking;
• consuming no more than 1–2 alcoholic drinks per day;
• getting regular exercise;
• not eating between meals;
• eating breakfast;
• being no more than 10% overweight.

Question 5

Name five health-risk behaviours associated with high levels of mortality.

Answer 5

1. Heart disease: smoking tobacco, high-cholesterol diet, lack of exercise;
2. Cancer: smoking tobacco, alcohol, diet, sexual behaviour;
3. Stroke: smoking tobacco, high-cholesterol diet, alcohol;
4. Pneumonia, influenza: smoking tobacco, lack of vaccination;
5. HIV/AIDS: unsafe/unprotected sexual intercourse.

Question 6

Worldwide, smoking accounts for almost 9% of deaths (12% of males, 6% of females). What does this look like in Australia?

Answer 6

Prevalence of smoking reducing in Australia (from AIHW):
2002 – 20% in 2002
2010 – 16.6% of adults
2014-15 – 14.5% of adults
2019 – 11.6% of adults

Question 7

What are the smoking inequalities in Australia?

Answer 7

21% prevalence in most disadvantages areas
8% in areas with least disadvantage
42% prevalence among First Nations Peoples

Question 8

Smoking is thought to be responsible for…

Answer 8

30% of coronary heart disease (CHD) cases
70% of cancers (90% of lung cancer)
80% of cases of chronic obstructive airways disease

Question 9

What does illicit drug use look like in Australia?

Answer 9

Relatively low prevalence. Australians 14+
43% have used illicit drug in their lifetime
15% in last 12 months
Cannabis most common

Question 10

How many people worldwide inject drugs?

Answer 10

12.7 million

Question 11

What are the factors of smoking intiation?

Answer 11

Genetics
Curiosity
Modelling, social learning and reinforcement.
Social pressure
Image
Self-concept and self-esteem
Weight control
Risk-taking
Health cognitions 
Stress and distress

Question 12

Why do people smoke?

Answer 12

• Pleasure or enjoyment of the behaviour, taste and effects reinforces positive attitudes towards smoking;
• Smoking out of habit (psychological and/or physical dependence);
• A form of stress self-management/coping, anxiety control;
• A lack of belief in their ability to stop smoking.

Question 13

What are some health reasons to stop smoking?

Answer 13

• Stopping at aged 30 – more than 90% of lung cancer risk being avoided AND average of 10 life years gained;
• Stopping at 50–60 – avoid most subsequent risk of developing lung cancer or other smoking-related disease or disability AND average of 5 life years gained.

Question 14

What are the main aspects considered in continuing unhealthy behaviours and developing dependence?

Answer 14

• Genetics and family history of problem drinking
• Personality characteristics i.e., anxiety, sensation-seeking (controversial evidence)
• Social learning theory (learned behaviour through reinforcement)

Question 15

What are the health promotion targets for unhealthy behaviours and developing dependence?

Answer 15

Primary prevention – educating children about risks of heavy drinking and ‘safe’ levels of consumption;
Secondary prevention – changing behaviour of those already in heavy drinking (applying behavioural principles to treatment).

Question 16

What are some negative health consequences of unprotected sexual behaviour?

Answer 16

• unwanted pregnancy

- diseases such as chlamydia, gonorrhoea, herpes, HIV, and more recently HPV.

Question 17

What does the modes of transmissions look like in Australia?

Answer 17

68% of transmissions occurred among men who have sex with men
5% of transmissions were attributed to male-to-male sex with injecting drug use
20% of transmissions were attributed to heterosexual sex
3% of transmissions were attributed to injecting drug use
4% were of an undetermined mode of transmission.

Question 18

What were the results of the NATSAL 2003 follow up on condom use?

Answer 18

Increased use in males and females;

M 43% to 51% vs. F 30% to 39%

Question 19

What are some of the barriers to condom use?

Answer 19

Some negative attitudes to condom use shared by males and females:

• Reduces spontaneity of behaviour or reduces sexual pleasure.
• Unrealistically optimistic estimates of personal risk of infection.

Women face additional barriers:

• Anticipated male objection to a female suggesting condom use (denial of their pleasure);
• Difficulty/embarrassment in raising the issue of condom use with a male partner;
• Worry that suggesting use to a potential partner implies that they or their partner is HIV positive or has another STI;
• Lack of self-efficacy or mastery in condom usage.

Question 20

What are the risks of an unhealthy diet?

Answer 20

Fat intake and cholesterol: Excessive saturated fat intake, if not burned off through exercise, can cause arteries to harden or blockages to build up. Coronary artery disease is a major predictor of angina and heart disease.

Salt: High salt (sodium chloride) intake has been implicated with persistent high blood pressure, i.e., hypertension, however mixed evidence to whether the relationship is linear.

Question 21

Definition of obesity…

Answer 21

‘normal weight’ if their BMI is between 20 and 24.9
mildly obese or ‘overweight’ (grade 1) if their BMI is between 25 and 29.9
moderate or clinically obese (grade 2) if their BMI falls between 30 and 39.9
severely obese (grade 3) if their BMI is 40 or greater.

Question 22

What does the current obesity rate look like in Australia?

Answer 22

• Increasing in 18+
• 2 in 3 adults were overweight or obese in 2017-18
• 1 in 4 children and adolescents

Question 23

What are some of the negative consequences of obesity?

Answer 23

Hypertension;
Heart disease;
Type-2 diabetes;
Osteoarthritis;
Respiratory problems;
Lower back pain;
Some forms of cancer;
Psychological ill-health;
Mortality.

Question 24

What causes obesity?

Answer 24

Simple explanation:
Obesity results when energy intake grossly exceeds energy output (Pinel, 2003)
Genetic explanations:
-Obese individuals are born with more fat cells.
-Obese persons inherit lower metabolic rates.
-Obese persons may have deficiencies in a hormone responsible for appetite control, or lack of controle.g., leptin studies.
-A neurotransmitter, serotonin, involved in producing satiety (i.e., where hunger is no longer felt) may have a role in obesity reduction.
Behavioural and environmental factors:
-Sedentary lifestyle e.g., watching TV, computing;
-Lack of physical activity slows down metabolism;
-Overeating e.g., portion size too high;
-Eating the wrong food e.g., high saturated fat;
-Stress can lead to overeating and fatty food intake.
**Note that extreme diet restriction is also unhealthy.

Question 25

Define adherence

Answer 25

This term suggests that a person sticks to, or cooperates with medication advice (or lifestyle changes, behaviours; NICE 2009) – viewed as a behavioural process influenced by individual and environmental factors (e.g., health-care practices, system influences)

Question 26

Why do people not adhere to health advice?

Answer 26

Patient-related factors: e.g., culture, age, personality, knowledge, personal and cultural beliefs, attitudes towards illness and medicines, self-efficacy beliefs

Condition-related factors: e.g., symptom type, perceived severity, pain, comorbidities, prognosis

Treatment-related factors: e.g., the number, type, timing, frequency and duration of dosage of medications, side-effects, expense

Socio-economic factors: low educational level, costs of treatment, access to health care, social isolation

System-related factors: communications with health-care providers, presence of traditional healing beliefs and systems.

Question 27

What are some health-protective behaviours in regards to diet?

Answer 27

1. To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs.
2. Enjoy a wide variety of nutritious foods from these five food groups every day:
   Vegetables of different types and colours, and legumes/beans
   Fruit
   Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
   Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
   Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat
3. Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
4. Encourage, support and promote breastfeeding.
5. Care for your food; prepare and store it safely.

Question 28

How many deaths are linked to low intake of fruit and vegetables globally per year?

Answer 28

1.7 million

Question 29

Why don’t people eat enough fruit and vegetables?

Answer 29

• Perception that vegetables only eaten with dinner
• Feeling that recommended serves too large
• Lack of preparation time
• Lack of knowledge and skills for preparation
• Attitudes and social norms impact consumption in adults
• Lack of confidence to cook vegetables in men, young adults, and low-income groups

Question 30

What types of food preferences are learned early in the family home?

Answer 30

• cooking methods: e.g., home-cooked/fresh vs. ready-made/processed;
• products: e.g., high-fat vs. low-fat, organic vs. non-organic;
• tastes: e.g., seasoned vs. bland, sweet vs. sour;
• textures: e.g., soft-crunchy, tender-chewy;
• food components: e.g., red/white meat, fruit/veg, carbohydrates.

Question 31

What was the result of the ‘food dudes’ health intervention targeting fruit and vegetable intake in pre-school and primary school children?

Answer 31

• Learning theory techniques used
• Increased taste exposure to fruit and vegetables
• Modelling healthy behaviour through cartoon youth characters
• Reinforcement by child-friendly rewards (e.g., stickers and crayons)
• Long term effects

Question 32

What are the health-protective guidelines for physical activity in Australia?

Answer 32

Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.
• Be active on most, preferably all, days every week.
• Accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
• Do muscle strengthening activities on at least 2 days each week.

Question 33

What are the physical health benefits of exercise?

Answer 33

• Reduced risk of cardiovascular disease, type-2 diabetes, obesity, osteoporosis and, some forms of cancer e.g., colorectal and breast;
• Increased functioning, quality of life and strength, and reduced fatigue and side effects in cancer treatment;
• Strengthens heart muscle, increases cardiac and respiratory efficiency;
• Muscle strength, coordination and balance can be gained from resistance-strengthening exercise (reduces risk of falls and fractures).

Question 34

What are the psychological health benefits of exercise?

Answer 34

• Reduces anxiety and depression;
• Heightens self-esteem and self-image;
• Increases levels of pro-social behaviour;
• Delays neuronal dysfunction (e.g., cognitive decline).

Question 35

What biological mechanisms are activated through exercise?

Answer 35

• Releases the body’s natural opiates into the blood stream, producing a ‘natural high’ and acts as a painkiller;
• Stimulation of the release of catecholamines such as noradrenaline and adrenaline, countering any stress response and enhancing mood;
• Muscle relaxation, which reduces feelings of tension.

Question 36

Why do people exercise?

Answer 36

Desire for physical fitness;
Desire to lose weight/change body shape and appearance;
Desire to maintain or enhance health status;
Desire to improve self-image and mood;
As a means of stress reduction;
As a social activity.

Question 37

What are the barriers to exercise?

Answer 37

Lack of time;
Cost;
Lack of access to appropriate facilities and equipment;
Embarrassment;
Lack of self-belief; 
Lack of someone to go with/support.

Question 38

What are 2 broad purposes of health screening?

Answer 38

1. To detect early asymptomatic signs of disease in order to treat;
2. To identify risk factors for illness to enable behaviour change.

Question 39

What is the criteria for establishing health screening programs?

Answer 39

1. The condition should be an important health problem, i.e., prevalent and/or serious.
2. There should be a recognisable early stage to the condition.
3. Treatment at an early stage should have clear benefits to individual (e.g., reduced mortality) compared with treatment at a later stage.
4. A test with good sensitivity and specificity should be available.
5. The test should be considered acceptable by the general population.
6. Adequate facilities for diagnosis and treatment should be in place.
7. Issues of screening frequency and follow-up should be agreed.
8. The costs (individual and health care) should be considered in relation to the benefits (individual and public health).
9. Any particular subgroups to target should be identified.

Question 40

What factors are associated with non-uptake of screening behaviour?

Answer 40

• Lower levels of education and income;
• Age (e.g., younger women tend not to attend risk-factor screening);
• Lack of knowledge about the condition;
• Lack of knowledge about the purpose of screening;
• Lack of knowledge about potential outcomes of screening;
• Embarrassment regarding the procedures involved;
• Fear that ‘something bad’ will be detected;
• Fear of pain or discomfort during the procedure;
• Lack of self-belief (self-efficacy) in terms of being able to practice self-examination correctly.

Question 41

What are the benefits of vaccination?

Answer 41

• Vaccination is the oldest form of immunisation, antigen is introduced to the body to produce antibodies
• Leads to the virtual eradication of infectious diseases
  e. g., smallpox, diphtheria and polio.