Models of Health Behavior, Health Benefits of Physical Activity

what are health-enhancing behaviors?

actions people take to improve health or maintain their health

what are some examples of health-enhancing behaviors?

exercise, sunscreen, healthy diet, sleep well, safe sex, seatbelt use

what are some health-risk behaviors?

alcohol/drugs, drinking excessively, coffee, risky behaviors

what are some factors related to health, whether a patient leads a healthy lifestyle or engages in health-compromising behaviors?

age, education, social influence, socioeconomic status, cognitive factors, cultural factors

what are some BARRIERS to leading a healthy life?

- need incentives to engage in healthy behaviors

- sometimes rewards for healthy behaviors are more immediate than those for healthy behaviors

what are 2 theories/models of health behaviors?

1. The Health Belief Model

2. Transtheoretical Model (Stages of Change)

what are the 4 factors that The Health Belief Model identifies that influence decision making behavior?

1. perceived susceptibility

2. perceived severity

3. perceived benefits of and barriers to

4. cues to action

describe perceived susceptibility to a health threat as a factor of the Health Belief Model

the greater the perceived threat the stronger the motivation to engage in health-promoting behavior

describe perceived severity to the disease as a factor of the Health Belief Model

asks the question, will pain, disability, or death result?

describe perceived benefits of and barrier to the behavior as a factor of the Health Belief Model

a person decides if the benefits of the behavior exceed the barriers ex. someone may overlook the huge advantages of quitting smoking due to concerns about becoming overweight and unattractive

describe cues to action as a factor of the Health Belief Model

advice from friends, media health campaigns, and factors such as age, socioeconomic status, and gender also will influence the likelihood that the person with act

people that take action (health behavior) to be healthy if they believe or perceive (health belief) what ?

1. they themselves are susceptible

2. the condition has serious personal consequences

3. a course of action will reduce either their susceptibility or severity of the condition

4. the benefits of the action outweigh the costs

5. outside influences are encouraging change

what does the Transtheoretical Model (Stages of Change) state?

- maintains that behavior often changes systematically through distinct stages

- contends that people pass through 5 stages in altering health related behavior

how can healthcare providers use the Transtheoretical Model (Stages of Change)?

allows the to match an intervention to the specific needs of each patient

what are the 5 stages of the Transtheoretical Model (Stages of Change)?

1. pre-contemplation

2. contemplation

3. preparation

4. action

5. maintenance

describe Stage 1: precontemplation

when the cons (reasons to stay the same) far outweigh the pros (reason to change), people are not seriously thinking about changing their behavior

describe Stage 2: contemplation

strengths of the pros and cons are about the same, people acknowledge the existence of a problem and are seriously considering changing their behavior

describe Stage 3: preparation

pros far outweigh the cons, patients are willing to change within 1 month, people engage in both thoughts and actions (ex. buy nicotine patches)

**time to intervene**

describe Stage 4: action

put their goals into action, people have actually changed their behavior and are trying to sustain their efforts

describe Stage 5: maintenance

achieved their goal for more than 5 months, people continue to be successful in their efforts to reach their final goal

PAs should offer tailored messages to their patients, what are tailored messages?

tailoring messages and interventions instead of giving everyone identically framed information, make it specific to that person

what is the term for how information is worded and is an important factor in the effectiveness of health education?

framed

how are health messages typically framed?

in terms of the benefits associated with a particular preventative action or the costs of failing to take preventative action

what is gained framed?

health messages that focuses on positive outcomes or avoiding undesirable ones by adopting a health promoting behavior

ex. if you exercise regularly, you are likely to look and feel better

what is loss framed?

health messages that focuses on negative outcomes from failing to perform a health promoting behavior

ex. if you don't exercise, you increase the risk of life-threatening disease

should PAs use fear-arousing messages to engage attitude and behavior change?

need just enough fear PLUS reassurance, too much fear upsets people and they are less likely to change their behavior

what is motivational interviewing?

collaborative, person-centered form of guiding designed to help patients elicit and strengthen motivation for change

what 5 basic strategies of motivational interviewing do health providers use?

1. expressing empathy through listening rather than telling

2. identifying discrepancies between where patients are now and where they want to be

3. avoiding argumentation

4. rolling with the patient's resistance rather than challenging it head-on

5. supporting self-efficacy instilling hope, encouraging patient's belief they can change

what is OARS?

Open-ended questions

Affirmations

Reflections

Summarizes

what is self-efficacy?

the confidence in being able to achieve a behavioral goal, if low providers seek to boost confidence in their ability to change

what is primary prevention?

refers to health promoting behaviors that are taken to prevent a disease or injury from occurring

what are examples of primary prevention?

seatbelt, diet, exercise, avoid smoking, healthy sleep, regular health screens

what is secondary prevention?

consists of actions taken to identify and treat illness early in its course

What are examples of secondary prevention?

pt has HTN - secondary would be monitor symptoms and medications, diet changes

What is tertiary prevention?

actions taken to contain damage once a disease has progressed beyond its early stages

What are examples of tertiary prevention?

use of radiation or chemotherapy to destroy cancerous tumors

is tertiary prevention as cost-effective as primary prevention?

NO, less cost effective, less beneficial than secondary prevention

which type of prevention is most commonly the focus of medical schools and PA programs?

teritary

what is physical activity defined as?

any movement that uses skeletal muscles and requires more energy than resting

what is the minimum physical activity recommended for healthy adults between 18-64 yo?

moderate intensity physical activity: 30 minutes five days a week

vigorous intensity physical activity: 75 minutes throughout week

what is a major risk factor for premature mortality?

lack of physical activity

what percent of adults of the US get the minimum recommended amount of aerobic and muscle-strengthening physical activity?

about 20%

what are some things increasing physical activity and aerobic exercise will promote/reduce?

- promote relaxation

- improve mood and sense of well-being

- reduces perceived stress

- improves cognitive functioning, memory

- improves regulation of blood glucose

- decrease risk of CA

- decrease BP

- decrease resting HR

- increase strength and efficiency of heart

- decrease risk of cardiovascular disease

- increase HDL, reduce LDL and triglycerides

- decrease biological aging

- improves immune system

- protect against decline in bone density and osteoporosis

- increase deep sleep

how does physical activity decrease biological aging?

telomeres typically shorten with age, exercise reduces such shortening

more things increasing physical activity and aerobic exercise will promote/reduce

- protect against diabetes

- decrease obesity

- promote neurogenesis

- increase angiogenesis

- improves hippocampal size and function

- lower risk of dementia

- reduce pro-inflammatory cytokines - blocks development and growth of CA cells

what is neurogenesis?

growth of new neurons in brain

what is angiogenesis?

formation of new blood vessels and that increases blood supply to the cortex

what are some benefits of physical activity?

- better management of chronic disease

- improved mental health

- better quality of life and general overall well-being

how could writing an exercise prescription be helpful for patients?

helps them meet the guidelines for physical activity and gives them an attainable goal to start building self-efficacy