Chapter 6 – Health Psychology

Lecturer PowerPoint
Lecturer Lesson Plan
Additional Case Study
3 Papers
3 Websites
3 Media Articles
Learning Tasks Discussion
Issues you may have considered in relation to the Learning Tasks in the book…

Learning Task 1: Reflection on changing behaviour

In carrying out this reflective exercise, you will have considered a range of different influences on your behaviour. Taking the idea of eating more healthily, responses to the questions might be as follows:
a) Putting on weight over Christmas.
b) The prompt of the New Year and it being a time when resolutions are made.
c) A friend, partner or family member might also be trying to eat more healthily which could help in changing behaviour (increase motivation); however, the same people might hinder behaviour change by tempting you into less healthy eating.
d) The answer to this question will depend on you!

The answer to this question is also individual but in this example you might try to avoid being in situations where you are faced with less healthy food choices, like not going into fast-food outlets.

Learning Task 2: Lifestyle factors

You may have included things like smoking, food habits, alcohol consumption, patterns of physical activity, legal and ill-legal drug-use, etc.
Part b) should be self-explanatory and, as noted, certain behaviours may be both enhancing and risky. To a certain extent this depends on how you view health and what it means to be healthy (your own personal concepts and perceptions of health).
Taking the issue of alcohol use as an example, drinking can be viewed as harmful to physical health (increasing risk of accident and injury in the short term and a range of physiological problems in the long term, such as liver disease). On the other hand, there is also the perspective that drinking alcohol is beneficial for social health – increased confidence interacting with others – and also for mental health – dealing with feelings of stress and anxiety.

Learning Task 3: Determinants of health behaviour

Your spider diagram will no doubt be extensive if you have given it a lot of thought. Ideas you might have included could be the environment – physical, social, political; access to resources; psychological factors such as motivation, etc.
An example of a pattern you may have identified is factors which may be considered as ‘internal’ to the individual or as ‘external’ to the individual.
Psychological factors will include things like motivation, beliefs about the ability to do something, beliefs about control, etc. Further information about this is available in the chapter.

Learning Task 4: Limitations of models of behaviour change

None of the models provide a complete explanation about behaviour, nor do they account wholly for the factors involved in behaviour change; however, they can be useful in explaining health behaviours to a certain extent. How you answer this question will depend on whether you choose to critique the models one by one or as a ‘whole’. A useful critique of the models as a whole is provided in Chapter 6.

Multiple Choice Quiz

1. Which of the following sub-disciplines of psychology has a lot to offer to understanding health-related behaviours?
a. Health Psychology
b. Educational Psychology
c. Forensic Psychology
d. Feminist Psychology

ANSWER

The correct answer is a. The other answers are also sub-disciplines of psychology which may be of some relevance but, of this list, health psychology has been most influential in the study of health-related behaviours.

2. Which of the following is NOT a way to describe health behaviour?
a. Behaviours that we engage in to enhance our health
b. Behaviours that we engage in when we are sick
c. Behaviours that we engage in to keep ourselves healthy
d. Behaviours that we engage in to protect ourselves from getting sick

ANSWER

The correct answer is b. This would be called ‘illness’ behaviour rather than health behaviour. The other answers are examples of different types of health behaviours.

3. Which of the following behaviours would NOT be described as ‘lifestyle’ factors?
a. Obesity
b. Physical activity
c. Dietary choices
d. Alcohol consumption

ANSWER

The correct answer is a. Obesity may result in part from a range of behaviours or lifestyle factors but it is not a lifestyle factor in itself. The other three answers are examples of lifestyle or behavioural factors.

4. Which of the following is NOT a type of health behaviour identified in Hubley & Copeman’s typology of behaviours?
a. One-time
b. Decision-based
c. Addictive
d. Impulsive

ANSWER

The correct answer is d. This does not appear on Hubley and Copeman’s typology – but maybe it should! The other answers all do appear.

5. Why is the concept of ‘internal control’ important for understanding health behaviour?
a. Because it is linked to health experience
b. Because we need to be able to control our own health
c. Because without control we will get sick
d. Because we are controlled by other people

ANSWER

The correct answer is a. Internal control is linked to health experience. People with higher levels of internal control are more likely to engage in health-promoting behaviours and to see health as being within or under their control.

6. Which of the following is a model which describes the process of behaviour change?
a. The Health Belief Model
b. The Theory of Planned Behaviour
c. The Stages of Change Model
d. Protection Motivation Theory

ANSWER

The correct answer is c. The Stages of Change Model describes the process of behaviour change, whilst the other three models attempt to provide an explanation of behaviour change and do not describe the stages which someone might go through when they attempt to change their behaviour.

7. Which of the following models takes into account the concept of fear in behaviour change?
a. The Health Belief Model
b. The Theory of Planned Behaviour
c. The Stages of Change Model
d. Protection Motivation Theory

ANSWER

The correct answer is d. This is the only model in this list which explicitly uses the concept of fear as a construct or variable within it.

8. Which of the following models takes into account the role that other people have in influencing our behaviour?

a. The Health Belief Model
b. The Theory of Planned Behaviour
c. The Stages of Change Model
d. Protection Motivation Theory

ANSWER

The correct answer is b. The Theory of Planned Behaviour takes this into account in the variable called ‘Subjective Norms’.

9. Which of the following is a general critique of models of behaviour change?
a. They do not take into account wider influences on health behaviour
b. They are too complex
c. They are not complex enough
d. They do not focus on the individual enough

ANSWER

The correct answer is a. All of the models tend to focus at the individual level at the expense of wider determinants of health.

10. Which of the following is NOT a component of the Health Action Model?
a. Affective system
b. Motivation system
c. Normative system
d. Belief system

ANSWER

The correct answer is a. All of the others are systems within the Health Action Model except this one.

Additional Case Study: Taking part in extreme sports

Examples of so-called ‘Extreme Sports’ include mountaineering, surfing and paragliding. They are labelled this way because there is a greater degree of risk involved – risk in terms of potential accident and injury (even death) alongside notions of risk-taking, adrenaline- and thrill-seeking or even death-defiance (Immonen et al, 2018). This risk is (far) greater than engaging in more everyday activities.

Despite the risks involved, an increasing number of people take part in this type of activity. People describe their experiences as positive, deeply meaningful and life enhancing (Immonen, et al, 2018). Stranger (1999) carried out a study on people who surf. He found that surfing had many attractions to the surfers whom he researched. These included ideas of pleasure and reward.

Brymer and Schweitzer (2017) state that there is a significant increase in, and engagement with, extreme sport activities such as BASE jumping, big-wave surfing, extreme skiing, waterfall kayaking, extreme mountaineering, and solo rope-free climbing. In their research into the experiences of people who engage in extreme sports, they found three key themes – invigorating experiences, inadequacy of words (to explain the experience) and the participants’ experiences of transcendence.

Terms like ‘thrill-seeking’ and ‘getting a buzz’ are often ways in which high-risk activities like surfing are spoken about. These feelings appear to outweigh any anxieties about the risks involved and consequently they are viewed as being ‘worth it’.

3 Papers

Laverack, G. (2017) The Challenge of Behaviour Change and Health Promotion. Challenges, 8 (25). LINK
In this commentary, Glenn Laverack discusses the challenges of the behaviour-change approach to promoting health. He argues that the evidence for behaviour-change approaches is unclear and that they have little impact on the wider social determinants of health. Read the paper to find out more about what he has to say and how he thinks efforts should be focused at governmental rather than individual levels.

MacDonald, B., Fitzsimons, C. and Niven, A. (2018) Using the COM-B model of behaviours to understand sitting behaviour in UK office workers. Sport & Exercise Psychology Review, 14 (1), 23–32. LINK
Many people spend a lot of time sitting down at work and a sedentary lifestyle is known to increase the risk of a number of chronic health conditions. This paper reports on a study that used the COM-B model of behaviour to examine how capability, opportunity and motivation influenced sitting behaviour in office workers. Read the paper to find out what factors influence sedentary behaviour and how this knowledge might translate into designing more effective health-promotion interventions.

Kebbe, M., Perez, A., Buchholz, A., McHugh, T.F., Scott, S.S., Richard, C., Mohipp, C., Dysoon, M.P. and Ball, G.D.C. (2018) Barriers and enablers for adopting lifestyle behaviour changes in adolescents with obesity: A multi-centre, qualitative study. PLoS One, 13 (12). LINK
Many adolescents with obesity do not meet recommendations for nutrition, physical and sedentary activities, or sleep habits and all of these factors can impact on weight management. In this paper from Canada, the authors use qualitative methods to explore what factors enable and hinder changes in lifestyles and behaviour for adolescents who are struggling with their weight. Three key themes emerged which were shared barriers/enablers: the degree of controllability, the impact of mental health, and social pressures related to healthy weight management. The authors suggest that these findings have implications for practice – read the paper to find out more about how interventions might be tailored to better support adolescents to maintain a healthier lifestyle.

3 Websites

1. The King’s Fund
A reading list on ‘encouraging healthy behaviour’.

2. The National Institute for Health and Care Excellence
A useful document on individual approaches to behaviour change.

3. ‘Change4Life’ campaign
A good example of an intervention designed to encourage people to change a range of behaviours relating to health. Have a look at the website and see how the content/strategies relate to the issues raised in Chapter 6.

3 Media Articles

1. Call for complete ban on smoking in vehicles
A short piece about the debate on whether to ban smoking in cars, illustrating some of the complexities around health-related behaviours.

2. Extreme adventures: the top 10 stories of real-life peril
These real-life stories illustrate many of the factors discussed within this chapter in relation to health and behaviour, how behaviour might be risky to health in one sense yet health enhancing in another.

3. The forgotten global health crisis
This YouTube clip about Zambia illustrates many things to do with behaviour, not least that our social and political environment impacts on the choices we make and the things that we can do.