Session 3 - Health behaviour and Adherence

Question 1

How can you use social learning theory to design health promotion interventions?

Answer 1

Celebrities/role models campaign to promote healthy behaviours

Question 2

How can you use operant conditioning to design health promotion interventions?

Answer 2

Rewards and repeated techniques can be used

Question 3

Define compliance

Answer 3

Extent to which patient complies with medical advice

Question 4

Define adherence

Answer 4

Extent to which patient behaviour coincides with medical advice

Question 5

Define concordance

Answer 5

Negotiation between patient and doctor over treatment regimes, patient is active and can make decisions with help from doctor

Question 6

Why does concordance lead to better adherence?

Answer 6

• Patient is involved and has shared ownership of treatments
• Patients beliefs and lifestyles can be taken into account
• Barriers to adherence can be addressed
• Promotes patient trust.

Question 7

Describe how adherence changes across different patient groups

Answer 7

50% non adherence in chronic illnesses

Non adherence higher in less severe diseases

Question 8

Name 4 methods to measure adherence

Answer 8

1) patient self report
2) urine or blood test
3) pill counts
4) electronic measures of dose

Question 9

Name the pros and cons of the 4 methods to measure adherence

Answer 9

patient self report - easy to obtain, cheap. But prone to inaccuracis, bias

Urine or blood test - direct measure of adherence, but invasive, expensive.

Pill counts - more objective than self counts but subject to inaccuracies e.g. lost pills

Electronic measures of dose - Measures whether a dose has been dispensed but doesnt measure if drug actually taken

Question 10

According to the health belief model, what is adherence based on?

Answer 10

• Perceived disease severity
• Perceived susceptibility to disease
• Benefits of treatment
• Barriers to following treatment

Question 11

Outside of the health belief model, name the 5 factors that influence adherence.

Answer 11

1) Understanding - both illness and consultation
2) Illness factors - whether patient experiences symptoms and health of patient
3) Treatment factors - side effects and convenience and expense of drugs
4) Doctor-patient interaction
5) social support and context - social and family support = higher adherenc

Question 12

Define intentional non adherence and why it might occur

Answer 12

beliefs, attitudes and expectations that influence patients motivation to adhere to treatment

Question 13

Define unintentional non adherence and why it might occur

Answer 13

Limitations prevent patient from following treatment, e.g. memory problems, dexterity problems, or aspects of their environment (e.g. problems accessing prescriptions)

Question 14

Describe the main problem concerning interventions to improve adherence

Answer 14

few approaches individualise the approach to suit a patient