Week 1 Lecture Slides - Health Psychology - PDF

Week 1 – Introduction to Health Psychology Dr Mark Stevens Course convenor and lecturer PSYC3020 Acknowledgement I acknowledge and celebrate the First Australians on whose traditional lands of Country we meet, and pay my respect to the elders of the Ngunnawal people past and present. About me •...

Week 1 – Introduction to Health Psychology Dr Mark Stevens Course convenor and lecturer PSYC3020 Acknowledgement I acknowledge and celebrate the First Australians on whose traditional lands of Country we meet, and pay my respect to the elders of the Ngunnawal people past and present. About me • Degree, masters, and PhD in the UK, postdoc at ANU 2019-2021. • Lecturer in Health Psychology since Jan 2022. ØOffice: Room 211, Building 39 • Research interests: ØSocial influences on health behaviours ØHealth behaviour change ØPhysical activity ØSports performance + mental health Outline for today • Course admin + organisation • Introducing health psychology ØWhat is health psychology and how did it come about? ØWhy do we need health psychology? ØWhat do health psychologists do? • Burden of disease • Research methods in health psychology A quick note on COVID • ANU Covid info: https://www.anu.edu.au/covid-19-advice#returning • Online form if you test positive: https://forms.office.com/pages/responsepage.aspx?id=XHJ941yrJEaa5f BTPkhkN3O6NNNDDHVJhpatjGu07ZBUNVBZSk9UVUMwOTRPNExJQTFS VUIwNTA4RC4u Learning outcomes • Understand the key issues and topics in, and scope of, health psychology. • Have an in-depth and integrated understanding of the key determinants of health. • Understand and critically evaluate evidence pertaining to the incidence and importance of key health-related lifestyle behaviours (e.g., physical activity, smoking, drinking). • Describe and critically appraise dominant and emerging theoretical models of health behaviour, and the factors that are proposed to underpin positive and negative changes in people’s health-related behaviours. • Critically evaluate health behaviour change interventions and the methods used to assess health behaviours. Structure of the course Lectures: 12 x 2 hour lectures (1 per week) • Lecture slides will be posted on Wattle before the lecture. • Lectures are recorded and should be available within 24hrs. • In some weeks the lecture will be pre-recorded (no live lecture) – keep an eye on Wattle. Labs: 6 x 2 hour labs, weeks 4, 5, 6, 7, 8, & 9. Designed to: • Enhance your understanding of the topics taught in the lectures. • Introduce new material pertinent to the objectives of the course. • Provide guidance with the assessments. Readings: • Will be available on Wattle and will be essential and/or recommended. • Sometimes these will be to be read before labs and there’ll be questions to answer. Expectations/suggestions • Please come to the lectures if you can. ØThis is an in-person course. • Engage with the lecture content and any prescribed readings and tasks before you attend labs. • Please go to the labs. Course teaching staff Teaching assistants: Jasmine Kaur Sareen ([email protected]) Jessica Donaldson ([email protected]) Tutors: Adam Kinasch ([email protected]) Aseel Sahib ([email protected]) Jessica Donaldson ([email protected]) Fiona Xu ([email protected]) Communication In lectures: • Please ask questions. Outside of lectures: • I’ll post announcements on Wattle as and when I need to communicate something with you. • If you have questions or comments about the course/the course content or the assessment you can either post these on the discussion forum on the course Wattle page or email [email protected] • If there are questions that keep popping up or that I think everyone should know about I’ll post these and the answers on Wattle so everyone can see them. • Before you ask questions, please look at the course Wattle page and read the course outline to see if the answers are there. Who to contact with issues/queries • For practical issues about lab classes please contact the TA via course enquires email address. • For queries about content in the labs please contact your tutors. • For queries related to course and program plan, contact Science Central: [email protected] • For requests relating to exams (deferred exam etc.): extenuating circumstances application through ISIS eForms, see: https://www.anu.edu.au/students/program-administration/assessmentsexams/extenuating-circumstances-application • For requests for extensions: https://psychology.anu.edu.au/extensionrequest-form Questions about… Assignment due dates Assignment details/requirements Late penalties for assessments Extensions for written assignments This table can also be found in the Course Outline on Wattle Issues with assignment submission + Wattle Additional feedback on assessments Getting assignments re-marked Special consideration Deferred examinations Alternative assessment arrangements (including extra time during exams) General academic/enrolment/administrative advice Feedback or questions about the course Where to find answers… Course outline (below) and course Wattle page Course outline (below) and course Wattle page Class summary and Course outline (below) Submit application for extension online at: https://psychology.anu.edu.au/extension-request-form – see further details below. Contact TA Contact marker/TA See outline for procedure below/email teaching assistant All requests must be submitted via ISIS e-forms. See: https://www.anu.edu.au/students/programadministration/assessments-exams/extenuatingcircumstances-application and below for further details. All requests must be submitted via ISIS e-forms. See: https://www.anu.edu.au/students/programadministration/assessments-exams/extenuatingcircumstances-application and below for further details. Contact Access and Inclusion services, then teaching assistant. Access and Inclusion: Di Riddell Student Centre 6125 5036 (office phone) [email protected] (e-mail) www.anu.edu.au/students/contacts/access-inclusion (web page) Science Central Peter Baume Building (Building 42) 6125 2809 (office phone) [email protected] (e-mail) Contact student reps/Course convenor Assessment 1 – Mid-semester exam (20%) • Date to be confirmed – most likely Week 7. • Will include mixture of multiple choice and brief response questions. • All course content from weeks 1-6 – from lectures, labs, and essential readings will be assessable. Assessment 2 – Essay (40%; 2500 words max) • Due Thursday week 10 (12th October). Choose a health behaviour intervention from the options provided. 1. Outline why this intervention is needed. That is, describe the behaviour (i.e., the problem) it is trying to address and its importance. 2. Outline the intervention itself and discuss whether and how it’s approach maps against the propositions of health psychology theory or theories. 3. Then, choose one theory that we have covered in the course. Working from that theoretical perspective, describe what you would consider the limitations of the intervention to be (e.g., what does it fail to do) and how you would suggest improving it. Justify your recommendations with evidence from empirical research. Assessment 3 – End of semester exam (40%) • Will be during the end of semester exam period, date to be confirmed – will be an invigilated in person exam. • Will include a mixture of multiple choice and brief response questions. • All course content - from lectures, labs, and essential readings will be assessable. Questions? Student reps • Need 2-3 volunteers to represent PSYC3020. • Role is to provide feedback on the course and raise issues on behalf of the student cohort. • Application form on the course Wattle site. • Complete the form and send this to [email protected] by 4th August. Introduction to Health Psychology A brief history lesson… The biomedical model • Modern medicine born in 19th century and the dominant perspective was the biomedical model. • Argues that: ØDiseases come from outside the body, invade the body and cause physical changes, or originate as involuntary internal physical changes. ØIndividuals are not responsible for their illness. ØResponsibility for treatment should lie with the medical profession – vaccination, surgery, chemotherapy etc. ØMind and body are separate – illness can have psychological consequences but not psychological causes. ØHealth and illness qualitatively different – you are either ‘healthy’ or ‘ill’. The biomedical model Has stimulated an enormous body of research identifying pathogens for disease and enabling the development of treatments and technologies. But has been criticised and challenged: ØPsychosomatic medicine argued that psychological factors can also contribute to causing illness. ØBehavioural medicine emphasised a focus on prevention and intervention rather than just treatment. The emergence of health psychology • Relatively new discipline – developed in the 1970s and 1980s. Argues that: ØIllness (and health) is determined by a range of biological, psychological, and social factors. ØIndividuals are at least partly responsible for their health. ØHolistic approach to ‘treatment’ needed – e.g., encourage behaviour change, changes in beliefs, and compliance with medical recommendations. ØThe mind and body interact to influence health. ØThe mind plays a role in both the cause and treatment of illness. ØHealth exists on a continuum… The illness/wellness continuum The Biopsychosocial model (Engel, 1977, 1980) Biological Social Health Psychological Biological • Genetics • Physiology • Sex • Age • Immune system • Viruses • Bacteria Psychological: • Cognitions • Personality • Emotions • Motivations • Behaviours • Beliefs • Coping skills • Stress Social: • Class • Poverty • Education • Ethnicity • Environment • Medical care • Social norms • Family relationships Example: biological factors (e.g., genetic predisposition), psychological factors (e.g., smoking and not having the motivation to quit), and social factors (e.g., work colleagues all smoking) contribute to the development of a particular disease (e.g., lung cancer). What are some of the goals of health psychology? • To understand how all facets of our lives impact our physical health. Øi.e., biological, psychological, and social factors. • To use this knowledge to help promote health, prevent illness, and improve healthcare systems and policies (e.g., see APA). How? • Often through a focus on people’s behaviours. • By developing and testing theories of human behaviour and motivation that seek to specify the (psychological) factors and processes that impact our behaviours. Health versus clinical psychology • Sometimes a distinction is made between health and clinical psychology, where the focus of health psychology is seen as physical health and the focus of clinical psychology is mental health. • However, this increasingly seems artificial and arbitrary. • Clear crossover and often comorbidity. For example: ØSomeone with physical health problem (e.g., cancer) may well have associated mental health issues (e.g., suffer from anxiety/depression). ØSomeone suffering from anxiety might engage in unhealthy behaviours (e.g., smoking). What is health? “A state of complete physical, mental and social well-being and not merely the absence of disease and infirmity” (World Health Organization, 1948) Why do we need health psychology? Causes of death comparison 1900 and 2010 Source: Jones et al. (2012): https://www.nejm.org/doi/full/10.1056/NEJMp1113569 Leading underlying cause of death (by sex), 2019, Australia https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/leading-causes-of-death Changes in causes of death: CDs and NCDs Communicable diseases (CDs): • Result from the infection, presence and growth of biological agents (virus, bacteria, fungi) in an individual host organism. • May be asymptomatic for much or all of their course. Non-communicable diseases (NCDs): • Non-infectious diseases. • Generally long duration (>6 months) and slow progression. • Almost never asymptomatic. • Rarely cured but can be ‘managed’. ØMost premature deaths in Australia (and other developed countries) today are caused by non-communicable diseases. Percent change in total disability adjusted life years (DALYs), 1990 – 2010 • DALYs are a quantitative indicator of the burden of disease (we’ll talk more about these later): —The sum of life years lost from premature mortality plus years of the life with some form of disablement, adjusted for the severity of the disablement. Source: https://www.healthdata.org/infographic/percent-changetotal-dalys-1990-2010 Why the change? Better medical and healthcare systems. A better understanding of disease and disease prevention has helped slow the spread of infectious diseases. • COVID-19 has been the exception – in 2020 COVID-19 became the first infectious disease for a long time to be among the top causes of death in the United States, falling right behind heart disease and cancer. ØBut imagine what the effect of COVID would have been without the medical knowledge we have now and have been able to quickly generate. Changes in life expectancy in Australia (Red=females; blue=males) Source: https://www.healthdata.org/australia See also: Vollset et al. (2020) https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30677-2/fulltext But, NCDs represent a major and growing problem… • People are (increasingly) dying and living in poor health because of NCDs. • What are the key causes of NCDs? ØLifestyle and behaviours E.g., Heart disease, certain cancers etc. are linked to people’s: ØDiet ØPhysical activity ØSmoking ØAlcohol consumption Khaw et al. (2008) • Recruited >20,000 people with no known heart disease or cancer. • Measured 4 key health behaviours: not smoking, being physically active, only drinking alcohol moderately, and eating 5 portions of fruit and veg a day. • 11-years later, controlling for age, gender, BMI, and socioeconomic status, found that those engaging in none of the healthy behaviours were 4 times more likely to have died than those engaging in all 4. • Those who engaged in all 4 behaviours demonstrated the health of someone 14 years younger than someone who engaged in none of the behaviours. Feigin et al. (2016) • Found that, globally, >90% of the stroke burden (measured in DALYs) is caused by modifiable risk factors. • 74.2% due to 3 behavioural factors: Smoking Poor diet Low physical activity Health psychology (and health psychologists) can help: • Determine the distribution of disease and the health needs of populations and communities. • Examine the factors that predict people’s engagement in behaviours that positively and negatively impact their health. • Design and advise on public health education programs and interventions to promote healthier behaviours. • Work with community members to improve their health behaviours. • Pass on their knowledge and skills in how to facilitate behaviour change to health and social care practitioners – i.e., train the trainer (e.g., see Lawrence et al., 2016) *Health behaviours = Any behaviour that is related to the health status of the individual (Ogden, 2019) Week/lecture Topic Lab? 1 Introduction to health psychology 2 Health-related behaviour 1 (smoking & alcohol) 3 Health-related behaviour 2 (healthy eating & diet, guest) 4 Health-related behaviour 3 (physical activity + exercise) ✓ 5 Models of health behaviour 1 ✓ 6 Models of health behaviour 2 ✓ 7 Models of health behaviour 3 ✓ 8 Health interventions & changing behaviour ✓ 9 Critical health psychology (guest) ✓ 10 Wellbeing (guest) 11 Stress (guest) 12 Course summary and exam preparation & revision Questions? Burden of disease Why is it useful? • Can help us to understand the relative impact of different diseases/illhealth conditions. ØThis, in turn, can help tell us which ones it’s most valuable to focus on. ØE.g., If we know that a particular disease with behavioural causes or risk factors (e.g., heart disease or HIV) is exerting a particularly large burden then it tells us we need to invest some time, money, and energy into changing those behaviours. • Also allows us to assess whether our efforts are making a difference (i.e., by tracking burden over time). Measuring the burden of disease • Healthcare costs • Hospitalisations • Days of work lost (i.e., number of sick days and thus productivity lost) • Mortality • Disability Adjusted Life Years (DALYs) Disability Adjusted Life Years (DALYs) • Are a widely used measure of disease burden. • Developed because it was felt that mortality does not give a complete picture of the burden of disease. • Using DALYs, the burden of diseases or factors that cause premature death but little disability (e.g., drowning) can be compared to that of diseases that do not cause (immediate) death but do cause disability (e.g., a cataract causing blindness). ØMore often used to compare the burden of different diseases that cause different amounts of disability and vary in their duration (e.g., different types of cancers). How are they calculated? • Can broadly be thought of as years of healthy life lost. • One DALY represents the loss of the equivalent of one year of full health. Combine: • Years of Life Lost due to premature mortality (YLLs). • Years of life lost due to time lived in states of less than full health (i.e., Years of healthy Life lost due to Disability; YLDs). For a disease or health condition DALYs = YLLs + YLDs • YLLs = the number of cause-specific deaths in the population of interest x a loss function specifying the years lost for deaths as a function of the age at which death occurs. ØE.g., if calculating YLLs for heart disease in Australia in 2022… The number of deaths due to heart disease in Australia in 2022 (approx. 17,000) x the average number of life years lost by the people that died (estimated using life expectancy data). • YLDs = prevalence of the condition in the population of interest (i.e., number of people who have it and for how long) x disability weight ØE.g., if calculating YLDs for chicken pox… 100,000 people x 0.04 of a year (2 weeks) x 0.006 (disability weight for chicken pox) Disability weights: https://ghdx.healthdata.org/record/ihme-data/gbd-2019disability-weights Hypothetical example for a single person • Sheila, an Australian female lives a healthy life until she’s 55. • Between ages 55 and 70 she suffers from severe cardiovascular disease when she passes away. • The life expectancy for Australian women is 80. ØYLL = 1 (i.e., 1 person) x 10 (years of lost life) = 10 ØYLD = 1 (i.e., 1 person) x 15 (years living with the disability) x 0.179 (weight for severe cardiovascular disease) = 2.685 ØDALYs (i.e., years lost of healthy life) = 10 + 2.685 = 12.685 More complicated in reality… For example: • There are different weights for different phases of heart disease, with higher weightings attached to phases that cause greater disability/lifestyle limitations. • It’s likely a person would progress through those stages and the years lived with disability would need to be broken down accordingly. Think about how the numbers would change for populations • Sheila, an Australian female lives a healthy life until she’s 55. • Between ages 55 and 70 she suffers from severe cardiovascular disease when she passes away. • The life expectancy for Australian women is 80. ØYLL = 1 (i.e., 1 person) x 10 (years of lost life) = 10 ØYLD = 1 (i.e., 1 person) x 15 (years living with the disability) x 0.179 (weight for severe cardiovascular disease) = 2.685 ØDALYs (i.e., years lost of healthy life) = 10 + 2.685 = 12.685 According to the Australian Institute of Health and Welfare (AIHW), in 2018… • Australians lost 5 million years of healthy life (DALYs). • 52% of that due to premature mortality (i.e., YLLs) and 48% due to living with illness/disability (i.e., YLDs). • E.g., An estimated 646,000 years of healthy life (DALYs) were lost due to all forms of cardiovascular disease. Researchers have also sought to estimate how many DALYs are caused by unhealthy behaviours • We’ll look at some numbers for smoking, drinking etc. in the coming weeks. Questions? Research methods in health psychology Broad points • Lots of different research methods are used. • Different methods more/less appropriate for different research questions. ØE.g., Qualitative methods might be best suited to understanding people’s experience living with chronic pain but quantitative methods needed to evaluate the efficacy/effectiveness of a new treatment or intervention. • Not all quantitative research methods were born equal… Experimental research (the only type of research that enables causality to be inferred) Observational research (longitudinal) Observational research (prospective) Observational research (cross sectional) Randomised controlled trials (RCTs) • The most stringent way of determining whether a cause-effect relationship exists between a treatment/intervention and an outcome. • Participants are randomly assigned to one of two (or more) groups: ØExperimental group(s) – who receive the intervention/treatment(s) being tested. ØControl or comparison group – who receive an alternative treatment or no treatment. • The groups are then followed up to see if there are any differences between them in the outcome of interest. Source: Kendall (2003), Emergency Medicine Journal Features of RCTs • Normally assess new treatments/interventions vs. established treatments or no treatment. E.g., ØNew treatment for depression versus cognitive-behaviour therapy or medication (e.g., Cruwys et al., 2022; British Journal of Psychiatry). ØNew intervention to increase group exercise participation versus standard exercise group or waitlist control (e.g., Beauchamp et al., 2018; Health Psychology). Features of RCTs (continued) • All groups are treated identically except for the experimental treatment/intervention. • An a priori power analysis should be used to decide the size of the groups. • Allocation to groups is done randomly – ensures there are no systematic differences between the groups which may affect the outcome (e.g., difference in age or income at different locations). • Blinding/Double-blinding (sometimes) – participants/participants + researchers unaware of which group participants are in until the study is complete. Reduces bias, but not always feasible or appropriate. Considerations • Exposing patients to inferior/no treatment or wait-list control condition may be unethical (e.g., not offering best treatment for cancer or to help someone quit smoking). • Costly and time-consuming – require a lot of organising, time spent developing materials/procedures, and often lots of participants to be recruited. What can be better than an RCT? – Systematic reviews and meta-analyses Systematic reviews • “A comprehensive high-level summary of primary research on a specific research question that attempts to identify, select, synthesize, and appraise all high-quality evidence relevant to that question to answer it” (Harris et al., 2013, p.2762) • In short – asks a research question and then answers it by summarising the evidence that meets a set of pre-specified criteria. Steps in a systematic review (see Harris et al., 2013; Khan et al., 2003) 1. Identify an answerable question(s) – not too broad or narrow. 2. Identify eligible work – use a systematic search strategy and apply inclusion and exclusion criteria. 3. Extract studies’ data into a coherent format – a table briefly summarising each article is often included. 4. Evaluate the methodological quality of the studies reviewed. 5. Summarise the findings – address the answerable question(s). Examples… 1. Identify an answerable question(s) – not too broad or narrow. To what extent is social identification associated with objective physical health indicators? (Cruwys et al., in prep) To what extent is social identification associated with objectively assessed or selfreported mental or physical health indicators? To what extent is social identification associated with objectively assessed smoking behaviours? Systematically review and summarise studies examining the association between social support, or loneliness, and physical activity in older adults (60+) (Smith et al., 2017). Systematically review and summarise studies examining the association between social support, or loneliness, and physical activity or healthy eating. Systematically review and summarise studies examining the association between social support and physical activity in adults aged 55-60. 2. Identify eligible work – use a systematic search strategy and apply inclusion and exclusion criteria. Systematic search strategy – things that you have to specify include: • The databases you searched (e.g., MEDLINE, PSYCInfo, SportDiscus, PubMed etc.) • The date you conducted that search. • The dates you searched within (e.g., from the inception of the databases to present day). • The search terms you used. Systematic search strategy example ((“social identi*” or “group identi*” or “organi?ational identi*” or “work* identi*” or “team identi*” or “school identi*” or “family identi*” or “collective identi*” or “neighbourhood identi*” or “group membership*”) and (health or “objective health” or “physical health” or “health behav*” or “physical activity” or “substance use” or “eating behav*” or “life expectancy” or mortality or cardio* or physiol* or stress or cortisol or neuroendocrine or immun* or longevity or illness or muskoskelet*)) Social Identity Social identi* Group identi* Organi?ational identi* Work* identi* Team identi* School identi* Club identi* Family identi* Collective identi* Neighbourhood identi* Group membership* Objective Health Health Physical health Health behav* Physical activity Objective health Life expectancy Mortality Cardio* Physiol* Stress Cortisol Neuroendocrine Immun* Longevity Illness Substance use Eating behav* Muskoskelet* Inclusion and exclusion criteria might relate to • The sample – e.g., limited by age, gender, nationality etc. • Research design – e.g., only interventions, only randomised controlled trials, only longitudinal studies, only quantitative research etc. • The measures used – e.g., only objective, only well-validated etc. Inclusion and exclusion criteria example Inclusion Criteria • Retain studies that use a quantitative research design. • Retain studies that use experimental and correlational research designs. • Include studies that use a measure of social identity (salience), identification with a social group, or multiple group memberships. • Retain studies of both biological and proxy health (behaviour) measures, as long as both are measured objectively (i.e., not self-report). Exclusion Criteria • Exclude studies that do not use experimental and correlational research designs. • Exclude studies that use a qualitative research design. Once you’ve conducted your searches and decided on your inclusion and exclusion criteria there’s lots of screening to do! • First title and abstract. • Then full text for papers that are considered potentially eligible. The end result – a PRISMA diagram Example from Steffens et al. (2021; Health Psychology Review) 3. Extract studies’ data into a coherent format – a table briefly summarising each article is often included. From Smith et al (2017) - The association between social support and physical activity in older adults: A systematic review 4. Evaluate the methodological quality of the studies reviewed. • Loads of different tools for this, focusing on quality and risk of bias. • Can involve the authors rating the papers against pre-set or agreedupon criteria. • Results can be summarised in various ways… Steffens et al. (2021; Health Psychology Review) • Bar chart shows percentage of studies in their review that were considered to have a high, low, or unclear risk of different types of bias 5. Summarise the findings – address the answerable question(s). • Harris et al. (2013) suggests that the review’s conclusions should answer the question: ‘‘If a reader were to remember one thing about my review, what would it be?’’ • In reality, the questions being examined are often nuanced and there may be multiple things to address in a summary. • But, in addition to a Discussion section, incorporating a succinct summary statement is good practice. Examples - Smith et al. (2017) “In general it seems social support specific to physical activity is an important factor assisting older adults to be physically active, especially when coming from family members. The evidence also highlights the importance of friend support for leisure time physical activity in older adults. In terms of general social support, there does not seem to be an association with physical activity, however with far fewer studies investigating this relationship, more studies are needed to either confirm or challenge this finding. Finally, the moderate quality loneliness studies suggest a negative association between loneliness and physical activity levels, especially in females.” Examples - Steffens et al. (2021) “Key results show that social identification-building interventions have an overall moderate-to-strong positive effect on health outcomes. Furthermore, the benefits of these interventions are similarly strong across a variety of outcomes ranging from reducing aversive experiences such as depression and anxiety, to building positive experiences such as physical health and quality of life. At the same time, interventions involving group-relevant decision-making and therapy interventions had relatively large effects, while those involving shared activities and reminiscence had relatively small effects.” Meta-analyses • Use statistical methods to quantitatively evaluate pooled data from single studies, generating an average result. • Individual studies are assigned a weight in the analysis based on the sample size. • Meta analyses add value because they can produce a more precise estimate of the effect of a treatment than considering each study individually. Example: Steffens et al. (2021) - Social identification-building interventions to improve health: a systematic review and meta-analysis What can be better than systematic reviews and meta-analyses? Reviews of systematic reviews and meta-analyses! Questions? Reading (all on Wattle) Essential: Kendall, J. (2003). Designing a research project: Randomised controlled trials and their principles. Emergency Medicine Journal, 20(2), 164-168. Recommended: Harris, J. D., Quatman, C. E., Manring, M. M., Siston, R. A., & Flanigan, D. C. (2014). How to write a systematic review. The American Journal of Sports Medicine, 42(11), 2761-2768. Khan, K. S., Kunz, R., Kleijnen, J., & Antes, G. (2003). Five steps to conducting a systematic review. Journal of the Royal Society of Medicine, 96(3), 118-121. Appendices – Where to find Health Psychology Research The growth of the discipline has meant that there are now numerous established journals that specialize in publishing research in the area. Journals with a broad scope include: • • • • • • • • Health Psychology Health Psychology Review British Journal of Health Psychology Journal of Health Psychology Psychology and Health Applied Psychology: Health and Well-being Annals of Behavioral Medicine Journal of Behavioral Medicine Addiction, smoking, and drinking journals ØAddiction ØJournal of Addictive Behaviours ØJournal of Behavioral Addictions ØPsychology of Addictive Behaviours ØJournal of Studies on Alcohol and Drugs ØDrug and Alcohol Review ØNicotine and Tobacco Research Healthy eating/diet journals • International Journal of Behavioral Nutrition and Physical Activity • Appetite • Journal of Nutrition • Public Health Nutrition • Nutrients • Obesity Reviews Physical activity + exercise journals • International Journal of Behavioral Nutrition and Physical Activity • Journal of Physical Activity and Health • Psychology of Sport and Exercise • Sport, Exercise and Performance Psychology • Journal of Sports Sciences • Scandinavian Journal of Medicine and Science in Sports • Sports Medicine