Seeking Health Care I

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Seeking Health Care I

• Modeling Health-Related Behavior

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Health-Related Behavior

• Behavior toward the goal of maximizing health and
  minimizing disease/disability
• Health maintenance behaviors
• Seeking medical advice/intervention
• Risk behaviors and/or lack thereof
• Theories attempt to explain factors predictive of
  these myriad behaviors

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Theories and Models in Psychology

• Theory A set of related assumptions from which
  testable hypotheses are drawn
• Model Theory in progress

• Uses of Models and Theories
• Generate Research
• Organize and explain observations
• Guide practitioners in predicting and modifying
  behavior

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Evaluating Theory

• Is it comprehensive?
• Is it logical
• Is it parsimonious (simple, not too simple)?
• Does it agrees with empirical research?
• Does it generate ideas/research?
• Is is disconfirmable?
• Part of the evolution controversy
• This is why most scientists believe that ID is
  not a science
• Is it practically useful?

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Models of Health Behavior
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The Health Belief Model

• Assumption People hold certain beliefs about
• personal vulnerability
• the severity of the disease
• the costs of taking action
• benefits of taking action
• These beliefs motivate individuals to a greater
  or lesser degree to modify high-risk behaviors or
  seek help in doing so.

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Health Belief Model
Demographic Psychosocial Factors
Perceived Benefits Barriers
Health- Related Behavior
Perceived Seriousness Susceptibility
Perceived Threat
Cues to Action
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Studying the HBM

• Support for model
• Flu shots
• Breast self-examination
• Seat belt use
• Diet
• Smoking
• No support for the model
• Exercise

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Critique of the HBM

• Leaves out emotions, habit, social norms,
• and other motivations (e.g. appearance)
• What about context?
• Does not define how to test relationships
• between different elements

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Is the HBM useful?

• Comparison of different behaviours
• and populations
• Identifies most salient beliefs (i.e. barriers,
• susceptibility)
• Interventions health education, risk appraisal,
  decisions balance sheets, relapse prevention
  plans

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Theory of Planned Behavior

• General theory of behavior Not specific to
  health behavior
• Assumption People are reasonable and use
  information to freely choose behavior. Behavior
  happens secondary to an INTENTION.
• The intention to perform a behavior is an
  interaction between
• Attitude
• Subjective Norm Social Pressure
• Perceived Behavioral Control
• Actual Control

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Theory of Planned Behavior
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Critique of TPB

• For some behaviors attitudes, norms and perceived
  control independently predict intentions
• In some contexts intentions predict behaviour
• Attitudes shown to be independently related to
  perceived control
• Perceived control independently predicts
  behaviour
• Perceived control is the strongest predictor

• Environmental influences (access to healthcare)
• Social support
• Adoption versus maintenance of behaviour
• Competing behaviours (weight loss versus smoking
  cessation)

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What interventions are related to the TPB?

• Attitudes education
• Norms public health campaigns
• Perceived control relapse prevention planning

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The Transtheoretical Model

• Stage model of general behavior change
• Assumption People utilize a number of processes
  of change to move through 5 stages of change
• Processes
• Consciousness Raising, Dramatic Relief,
  Contingency Management, Stimulus Control,
  Self-libertation
• Stages
• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance

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The Behavior Change Spiral
Maintenance practice required for the new
behavior to be consistently maintained,
incorporated into the repertoire of behaviors
available to a person at any one time
Maintenance
Action people make changes, acting on previous
decisions, experience, information, new skills,
and motivations for making the change
Action
Preparation person prepares to undertake the
desired change - requires gathering information,
finding out how to achieve the change ,
ascertaining skills necessary, deciding when
change should take place - may include talking
with others to see how they feel about the likely
change, considering impact change will have and
who will be affected
Preparation
Contemplation something happens to prompt the
person to start thinking about change - perhaps
hearing that someone has made changes - or
something else has changed - resulting in the
need for further change
Contemplation
Precontemplation changing a behavior has not
been considered person might not realise that
change is possible or that it might be of
interest to them
Pre-contemplation
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TM

• People often use different processes during
  stages and different stages require different
  interventions
• Precontemplation Consciousness Raising
• Contemplation Environmental Re-evaluation
• Preparation Self Re-evaluation,
• Action Contingency Management, Stimulus Control
• Maintenance - Contingency Management, Stimulus
  Control

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TM Empirical Findings

• Quitting Smoking
• Alcohol and Drugs
• Exercise
• Safe sex
• Mammography

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Critique of Models of Health Behavior

• All have produced substantial research
• All are predictive of health-related behaviors.
  Some behaviors more-so than others
• Do not explain how people judge thing like
  susceptibility, or go from stage to stage
• Lack coherence
• Models simply list variables
• No overall model of the person
• Assessment is and issue
• Adherence is a separate process
• Barriers are innumerable and not adequately
  researched