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 à 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 person’s 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 person’s 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 person’s 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 Practitioner’s Office

•The Family

•Schools

•Self-Help/Support Groups

•Work-site Interventions

•Community Programs

•Mass Media

•The Internet

•The Private Therapist’s Office

Social Engineering

•Changing the environment to change our behaviors

–Examples:

•Automatic seat belts

•Making some types of ads illegal

•Making some fats illegal