Education

1. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com.
CHAPTER 14
How Psychosocial
Factors Affect
Health Behavior

2. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Behavior and the Social Environment
 Most important predictor of health is socioeconomic status (SES).
 Health gradient holds at all levels of the social scale.
 Health is also affected by gender, marital status, race, and ethnicity.
 U.S. racial and ethnic minorities have poorer health than whites.
– Health disparities are a big concern of public health.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Why the Effect of SES?
 Nutrition
 Sanitation
 Conditions of the physical environment
 Levels of healthy behavior
 Access to medical care

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Psychological Factors
 Stress
– Mortality increase after death of a spouse, loss of a job, divorce, etc.
– Increased risk of heart disease and common cold
– More daily hassles at lower SES
 Social support
– Alameda study
– Stress buffer

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Psychological Models of Health Behavior:
Health Belief Model
 The classic frame of reference for understanding health behavior, and
especially behavior change, is the Health Belief Model.
– I am vulnerable to the threat.
– The threat is serious.
– By taking action, I can protect myself.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Psychological Models of Health Behavior: Self-Efficacy
 Self-efficacy is:
– The sense of having control over one’s life
– Increased by previous successful performance
– Increased by seeing others successfully perform, especially if the model is a peer
 Learned helplessness is a pattern of “numbed acceptance of a negative
situation.”

7. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Psychological Models of Health Behavior:
Transtheoretical Model
 Transtheoretical model has been widely useful in health education.
 Process involves progress through five stages:
– Precontemplation
– Contemplation
– Preparation
– Action
– Maintenance
 It is not contradictory to the health belief model.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Ecological Model of Health Behavior
 Ecological model describes five levels of influence that determine health-related
behavior.
– A potential target for health promotion intervention
 Intrapersonal level
– Psychology
 Interpersonal level
– Family, friends, coworkers
 Institutional level
– School, workplace
 Community level
– Churches, community organizations
 Public policy level
– Government regulations

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Example of Health Promotion Program: AIDS Prevention
 AIDS prevention in San Francisco in the 1980s
 Targeted different levels of influence
– Intrapersonal level
• I am susceptible to infection.
• There is something I can do that will lessen the threat of infection.
• I am capable of making these changes.
– Interpersonal level
• My peers support new behavior.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
AIDS Prevention (cont.)
– Community level
• Educational programs for bartenders in gay establishments
• Distribution of condoms
– Public policy level
• Free, confidential HIV testing

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Changing the Environment
 Is more effective than trying to change individual behavior
 Changes focus from blaming the victim
 Was pioneered in injury control programs
 Is effective in tobacco control programs
 Is now being considered for improving diet and decreasing physical inactivity

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 1
 Describe five ways in which high SES contributes to good health.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 2
 Discuss how social support can protect against the health effects of stress.

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2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 3
 How would the health belief model help predict whether someone you know
could quit smoking?

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 4
 How could the concept of self-efficacy be used to lead a class in a weight-loss
program?

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2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 5
 Using the ecological model, explain why the U.S. has a high rate of adolescent
pregnancy.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 6
 Think of a movie, video, or TV program you have seen in which one or more
characters behave in self-destructive ways.
 Analyze that behavior using the ecological model.
 A good video to use for this purpose is Women of Substance, about cocaine-
addicted pregnant women, available on the Internet at
www.archive.org/details/ddtv_170_women_of_substance.

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 7
 Visit the website for the Office of Minority Health, minorityhealth.hhs.gov.
 Choose a health topic you are interested in.
 What is the latest news on that topic?
 What health disparities are being addressed?

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©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 8
 Visit the CDC website, www.cdc.gov.
 Search for state data (from BRFSS) on risk behaviors, such as smoking,
physical activity, alcohol consumption, etc.
 How does your state compare with other states and with the nation as a whole?