2H models of health promotion Flashcards
What do models of health promotion cover? (3 areas)
- the scope and aims of health promotion
- understand what motivates individuals/ communities to adopt health harming/ improving behaviours
- inform health promotion programmes aiming to influence behaviour
Name 7 models of health promotion
- Health Belief model
- Social learning theory/ social cognitive theory
- Theory of planned behaviour
- Stages of change model
- Spheres of health promotion
- Beattie Model
- Ewles and Simnett model
Health Belief model
- Hochbaum et al
-1958 - individuals will adopt health related actions if they belief they are faced with risk and they have the potential to reduce the risk
- developed in response to failure of a free TB health screening programme and has developed over time
- individuals will adopt health promoting actions if they believe all of the following statements:
1. they are SUSCEPTIBLE
2. The consequences are potential SEVERE
3. There is a COURSE OF ACTION they could take to reduce risk
4. the BENEFITS of action outweigh the COSTS
5. They have the ABILITY to change behaviour - health promotion activities may act as a ‘cue to action’ to influence one or all of these perceptions
Social Learning theory (AKA social cognitive theory)
- Bandura
-1977 - model focuses on 3 influences of behaviour
- RECIPROCAL DETERMINISM
- the continuous, complex and subtle interaction between a persons behaviour and their environmeant - SOCIAL NORMS
- the effects of social and cultural conventions on behaviour - COGNITIVE FACTORS which encompass
1.Observational learning
- people learn not just by doing but also by watching others behaviours and the rewards for those behaviours - expectations
- used to describe the capacity of a person to anticipate and value the outcome of a particular behaviour
- capacities varies between individuals which highlights the importance of exploring personal attitudes and beliefs when seeking to change beavoiur
- ie young women who believe smoking helps with weight loss are more likely to quit if given information on alternative weight loss methods - Self-efficscy
- describes a persons perceived ability to control their own behaviour (person and environment specific)
- ie a person may be confident they can not drink alcohol at home but may struggle when out
Theory of planned behaviour
- Azjen and Fishbein
- 1980
- 3 beliefs affection intention and subsequent behaviour:
1 BEHAVIOURAL BELIEFS
- attitudes and perceived likelihood of the desired outcome if the behaviour is followed
- NORMATIVE BELIEFS
- encompass what others expect (the subjective norm)
- ie health promotion can target this such as challenging the view amongst teenagers that many of their peers take drugs - CONTROL BELIEFS
- covers self-efficacy (as seen in social cognitive theory)
- ie health promotion can target promoting self efficacy ie how to say no to drugs
Spheres of Health promotion
-Tannahill
- 1985
- considers health promotion to be defined by 3 overlapping spheres of activity:
HEALTH PROTECTION
ie health protection legislation to prevent injury or illness (ie seatbelt laws)
HEALTH EDUCATION
- education to prevent disease (ie stop smoking advice)
PREVENTION
- programmes to prevent illness (ie immunisations)
Beattie Model
- Beattie
- 1991
- considers the activities involved in health promotion and how they are delivered
- tool for critically appraising health promotion activities, particularity regarding the balance of authoritative and negotiated approaches
Beattie outlined 4 approaches to health promotion
1. Health legislation (authoritarian and collective)
2. Health persuasion (authoritarian and individual)
3. Personal counselling for health (individual and negotiated)
4. Community development (negotiated and collective)
which approach should be used depends on the:
-MODE of the programme (ie is it authoritarian (top down) or negotiated (bottom up))
- FOCUS of the programme (ie is it individual or collective)
Ewles and Simnett model
- Ewles and Simnett
- 2003
- Considers the different approaches to health promotion from a multidisciplinary perspective
- approaches can be used in combination
- identified 5 approaches (acronym BEEMS)
- BEHAVIOUR
- encourages individuals to adopt healthy behaviours (ie healthy cooking class) - EDUCATION
- provision of information and knowledge as well as skills to make informed decisions
- ie schools - EMPOWERMENT
- helps individuals identify their own needs and concerns
- health educator a a facilitator
- ie community development work - Medical
- focuses on the biomedical causes of disease
- narrow concept of disease (ignores the social and environmental aspects)
- ie screening/ immunisation - SOCIAL CHANGE
- focuses on the socioeconomic environment in determining health
- ie lobbying, policy planning and negotiating
Strengths and weakness of the health belief model
STRENGTHS
- good for simpler, less entrenched preventative behaviour changes (ie uptake of imms/screening)
- evidence that it can be useful in predicting behaviour or improving the effectiveness of some interventions
WEAKNESSES
- less useful for complex, long term behaviours (ie alcohol dependence)
- does not account for other circumstances influence behaviour outside of individual beliefs (ie societal norms, provision of healthcare)
Strengths and weaknesses of social learning theory/social cognitive theory
STRENGTHS
- appropriately complex solutions to health problems (ie not too simple)
- unlike HBM and stages of change model it explicitly recognises the impact of environmental, social and behavioural factors
- widens the role of health promotion beyond individual persuasion about a discrete behaviour to the cover the entire social environment and wider personal beliefs.
WEAKNESSES
- can be difficult to implement due to its scope and complexity
Stages of change model (aka trans- theoretical model)
- Prochaska and DiClimente
- 1984
- people go through 6 possible stages when changing a behaviour (they can enter/ exit or stall in the stages at any point)
- PRECONTEMPLATION
(they see no problem but others disapprove) - CONTEMPLATION
( weighing up pros and cons of change) - DETERMINATION
(planning for change) - ACTION
(implementing change) - MAINTENANCE
- (TERMINATION)
Strengths and weakness of stages of change model
STRENGTHS
- good for complex, long term behaviour changes (ie stop smoking(
- good for counsellors wanting to tailor their approach according to which stage the client is at
- good for programme planning ie can plan sequential interventions based on stages aiming to move people through them
WEAKNESSES
- not so good for programmes aimed at whole communities
Strengths and weaknesses of the spheres of health promotion model
STRENGTHS
- simple to understand
- widely used to define what health promotion encompasses
- covers wellbeing, not simply the absence of disease
WEAKNESSESS
- distinction between health protection and prevention is arbitrary at times
3 factors affecting a person tendency to risky behavioiurs
- demographics (age, gender, ethnicity)
- Familiarity with the potential outcome of the risky behaviour
- degree of personal control over the risk factor
