1. Models of health belief
Week 4

2. Attribution theory
According to the basic principles of attribution theory people attempt to provide a causal explanation for events in their world particularly if those events are unexpected and have personal relevance (Heider, 1958).
Thus it is not surprising that people will generally seek a causal explanation for an illness, particularly one that is serious.

3. Attribution theory
According to Heider a person can make two attributions
1) internal attribution, the interpretation that a person is behaving in a certain way because of something about the person, such as attitude, character or personality.
2) external attribution, the interpretation that a person is behaving a certain way because of something about the situation he or she is in.
Heider, F. (1958). The Psychology of Interpersonal Relations. New York: Wiley.

4. Attribution theory
Attribution theory argues that individuals are motivated to understand the causes of events as a means to make the world seem more predictable and controllable.
Attribution theory has been applied to the study of health and health behaviour. For example, Bradley (1985) examined patients’ attributions of responsibility for their diabetes and found that their perceived control over their illness (is the diabetes controllable by me or a powerful other?) influenced their choice of treatment.
An individual who attributed their illness externally and felt that they personally were not responsible for it was more likely to choose an insulin pump and to hand over responsibility to doctors.

5. Health locus of control
The issue of controllability emphasized in attribution theory has been specifically applied to health in terms of the health locus of control. Individuals differ in their tendency to regard events as:
controllable by them (an internal locus of control) or
uncontrollable by .them (an external locus of control)

6. Critical evaluation – health locus of control
There are several problems with the concept of a health locus of control:
Is health locus of control a fixed trait or a passing state?
Is it possible to be both external and internal?
Going to the doctor could be seen as external (the doctor is a powerful other) or internal (I am looking after my health).

7. Transtheoretical model – stages of change model
1. Pre-contemplation: not intending to make any changes
2. Contemplation: considering a change
3. Preparation: making small changes
4. Action: actively engaging in a new behaviour
5. Maintenance: sustaining change over time
6. Relapse: a person lapses into their former behaviour pattern and returns to a previous stage

9. Transtheoretical model – stages of change model
How does this theory apply to health behaviour? How does it relate to deciding to change to a healthier diet?
Which psychological processes may be at work in stages 1 - 4?

10. Transtheoretical model – stages of change model
1. Pre-contemplation: denial, could also have low self efficacy to change, feel there are many barriers to change
2. Contemplation: may seek information, feel fewer barriers and increased benefits, may still underestimate susceptibility
3. Preparation: goal setting – may set unrealistic goals or under estimate their ability to succeed, motivation and self efficacy are vital at this point, start to focus more on the benefits of change, weighing up the ‘pros’ and ‘cons’ from pre-contemplation to preparation is called ‘decisional balance’
4. Action: realistic goals are vital here, social support is also very important for success

11. Transtheoretical model – stages of change model – critical evaluation
‘Stages’ as defined do not exist in any meaningful sense - people may desire a change but actual intentions are more unpredictable
Transition through pre-action stages is not the norm or even necessary for successful change – people often decide to give up smoking or go on a diet without pre- planning

12. Transtheoretical model – stages of change model – critical evaluation
The change process is much more dynamic and varied than is implied by the model
Attempts at change are made, suspended, abandoned and re-instated in a much more dynamic manner than the model implies;
The nature of the intention regarding change is also variable (e.g. ‘cutting down on smoking’, ‘stopping’, ‘only smoking in the evening’ etc.)
The emphasis on processes of change is on conscious decision making factors and the model underplays key determinants of success at change such as habit and addiction

13. Research task – 1 hour
Protection Motivation Theory & Theory of Planned Behaviour
Research the theory given to you individually at first
Pool your information with other people in your group
Create a brief power point that covers the following in relation to each theory using your interpretation of the information you have researched – not simply copying and pasting information onto slides
Description – what are the main ideas
Critical Evaluation (pros and cons) of the theory