Health Psychology concerns all psychological processes that are direct or indirect causes or
effects of physical health or physical illness
➔ These processes are embedded in the context.
Healthy person:
Want to stay healthy
They engage in unhealthy behaviors, such as smoking and bingedrinking or they don’t
engage in healthy behavior, such as healthy eating and physical exercise.
These behaviors are governed by psychological processes.
Stress, caused by psychological meaning giving to events, can harm the body.
Unhealthy person: They have to adjust their behavior and stabilize their negative
consequences of their illness. They have to adhere to medical treatment, take their pills, visit
the doctor, change their lifestyle.
Psychological processes are embedded in the social and physical world and specific states of
or changes in these external factors may have typical and psychological effects.
Context: factual, physical reality that is around the individual
People have mental representations of reality. It is relevant to know whether those
representations are true and valid.
Relevant contextual knowledge
Knowledge on the actual reality:
- Social environment
- Close physical environment; the body
- Distant physical environment; the external environment
Social context:
It makes a different if only 2% engage in an unhealthy behavior or 88%. This factual reality
shapes and explains how people perceive a behavior or an illness.
The more people have an illness, the more common it seems, the less serious it might seem.
The high prevalence signals if the health care system is prepared to treat the illness
adequately.
Close physical context: the body:
Unhealthy behaviors have negative physical consequences. It is relevant to know what is
unhealthy.
So: Knowledge of what is unhealthy about smoking, on how and to what extent condoms
influence the risk of STD, and what levels of physical exercise or healthy for what. It is
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,important to know about the basics of physiology and organ functions. For example that the
liver can be damaged by alcohol.
There are different types of symptoms. To completely understand people’s reactions to an
illness it is important to know what people are or can be exposed to. It is important to know
the patient interprets the symptoms in the right way in order to guide the patients behavior.
Distant physical environment: the external environment
Healthy people: the opportunity to take healthy choices is relevant: prices, availability,
number of selling points. The physical environment can stimulate or inhibit physical exercise.
Unhealthy people: people in wheelchair the accessibility of public buildings is relevant. For
patients waiting lists and medicine costs are relevant to understand their situation and their
reactions and to develop solutions.
Also the treatment may be important to know. Does the treatment take long? Does it hurt?
Epidemiology
Physiology
Pathology
Societal/environmental context
Health care context
➔ Important to get the full understanding of health psychology. In practice it is not
necessary to know all areas. It differs from the diseases.
The context in interventions
Always take context in consideration by designing interventions
For example:
Smoking cessation -> environmental measure: nicotine-replacement
Alcohol education -> environmental measure: alcohol accessibility
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,eLecture HP 1: Basic Determinant Models
The psychology-behavior link
Actions in health psychology start with a population health problem.
That is when the health problem is caused by behavior. The question is what are the
psychological causes of that specific behavior.
These psychological causes determine behavior -> psychological determinants
Underlying idea is that we want to change these determinants with the effect that the
behavior will also change.
What are the psychological determinants of a specific behavior?
We have different types of evidence that cause behavior. The more evidence we have, the
more certain we are.
3 types of evidence:
- Evidence from determinant analyses
- Psychological plausibility: can we understand the relation? Is it plausible that this
psychological factor determents behavior?
- Experimental evidence: psychological factor has been manipulated and the behavior
changes.
Models
They all try to explain and predict behavior.
One central observation: for the largest part they refer to the same or similar psychological
factors.
Yellow square: motivational factors -> reasons people have to engage or not engage in
behavior
Orange square: control factors -> people‘s ideas they are able to control their behavior in a
certain context.
Two core factors (that underly behavior)
- Reasons to engage or to not engage in the behavior
- Perceived control over the behavior: people’s estimate whether they are able to
engage in behavior
Important to use (not know) the models and to know the two core psychological
phenomena that determine behavior.
Complex phenomena
Both factors can be described by different constructs
Core mediators
External factors:
Their influence on behavior is mediated through the two psychological factors.
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, E.g. personality may determine the type of outcomes people prefer
e.g. Experience shapes attitudes
e.g. Environmental aspects influence once’s abilities
Behavior can be changed by changing these external factors.
Theory of Planned Behavior (TPB)
It has been applied to lying, car driving, shop lifting.
It combines different psychological factors into one theory.
3 main determinants:
- Attitude
- Subjective norm
- Perceived behavioral control
These factors are based on specific beliefs about reality. Beliefs are the building blocks of
perceptions. Together they give people the bigger picture.
Main determinants are translated into an intention which leads to the execution of behavior.
Determinants -> intentions -> behavior
TPB is not only about deliberate/rational behaviors, but also explains
subconscious/automated behaviors and it refers to emotions.
Prediction: guessing what the state of a variable will be
Predictive power
41% of the variance in intentions could be explained by the three determinants
34% of the variance was explained by intention and pbc (perceiver behavioral control) on
behavior
21% explained by intention
The variance in behavior that can be explained or predicted by the TPB determinants
(attitude, subjective norms, pbc and intentions) will rise between the 20-30%.
➔ This effect is substantial/not bad
Intention-behavior gap: the phenomenon that intention can only explain behavior partly
Explanation: not all relevant determinants are recessed in the TPB.
Several additional determinants have been tested, such as personal norm and anticipated
regret.
Different types of factors has been tested: habit and implementation intentions (= action
plans that stayed when and behavior action will be conducted)
External influences
Another explanation: time between the measurements of the determinants.
➔ A test of the extent to which the determinants (intention) can explain future
behavior despite or beyond all the other external factors, such as new information
and changing events. The longer the interval, the more external factors can occur.
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