20 - Health Behaviours

Question 1

What internal/personal factors influence health?

Answer 1

Knowledge about risk Attitudes/beliefs Circumstances e.g. finances, time, stress Physiology/genetics

Question 2

What external factors influence health?

Answer 2

Social support Social norms Media Laws & regulation Environment Healthcare system

Question 3

How have causes of deaths changed over the years?

Answer 3

Switched from infectious diseases to non-communicable diseases (e.g. cancer, heart disease) Deaths more concentrated in the older ages

Question 4

What are the top 5 causes for premature death?

Answer 4

1. Cancer 2. Cardiovascular disease 3. Other 4. Respiratory disease 5. Liver disease

Question 5

What are the cancer risk factors?

Answer 5

• Smoking, exposure to another person’s cigarette smoke - Drinking more than 1 unit of alcohol a day - Eating less than 5 portions of fruit and vegetables - Eating red or processed meat once a day or more - BMI over 25 - Getting sunburnt more than once as a child - Infection with HPV (Human Papillomavirus) - Doing less than 30 mins of moderate physical activity 5 times a week - Being over 70 - Having a close relative with cancer

Question 6

What improved the transmission of infectious diseases?

Answer 6

• Clean water - Immunisation - Better hygiene

Question 7

What is needed to improve health conditions today?

Answer 7

Health behaviours (laws; education campaigns; screening)

Question 8

What are examples of behavioural pathogens?

Answer 8

• Smoking, drinking (heart disease, cancer) - Sex, contraception (HIV, STD) - Stress (immune system response, CVD)

Question 9

What are examples of behavioural immunogens?

Answer 9

• Exercise (e.g. 20 minutes walking a day; stairs) - Balanced diet (e.g. 5 a day) - Immunisation (e.g. polio, TB, MMR) - Screening (e.g. breast, cervical, cholesterol)

Question 10

How can health behaviours be changed?

Answer 10

Information on health risk

Question 11

When using fear appeals, what must they do to be effective?

Answer 11

Increase people’s self-efficacy (i.e. confident that they can change) I.e. how to do it not just what to do

Question 12

What are fear appeals?

Answer 12

Persuasive messages that arouse fear

Question 13

What are reasons people keep their lifestyle behaviours?

Answer 13

Habit; fun; rebellious; friends; enjoyable; relaxing; happy; risk perceptions of health/ illness.

Question 14

What are reasons people change their lifestyle behaviours?

Answer 14

External restrictions; not well; friends/ family; other changes lifestyle; values/ risk perception changes.

Question 15

What are the societal causes for premature death?

Answer 15

Working class, ethnic minority, northern UK, male, MH, disability

Question 16

What is purpose of health behaviour models?

Answer 16

• Outline psychological responses relevant to health - Are used to predict, explain and change behaviour - Offer explicit hypotheses regarding determinants and processes underlying behaviour - Allow us to build on and further behavioural science

Question 17

How are psychological determinants involved in behaviour?

Answer 17

Are conceived of as proximal determinants of behaviour and assumed to mediate the influence of interventions Assumed to be more open to modification than other factors (e.g. personality) Intervention –> Psych construct –> Behaviour –> Health

I.e. target pyschological constructs in order to target behaviour

Question 18

What is the COM-B Model?

Answer 18

The Capability, Opportunity, Motivation, Behaviour (COM-B) model Implies behaviour occurs as an interaction between these 3 necessary conditions

Question 19

What is ‘capability’?

Answer 19

Psychological or physical ability to enact the behaviour Includes things like knowledge, physical and mental skills, mobility, and strength

Question 20

What is motivation?

Answer 20

Reflective and automatic mechanisms that activate or inhibit behaviour Intentions and evaluations (‘reflective’ motivation), and desires, emotions and habits (‘automatic’ motivation)

Question 21

What is opportunity?

Answer 21

Physical and social environment that enables the behaviour

Question 22

What is the COM-B Model used for?

Answer 22

This model seeks to aid our understanding of barriers and facilitators of behaviour through categorising them as related to our capability, opportunity or motivation. If one or more of the factors are deficit, then it is less likely behaviour change will occur.

Question 23

Use the COM-B model in regards to trying to increase physical activity

Answer 23

M - Do people want to do this? O - Easier by improving cycle routes or access to gym facilities C - Providing cycling proficiency

Question 24

What did Ajzen and Madden come up with?

Answer 24

The Theory of Planned Behaviour

Question 25

What is the Theory of Planned Behaviour?

Answer 25

Motivational theory Behavioural change determined by attitude, subjective norms and perceived behavioural control

Question 26

What are the strengths of the Theory of Planned Behaviour?

Answer 26

* Identifies constructs and behaviour to change, not the disease * Links beliefs to behaviour * Has been shown to predict behaviour well (but better at intentions) * Identifies potential targets for health promotion intervention * Can be used to study the population and identify specific beliefs * Highlights the importance of society (norms)

Question 27

What are the weaknesses of the Theoery of Planned Behaviour?

Answer 27

* Intention-behaviour gap * Perceived Behavioural Control is both a proxy for actual control and a measure of confidence in one’s own ability * Superior prediction over other models may be only due to better definition of constructs (causality?) * Provide only targets for behaviour change, not methods for change * Assume that people are rational and deliberative

Question 28

What was Bandura's theory on behaviour?

Answer 28

Social Congition Theory --\> behaviour governed by: expectancies about behaviour and self-efficacy, incentives or consequence behaviour, social cognitions – people representations of the social world

Question 29

What are the limits of health behaviour models?

Answer 29

- Causality rarely tested - Assumes that people are rational and deliberative, what about impulsive health actions? - Provides only targets for behavioural change, not methods for change

Question 30

What are habits?

Answer 30

Relatively automatically triggered actions formed through a repetition in a consistent context Can be used to help people learn healthy behaviours

Question 31

What are the benefits of habit-based interventions?

Answer 31

* Require less engagement or motivation * Less time-consuming to explain * Easier to implement * Promotes long-term maintenance

Question 32

What are individual interventions?

Answer 32

Advice / empowerment e.g. Ten Top Tips

Question 33

What are organisational interventions?

Answer 33

Work place/ school responsibility for health workforce, e.g. messages in lifts, parking restrictions, smoking support on campus, buying bike schemes, showers

Question 34

What are community interventions?

Answer 34

Skills and resources set up by communities (e.g. walking buses, running groups).

Question 35

What are societal interventions?

Answer 35

Laws, taxation, nudges

Question 36

What is 'nudging'?

Answer 36

A technique that alters a person’s decision-making context without removing options or changing the incentives in order to promote choice and behaviour in accordance to their own preferences, such as choosing healthy food over unhealthy food in a supermarket

Question 37

What are the individual / organisation / societal interventions for hand washing?

Answer 37

Individual: - Knowledge, skills, motivation, beliefs, attitudes, risk perception, intention, social norms, self-efficacy Organisation: –Posters, anti-bacterial gel at doorways, on belts, etc –Monitoring Society: –Guidelines, patient safety

Question 38

Who came up with the habit formation theory?

Answer 38

Lally et al

Question 39

What is the habit formation theory?

Answer 39

Habits formed through repetition