Attitudes

Question 1

What is an attitude

Answer 1

an organisation of beliefs, feelings, and behavioural tendencies towards significant objects, groups, events or symbols” (Hogg & Vaughan, 2005)

Question 2

ABC model

Answer 2

Affect – a person’s feeling/emotions towards the attitude object
Behavioural – the way the attitude influences how we act or behave Cognition: persons belief or knowledge about an attitude object.

Example: Attitude object is a spider
o A – I am scared of spiders
o B – I will avoid spiders if I see them
o C – I believe that spiders are dangerous

Question 3

How are attitudes formed

Answer 3

●Imitation & Role models - e.g. family members that admire
●Conditioning - based on positive and negative reinforcement.
●Experience
●Social Norm

Example: I may have a negative attitude to smoking when pregnant as:
▪ My mother quit when she was pregnant (role-modelling)
▪ I will be given a lot of praise from my partner (conditioning)
▪ When they smoked during last pregnant baby was born prematurely (experience)
▪ Family/fiends strongly advise me to stop smoking (social norms)

Question 4

Features of attitudes

Answer 4

●Evaluative: liking vs. disliking, beneficial vs. harmful
●Subjective: not necessarily based upon fact/knowledge
●Explicit vs. Implicit - consciously vs unconsciously formed
●Learned - not innate
●Enduring but possible to change

Question 5

Why do we have attitudes

Answer 5

Self expression
Social acceptance
Understand world
Avoid punishments
Protect our self esteem

Question 6

Do attitudes predict behaviour

Answer 6

No.
ABC model - behaviour
Lapiere explored racism. Concluded attitudes don’t predict behaviour
Wicker investigated students cheating.

Question 7

Theory of planned behaviour

Answer 7

Attitudes can only indirectly affect human behaviour by being one of three main factors which influence human intention.
- perceived social pressure
- attitudes
- perceived control

Question 8

Attitudes can be a good way of predicting behaviour under certain conditions:

Answer 8

When they are measured specifically
When an attitude is formed through experience
When there is more at stake
When there are fewer potential barriers
When the attitude is repeatedly expressed

Question 9

Attitudes can therefore be used to predict:

Answer 9

Adherence to lifestyle advice
Concordance with treatment
Engagement with non- pharmacological interventions
Uptake of screening tests
Willingness to attend appointments

Question 10

How do you measure attitudes

Answer 10

●Extremely difficult!

●Behavioural observation
- Easy to perform, requires no
specialist equipment
- Time consuming & unreliable
(Hawthorne Effect)

●Covert measurement
e.g. EMG, Galvanic skin response More objective
- Non-directional, false positives

●Self-report scales
Likert, Osgood’s Semantic Differential

Question 11

What is Hawthorne effect

Answer 11

People act in a better way if they know they’re being observed

Question 12

What is likert scales

Answer 12

Has an opinion or attitude
how much participant agrees or disagrees with a particular
statement about a concept.

(Know what scale looks like)

Question 13

What is semantic differential scale

Answer 13

Polar opposite statements given and rate based on those
asks people how much of a trait or quality a concept
has.

Question 14

Bogus pipeline method

Answer 14

Lie detector not accurate
Not ethical

Question 15

Cognitive dissonance (Festinger, 1957)

Answer 15

●Leon Festinger (1957)
●Human have an innate desire
for consistency
●Inconsistency = dissonance

Question 16

Ways to resolve dissonance

Answer 16

1. Gain new information that
   overrides a dissonant cognition
2. Reduce the importance
3. Change attitudes

Question 17

Are dissonance based interventions helpful

Answer 17

●Growing evidence
●Induced cognitive dissonance
Belief Disconformation
Free Choice Hypocrisy
Effort Justification Induced Compliance

Question 18

Why are attitudes important to doctors

Answer 18

Doctors can use their patient’s attitudes to predict their behaviour: o Adherence to lifestyle advice
o Concordance with treatment
o Willingness to attend appointments
o Engagement with non-pharmacological interventions e.g talking therapy
o Uptake of screening tests
• As a result doctors can target intervention more specifically to people who need it/will
benefit from it à more effective and effective.

Question 19

Changing attitudes in Primary prevention

Answer 19

Changing attitudes can be important for of primary prevention à make patients more
likely to make healthy life choices which could the reduce possibility of them developing health problems in future e.g though stopping smoking can reduce the risk of lung cancer.

Question 20

Changing attitudes in secondary prevention

Answer 20

Changing attitudes can also be important is secondary prevention à encourage patients to take medication regularly or make healthy life styles after they have been
diagnosed with health problem

Question 21

What is persuasive communication (Yale attitude change approach)

Answer 21

o It is dependent on three main factors:
o Source of communication: change attitude if persuaded by someone trustworthy

o The message
• Quality and sincerity of message
• Structure of message
• Order of arguments in message
Primacy – people more persuaded by information they hear first
in a discussion
Recency – people are also more likely to be persuaded by
information they hear at the end of a discussion.
Or to a message they have been exposed to repeatedly.

o Audience:
Some people are more receptive to being persuaded by others e.g:
• More persuadable personality
• People low IQ
• People aged 18-25 old
• People who are not distracted by other messages.

Question 22

What is the self perception theory

Answer 22

acknowledges the traditional view that attitudes can
influence behaviour but then also suggest that this may be reciprocal relationship and the way we behave and act can influence our attitudes.

Question 23

What is cognitive dissonance

Answer 23

Based on the idea that humans have an innate desire for consistency between thoughts
emotions and actions.
• Cognitive dissonance refers to a state of psychological discomfort that occurs when
individual holds two or more conflicting thought about something
o I want to go and partying but I want to stay in and catch up on University work.

Question 24

What does cognitive dissonance motivate someone to do

Answer 24

o Gaining new information that overrides one of the dissonant cognitions e.g. order dessert or not new info is that you don’t have enough money to afford dessert.
o Reduce importance of one or more of cognitions e.g it does not matter if you don’t eat dessert today as gran promised cake later
o Change attitude towards something (most important method) e.g believing that if you go to gym regularly you can eat dessert and be healthy.

Question 25

Why is cognitive dissonance important to doctors

Answer 25

• This is important to doctors as there is more evidence that dissonance based
intervention can assist people to make positive changes to health behaviours.

Question 26

What are ways a doctor can use cognitive dissonance to help patients

Answer 26

They work by forcing patients to experience cognitive dissonance involving the health
behaviour you want them to address e.g. in appointment with obese patient who has unhealthy diet you can induce cognitive dissonance by:
▪ Belief disconfirmation – providing someone with information that contradicts currently held ideas
▪ Free choice – involves forcing people to acknowledge to positive aspect of a choice they are missing out on e.g not eating dessert they will be at reduce CV risk and diabetic risk
▪ Hypocrisy – involved highlighting to patient all the times you have observed contradictions in their thinking and behaviour e.g you say you want to eat healthy but I saw you order takeaway 4 times last week
▪ Effort justification – works by making behaviour less desirable by putting additional unpleasant barriers in the way of them e.g you can have a dessert if you walk to restaurant.
▪ Induced compliance – involved creating dissonance by forcing indivudal to act in a way that contradicts currently held belief e.g. by giving them free cinema ticket if they manage to not eat dessert for whole week.

Question 27

What is the petty elaboration likelihood model

Answer 27

• Argues that when person encounters a form of persuasive communication, they can process this with varying levels of thought.

• Therefore as a GP you are much more likely to generate longer lasting attitudes towards smoking cessation if you persuade patients by encouraging a deeper level of understanding.

Question 28

What does a elaboration likelihood model say about a central message

Answer 28

Audience factors: high motivation to think about msge
Processing approach: deep processing
Persuasion outcome: creates lasting

Question 29

What does a elaboration likelihood model say about a peripheral message

Answer 29

Audience factors: low motivation
Processing approach: shallow processing, focused on superficial information
Persuasion outcome: temporary change only

Question 30

What is the brief intervention (the 5as)

Answer 30

• This is a technique used to initiate attitudinal change for risk behaviours. • They are quick so can be incorporated into most clinical encounters.
• To perform remember the 5 As
• ASK about smoking (<1 min)
o Identify and document tobacco use for every patient you see
• ADVISE to quit smoking (<30 seconds)
o In a clear, strong and personalised manner
• ASSESS willingness to quit (1-2mins)
o if they ready to attempt to quit?
• ASSIST patient in their quit attempt (1-3mins)
o Leaflet, referral for counselling/hypnotherapy, NRT (nicotine replacement
therapy)
• ARRANGE follow-up (<1min)
o Schedule follow up, preferably within one week of them quitting

Question 31

What are adv and disadv of self reported scales

Answer 31

Adv:
Cheap, quick, easy
Disadv:
Assume attitudes are fixed, dependent on honesty and
self-awareness and prone to Responder bias
- People tend to always agree/disagree
- People generally avoid extreme responses
- People generally choose responses that make them look good
- People tend to choose socially acceptable responses

Question 32

How to minimise responder bias

Answer 32

o To minimise responder bias we need to ask questions about attitudes in a neutral way that does not lead people to an answer.
o When likelihood of social desirability bias is high researchers can reduce this by allowing respondents to provide answers anonymously or in private.

Question 33

Why are attitudes important to doctors

Answer 33

• Doctors can use their patient’s attitudes to predict their behaviour: o Adherence to lifestyle advice
o Concordance with treatment
o Willingness to attend appointments
o Engagement with non-pharmacological interventions e.g talking therapy
o Uptake of screening tests
• As a result doctors can target intervention more specifically to people who need it/will
benefit from it more effective and effective