What do people think about changes in health behaviors? Differential perceptions of consequences of increases and decreases in health behaviors

Most health decision-making models posit that cost-benefit analyses underlie decisions to make changes in health-related behavioral practices. In a series of studies, participants imagined either increasing or decreasing the frequency of a variety of health behaviors and estimated the consequences of those changes. In Studies 1 and 2, individuals consistently estimated that increasing a health behavior produced greater consequences than did decreasing the behavior by an equivalent amount. The results of Study 3 demonstrated that this effect is due to differences in how individuals judge the impact of health behavior changes which involve not engaging in the behavior at all versus other types of changes. Taken together, these findings suggest that perceptions of the outcomes afforded by health behavior changes depend on both the behavioral frequency and direction of changes in behavior an individual is considering. This asymmetry has the potential to help explain patterns of behavior in a range of important health domains and may impact the effectiveness of behavior change interventions.     

Predicting uptake of a routine cervical smear test: A comparison of the health belief model and the theory of planned behaviour

Abstract

This paper reports on a study carried out to identify predictors of uptake of cervical screening among 142 women (59% response rate) in inner London. Two social cognition models were used: The Health Belief Model (HBM; Becker, 1974) and the Theory of Planned Behaviour (TPB; Ajzen, 1991) and in addition anticipated affect following non-attendance for screening was assessed. The TPB emerged as by far the superior model for predicting screening intentions, explaining 51% of the variance in comparison with only 4% explained by the HBM variables. However, neither model was able to predict a significant amount of variance in uptake of screening three months later. Possible reasons for the poor prediction of this type of behaviour are discussed.     

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.     

Personality and attitudinal correlates of healthy and unhealthy lifestyles in young adults

Abstract

The relationship between healthy lifestyle and personality and attitudinal variables was analyzed with data collected from 809 men and 996 women aged 18–30 years in England, Belgium, Finland and Norway as part of the European Health and Behaviour Survey. A health practices index was constructed on the basis of performance of sixteen behaviours including smoking, alcohol consumption, exercise, sleep time and a variety of dietary and preventive practices. Scores on the health practices index were higher in women than men, but in both sexes the index was normally distributed. Consistently healthy practices were positively correlated with extraversion and optimism, and negatively associated with neuroticism, psychoticism and chance locus of control beliefs. These effects were maintained after controlling for social desirability, but together accounted for only a modest proportion of the variance in the health practices index. The results are discussed in relation to the factors characterising health conscious and unhealthy lifestyles.     

Planning and Self-Efficacy in the Adoption and Maintenance of Breast Self-Examination: A Longitudinal Study on Self-Regulatory Cognitions

Many women may be reluctant to perform breast self-examination (B.S.E.) regularly due to motivational or self-regulatory deficits. The Health Action Process Approach (Schwarzer, R. (1992). Self-efficacy in the adoption and maintenance of health behaviors: theoretical approaches and a new model. In: Schwarzer, R. (Ed.), Self-efficacy: Thought Control of Action , pp. 217-243. Hemisphere, Washington DC; Schwarzer, R. (2001). Social-cognitive factors in changing health-related behavior. Current Directions in Psychological Science , 10 , 47-51.), a health behavior change model that advocates the separation of motivation and action phases, such as goal setting and goal pursuit, was applied to data from 418 young women whose risk perceptions, outcome expectancies, self-efficacy, intention to perform B.S.E., planning, and reported examination behaviors were examined at two points in time. Risk perception was found to have a negligible influence in a path analysis, whereas self-efficacy emerged as the best predictor of intention and planning. Planning, in turn, appeared to be the best predictor of B.S.E. behaviors, followed by self-efficacy. The results point to the influential role that self-regulatory strategies (such as planning) play in translating goals into action. The study contributes to the current debate on stage theories of health behavior change and the orchestration of self-beliefs and strategies in the context of goal-directed behaviors.     

Development of decisional balance and self-efficacy measures for adolescent sedentary behaviors

Writing about traumatic events can produce health benefits, yet emotionally non-expressive or cognitively avoidant individuals may be unwilling or unable to express their emotions. This study examined non-expression, cognitive avoidance, response to writing, and subsequent health. As part of a larger study, participants ( N = 71) with asthma or rheumatoid arthritis (RA) wrote about traumatic experiences for 20 min on three consecutive days. Alexithymia, denial, behavioral disengagement, mental disengagement, focus on/venting of emotions, avoidant thoughts, and health status were assessed at baseline, health status again 4 months after writing. Essays were coded for how personal and how emotional they were, and for narrative structure. Non-expression and cognitive avoidance were neither related to how personal or emotional essays were, nor to affective response to writing. High levels of denial or avoidant thoughts predicted less narrative structure. Avoidant thinking marginally predicted health improvements in RA patients. Results suggest that non-expression and cognitive avoidance do not interfere with writing in terms of emotional engagement, but may influence narrative use.     

Book Review of Health and the Construction of the Individual. J. Ogden. London: Routledge, 2002. i–viii + 130 pages ISBN 0415233070

Abstract

Recent theoretical and empirical research has challenged the assumption of health psychologists employing social cognitive models that beliefs can confidently be inferred on the basis of questionnaire responses. It is charged that responses to questionnaires are a function of the intelligibility of the items, constructs and theoretical framework to survey participants. To investigate this contention, cognitions specified by Protection Motivation Theory (PMT) were measured with respect to intentions to use a condom and intentions to use dental floss. Three alternative formats of a questionnaire which varied the order of presentation of PMT items were distributed to student samples. Analyses showed that while questionnaire format did not affect the reliability of cognition measures, there was some variation in the significance and strength of correlations between PMT cognitions across formats. Individual differences in social desirability and salience of the target behaviour had small and predictable effects upon reliabilities and intercorrelations. Implications for the measurement of health beliefs and the status of questionnaire responses are outlined and suggestions are made for controlling bias associated with respondents' capacity to “read” a questionnaire.     

Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: theory,review, and hypotheses

Experimental evidence suggests that when people are transgressed against interpersonally, they often react by experiencing unforgiveness. Unforgiveness is conceptualized as a stress reaction. Forgiveness is one (of many) ways people reduce unforgiveness. Forgiveness is conceptualized as an emotional juxtaposition of positive emotions (i.e., empathy, sympathy, compassion, or love) against the negative emotions of unforgiveness. Forgiveness can thus be used as an emotion-focused coping strategy to reduce a stressful reaction to a transgression. Direct empirical research suggests that forgiveness is related to health outcomes and to mediating physiological processes in such a way as to support the conceptualization that forgiveness is an emotion-focused coping strategy. Indirect mechanisms might also affect the forgiveness-health relationship. Namely, forgiveness might affect health by working through social support, relationship quality, and religion.     

Indulgences in the Catholic Reformation

Abstract

Ever since Luther’s ‘Ninety-five Theses’ (1517), indulgences have been synonymous with corruption in the Catholic Church, although their proper use was to be reaffirmed at the Council of Trent. This article comprises firstly, an exploration of the theory, nature, uses, and evolution of indulgences after Luther up to about 1700; secondly, an examination of indulgences as a product of ecclesiastical jurisdiction of popes and bishops; and thirdly, an exploration of the individual acquisition of pardons and the progression of different devotions over time. The focus will be on France as a case study. It will be shown how indulgences in Catholicism survived Luther, were reinvented and emerged as a powerful tool of personal and institutional reform. They provide a lens through which to explore the history of the institutional Church, in particular relationships between centre and periphery during the Catholic Counter-Reformation centuries.     

‘Between Rome and Constantinople’: the Italian-Albanian Church: a study in Eastern Catholic history and ecclesiology

This article examines the Eastern Christian presence on the Italian Peninsula and the Island of Sicily; the settlement of Albanian Christians after the Ottoman conquest of the Balkans, the emergence of a distinct Italo-Albanian Church and the jurisdictional arrangements made to accomodate this. Concentrating on the period from the 15th century onwards, from the arrival of large numbers of Eastern Christian Albanians in southern Italy and Sicily, the article examines the unique arrangement between Rome and Constantinople, from the Council of Florence (1439) to the Council of Trent (1545–1563), when the Orthodox Bishop of Ohrid provided ecclesial jurisdiction, an arrangement which has no direct historical parallel. The article highlights the work of the eighteenth-century historian Pietro Pompilio Rodotà (who related the two distinct phases of Eastern Christian presence, for historical, cultural, ethnic and linguistic reasons, to the development of the general category of the ‘Greek Rite’) and more contemporary attempts by some Italo-Albanians to establish a metropolitanate (posing questions for the relationship of the Italo-Greek Monastery of Grottaferrata to any future Italo-Albanian ecclesial body). The history and tradition of the Italian-Albanian Church and of the Monastery of Grottaferrata, present a unique and significant Eastern Christian–Eastern Catholic presence in Italy, raising important questions for ecumenism and ecclesiolgy in Europe today.