S3 - Health Related Behaviour Flashcards
what are health related behaviours
any behaviours that might promote or protect good health, or lead to illness
eg risk behaviours include…
* smoking
* drinking
* drug use
eg health promoting behaviours include…
* taking exercise
* eating healthy diet
* safe sex
* attending screening
why is understanding health related behaviour important
- large majority of deaths in high-income countries are due to non-communicable diseases eg heart disease, stroke and diabetes
- primary risk factors for non-communicable diseases are behavioural (eg tobacco use, physical inactivity, alcohol use and unhealthy eating)
what are the main theories that help us understand health-related behaviour
learning theories
☞ look at how we learn behaviours as a result of making associatations with sensations, experiences or outcomes
- classical conditioning
- operant conditioning
- social learning theory
social cognition models
☞ look at how we decide to behave in particular ways, and how people think, feel and reason about their behaviours
- cognitive dissonance theory
- health belief model
- theory of planned behaviour
what are the main theories that help us understand health-related behaviour
learning theories
☞ look at how we learn behaviours as a result of making associatations with sensations, experiences or outcomes
- classical conditioning
- operant conditioning
- social learning theory
social cognition models
☞ look at how we decide to behave in particular ways, and how people think, feel and reason about their behaviours
- cognitive dissonance theory
- health belief model
- theory of planned behaviour
classical conditioning
learning theory
- environmental cues eg sights, smells, location, people and expectation of alcohol etc
- cues may be emotional
- cues with connection to using drugs/alcohol can trigger behaviour and lead to relapse when quitting
☞ avoid cues/change association with cues (eg pairing medication that induces nausea when taking alcohol)
☞ creates new associations that discourage behaviours
☞ disrupting ingrained pattern of behaviour
operant conditioning
learning theory
- helpful in explaining why we start behaviours
- people act on environment and behaviour is shaped by the consequences (reward or punishment)
☞ behaviour increases if its reinforced: rewarded or punishment is removed (negative reinforcement)
☞ behaviour decreases if punished: negative consequences or a reward is taken away
the problem is
* unhealthy behaviours (eg drug taking, alcohol, eating unhealthily) are immediately rewarding, so acts as positive reinforcement
* we are driven by short term rewards and avoiding short term negative consequence (withdrawal)
* harder to reinforce good behaviours if positive consequences are longer-term
* no account of social context
social learning theory
learning theory
people can learn through observation (modelling) and vicarious reinforcement
- considers how we’re influenced by poeple around us
- behaviour is goal-directed
- people are motivated to perform behaviours (that they are valued, leading to rewards and that they beleive they can enact ie self-efficacy)
- we learn what behaviours are rewarded, how likely it is that we can perform behaviour, from observing others
- modelling more effective if models are high status or ‘like us’
☞ influence of family, peers, media figures, celebs as role models
☞ also easily influenced in neg way eg drinking, drug use and unsafe sex
positives:
* celebrities in health promotion campaigns
* peer modelling/education (if we see someone ‘like us’ then more likely to mimic behaviour)
cognitive dissonance theory
social cognition theory
- discomfort when we hold inconsistent beleifs or behaviours/events don’t match beliefs
- reduce discomfort by changing beleifs or behaviour
health promotion
☞ providing health information that counters their belief (usually uncomfortable) creates mental discomfort and can prompt change in behaviour
eg smoker who doesn’t believe they can get lung caner from smoker, so given story about someone similar who has lung cancer… this is uncomfortable and therefore prompts change in behviour
health belief model
social cognition model
beliefs about health threat and health-related behaviour act as cues to action and influence our health-related behaviour
eg beliefs about health threat
☞ percieved susceptibility (ie don’t think they’re candidate for cancer)
☞ percieved severity (eg treatment is easy and quick)
eg beliefs about health- related behaviour
☞ percieved benefits
☞ percieved barriers (eg feeling embarrassed about buying condom)
therefore can better understand people’s beliefs and can therefore help inform health promotion campaigns
theory of planned behaviour
social cognition model
three factors that feed into intention of changing health-related behaviour
* attitude towards behaviour
* subjective norms
* percieved behavioural control (tend to engage in behaviour that we beleive we have resources and ability to do)
☞ good predictor of intentions but poor predictor of behaviour
☞ problem is translating intentions into behaviour
☞ need to implement intentions (ie concrete plans of action)
problems of interventions to change behaviour
- multiple and poorly-integrated models of behaviour
- this suggests there are different targets for behaviour change
- interventions to change health related behaviours have variable and modest effects (NICE 2007)
- impact of interventions depends on type of behaviour, the population being targeted and context
integrative model for targeted intervention
- specify behaviour to be changed
- understand the nature of the behaviour and underpinning influences (behavioural diagnosis)
- choose behaviour to change technique matched to diagnosis (prescription)
why don’t people behave in ways that promote good health
- lack of capability (ie inadequate knowledge and skills)
- insufficient opportunity (ie working full-time)
- motivation at key moments to engage in healthy behaviours is lacking (healthy behaviours are usually difficult, boring or unpleasant while unhealthy ones are enjoyable or meet immediate needs)
what is the COM-B model
capability
* physical + psychological capability
* feeds into motivation and influences behaviour
* knowledge, skill, strength and stamina
opportunity
* physical and social opportunity
* time, resources, environment and social support
* social support and role-modelling eg running club
* feeds into motivation and influences behaviour
motivation
* reflective and automatic motivation
* reflective = cognitive, conscious processes that impact our health-related behaviour
* automatic = unconcious eg emotions and impulses that direct our behaviour
* eg plans, evaluations, desires and impulses
these factors all feed into behaviour
how to use intervention strategies to help patients
- match intervention to diagnosis eg lack of social capability may require education and training
- may need policy levers (legislation and guidlines)… ie government may need to do something
- use behaviour change wheel (this is wheel with sources of behaviour, intervention functions and policy categories)
- digital intervention: personal, tailored interactive website
- nudge theory (more detail on next card)
