Models of Behavioural Change + Health promotion

Peer support 2014-15P and Virginia

Defintion

• What is health promotion?– Is the process of enabling people to increase

control over their health and its

determinants and thereby improve the their health

Definition• What is disease prevention?

– Action aim at eradication, eliminating, or minimising the impact of disease and disability or if none of these is feasible, retarding the progress of disease and disability

• What is the difference between health promotion and disease prevention?– Health promotion: Think about the positive

definition of health• Achievning harmony and equilibrium between physical,

emotional and spritiual aspects of health• Freedom to live the fulfest

– Disease prevention: Think about negative definition of health

• Absence of disease

What are the models of Health promotion? (2)

• Ewles and Simnett’s FIVE appraoch• Beattie’s Model of health promotion

Ewles & Simnett’s FIVE Approaches in Health Promotion

ApproachMedical Early detection of smoking related

disorders e.g. spirometryEducational Giving information on health effects

of smoking in schoolsClient Centered Client identifies what they want to

know / do about smokingBehaviour change Smoking cessation supportSocietal change No smoking policies, taxation

No ‘right’ approach, need mix

Beattie’s Model of Health Promotion

INDIVIDUAL COLLECTIVE

AUTHORITATIVE (Top Down)

NEGOTIATED (Bottom Up)

HEALTH PERSUASION (Conservative ideology)

•Behaviour change•Education / advice•Mass media / social marketing

PERSONAL COUNSELLING (Libertarian ideology)

•Counselling•Empowering individuals to make changes

LEGISLATIVE ACTION (Reformist ideology)

•Legislation•Policy making / implementation•Health surveillance

COMMUNITY DEVELOPMENT (Radical pluralist ideology)

•Lobbying•Community development•Action research•Skills sharing

Disease prevention

• What are the 3 level of disease prevention?– Primary, secondary and tertiary

• Defintion?– Primary: prevent disease in the first place– Secondary: find and treat– Tertiary: prevent complication, maintain QoL

What kind of prevention are the following?

• Immunisation before going to medical school• Cervical screening• Stroke rehabilitation• 5-a-day• Regular exercise• Faecal specimen to test for occult blood

Health belief model

• Based on social cognition theory– Transetheoretical model– Theory of planned behaviour– Health belief model

Precontemplation

Preparation

Contemplation

Maintenance

Action

Relapse

Which stages are they?

• Paul is a 40 years old, he stops smoking for 3 months and now he has a stressful situation and he started smoking again

• Steve Way was 16.5 stone, and started exercise, now he is planning to run London Marathon

• Mary, a 32 years old woman. She was just diagnosed with diabetes and was told to lose weight, she is thinking about it.

• Sarah, 19 years old student has been saying that she need to quit smoking for 2 months to her family, and this is the one day she hasn’t smoked

• Harry is a binge drinker, and admitted to hospital because of oesophageal varices, and doctor told him to stop drinking. He said “I don’t give a sXXX of it”

Theory of Planned Behaviour (TPB)

Behaviour

BehaviouralAttitude

SubjectiveNorm

PerceivedBehavioural

Control

Behavioural beliefs+

Outcome evaluation

Normative beliefs+

Motivation to comply

Control beliefs +

Self-efficacy

BehaviouralIntention

(Ajzen, 1988)

Health-Belief Model (HBM)

HealthBehaviour

PerceivedThreat

PerceivedSeverity

PerceivedEfficacy

PerceivedSusceptibility

PerceivedBenefits

PerceivedBarriers

(Rosenstock, 1966)