Session 3: Health related behaviour

Question 1

Describe 2 conditioning theories

Answer 1

1. Classical conditioning: Environmental cues which lead to using dugs/alcohol, can lead to relapse when quitting. Eg. Antabuse: causes discomfort during alcohol consumption. Pavlov’s dogs
2. Operant conditioning: Behaviour is shaped by consequences, and people are influenced by their environment. Behaviour increases with positive reinforcement or decreases with negative consequences. Note: behaviour and consequence must occur within short period of time fo association ot occur. Problem: unhealthy behaviours are immediately rewarded, we are driven to avoid short term negative consequences( withdrawal symptoms). Eg: 25% of preggo women stopped smoking with $ incentive.

Question 2

What are some limitations of conditioning theories

Answer 2

These theories are based on simple stimulus-response associations, congnitive processes, knowledge, beliefs, social context are not taken into consideration.

Question 3

Name and describe a learning theory

Answer 3

Social learning theory. Behaviour is goal oriented. People feel motivated to perform behaviours that are valued, or they feel someone of the same level can do it too(so they should be able to do it). We learn what behaviours are rewarded and how likely we can perform that behaviour by observing others. Modelling more effecting if models high status or ‘like me’. Often due to influence of people around patients.

Question 4

Describe 3 social cognition models( cognitive dissonance theory, theory of planned behaviour, health belief model)

Answer 4

1. Cognitive dissonance theory: discomfort when behaviours and events dont match beliefs. Either is changed to reduce discomfort. Eg: providing health information creates mental discomfort, change in belief, and can prompt change in behaviour. However, people may choose to avoid the info, or look specifically for sources that disproof the info to conform their original beliefs. Or could create fear- counterproductive, as anxiety may form.
2. Health belief model: Individuals belief about health threat( perceived suspectibility, severity) and belief about health-related behaviour( perceived barriers, benefits) lead them to action. Cues to action required: understanding barriers pts face and overcoming them. Eg: increase availability of condoms in toilets as people may be too in the moment to purchase one themselves.
3. Theory of planned behaviour: Attitude towards behaviour, subjective norms, perceived behaviour control leads to intention to change bahviour. Solution: bridge intention behaviour gap. Implementation intents should be created. Problem with theory: good at predicting intentions but bad with behaviour.

Question 5

Why dont people behave in ways that promote health?

Answer 5

COM-B
Capability: knowledge, skills, strength
Opportunity: time, resources, social support
Motivation: plans, desires, impulses because healthy behaviour are unpleasant or difficult.

Question 6

What is nudge theory?

Answer 6

It focuses on unconscious influences on behaviour. It attempts to change behaviour by changing environment, using positive reinforcement, messaging and indirect suggestions.
Based on the idea that 80% of human behaviour is automatic based on environment. Solution: make small changes in choice architecture to steer decisions in right direction. Place fruit bowl in front counter to encourage consumption etc. It must decrease the effort required to make right choice and improve motivation to opt that choice. Problem is that public policies look at the other 20%. We lack evidence on their efficacy and it is unlikely that this strategy alone can improve population health.