Introduction to Health Psychology

• Health psychology examines psychological and behavioral processes in health, illness, and healthcare.

Biopsychosocial Model

• The biopsychosocial model considers biological, psychological, and social factors in health and illness.
• Differs from the biomedical model which focuses solely on biological factors.

Māori and Pasifika Health Models

• Differ from the biomedical and biopsychosocial models by incorporating cultural and spiritual dimensions of health

Rise of Health Psychology

• Factors contributing to the rise of health psychology include:
  • Changing patterns of illness
  • The role of behavior in health
  • Rising healthcare costs.

Changing Patterns of Illness

• Developed countries see a shift from acute infectious diseases to chronic lifestyle-related diseases.

Importance of Behavioral Patterns

• Behavioral patterns significantly impact individual and public health, making effective behavior-change interventions essential for healthcare.

Cognitive Determinants of Health Behaviors

Health Belief Model (HBM)

• Perceived susceptibility: Belief about the likelihood of getting a condition.
  • Example: A smoker believes they are likely to develop lung cancer.
• Perceived severity: Belief about the seriousness of a condition and its consequences.
  • Example: A smoker believes lung cancer is a severe and life-threatening disease.
• Perceived benefits: Belief about the effectiveness of taking action to reduce risk.
  • Example: A smoker believes that quitting smoking will significantly reduce their risk of lung cancer.
• Perceived barriers: Belief about the tangible and psychological costs of taking action.
  • Example: A smoker believes quitting will be difficult due to withdrawal symptoms and social pressure.
• Cues to action: Factors that trigger action.
  • Example: Seeing a public service announcement about the dangers of smoking prompts a smoker to consider quitting.
• Self-efficacy: Belief in one's ability to succeed in performing a behavior.
  • Example: A smoker feels confident in their ability to quit.

Protection Motivation Theory (PMT)

• Perceived severity: Belief about the seriousness of a health threat.
  • Example: A smoker believes lung cancer is deadly.
• Perceived probability of occurrence: Belief about the likelihood of experiencing the health threat.
  • Example: A smoker believes they are likely to get lung cancer if they continue smoking.
• Response efficacy: Belief that the recommended behavior is effective in reducing the threat.
  • Example: A smoker believes quitting will reduce their risk of lung cancer.
• Self-efficacy: Belief in one's ability to perform the recommended behavior.
  • Example: A smoker feels confident they can successfully quit.

Theory of Planned Behavior (TPB)

• Attitude: Positive or negative evaluation of performing the behavior.
  • Example: A smoker believes quitting will improve their health and well-being.
• Subjective norm: Belief about whether significant others think one should perform the behavior.
  • Example: A smoker believes their family and friends want them to quit.
• Perceived behavioral control: Belief about one's ability to perform the behavior.
  • Example: A smoker feels they have the willpower and resources to quit.
• Intention: A plan to perform the behavior.
  • Example: A smoker intends to quit smoking within the next month.

Social Cognitive Theory (SCT)

• Self-efficacy: Belief in one's ability to succeed in specific situations or accomplish a task.
  • Example: A smoker is confident in their ability to resist cravings and avoid smoking triggers.
• Observational learning: Learning by watching others.
  • Example: A smoker sees a friend successfully quit and is motivated to do the same.
• Reinforcements: Responses to a person's behavior that increase or decrease the likelihood of reoccurrence.
  • Example: A smoker receives praise and support from family members when they reduce their smoking.
• Behavioral capability: Knowledge and skills to perform the behavior.
  • Example: A smoker understands different quitting strategies and has coping mechanisms for dealing with cravings.

Comparing HBM and TPB

• The Health Belief Model (HBM) focuses on perceived susceptibility, severity, benefits, and barriers
• The Theory of Planned Behaviour (TPB) emphasizes attitudes, subjective norms, and perceived behavioral control

Injunctive norms

• Beliefs about what others approve of.

Descriptive norms

• Beliefs about what others do.

Cognitive attitudes

• Beliefs and thoughts about the attitude object.

Affective attitudes

• Feelings and emotions about the attitude object.

Contribution of Social Cognition Models

• Offer frameworks for understanding and predicting health behaviors

Using Social Cognition Models

• Can be used to inform interventions by targeting specific beliefs and attitudes

Rutter (2000) Findings

• Theory of Planned behaviour (TPB) applied to attendance and reattendance for breast cancer screening.
• Intention predicted attendance, but other factors also play a role.

Intention-Behavior Gap

• The intention-behavior gap refers to the discrepancy between intentions and actual behavior.
• Intention stability is the extent to which intentions remain consistent over time.

Implementation Intentions

• "If-then" plans that link a specific situation to a specific action.
• Help bridge the intention-behavior gap by specifying when, where, and how to act.

Stage Models

• Stage models differ from social cognition models by describing behavior change as a process involving distinct stages.

Health Action Process Approach (HAPA)

• Divides the behavior change process into pre-intentional motivation, intentional planning, action, and maintenance stages.

Maximizing Impact

• Health-related information should be clear, simple, and personally relevant.

Social Influence Techniques

• Can be used in health promotion, including persuasion and social norms.

Message Framing

• Presenting information in terms of gains or losses
• Gain-framed messages are more effective for promoting prevention behaviors.
• Loss-framed messages are more effective for promoting detection behaviors.

Degree of Cognitive Elaboration

• Determines which message features have the most impact on attitude change.
• When elaboration is high, the quality of the argument is most important.
• When elaboration is low, peripheral cues are more influential.

Self-Efficacy

• Belief in one's ability to succeed in specific situations or accomplish a task.
• Important for motivation and behavior change because it affects goal setting, effort, and persistence.
• Enhanced by providing opportunities for success, modeling, social persuasion, and reducing stress.

Elicitation Research

• Prior to intervention design, it's important to answer questions about the target behavior, population, and context.

Information Motivation Behavioral Skills (IMB) Model

• Information, motivation, and behavioral skills are fundamental determinants of health behavior.

Evidence-Based Health Promotion

• Uses research and theory to inform the design and implementation of interventions.
• Important for ensuring that interventions are effective and efficient.

Regulatory Processes

• Theoretical and empirical specification facilitates identification of change techniques.

Anticipated Regret

• Encourages behavior change by highlighting the potential negative consequences of not acting.

Fear Appeals

• Persuasive messages designed to scare people by describing the terrible things that will happen if they do not do what the message recommends.
• Can be effective if they include information about how to avoid the threat; otherwise, they may lead to defensive responses.

Problem-Solving Skills

• Includes:
  • Identifying problems
  • Generating solutions
  • Evaluating solutions and implementing them.

Implementation Intentions

• "If-then" plans that link a specific situation to a specific action.
• Involve both the reflective and impulse system.

Stimulus-Control

• Modifying the environment to reduce exposure to stimuli that trigger unhealthy behaviors.

Cognitive Restructuring

• Changing negative or irrational thoughts to more positive ones.
• Used in weight loss and smoking cessation programs.

Reinforcement

• Reinforcement in the maintenance of unhealthy behaviors.
• Positive reinforcement involves adding something desirable.
• Negative reinforcement involves removing something undesirable.

Reinforcement Techniques

• Can be used to change a health behavior by rewarding desired behaviors and punishing undesired behaviors.

Intervention Evaluation Research

• Should investigate changes in both the target behavior(s) and the determinants/antecedents of those behaviors.