By simply taking a few small steps and trying to change health behaviours this could have crucial impact on mortality and enhance life. 50 per cent of mortality from the ten principal causes of death is because of behaviour. Therefore it is very important to understand how and what helps people change health behaviours, taking the right steps to change could be as simple as wearing a SPF when out in the sun to reduce risks of cancer (Mark P. Zanna, 2011).
‘A health behaviour can be categorised as an action taken place by a person believing that they are doing so to prevent disease' according to Karl and Cobb (1966). A general assumption is that behaviour is motivated by the goal of health – however not always is this the case. Change in behaviour is not always motivated by disease prevention for example personal pleasure may have an impact, and possibly even social interactions. An individual overweight may begin to exercise and eat a healthier balanced diet in the hope to lose weight however not always is this done with intentions to reduce any chances of increasing risk of life threating illnesses but for themselves to look and feel more attractive about their own body. Nevertheless if motivated by prevention of disease or to make themselves look good health will be achieved (Ogden, 2012). The Transtheoretical Model, health belief model and the Social cognitive theory are all theories that attempt to explain health behaviour and ways to change behaviour. Government organisations have been put in place to deal with the current health behaviours and lots of research and investigation have taken place to come to the best conclusion as to what helps behaviour changing.
In society today around half of all deaths are connected to behavioural and lifestyle aspects, such as smoking, unhealthy diets, lack of physical activity and large consumptions of alcohol. Therefore in 2010 a political group starting at 10 Downing Street as the world's very first organisation devoted to the application of behavioural sciences. The organisation was set up to ensure that people could have better life choices and change certain aspects of their life to try and improve health and wellbeing. The BIT team use tactics to make many services more affordable and convenient for every citizen. Many ideas that are formed are from behavioural science literature where testing's and trials are used to ensure that their discovery's work (Behavioural Insights Team, 2014).The role of the team is to reflect in different ways real life situations and to show how people truly behave, rather than how people intend to behave. In 2011 the insight team collaborated with boots the pharmacy introducing a smoking cessation hoping to motivate individuals to give up the habit. Therefore this organisation try and tackle the problem of bad health through environmental factors, not only psychological factors through interventions. By producing posters, looking at the prices trying to target the media when supplying the world with crucial information that could improve health (Cabinet office, 2010).
Interventions directed from the environment play vital roles throughout human life, usually through employment, socialisation and interaction. For most individuals having easy access to food shops such as supermarkets is no issue however for a lot of individuals it's considerably difficult which means a lack of opportunities to buy fresh fruit and vegetables that are needed to maintain a healthy balanced diet. Therefore left with no choice but to ‘nip to the small corner shop' that only have little selection and disadvantage of getting nutritious goods price (Riekert, 2014).
Marketing studies establish that the sales of fresh fruit and vegetables improved by approximately 40% when expanding the shelf size of the shelf, concluding that individuals seeing more of a product means they are more likely to buy. Not only is this effect on healthy food However it has been discovered that this applies to unhealthy food as well such as sugary sweets and fatty snacks, Leading to bad diets which then have major impact on health (Farley, 2009). Cardiovascular diseases have a high contribution to deaths via heart attacks or strokes and can highly be down to specific behaviour choices (Buttar, 2005). The NHS stated that Coronary heart disease causes 80% of death with individuals who have diabetes, however, heart attacks can be avoided if precautions are followed and behaviours are changed. A study done in Alameda County Focusing on daily routines and social factors to discover which ones might have complications with poor health by investigation the community. Belloc and Breslow (1972) a large group of Adults in California were asked to participate by completing questionnaires around the late 1960's on a study involving and relating to health. All participants of the study were followed up 5 and then 10 year intervals for up to 20 years after the initial investigation. Once the study was complete the results showed seven risk factors which linked to mortality (smoking, heavy alcohol consumption, obesity, inactive, heavy snacking, and not eating breakfast (Breslow, 1993). This shows that it is very easy to get into bad behaviours without realising, and these behaviours can have a negative effect on mortality.
The transtheoretical Model (TTM) established by Prochaska and DiClemente during the 1970's was discovered after examining smokers who successfully managed to quit on their own and others who required treatment to help them follow through with quitting. After studying a selection of people it came clear that the people who quit only did so as they were ready to quit. After many years of studying and research the TTM has discovered individuals tend to move through five stages (Hales, 2006). Pre-contemplation being the first stage when individuals have no intent to change their behaviour straight, usually associated as unenthusiastic and tend to discard beneficial information, or warnings that may be given. Followed by the Pre-contemplation stage individuals have the intentions to change within the future and usually within the next 6 month and become aware of benefits that changing behaviour can have (getting ready to make the change). Preparation where individuals take small steps for example someone looking to lose weight may join a gym, or always wearing a seatbelt when driving/being a passenger, small steps to push them along the journey. When an individual has taken the step and has actively engaged in the new behaviour. Finally Maintenance the behaviour change is sustained over time. Usually there are only 5 stages however termination can be taking into consideration, if a individual manages to stick to the change for even if it takes them a few years it becomes deeply ingrained that they always have it in their life (Odgen,2012).
However individuals do not always flow from one stage to another there may be certain times that they drift back and forth from two of the stages for example, an individual may be in preparation stage however drift back to the contemplation stage on many different occasions before finally getting to the action stage(Contento, 2012). When individuals do manage to get to the maintenance stage it does not mean they will forever be in the final stage there are chances of a slip up. It's easy to have good Intentions however when at any point intentions can change (Hales, 2006). TTM looks closely at the individual however misses out environmental factors. The TTM uses stages to determine a behaviour change however it is very difficult to conclude if this behaviour is due to the stages or continuum.
Social Cognitive theory plays a valuable contribution towards health behaviour, the theory suggests that the social environment, behaviour and also personal characteristics that the individual may carry can affect an individual's behaviours. Albert Bandura's social learning theory where he examined the basics of human learning by examining learning development through a social content which involves observing behaviours, modelling and reinforcement. The learning theory states that to learn behaviours is by watching the environment and surroundings through observation (Bandura, 1986). Therefore there is evidence that learned behaviours in adolescence for example watching globalised violence through media forms shows likeliness to engage in aggressive behaviour. The majority of the research done towards the Cognitive theory is linked to the social learning theory however provides lots of evidence for both to correspond with each other. (Diclemente,2011). Interventions have been done using the theory, CATCH (The Child and Adolescence Trial for Cardiovascular Health) programme using educational activities from a social cognitive point of view when trying to decrease both sugary and fatty consumptions and also a higher amount of exercise. For instance when changing the types of food social reinforcement from family and teachers, self-efficacy for increasing exercise (Contento, 2010). Self-efficacy comes from the social learning theory and according to Bandura it is when an individual believes they are confidentially capable to complete any given behaviour successfully despite any complications. For example wanting to become more actively healthy ‘I will start exercising more'. Self-efficacy is key to changing behaviours and having the right mind-set to take action and maintain a behaviour.
Health Belief Model suggests that those who believe they may develop an illness/disease will practice health behaviours depending on their situation. I smoke therefore I have high chances of developing lung cancer. The behaviour will then depend on how serious/severe they believe the illness to be. Cost effects of carry out the behaviour, by stopping smoking I may become more stressed, however may save money. There may only be action taking to stop the behaviour due to certain cues or triggers, for example a family member dying from lung cancer due to smoking may have an effect on the individual. Struggling to breath may be another issue or a cue to action could be from information that they have seen in the media portraying the health behaviour as a risk for their own wellbeing. Keeping active regularly, ensuring that vaccinations happen, preforming safe sex, are linked to individual's ideas of susceptibility towards health behaviours by believing that the issue is serious and therefore outweighs any underlying problems they may have previously had (Rosenstock, 2014). It is common for health promotors to use forms of fear-arousing, for example health promotion interventions showing images/videos of road accidents, in the hope people will drive more carefully, cigarette packets having photos of rotten lungs making everyone more aware of how dangerous and damaging smoking can be.
There have been many campaigns across the world targeting levels of fear towards HIV, by showing graphic videos and statistics such as “Approximately 18,100 (17%) people living with HIV in the UK are unaware of their HIV infection and have not yet been diagnosed” (National AIDS Trust, 2015). This scares people and provides more awareness of the disease, and by doing so it's promoting and encouraging more people to have safe sex. Unfortunately not only does Health belief influence individuals health practices factors such as culture and possibly personal experiences can have affects. It can be awfully difficult for research to be reliable due to different questions being asked in different studies on similar behaviours leaving it difficult to compare results (Odgen, 2012).
When trying to tackle unwanted health behaviours it can be challenging, having self-efficacy by believing that you can change your behaviour usually produces motivation, having motivation within yourself may be hard and take time however it does have a large impact. The TTM stages of change explains step by step how individuals are able to change their behaviour, only by doing so through psychological aspects. Failing to take environmental effects into consideration, Social learning theory suggests that by observing someone else doing something can have an impact on whether an individual decides to do the same thing, therefore learning through parents. A teenager may have watched their parents smoke growing up, the likelihood is that the teenager when older wants to do the same; learning through behaviours. In the UK Smoking has been banned in all public places, there has been Taxation on cigarettes, school cafeterias promote healthy eating, occasion on television there may be emotional car crash adverts these interventions based around environmental factors contribute to the help of changing behaviours. Therefore both psychological and environmental factors contribute when trying to come to a conclusion on which factor is more important. Different things work for different individuals and therefore both contribute in tackling health issue, whether an individual uses self-efficacy to quit a bad habit, not being able to smoke in public places will help as there will be no temptations. Therefore both psychological and environmental correspond with each other when trying to change health behaviour.
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