Behaviour

Human Behaviour

• Achieving health and well-being in populations is a priority for public health specialists, although definitions of these concepts are contested and reactions to illness vary between cultures.
• The chapter discusses pre-conceptions of health and illness (e.g., the "sick role" and social expectations), deviant behaviour, and stigma.
• Personal characteristics and social position influence help-seeking behaviour.
• Social sciences aim to understand human behaviour, motivations, and attitudes, and how they change over time.
• Society is more than just a collection of individuals; it's defined by interaction, shared geography, identity, and culture.

Disciplines Concerned with Human Behaviour

• Psychology: Studies mental processes and behaviours of individuals.
• Sociology: Studies social interactions, groups, and institutions. Sociology acknowledges that group behaviour can differ from individual behaviour.
• Anthropology: Studies human cultures (often differentiated from biological anthropology, which focuses on evolution).
• History: Records and interprets past events.

Importance to Public Health

• These disciplines are crucial for understanding:
  • Individual behaviour
  • Group behaviour within populations
  • Healthcare organisation behaviour

Social Research

• Data can be quantitative (numerical) or qualitative (textual/pictorial).
• Most social research combines both types.

Terminology (in Social Sciences)

• Epistemology: Study of knowledge (origin, nature, methods, and limits).
• Theoretical Perspective: Philosophical stance guiding research design and methodology (affecting the approach to the researched phenomenon).
• Methodology: Strategy for answering research questions using specific methods.
• Ontology: Study of the nature of being (e.g., whether facts are constructed in the mind or exist in an external world).
• Reflexivity: Acknowledging that observation can affect the studied environment.

Major Theoretical Perspectives (in Sociology)

• Structural Functionalism: Society viewed as objective reality, with interdependent components working together.
• Social Conflict: Society focused on competition for resources and material production. This can lead to class divisions and impacts on health inequalities.
• Interpretivism (or Symbolic Interactionism): Focuses on social interactions and how individuals subjectively interpret society, including labelling which can lead to stigmatisation.

Qualitative Methods

• Ethnography: Detailed study of a group's behaviour through prolonged participant or non-participant observation.
• Interviews: Semi-structured (guided discussions) or in-depth.
• Focus Groups: Gathering 6-10 people to explore opinions and responses through discussion.
• Case Studies: Investigating particular systems (e.g., a healthcare organisation) using multiple data collection methods for thorough analysis.

Individual Behaviour Change

• Motivational Interviewing: A patient-centred method focused on developing motivation for change by exploring reasons for ambivalence to behaviour change.
• Cognitive Behavioural Therapy (CBT): Aims to interrupt cycles of unhealthy behaviour by replacing them with healthier ones.

Incentives for Behaviour Change

• Personal financial incentives are sometimes used to encourage positive behaviour changes (e.g., vouchers for smoking cessation).

Changing Behaviour

• Health systems constantly change, encompassing practice innovations, structural reconfigurations, and evolving population needs.
• Different attitudes exist toward change (e.g. missionaries vs. laggards).
• Rogers' diffusion model explains how people adopt new ideas/behaviours.
• Various psychosocial theories explain why people behave as they do. These theories include social learning theory, organisational change theory, diffusion of innovations theory, and social constructivist theory.

Lifestyle Factors and Health

• Obesity prevalence has risen substantially since the 1980s.
• Obesity is linked to increased risks of chronic disease (e.g., type 2 diabetes, CHD, cancer).
• Physical activity is important for reducing obesity risk and chronic disease risk.
• Alcohol consumption guidelines and recommendations are discussed.

Other Health Behaviours

• Recreational drug use, smoking, and sexual behaviors influence health.
• The discussion of societal implications of these choices is also discussed.

Psychology of Decision-Making in Health

• Patients' decision-making processes and choices about healthcare are complex, impacted by symptom perception, perceived severity, and potential social and personal concerns.

Occupation and Health

• Employment has positive impacts on general health. However, certain jobs can expose workers to risks.
• Unemployment has substantial negative impacts on individuals, families, and society (e.g., mental health, financial strain), influenced by duration and anticipatory factors.

Complex Interventions

• Combating complex health problems often involves comprehensive interventions that integrate medical, behavioral, and socio-environmental approaches.
• This multi-faceted strategy requires recognizing both individual and social factors influencing behaviour.
• A broad range of strategies (including "nudges") can influence health-related outcomes.

Concepts of Health and Well-being

• Different agencies and thinkers have different definitions of health and well-being, often emphasizing different aspects/components.
• The World Health Organization (WHO) definition emphasizes health well-being not just the absence of disease.

Concepts of Primary and Secondary Deviance

• Deviance is considered a behaviour unacceptable in a specific culture.
• Primary deviance is the initial behaviour before labeling as deviant.
• Secondary deviance is the consequence of the label and how it affects the person.

Illness Behaviour

• This section examines factors influencing individuals' responses to illness (e.g., symptoms, cultural differences, perceived severity of symptoms).

Illness as a Social Role

• Illness (and health) have social aspects.
• The "sick role" concept describes expected rights and responsibilities of individuals who are perceived as ill by society.

Patient-Centred Versus Doctor-Centred Care

• Contemporary health care is moving towards more patient-centered approaches.
• Patient-centered care emphasizes shared decision-making, active patient involvement, and written communication . Doctor-centred approaches tend to be more hierarchical and focused on expert advice.

Risk Behaviour

• Individual risk behavior is contingent on a range of personal, social and environmental factors.