Understanding Health Habits and Behaviour Change Flashcards
What is a health habit?
Actions that are triggered automatically in response to contextual cues that have been associated with their performance
Examples of health habits
Washing hands (action) after using the toilet (contextual cue)
Putting on seatbelt (action) after getting into the car (contextual cue)
Tooth brushing (action) after breakfast/before bedtime (contextual cue)
7 important health habits
How many hours do you sleep per night?
Do you eat breakfast every day?
Do you snack between meals?
Are you near or within a normal body weight?
Healthy eating
Do you smoke?
If you drink alcohol, is this at a moderate level?
Do you exercise regularly?
Outline the habit loop
Cue/trigger: Can be internal or external -a person, place, time, a thing or even an emotion
Routine: Behaviour to reinforce/change
Reward: Makes doing the routine worthwhile
Positive reinforcement
Keep habits going – maintains behaviour
3 phases of habit formation
Initiation phase: Define the new behaviour and context it will be practiced are selected
Learning phase: Behaviour is repeated in chosen context to strengthen the context-behaviour association
Stability phase: The habit has formed and its strength has plateaued, habits persists over time with minimal effort
How long does it take to form a habit?
Average 66 days
Range 18-254 days
What theories supply the idea that parents play an important role in encouraging and modelling good habits?
Social Learning Theory (Bandura, 1977)
Peer modelling – children and vegetable study (Birch, 1980)
Classical conditioning – learning process based on a paired stimulus (e.g. Pavlov’s dogs)
Operant conditioning
How is behaviour critical to health?
Non-communicable diseases are the leading cause of death globally e.g. T2DM and CVD
Consequences of unhealthy habits on health (health + social consequences)
Health: Increased mortality, increased risk of developing chronic conditions e.g. diabetes, obesity, cancer, hypertension, depression, anxiety
Social consequences: Problems with debt, relationships, employment
Examples of unhealthy habits
Too little sleep
Smoking
Alcohol
Caffeine
Drugs
Sedentary behaviour
Social media
Shopping
Gambling
What is the COM-B model? (Michie et al, 2011)
How is the COM-B model applied?
What is the transtheoretical/stages of change model? (Prochaska & Di Clemente, 1982)
How is the transtheoretical/stages of change model applied?
Behaviour change techniques
Action planning
Goal setting (behaviour/outcome)
Self-monitoring of behaviour
Goal setting behaviour change techniques
Set goal specific to behaviour you want to change:
Mode/ Type
Intensity
Duration
Frequency
Make it a SMART goal:
Specific Measurable Attainable Relevant Time-Based
Problem solving behaviour change technique
Identify a barrier, then identify a strategy to overcome that barrier
E.g. feel self-conscious at the gym -> exercise at home using YouTube
Why is it so difficult to break old habits?
Enjoyable behaviours prompt brain to release dopamine (REWARD)
If you repeat a behaviour and dopamine present – strengthens habit even more
Replacing first-learned habit with a new one does not erase original behaviour
Techniques to break old habits with examples
Disrupting old habits e.g. put phone in another room at night, don’t keep certain foods in house
Replace unhealthy habit with a more healthy one e.g. drink water instead of sugary drinks, eat fruit instead of crisps
Increase social support e.g. engage in group activities involving physical activity - buddying/partnering
Seek counselling support e.g. help understand how the habit developed/maintained/quit
Principles of motivational interviewing (RULE)
Roll with resistance: Avoid telling patient what to do, persuasion or argument. Instead, reflect and re-frame
Understand motivations: Understand values, needs, abilities, motivations and barriers to change behaviours
Listen with empathy: Seek to understand from patient’s perspective, respect decisions and choices
Empower: Help patient to explore how they can make changes e.g. set goals/techniques to overcome barriers, encourage patient to come up with own solutions
Motivational interviewing techniques
OARS
Open questions
Affirmation
Reflection
Summarising
Useful models/approaches for helping patients change their behaviour
Models such as COM-B to understand behaviours
Using behaviour change techniques
Motivational interviewing
7 steps to change a habit
Identify the habit you wish to change
Examine the possible habit loop that maintains the behaviour
Identify what new habit you want to form
Disrupt old habit and introduce new behaviour
Set realistic goals and identify rewards
Monitor
Long-term goals
List advantages of the Transtheoretical Model
Predicts change in some behaviours
Broad and has identified many useful processes involved in behaviour change
List disadvantages of the Transtheoretical Model
Stage definitions are arbitrary
Assumes that change is planned (spontaneous change left out)
Doesn’t assess readiness to change
Doesn’t consider negative processes (e.g. wishful thinking, avoidance, blame)
Suggests insight into behaviour
What is operant conditioning?
Learning by consequences
Behaviour becomes more or less frequent depending on the stimulus that follows it: e.g. patient in need of social interaction visits GP frequently, if the GP provides the social stimulation
Individual makes association between a particular behavior and consequence
Positive and negative reinforcement can be used to change behavior:
- Reinforcement= increases a desired behavior
- Punishment= decreases an undesirable behavior
Outline posiitve reinforcement
Reward is given after a particular behavior occurs, this increases the expression of the behavior in hope that the reward will occur again
Outline negative reinforcement
Upon achieving the desired behavior, a negative stimulus is removed
For example: loud noise sounding until a rat pushes the button to make it stop. They then press the button far more often
Outline positive punishment
When a behavior is followed by an aversive stimulus, such as pain from a spanking, resulting in a decrease in that behavior (positive because you are adding a stimulus)
Outline negative punishment
Occurs when a behavior is followed by the removal of a stimulus, such as taking away a child’s toy following an undesired behavior, resulting in a decrease in that behavior
