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Chapter 3

Chapter 3 Health Behaviors.docx

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PSYC 3170
Joseph Baker

Chapter 3 Health Behaviors - Describe + define health promotion - Explain why health behavior are important - Know the theories and models used for understanding health behavior change Describe how cognitive behavioral approaches are used to change health - behaviors - Relate how social engineering can change health behaviors - Identify venues for health-habit modification - Good health is achievable through health habits practiced conscientiously - Health promotion means being aware of health habits that pose risk for future disease and already existing risk like vulnerability  Having eye for reducing risk to modification of habits before they develop into illness What is Health Promotion? - General philosophy w/idea that good health or wellness is personal and collective achievement  1986, WHO first international conference in Ottawa defined health promotion as enabling ppl to increase control and improve their health - At individual level, HP involves developing program of good health habit early in life + carrying them thru adulthood/old age - Medical practitioner level HP involves teaching ppl how best to achieve healthy lifestyle and helping ppl at risk for particular health problems learn behavior to offset/monitor risk - Psychologist lvl HP involves development of intervention to help ppl practice healthy behavior + change poor ones - Community + policy makers HP is general emphasis on good health, availability of info to help ppl develop + maintain healthy lifestyle + availability of resource, condition, facilities to help ppl change poor health habits Mass media contribute HP by educating ppl about health risk posed by certain - behavior - Legislation contribute to HP by mandating certain activities to reduce risk Why are health behaviors important? Role of behavioral factors in disease and disorder - Half of death in Canada are caused by modifiable behaviors Smoking, poor diet, physical inactivity among the leading causes   Cancer deaths can be reduced by 50% thru avoiding smoking and eating more vege/fruits, protect from sun, tell doctor about health changes, early screening Successful behavior modifications leads to beneficial effects -  Reduce death due to lifestyle related disease  Delay time of death, increase longevity + general life expectancy  Product of good health expand number of yrs person enjoy life free from complication of chronic disease Lead to decrease in health spending due to disease  What are health behaviors? - Undertake by ppl to enhance/maintain health  Poor health behavior lead to illness and bad habits - Health habit = health related behavior that’s firmly established and performed automatically Developed around 11/12 yrs old   May be developed initially b/c reinforced by specific + outcome, like parental approval, later becomes independent of reinforce and maintained by environment  Highly resistant to change - Belloc + Breslow in 1972 showed those who practice more good habits had fewer illness, less disabled and felt better  Even 9-12 years later men who followed health practice had mortality rate @ 28% compared to those who followed 0-3 of 7 practice  Women had 43% - Primary prevention:  Instilling good health habits + changing poor ones Combat risk factors before illness had chance to develop   2 general strategies  Most common is to employ behavior change method to alter problematic health behavior  Second is keep ppl from developing health habit in first place  More preferable to keep ppl from develop problematic behavior What factors influence the practice of health behavior? - Individual health behavior are influenced by social, cultural, physical environment - Socio economic: differ according demographic, younger more affluent, better educated ppl under low lvl of stress w/high level of social support practice better health habits than those w/high level stress and fewer resource or those in lower class - Age: health habit good in childhood and deteriorate in adolescence but improve in retired adults - Gender: at school aged children, girls eat more nutritious food but also engage in unhealthy dieting + meal skipping  Girls less likely to engage in sport - Values: dependent on culture - Personal control: health locus of control help determine health behavior, those who are predisposed to be under control practice good habits - Social influence: either beneficial or adverse (peer pressure), media act as indirect source - Personal goals: if personal fitness is goal that doesn’t interfere w/achievement of other goals, person more likely to exercise on regular basis - Perceived symptoms: - Access to health care service: using tuberculosis, Pap smear, immunizations are direct ways whereas losing weight, stopping smoking are indirectly encouraged - Place: access to practice behavior is important - Cognitive factors: belief that certain health behavior are beneficial or sense that one may be vulnerable to underlying illness if one doesn’t practice particular health behavior Barriers to modifying poor health behavior - Determinants are important because bad habits are difficult to chance  Etiology is still hard to pinpoint  Why child go from being active to sedentary?  Process is gradual and decline is due to changes in environment  Ppl have little immediate incentives for practicing good health behavior  Smoking doesn’t have effect of health since cumulative damage occurs later Ppl not highly motivated to change them b/c they can be pleasurable,  automatic, addictive Instability of Health Behavior - Habits are unstable because:  Different health habits control by different factors  Difference factors may control same health behavior for different ppl Factors controlling health behavior may change over history of behavior   Factors controlling health may change across lifetime  Health behavior patterns and developmental course vary btwn individual Intervening w/Children + Adolescence - Socialization: like influence of role models which may become automatic - As we get into adolescent often ignore early training and have incomplete appreciation of risk they encounter from faulty habits - Using teachable moment: certain times are better to teach like early childhood (putting on seatbelt) even if parent have limited understand of role in promoting healthy behavior  Some moments are built into health care delivery: physical make use of new born visit to motivate new parents basic of accidence prevention  Pregnancy also teaching moment - Closing window of vulnerability: when first exposed to risk - Adolescence health behaviors influence adult health: health behavior determine chronic disease in adulthood Intervention w/at risk people: vulnerable group - Benefits of focusing on at risk people:  Early identification may prevent or eliminate  If not intervention available, knowledge may help monitor their situation Represent efficient + effective use of health promotion dollar rather than  making a general intervention if it only affect certain ppl  Also easier to identify other risk so even if person w/family history of hypertension may not get it but recognizing risk help identify other risk - Problems on focusing risk :  Ppl don’t always perceive risk correctly or unrealistically optimistic about vulnerability  Ppl become defensive + minimize significance of risk factor and avoid using appropriate service or monitor condition - Ethical issue  When is right time to alert ppl at risk, some may have low risk of developing or will develop later so when is good time to start checking?  Should daughters of mothers who have breast cancer get screen at young age  Sometimes those who are predisposed to depression will react badly to prospect result  Some factors like alcoholism there is not yet known effective intervention  Emphasizing risk may put family against each other and blame each other for not early identification or fight over issues Health Promotion in the Elderly Healthy elderly population helps increase QOL as it keeps them mobile and able - to care for themselves reduce mortality and increase social network support and general self efficacy - Control alcohol consumption is important as metabolic rate decrease but elderly may consume same about - Vaccinations are important as influenza is major cause of death in elderly with reduce immune system, it also increase heart disease + stroke - By 80 health habits are major determinant of whether individual have nfirmed old age Ethic + gender difference in health risk + habits - Alcohol consumption is greater problem fro men then women - Smoking is problem for non minority men than other groups  Aboriginals 3x more likely to smoke and exercise less  South Asians and Chinese have more dangerous abdominal fat than Europeans w/same amount of body fat which increased risk for CV disease - Health guideline need to take into account different ethnic groups + social status What theories and models are used for understanding behavior change? - Health campaings may be able to persuade ppl to change but they may still not know how - Attitude change + health behavior  Education appeals: makes assumption ppl will change if they have correct info Communication should be colorful + vivid rather than just statis   Communicator should be expert, prestigious, trustworthy and likeable, w/info directed to particular cultural group  Strong arguments presented at beginning and end not in middle  Message should be short, clear, direct  Message should state conclusion explicitly  Extreme message produce more attitude change but only up to a certain point  Illness detection behavior (HIV) should emphasize problem if not taken and health promotion behavior (sunscreen use) should emphasize benefits  Depending on audience should present both sides of issue  Fear appeals: assume ppl will change if they fear habit hurts their health  Relationship should be direct, more fear, more change but not too extreme  Message framing: matching the framing (+/-) will impact effectiveness of message  Prospect theory states different presentation of risk info will change ppl’s perspective + actors  Message emphasize potential problems should work for behavior that have uncertain outcomes (high risk) but message for benefits (gain) will work for certain outcomes (low risk)  Condom use would be threat (high risk) presented in loss frame where as disease prevention (low risk) should be presented in gain frame  Those who are approach oriented like gain frame and avoid oriented like loss frame Social Cognition Models of Health Behavior change - Beliefs tha
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