Healthy living

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Theories of health belief: Becker

Aim: to use HBM to explain mothers' adherence to a drug regimen for their asthmatic children.

Method: correlation between belief reported in interviews and compliance with self reported administration of asthma medi. 111 mothers, aged between 17-54 children between 9-17. mother interviewed around 45 minutes, questions about childs susceptibility and how serious asthma is,interfere with education and mothers activity, how much faith in doctors and medi.

Findings: positive correlation between belief of child susceptibility and compliance to medi regime and perception of serious attack . demographic variable of marital status and educational levels:

married mothers were more liekly to comply and greater the mothers educaion more likely show would be to adhere.

Conclusion: HBM is useful model to predict and explain different levels of compliance with medical regimens.


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Theories of health belief: Rotter

Aim: correlation between locus of control and behaviour

Method: a review, initially six pieces of research into individual perceptions of ability to control outcomes based on reinforcement. Rotter made I-E scale correlated with interviews and secondary sources.

Findings: found correlation between smoking,gambling and persuasion,internals less likely to gamble, internals perform better in task requiring people to persuade others and externals are more likely to smoke, internals who smoke more likely to give up. participants who were in control more about to cope with potential threats than others who thought they had no control. 

Conclusion: internals are more able to take initiative of lives and resit manipulation and lead healthier lives. 

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Theories of health belief: Bandura

Aim: assess the self efficacy of patients doing sysematic desensitisation for snake phobia

Method: 10 snake phobic patients(affected social and recreational), replied to newspaper advertisement mean age 31.Bandura mesured level of fear and perception of how well they could cope ( rating fear, 29 task and fear arousal).desensitisation first picture arousal level down,room with them and then handle them. fear and coping perception was measured again.

Findings and Conclusion: the second scores were significantly lower and the coping perception scores were significantly highier. supports the concept of self efficacy because the activites change in perception, both cognitive and behavioural concept.


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Heath promotion:Cowpe

Aim: test the effectiveness of an advertising campaign providing information and encouraged preventive actions.

Method: quasi experiment media shown in 10 regional areas.analysis of number of chip pan fires and two quantitative consumer surveys.two 60 second commercials called in attendance and over filling were shown in ten areas 76-1984 for 4 months. these shown the initial cause of fire and how to prevent them. shown one in area apart from Granada Harlech.. shown 3 times. the number of chip pan fires analysed for each area.

Findings: questionnaires shown increase in chip pan fires from 62% to 90% after first advert. areas that were exposed to chip pan fires moe than once e.g. Granada showed less impact. decline each year between period of campaign was between 7%(central) to 25% (granada).

Conclusion: proved effective shown by reduced fires,behaviour changed seen most during campaign and viewer less likely to be influenced if over exposed. 

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Heath promotion:Dannenberg

Aim:review impact of passing law(bicycle helmets) in  Maryland and compared with simple health education.

Method: around 7200 from 47 schools in one county, two control countries aged 9-15.Natural experiment law passed in howard county children under 16 have to wear helmet. independent measures naturally fall into three different county, one control group health education campaign other non. data collected through using a questionnaire. contained helmet ownership and use, awareness of law and peer pressure using 4point likhert scale. consent gained, parents were asked to help kids.

Findings: new law sowed improvement from 11% to 37% compared to 8% to 12% in county without law. 38% of children who were aware of law wore helmets compared with 14% who didn't now.

Conclusion: legislation show increase in wearing helmets, more effective than health educational campaign alone.

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Heath promotion:Janis

Aim: whether arousing fear changes behaviour

Method: 200 students from Connecticut high school, 4 control groups 50 in each equal on gender,age, IQ. three groups given a 15 minutes illustrated lecture on tooth decay and fourth group act as control group.given questionnaires before lecture on general health hygiene, second one given after and third one week later. strong fear: painful consequences of tooth decay and personalise threatmoderate fear: dangers describe in milder form, factual minimal fear: presented factual manner, causes of tooth decay rarely mentioned last same time and delivered by same speaker.

Findings: strong fear arousal had higher levels of fear and anxiety about tooth decay. minimal most likely to change dental habits 38%, moderate 22% and strong only 8%

Conclusion: when fear is strongly aroused, but no reassurance audience will become motivated to ignore or minimise the threat.

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Adherence: reasons for non-adherence Bulpitt

Aim: review research on adherence in hypertensive patients

Method: review articles, research analysed to find out the physical and psychological effect of new drug treatment on person's life include hobbies,well being. 

Findings: Curb, 85 males discontinued due to sexual problems, 15% withdrew because of side effects. Drug did reduce headaches and depression compared to old drug.

Conclusion: when side effects(cost) outweigh benefits less likely to adhere, confirms patient weigh up the cost-benefit before deciding to adhere to medical advice.


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Measure of non-adherence: Lustman

Aim: assess the efficacy of anti- depressant fluoxetine in treating depression, by measuring glycemic control

Method: 60, diagnosed with either type1 or type 2 diabetes and depression. Independent measures, randomised controlled double blind study. Randomly assigned to either fluoxetine group or placebo. assess for depression using psychometric test.

Finding: patients with fluoxetine reported lower levels of depression, lower levels of GHB as well, improved adherence.

Conclusion: measuring GHB in patients with diabetes shows level of adherence. great adherence in patients with lower levels of depression, reducing may improve adherence.

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Improving adherence: Watt

Aim: if using fun haler would improve children's adherence to taking asthma medication

Method: field/ quasi experiment, 32 Australian children1 and a half to 6, parents give consent. each child given breath-a-tech to use for 1 week and parents given questionnaire to complete. second week fun haler and a matched questionnaire after second week.

Findings: 38% more parents were found to have medicated their children the previous day when using the fun haler. 

Conclusion: reasons for non-adherence in children as boredom forgetfulness and apathy. fun haler use reinforcement correct usage of inhaler with toy that spins and whistle that blows. making regime fun can improve adherence in children.

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