Health Promotion G543

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  • Health Promotion- G543
    • Theories of Health Belief
      • Locus of Control
        • Brief overview- whether people think they can control themselves or whether the case is out of their hands
        • Wineman (1980)
          • Cognitive
          • Investigate locus of control, body image and weightloss in obese individuals
          • 116 adult caucasian particpants
            • 12 male, 104 female
          • 3 self report questionaires completed by particpants
            • 1st- DEMOCRATIC DATA QUESTIONAIRE- age, sex and age onset of obeisity
            • 2nd- ROTTER'S SCALE- 29 forced questions on beleifs that would imply either internal or external control
            • 3rd- SECORD & JOURNARD'S likert rating scale out of 5 as to whether they were satisfied with different parts of their body
          • Concludes- external cues influence eating habits but may not reflect in a person's beliefs about locus of control
            • evaluated Rotter's scale as being not very suitable in regards to eating habits
        • Rotter (1966)
          • Cognitive
          • Review article
            • 6 articles individual perceptions of ability to control outcomes based on reinforcement
          • Participants who thought that they had control were better at dealing with potential threats
          • Concluded that our locus of control would affect all of our behaviour- not just health related
        • External locus of control = individual believes that their behaviour is guided by fate, luck, or any external force
        • Internal locus of control = individual believes that their behaviour is controled by their personal decisions
      • Self-Efficacy
        • Brief overview- how effective they think they will be in successfully changing their behaviour
        • Confidence in your ability to sustain the bahaviour
        • Bandura's Theory
          • sources affecting self efficacy
            • social persuations
              • encouragements/ discouragements
            • Experience
              • vicarious experience= "if they can do it, I can do it"
            • physiological factors
              • shakes, pain, "butterflies in stomach", nausea. perception of these may change the person's belief in themselves
        • Bandura and Adams(1977)
          • analysis of self-efficacy theory behind behavioral change
          • Patients with snake phobias
            • Self selecting from advert in newspaper
            • 9 females, one male
            • aged 19-57
          • Controlled quasi experiment
          • Pre-testing- assesed avoidance behaviours towards a boa constrictor
            • Fear arousal measureed on a 1-10 oral rating scale
              • self report efficacy expectations- whether they would be able to carry out certain behaviours
            • during -desensitization- patients introduced to different situations with snakes and taught relaxation techniques
              • After- both behaviour and self-efficancy was taested after
          • during -desensitization- patients introduced to different situations with snakes and taught relaxation techniques
            • After- both behaviour and self-efficancy was taested after
          • Self efficacy rose after treatmen as well as behaviour involving snakes
      • The Health Belief Model
        • Brief overview- Predicts whether behaviour will be changed, based on multiple factors
        • Considers benefits and barriers of adopting the health behaviour
        • Things that effect whether a person will change their behaviours- dependent on perception
          • Threat of illness
            • Severity
            • suseptability
          • Potential benefit or efficacy of adopting the behaviour
          • Barriers
            • Physical, psychological, financial or other
          • A cue to change behaviour
            • Internal- seeing a change in your health such as struggling to breath
            • External- such as a media capaign
          • All of these mentioned factors make the persona aware- they must be conscious of the change
        • Becker and Rosenstock 1978
          • Cognitive
          • use HBM to explain mothers' adherance to asthma medical regime for their children
          • 111 mothers participated- 94% of which were black
          • Self report + covert blood tests taken of children to varify the answers of the mothers
          • mothers complied despite a) limited efficacy of the treatment, b) their child still ended up needing other medical assistance despite the medical regime
    • Changing Health Behaviours Studies
      • Dannenberg et al (1993)
        • Questionnaires contain a 4 point likert scale on topics such as
          • Bicycle use, helmet ownership, use, awareness of law, sources of info about helmets and peer pressure
        • Aim- review the impact of the passing of a law requiring cycle helmet wearing children
        • Findings
          • Response rates were between 41 and 53 %
          • In Howard county
            • helmet use increased from 11.4% to 357% after the law came in
              • Both were higher than the control group
          • Montgomery county- educational campaigns
            • increased from 8.4% to 12.6%
              • Both were higher than the control group
        • children from 47 schools in Howard County + control groups from Montgomery county and Baltimore county
          • Montgomery- already campaign for cycle safety
          • Total of 7322 children were sent the questionaires
          • Law was changed in Howard County- children under the age of 16 HAVE to wear a helmet at all times
      • Janis and Feshbeck (1953)
        • Effect of fear arosal
          • Based on dental hygiene
        • Lab experiemnt = showing people varying strength of graphic images
          • Follow up rating scales to ask whether fear arousal had changed their health behaviour
        • Participants
          • 200 students from the same high school
            • 4 groups
              • one control group
              • high fear arousal
              • medium fear arousal
              • low fear arousal
        • Findings
          • minimal fear arousal caused most change (36%)
            • strongest fear arousal caused the least change (8%)
        • Conclusion
          • High fear arousal does not necessarily lead to increased levels of change in behaviour
      • Cowpe (1989)
        • Chip pan fire study - researching the effect that TV campaigns had on changing health bahaviours
        • two adverts shown on TV in the 70s in different areas in England
          • Shown from January- March, then not shown for the rest of the year
          • Opportunity sampling of people who watched the advert
            • Actually gathered data of the whole areas involved in the study
        • Results
          • Not all of the data was sucessfully gathered as information taken from the fire brigades was unavailable for some of the years
          • In the years between 1976 and 19882
            • 7% decrease in chip pan fires in central areas
            • 25% decrease in Granada area
            • In 1976 results showed that the effect of the adverts were diminishing by August (around 4/5 months after the adverts stopped)
          • Adverts had little effect on places that already had low levels of chip pan fires
          • Areas where there were overlap, the adverts had less of an effect on the decrease in chip pan fires
            • 19% reduction in chip pan fires in areas with no overlap
              • 9% decrease in areas with overlap.
        • Conclusion
          • There is a casual relationship between advertising and the reduction of chip pan fires
            • Shows the diminishing effect of adverts over time
          • Advertising is effective in reducing injuries, deaths and is cost effective as it saves the authorities money in the long run
        • Cognitive and behavioral approach/ perspetive

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