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Chapter 4

PSYC 328 Chapter 4: Chapter 4 Preventive and Health Promoting Behaviours


Department
Psychology
Course Code
PSYC 328
Professor
Barbel Knauper
Chapter
4

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Chapter 4 Preventive and Health Promoting Behaviours
LO1 What are Preventable Injuries?
Preventable injuries at work and their resulting impact on disability are a particular health risk for
working men  strategies to reduce unintentional injuries have increasingly been a focus of health
psychology research and interventions
Home and Workplace Unintentional Injuries
oHome: most common causes of death and disability among children under age five
oInterventions are typically conducted with parents because they have control over the child’s
environment
oParents are most likely to undertake injury prevention activities if they
Believe that the recommended steps really will avoid injuries
Feel knowledgeable and competent to teach safety skills to their children
Have a realistic sense of how much time will actually be involved in doing so
oProviding education and resources about how to keep the home safe is key to preventing
accidents in the home
Motorcycle and Automobile Unintentional Injuries
oThe single greatest cause of death from unintentional injury is motorcycle and automobile
accidents
oLittle psychological research
oPsychological research can address factors associated with accidents, including driving
distractions, the way people drive, the speed at which they drive, and the use of preventive
measures to increase safety
oWe usually associate impairment with alcohol consumption  BUT increasing evidence
that using common technological devices such as cell phones while driving can be just as
impairing and dangerous
Hands-free is not risk free
People keep using cell phones while driving because of positive illusions and high
illusory control may partly explain why
Safety measures such as reducing highway driving speeds, requiring seat belts, and
placing young children in safety restraint seats have reduced the number of severe
injuries and vehicular fatalities
oGetting people to follow these safety measures is difficult
oTo promote the use of seat belts, a combination of social engineering, health education, and
psychological intervention may be most appropriate
oInterventions to increase seat belt use have involved social influence and social engineering
principles.
Social engineering solutions may be more effective  penalization
Enforcement of penalties is also essential, as decreases in seat belt use are known to
correspond with decreases in enforcement of fines for non-use
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LO2 What are Cancer-Related Health Behaviours?
Breast Cancer Screening
oDeath rate from breast cancer in Canada has dropped 25 percent since the time that breast
screening programs were initiated across Canada Educational
oBreast cancer remains one of the leading causes of cancer deaths among Canadian women and
the most common cause of cancer death in women under 50
oCanadian Task Force on Preventive Health Care: different screening activities for women in
didferent age and risk groups
oClinical breast exams: A thorough physical examination of the breast by a health care
professional to detect changes or abnormalities that could indicate the early signs of breast
cancer.
Formerly recommended
Current recommendations are to not routinely perform this exam as a screen for breast
cancer
Women ages 50 to 69 should have a mammogram every two to three years
current evidence suggesting that the BSE (breast self-exam) is not an effective method of
screening
WHO: recommend that national cancer screening programs should not recommend BSE
as a screening activity
Mammograms
oThe recent decrease in breast cancer mortality has been linked in part to better screening
oReasons for older and high-risk women to get mammography
Prevalence of breast cancer in this country remains high
Majority of breast cancers continue to be detected in women over age 40, so screening
this age group is cost effective; BUT mammography is usually only warranted in women
under 50 if recommended by a nurse or doctor, as the benefits of mammography for this
age group remain unclear
Early detection, as through mammograms, can improve survival rates
oGetting Women to Obtain Mammograms
Compliance with mammography recommendations is low among certain groups
Immigrants, smokers, people without regular family doctor
BC, PEI, Nunavut
Fear of radiation, embarrassment over procedure, anticipated pain, anxierty, fear
of cancer, perception of need
Lack of awareness, time, incentive, and availability
It may be necessary to tailor this material to women’s readiness to adopt mammography
as part of their regular preventive health behaviour
Consistent with the stages of change model, women in precontemplation, relapse,
contemplation, and action stages were significantly less likely to report a recent
mammogram during follow-up compared to those in the maintenance stage
Interventions for increasing mammography behaviour may be more successful if
they are geared to the stage of readiness of prospective participants
Changing attitudes toward mammography may increase the likelihood of obtaining a
mammogram
Health belief model: attitudes of perceiving benefits of mammograms and
encountering few barriers to obtaining one  greater likelihood of obtaining a
mammogram
oBUT educational programs designed to raise awareness of the need for
mammography also need to be culturally sensitive
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Theory of planned behaviour: framework to predict the likelihood of obtaining
regular mammograms  the addition of other factors such as optimism, risk
perception, social support (low-income and older) may also enhance the
effectiveness of this model for explaining mammography use
But interventions with women alone will not substantially alter rates of
participation in mammography screening programs if the health care system is not
also changed
Prostate Cancer Screening
oIn Canada, prostate cancer is the most common cancer among men
oRisk for prostate cancer increases with age, and men over 50 are encouraged to discuss screening
options with their family doctor
oControversy over effectiveness: susceptible to false positives and false negatives
Digital rectal exam (DRE): most common
Prostate specific antigen test (PSE): blood test
oRecommendations for screening depend on the presence of risk factors such as age, family history,
and African ethnicity
Colorectal Cancer Screening:
oColorectal cancer is the second highest cause of cancerous deaths in Western countries
oFourth highest in Canada, increasing among Aboriginal population
oMedical guidelines have increasingly recommended routine colorectal screening for older adults
oColorectal screening is distinctive  people often learn that they have polyps (a benign condition
that can increase risk for colorectal cancer) but not detected malignancies.
oCanadian Cancer Society: recommends screening for colorectal cancer with a fecal occult blood
test at least once every two years for men and women over 50 with normal risk, and more frequently for
those at high risk
oFactors that predict the practice of other cancer-related health behaviours also predict participation
in colorectal cancer screening
Self-efficacy
Perceived benefits of the procedure
Physician’s recommendation to participate
Low perceived barriers to taking advantage of the screening program
oCommunity-based programs can attract older populations to engage in appropriate screening
behaviours
oAn intervention aimed at a hard-to-reach group of older adults that provided reassuring
information regarding colorectal screening was effective in modifying initially negative attitudes and
increasing rates of screening attendance
Sun Safety Practices
oAmong the most preventable cancers
oChief risk factor: excessive exposure to ultraviolet radiation
oWomen are more likely than men to practise sun protective behaviours
oSun safety behaviours do increase with age, but rates of sun exposure and lack of sun protective
practices are lowest among those ages 15 to 24
oMeasures:
Educational interventions designed to alert people to the risks of skin cancer and to the
effectiveness of sunscreen use for reducing risk
Some debate as to whether individualized or generic materials are more effective for
changing sun safety behaviours
* both are equally effective, with generic materials having the advantage of reaching a
greater number of people
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