OCR psychology - Theories of health belief

HBM - A cognitive model (with some social aspects such as culture) which predicts & identifies factors that indicate the possibility of an individual adopting a health behaviour

The model was developed in repsonse to a study in 1954 on why people did or didn't go for a free tuberculosis (TB) screening - seemed to indictate that people didn't go because they didn't think they were likely to get or didn't think it was that serious.

Therefore, the model is based on 2 main factors:

• Perceived seriousness - 'Will it kill me?'
• Perceived suscetibility - 'Am I likely to get it?'

It's HOLISTIC - takes into accounts many factors: A person will adopt a health behaviour if...

• The benefits outweigh the costs (cost-benefit analysis).
• If they're reminded by internal or external cues (e.g. IC - period of ill health, insecurities? EC - tv adverts, doctors).
• And also depending on Demographic Variables - age, gender, education, occupation etc.

Aim: To use the HBM to explain mother's adherence to a drug regimen for their asthmatic children.

Methodology - A correlation between beliefs reported during interviews & compliance with self reported administration of asthma medication --> A correlational design

Participants: 111 mothers responsible for administering asthma medication to their children:

• Mother's aged from 17-54 years
• Children aged from 9 months - 17 years

.

Procedure: Each mother was interviewed for 45 mins and asked about...

• Their perception of their child's susceptibility to illness & asthma.
• Their beliefs about how serious asthma is, how it interferres with their child's education and/or mother's activities.
• Whether it causes embarrassment
• Their faith in the doctors and the effectiveness of the medication

.

70% of participants also had blood tests (covert) to test the levels of medication - this confirmed the validity of the mother's answers in the interview).

Findings:

• A positive correlation was found between a mother's belief about her child's susceptibility to asthma attacks & compliance with a medical regimen.
• 66% of participants who had had blood tests were found to be compliant with their medical regimen.
• Two demographic variables correlated with compliance: martial status & education.

However...The costs which negatively correlated with compliance were:

• Disruption of daily activities
• Inaccessibility of chemists
• The child complaining about/disliking the medication.

.

Conclusion:

The HBM is a useful model to predict & explain different levels of compliance with medical regimens.

LOC - Suggests that where a person thinks the control of their health lies will influence whether they adopt a health behaviour.

Two 'types' of locus of control:

Internal LOC - when a person thinks that their health is in their contol.

External LOC - seeing that their health is in someones else's hands/control (e.g. Doctors, parents, fate or religion).

Evaluative points:

Reductionist - Implies that people with internal LOC will engage in more healthy behaviours. This is simplistic. Doesn't consider other factors such as the impact of demographic variables or the cost-benefit analysis.

Determanistic - Suggests that if someone has a high internal LOC then they will engage in a health related behaviour which is promblematic as lots of other mediating factors will influence if this actually happens e.g. finances/costs or having the time to exercise.

REMEMBER USES SELF REPORT METHODS!

Methodology - A Review Article

Sample - Initially 6 pieces of research into individual perceptions of ability to control outcomes based on reinforcement.

Findings:

Rotter found that results from the studies reviewed consistently showed that participants who felt that they had control over the situation were more likely to show behaviours that would enable them to cope with potential threats, than participants who thought that chance or other non-controllable forces determined the effects of their behaviour.

Conclusion:

Rotter concluded tha LOC would affect many of our behaviours --> not just health behaviours!

Self efficacy - How effective a person thinks they will be at successfully adopting a health behaviour.

--> Links to the cognitive idea of locus of control (high internal control).

Bandura's concept of self efficacy involves:

• The Social explanation
• The Behavioural explanation - e.g. positive reinforcement (operant conditioning).

Aim: To assess the sefl efficacy of patients undergoing systematic desensitisation in relation to their behaviour with previously phobic objects.

Methodology - A controlled quasi-experiment.

Participants:

• 10 snake phobic patients who replied to an advertisement in a newspaper.
• 9 females and 1 male
• Aged 19-57 years

Procedure: Pre-test assessment: Each patient was assessed for...

• Avoidence behaviour towards boa constrictor.
• Fear arousal was then assessed with an oral rating of 1-10.
• And finally, efficacy expectations (how much they thought they would be able to perform different behaviours with snakes).

Procedure (continued...)

Systematic Desensitisation: A standard desensitisation programme was followed...

• Patients ere introduced to a series of events involving snakes
• At each 'stage', patients were taught relaxation
• (The stages ranged from imagining snakes to handling live snakes).

Post- test assessment: Each patient was again measured on behaviours & belief of self-efficacy in coping.

Findings: Higher levels of post-test self efficacy were found to correlate with higher levels of interaction with snakes

Conclusion: Desensitisation enhanced self-efficacy levels --> which in turn led to a belief that the participant was able to cope with the phobic stimulus of the snake.