This is the Chapter 7 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. 7: Health problems prevented

Screening:

• OXCHECK Study Group (1994): invited to attend a ‘health check’, participants were advised healthy-initiatives when necessary --> one-year follow-up, participants’ blood pressure levels were lower than those of people who did not take part in the screening programme
• Body Mass Index: measurement relative percentages of fat/muscle mass body à BMI = weight (kg) divided by height (m) squared
• Colposcopy: low-power microscope to identify cells may develop into cancer of the cervix. Sometimes follows a cervical smear if abnormalities are found.
• Cervical smear: smear of cells taken from cervix --> examine presence of cell changes indicating risk of cancer.

Motivational interviewing:

• Integration of motivational interviewing or similar techniques within more complex intervention programmes --> really adds to the effectiveness of the programme

Problem-focused approaches:

• Health Action Process Approach (HAPA; Schwarzer and Renner 2000): identified planning as an important determinant of behavioural change. These approaches have simply encouraged individuals to plan when, how, or under what circumstances they will engage in their behaviour of choice

Reducing anxiety:

Barriers to attending screening for risk of disease is anxiety about its outcome

• Risk assessment process: patients given the coping booklet were less anxious

1. Coping booklet: information about the procedure they were about to experience, information on the likely outcomes of the procedure, and instructions on relaxation and distraction techniques could use to help them to cope before and during the procedure
2. Medical booklet: more details on the nature of cervical abnormalities, the procedure and its likely outcomes, not suggest any coping strategies

Mass media:

• ‘Hypodermic’ model of behavioural change: assumed a relatively stable link between knowledge, attitudes and behaviour
  • “if we could ‘inject’ appropriate information into the recipients, this would change their attitudes and in turn influence their behaviour”
• Adequate source:
  • Expert
  • Account population
• Huberty et al. 2012: media campaigns are best used to raise awareness of health issues rather than attempts to engender significant behavioural change,
• Cumulative effects: repeating media campaigns --> change people’s beliefs/behaviours
• Methods to maximise media effectiveness:
  
  • Refining communication to maximise its influence on attitudes
    
    • Elaboration Likelihood Model: information containing carefully chosen peripheral cues can facilitate attitudinal change in people who are relatively unmotivated to consider particular issues --> enhanced effectiveness when combined with central processing
  • use of fear messages
• If fear messages are used, they need to be accompanied with simple, easily accessible strategies of reducing the fear
  
  • Protection Motivation Theory: response info depend severity threat and ability to do something about it
    
    • strong fear-defensive responses: when strong levels of fear and outcome of which is the maintenance of the old behaviour rather than behavioural change
  • Information framing
    
    • Neutral approach
    • No strong prior judgment about type of framing
  • Specific target interventions
    
    • Audience targeting:
      
      • behaviour, age, gender and socio-economic status
      • level motivation to consider change

Environmental interventions:

• Cues of action: use to promote/remind healthy behaviour (exposure advertisements increases perception prevalence smoking/alcohol

• Minimize cost healthy behaviour --> to stimulate walking/jogging, trees and good road surface
  • needle-exchange schemes: exchange old for new needles, preventing the need for sharing and reducing the risk of cross-infection of blood-borne viruses
  • Healthy Cities movement
• Maximize cost healthy behaviour --> act as a barrier to unhealthy behaviour and a facilitator of healthy behaviour
  
  • Change alcohol prices
  • Bans

Health programs:

Coronary Heart Disease (CHD):

• Stanford Three Town Project: intervention decreases risk of CHD. 3 interventions levels:

• First city: no intervention
• Second city: received media campaigns focused CHD
• Third city: people increased risk CHD, one-on-one intervention, report positive effects media
• --> CHD scores fallen most in 3^rd city

• Disappointing data in other studies, due to contextual influences. Such as what happened in Heartbeat Wales, its ‘control’ area was in the northeast of England, which itself was subject to large-scale heart health programmes conducted in England at the same time as Heartbeat Wales. It was certainly not a ‘no intervention’ control.
  • European equivalent of this study --> not consistently better than those in a control area
  • Five City project --> found no difference in smoking and risk levels for CHD
  • The Minnesota Heart Health programme --> little impact on health and health behaviour
  • Community Intervention Trial for Smoking Cessation (COMMIT) --> did not change heavy smokers’ behaviour

HIV infection:

• Modelling and Reinforcement to Combat HIV (MARCH):
  • use of the media --> entertainment that educates
  • use of local influences of change
• --> Successful cessation intervention because:
  • AIDS prevention programs use communication between friends
  • Nature of disease

Workplace health:

• Reduces health insurance cost and people get sick less often:
  • Screening risk factor
  • Health education
  • Healthy options
  • Economic incentives for risk behaviour change
  • Social support
  • No-smoking areas
• Mujtaba and Cavico (2013) outlined a range of interventions applied in workplace categorized into carrots or sticks:
  
  • Carrots: free gym membership/provide low-fat meals
  • Sticks: increasing ‘deductibles’ for employees with unhealthy lifestyles who fail to meet health-care standards/not hiring job applicants who are smokers.

School-based interventions:

• WHO health-promoting schools initiative: integrated approach to enhancing health, preventing uptake of unhealthy behaviour and educating pupils about health-promoting activities
  • Rules (no candy allowed)
  • Healthy physical/social environment
  • Health services within school
  • Education health-related topics
  • Offer healthy food
  • Peer education: class discussions/ conversations one-on-one
    
    • Can involve training influential pupils in a school about a particular health issue
    • Health promotion staff
    • School counselling/psychological programmes
    • PE program
• --> Info healthy behaviour most effect when environment makes behavioural change easy

Technology:

• Useful when interactive aspect to intervention
• Australian study: allowed people to ‘photoage’ a photograph of themselves to see how they would look in the future as a smoker and a non-smoker
• Schulz et al. (2014): participants received feedback via the internet, tailored motivational feedback, in a sequential flow addressing one behaviour at a time --> showed significant gain