SWN005 Models of Health and Health Behaviour

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Models of health and health behaviour

• SWN 005
• Part two

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Theories of health behaviours (Gehlert and
Browne, 2012)

• Two families of theories
• Those based on rational choice
• Those based on social networks

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Rational choice

• Two major theories
• The health belief model
• Theory of reasoned action

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Health belief model

• Based on the beliefs relating to threat (how
  likely am I to get this? How serious is it if I
  get it?) and outcome expectations (are
  preventative or curative measures likely to work?
  And barriers to engaging with those e.g. cost,
  social embarrassment).

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Theory of reasoned action

• Extends the health belief model to include the
  influences of the social environment.
• It includes the role that the beliefs of
  significant others and societal norms have in
  shaping behavioural intention.
• Also has a good body of evidence to support its
  use, particularly in work with adolescents.
• The theory has also been expanded in the theory
  of planned behaviour to include perceived
  control over behaviour.

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Approaches based on social networks

• Response to the lack of recognition of the
  broader environmental and structural influences
  on health behaviour.
• The role of culture is acknowledged
• Two of the main approaches are
• Social action theory
• Behavioural model of health services

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Social action theory

• Locates personal change in its broader social
  context. Examines how the broader environment
  influences the individual cognitive processes.
• Other people are active players in influencing
  behaviour tries to capture the recursive nature
  of relationships

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Behavioural model of health services use

• Considers the bigger systems issues on health
  behaviour, such as the health care system itself
• Has evolved over time
• Is more focused on the use of health services as
  a specific health behaviour than health
  behaviours more generally
• It clearly recognises the role that the resources
  and characteristics of the health system itself
  play in determining health practices and service
  use.
• Particularly relevant for marginalised groups who
  may find multiple barriers within the system
  itself.

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Prompts for practice

• Every approach has its strengths and weaknesses
• Need to think critically about the assumptions of
  the systems we work in and how it is that people
  experience them
• Need to be open to the biomedical model and work
  constructively with it and within it, without
  losing the social work person in environment
  perspective

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References

• Gehlert, S. and Bollinger, S.E. (2012). Theories
  of health behaviour. In Gehlert, S. and Brown, T.
  (Eds.) Handbook of Health Social Work (2nd ed.).
  Hoboken John Wiley Sons. pp. 125 -140.
• Samson, S. (1999). Biomedicine and the body. In
  S. Samson (Ed.) Health studies A critical and
  cross-cultural reader. Oxford Blackwell
  Publishers.
• Taylor, S. (2008). Contemporary frameworks in
  health care. In S. Taylor, M. Foster J. Fleming
  (Eds.), Health care practice in Australia Policy
  context and innovation. Melbourne Oxford
  University Press

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