Week 2 Flashcards
Placebo effect
Where a patient is led to believe they have been treated leading to an improved health outcome.
Big pills work better than small. Coloured pills work better than white ones. Capsules work better than tablets and placebo’s with brand names are more effective than those without. The more expensive a treatment the more effective.
Nocebo Effect
Adverse effects of placebos. When patients are led to believe that there will be side effects they can experience adverse effects as strong as a placebo.
Double blind design
An experiment where both the researcher and the participant have no idea who has received the treatment and who has not.
Single blind design
An experiment where only the participant is unclear whether they have received a treatment or placebo.
Correlation
The relationship between two variables. The correlation co-efficient refers to the strength of the relationship between the two variables.
Prevalence
Refers to the proportion of the population that has a particular condition at a given time.
Incidence
Measures the frequency of new cases in a specified time period, usually a year.
What are the six conditions that determine whether people seek medical advice?
personal factors
gender
age
SES
stigma
symptoms
Five components are typically incorporated into the conceptualisation of a disease. What are they?
Identity
Timeline
Cause
Consequences
Controllability of the disease
Sick role behaviour
Behaviour which enables one to get well. Relief from regular duties and taking action to feel better/improve.
Lay referral network
Family and friends who can offer advice before seeking advice from a clinician.
50% of deaths are due to what?
modifiable lifestyle factors and behaviours
Health behaviours that enhance or maintain current health are:
reducing harmful activities
taking up new preventative behaviours
increasing frequency of good behaviours
The most common studied health behaviours are
compliance with medical regimes i.e. rehab, medications and
attendance at screening programs i.e. breast, skin etc
What are some self-directed health behaviours?
Diet
Exercise
Sunscreen use
Supplement intake
Alameda 7 Study (1965) features of lifestyle with lower disease incidence
Not smoking
Moderate alcohol intake
Sleeping 7-8 hours each night
Exercise regularly
Maintaining desirable body weight
Avoiding snacks
Eating breakfast regularly
The best way to change people health habits?
Initiate new behaviours
Decrease/stop existing behaviours
Need to PREDICT people’s behaviour
Health Belief Model (1950’s)
Oldest and most widely used with wide empirical support across diverse health areas
A value-expectancy theory > the desire to avoid illness influences preventative behaviour
Susceptibility +
Severity +
Benefits +
Costs influence behaviours
Perceived barriers and perceived susceptibility were the strongest predictors of health behaviours.
Limitations - vague descriptions/measurements and imprecise relationship between variables i.e. do they affect effect other in a sequential way?
Theory of Reasoned Action (TRA) (Fishbein, 1967)
Behaviour can be predicted by asking someone their intention to perform/not perform.
Predictive power strongest when testing specific behaviours.
Attitudes + Subjective norms + perceived behaviour control influence INTENTION which leads to BEHAVIOURS.
Intention is a function of attitudes and subjective norms.
Background factors may include:
demographic
economic
personality i.e. optimist/pessimist
Theory of Planned Behaviour (TPB)
Extension of Theory of Reasoned Action however incorporate control beliefs (sense of self control).
Someone is more likely to change their health behaviours when they have the right attitude, have social pressure to perform and perceived behavioural control.
Best predicts physical activity (24%) and diet (21%). Relies heavily on student samples.
Limitations -
Assumes intention is stable
Narrow theoretical approach
Attitudes alone can influence behaviour
Over time intentions dissipate and external cues take over.
Transtheoretical Model
A continuum approach
Some variable influence people’s health behaviours; variables can combine to predict likelihood.
Limitations -
Continuum model only focuses on the outcomes and not processes.
Stages -
Pre-contemplation
Contemplation
Determination
Action
Maintenance
Pre-contemplation
No intention of changing behaviour in the near future
No perceived heath problem
Unhealthy behaviour not serious enough to cause action
Lack of knowledge
Repeated past failures to change behaviours
Cost of change outweighs the benefits
Contemplation
Admission of problem
May change behaviour within next six months
Accept benefits but aware of costs
Indecisive
Can get stuck for long periods of time
Preparation
Getting ready to make change in the next month
Have a plan of action to change behaviours
Possible history of failed attempts
Time to make better strategies
Action
Actively engaging in behaviour change
Period of the greatest risk of relapse (6 months)
Solid attempt at changing behaviour
Maintenance
Reached 6 months of continuous successful action
Goal is to sustain new behaviour and prevent relapse
Need confidence to cope with challenges
Common to relapse at an early stage and then start again to make progress
What are the intermediate variables that can influence the process of change?
decisional balance (pros and cons)
self-efficacy (self control)
temptations (overcome objections)
What has the research on the Transtheoretical Model (TTM) revealed?
Four distinct profiles:
not intending to change
intending to change (no action)
intending to change (with action)
maintaining
Limitations -
Not parsimonious
Studies have shown larger effect sizes for studies that did not use the TTM
Interventions for diet and exercise change were largely ineffective
Which is the best model for predicting behaviour change?
Not clear which model is the best.
All models are multi-factor theories - different factors applied in each one
Different models may be more useful when predicting specific behaviours
Focuses on cognitions not emotions
The Cognitive Social Health Information Processing Model (C-SHIP) (Miller, 1996)
Comprehensive model that incorporates many aspects of other models
Individuals have unique cognitive and emotional responses to health threats
These responses determine health behaviours
Five processes -
encodings (risk perceptions)
expectations and beliefs (benefits and drawbacks)
Values and goals
Disease related affect (emotion)
Self regulatory strategies
