Chapter 6
Health Behavior any activity one performs to maintain or improve health (whether or not its successful)
Well
behavior- activity done to maintain or improve current good health
Symptom
based behavior activity done when ill to determine the problem and find a
remedy
Sick
role behavior activity done to recover from known illness
Of
course health psychologists are also interested in: Health-risking behaviors
non-optimal health habits
Belloc and Breslow (1972)
Studied health and health behaviors of 7000 adults ranging in age from 20-75
Found that at each age health was correlated with # of healthful behaviors
The health of those who followed 7 good health practices was as good as that of individuals 30 years younger who had few healthful behaviors
A follow-up a decade later showed the % dying decreased with increased healthful behaviors
Health Behavior National Survey (1995)
Breakfast most days 55% M, 58% F
Exercise regularly -- 44% M, 37% F
Rarely snack -- 25% M, 25% F
Overweight by 20% -- 30% M, 26% F
Smoke regularly -- 28% M, 23% F
Avg 2 or more drinks -- 10% M, 2% F
What determines if someone will engage in a healthful action?
Here are the most influential theories
in health psych concerning this question:
Learning Theory
Behaviors are shaped and maintained by consequences. Health behaviors are learned behaviors responding to:
Reinforcements
Lack of reinforcement ΰ extinction of behavior
Punishment
Learned discriminative stimuli (or antecedents) that set the stage for healthy or unhealthy behaviors
Also Social Learning Theory observational learning or modeling
Health Behaviors Can be Associated with Emotional and Bodily Responses Through Classical Conditioning
The Health Belief Model (HBM)
Likelihood of a health behavior depends on persons beliefs concerning these 4:
Perceived seriousness of the health problem
Perceived susceptibility to the problem
Cues to action or reminders of the problem
Benefits vs Barriers (costs) of engaging in the behavior
Characteristics of the individual (e.g. age, sex, ethnicity, personality, knowledge) can influence these beliefs. E.g. adolescents tend to have a sense of invulnerability, not susceptibility.
Examples of Barriers to Healthful Behaviors
Individual/psychological
Inertia
Healthful behaviors may be less appealing
May require breaking long-standing habits
May lack knowledge, skills; time; money
May lack self-efficacy; motivation
Interpersonal/Social
May lack social support or role models
Changes may affect friends, family relationships
Community
May not provide resource
May not encourage wellness
Updated version of HBM includes self-efficacy too
Health Belief Model
Supported by hundreds of studies for a wide array of health behaviors like:
Getting vaccinations
Getting dental check-ups
Exercising
Dieting
Taking medication as prescribed
Getting health screenings
Condom use
Sick role behaviors and clinic utilization
Perceived barriers strongest predictor but all factors contribute
BUT health beliefs are just moderate predictors of behavior
What factors influence a persons health behavior intentions or plans?
Theory of Planned Behavior
(earlier version called Theory of Reasoned Action)
TPB example of what goes into an intention
Should I refrain from binge drinking?
Got Milk campaign to influence attitudes and perceived social norms
The 1% or Less Campaign
Supermarket milk sale data collected
Randomly selected indivs from intervention and control communities surveyed via phone on milk use
Intervention communities received a 6 week mass media education campaign
Intervention communities showed signif. change in milk attitudes, behavioral beliefs, & intentions, but not subjective norms. These changes mediated signif. change in self-reported milk use.
8 oz. of whole milk has the saturated fat of 5 strips of bacon
8 oz. of 2% = 3 pieces
8 oz. of 1% = 1.5 pieces
8 oz. of skim = no saturated fat
TPB Supporting Studies on
Using sunscreen
Self-examinations
Condom use
Breast feeding
Health screenings
Wearing seat belts
Stopping tobacco or alcohol use
Shortcomings of these theories
People do not always do what they intend (or claim they intend) to do (the intention-behavior gap)
Encouraging not only intention but preparation works better.
Attitudes predict some health-related behaviors, but not others
The predictive power of these theories is greater for some groups (high-SES, for example) than for others
The theories ignore past experience with a specific health-related behavior
Stages of Change
Model
(aka Transtheoretical Model)
All people not equally ready for change
People pass through 5 stages in altering health behavior
Stage 1: Precontemplation
Stage 2: Contemplation
Stage 3: Preparation
Stage 4: Action
Stage 5: Maintenance
Move thru stages often not smooth multiple starts, stops and relapses
Stage theories enable interventions to be matched to the specific needs of a person who is stuck at a particular stage
Other Less Rational Processes
Motivated Reasoning use biased cog. processes and pay more attention to supportive info than disconfirming info
Unrealistic Optimism underestimate our own risk of bad events (like a health problem) and overestimate our chance of experiencing good events
Methods for Promoting Health
Providing information (via education, media, handouts, online, medical professionals)
Goal may be educate, change beliefs, motivate, change intentions, provide cues
Campaigns that
merely inform people
of the hazards of certain behaviors
(e.g., antismoking messages) are typically ineffective
But tailoring the message to the audience may make a difference
Message Framing
Tailoring Content to Target Audience
Gain-Framed Messages
Loss-Framed Messages
have an advantage for detection behaviors, such as skin cancer screening
Fear Appeals
Scare tactics that arouse fear may backfire and decrease a persons likelihood of changing his or her beliefs and behavior
Health Promotion Methods
Motivational interviewing.
Behavioral methods. Calendars;
reminders; rewards
Relapse prevention programs.
Venues for Health Behavior Change
Health Practitioners Office
The Family
Schools
Self-Help/Support Groups
Work-site Interventions
Community Programs
Mass Media
The Internet
The Private Therapists Office
Social Engineering
Changing the environment to change our behaviors
Examples:
Automatic seat belts
Making some types of ads illegal
Making some fats illegal