4)Health Behaviours

Question 1

What are health-related behaviours?

Answer 1

Anything that may promote good health (exercise, healthy diet, safer sex behaviour, screening activities) or lead to illness (smoking, drinking, drug use)

Question 2

What are the 2 broad categories of theories used to help understand people’s HRBs?

Answer 2

1. Learning theories

2. Social cognition models

Question 3

What are learning theories?

Answer 3

Look at HOW we learn behaviours as a result of (often unconscious) association. And how this can be reinforced through its association with sensations, experiences or outcomes.

Question 4

Name the 2 types of conditioning used in learning theories

Answer 4

Classical conditioning- association

Operant conditioning- reinforcement

Question 5

Outline use of classical conditioning in humans

Answer 5

• environmental cues ie sights, smells, location, people signal expectation of drug/alcohol
• cues can be emotional ie anxiety (associate the internal emotional state with the behaviour)
• cues with a connection to drug/alcohol use can trigger behaviour and lead to relapse when quitting

Question 6

How can CC be utilised to change behaviours?

Answer 6

• avoid cues/change the association with the cues (else will continue to evoke a maladaptive behavioural response)
• aversive techniques= pair behaviour with an unpleasant response (use of disulfiram in chronic alcoholics)

Question 7

Outline operant conditioning

Answer 7

Behaviour is dependent on the consequences of behaviour (reward or punishment)

• reinforced (increases) if rewarded or punishment removed
• behaviour decreases if it is punished or a reward is taken away.

Consequences must be observed within a short time of the behaviour in order for an association to be formed

Question 8

How does operant conditioning relate to health behaviour?

Answer 8

• unhealthy behaviours drug-takin, alcohol, cooking, chocolate and unsafe sex) are immediately rewarding
• we are driven by short term rewards & avoiding short term negative consequences

Question 9

Outline some limitations of conditioning theories

Answer 9

• classical/operant conditioning based on simple stimulus-response associations
• no account of cognitive processes, knowledge, beliefs, memory, attitudes, expectations etc
• no account of social context (surrounded by other people, yet this influence is ignored)

Question 10

What is involved in Social Learning theory

Answer 10

People learn through vicarious re-inforcement (through observing the behaviour of role models and the consequences of this behaviour)
Example: Bandura’s Bobo Doll study

Question 11

Describe the use of SLT

Answer 11

• behaviour is goal-directed
• people are motivated to perform a behaviour if it is valued(rewarded) and they believe they can execute the behaviour (have the self-efficacy)
• modelling behaviours are more effective when role models are of high status or like us (in terms of value/ability)

Question 12

How does SLT impact health-related behaviour?

Answer 12

• influence of family, peers, media figures, celebrities as role models
• harmful behaviour(modelled by media/films) ie drinking, drug use and unsafe sex, without consequence

Positives

• peer modelling/education (effective in health promotion)
• celebrities in health promotion campaigns

Question 13

What do social cognition models do?

Answer 13

Look at how we decide to behave in particular ways (cognitions underlying behaviour)
Look at how people think, feel and reason about their behaviours

Question 14

What is involved in cognitive dissonance theory?

Answer 14

Used in health promotion when providing heath information that makes people feel uncomfortable, creates mental discomfort and can prompt change in behaviour.

• discomfort arises when we hold inconsistent beliefs/conflict with external information
• reduce discomfort by changing beliefs or behaviour

Eg introduction of graphic images of health issues on cigarette packaging

Question 15

Outline the Health Belief Model

Answer 15

• developed to explain why people engage with preventative health measures ie breast screening
• action influenced by beliefs about health threat (perceived susceptibility/perceived severity) and beliefs about health related behaviours (perceived benefits/perceived barriers)
• cues in the environment prompt action (use of service) ie condom machine in the toilets at a bar

Question 16

Outline the Theory of Planned Behaviour

Answer 16

Intentions may lead to behaviour (what do I think? What do other people think? Can I do it?). Influenced by:

• complex range of +ve/-ve attitudes toward behaviour
• subjective norm(what people around us think/do, social influence/peer pressure)
• Perceived control (self efficacy- Do we have control over behaviour? Resources/ abilities)

Question 17

Outline limitations of Theory of Planned Behaviour

Answer 17

• the theory is a good predictor of intentions but a poor predictor of behaviour (as intentions do not always lead to behaviour/action)

Question 18

What are the 3 core factors that cause people to behave in ways that do not promote health?

Answer 18

1. Lack of capability (inadequate knowledge/skills)
2. Insufficient opportunity (lack time/resources)
3. Motivation at key moment to engage healthy behaviour is lacking (healthy behaviours are usually difficult, boring or unpleasant; whilst unhealthy behaviour satisfy our immediate needs)

Question 19

Outline the 4 elements of the COM-B model

Answer 19

Capability
Motivation
Opportunity

Behaviour

Question 20

What does the C stand for?

Answer 20

Capability

Can be physical and psychological capabilities: knowledge, skill, strength, stamina

Question 21

What does M stand for?

Answer 21

Motivation
Reflective (plans/goals-thoughts about behaviour) and automatic (emotional response/desires-in the moment):
Plans, evaluations, desires, impulses

Question 22

What does the O stand for?

Answer 22

Opportunity
Physical and social opportunity:
Time, resources, cues/prompts, environment, social support

Question 23

How can the COM-B model be used in healthcare?

Answer 23

Identify the barriers and target strategies that will effectively alleviate the barrier.
Ie modelling, enablement, coercion, incentivisation, education

Question 24

What is the behaviour change wheel?

Answer 24

Includes the sources of behaviour, intervention functions AND policy categories imparted by the government

Question 25

What are the key influences on behaviour in terms of intervention development?

Answer 25

- psychological capability= knowledge - motivation (more significant barrier)= beliefs about consequences

Question 26

What is Nudge theory?

Answer 26

-focus on unconscious influences on behaviour - change behaviour by changing the environment, using positive reinforcement, using messaging and indirect suggestions. Thus ‘nudging’ them towards positive health related behaviours.

Question 27

What is nudge theory based on?

Answer 27

Around 80% of all human behaviour is automatic; people responding to cues in the environment unconsciously shape choices= choice architecture.

Question 28

What are the 2 requirements for a successful nudge?

Answer 28

Must: A) decrease the effort required to make the desired choice B) improve out motivation to opt for that choice

Question 29

Implications for health promotion: requires application of a comprehensive strategy with which core components?

Answer 29

1. A behaviour change approach (ie incentives for weight loss- on its own insufficient, must be used in conjunction with other methods) 2. Strong policy framework that creates a supportive environment (at national level- ie fruit in schools- starting habits in early childhood) 3. Empowerment of the people to win control over making healthy lifestyle decisions (particularly people in lower SES)