Bi-dimensional attitudes,attitude accessibility and speeding behaviour

Positive and negative attitude dimensions (i.e., bi-dimensional attitudes) asymmetrically predict behaviour, with the positive dimension being the better predictor than the negative dimension. These findings have been demonstrated using self-reported behaviour measures. In this study, we aimed to test the bi-dimensional attitude-behaviour relationship using objectively measured speeding behaviour derived from a driving simulator and test if the asymmetrical prediction of behaviour from the positive and negative attitude dimensions could be explained by attitude accessibility (how available an attitude is in memory and therefore how readily it is able to guide behaviour). One hundred and six drivers completed online measures of the positive and negative dimensions of their attitudes towards exceeding the speed limit. Response latency measures of the accessibilities of both dimensions were also taken. A driving simulator was used to measure speeding behaviour. Both attitude dimensions independently predicted speeding, with the positive dimension being the stronger predictor. The positive attitude dimension was also more accessible than was the negative dimension. The difference in the accessibilities of the positive and negative attitude dimensions significantly mediated the difference in their predictive validities. The results demonstrate that the positive attitude dimension is the principle predictor of speeding and a reason for this is that it is more accessible in memory than is the negative attitude dimension. Road safety interventions (e.g., education) that aim to reduce speeding and associated traffic crashes might usefully decrease the valence or accessibility of the positive attitude dimension. There would also appear to be scope to reduce speeding by increasing the valence or accessibility of the negative attitude dimension.     

Finding new ways to practise critically: applying a critical reflection model with Australian health promotion practitioners

Greater support is required in health promotion for practitioners to adopt critical approaches to their practice. Despite recognition of the role that critical reflection can play in supporting critical practice, it is underdeveloped in health promotion. This pilot study aimed to explore the use of critical reflection with health promotion practitioners. Critical postmodernism provided the theoretical perspective and critical reflection methodology guided the study. The data collection method involved the application of a critical reflection model via in-depth semi-structured interviews with two health promotion practitioners who were recruited using purposive sampling. Critical postmodernism and critical health promotion values and principles were the thematic frameworks used to analyse the data. Four types of assumptions were identified across both participants’ narratives: binary opposites and dichotomous thinking; identity and othering; professionalism; and power. Two key themes that evidenced these assumptions were conceptualising power as a commodity, and identity in the Aboriginal and Torres Strait Islander context. Both traditional and critical health promotion practice approaches were evident in participants’ practice. The process of engaging in critical reflection resulted in positive outcomes for the practitioners, including the identification of new, more critical ways of practising. Critical reflection provides a process for developing critical health promotion practice. The designation of critical reflection as a core health promotion competency may enhance the development of critical health promotion. Further research is needed to develop and test a critical reflection model incorporating the values and principles of health promotion with a larger sample of practitioners.     

Evaluating complex interventions: Perspectives and issues for health behaviour change interventions

Objective: Health behaviour change interventions (HBCIs), used in health education, health promotion, patient education and psychotherapy areas, are considered complex interventions. The objective of this article is to discuss the value and limitations of using randomised clinical trials (RCTs) to asses HBCIs.

Methods: A scoping review of the literature was conducted to identify the main challenges of using RCTs for evaluating HBCIs. The issues were illustrated by case studies selected from research conducted by our multidisciplinary team.

Results: In complex interventions, effects are produced not only by the intervention, but are strongly linked to context. Issues relating to transferability of results are therefore critical, and require adjustments to the RCT model. Sampling bias, biases related to the experimental conditions and biases due to the absence of double-blindness were examined and illustrated by case studies.

Conclusion: The results underline the importance of a multidisciplinary approach. They call for adapted or alternative evaluation models that overcome the limitations of RCTs.     

Teleonics of health and healthcare: Focus on health promotion

Teleonics is an approach to the study of living systems. The latter can be regarded as synergistic collections of processes through which the systems interact with their internal and external environments. Teleonics can serve as a framework for positioning issues of health into the wider context of the fabric of life. There are essentially three webs of processes that are of relevance for a discussion of healthcare, viz, the normal web of the living fabric (Biomatrix), the “web of disease” (Pathomatrix) and the web of Healthcare. The latter interacts with the first two through the processes of Health Promotion, Disease Prevention and Disease Management. The end result of these interactions is an entirely new web of great complexity that incorporates the processes of all three webs intertwined with each other. This complexity presents a considerable challenge to all those involved in healthcare and can only be untangled with the aid of a process‐based methodology, such as teleonics.     

Psychology,health and health care

This article traces the development of the World Health Organization's emphasis on psychological and behavioural factors in health and notes its encouragement of recognition of these factors by member states. The article further outlines the reasons for this increasing recognition and stresses the important role of psychological and behavioural factors in the maintenance of health and prevention of illness.     

Preventive behaviour and health status among the elderly

Abstract

The research describes the range of preventive health behaviours undertaken by the elderly, investigates the dimensionality of preventive health behaviour, and explores the relationship between preventive health behaviour, self-assessed and medically assessed health status. Previous research has relied mainly on self-reports of health status. Data from medical examinations and interviews with 115 elderly individuals (aged 65–75) indicated that most elderly persons performed some intentional preventive health practices, as well as a broad range of normative preventive health practices. Particular clusters of preventive health behaviour emerged when the data were subjected to cluster analysis. A short index consisting of five personal preventive health behaviours found in other studies to have a protective effect on long-term health was found to have a low to moderate correlation with the medical and self-assessments of health status employed in the study. These findings indicate particular types of preventive health behaviour of importance for health promotion programmes with the elderly.     

Testing the bi‐dimensional effects of attitudes on behavioural intentions and subsequent behaviour

Attitudes are typically treated as unidimensional predictors of both behavioural intentions and subsequent behaviour. On the basis of previous research showing that attitudes comprise two independent, positive and negative dimensions, we hypothesized that attitudes would be bi‐dimensional predictors of both behavioural intentions and subsequent behaviour. We focused on health‐risk behaviours. We therefore also hypothesized that the positive dimension of attitude (evaluations of positive behavioural outcomes) would better predict both behavioural intentions and subsequent behaviour than would the negative dimension, consistent with the positivity bias/offset principle. In Study 1 (cross sectional design), N = 109 university students completed questionnaire measures of their intentions to binge‐drink and the positive and negative dimensions of attitude. Consistent with the hypotheses, both attitude dimensions independently predicted behavioural intentions and the positive dimension was a significantly better predictor than was the negative dimension. The same pattern of findings emerged in Study 2 (cross sectional design; N = 186 university students) when we predicted intentions to binge‐drink, smoke and consume a high‐fat diet. Similarly, in Study 3 (prospective design; N = 1,232 speed limit offenders), both the positive and negative dimensions of attitude predicted subsequent (6‐month post‐baseline) speeding behaviour on two different road types and the positive dimension was the better predictor. The implications for understanding the motivation of behaviour and the development of behaviour‐change interventions are discussed.     

Australian community responses to the use of genetic testing for personalised health promotion

Personalised genetic health promotion may soon be available and affordable. To explore its likely public acceptance in Australia, a community sample (N = 800) provided quantitative and qualitative responses to a vignette scenario about a hypothetical expert who could test their genes and, based on this genetic profile, provide personalised health promotion advice. Three theoretical models were tested to explicate the process by which cognitive–affective factors of risk beliefs, benefit beliefs, and trust judgements influenced behavioural intentions. Results supported an expert trust model, where general beliefs about the risks and benefits of medical advances and general medical trust had indirect influences, while trust in a specific medical expert had a direct influence, on health promotion intentions. Subjective reasons for intentions included moral concerns, fear, trust, mistrust and a desire to maintain health at any cost. The advent of personalised genetic health promotion may heighten the need for specialised health psychologists.     

Health behavior, knowledge and attitudes among Swedish university students

A range of health behaviors was related to beliefs concerning health practices and health knowledge. A questionnaire dealing with health-related practices, health beliefs and knowledge of health risk factors was answered by 166 male and 179 female students aged 18–30 years at Stockholm University. Female students reported engaging in better health behavior than males. Beliefs about the importance of health behaviors were closely related to their frequency of occurrence. There was only a weak relationship between health behaviors and knowledge of specific health matters. It is concluded that health attitudes rather than health knowledge determine health behavior.     

The effects of message quality and congruency on perceptions of tailored health communications

Recent research has documented the effectiveness of tailoring health behavior change messages to characteristics of the recipients, but little is known about the processes underlying these effects. Drawing from the elaboration likelihood model (Petty & Cacioppo, 1986), we examined the role of message scrutiny in moderating the congruency effect (Mann, Sherman, & Updegraff, 2004). One hundred and thirty-six undergraduate participants read either a strong or weak message promoting regular dental flossing with a frame (gain vs. loss) that either matched or mismatched their motivational orientation (approach vs. avoidance). Results showed that participants were sensitive to argument quality in the matched but not mismatched conditions. Further, argument quality moderated the effect of congruency on participants’ attitudes and perceived norms regarding flossing, as well as their subsequent self-reported flossing behavior. Results suggest that increased message scrutiny underlies message tailoring effects.     

Community as practice: social representations of community and their implications for health promotion

Health promotion researchers and practitioners have increasingly turned to community-based approaches. Although there has been much work around the diverse understandings of the term in areas such as community psychology and sociology, I am concerned with how such understandings relate directly to community health research and practice. From a discursive perspective ‘community’ is seen as a socially constructed representation that is used variously and pragmatically. However, from a wider view, community can be seen as a matter of embodied practice. This paper draws on social representations theory to examine the shifting constructions of ‘community’, the functional use of those understandings in social life, and the practices that suggest that it is important to attend to their use in particular contexts. Accordingly, the paper argues that meanings of community in the health promotion or public health context must be seen as representations used for specific purposes in particular situations. Furthermore, the broader notion of embodied practice in social life has implications for community participation in health promotion. Copyright © 2007 John Wiley & Sons, Ltd.     

Testing the health promotion model for adherence and quality of life in individuals with multiple sclerosis

The nature of multiple sclerosis (MS) presents challenges to health-promoting behaviors (e.g. adherence) and quality of life. The Health Promotion Model (HPM) proposes that these outcomes are explained by individual characteristics (i.e. biological, social, psychological) and behavior-specific cognitions (e.g. self-efficacy). The current study sought to test the HPM in explaining self-reported adherence and MS quality of life among 121 MS patients receiving care in an MS clinic in the southeastern United States. Hierarchical regression models partially supported the HPM for adherence (R² = .27) and more fully for quality of life (QoL) (R² = .64). Depression and stigma were among the variables most strongly related to both adherence and QoL; contrary to HPM theory, self-efficacy was not significantly related to adherence but was to QoL. Thus, the HPM may help to guide strategies used to improve QoL among individuals living with MS; however, the model may need further refinement to be used with adherence.     

Mental health professionals' attitudes towards people who are deaf

Mental health professionals' attitudes towards deaf people were examined in relation to their previous contact with deaf people and their knowledge of deafness. Data were gathered regarding different aspects of contact, including the number and type of relationships participants had had with deaf people. A cognitive-processing theory of attitude change following contact (Rothbart & John, 1985) was explored. Knowledge of deafness did not correlate with attitudes towards deaf people but a relationship was found between the amount of contact that professionals had with deaf people of equal or higher status and more positive attitudes.     

Health promotion from the perspective of social cognitive theory

Abstract

This article examines health promotion and disease prevention from the perspective of social cognitive theory. The areas of overlap with some of the most widely applied psychosocial models of health are identified. The models of health promotion and disease prevention have undergone several generational changes. We have shifted from trying to scare people into health, to rewarding them into health, to equipping them with self-regulatory skills to manage their health habits, to shoring up their habit changes with dependable social supports. These transformations have evolved a multifaceted approach that addresses the reciprocal interplay between self-regulatory and environmental determinants of health behavior. Social cognitive theory addresses the socio structural determinants of health as well as the personal determinants. A comprehensive approach to health promotion requires changing the practices of social systems that have widespread detrimental effects on health rather than solely changing the habits of individuals. Further progress in this field requires building new structures for health promotion, new systems for risk reduction and greater emphasis on health policy initiatives. People's beliefs in their collective efficacy to accomplish social change, therefore, play a key role in the policy and public health approach to health promotion and disease prevention.     

From health beliefs to self-regulation: Theoretical advances in the psychology of action control

Abstract

The paper reviews the theoretical concepts included in a range of social cognitive models which have identified psychological antecedents of individual motivation and behaviour. Areas of correspondence are noted and core constructs (derived primarily from the theory of planned behaviour and social cognitive theory) are identified. The role of intention formation, self-efficacy beliefs, attitudes, normative beliefs and self-representations are highlighted and it is argued that these constructs provide a useful framework for modelling the psychological prerequisites of health behaviour. Acknowledging that intentions do not translate into action automatically, recent advances in our understanding of the ways in which prior planning and rehearsal can enhance individual control of action and facilitate the routinisation of behaviour are considered. The importance of engaging in preparatory behaviours for the achievement of many health goals is discussed and the processes by which goals are prioritised, including their links to self-representations, are explored. The implications of social cognitive and self-regulatory theories for the cognitive assessment of individual readiness for action and for intervention design in health-related settings are highlighted.     

Health performance of individuals within the Campbell paradigm

In this paper, we developed a comprehensive health performance measure that formally links individual health attitudes with the likelihood of engaging in a wide variety of health‐related behaviours from various domains such as sustenance, hygiene, and physical exercise. Within what Kaiser, Byrka, and Hartig (2010) call the Campbell paradigm, we equated general health attitude with what a person does to retain or promote his or her health. Thus, health behaviours, on one hand, were expected to form a homogeneous, transitively ordered class of behaviours. On the other hand, the very behavioural class was in turn thought to be the basis from which an individual's health attitude could be directly assessed. A sample of 391 adults provided us with survey data containing different sets of health behaviours as well as variables and personality measures that had been corroborated as health‐behaviour relevant in previous research. We found that self‐reports of 50 behaviours and expressions of appreciation for 20 of these behaviours from various domains formed a transitively ordered class of activities. In contrast to the conventional view in health psychology, in which attitudes are regarded as a psychological cause behind individual behaviour, and in contrast to conventional findings in health psychology, where behaviours appear to fall into numerous sets of more or less distinct domains of health‐enhancing activities (e.g., exercising or avoiding risks), our findings speak of the psychological and formal unity of health behaviour. Inevitably, attitude measures grounded in the Campbell paradigm gauge individual attitudes, and just as much, they measure the health performance of individuals.     

The Global Coherence Initiative: A global psychological paradigm for health promotion

This review proposes the value of a global psychology-oriented initiative to promote health and wellbeing. It discusses the concept of collective consciousness, especially heart-based, moral consciousness and related actions as resources for health promotion. The review draws on a collaborative South African Global Coherence Initiative to support communal coherence and interconnectedness in an indigenous community setting.     

Prediction of dietary adherence in cholesterol reduction: Relative contribution of personality variables and health attitudes

Abstract

The purpose of this study was to identify personality and health attitude variables that might predict adherence to a cholesterol-reducing diet.

After taking a battery of psychological inventories, 66 subjects entered a 26 week diet program. Adherence indices included attendance rate at scheduled appointments, changes in diet, and changes in serum cholesterol levels.

Of the 55 subjects with complete data, 7 dropped out, 7 attended inconsistently, and 41 completed the program. Drop-outs scored significantly lower on the Health Belief measures of seriousness, susceptibility, and benefits. Improvement in serum cholesterol was positively correlated with the Health Belief Benefits Scale and negatively correlated with the Health Locus of Control chance scale. Dietary reduction in saturated fat was positively associated with the Health Belief Seriousness and Benefits Scales.

Health attitudes and beliefs were better predictors of adherence than personality trait measures.