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Theories Of Health Belief

• Health Belief Model (Marshall H Becker)
• Locus Of Control (Rotter)
• Self-Efficacy (Bandura)

HMB: Perception of threat; Cost-benefit analysis; Cues for action; Demographic Variables

Aim: Use HBM to explain mothers’ adherence to drug programme for asthmatic children

Findings:

Positive Correlation of Compliancy: 

• Susceptibility to asthma 

• Extent of interference with their own life

• Better education 

• Being married

• Negative correlation of compliancy:

• Distance to chemist

• Child complaining about medication 

• Programmes disruption to daily routine 

Conclusion:

• Findings confirmed HBM 

• HMB is useful in predicting health behaviour

External Locus: Consequences of behaviour controlled by luck, fate or powerful others

Internal Locus: Events and patterns due to their own behaviour and personality

Aim: Investigate correlation of locus of control and behaviour

Procedure: Devised I-E scale questionnaire (RSI); Used interviews and secondary sources to correlate I-E scores with behaviour.

Findings:

• Gambling: internals less likely to gamble but preferred to back favourites while externals preferred outsiders 

• Externals prone to gamblers fallacy 

• Internals better at persuading others

• Smoking: Externals more likely to smoke and Internals more likely to quite 

Conclusion:

• Internals: gain information to improve their lives; take initiative in their life; Resist manipulation by others; Lead healthier lives 

4 Different factors affect self-efficacy: enactive influences; Vicarious influences; Persuasory influences; Emotive influences

Aim: Assess self efficacy of patients doing synthetic desensitisation for snake phobias

Method: Quasi

Participants: 10 self selected snake phobia patients 

Procedure:

• Measured fear and perception on how they would cope
• Given relaxation exercises 
• Desensitisation: Looked at snake pictures and when arousal level fell, they was placed in the same room with a snake and then were able to handle one
• fear and coping perception measured again

Findings: Second fear scores significantly lower and perception scores were significantly higher

Conclusions:

• Desensitisation works
• Self-efficacy is both a cognitive and behavioural process. Cognitive because of perception and behavioural due to enactive influence 

Health Promotion

• Cowpe- Media Campaigns
• Dannenberg- Legalisation 
• Janis and Feshbach- Fear Arousal 

Aim: Test effectiveness of an advertising campaign aimed to reduce chip pan fires 

Procedure:

• 2 60 second commercials showing causes of chip pans fires and how to extinguish them
• Real time + slow motion = heighten then effect
• Two quantitative consumer attitude surveys

Findings: 

• 12% reduction in chip pan fires
• Reduction highest immediately after screaming and then levelled off
• 62% aware of chip pans fires before advert and 92% at the end

Conclusion: Media campaigns effective in increasing awareness and changing behaviour. Most useful when they contain information what to do and not what to think or be scared off.

Yale Model of Communication: The communicator; The message; The audience 

Aim: Assess impact of legalisation requiring helmets to be worn by cyclists 

Method: Quasi + Self report questionnaire 

Participants: 7332 children; 46% response rate on questionnaire; 3 Counties: Montgomery, Howard and Baltimore 

Procedure: Questionnaire sent by post; Compare present helmet use with the year before; anonymous and parens helped children fill it in

Findings: 

• Howard country use rose 11-38%
• Montgomery 8-13%
• Baltimore 7-11%

Conclusions: Legalisation is effective and education campaigns had no significant effect

Aim: Study whether fear arousal changes behaviour

Sample: Entire freshman class of a large Connecticut school; mean age 15; Equal M:F

Procedure: Divided into 4 groups; Given 15 minute lecture on tooth decay however 4th group acted as a control:

• Strong fear group = emphasised painful consequences of tooth decay 
• Moderate fear group = Dangers were described in milder and more factual way
• Minimal fear Group = Consequence of tooth neglect rarely mentioned

Participants then given 3 questionnaires: One week before lecture; Immediately after; One walk after lecture

Findings: 

• All groups gained similar amounts of information 
• Strong fear group had higher levels of fear arousal + great anxiety about tooth decay
• Minimal fear group most likely to change behaviour (36%); Moderate fear (22%); Strong fear group (8%)

Conclusion: When fear is strongly aroused, but not relieved by reassurance, the audience will become to ignore or minimise threat.

Adherence 

• Bulpitt- Reasons for non adherence 
• Lustman- Measures of non adherence
• Funhaler- Improving adherence using behavioural methods

Aim: Investigate adherence in hypertensive patients 

Method: Review article of research into problems with taking drugs for hypertension 

Findings:

• Anti-hypertension has many side effects: Sleepiness, dizziness, lack of sexual functioning and also cognitive functioning so work and hobbies are curtailed. 
• Study by Curb: 8% of males stopped treatment because of sexual problems
• Medical Research council study: 15% of patients withdrawn from treatment due to side effects 

Conclusion: When costs of medicine outweigh the benefits, there is less likelihood of adhering to treatment. 

Aim: Assess effectiveness of fluoxetine as treatment for depression in patients with diabetes 

Methodology: Lab; Double blind experiment and placebo 

Participants: 60 participants with both depression and diabetes from a self selected sample

Procedure: 

• All screened for depression using becks depression inventory
• Randomly assigned to two groups 
• One group given fluoxetina and the given a placebo
• Given ‘medication’ for 8 weeks
• double blind to avoid demand characteristics 

Findings: 

• Reduction in depression signficatnly greater in patients treated with fluoxetina rather than placebo
• These patients also had nearer normal blood sugar levels = more adherence to new diet and insulin self injection

Conclusion: Measuring blood sugar in patients with diabetes was a  good way of measuring adherence to the medical regime.

Aim: To see if using a Funhaler can improve children use of children asthma medication

Methodology: Field experiment; comparing 2 asthma inhalers with a self report method

Participants: 32 asthmatic children; Age 1.5-6; Parents given informed consent

Design: Repeated measures design; 1 week using breath-a-tech and 1 week using Funhaler

Procedure:  

• Parents given a questionnaire at the end of each weak

Findings: 

• 38% more parents were found to have medicated their children the previous day when using the Funhaler compared to existing treatment 

Conclusions: 

• Previous research found non-adherence by child asthmatic due to to child resistance and forgetfulness
• Funhaler did improve adherence to medicine
• So by making medical regime fun = adherence removed