Health Behavior Models

• About half of all deaths are related to unhealthy behaviors.

Models of Health Behavior

• Learning theories suggest health-related behaviors are learned through classical and operant conditioning, as well as observational learning.
• Continuum models focus on identifying sets of factors to predict behavior.
• Stage models view behavior change as a complex process, emphasizing stages of change rather than a simple shift.

Learning Theories

• Classical conditioning involves learning to respond to a new stimulus associated with a stimulus that naturally produces a response.
• Operant conditioning modifies behavior through rewards and punishments.
• Temptation bundling pairs activities that are difficult but beneficial in the long-term with immediately satisfying activities.
• Adding "friction", like external barriers, to unwanted behaviours makes them less rewarding.
• Introducing "friction" makes unwanted behaviours more difficult to perform.
• Desired behaviors can be made easier by removing "friction".
• Vicarious learning (modeling) involves learning through the experiences of others.

Social Cognitive Theory

• Self-efficacy, or a person's belief in their ability to do something, is important in predicting health-related behaviors.
• Self-efficacy is predictive of perseverance when facing stress.
• The Health Belief Model includes perceived susceptibility, severity, benefits, and barriers that influence participation in preventative health behaviors.
• Additional concepts - cues to action serve as reminders about potential health problems or behaviors and self-efficacy, a person's belief that they will be able to execute a behavior.
• These models can be used for intervention in changing health related behaviours.

Theory of Planned Behavior

• Behaviors are determined by behavioural intentions, which are a person's commitment to performing a behaviour.
• Intentions are determined by their attitudes, subjective norms, and perceived behavioral control.
• Implementation intentions create specific plans for engaging in a behavior to better achieve goals.

Transtheoretical Model (Stages of Change)

• Behavior change includes relapse and is a complex, non-linear process.
• Six stages include:
  • Precontemplation: no intention to change.
  • Contemplation: starting to consider behavior change.
  • Preparation: commitment to change.
  • Action: engaging in new behavior.
  • Maintenance: sustaining change over time.
  • Termination: no longer risk of relapse.

Prevention Strategies

• Primary prevention: taking measures to prevent illness.
• Secondary prevention: detecting or treating illness early to reduce potential effects.
• Tertiary prevention: actions to minimize or slow damage from an illness.
• Levels of prevention target, individuals, groups, organizations, communities, or populations.

Prospect Theory (Message Framing)

• Decisions are affected by how messages are presented and the behaviour they target.

• Loss-framed messages emphasize the costs of a negative behavioral choice.

• Gain-framed messages emphasize the benefits of a positive behavioral choice.

• Loss frame works best for screening, while gain frame is better for prevention.

• Information based approaches may not always be effective.

• Emotion based approaches should pair fear with strategy.

• Behavioral nudges increase COVID-19 vaccination rates.

• Limiting choice or putting certain foods by the entrance to make it easier to get them.

Smoking

• Health consequences include high cardiovascular decease, cancers and respiratory deases, increasing mortality risk.
• Optimistic bias, depression, low self-esteem, and perceived benefits psychological factors for why people start smoking.
• Weight control, social factors and media contributes to starting.
• Addiction, tolerance, withdrawal, and nicotine stimulating certain hormones are reasons for continuing.

Nicotine-Based Models of Smoking

• Nicotine fixed-effect model proposes that people smoke because it feels good.

• Nicotine regulation model suggests individuals smoke to maintain a nicotine level above the body's "set-point" for pleasurable effects.

• People smoke to increase positive affect or decrease negative affect.

• Negative affect: smoke to cope with anxiety, stress, tension.

• Social influence affects - programs targeted at high-risk groups help.

• Mass media approaches - TV/magazine/billboard advertisements work.

• Government programs - restrict advertisement increase cost, and prohibit use in public places.

• Help quitting nicotine and have support.

• Aversion strategies - classical conditioning can help.

• Self-management - stimulus control and stress management can help.

• Electronic cigarettes are safer and similar.

Alcohol Use

• Direct Effects health consequences include: Liver damage, cirrhosis, Hepatitis, Brain damage, Cardiovascular effects, Cancer and Immune functioning.

• Indirect Effects include: Behavioral disinhibition.

• Int tension-reduction theory - alcohol helps reduce or cope with negative emotions.

• Social learning theory - people more likely to drink the alcohol they see on ads

• Pluralistic ignorance: assumption that actions are differ from others actions but they are really just the same (but our actions are really the same) (and vise versa)

• Early intervention should focus on at risk people,

• skills training is effective.

• Challenge expectation about alcohol use.

• Treatment:

  • Alcoholics Anonymous (AA).
  • Classical conditioning (aversion) techniques:
  • Alcohol with aversive stimulus.
  • Antabuse.
  • Emeline.

• Self Management: Stimulus control, Response substitution, Contingency contracting, Coping with stress

• Increased likelihood of chronic disease and chronic mortality.

Eating and Exercise

• “Fat but fit" - is obesity a problem or are but but fit, no with increased fitness.

• Exercise more optimal fat storage.

• "Fat but fit “ is a myth study.

• Food sizes, obesity is a result.

• Psychological factors may cause Internal-external cues for eating, for hunger.

• High Mood regulation leading to, emotional eating/stress eating.

• Used to manage moods (stress, anxiety, depression)

• Begin in childhood is part of prevention.

• Model healthful eating habits and eating.

• Avoid food for reward, also negative ones.

• Weight cycling is unhealthy.

• Dieting increases stress, not helpful really for controlling eating habits.

• Monitoring or restricted eating increases stress, in general.

• The healthiest way to treat obesity is physical activity.

• Increasing physical activity has better lower blood pressure and cognitive function.

• What are the barriers to physical activity:

  • Time, energy, and environmental barriers. Interventions should:

• Change environmental factors.

• Create habits.

• Social support.

• Mobile Health using apps.

• Need to incorporate lifestyle changes.

Medical care

• Delay behavior: postponing medical attention.
• Perceiving social situations, what influences it.
• Hospitalization.
• Stressful.
• Factors and psychological effects.
• Study shows that patients with information video do better with recovery.
• ways of not adhering and its importance when patients recommend to take medications and adherence to their drugs.
• adherence important of why they recommend?
• Causes of Non adherence!
• Patient with factors
• Unclear physician patient communication is hard to understand with each other.
• Increasing Adherence is better.