Health Psychology Chapter 3: Health Behaviors

Health promotion philosophy: health and wellness is a personal and a collective achievement

Health promotion: positive view of health; maintain and improve health throughout life

Disease prevention: negative view of health, focuses on early detection and prevention

Primary: combat risk factors BEFORE illness; change behaviors and prevent poor habits from forming

secondary, and tertiary prevention

Health habits: health behaviors that are established and practiced automatically; easier to establish when young (~11-12 yrs)

Problem with health habits at young age: low incentive to change and aren’t immediate effects (delayed gratification)

Intervention factors in childhood: socialization and teachable moments are important, tend to ignore parents training as they grow up

Indigenous people are facing a _____ epidemic: diabetes; 3 times the national rate

Benefits of targeting at-risk individuals: may prevent or eliminate poor health habits, effective use of health promotion dollars, easier to identify other risk factors

Problems with targeting at-risk individuals: inaccurate perceptions of risk, hypervigilant and restrictive behavior, defensiveness and minimizing the significance of risk factors to avoid changing their behavior

Ethical considerations of targeting at-risk individuals: psychological disturbance (self-esteem, stress, depression) exchange for risk-reduction; is the stress to individuals and family worth targeting them?

Effective components of good educational materials: color, expert/trust, primacy and recency effects, short & clear, explicit, not too extreme, align framing with targeted population

Loss-framed message: what you might lose from avoiding a behavior, good for illness detection (cancer)

Gain-framed message: what you can gain from doing a behavior, good for health promotion (eating veggies)

Preventative health messaging: emphasize risk and trust in health authorities (COVID)

Fear-appeal: induce arousal/fear to increase motivation, too much can trigger avoidance, fear also needs recommendations for action

Prospect theory: use loss-framing in uncertain outcomes and use gain-framing in certain outcomes

Social cognition models: motivate people to change behavior based on their beliefs about that behavior

Expectancy-value theory: people determine their behavior motivation based on the expected likelihood of a positive outcome and the value of that outcome

Health Belief Model (HBM): practice of a health behavior depends on perception of health threat, perception of threat reduction; later cues to action and self-efficacy were added

Perception of health threat: stage of health belief model; influenced by general health values, perceived susceptibility, perceived severity

Perception of threat reduction: stage of health belief model; perceived efficacy (will the change be effective?), perceived barriers (do costs exceed benefits?)

Cues to action: stage of health belief model; people, events or things that activate that readiness (coughing after a cigarette, having friends go for a walk)

Self-efficacy: stage of health belief model; belief that you can change the behavior, becomes a significant barrier to change even if other factors are doing well

Theory of Planned Behavior (TPB): health behavior is the result of behavioral intention, including attitude, subjective norm, and control

Implementation intentions: specific behavioral intention that highlights how, when, and where of a behavior; if-then contingency plans; common among coaches and therapists

Caveats to attitudinal approaches: don’t explain spontaneous or long-term behavior change, can provoke maladaptive or defensive reactions, may not be enough to cause behavior change

Stages of Change Model: AKA Transactional Model of Behavior Change; multi-level model that lays out the process/cycle of behavior change

Precontemplation: stage of change; no intent of behavior change, may be unaware of problem

Precontemplation intervention: stage of change intervention; provide information

Contemplation: stage of change; aware of problem, not committed to change yet

Contemplation intervention: stage of change intervention; discuss pros and cons of changing behavior and methods for change

Preparation: stage of change; intend to change behavior but may not have started actions yet

Preparation intervention: stage of change intervention; make explicit commitment to change, build confidence

Action: stage of change; individuals are making changes

Action intervention: stage of change intervention; self-reinforcement, coping skills, social support

Maintenance: stage of change; behavior changed (after ~6 months)

Maintenance intervention: continue action stage items and build in relapse prevention

Benefits of Stages of Change Model: captures actual process, illustrates that change may not happen on the first try, explains why many people are not successful in changing behavior

Hawthorne effect: observing a behavior causes it to change; knowing it’s monitored at some level changes the behavior

Ostrich problem: defensive when you check behavior; “digging head in the sand”; caused by fear, avoid monitoring as it creates pain/stress

Classical conditioning: Unconditioned response is paired with a new stimulus which causes a conditioned response

Antabuse: drug that causes adverse reaction to alcohol, used to condition people to not like alcohol

Operant conditioning: pairs voluntary behavior with systematic consequences

Stimulus control: associating a thing or place with certain behaviors; bed is for sleeping

Modelling: observing someone else doing a behavior to reduce anxiety about engaging in a behavior

Stimulus control interventions: rid the environment of the stimuli, or create new discriminative stimuli signaling behavior change will be reinforced

Contingency contract: making a contract with another person regarding rewards and punishments for certain behaviors

Covert self-control: altering private events (thoughts) using positive reinforcement

Cognitive restructuring: target thoughts for modification (monitor then develop more balanced thinking); thought recording, balanced thoughts can be negative

Journaling + cognitive restructuring: identify situation, write down thoughts and emotions associated with that situation, then try to create an alternative thought using evidence for or against thought

Poor health habits associated with interpersonal anxiety can be helped with…: social skills training or assertiveness training

Motivational interviewing: person works through conflicting thoughts about a health behavior

Relaxation training: progressive muscle relaxation, breathing techniques paired with tension/relaxation of muscle groups

Relapse: difficult aspect of health behavior change; person reverts to previous behavioral pattern

Reasons for relapse: depression, anxiety, stress, conditioned associations, lack of social support, withdrawal, abstinence violation effect

Abstinence violation effect: slips are complete breaks of relapse

Paradoxical effect of relapse: not black and white; relapse with reflection decreases the chance of future relapse (w/o reflection increases)

Relapse interventions: booster sessions (check-in), lifelong process (long-term prep), relapse prevention (monetary incentive, deliberate exposure), relapse management

Social engineering: modifying the environment to affect people’s ability to practice a particular behavior (no texting during driving)