Testing compensatory health beliefs in a UK population

Compensatory health beliefs, beliefs that healthy behaviours can compensate or neutralise unhealthy behaviours, have been proposed as one way of understanding why people engage in health-risk behaviours (Kn?uper, B., Rabiau, M., Cohen, O., & Patriciu, N. (2004). Compensatory health beliefs scale development and psychometric properties. Psychology and Health, 19, 607-624). However, measuring compensatory health beliefs has proved a challenge, with several recent studies being unable to replicate the psychometric properties of Kn?uper et al.'s (2004) scales. The aims of this study were to: (1) test the factor structure of the compensatory health beliefs scale in the UK, (2) examine the predictive validity of the scale by testing the relationships between compensatory health beliefs and health behaviours over a six-month time interval and (3) assess the 6-month test-retest reliability of the scale. A total of 393 participants completed measures of compensatory health beliefs and health behaviours at two time points separated by six months. The findings were potentially problematic for research into compensatory health beliefs: the factor structure was not confirmed, there was little evidence of predictive validity, and test-retest reliability was poor. Further research is required to understand the operation of compensatory health beliefs and to develop the measurement of compensatory health beliefs.     

Resisting temptation: alcohol specific self-efficacy mediates the impacts of compensatory health beliefs and behaviours on alcohol consumption

Awareness of health risks linked with excessive alcohol consumption appears to have little influence on how much some people drink. Compensatory health beliefs (CHBs), in which the consequences of unhealthy behaviour are considered to be neutralised by additional healthy behaviours, are one way of justifying poor health choices. Currently, the role of CHBs within the context of drinking behaviour is not well understood. This research examined associations between alcohol specific compensatory health beliefs (ACH-Beliefs) and behaviours (ACH-Behaviours), alcohol consumption and alcohol specific self-efficacy (ASE), via an online survey completed by 249 participants, aged 18 + years (63.1% female; M age = 41.62 years; SD = 14.80). Higher ACH-Beliefs were associated with increases in ACH-Behaviours. While both predicted alcohol consumption, a greater proportion of variance was explained by ACH-Behaviours. ASE was a significant mediator of those relationships, suggesting that those with higher ASE may be better equipped to regulate drinking behaviour. Recommendations for future research include measuring both CHBs and behaviours within an experimental design, and further investigation of related cognitions such as compensatory behaviour intentions. Alcohol misuse interventions may wish to consider the potential roles of CHBs and behaviours in facilitating maladaptive coping strategies, and how addressing these may reduce harms.     

Predicting physical activity in adolescents: The role of compensatory health beliefs within the Health Action Process Approach

Objective: Compensatory health beliefs (CHBs), defined as beliefs that healthy behaviours can compensate for unhealthy behaviours, may be one possible factor hindering people in adopting a healthier lifestyle. This study examined the contribution of CHBs to the prediction of adolescents’ physical activity within the theoretical framework of the Health Action Process Approach (HAPA).

Design: The study followed a prospective survey design with assessments at baseline (T1) and two weeks later (T2).

Method: Questionnaire data on physical activity, HAPA variables and CHBs were obtained twice from 430 adolescents of four different Swiss schools. Multilevel modelling was applied.

Results: CHBs added significantly to the prediction of intentions and change in intentions, in that higher CHBs were associated with lower intentions to be physically active at T2 and a reduction in intentions from T1 to T2. No effect of CHBs emerged for the prediction of self-reported levels of physical activity at T2 and change in physical activity from T1 to T2.

Conclusion: Findings emphasise the relevance of examining CHBs in the context of an established health behaviour change model and suggest that CHBs are of particular importance in the process of intention formation.     

Compensatory health beliefs: scale development and psychometric properties

Compensatory Health Beliefs (CHBs) are beliefs that the negative effects of an unhealthy behavior can be compensated for, or “neutralised,” by engaging in a healthy behavior. “I can eat this piece of cake now because I will exercise this evening” is an example of such beliefs. The present research describes a psychometric scale to measure CHBs (Study 1) and provides data on its reliability and validity (Studies 2 and 3). The results show that scores on the scale are uniquely associated with health-related risk behaviors and symptom reports and can be differentiated from a number of related constructs, including irrational health beliefs. Holding CHBs may hinder individuals from acquiring healthier lifestyles, for example lose weight or exercise.     

Gender and health behaviours of hypertensive patients: mediating role of control beliefs

Previous studies have reported gender differences in patients’ health behaviours but few studied hypertensive patients. The potential underlying factors that may mediate gender influences on health behaviours is also a more critical area worthy of investigation. This study examined health locus of control (HLC) as a pathway of gender effects on health behaviours of hypertensive patients. The Multidimensional HLC Scale (Form C) and Wellness behaviour subscale of Health Behaviour Checklist were completed by 400 hypertensive outpatients in two Nigerian hospitals: Enugu State University Teaching Hospital, Park Lane, Enugu, and Bishop Shanahan Specialist Hospital, Nsukka. Hierarchical multiple regression results showed that gender significantly predicted health behaviours. Gender also significantly predicted internal HLC, chance HLC, and other people HLC, but did not predict doctor HLC. The association between gender and health behaviours was fully mediated by internal HLC, chance HLC and other people HLC. Understanding the explanatory mechanisms linking socio-demographic factors and health behaviours is considered of great importance for future research and healthcare intervention.     

Effects of tailoring ingredients in auditory persuasive health messages on fruit and vegetable intake

Objective: Health messages can be tailored by applying different tailoring ingredients, among which personalisation, feedback and adaptation. This experiment investigated the separate effects of these tailoring ingredients on behaviour in auditory health persuasion. Furthermore, the moderating effect of self-efficacy was assessed.

Design: The between-participants design consisted of four conditions. A generic health message served as a control condition; personalisation was applied using the recipient’s first name, feedback was given on the personal state, or the message was adapted to the recipient’s value.

Main outcome measures: The study consisted of a pre-test questionnaire (measuring fruit and vegetable intake and perceived difficulty of performing these behaviours, indicating self-efficacy), exposure to the auditory message and a follow-up questionnaire measuring fruit and vegetable intake two weeks after message exposure (n = 112).

Results: ANCOVAs showed no main effect of condition on either fruit or vegetable intake, but a moderation was found on vegetable intake: When self-efficacy was low, vegetable intake was higher after listening to the personalisation message. No significant differences between the conditions were found when self-efficacy was high.

Conclusion: Individuals with low self-efficacy seemed to benefit from incorporating personalisation, but only regarding vegetable consumption. This finding warrants further investigation in tailoring research.     

Essentialist beliefs affect children's outgroup empathy,attitudes and prosocial behaviours in a setting of intergroup conflict

Empathy for salient outgroups can promote positive intergroup attitudes and prosocial behaviours. Less is known about which factors may promote empathy, particularly among children, in contexts of intergroup conflict. Empathy may depend on underlying cognitions, such as social essentialist beliefs, that is, believing that certain social categories have an underlying essence that causes members to share observable and non-observable properties. This study explored the influence of essentialist beliefs about ethno-religious categories on outgroup-directed empathy, attitudes and prosocial behaviours of children living in Northern Ireland (N = 88; M = 7.09, SD = 1.47 years old). Bootstrapped chain mediation found that lower essentialist beliefs predicted greater outgroup-directed empathy, which was positively related to outgroup attitudes, which in turn, predicted more outgroup prosocial behaviours. The findings highlight the importance of essentialist beliefs as an underlying factor promoting empathy, with links to prosocial behaviours in settings of intergroup conflict. The intervention implications are discussed.     

A narrative review: arguments for a collaborative approach in mental health between traditional healers and clinicians regarding spiritual beliefs

This review explores the possibility of a more collaborative approach between mental health clinicians and traditional healers, from a clinical psychology perspective, for clients with spiritual beliefs. Spiritual beliefs are incorporated into the identity and functioning of clients within a cultural context and prevalence rates reveal this is not uncommon. It is argued that working collaboratively would address many access difficulties to mental health services and support is generated through a number of studies and case reports in the United Kingdom, worldwide and across cultures. This approach appears to be in accordance with current theories of acculturation. The problems in the current system when working non-collaboratively are also explored. Counter arguments and pragmatic difficulties of collaboration have been discussed. Research in the United Kingdom is limited and it is suggested that more research is needed in the field. Pragmatic solutions are suggested to stimulate discussion.     

Pilot study of the effects of a workplace smoking ban on indices of smoking,cigarette craving,stress and other health behaviours

Abstract

Worksite smoking bans provide an ideal opportunity to examine the effects of enforced smoking restrictions on not only smoking behaviour, but also other health behaviours. This pilot study examines the short term effects of a such a ban on self-reported smoking behaviour, carbon monoxide and plasma cotinine levels and a number of other appetitive behaviours. The total number of cigarettes smoked on a working day and the number smoked just during working hours both declined following the introduction of a ban. Although the carbon monoxide levels of smokers during working hours demonstrated a similar trend to self-reported smoking, smokers' cotinine levels tended to increase, following an initial decrease following the ban. These data are suggestive of a compensatory process and a change in smoking topography, probably outside working hours. Measures of stress and craving also appeared to be affected by the introduction of smoking restrictions.     

Dietary planning,self-efficacy,and outcome expectancies play a role in an online intervention on fruit and vegetable consumption

Objective: An online intervention to improve fruit and vegetable (FV) intake examines the role of planning, outcome expectancies, self-efficacy and gender. Women are not only expected to eat more FV than men, but they are also expected to be more responsive to nutritional advice and benefit more from treatment.

Method: A two-arm digital intervention with 269 men and 395 women (M_age = 41.2, SD_age = 11.45; range: 19–66 years) was conducted in Italy, Spain and Greece, followed up at three and six months, comparing a static with a dynamic, feedback-intensive platform.

Results: Linear mixed models yielded an increase in FV consumption in both the dynamic and the static intervention arms. In men, outcome expectancies were positively related to follow-up FV intake. Dietary planning interacted with self-efficacy on behavioural outcomes.

Conclusion: FV intake increased overall, and being a woman and involvement in planning facilitated behaviour change. Women seemed to be more engaged in the dynamic platform resulting in a higher amount of planning. Initial motivation, as indicated by outcome expectancies, seemed to be beneficial for men. Self-efficacious individuals benefitted from their engagement in planning, but self-efficacy did not compensate for failing to plan.     

Health-related behaviours and their correlates in a general population sample of 45-year old women

Abstract

Preventive strategies for menopausal women to reduce the risks for osteoporosis and cardiovascular disease has been the focus of considerable attention, but understanding of mid-aged women's behavioural risk factors for these diseases is meagre. The current study describes a range of health-related behaviours and their psychosocial correlates, in a sample of 45-year old women, recruited from five general practices and assessed by postal survey (N=106, response rate 60%). Results suggest that health promotion for this group might best focus upon increases in regular exercise, calcium intake and breast awareness, and decreases in cigarette and caffeine consumption. The behaviours assessed were generally not inter-related. However, several associations were identified between behaviours and health and psychosocial variables. The main ones were the association between menopausal status and smoking, and the relationship between body weight, self-esteem and physical exercise. It is argued that the menopause transition can be an opportunity for preventive work.     

An experimental test of the relationship between voice intonation and persuasion in the domain of health

Objective: In the process of behaviour change, intonation of speech is an important aspect that may influence persuasion when auditory messages are used. In two experiments, we tested to what extent different levels of intonation are related to persuasion and whether for some recipients the threat posed by the message information might become too strong to face.

Design: In Study 1, 130 respondents listened to a health message with either a low, moderate or high level of intonation. In Study 2 (N?=?143), the same manipulations of intonation were applied but half of the respondents were affirmed before they listened to the persuasive message. Intention to increase fruit and vegetable intake was used as a dependent variable.

Results: Both studies showed that high intonation led to a significant drop in intention among respondents who perceived their own health as good. After self-affirmation, persuasion was increased.

Conclusion: A high level of intonation seems to induce self-regulatory defences in people who do not see the necessity to change their health behaviour, whereas people with poor perceived health might perceive potential to change. The use of a normal level of intonation in auditory health messages is recommended.     

Health messages to promote fruit and vegetable consumption at different stages: A match-mismatch design

Objective: To examine the effectiveness of matching health messages promoting fruit and vegetable intake to the Health Action Process Approach stages of change.

Design: In a randomised controlled trial, 205 undergraduate students (non-intenders n = 123; intenders n = 82) were exposed to one of three health messages, targeted at non-intenders, intenders and controls.

Main outcome measures: Three longitudinal assessments of stage, fruit and vegetable intake, and social-cognitive determinants were obtained.

Results: Stage-specific effects of the interventions were confirmed. For self-efficacy, a stage by health message crossover interaction emerged, with both non-intenders and intenders in the matched conditions scoring higher in self-efficacy. Furthermore, in line with predictions, non-intenders in the matched condition showed higher risk perception, outcome expectancies, intention, and stage progression immediately after message exposure, and lower levels of action planning and coping planning a week later in the mismatched condition, but for these outcomes no differences across conditions were obtained among intenders. Multiple mediation analyses confirmed the facilitating role of self-efficacy and behavioural intention among non-intenders.

Conclusions: Stages should be considered when designing health messages, although more interactive interventions for intenders and extended measurement time frames may be required.     

Prevalence and behavioural risk factors of light or moderate and heavy cigarette smoking in 32 countries

The aim of this study was to predict the prevalence of light or moderate and heavy smoking from lifestyle behavioural risk factors among South African adults compared to others from 31 countries around the world. Secondary data from 53 391 adults who completed the International Social Survey Program (ISSP), 2011–2013, Health and Health Care Module were accessed for this study (South Africans, N = 3 004). Findings from multinomial logistic regression with adjustment for personal factors (e.g. physical and psychological well-being variables) were used to explain a significant proportion of both light or moderate smoking and heavy smoking among South African adults as well as adults from the other countries. Specifically, lifestyle factors of being underweight and overweight or obese were negatively associated with light or moderate smoking, but body mass index (BMI) weight status was not associated with heavy smoking. Smoking interventions should target modifiable lifestyle factors to prevent risk for light or moderate smoking and heavy smoking.     

Rational beliefs,happiness and optimism: An empirical assessment of REBT's model of psychological health

This study sought to test the validity of the psychological health model of Rational Emotive Behaviour Therapy (REBT). Specifically, this study sought to investigate if rational beliefs were associated with happiness and optimism. A multinational sample of 397 university students completed self‐report measures of rational beliefs, happiness and optimism. Structural equation modelling (SEM) was used in order to test the validity of the REBT model of psychological health. The result of the SEM analysis provided empirical support for REBT's psychological health model of happiness and optimism. The model as a whole explained 33% of variance in levels of happiness and 40% of variance in levels of optimism. Self‐acceptance beliefs were positively and directly associated with happiness and optimism. Preference beliefs were positively and indirectly associated with happiness and optimism via self‐acceptance beliefs. REBT may offer a viable psychotherapeutic method to not only alleviate psychological distress, but also build positive emotion. Current findings may help to bridge the divide between the fields of positive psychology and clinical psychology.     

Social representations of health and illness: the case of the Chinese community in England

This paper reports results from a qualitative study on social representations of health and illness among the Chinese community in England. It is assumed that representations of health and illness are grounded in cultural frameworks and are constructed through communication, social interaction and the practices of daily life. Our findings show that in spite of differences related to age and degrees of acculturation, Chinese people in England share a common representational system with respect to health and illness. This system is based on the traditional notions of “balance” and “harmony” between the interdependent forces of Yin and Yang. Health results from balance, whereas illness is brought about by disequilibrium. It is through these traditional Chinese concepts that Western biomedical knowledge is incorporated, producing a mixed representational field where Chinese and Western knowledge co‐exist. This representational field is transmitted through the most fundamental dimensions of culture: food, language and kinship relations. We conclude by showing that social representations of health and illness are inseparable from the struggles over identity experienced by the Chinese people in England. Copyright © 1999 John Wiley & Sons, Ltd.     

Family characteristics and health behaviours of adolescents and families

Abstract

The relationship between general family characteristics, represented by family cohesion and adaptability, and health behaviours (smoking, alcohol use, food choice, sleeping, Body Mass Index, and physical activity) is studied in a first study of 429 adolescents and young adults, and in a second study of 522 family triads (adolescent-mother-father). Using cluster analysis, adolescent groups with four different profiles of health behaviour were identified. Very similar results were found in the two studies. The health behaviour patterns in the different subgroups show that forms of (un)desirable health behaviours are interrelated in some clusters. Adolescents in the most healthy clusters, consistently reported highest levels of family cohesion. The relationship between family adaptability and health behaviours showed only limited significance. In families characterised by a high level of emotional bonding between family members together with stability and regularity in roles rules and power structure, adolescents' behaviour is the most healthy. The findings suggest that parental involvement is desirable in health promotion intervention. Further, it seems possible that health behaviours originate from a relatively small set of family Characteristics and that modifying family interactions might be powerful, albeit very difficult to do so, in changing a variety of health behaviours in adolescents.     

Delays in seeking cancer diagnosis in relation to beliefs about the curability of cancer in patients with different disease locations

This study is aimed at investigating factors leading to delayed oncologic examinations versus immediate consultation with a physician in patients with various cancers. We analysed the results of a study of patients (n?=?291) reporting for their first oncologic examinations. We conducted structured interviews containing social, demographic and clinical data, the Spielberger State-Trait Anxiety Inventory, the Beck Depression Inventory and Harris and Guten's health appraisal scores. Based on an analysis of decision-making trees, the results indicate that it is possible to predict beliefs regarding the curability of cancer and immediate versus delayed reporting to a physician. Delayed reports may be predicted on the basis of two factors: (1) a belief that cancer is incurable combined with increased state anxiety, ‘good’ or ‘very good’ self-appraisal of health and low depression; and (2) a belief that cancer is incurable accompanied by increased anxiety and depression. The characteristics of patients delaying a visit to the oncologist suggest the existence of three independent factors leading to both considerable (longer than nine months) and minor (up to one month) delays in seeking treatment.     

Examination stress and changes in mood and health related behaviours

Abstract

The present exploratory study evaluated the effect of stress (an examination period) on changes in mood and health related behaviours. 83 medical students completed measures of mood and health related bchaviours at baseline and four weeks later either during their examinations period (the stress condition) or after a comparative control period (the control condition). All subjects also completed ratings of stress mediating variables: social support, perceived control and coping style at baseline. The results showed deterioration in mood in terms of increases in depression and anxiety and changes in health related behaviours in terms of increased numbers of subjects who identified thcmsehes as smokers, and dcmascs in alcohol consumption, exercise and food intake in subjects in the stress condition. The results also suggest that social support moderated the effects of the examination stress and was related to greater decreases in smoking, decrcases in alcohol craving and increases in eating behaviour. In addition, an avoidance coping style (problem avoidance, wishful thinking) was related to greater decreases in eating behaviour. 'Ihe nsults an discussed in the context of the stress/illness link and the role of behavioural change.