Lecture 5: Health Psychology

health behaviour

-any activity undertaken for the purpose of preventing or detecting disease or for improving health/wellbeing

non-communicable diseases (NCD)

1. cardiovascular diseases

2. cancer

3. chronic respiratory diseases

4. diabetes

-risk of morbidity and increased burden on healthcare system

-health behaviours as modifiable risk factors for NCDS

behavioural determinants of health and illness

-sedentary lifestyle

-smoking

-fruit and vegetable intake

-physical activity

-alcohol consumption

-nutrition

changing health behaviours

-become habits that are difficult to break

-often come with immediate costs and long-term benefits

-tendency to maximise immediate rewards and ignore long term benefits

-reinforced by social environment and peers

individual differences and health

-social

-demographics

-genetic factors

-emotional

-perceived symptoms

-cognition

-access to healthcare

-personality

social cognitive models of health behaviour

• individual differences are modifiable risk factors for health behaviours, which are modifiable risk factors for NCDs

-models to help change our beliefs in relation to our health

social cognitions about health

• beliefs

• attitudes

• knowledge

theory of planned behaviour (social cognitive models of health behaviour)

-attitudes towards the behaviour, subjective norms and perceived behavioural control all mediate intentions

-behaviours are determined by intentions

-intentions are a proximal predictor of health behaviours

Norman & Conner (theory of planned behaviour)

-398 students completed ToPB questionnaires on binge drinking

-predicting intentions:

• attitudes and self efficacy were significant predictors

• perceived control was a predictor too

• no significant effect of subjective norms

-predicting behaviour:

• intentions, self efficacy and past binge drinking were significant predictors

Norman, Webb, Millings - method (theory of planned behaviour)

-randomly allocated to intervention conditions:

• contained ToPB messages

• lacked ToPB messages

-ToPB mesages about binge drinking targeted beliefs about binge drinking

Norman, Webb, Millings - measures (theory of planned behaviour)

-measured:

• attitudes

• subjective norms

• self efficacy

• perceived control

• intentions

• previous frequency of binge drinking at baseline

• binge drinking frequency at one month

Norman, Webb, Millings - results (theory of planned behaviour)

-exposure to ToPB messages resulted in more negative cognitions about binge drinking:

• weaker intentions to engage in binge drinking

• more negative attitudes towards binge drinking

-no effect of intervention on frequency of binge drinking at follow up → intention behaviour gap

social norms theory (social cognitive models of health behaviour)

-individual’s behaviour is influenced by the perception of how their peers think and act

-social comparisons are linked to the potential influence of social norms for changing health behaviour

-norms provide information about which action is desirable, how, when and where the action will be achieved

overestimation of drinking norms (social norms theory to predict binge drinking)

-students tend to overestimate alcohol consumption among other students

-nearly half of students incorrectly believe that their peers regularly drink 6 or more drinks in one session

-students who correctly identify that most students drink less than 6 drinks in a session are more likely to drink responsibly

Robinson (social norms theory to reduce binge drinking)

-intervention:

• norm messages to correct misperceptions of social norms related behaviours

-norm messages influenced normative drinking perception but only among norm believers

-norm messages were ineffective for participants who overestimated peers’ drinking baseline

Robinson - results (social norms theory to reduce binge drinking)

-norm messages were not successful in increasing intention to drink responsibly

-possibly due to messages not being seen as credible

-impersonal nature of social norm messages

Neighbors, Larimer & Lewis - method (social norms theory to reduce binge drinking)

-252 heavy drinking uni students

-intervention:

• personalised feedback about own drinking

• perceived drinking norm

• actual drinking norm

Neighbors, Larimer & Lewis - results (social norms theory to reduce binge drinking)

-intervention led to:

• changes in perceived drinking norms

• reduced drinking at 3 and 6 months follow up

-effect sizes were relatively small

Dotson (social norms theory to reduce binge drinking)

-meta analysis of personalised feedback interventions to reduce alcohol consumption among student drinkers

-significant but small effects vs control groups

-reduction in alcohol related harms associated with intervention but effects were minimal

threat appraisal (protection motivation theory)

-intrinsic and extrinsic rewards

-perceived severity of the threat

-probability of being vulnerable to the threat

coping appraisal (protection motivation theory)

-response efficacy → the efficacy of the health behaviour for dealing with the threat

-self efficacy or confidence for being able to engage in the behaviour

-response costs

protection motivation theory (Rogers)

-designed to help what kind of messaging can help change people’s health behaviour

-messages focussing on threat appraisal:

• heighten threat by targeting perceived severity of the problem or the probability of vulnerability

-messages that target the coping appraisal:

• assuring individuals of the response efficacy

• increasing individuals’ self efficacy

Norman (PMT to understand health behaviour)

1. PMT components are manipulated via persuasive communication to see the effects on health behaviour

2. PMT used as a social cognition model to predict health behaviour change

fear appeals

-three major components:

1. the message → addresses issues that instil critical amounts of fear

2. the audience → needs to be targeted to those who are the most susceptible to the risk

3. the recommended behaviour → gives instruction on what to do to avert or reduce the risk of harm

Dijkstra & Bos - method (PMT to reduce smoking: fear appeals)

-smokers assigned to either:

• graphic fear appeals

• text warnings on cigarette packages

-measured fear, disgust, intention to quit smoking and quitting activity over 3 weeks

-measured disengagement beliefs

Dijkstra & Bos - results (PMT to reduce smoking: fear appeals)

-fear appeals + low engagement beliefs:

• stronger intention to quit

• higher percentage of smokers cutting down

• no significant effect on quitting

-only when disengagement beliefs did not interfere with fear appeals, smokers’ perceived level of threat was increased → some effects on behaviour

Tannenbaum (fear appeals)

-fear appeals are more effective:

• when used for one time behaviours vs repeated behaviours

• for women because they tend to be more ‘prevention focused’ than men

disadvantages of fear appeals

-arousing fear could result in a defensive response or risk denial

-people who are the most susceptible to the threat may react with denial

-fear appeals only work when accompanied by an efficacy message

-strong fear appeals and high-efficacy messages produce the greatest behaviour change

-strong fear appeals with low-efficacy messages produce the greatest defensive responses