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Chapter 4

PSYC 314 Chapter Notes - Chapter 4: Transtheoretical Model, Prostate-Specific Antigen, Menopause


Department
Psychology
Course Code
PSYC 314
Professor
David King
Chapter
4

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CHAPTER 4 PREVENTIVE AND HEALTH-PROMOTING BEHAVIOURS
What are Preventable Injuries?
Unintentional injuries are a major cause of preventable death, especially among children
Adolescents are particularly vulnerable to being injured while engaging in sports activities
Bicycle accidents constitute major cause of head injury -> head injury rates lower in provinces with
helmet use legislation compared to those without
Unintentional injuries in home (falls, accidental poisonings) are most common causes of death &
disability among children under 5
Interventions typically conducted with parents b/c they have control over child’s environment
Providing education & resources is key ex. Physicians can train new parents about child safety
Parents are most likely to undertake injury prevention activities:
oif they believe the recommended steps will avoid injuries
oif they feel knowledgeable and competent to teach safety skills to their children
oif they have realistic sense of how much time will actually be involved in doing so
single greatest cause of death from unintentional injury is motorcycle & automobile accidents
safety measures such as reducing highway driving speeds, requiring seat belts & placing young
children in safety restraint seats have reduced # of severe injuries & fatalities
getting people to follow these safety measures is difficult
to promote use of seat belts, combo of social engineering , health education, & psychological
intervention may be most appropriate
study in Norway found that signs reminding drivers of seat belt enforcement were somewhat effective in
increasing driver’s intentions to wear seat belts
enforcement of penalties is essential -> decreases in seat belt use known to correspond with decreases
in enforcement of fines for non-use
What are Cancer-Related Health Behaviours?
Promoting practice of cancer-related health behaviours, such as screening, is essential to help reduce
future incidence of cancer & loss of life
Breast Cancer Screening & Mammograms
Breast cancer is most common cancer in women
Mammogram is recommended screening test for breast cancer -> rates of screening have increased
since 1990, but many still do not participate
Women ages 50-69 should have a mammogram every 2 or 3 years
Reasons for why screening through mammography so important for older & high-risk women:
oPrevalence of breast cancer in this country remains high, with approx. 22000 Canadian women
being diagnosed each year
oMajority of breast cancers continue to be detected in women over 40 so screening this age
group is cost effective; mammography usually only warranted in women under 50 if
recommended by nurse or doctor as benefits for this age group remain unclear
oMost important, early detection, through mammography can improve survival rates
Women who are immigrants, who smoke & do not have a regular family doctor are less likely to get
screened
Factors associated with lack of clinical breast exam & mammography uptake include:
oPerceived barriers
oLack of self-efficacy
oFear of radiation & cancer
oEmbarrassment of procedure
oLack of knowledge about breast cancer or the ned for screening
oLack of awareness, time, incentive & availability
Counselling & mailed materials promoting mammography are effective at increasing use

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Interventions for increasing mammography behaviour may be more successful if they are geared to the
state of readiness of prospective participants
Transtheoretical model: women in precontemplation, relapse, contemplation and action stages
significantly less likely to report a recent mammogram than those in maintenance stage
Health behaviour model: changing attitudes of perceived benefits of mammograms & barriers to
obtain one associated with greater likelihood of screening
Educational programs designed to raise awareness of the need for mammography need to be culturally
sensitive, consider beliefs, attitudes & practices of minority groups
Theory of planned behaviour: perceived behaviour control may be most important for predicting
mammography use, addition of other factors such as optimism & risk perception also enhance
effectiveness of this model for explaining mammography use; social support also predicts use
Minority women & older women, & those living in rural areas often do not have regular health care ->
less likely to participate, interventions need to be sensitive to their diverse needs
Prostate Cancer Screening
Most common cancer among men, with 1/8 likely to develop during their lifetime
Risk increases with age & men over 50 are encouraged to discuss screening options with family doctor
2 recommended screening tests for early detection -> still some controversy over their effectiveness
Digital rectal exam (DRE) is most common screening method
Prostate specific antigen test (PSE) involves blood test to screen for prostate problems
Both are susceptible to false positives, detecting cancer that is not present & false negatives, missing
cancer that is present
Recommendations for screening depend on presence of risk factors such as age, family history, &
African ethnicity
Colorectal Cancer Screening
Increasing at higher rates among Canada’s Aboriginal population than among general public
Recommended routine colorectal screening for older adults
Distinctive for the fact that people often learn they have polyps (benign condition that can increase risk
for colorectal cancer) but not detected malignancies
Canadian Cancer Society recommends screening with a fecal occult blood test every 2 years for men &
women over 50 with normal risk, more frequently for those at high risk
Factors that predict practice of other cancer-related health behaviours also predict participation in
colorectal cancer screening
Factors that predict other preventive cancer behaviours are self-efficacy, perceived benefits of
procedure, a physician’s recommendation, & low perceived barriers
Community-based programs can attract older populations to engage in appropriate screening
behaviours
Sun Safety Practices
Rates of skin cancer steadily rising
These cancers are among the most common yet preventable cancers we have
Chief risk factor is excessive exposure to ultraviolet radiation
Sun safety behaviours increasing with age but rates of sun exposure & lack of sun protective practices
are lowest among ages 15-24
Health psychologists have increased efforts to promote safe sun practices
Educational interventions designed to alert people to risks & effectiveness of sunscreen use
People who are persuaded of importance of safe sun habits often practice them incompletely
Use an inadequate SPF, few of us apply sunscreen as often as we should during outdoor activities
Type of skin one has is strongest influence on likelihood of using sun protection
Effective sun screen use influenced by factors including:
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