Transcript Healthy Living - Surbiton High School

A2 Psychology
Unit G543
Health & Clinical Psychology
Healthy Living
Lesson One:
Health belief model
Locus of control
Health Belief Model (Becker)
Aims to predict the likelihood that a person will carry out a
health behaviour.
According to the health belief model, the
likelihood that individuals will carry out a health
behaviour depends directly on two assessments
that they make
(i)
Evaluating the threat
(ii)
Cost-benefits analysis
Terminology
 perceived seriousness (‘Will it actually kill you?’)
 perceived susceptibility (‘Am I likely to get it?’)
 costs/benefits analysis
 cues to remind us (external or internal cues)
 demographic variables (factors such as gender, culture,
age, etc.)
(i) Evaluating the Threat
 Perceived seriousness
 Perceived susceptibility
 Cues to action
 Other variables
Cost-benefits analysis
Do the perceived benefits of changing
behaviour exceed the perceived barriers?
Benefits include improved health, relief from anxiety
Barriers include financial, situational (getting to a gym)
Other Variables
 Demographic such as age, race ethnicity, class sex etc.
 Socio-psychological such as peers, personality, social
pressure.
 Structural such as prior contact or knowledge about the
disease.
Health Belief Model: Becker 1978
A person will adopt a health behaviour
If they perceive
a threat to their
health if they
don’t adopt it
If the benefits
outweigh the costs
Perceived seriousness
will increase the
threat
Perceived
susceptibility will
increase the threat
If they are reminded
by internal and/or
external cues: media
campaigns, lay
advice, reminders
from GP’s, magazine
articles
Depending on
demographic
variables: age, race,
ethnicity, class,
gender, peers,
personality, social
pressure, prior
knowledge of the
disease
HBM – what is it actually for?
 It is used to predict the uptake of health behaviours
based on several factors
 The more factors that are present in a particular
situation, the more likely you are to behave healthily
 Health behaviours include giving something up
(smoking), refusing to try something (drugs),
regularly checking your health (self-examination),
regularly preventing problems (brushing your teeth)
Applying the HBM
1.
2.
3.
4.
5.
6.
7.
Why a teenage boy may not want to go to the doctors about a
rash he has.
Why an elderly lady may not be taking her asthma medication
every day.
Why a middle-aged couple who have just met through online
dating may not be using condoms when they first have sex.
Why an elderly man may not visit the doctor about some chest
pains he has been feeling.
Why a mother may not give her children the cough medicine they
need to cure their chest infections.
Why a 30-year-old female may not lead a very healthy lifestyle.
She does not exercise, she eats fast food and she drinks alcohol.
Why a 20-year-old student may suddenly start taking illegal drugs
like amphetamines and ecstasy.
Does the HBM work?
 Becker’s study used the HBM to explain mums’ adherence
to a drug regimen (i.e. routine for taking
medication) for their asthmatic children
 The study confirms the HBM is an accurate predictor of
the likelihood of a parent giving the medication
Becker’s Method
 A correlation between beliefs reported during interviews
and compliance with administration of asthma medication
(also self-reported)
 A blood test was used on some participants to confirm
the validity of the self-report
Becker’s Participants
 111 mothers responsible for administering asthma
medication to their children
 Aged 17 – 54
 Children aged 9 months to 17 years
Becker’s Procedure
 Mum interviewed for 45 minutes
 Asked questions about
 Perception of child’s susceptibility to illness
 Beliefs about seriousness of asthma
 How much child’s asthma interfered with their education, caused
embarrassment and interfered with mum’s activities
 Faith in doctors and medication
Becker’s Results
 Positive correlation between mother’s belief about child’s
susceptibility to asthma attacks and compliance with
regimen
 Positive correlation between mother’s perception of child
having a serious asthma condition and compliance with
regimen
Becker’s Results
 Negative correlation between costs and compliance
 These costs included:




Disruption of daily activities
Inaccessibility of chemists
Child complaining about medication
Prescribed schedule for administering the medication
 2 demographic variables that correlated with compliance were
marital status and education
Becker’s Conclusion
 HBM is a useful model to predict and explain different
levels of compliance to medical regimes
Person will
adopt a
Health
behaviour
If they perceive a
threat to their
health
Perceived
seriousness
will increase
the threat
Perceived
susceptibility
will increase
the threat
If the benefits
outweigh the
costs
If they’re reminded
by internal and/or
external cues
Depending on
demographic
variables (e.g. age
and gender)
Becker (1978)
 Pps = 111 mothers responsible for administering asthma
medication to their children.
Design
 Correlational design.
Becker (1978)
What can we conclude from Becker’s research?
Evaluation
Rotter
Generalisability
Reliability
Validity
Ethics
Debates:
 Approach
 Reductionism/holism
 Any others?
Choose a health
behaviour and
complete the diagram.
Locus of control
Locus of Control refers to the individual
differences in people’s beliefs and expectations
about what/who controls events in their lives.
It is measured along a scale from high internal
locus of control to high external locus of control.
Rotter (1966)
 Internal locus of control – where a person feels he or she is in
control of his or her health and is therefore likely to adopt
healthy behaviour.
 External locus of control – where a person feels his or her
health is controlled by external factors (e.g. fate) and is
therefore less likely to adopt a healthy behaviour.
How might someone who has
internal locus of control act?
(Health behaviours)
AND
How might someone who has
external locus of control act?
(Health behaviours)
Example:
Rotter (1966)
Method
 Review article.
Procedure
 Sample – six pieces of research into individual perceptions of
ability to control outcomes.
I’m in control
of my health
behaviour
Findings
I’m not in
control of my
health
behaviour
Conclusion
Rotter concluded that LOC would effect many of our
behaviours, not just health.
 James et al. (1965): smokers who give up and did not
relapse had a higher level of internal LOC than those who
did not.
 However, for women, where there was no significant
difference between internal and external LOC in those
giving up instead other factors such as weight gain were
influential in giving up smoking. (Therefore indicating that
LOC a factor in health behaviours but other factors play a
part).
Evaluation
Rotter
Generalisability
Reliability
Validity
Ethics
Debates
1.
Determinism and Free will (does this study/perspective suggest we have
that our behaviour/experience is determined?)
freewill or
2.
Reductionism and Holism (do the results of the study focus on one single level of
explanation, ignoring others or do they consider many explanations?)
3.
Nature and Nurture (is this characteristic/behaviour due to genetics or learning?)
4.
Individual and situational explanations (can this behaviour be explained by the
situation/environment or is it due to personal characteristics?)
5.
Ethnocentrism (can this behaviour be considered to be biased towards one ethnic group or
society?)
6.
Psychology as a Science (is the method used within the study rigorous, ie. objective,
reliable, falsifiable?)
7.
Usefulness?
Internal or External?
 A person believes they can beat heart disease through a
better lifestyle
 Someone believes God will decide if they will survive
their heart transplant
 A parent believes that healthy eating for their child is the
responsibility of the school
 A woman stays out of the sun to avoid skin cancer
 A man thinks he can still smoke as no one else in his
family got cancer despite all smoking
Homework
 Describe the Health Belief Model. (10)
 Due next lesson
Lesson Two:
Self-efficacy
Exam practice
Social Cognitive Theory
Source: http://www.uky.edu/~eushe2/Bandura/BanEncy.html
Self-efficacy
 How effective a person thinks they will be at successfully adopting
a health behaviour.
 Cognitive approach based on thought processes of the individual
Bandura – Self efficacy (1977)
Bandura was interested in treating people with a fear of
snakes
He believed Locus of Control was too simple as a theory of
health belief
Why would he say this?
Bandura’s theory
 Bandura developed a theory of self-efficacy (1977): Went further than the locus of control which he thought was too
simplified
 Considered how treatments for disorders such as anxiety can be
helped by increasing self-efficacy
 It is important to note that this isn’t just about treating anxiety – you
must link it to self-efficacy, i.e. does self-efficacy effect the likelihood
of a coping behaviour being developed?
Bandura’s ideas
 Outcome expectation: We learn from previous experience and use this to estimate a
likely outcome in any situation.
 Efficacy expectation – we believe we can successfully do whatever is required to
achieve the outcome
The three factors that affect our efficacy expectation:
1. Vicarious experiences – when we see people succeeding our self efficacy
increases; when we see people failing it decreases
2. Verbal persuasion – direct encouragement or discouragement;
discouragement will lower self-efficacy more than encouragement will
increase it
3. Emotional arousal – how is this perceived? Someone with low selfefficacy will perceive physiological symptoms or emotional symptoms as
proof they are incompetent, rather than as a normal response.
Aim – Bandura and Adams
 To assess the self-efficacy of patients undergoing systematic
desensitisation.
WHY?
Method
 A controlled quasi-experiment with patients with snake phobias.
Systematic desensitisation
 Phobia treatment
 Anxiety hierarchy
 Move up step by step – using relaxation techniques
Client forms positive associations
•
•
•
•
10 snake phobics
9 females 1 male
19-57 yrs old
Replied to an
advert in paper
Procedure
Boa constrictor
Assessed on:
Procedure (cont.)
 Systematic desensitisation – a standard desensitisation
programme was followed where patients were introduced to a
series of events involving snakes and at each stage were taught
relaxation.
 Post-test assessment. Each patient was again measured on
behaviours and belief of self-efficacy in coping.
Findings & conclusion
 Higher levels of post-test self-efficacy were found to
correlate with higher levels of coping behaviour with
snakes.
 Desensitisation enhanced self-efficacy levels, which in
turn lead to a belief that the participant was able to
cope with the phobic stimulus of a snake.
Knowledge check
 What does self efficacy mean?
 What factors influence self efficacy?
 What were the conclusion in Bandura and Adam’s study?
Evaluation
Reductionist
Holist
Science
Not Science
Individual
Situational
Approach
bias
Not approach
bias
Evaluation
Study
G
R
A
V
E
Homework
 Discuss the theoretical approaches to
beliefs about health. (15)
 Due next lesson