Health beliefs and breast examination behaviors: Analyses of linear structural relations

Abstract

A survey of 619 Detroit-area women was conducted in order to understand why women do or do not perform breast self-examination and obtain or not obtain professional breast examinations. The survey assessed these behaviors and women's beliefs about (a) their susceptibility to breast cancer, (b) the seventy or seriousness of breast cancer, (c) the benefits of breast examinations and (d) the costs or disadvantages of the examinations. Separate sets of questions measured seventy of breast cancer when it is treated (a) late (seventy-late) and (b) promptly (seventy-early). Predictions were derived by combining the health belief model with the theory of subjective expected utility. Path analysis supported most predictions of the combined theory. As predicted, high severity-late increased perceived benefit, high seventy-early decreased benefit, and perceived benefit mediated the effects of seventy on behavior. Implications for understanding health decisions, measuring health beliefs, and modifying health behaviors are discussed.     

Shock tactics to counter AIDS: The australian experience

Abstract

The use of shock tactics to motivate people to learn more about AIDS and to take appropriate protective action characterised the approach adopted by the national health authorities in Australia during 1987. The rationale underlying this approach is critically examined, particularly in the light of results obtained from surveys of community concern and knowledge about AIDS in the state of South Australia before the campaign and after it had been in progress for some five months. Contrary to expectations no significant increases in either personal or social concern were found; in fact, among older respondents personal concern had decreased significantly. Levels of knowledge about AIDS, in general, remained unchanged, apart from an increase in acceptance of the safety of blood transfusions from a very low to a somewhat higher level. Among a minority of respondents (29%) who approved of the campaign and also believed they had been influenced by it, personal and social concern about AIDS, but not knowledge, was significantly greater than among others. The view that fear-inducing techniques can be used to bring about increases in knowledge about AIDS was not supported, although some positive effects on the social attitudes of respondents most affected by the campaign are suggested.     

Training in health psychology: An international look

With the progression of health psychology as a new field in psychology specific training programs are more and more needed. A survey of the training situation of health psychology in Northern America, Europe, Australia, and New Zealand highlighted a lack of formalized training programs in most countries except the United States and Canada, as well as an enormous variety between countries on standards of training, and on the differentiation of health psychologists from clinical psychologists.

For the qualification of health psychology as an independent psychological discipline a plea is made for international standardization of quality control and suggestions for the content of formalized training programs in health psychology are given.     

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.