© 2012 McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin Health Psychology 8 th edition Shelley E. Taylor Chapter Three: Health Behaviors

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-2 Health Promotion Overview: - the idea that good health, or wellness, is a personal and collective achievement - health promotion appears to be more successful and less costly than disease prevention

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-3 Health Behaviors Role of behavioral factors in disease and disorder: - s uccessful modification of health behaviors can: - r educe deaths due to lifestyle related illnesses - delay time of death, increasing longevity - expand years of life free from chronic disease complications

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-4 Health Behaviors (cont.) Health Behaviors: - behaviors undertaken by people to enhance or maintain their health -health habits: - firmly established behaviors that are often performed automatically such as wearing a seatbelt, brushing one’s teeth and eating a healthy diet - primary prevention – instilling good health habits and changing poor ones

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-5 Health Behaviors (cont.) Demographic factorsAge ValuesPersonal control Social influencePersonal goals/values Perceived symptomsCognitive factors Access to the health care delivery system Practicing and changing health behaviors: Overview:

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-6 Health Behaviors (cont.) Barriers to modifying poor health behaviors: - not knowing when to intervene to change health habits - instability of health habits - health behaviors are elicited and maintained by different factors for different people

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-7 Health Behaviors (cont.) Intervening with children and adolescents: -socialization: - the influence of parents as role models -using the “Teachable Moment”: - window of vulnerability -adolescent health behaviors influence adult health: - precautions taken in adolescence may affect disease risk after age 45 more than adult health behaviors

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-8 Health Behaviors (cont.) Interventions with at-risk people: - children and adolescents are vulnerable Benefits of focusing on at-risk people: - may prevent or eliminate poor health habits - an efficient and effective use of health promotion dollars - makes it easier to identify other risk factors

© 2012 McGraw-Hill Companies, Inc. All rights reserved. 3-9 Health Behaviors (cont.) Problems with focusing on risk: - people do not always perceive their risk correctly - testing positive for a risk factor causes worry and restrictive behavior Ethical issues: - when is it appropriate to alarm at-risk people? - some may react defensively - sometimes there is no successful intervention - emphasizing risks can raise complicated issues of family dynamics

© 2012 McGraw-Hill Companies, Inc. All rights reserved Health Behaviors (cont.) Health promotion and the elderly: - focus is on: - maintaining a healthy, balanced diet - developing a regular exercise regimen - taking steps to reduce accidents - controlling alcohol consumption - eliminating smoking - reducing the inappropriate use of prescription drugs - vaccinating against influenza

© 2012 McGraw-Hill Companies, Inc. All rights reserved Health Behaviors (cont.) Ethnic and gender differences in health risk and habits: - differences in the health risks of African- American, Hispanic and Anglo women - socioeconomic status and biological predispositions to particular illnesses put certain groups at greater risk

© 2012 McGraw-Hill Companies, Inc. All rights reserved Changing Health Habits Attitude change and health behavior: - educational appeals: - v ivid communications - expert communicator - strong arguments at beginning and end - short, clear, direct messages - messages should state conclusions explicitly - caution with extreme messages - depending on the audience, communication should include favorable and/or non-favorable points - fear appeals - message framing

© 2012 McGraw-Hill Companies, Inc. All rights reserved Changing Health Habits (cont.) Health Belief Model: – whether a person practices a health behavior depends on: - perception of health threat - perception of threat reduction - support for the Health Belief Model - using the Health Belief Model to change behavior

© 2012 McGraw-Hill Companies, Inc. All rights reserved Changing Health Habits (cont.) Self-Efficacy and Health Behaviors - the belief that you can control your behaviors Theory of Planned Behavior: - a health behavior is the direct result of a behavioral intention - benefits of the Theory of Planned Behavior - evidence for the Theory of Planned Behavior Self-Determination Theory

© 2012 McGraw-Hill Companies, Inc. All rights reserved Changing Health Habits (cont.) Caveats to Changing HealthBehaviors: - attitudinal approaches not very successful for explaining spontaneous or long-term behavior change - communications can provoke irrational, defensive reactions - some people hold irrational beliefs about health - thinking about disease may produce a negative mood - attitude change may not alter behavior and maintain behavior change

© 2012 McGraw-Hill Companies, Inc. All rights reserved Cognitive-Behavioral Approaches to Health Behavior Change - Cognitive-Behavior Therapy (CBT) - self-monitoring - classical conditioning - operant conditioning - modeling - stimulus control

© 2012 McGraw-Hill Companies, Inc. All rights reserved Cognitive-Behavioral Approaches to Health Behavior Change (cont.) The self-control of behavior: - self-reinforcement - contingency contracting - cognitive restructuring - behavioral assignments - social skills training - motivational interviewing - meditation - relaxation training

© 2012 McGraw-Hill Companies, Inc. All rights reserved Cognitive-Behavioral Approaches to Health Behavior Change (cont.) Relapse: - reasons for relapse? - consequences of relapse - reducing relapse - relapse prevention - lifestyle rebalancing

© 2012 McGraw-Hill Companies, Inc. All rights reserved Transtheoretical Model of Behavior Change Stages of change: - precontemplation - contemplation - preparation - action - maintenance

© 2012 McGraw-Hill Companies, Inc. All rights reserved Transtheoretical Model of Behavior Change (cont.) Using the stage model of change: - particular interventions may be more valuable during one stage than another - at each stage, particular types of interventions may be warranted - studies have shown mixed success

© 2012 McGraw-Hill Companies, Inc. All rights reserved Changing Health Behaviors Through Social Engineering Social Engineering: Modifying the environment in ways that affect people’s ability to practice a particular health behavior - banning certain drugs such as heroin and cocaine - requiring vaccinations for school entry - using safety containers for medications - lowering speed limits - raising the drinking age

© 2012 McGraw-Hill Companies, Inc. All rights reserved Venues for Health Habit Modification - private therapist’s office - health practitioner’s office - family - managed care facilities - self-help groups

© 2012 McGraw-Hill Companies, Inc. All rights reserved Venues for Health Habit Modification (cont.) - schools - work-site interventions - community-based interventions - mass media - Telephone - The Internet