Psychology 2036A/B Lecture Notes - Lecture 2: Transtheoretical Model, Revised Version, Health Belief Model

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Strategies of Primary Prevention
Preventing Illness before it Develops
Lecture 2
Taking steps to prevent an illness before it begins
Health psychologist interested in primary prevention because stroke, cancer
etc. can be prevented by modifying health behaviors
Prologue: Approaches to Primary Interventions
1. We can eliminate unhealthy behaviors after they begin (but before they cause
damage)
e.g. get people to stop smoking
2. Prevent unhealthy behaviors before they begin
e.g. prevent people from starting to smoke
Q. Why do people engage in unhealthy behaviors?
OR why do we need primary intervention?
Part 1: Barriers to Healthy Behaviors
A. Biological Barriers:
1.Physical addictions (smoking, alcohol abuse)
-can be very difficult to change
2. Genetic contributions (alcoholism)
B. Psychological Barriers:
1. Unhealthy behaviors are PLEASURABLE (e.g. unhealthy eating, alcohol
consumption)
2. Healthy behaviors are difficult to perform (easier to watch tv than exercise, easier
to take elevator than stairs)
3. Unhealthy behaviors are too easy to perform,
-Acquired at an early age;
-Become a “habitual” part of lifestyle
4. No immediate incentive for engaging in healthy behaviors
-positive consequences are not immediate
(e.g. taking jogging to lose weight, you wont immediately see that you’ve lost
weight)
5. No immediate incentive for not engaging in unhealthy behaviors
-negative consequences are not immediate (smoking doesn’t give you cancer right
away)
6. False Consensus Bias:
-overestimate number of other people who engage in unhealthy behaviors
(e.g. smokers will overestimate the number of people who smoke)
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7. False Uniqueness Bias:
-see self as less similar to the average person who becomes ill
(e.g. if we aren’t similar, we are concluding that we are less likely to become ill,
know that there are smokers who have died of heart disease but “im not like them
because they also drink alcohol so I won’t get it”)
8. Unrealistic Optimism Bias:
-see self as less likely than average person to become ill.
(e.g. most teenagers believe that they are less likely to develop HIV, most adults less
likely to believe they will die of heart attack)
9. Medical interventions will be available to “cure” illness when it strikes.
-if there’s going to be a cure for cancer, why quit smoking?
-No need to engage in safe sex if cure for AIDS will soon be found.
10. Personality Factors (individual differences)
-Locus of Control (internal and external)
EXTERNALS believe that illness is determined by external things that cannot be
controlled (e.g. fate, bad luck)
-not likely to take steps to prevent illness
INTERNALS believe they have control over health outcomes –more likely to take
steps and prevent illness
Health values:
Some people value good health, but not everyone does.
*good health is not valued by everyone; this becomes a barrier to engaging in
healthy behaviours
C. Social Barriers
1. Family
(e.g. you want to lower cholesterol, but your family is interested in unhealthy food)
2. Peer
(e.g. peers are interested in drugs, alcohol)
3. Media
(e.g. “tempting” commercials for unhealthy foods)
4. Economic Forces (e.g., tobacco and alcohol industries)
5. Health-Care System (physicians trained in “treatment”, not “prevention”)
Part 2: Models of Health Behavior
-1950’s psychologists started to address question
“Can we frighten people into engaging in healthy behaviours?”
A. Research on Fear Appeals
1. The “Dental Hygiene” study (1953)
-high school students read one of 3 messages (which all said that they should
practice good dental hygiene and brush teeth after every meal)
-3 messages aroused different levels of fear:
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