Health Psychology

Chapter 6: Staying Healthy

Oct 3-5, 2007Classes #18-19

Health Belief Model

Predictive model used to predict what a person is going to do

Perceptions guide behavior

Perceptions are usually inaccurate

Health Belief Model

Individuals are more likely to take preventive actions to asymptomatic conditions if:

1. They perceive that they are personally susceptible to the disease or condition.

Health Belief Model

Individuals are more likely to take preventive actions to asymptomatic conditions if:

2. They perceive that occurrence of the

disease/condition would severely affect

at least some component of their life.

Perceived Seriousness

Trigger factors such as alarming symptoms, advice from family or friends, messages from the media, disruption of work or play.

Health Belief Model

Individuals are more likely to take preventive actions to asymptomatic conditions if:

3. They perceive that taking a certain preventive action would be beneficialin either reducing the susceptibility orseverity if the disease/condition didoccur.

Health Belief Model

Individuals are more likely to take preventive actions to asymptomatic conditions if:

4. They perceive that taking a given

action would not entail overcoming

important barriers (Eg. cost, fear,

embarrassment, pain, inconvenience)

HBM ConclusionsThe model is most effective when used to predict preventive health behaviors such as obtaining vaccinations to avoid specific illnesses.

It is less effective when the preventive action is not associated with a specific threat (Eg. Annual physical exams)

The benefits/barriers component of the model seems to have more predictive value than any other single component.

HBM Conclusions

The model is effective when the preventive behavior is a short term or “one shot” action

It is less effective when the preventive behavior requires a long term, established routine (Eg. Hypertension medication)

Relatively little research has examined the “cues to action” component of the model

The Theory of Reasoned Actionand

The Theory of Planned Behavior

Behavioral Beliefs

Evaluations of Behavioral Outcomes

Normative Beliefs

Motivation to comply

AttitudeToward Behavior

Subjective Norm

Behavioral Intention

Behavior

Theory of Reasoned Action

Behavioral Beliefs

Evaluations of Behavioral Outcomes

Normative Beliefs

Motivation to comply

AttitudeToward Behavior

Subjective Norm

Behavioral Intention

Behavior

Control Beliefs

Perceived Power

PerceivedBehavioral Control TPB

Theory of Reasoned Action

Knowledge, attitudes, and behavior

Attitudes do effect behavior but not as simple as one might think

Developed by Fishbein (1967)

Concerned with relations between beliefs, attitudes, intentions, and behaviors

Distinguishes between attitude toward an object and attitude toward a behavior

Attitude toward breast cancer vs. Attitude toward mammography

Behavioral Intention

Perceived likelihood of performing the behavior

Must be a “firm” indication of intent

Affecting “intent” is the goal of a TRA based intervention

Attitude Towards BehaviorBehavioral Belief

Belief that behavioral performance is associated with certain attributes or outcomes

Influential factors?

Past experience

Information received or not received

Social influences (family, peers, etc.)

Evaluation

Value attached to a behavioral outcome or attribute

Subjective Norm

Normative BeliefBelief about whether each referent approves or disapproves of the behavior (Supportive Env.)

Most influential referents? (Media, teachers, peers, parents, spouses, etc.)

Motivation to ComplyMotivation to do what each referent thinks

Parents vs. Peers?

Theory of Planned Behavior

Adds one component to the TRA…Perceived Behavioral Control

To account for factors outside the individual’s control that may affect intention and behavior

Based on the idea that behavioral performance is determined jointly by motivation (intention) and ability (behavioral control) (skills and resources)

Theory of Planned Behavior

Perceived Behavioral Control A person’s perception of the ease or difficulty of behavioral performance

Similar to self efficacy (Inc. w/ repeated successes

What characteristics is the person with a high perceived behavioral control likely to have?

Introduction to the Transtheoretical Model (TTM)

Transtheoretical Model (TTM)

Major ConstructsStages of Change

Decisional Balance

Self-Efficacy

Processes of Change

Stages of Change

Precontemplation

Contemplation

Preparation

Action

Maintenance

Applying Stages of Change

Program Planning/Needs Assessment

Use in needs assessment surveysBehavior is not dichotomous

Use stages to form questions

Determine the current stage of readiness of population

Measuring the Stages

Have you quit smoking cigarettes? Check one.

___ Never smoked, or quit for at least 5 years (skip Quest).

____ Yes, I have for more than 6 months.____ Yes, I have, but for less than 6 months.____ No, but I intend to in the next 30 days and have

tried for at least 24 hours in the past year.____ No, but I intend to in the next 6 months.____ No, and I do not intend to in the next 6 months.

Applying the Stages of Change

Program ImplementationPrograms for everyone right now?

Stages of Change

Processes

Precontemplation Contemplation Preparation Action Maintenance Consciousness raising Dramatic relief Environmental reevaluation

Self-reevaluation self-liberationContingency Manage.Helping relationshipsCounterconditioningStimulus Control

Applying the Stages of Change

Program EvaluationHow do we determine if a program is successful?

Applying Stages of Change

Program EvaluationStages of Change can help provide intermediate goals for success

Movement thru the stages can be seen as success

Prevention

Primary

Secondary

Tertiary

Exercise

Any age…

Message Framing

Gain-Framed messages

Loss-Framed messages

Positive Psychology

Martin SeligmanAPA President 1996Psychology split into two camps:Academics more interested in science.Clinicians interested in practice of psychotherapy.Hoped to bring science and practice together.

Nikki and the weeds

Seligman’s inspiration.

Weeding garden.

5-year old daughter throwing weeds.

Seligman irritated, yelled at Nikki.

“Daddy. From when I was 3 until I was 5, I was a whiner. I whined every day. On my 5th birthday, I decided I wasn’t going to whine anymore. That was the hardest thing I’ve ever done. If I can stop whining, you can stop being such a grouch.”

An epiphany

Seligman resolved to change.

His purpose in life was not to correct his daughter’s shortcomings.

Instead, raising her to nurture the strength she displayed (social intelligence).

Can psychological science be about identifying and nurturing strengths?

His mission as APA president.

Seligman (1998)

He calls this new orientation “Positive Psychology”…

At the subjective level, the field is about positive experience: well being, optimism, etc.At the individual level it is about the character strengths—Love, vocation, courage, aesthetic sensibility, leadership, perseverance, forgiveness, originality, future-mindedness, and geniusAt the community level it is about the civic virtues and the institutions that move individuals toward better citizenship: responsibility, parenting, altruism, civility, moderation, tolerance, and work ethic

Seligman (1998)

We’ll have to wait and see if psychology moves in this direction…

Credits

http://hlth.tamu.edu/Chaney/HLTH415/hbm.ppt

http://hlth.tamu.edu/Chaney/HLTH415/tra.ppt

http://uwacadweb.uwyo.edu/Kandh/behavior%20change%20theories.ppt

http://www.psychology.ccsu.edu/engwall/Positive%20Psychology.ppt