Health and Clinical Psychology - Healthy Living

- Theories of health belief

  • Becker - Health belief model
  • Rotter - Locus of control
  • Bandura - Self efficacy (snakes)

- Methods of health promotion

  • Cowpe - Media campaign (chip pan fires)
  • Dannenberg - Legislation (helmets)
  • Janis & Feshbeck - Fear arousal (dental)

- Adherence to medical regimes

  • Bulpitt - Reasons for non adherence
  • Lustman - Measures of non adherence
  • Watt - Improving adherence (Funhaler) 
  • Created by: SarahD95
  • Created on: 28-05-14 12:11

Becker - Health belief model

Aim: use HBM to explain mother's adherence to drug regimen to their asthmatic child

Method/Design: correlation design - between beliefs reported during interviews & the compliance with self-reported admin of asthma med

Participants: 111 mother responsible for admin asthma med to their child

Procedure: Ps interviewed for 45 mins, Q regarding their perception to their child's susceptibility to illness & asthma etc.. caused embarrasment/inferresd with her activities, faith in doc/med effective

Results: pos correlation between mother's belief about child's susceptibility to asthma attacks & compliance to med regmen. Mothers who reported admin inferred with activities also complied. Greater mother's ed the mother's ed more likely to keep admining med and if she was married.

Conclusion: HBM is a useful model to predict & explain diff levels of compliance with medical regimes.

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Rotter - Locus of control

Aim: to find out whether locus of control affects our health beliefs

  • Internal locus of control - control of their own health
  • External locus of control - health is guided by fate or extenal circumstances, docs/god

Procedure: reviewed 6 pieces of research which had all investigated an individual's perception of the extent to which they could control the outcome of their behaviour in diff situations

Results: Ps with an internal locus of control were more likely ro show behaviour that would enable them to cope with potential threats, than Ps who thought chance determine the effects of their behaviour

Conclusion: locus of control would affect many of our behaviours, not just health behaviours

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Bandura - Self efficacy

Aim: assess the self efficacy of patients undergoing systematic decentisisation in relation to their behaviour with previously phobic ibjects

Method/Design: controlled quasi exp

Participants: 10 snake phobic patients, replied to an add in paper, 9F & 1M, aged 19-57

Procedure: pre test assessment, each tested for avoidence behaviour towards a boa constrictor, fear arousal - rating 1-10, efficacy explanations & fear of snakes measured.
Systematic desntisisation - standard desen programme was followed. Ps introduces to series of events which involved snakes & were taught relaxtion at each stage - pics-handling snakes

Results: higher level of post test efficacy were found to correlate with higher levels of interaction with snakes

Conclusion: systematic desentisisation enhanced self efficacy levels which inturn led to a belief that the Ps were able to cope with their phobia of snakes 

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Cowpe - Media campaigns (chip pan)

Aim: test the effectiveness of advertising campaigns

Method/Design: quasi exp, 2 media campaigns (tv ads) shown in 10 reginal tv areas 1976-1984, analyse of num of chip pan fires reported & 2 quan consumer surveys. Repeated MD

Participants: people living in the chosen tv areas

Procedure: 260 sec ads, showing cause of fire, actions to put it out, turn off heat, cover with damp cloth, leave to cool 

Results: overall net decline in fires between 7% & 25% in 12 months, greates effect immediately after the campaign. 

Conclusion: advertsing was effective as chip pan fires reduced. However, the effectiveness decreases overtime. Viewers are also less likely to be influenced by th ecampaign if overexposed.

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Dannenberg - Legislation (helmet)

Aim: to review the impact of the passing of a law promoting cycle helmet weariing in children

Method/Design: quasi exp - where they lived, idependent MD - each child naturally falling into 1 of 3 counties (Howard county had a law that children should wear safety helmets when in the road)

Participants: children from Howard county and 2 control groups - Montgomery & Baltimore. 7322 children from 47 schools aged 9-15 (4th,7th,9th grade)

Procedure: questionnaire asked about bicycle use, helmet ownership, use & awareness of the law, 4 point likert scale used, parents asked to help children complete q - consent was given

Results: overall response rates between 41% & 53% across the 3 ages. Howard county reported useage had increased from 11.4% - 37.5%, compared with Montgomery 8.4% - 12.6% & Baltimore 6.7% - 11.1%. helmet ownership highest in younger age group.

Conclusion: although people may not wear helmets on a daily basis, the law did help improve useage

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Janis and Feshbeck - Fear arousal (dental)

Aim: investigate the consequences on emotions & behaviour of fear appeal in communications

Method/Design; lab exp, showed fear arousing material, independent MD, 4 groups -3 exp & 1 cg

Partcipants: 2000, 14-16 year olds american high school students, divided into 4 groups

Procedure: Q sent a week before lecture on helath to accertain dental preactices. 15 min lectures (with pics) presented to each group, 3 had a lecture on dental hygiene (strong, moderate, minimal fear) & control g had lecture on the human eye. Q immediately after the lecture asking for emotional reactions from it. 1 week later a follow up questionnaire - longterm effects of the lecture

Results: strong fear arousal group showed an increase in conformity to dental hygiene 8% (agreed talk was interesting but didnt affect their behaviour), moderate fear group increase 22%, minimal fear group increase 36% (was easier to follow, more people altered their behaviour) and cg showed 0% change. 

Conclusion: fear appeal can be helpful in chaning behaviour but it is important that the level of fear appeal is right for each audience

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Bulpitt - Reasons for non adherence

Aim: review reseach on adherence in hypertensive patients

Method/Design: a review article of research indentifying problems with taking drugs for high blood pressure (only male Ps were used)

Procedure: reseach was analysed to identify the physical & psychological effects of drug treatment on a person's life. Included work, physical wellbeing, hobbies etc...

Results: many side effectss of taking anti-hypertension med including sleepiness, dizziness and lack of sexual functioning. Side effects also affect cognitive functioning which impacted people's concentration at work and involvement in hobbies

Conclusion: the costs of taking med (side effects) out-weigh the benefits of treating a mainly asymptomatic problem such as hypertension (high blood pressure) which has no symptoms. Therefore some types of treatment may be difficult to treat as people can't feel the benefits of the adherence.

Curb 1985 - 8% of men dicontinued treatment because of sexual probs. Reseach by the medical council 1981 found that 15% of Ps had withdrawn taking the med dure to side effects.

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Lustman - Measures of non adherence

Aim: assess the efficacy of the antidepressant fluoxetine in treating depression, by measuring glysemic control

Method: radomised controlled duble blind

Participants: 60 patients with type 1&2 diabetes & diagnosed with depression

Procedure: ps randomly assigned to either fluocetine or placebo group. Ps assess for depression using psychometric tests. Thies adherence to their med regimen was assessed by measuring thier GHB levels whihc indicated their gylcemic control.

Results: after 8 weeks Ps given the fluoxetine reported lower levels of depression & had lower levels of GHB which indicated their improved adherence

Conclusion: measuring GHB in patients with diabetes indicates their level of adherence to prescribed medical regimes. Greater adherence was shown by patients who were less depressed.
Previous reseach had suggexted that reducing depression may improve adherence in diabetic patients.  

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Watt - Improving adherence (Funhaler)

Aim: see if using a Funhaler can improve children's adherence to med for asthma

Method/Design: field exp, quasi exp childrenw ith asthma, repeated MD (p used pmDi breath-a-tech for 1 wek & funhaler for the second week) 

Participants: 32 Australian children, 10M & 22F aged 1.5-6 years

Procedure: Questionnaires given to parents to complete (consent) after each week of using the inhalers. (funhaler - incentive toys, spinner & whistle for feed back)

Results: 38% more parents were found to have medicated their child the previous say using the funhaler compared to the standard inhaler

Conclusion: funhaler helped improve adherence to med, by making a medical regimen fun can improve adherence in children

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