Health Behaviors

Health Behaviors: Why do we care?

  • Epidemiogical Transition
  • Health care is ill equipped to cope with chronic disease 
  • Prevention of problems is much more effective than treatment 

Healthy Behavior
Actions that individuals and groups undertake (or avoid) to maintain a healthy body and mind
Health Promotion
Process of enabling people to increase control over, and to improve, their health (WHO)
Health promotion consists of:

  1. Education 
  2. Social Marketing 
  3. Public Policy

Individual Health Behavior Theories

  • Health Belief Model (HBM)
  • Theory of Planned Behavior (TPB)
  • Transtheoretical Model (TTM)

Health Belief Model (HBM)

  • Oldest and most widely used 
  • Motivated by: 
    • Perceived susceptibility 
    • Perceived severity 
    • Perceived benefits 
    • Perceived barriers 
    • Cues to action 
    • Self-efficacy 
  • Value expectancy model 
    • People engage in healthy behvaior if they value the outcome and they think behavior will result in outcome

Critiques of HBM

  • Focuses on individual, doesn’t address social and enviornmental factors that influence decisions 
  • Doesn’t account for disparities in knowledge/access to health-related information

Theory of Planned Behavior (TPB)

  • Focuses on rational, reasoned behavior
  • Behavioral intention (as opposed to attitude) is a better indivator of behavior 

Components of TPB

  • Attitude 
    • Attitude towards outcome 
  • Subjective Norms
    • Motivation to conform to perceived norms 
  • Behavioral Intention
    • Intention to perform behavior 
  • Perceived Behavior Control 
    • Contextual factors that make it easy/difficult to perform behavior 
  • Perceived Power
    • Amount of power they believe they have over performing behavior

TPB Critiques

  • TPB assumes that behavior is the result of rational decision making 
  • “Perceived” part is difficult 
    • May have little to do with their actual ability to perform a behavior
  • Time 
    • Does intention wane over time? 

Transtheoretical Model (TTM)

  1. Pre-contemplation 
  2. Contemplation 
  3. Preparation 
  4. Action 
  5. Maintenance 
  6. Relapse

TTM Critiques

  • People don’t go through fixed stages 
  • Measurement of stages may be difficult or arbitrary 

Social Theories

  • Social Cognitive Theory 
  • Social Network Theory 
  • Diffusion of Innovations 
  • Social Marketing 

Social Cognitive Theory (SCT)

  • Back and forth interaction between enviornment and people that influence behavior 
  • Individual Characteristics 
    • Self-efficacy 
    • Behavioral capability 
    • Expectations 
    • Expectancies 
    • Self-control 
    • Emotional coping 
  • Environmental Factors 
    • Vicarious learning 
    • Situation 
    • Reinforcement 
    • Reciprocal determinism 

SCT Critiques

  • Complexity 
    • A lot of factors
  • Evolutions never get rid of old constructs

Social Network Theory (SNT)

  • Relationship between and among individuals are more important in determining behavior 
    • More inclined to follow what people are doing around you 
    • People around you also determine the kind of information you have access to 

SNT Relationship Characteristics

  • Centrality vs. Marginality of Individuals 
  • Reciprocity 
  • Complexity or Intensity of Relationships
  • Homogeneity vs. Diversity 
  • Subgroups and Linkages
  • Communication Patterns 

SNT Critiques

  • Limited to small or defined groups 
    • Difficult to define groups –> where is the cutoff?
  • Labor intensive and difficult

Diffusion of Innovations
Process by which a behavior or technology makes its way into a population and is (or is not adopted) 
DOI: Innovations are adopted by different cateogories of adopters

  1. Early adopters 
  2. Early majority adopters
  3. Late majority adopters 
  4. Laggards

Social Marketing
Using marketing theories to encourage people to engage in healthy behaviors 
Social Marketing: The Four P’s

  • Product
    • Exercise/behavior itself 
  • Price 
    • Cost/benefits of engaging in behavior
  • Place 
    • Accessibility
  • Promotion 
    • Way we communicate to people about the product
  • (5th) Participation 
    • Need people to engage in behavior

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