This is the Chapter 5 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch.5: Health behaviour explained

Distal influences health behaviour:

• Proximal: beliefs/attitudes towards health-risk/health-protective behaviour. Can mediate distal influences
  • Teenage seek autonomy --> smoking behaviour/take health-related decisions for themselves
• Mediator: explain how/why relationship exists between 2 variables --> effects age upon behaviour, mediated health beliefs
• Moderator: explain conditions under which relationship between variables exist à individual beliefs/behaviour different depending gender/health status

Personality:

• Particularly enduring traits regardless situation
• Eysenck’s three-factor model: personality reflected scores along 3 dimensions:

1. Extroversion: outgoing social nature/ Introversion: solitary nature
2. Neuroticism: guilt-ridden nature/ Emotional stability: contented nature
3. Psychoticism: antisocial nature/ Self-control: considerate, obedient nature

• McCrae and Costa’s five-factor model: (the Big Five)
  • 4 of those validated different cultures --> relatively stable and enduring
  • Conscientiousness: health-protective behaviour --> Neuroticism: health-risk behaviour
    • Neophobia: chronic fear of anything new
• Locus of control: trait distinguish attribute responsibility for event to themselves (internal LoC) or external factors (external LoC)
  • Health Locus of control: perception one’s health under personal/professionals/external factors control
    • Internal: consider themselves prime determinant heir health state
      • Low levels internal LoC, higher perceived risk/lower intention engage prevention
    • External/chance: external forces determine health state
    • Powerful others: health state determined actions powerful others(health professionals)
• Perceived behavioural control: beliefs personal control over specific action/behaviour --> about behaviourally specific and proximal constructs
• Self-efficacy: belief one can perform particular behaviour in given set circumstances
• Dispositional pessimism: generally negative outlook on life, tendency anticipate negative outcomes.

Self-determination theory:

• Personality effect motivations (intrinsic/extrinsic) for behaviour --> motivation from inherent personal satisfaction/reward
• Extent behaviour is self-motivated. Influenced by needs of competence/autonomy/relatedness others

Social influences:

• Learn form experiences/vicariously
• Social norm: implicit/explicit approval for certain behaviours/values/beliefs
• Descriptive norms: assumptions of what relevant others do
• Injunctive norms: norms proscribe bow others want you to behave

Self-regulation behaviour:

• Health protective/risk behaviours: based outcome expectancies, thus behaviours tend to be goal-directed --> Social cognition theory: highlights explanatory role of cognitive factors
• Self-regulation: cognitive/behavioural processes, guide/control/modify/adapt to responses --> enable achieve desired outcomes/reduce undesired outcomes --> maintain sense of normal function
  • SMART: goal-setting related behavioural change techniques
  • Inability control --> may increase impulsivity/risk-taking behaviour
  • Attentional control: extent person focus activities/goals and avoid being distracted
  • Action control: self-regulation of behaviour

Models of Health Behaviour:

• Attitudes: common-sense representations hold in relation to objects/people/events --> relatively enduring and generalisable, made up 3 related parts:

1. Cognitive: belief about attitude-object (smoking is cool)
2. Emotional: feelings towards attitude-object (Smoking is pleasurable)
3. Behavioural (or intentional): intended actions towards attitude-object (I am going to smoke)

• Ambivalence: existence positive/negative evaluations of attitude-object
• Social desirability bias: people report about oneself/one’s behaviour in way thought to meet with social (or interviewer) approval.
• Implicit attitude: attitudes activate unintentionally in response symbolic presence of an attitude-object (stimulus) and which therefore don’t require cognitive effort of explicit attitudes.
• Personal relevance and perceived risk --> shape/challenge/change initial attitudes

Risk perception:

• Individually generated cognitions, extent person considers themselves as facing potential harm
• Unrealistic optimism (optimistic bias): less likely than comparable others to develop illness/experience negative event.
  • Lack personal experience with behaviour/problem concerned
  • Belief individual actions prevent problem
  • Belief if problem has not emerged yet, it won’t future
  • Belief problem is rare
• --> Importance asses context which beliefs arise

Self-efficacy:

• Less predictive outcome: when competence one’s performance unrelated to outcome

Sociocognitive models behaviour change:

• Describe how encode/process/interpret/remember and then learn from and use information form social interaction --> to make sense behaviour others/world
• Social cognitions: shape judgments/attitudes/responses --> shape behaviour
• Behaviour 3 types expectations:
  • Situation-outcome expectations
  • Outcome expectations
  • Self-efficacy expectations
• --> Social cognitive theory: expectancies may provide incentives to change

The Health Belief Model (HBM):

• Cognitive model, likelihood person engage particular health behaviour depend demographic factors --> 4 beliefs arise from internal/external cue to action (examples obesity)
  • Perception of threat: ideas about how obesity affects heart/vascular diseases
  • Evaluation behaviour: realization you’re overweight
  • Cues to action:
    • Internal: being out of breath when walking
    • External: watching cooking program
  • Health motivation: health improve after fighting obesity
• Critics:
  • Says nothing element working together --> other studies evidence interaction elements
  • Benefits should be weighed against obstacles
  • Suggests beliefs occur simultaneously, is a static model
  • Importance severity of disease --> studies show not necessarily major impact on behaviour
  • Limited attention social/Mood influence
  • Overestimate role of threat

The Theory of Reasoned Action (TRA):

• Behaviour determined someone’s view/perceptions/expectations about behaviour --> focus goal
• Intention: proximally influences behaviour, and it’s influenced by attitudes
• Outcome expectancy belief: someone’s expectation outcome value --> motivation behind behaviour
• Attitudes & Subjective norm: someone who does not feel like losing weight, might do so because subjective norms convince them

The Theory of planned behaviour:

• Conscious/controlled behaviour --> alleged control: variable to include uncontrolled behaviour
• Beliefs: formed by behaviour and possible success in past
  • Illness representation: beliefs particular illness/state of ill health --> explain 22% variation behaviour, TPB adds 7%
• Variables not included model, also predict behaviour:
  • Moral norms (not only social norms)
  • Regret earlier behaviour
  • Identity (someone sees himself as environmentally aware)
• Implementation intentions (II): intention/behaviour step in between. About making specific plans
  • Goal intention: describes behaviour will take place, but nothing about when/where/with whom/how
• --> TRA and TPB static models, unlike phase models, describe different steps

Stage models of behaviour change:

1. System define stages
2. Order stages
3. Similar barriers within same stage
4. Different barriers at different stage

Transtheoretical model (TTM):

• Processes/problems differ per face and are independent
  • Pre-contemplation: does not think about changing behaviour, not intention change in 6 months
  • Contemplation: realization something might have to change --> start looking info about problem/healthier behaviour
  • Preparation: ready change and make plans --> motivation + believing yourself important
  • Action: starts with healthy behaviour --> realistic goals + social support important
  • Maintenance: continues healthy behaviour and resist temptation
  • Termination: individual idea of falling back into healthy behaviour
  • Relapse: falling back old behaviour or going back one phase

Precaution Adoption Process Model (PAPM):

• Assume people go step by step though faces, but no specific time for transitions determined

1. Unaware: not aware health hazard
2. Unengaged: aware of risk, but there is unrealistic optimism
3. Consideration: considering something should happen and whether they’re willing to change things
4. Decide not to act: aware risk, decide not to change behaviour
5. Decide to act: make decision take action
6. Action: action
7. Final stage: not always reached by everyone, questionable how long new behaviour will be sustained

The Health Action Process Approach (HAPA):

• Model phases, transition intention/behaviour included
• Belief own abilities/action plans major role model
• Motivation phase: awareness risk content/personal aspects contribute to this