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Theories of Health Belief-HealthBeliefModel

Percieved Threat of Disease- To convince people there's threat of disease to get them to change behaviour they must be convinced consequences are serious (PercievedSeriousness) & they are at risk. (Percieved Susceptability). 
Will change behaviour if: there are Percieved benefits, cues to action. Sociodemographic variables effect this. Write in context to smoking.

Becker
111 mothers to self report on childs asthma regimes. Also did blood tests and traingulate.
Positive correlation between mums percieved threat of disease and seriousness to compliance with medical regime.
Greater education undertaken by mother the more compliance.

So supports HBM model 

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Theories of Health Belief- LocusOfControl

Locus of control- the way in which a person explains responsibility to either themselves or external sources. May change with different health behaviours.
Internal Health Locus of Control- Feel responsible for their own health.
External Health Locus of Control- Others responsible for their health. e.g doctors.
Chance Health Locus of Control- Chance or luck determines their health. 

Wallston
Questionnaire with scale measure if locus of control is internal, external or chance.
18 questions such as:
When i get sick i am to blame. With leveling opinions: strongly disagree to strongly agree.

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Theories of Health Belief- Self Efficacy

Self Efficacy- belief in your ability in a particular situation. Impacts: perception, motivation and performance.
E.g Believing they can give up smoking or drinking or loosing weight.

Bandura
4 influences on self efficacy:
Enactive Influences- Past experiences - success & failure
Vicarious Influences- Comparing ourselves to others and judging our ability accordingly
Persuasory Influences- Positive encouragment or persuasion about their ability to be successful.
Emotive Influences- Over anxiety may lead to feeling helpness which decreases self efficacy. 

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MethodsOf Health Promotion- MediaCampaigns

Tv, Posters, Magazines. Work by- shock, fun, story, emotive
NHS FAST campaign
- Face,arms,speech, time. Factual intrustions, acronym and memorable. In first 4 months dialling 999 for strokes increased 55%
Smoking - focus on the positive- Musical, fun, humorous- aimed at young smokers. Longitudinal study showed it was responsible for 300,000 less younger smokers in 2000.
Drinking- girls night out- Shocking, disgusting, story. 42% increase with negative association with binge drinking.  

Cowpe
Chip pan fire tv advert. televised 10 uk reigons.
Questionnaires completed form this show 96% increase in awarenss in Yorkshire.

Concludes media campains are effective. 

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Methods Of Health Promotion- Legislation

Legislation- laws passed to increase health. Vary between countries.
E.g Smoking- public area ban. Alcohol- Age limits. Diriving- Seatbelts ,car seats. 
Difficulity with legislation is enforcing it - so is it effective on its own?

Dannenberg.
Natural Exp. as legislation recently passed in Howard County requiring under 16's to wear a cycle helmet.
Control groups- Baltimore and Montgomery (where a bike safety campaign was already).
Questionnaires sent out with likert scales asking about: helmet use, law awareness and peer pressure. Consent obtatained- parents helped completion.

Howard County has highest helmet usage- 37.5%
Baltimore Lowest at 11.1% 

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Methods Of Health Promotion- Fear Arousal

Adverts use fear of death, negative appearance, loosing independence and other fear factors to help change unhealthy behaviours.
Promite fear enough to cause change due to avoiding unpleasant consequences.
Enethical to pray on fear?

Janis & Feshbeck
Lab Exp.
14-15 yrs students
3 lectures: 1- strong fear on dental hygeine (Gym disease, this could happen to you) .2- moderate fear- (factual) 3- minimal fear (nuetral infor on tooth growth)
1 week later questionnaire:
grp 1- 8% conformity increase
grp 2- 22%
grp 3- 36%

Low fear arousl is optimal level for promoting health. 

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FeaturesOf Adherence- ReasonsFor Non-Adherence

Many factors influecing adherence: age, cultural beliefs (jehova witness dont accept blood transfusions), 
Rational Non-adherence- delibetate decision not to adhere.
May be due to: belief medication isnt helping, side effects, money.

 Bulpitt
Reviewed arcticle and research analysed identifying the physiological and psychological effect of high blood pressure medication and possible reasons for non adherence.
Drugs have side effects- Dizziness, sleepiness
8% of males discontinued use due to sexual problems- erectile dysfunction. 

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FeaturesOfAdherence-ImprovingAdherenceWithBehaviou

Classical Conditioning- Pair a nuetral stimulus with an unconditioned response to create an association causing a conditioned response
Operant Conditioning- positive and negative reinforcement. Punishment.
Social Learning- Learning through imitation.

Watt
32 Austrailian Children with asthma.
given normal inhaler for 1 week and funhaler for 1 week.
Parents given questionnaires both weeks so self report.

38% more parents medicated their children the previous day when using funhlaer compared to the normal inhaler.

Fun= more adherence.

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FeaturesOfAdherence- Measuring Non-Adherence

Explain and use strengths and weaknesses of:
Self report- questionnaires/ interviews
Biochemical Tests- blood tests, urine tests e.g to see if medication has been taken
Pill & Bottle Counts- count no. of pills left in bottle & compare with what's meant to be there.
Therapeutic Outcome- Is the paitent getting better? 

Becker
111 mothers to self report with an interview for 45 minutes on childs asthma regimes. Did blood tests and traingulated to see truthfulness of interview.

Less complaint if- disrupts daily acitivites, child complained, complexity of drugs. 

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