Health Beliefs and Cognitions

Question 1

Give 4 examples of health related behaviours

Answer 1

• Smoking • Physical activity • Diet • Weight control • Drug & alcohol use • Contraceptive use • Sunscreen use • Tooth-brushing • Safety measures • Vaccination uptake • Presenting at services • Healthcare attendance • Medication adherence • Self-monitoring • Trigger avoidance • General self-care

Question 2

How many times less likely were those who enagaged in good health behaviours to die than those who did not (Khaw 2008)

Answer 2

4 times less likely to die

Question 3

What is the impact equivalent of being 4 times less likely to die, by engaging in health behaviours

Answer 3

Live for 14 years more

Question 4

Reducing obesity, smoking, physical inactivity & improving people’s diets could prevent…?

Answer 4

• Most cases of Type 2 diabetes • 50% of deaths from circulatory diseases • 30% of cancers

Question 5

what proportion of children and adults are overweight/obese

Answer 5

2/3 adults & 1/3 children are overweight/obese

Question 6

What type of behaviour is primary prevention

Answer 6

Health behaviour

Question 7

What type of behaviour is secondary prevention

Answer 7

Illness behaviour

Question 8

What type of behaviour is treatment

Answer 8

Sick-role behaviour

Question 9

What type of behaviour is ongoing management

Answer 9

Self-care behaviour

Question 10

What generally are behaviours influenced by?

Answer 10

Biological Factors Environmental Factors Social Factors Psychological Factors

Question 11

Give an example of a biological factor

Answer 11

genetics Age pre-existing illness

Question 12

Give an example of an environmental factor

Answer 12

avaliability access cost weather

Question 13

Give an example of a social factor

Answer 13

culture class education employment support

Question 14

Give an example of a psychological factor

Answer 14

past/concurrent behaviours/habit personality emotions cognitions

Question 15

What are cognitions

Answer 15

Internal thought processes Active processing of “inputs” –> “output” = behaviour, and even perception of information is an active process.

Question 16

What are social cognitive factors

Answer 16

We develop cognitions as we grow up/experience the world: social = relationships with others/support/pressure/identity Cognitive= internal thought processes

Question 17

How are social cognitive factors acquired

Answer 17

through socialisation and learning

Question 18

What are beliefs

Answer 18

provide a link between socialisation and behaviour They’re enduring, individual characteristics but can be modifiable

Question 19

What is the sequence of events which occurs in psychological research

Answer 19

• Observation: identification of influencing factors • Model: describe how factors combine, interact • Theory: organise known facts as basis for further research • Predictions: specific questions/hypotheses to test • Testing: development of measures, approaches for testing • Revision: on basis of new findings, applications • Intervention: change on basis of model, theory

Question 20

Describe the health belief model (Becker)

Answer 20

• Perceived threat – perceived susceptibility, severity
• Evaluation of behaviour – pros, cons/barriers
• Health motivation
• Cues to action – internal, external
• =Behaviour

Question 21

What model is this?

Answer 21

Health Belief Model

Question 22

State 2 models of motivation/intervention

Answer 22

• Health locus of control Wallston – internal vs. external locus of control
• Self-determination theory Rogers – intrinsic vs. extrinsic motivation
• Health belief model Janz, Becker – Perceived threat, pros & cons
• Protection-motivation theory Rogers – Threat appraisal, coping appraisal
• Theory of planned behaviour Fishbein & Ajzen – Intention, attitudes, subjective norm, control

Question 23

Describe ‘Theory of Planned Behaviour’

Answer 23

• From social psychology Fishbein & Ajzen
• Based on Theory of Reasoned Action (TRA)
• Clear, causal ordering of factors
  
  • Distant - beliefs re: behaviour, others, control
  • Intermediate - attitudes, subjective norms, PC
  • Immediate - intention, perceived control
• Includes social, predicts intention well
• BUT, intention-behaviour gap

Question 24

What model is this?

Answer 24

Theory of Planned Behaviour

Question 25

Describe the Self-efficacy Theory

Answer 25

• From Social Cognitive Theory (Bandura)
• Motivation and action based on:
  
  • Situation outcome expectancy beliefs
  • Action outcome expectancy beliefs
  • Perceived self-efficacy (SE) = confidence

SE strongly predicts intention & behaviour across wide range of behaviours. Important in motivation, action, maintenance.

Question 26

Give one model of action/volition

Answer 26

• Social cognitive theory Bandura – Outcome expectancies, self efficacy
• Implementation intentions Gollwitzer – Plan when, where, how intention à behaviour
• Control theory / Goal theory Carver & Scheier – Goals, monitoring, feedback, revision of goals
• Self-regulation = learning from experience

Question 27

Describe the Stage of Change Model

Answer 27

1. Precontemplation …not thought about doing
2. Contemplation …thought about doing, no plans
3. Preparation …thought about doing, planning
4. Action …currently doing or recently started
5. Maintenance …doing for more than 6 months
6. Termination, relapse

Question 28

Which model is this?

Answer 28

Health Action Process Approach

Question 29

What are illness beliefs?

Answer 29

“a patient’s own implicit common-sense beliefs about their illness” (Leventhal et al)

• Mental representation for recognising symptoms & responding to illness experience
• Developed through own & others’ experiences, media, education etc

Question 30

What are the five dimensions of beliefs about illness:

Answer 30

1. Identity: label, signs, symptoms
2. Cause: biological, psychological, multi-factorial
3. Timeline: duration, pattern
4. Consequences: short & long term effects on life
5. Curability/controllability: by themselves/others

Question 31

Describe the Self-regulatory Model

Answer 31

Illness beliefs interact with emotional response to influence actions

Symptoms & illness dealt with like other problems (problem solving approach):

• Interpretation: understanding problem
• Coping: address problem to re-establish normality
• Appraisal: assessing success of coping
• Re-interpretation, additional coping as necessary

Question 32

What model is this?

Answer 32

The self-regulatory model

Question 33

Give three critiques of general Social Cognitive Approaches

Answer 33

• Overlap of models & components, inconsistent terminology & definitions
• Difficulties with operationalisation and measurement
• Evidence largely cross-sectional (descriptive), need more explanatory (longitudinal, experimental) studies
• Assume rational, reflective decision making
  
  • Neglect influence of past behaviour, habits and impulsive processes cued by environment
  • Neglect emotional and moral influences
• Little on maintenance needed for health outcomes
• Models of behavioural influences, rather than change
• Complexity and variability of behaviours, individuals