FNH 473 Video 1: Introduction to Health Behaviour Theories

would you like to hear something surprising but true learning about the various health behavior theories may be one of the most useful and exciting things you will learn in this course though theories may seem a little bit dry at first and I totally get that knowing and applying various health behavior theories is like having a sophisticated set of tools to help you achieve your goals for health promotion after watching this video you should have a pretty good understanding of what a theory is and why they are important in Public Health Nutrition be able to justify

why using an appropriate health behavior Theory or perhaps more than one is essential to good program planning and be able to explain the health belief model one of the earliest health behavior theories first what is a theory a theory is a systematic way of understanding things theories synthesize Bodies of Evidence into key principles that explain and predict various phenomena think of the theories you might have heard of already things like The Big Bang Theory the theory of evolution the theory of relativity all these theories synthesize evidence into explanations for observations and they enable us to

make informed predictions regarding expected outcomes given a particular set of circumstances let's turn our attention to why theories about health behavior are so important we want to promote health and well-being consider the leading causes of death in Canada things like cancer heart disease stroke and diabetes our health related Behavior plays an important role in whether or not we develop these conditions so many aspects of our Behavior influence our health status not the least of which is our dietary habits so understanding human behavior and designing interventions that are aligned with what we know about human behavior

and behavior change can make efforts to OTE Health more likely to succeed let's take a look at one of the earliest theories of health behavior the health belief model this model has a lot of appeal because it's logical simple and it provides very useful insights into behavior and behavior change there are four key constructs in the health belief model perceived susceptibility perceived severity perceived benefits and perceived barriers note the currence of the word perceived according to the health belief model it's our perceptions of benefits and barriers that are associated with particular actions that determine our

Behavior not the real benefits and behaviors perceive susceptibility refers to your opinion regarding your chance of getting a particular condition How likely do you think it is that you will develop osteoporosis for example perceive severity refers to your opinion of how serious the condition would be be if you were to get it if you were to get osteoporosis do you think that would be a mild inconvenience or do you think it would be painful in debilitating perceived benefits refers to your opinion of how effective the advised action would be for example you may be advised

that weightbearing physical activity and appropriate calcium and vitamin D intake in the context of an overall healthy diet would promote bone health and reduce your chance of developing osteoporosis how beneficial do you think those actions would be both in terms of effectively preventing osteoporosis and with respect to the other benefits of those behaviors perceived barriers refers to your opinion of the costs or drawbacks of the advised action perhaps you don't like exercise for example or you find it really hard to fit it into your day maybe you don't like dairy products or swallowing supplement pills

or you don't think you can afford supplements or sufficient healthy food these would all be barriers to your undertaking the recommended action the health belief model notes that all these perceptions are affected by modifying factors things such as age ethnicity socioeconomic status peer groups knowledge and so on so how did these perceptions come together to explain and predict Behavior our evaluations of our perceived susceptibility for a particular condition and the perceived severity of that condition combined to create the perception of threat if perceived threat is high the likelihood of engaging in the health protective behavior

is higher than it would be if the perception of threat was low which might result in little motivation to change Behavior this points to one goal for health promotion programs based upon the health belief model creating realistic perceptions of threat in the Target population strategies for increasing perceived threat could include educational materials to increase perceived severity or fear appeals to increase perceived susceptibility our evaluations of perceived benefits and perceived barriers combined to determine our response on some level we evaluate the pros and cons and determine whether there would be a net gain associated with this

action do the benefits of this action outweigh the costs this points to other tasks for health promotion programs based upon this model to ensure the benefits of the recommended action are clear clearly communicated and relevant for the Target population and to develop strategies to minimize the barriers people may experience there are two other important components of the health belief model cues to action and self-efficacy cues to action serve as a trigger for Behavior seeing a media campaign might serve as a cue to action others might be receiving advice receiving a reminder from a clinic becoming

aware of bodily sens such as feeling overly tired or experiencing dizziness or something like illness your own illness or that of someone you know exposure to these sorts of cues to action increase a person's Readiness to take action self-efficacy is a concept originally introduced by Albert bandura one of the most influential psychologists of all time and a UBC grad this concept which is a key element of Bandera's social cognitive theory has been incorporated into many health behavior theories because of the clear evidence of its importance in determining Behavior self-efficacy refers to the belief that one

can successfully undertake a particular behavior and persist with that behavior in the face of challenges the belief that you can perform a task or take an action at a particular level of competence is important in both initiating and maintaining Behavior change you know that theories explain and predict let's look at a couple of examples of how the health belief model has been used in this Regard in a study of 75 American women between the ages of 18 and 45 who were diagnosed with gational diabetes during their last pregnancy participants completed a survey examining their perceptions

of susceptibility and severity for type 2 diabetes and for the benefits and barriers to healthy eating to prevent type 2 diabetes being diagnosed with just stational diabetes that is diabetes that's first detected during pregnancy is a notable risk factor for the subsequent development of type 2 diabetes so the researchers thought that the women who had been diagnosed with gestational diabetes during their last pregnancy would have quite High perceived threat for type 2 diabetes they found that the women were actually evenly split in this regard half of the women perceived that they had a low chance

of developing type 2 diabetes in the next 10 years whereas the other half thought they had a moderate or high chance of developing type 2 diabetes these results showed that having been diagnosed with gestational diabetes during pregnancy did not increase perceived risk for developing type 2 diabetes for all women so that experience was not a cue to action for a healthier lifestyle for everyone this points to a potential Gap in terms of Education regarding risk for type 2 diabetes something that could be filled with a nutrition education initiative current dietary quality in this sample of

women was moderate not awful but not great either interestingly the researchers found that the only variables which were significant predictors of a healthier eating pattern were higher levels of self-efficacy for healthy eating and higher education the importance of self-efficacy for healthy eating in predicting healthy eating underscores the significance of self-efficacy and also highlights something that Health promotes motion initiatives could aim to effect dietary self-efficacy can be increased through strategies such as education problem solving observational learning and so on so increasing self-efficacy for healthy eating among women with a previous diagnosis of gestational diabetes would likely

support the adoption of healthier eating habits and thereby reduce the risk for developing type 2 diabetes let's consider an example of how the key constructs of the health belief model were applied to develop an intervention which aimed to increase the frequency of toothbrushing among unemployed adults between 18 and 24 years old living in New Zealand the keep on brushing project sent motivational text messages created according to the constructs of the health belief model to participants once per week for a 10-week time period these messages highlighted some of the benefits of toothbrushing one's susceptibility to tooth

decay or the severity of cavities of 171 People Who provided Baseline data 51% reported that they brush their teeth two or more times per day which corresponds to New Zealand's recommendations and when the frequency of toothbrushing was reassessed at the end of the text messaging intervention the proportion who reported brushing their teeth two or more times per day increased to 73% but interestingly only 26% of the original participants that's 44 of the 171 Who provided information at the beginning of the study were still participating in the study and answered the question about how many times

they brushed their teeth on the previous day the researchers conducting this trial concluded that motivational text messages based upon the health belief model constructs increased toothbrushing frequency in a population that can be hard to reach through traditional channels and they further noted that the increase in toothbrushing frequency primarily occurred by week three of the intervention and remain stable after that point these examples illustrate just two ways that this model has been applied to explain and predict health related behavior and how various health behavior theories can be key Tools in our efforts to understand and change

people's actions as you learn about some of the key health behavior theories used in public health consider these questions what are the main strengths and limitations of each model how are the models similar to and different from each other how have the models been used to develop health promotion interventions in the past overall you need to critically evaluate the various theories and consider how they've been used by others to explore which theories might be the best fit for the particular context in which you are working having a good working knowledge of health behavior theories will

be tremendously useful in designing evidence based Public Health Nutrition interventions and make it more likely that your health promotion goals will be achieved