medicine Sometimes, they are used interchangeably with “health psychology” It is a specialty area that discover how health and illness are influenced by biological, psychological and social factors (Cherry, 2020a) It concentrates on How biology, psychology, behavior, and social factors link to health and illness Promoting and maintaining health The prevention and treatment of disease and illness Exploring how people response to, handle with, and get well from illness
to health psychology It was introduced in 1978 (Sarafino & Smith, 2011) Joseph Matarazzo is the first president of the Division in 1982 Four goals To promote and maintain health To prevent and treat illness To determine the causes and diagnostic correlates of health, illness and related dysfunction To improve health care systems and health policy
are caused by many factors Contagious and hereditary illness They are common The whole physical well-being and different medical conditions They are the results of various behavioral and psychological factors
of infectious diseases In the U.S., life expectancy is about 80 years (Cherry, 2020) The leading causes of mortality are chronic diseases Such as heart disease and stroke Which are always connected to lifestyle Behavior that causes disease and death
Psychology? It stresses on how the health is influenced by the behavior It guides people to change the behaviors that leading to health and well-being (Cherry, 2020) For example, psychologists might conduct applied research on How to prevent unhealthy behaviors like smoking Look for new ways to encourage healthy actions like exercising
not good for their health Problem People still want to eat Reason They do not care about the consequences Discovering at their psychological factors that cause these health choices, psychologists find ways to encourage people to make better health choices (Cherry, 2020)
Centers for Disease Control National Center for Health Statistics collects data about death with its justification. In the CDC report in 2012, half of the deaths are avoidable. Heart disease and stroke Cancer Chronic lower respiratory diseases Primarily chronic obstructive pulmonary diseases (COPD) Like emphysema and chronic bronchitis Drug poisonings Including overdoses Fatal falls among an increasingly elder population a. b. c. d. e.
psychology (Mason, Roy, Spillane & Singh, 2016) A mixture of the following factors are linked to health and illness Biological factors Genetic conditions + inherited personality traits Psychological factors Lifestyle + personality characteristics + stress levels Social factors Cultural beliefs + family relationships + social support systems
A framework developed by George L. Engel States that interactions between biological, psychological, and social factors Determine the cause, manifestation, and outcome of wellness and disease Historically, (Lumen Boundless Psychology, n.d.) The nature versus nurture debate argued that Any one of these factors "was" sufficient to change the course of development The biopsychosocial model argues that Any one factor "is not" sufficient that determine the course of their health-related outcomes
Smith, 2011) Genetic materials and processes of our parents that we inherit characteristics from Function and structure of the person’s physiology contain structural defects Malformed heart valve Damage in the brain
learning + perceiving Problem solving + remembering + thinking Example (Sarafino & Smith, 2011) Imagine You enjoyed smoking cigarettes Question Would you stop to lessen your chance of getting cancer or heart disease? Response Probably not
Our thoughts, behavior and physiology Two types of emotions (Sarafino & Smith, 2011) Positive or pleasant - joy Negative - anger and fear Emotions relate to health and illness in various ways If comparing people whose emotions are relatively negative People whose emotions are relatively positive Less disease-prone More likely to take good care of their health Recover quickly from an illness
Why people behave the way they do? Why they start some activity, choose its direction and persist in it? Example Parents who stop smoking. Why? Because their child explain to them for their health protection
(Lumen Boundless Psychology, n.d.) Like losing a job or ending a romantic relationship may place one at risk of stress and illness The role of social factors (Sarafino & Smith, 2011) Family Friends Community Society
2011) Children learn from their parents, brothers and sisters Attitudes Beliefs Health-related behaviors Good examples for healthful behavior of parents Exercising Not smoking Using seat belts Serving and eating nutritious meals
& Smith, 2011) We influence them and they influence us An example of being influenced by peer pressure Adolescents often start Smoking cigarettes Drinking alcohol In their friend zone, they want To be popular To look “cool” or “tough”
another like in the same town or country Organization like government An example of the environmental characteristics of a community There are many green parks in the community It encourages the residents to do Walking or running Other physical activities Residents will be more active in the community (Sarafino & Smith, 2011)
Promoting certain values of our culture like being fit and healthy is good Example of the mass media (Sarafino & Smith, 2011) It shows these values by setting good examples, like Urging us to eat well Not to use drugs Not to drink and drive Sometimes, it shows celebrities on TV with unhealthful behaviors like Smoking cigarettes Drinking excessively
Biopsychosocial Model (Sarafino & Smith, 2011) The person consists of biological and psychological systems, which interrelate; and each of the systems includes component systems. The person interrelates with the social systems of his or her world. Each system can affect and be affected by any of the other systems.
that The workings of the body, mind, and environment all affect each other None of these factors in isolation Is sufficient to lead to health or illness It is deeply related to all of the three factors that leads to an outcome (Lumen Boundless Psychology, n.d.)
of biology Can confuse treatment versus etiology If true, it is trivial Inconsistent about the mind/body relationship Limited resistance to rebirth of biological dogmatism Not more advantageous than Osler’s medical humanist model Poor model to show costs and managed care Poor teaching tool when simplistically applied Presumes psychiatric superiority to other mental health disciplines Unclear boundaries
Is the “state of holistic physical, social and spiritual well-being, with the presence of illness” according to World Health Organisation (Rieger, 2017) Health behaviour is defined as “Activities that may assist to avoid disease, notice disease and disability at an early stage, encourage or enhance health or protect from risk of injury” Health promotion Targets behaviours likely to lessen the burden of illness within the population
(National Cancer Institute, 2005) The most commonly used theories of health behavior (Glanz, n.d.) Social Cognitive Theory Transtheoretical Model/Stages of Change Health belief model Theory of planned behavior Three commonly used health behaviour change models at the individual level (Bishop, 2014) will be discussed Health belief model Theory of planned behaviour Transtheoretical model 27
famous models for changing to healthy behaviour (Morrison & Bennett, 2016) In the early 1950s , social scientists at the U.S. Public Health Service developed it to examine (Behavioral change models, n.d.) Why people reject screening tests in the early detection of disease What are the patients' reaction to symptoms and take medical treatments in the later uses Good for predicting simple, one-time or limited behaviors like immunizations than habitual behaviors (Lakhan, 2006) It proposes that a person's belief in the following will predict the likelihood the person will adopt the behavior A personal threat of a disease or illness The effectiveness of the recommended health behavior or action
enough to have a negative consequence "I believe that coronary heart disease (CHD) is a serious illness contributed to by being overweight" Perceived susceptibility The condition may hurt the individual on any aspect of the biopsychosocial model "I believe that I am overweight" (Lakhan, 2006 and Morrison & Bennett, 2016)
lower, or lessen the affect, risk, and consequences of the condition, respectively "If I lose weight, my health will improve" Perceived barriers (to change) The corrective/preventive benefits outweigh the psychological and physical harms of abiding to the advised behavior "Changing my cooking habits will be difficult, and possibly more expensive" (Lakhan, 2006 and Morrison & Bennett, 2016) Behavioural Evaluation
cue, or both, that trigger the individual to finally act (Lakhan, 2006 and Morrison & Bennett, 2016) External cues "That recent television programme on obesity worried me" Internal cues "I feel breathless when I go upstairs, so maybe I should lose some weight" Health Motivation "My health is important to me"
influences are limited Does not explain how variables interact Does not allow for a dynamic “shift” into change Effectively to predict breast self-examination Not predictive of condom use (threat perceptions are weaker)
Theory of Reasoned Action in 1980 (Behavioral change models, n.d.) It proposes that both ability (behavioral control) and motivation (intention) are depended by the behavioral achievement To find out a person’s intention to perform a behavior, three judgments indicated by the theory are (Sarafino & Smith, 2011) Attitude regarding the behavior Subjective norm Perceived behavioral control An example of a scenario: Zoey has planned to start exercising a. b. c.
“would be good for me to do” This judgment is based on two expectations (Sarafino & Smith, 2011) The likely outcome of the behavior “If I exercise, I will be healthier and more attractive” Whether the outcome would be rewarding “Being healthy and good looking will be satisfying and pleasant” a. b.
influence on the behavior’s acceptability. (Sarafino & Smith, 2011) Zoey has decided that exercising “is socially appropriate thing for me to perform” This decision is based on: Her beliefs regarding others’ opinions about the behavior “My family and friends think I should exercise” Her motivation to follow those opinions “I want to do according to their expectations ” a. b.
contemplated behavior (similar to the self- efficacy concept) Zoey thinks she can exercise and follow the program (Sarafino & Smith, 2011) Perceived Behavioral Control
the following, she probably wouldn’t generate an intention to exercise “Exercising is a waste of time” “I do not care about my family’s opinion” “I will never find time to exercise” Self efficacy is a critical component (Sarafino & Smith, 2011) People evaluate their efficacy on the basis of the effort required, complexity of the work and other condition with the given support from others
received the chances and information to be successful in doing the desired behavior regardless of the intention Does not consider for other variables that cause the behavioral intention and motivation, like fear, threat, mood, or past experience Normative influences are considered, but not environmental or economic factors that may affect a person's intention to do Assumes that behavior is the consequence of a linear decision-making process, and does not consider that it can change in the future The added construct of perceived behavioral control was an important addition to the theory, but nothing is considered about the actual control over behavior The time frame between "intent" and "behavioral action" is not considered
Change Model Developed by Prochaska and DiClemente in the late 1970s Formulated through studies mostly for smoking cessation in 1991 (Behavioral change models, n.d.) This model has been employed in many other behaviours who are ready to change, like (Morrison & Bennett, 2016) Alcohol use, cocaine use, condom use, dietary fat intake Exercise, mammography screening, sunscreen use
plan for intentional and behavioural change which is not made immediately and decisively (Behavioral change models, n.d.) Instead, the change in habitual behavior happens endlessly via a cyclical process or a spiral linear pattern that the person may move forward or backward until the change is accomplished (Lakhan, 2006) It is a model, not a theory, because different behavioral theories can be effectively used on different stages They are the stages of motivational readiness (Morrison & Bennett, 2016)
Sarafino & Smith, 2011 and Morrison & Bennett, 2016) Precontemplation No idea about the problem or overlook its consequences "Having a weight problem" Contemplation Thinking to change their behaviour after realizing the issue within the next six months "I think I need to lose a bit of weight, but not quite yet" Preparation Ready to change, and set goals within a specific period of time, within three months "Changing to healthy food option for diet" Action The behaviors are obviously adapted to make a change, usually six months "Start eating fruits instead of snacks or junk food"
over six months Maintain the dietary change and resists temptation Termination It was not included as it is not always used (Behavioral change models, n.d.) Since the behaviour change has been maintained for some time, the person will feel no temptation to lapse and believes in themselves to maintain the change Relapse A person may lapse into older behaviour patterns and come back to a previous stage. This is common and possible to happen at any stage, because it is not at the terminal stage (Morrison & Bennett, 2016) Most likely to happen at the stages of action and maintenance (Lakhan, 2006) In each stage, moving the person to the following stage to the ideal behaviour will be effective for various intervention strategies
change happens, like cultural issues and income The lines between the stages can be subjective without limit criteria of how to find out a person’s stage of change. The questionnaires for each stage of change are not standardized. Uncertain for how long the period is required for each stage, or a person can stay in a stage Expects that everyone to make clear plans, but this is not always true People can naturally quit smoking without going through these stages
behavioural theories and adherence: Application and relevance in antiretroviral therapy. Southern African Journal of HIV Medicine, 19(1). doi:10.4102/sajhivmed.v19i1.762 For HIV or AIDS patients to reduce the infections
A., Henshaw, H., & Heffernan, E. (2016). Applying theories of health behaviour and change to hearing health research: Time for a new approach. International Journal of Audiology, 55(sup3), S99-S104. doi:10.3109/14992027.2016.1161851 For audiology field Hearing loss with hearing aid Promotion of hearing health in hearing screening
P., & Nightingale, J. (2017). Health behavioural theories and their application to women's participation in mammography screening. Journal of Medical Imaging and Radiation Sciences, 48(2), 122-127. doi:10.1016/j.jmir.2016.12.002 Concern Having a mammogram regularly would reduce the chances of dying due to breast cancer? Getting breast cancer due to exposing to ionising radiation? Culture influence Viewing breast cancer as a shameful illness, so women would willing to die without being diagnosed
Auburn University News. (2020). Learning healthy habits is vital in the time of COVID-19. Retrieved from https://ocm.auburn.edu/experts/2020/04/070958-healthyhabits- covid19.php [US News] Jan Kavookjian, an associate professor in the Department of Health Outcomes Research and Policy, from Auburn’s Harrison School of Pharmacy, is an expert on human health behavior in making healthy decisions One of the biggest factors in the spread of COVID-19 is the "individual decision making" for not bothering about preventive practices, like social distancing, quarantine and cleanliness
Behavior in a Pandemic. Retrieved from https://www3.nhk.or.jp/nhkworld/en/tv/directtalk/20200625/2058 647/?cid=wohk-fb-org_site_dt_changingbehavior-202006- 001&fbclid=IwAR2d4fhjzSDe_mzJInMr8cSBm9YV8QOOIIxvznv1Gy Cuye5drlFs5PShbOA [UK News] Health psychologist, Professor Susan Michie, Director of the Centre for Behaviour Change at University College London This professor is advising "the British government on how to assist people" to change their behavior in a pandemic to reduce the spread of coronavirus
about health and wellness The specific type of work may depend on the work setting on a daily routine (Cherry, 2020a) Work directly in hospitals to help individuals or groups to promote healthy behaviors and prevent illness Investigate on health-related issues Contribute public policy on health care issues
Conduct behavioral assessments Clinical interviews Personality tests Involve in interventions with individuals or groups Educating people about stress reduction techniques Offering smoking cessation tips Teaching people how to avoid unhealthy behaviors
such as The justifications of health problems Effective preventative measures The best health promotion techniques How to effectively help people to cope with pain or illness How to get people to seek treatment for medical conditions
of single-subject research design Advantage (Sarafino & Smith, 2011) It is a more complete analysis of the individual Disadvantage It can magnify sampling errors
Type of descriptive research design Advantage (Sarafino & Smith, 2011) It can examine variables that cannot be experimentally manipulated Intelligence quotient (I.Q.) Occupational status Disadvantage It cannot determine causality
time Age groups Ethnic groups Disease groups Advantage (Sarafino & Smith, 2011) To identify possible group differences at one point in time Disadvantage Cannot rule out cohort effects
A gets a certain drug Group B gets a placebo Advantage (Sarafino & Smith, 2011) Can determine causality Disadvantage High cost Many variables cannot be experimentally manipulated Example, smoke exposure over time
health or disease over time Example: progression of multiple sclerosis Advantage (Sarafino & Smith, 2011) Can see the time course of the disease or behaviour Example: smoking cessation over time Disadvantage It is costly It is still subject to bias
Purves R, Bryce S, MacDonald L, Gordon R. (2013). Systematic literature review to examine the evidence for the effectiveness of interventions that use theories and models of behaviour change: towards the prevention and control of communicable diseases. European Centre for Disease Prevention and Control (ECDC) Technical Report. Retrieved from https://dspace.stir.ac.uk/bitstream/1893/16455/1/ECDC%20Technic al%20Report_health-communication-behaviour-change-literature- review.pdf There are many researches conducted on a wide range of issues with various theories and models of behaviour change in this report
to improve public policy on health issues (Cherry, 2020a) This work involves Lobbying government agencies Concerning inequalities in healthcare Improving governmental bodies on healthcare reform
Hospitals, health care clinics, private companies and universities Specialized fields of health care, like Oncology, pain management, women's health and smoking cessation programs In government settings, like Managing community health programs or improving public policy (Cherry, 2020a)
It is related to clinical psychology Practices behaviour change, health education and psychotherapy Community Health Psychology Making interventions and prevention techniques at the community level Work with groups to encourage healthy behaviors or promote behavior change Public Health Psychology Understanding health at the population-level Give advice to health care professionals, health educator and government agencies Occupational Health Psychology Combines industrial-organizational psychology and related disciplines Understanding how workplace issues are related to both physical and mental illness
Application and relevance in antiretroviral therapy. Southern African Journal of HIV Medicine, 19(1). doi:10.4102/sajhivmed.v19i1.762 Angus K, Cairns G, Purves R, Bryce S, MacDonald L, Gordon R. (2013). Systematic literature review to examine the evidence for the effectiveness of interventions that use theories and models of behaviour change: towards the prevention and control of communicable diseases. European Centre for Disease Prevention and Control (ECDC) Technical Report. Retrieved from https://dspace.stir.ac.uk/bitstream/1893/16455/1/ECDC%20Technical%20Report_health-communication- behaviour-change-literature-review.pdf Behavioral change models. (n.d.). Retrieved from https://sphweb.bumc.bu.edu/otlt/MPH- Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories_print.html Bishop, D. (2014). Health promotion, disease prevention and behaviour change [PowerPoint slides]. Retrieved from https://www.westmidlandsdeanery.nhs.uk/Portals/0/Public%20Health/2014/Masterclasses/Behaviour%20Chan ge%20Presentation%207.4.14.pdf Cherry, K. (2020). Studying Health Psychology and Illness. Retrieved from https://www.verywellmind.com/what- is-health-psychology-2794907 Cherry, K. (2020a). Health Psychologist Career Profile. Retrieved from https://www.verywellmind.com/what-is-a- health-psychologist-2795652
National Health Report Highlights. Retrieved from https://www.cdc.gov/healthreport/publications/compendium.pdf Coulson, N. S., Ferguson, M. A., Henshaw, H., & Heffernan, E. (2016). Applying theories of health behaviour and change to hearing health research: Time for a new approach. International Journal of Audiology, 55(sup3), S99- S104. doi:10.3109/14992027.2016.1161851 Glanz, K. (n.d.). Social and Behavioral Theories. Office of Behavioural and Social Sciences Research. National Institute of Health. Department of Health and Human Services. Retrieved from http://www.esourceresearch.org/eSourceBook/SocialandBehavioralTheories/10Summary/tabid/749/Default.asp x Henriques, G. (2015). The biopsychosocial model and its limitations. Retrieved from https://www.psychologytoday.com/us/blog/theory-knowledge/201510/the-biopsychosocial-model-and-its- limitations Lakhan, S. E. (2006). Theories on health behaviors [Web log post]. Retrieved from https://brainblogger.com/2006/03/19/bps-theories-on-health-behaviors/ Lawal, O., Murphy, F., Hogg, P., & Nightingale, J. (2017). Health behavioural theories and their application to women's participation in mammography screening. Journal of Medical Imaging and Radiation Sciences, 48(2), 122-127. doi:10.1016/j.jmir.2016.12.002
Retrieved from https://courses.lumenlearning.com/boundless-psychology/chapter/introduction-to-health-psychology/ Mason, P., Roy, A., Spillane, J., & Singh, P. (2016). Social, Historical and Cultural Dimensions Of Tuberculosis. Journal of Biosocial Science, 48(2), 206-232. doi:10.1017/S0021932015000115 Michie, S. (2020). Changing Behavior in a Pandemic. Retrieved from https://www3.nhk.or.jp/nhkworld/en/tv/directtalk/20200625/2058647/?cid=wohk-fb- org_site_dt_changingbehavior-202006- 001&fbclid=IwAR2d4fhjzSDe_mzJInMr8cSBm9YV8QOOIIxvznv1GyCuye5drlFs5PShbOA Morrison, V., & Bennett, P. (2016). Introduction to health psychology. (4th ed). Pearson Higher Ed. National Cancer Institute. (2005). Theory at a Glance: A Guide for Health Promotion Practice. (2nd ed). U.S. Department of Health and Human Resources. National Institute of Health. Retrieved from https://cancercontrol.cancer.gov/brp/research/theories_project/theory.pdf Rieger, E. (2017). Abnormal Psychology: Leading Researcher Perspectives. (4th ed). McGraw-Hill Education. Sarafino, E. P., & Smith, T. W. (2011). Health psychology: Biopsychosocial interactions. (7th ed).John Wiley & Sons. The Official Source for Auburn University News. (2020). Learning healthy habits is vital in the time of COVID-19. Retrieved from https://ocm.auburn.edu/experts/2020/04/070958-healthyhabits-covid19.php
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