Psychology 2b - Health Behaviour Change Flashcards
Define health behaviour
Any activity undertaken by an individual believing himself to be healthy, for the purpose of preventing disease or detecting it at an
asymptomatic stage
List the levels targeted in behaviour change interventions
- Population (social media campaigns, those advertised on TV)
- Community level (eg. in cardiac rehabilitation targeting different cultures)
- Individual level (motivational interviewing, considering individual smoking and alcohol behaviour)
Describe Nutbeam et al study
- A programme of education about the effects of smoking was conducted in 39 comprehensive schools in England & Wales
- The programme involved specially trained teachers
providing teaching sessions spread over a 3 month period - Outcomes: a self report questionnaire combined with
a saliva test before teaching, immediately afterwards and at 1 year follow-up. No effect on % never smoked between the groups
What is the role of education in health behaviours?
- Information does have an important role and is most effective for discrete behaviours (eg getting a child
vaccinated) - Messages tailored to a particular audience are more effective (eg complete abstinence Vs condom use to
reduce teenage pregnancy) - But often people need more than knowledge to change
habitual lifestyle behaviours, particularly addictive
behaviours (eg social & psychological support, skills to
change)
List the cues for unhealthy eating (learning theory)
- Visual (eg. fast food signs, sweets at checkout)
- Auditory (eg. ice cream bell)
- Olfactory (eg. smell of baking bread)
- Location (eg. the couch or car)
- Time (eg. evening)/ Events (eg. end of TV programme )
- Emotional (eg. bored, stressed, sad, happy).
List the reinforcement contingencies in unhealthy eating
Positive reinforcement:
- Dopamine (feel good), filling an empty void/boredom.
- Praise for preparing a high-fat meal for the family.
Negative Reinforcement:
- Avoid painful emotions by comfort eating.
Punishment:
- Preparing a low fat meal is criticised.
Limited/delayed positive reinforcement for healthy eating:
- Efforts at dietary change/weight loss go unnoticed by others;
Avoiding future health problems is too remote.
List the behaviour modification techniques used to improve unhealthy eating
- Stimulus control techniques (keep danger foods out the house, eat only at the dinner table, use small plates)
- Counter conditioning (identify high risk situations or cues and healthier responses)
- Contingency management (involve significant others to praise healthy eating, plan rewards and vouchers)
- Naturally occuring reinforcers (improved self esteem [positive reinforcement], and reduction in symptoms of breathlessness [negative reinforcement])
List limitations of reinforcement programmes
- Lack of generalisation (only affects behaviour regarding the specific trait being rewarded)
- Poor maintenance (rapid extinction of the desired
behaviour once the reinforcer disappears) - Impractical and expensive.
Give evidence for using incentives to change health behaviours
Successful scheme in Dundee offered cash to expectant mothers for giving up smoking - over 90% of
the 52 participants quit throughout pregnancy and for 3
months after.
Give evidence for fear arousal in health behaviours
- 50 high school students given one of three different lectures on dental health.
- Lectures were given to cause low, moderate or high fear.
- High fear group had lowest change in behaviour, and the lowest fear group had the highest change in behaviour
Give evidence for the influence of social learning on health behaviours
- Smoking status of pupils increases with the number of smokers the pupil lives with
- Adolescents are particularly susceptible to social influences given their developmental stage and the importance of school and peer groups.
- Substantial peer group homogeneity with respect to adolescent smoking.
- Best friends have the greatest influence on adolescent smoking, followed by peer groups.
- Waterloo smoking prevention project rehearsed skills to build confidence in ability to resist peer pressure to smoke, which significantly effected reducing the number of children who started smoking
Define expectancy value principle
The potential for a behaviour to occur
in any specific situation is a function
of the expectancy that the behaviour
will lead to a particular outcome and the value of that outcome
Describe the health beliefs model
- Background variables (age, sex, ethnicity, personality and knowledge) influence perceived benefits and costs as well as perceived susceptibility and perceived seriousness
- Perceived threat is affected by background variables, cues to action, perceived susceptibility and perceived seriousness
- Likelihood of behavioural change is affected by perceived benefits vs perceived costs and perceived threat
Apply the health beliefs model to the decision to get a flu vaccine
Susceptibility – “A lot of people I know have
got flu symptoms”
Seriousness – “It’s not something to really
worry about”
Benefits – “The vaccination will stop me getting sick”
Costs/barriers - “The injection will be painful
and it might make me ill for a while”
Cues – Doctor strongly advises to have it.
Apply the health beliefs model to smoking cessation
Explore Cues to Action:
- Has anything made you think about giving up smoking?
Explore perceived susceptibility and severity:
- How do you think smoking is affecting your health?
- What would it be like if you got it (eg lung cancer)?
Explore perceived benefits and barriers:
- What are the pros and cons of smoking for you?
- Is there anything stopping you from quitting?
Define efficacy beliefs (outcome efficacy and self efficacy)
Outcome efficacy - Individuals
expectation that the behaviour will lead
to a particular outcome
Self Efficacy - Belief that one can
execute the behaviour required to
produce the outcome
What are the 4 sources of self efficacy?
- Mastery experience
- Social learning
- Verbal persuasion or encouragement
- Physiological arousal
Describe the theory of planned behaviour
- Attitude towards the behaviour are affected by beliefs about outcome (expectancy) and the evaluation of outcome (value). Attitude influences intention.
- Percieved behavioural control is affected by internal control factors (self efficacy) and external control factors (percieved costs/barriers). Influences intention and behaviour
- Subjective norm affects intention. Subjective norm is affected by beliefs about important others attitudes towards the behaviour
Describe smoking cessation using the theory of planned behaviour
Explore attitudes towards smoking
- What do you think about smoking?
- Is smoking a good or bad thing for you?
Explore the norms of important people around her:
- What do your friends/family think about you smoking?
- Would
you like to quit for [person]?
Explore whether she intends to quit smoking:
- Have you ever thought about quitting?
- Do you intend to quit in the next few months?
Explore how much control she thinks she has:
- Do you think you can quit?
- What makes you think that you can’t?
Describe the transtheoretical model of health behaviours
- Pre-contemplation (do not recognise the need to change a behvaiour)
- Contemplation recognises a problem
- Determenation is preparing to make a change
- Action is initiating change
- Maintenance is adjusting to change and practicing new skills and behaviours to sustain change
- There then may be permanent exit or relapse (may occur and start the cycle again)
What is the behaviour change wheel?
- COM-B
- Capability
- Opportunity
- Motivation
- Interaction between these three influence performance of a behaviour
- Outside of this, there are 9 forms of intervention functions
- Outside of this, there are 7 types of policy categories to try to cause interventions
