HE Chapter14: how psychosocial factors affect health behavior

what is the precontemplation stage of the trans theoretical model?

a a stage in which people have no intention to change the behavior so the first step involves consciously raising their awareness that their behaviors unhealthy and should be changed.

what is the health belief model?

a model that assesses several factors that determine whether a person is likely to change behavior when faced with the health threat through these four steps: 1. the extent to which the individual feels vulnerable to the threat 2. the perceived severity of the threat 3. perceived barriers to taking action to reduce the risk 4. the perceived effectiveness of taking an action to prevent or minimize the problem

what is stress?

a psychological and emotional state of tension, the state that occurs when a person's perceive that demands exceed their ability to cope

what epidemiologic study shows the effect of stress as contributing to Heart disease?

a study of the male employees of two banks. after One Bank changed its management policies to become commercial, the employees of the Commercial Bank had to deal with considerable competition, risk, and responsibility for investing funds while the employees of the other bank, so my public Savings Bank had less competition and fewer responsibilities. over a 10-year period, the employees of the Commercial Bank were found to have 50% higher rates of heart attacks and sudden death.

describe how socioeconomic status affects the health of the poor in the United States today?

adverse environmental conditions, such as lead and paint and tap water, air pollution, and violence. poor people have poor nutrition, less access to Medical Care and more psychological stress

how was the first belief that aids was a threat easy to achieve?

because of the extensive publicity about AIDS in the General Media

describe the socioeconomic relationship between blacks and whites?

blacks tend to be less healthy than whites and generally have lower socioeconomic status than whites do. however even wealthy, educated blacks have higher mortality rates than whites of comparable socioeconomic status

how was the governmental level of influence address during the AIDS epidemic?

by the city's provision of free and confidential testing for the HIV antibody. public bathhouses were changed by public health officers posting warnings to the clientele about safe sex.

describe the many reasons why lower socioeconomic status exposes people to Greater Life stress that by comparison higher income and education would otherwise provide resources that help buffer the impact of life's hassles?

car breakdowns, landlords complain about late rent checks, childcare is unreliable, officials are rude, exposure to incidents of racial prejudice

how would the public health approach to use the health belief model?

convince people that they are vulnerable, that the threat is severe, and that certain actions are effected preventative measures

describe demographic reasons for these differences to be believed is primarily social?

ethnic minorities have higher mortality rates than whites do. males have higher mortality rates than females do and females tend to suffer more from chronic illnesses. married people are healthier than unmarried people.

where did early evidence of the health effects of stress come from?

from observations that widows and widowers seem to have an unusually high risk of dying soon after the death of their spouses. the mortality rates of these survivors are 40 to 50% higher during the 6 months after the death of a spouse compared to the mortality of married people of the same age

how can public health programs focus on changing the environment for influencing people's diet?

giving people access to supermarkets or produce stands.

describe the socioeconomic status relationship between countries of low SES and mortality rates?

groups with the lowest SES have the highest mortality rates

why might social support have such a broad and consistent effect on health?

help is a buffer to stress by way of emotional or other support including hormonal responses to that support. secondly it may act through indirect channels like Piers modeling healthy Behavior, belonging to a group, and others establishing norms for self care. help establish a better sense of purpose, well being, and self-esteem.

how can knowing what stage an individual's reached in the trans theoretical model help a physician or health educator?

helps them move the person along to the next stage

describe successful programs that are enhancing student self-efficacy in relation to resisting drugs?

if they are led by older teens, with whom they can identify

what other such Studies have found that the rest of illness or death is higher?

in the effects of other stressful life events such as death of other family members, divorce, and loss of job.

what is a different approach that may be necessary to reach high risk groups such as men who have sex with men but don't identify as gay?

individual person to person counseling, group level programs that include a skill building component delivered by other men who have sex with men but don't identify as gay, and, to a lesser extent, Community level programs that can motivate and reinforce Behavior change.

what is the third level of influence of the ecological model?

institutional factors. it is significant because people spend 1/3 to 1/2 of their lives in an Institutional settings, which may have profound effects on their health and health related Behavior

what is the second level of the ecological model?

interpersonal relations. it includes family, friends, and coworkers and has very important effects on health related behaviors. family in peer relations represents the origin especially habits learned early in life.

what is the first level of the ecological model?

intrapersonal factors. it encompasses the knowledge, attitudes common skills of the individual.

what relationship could Public Health have on socioeconomic status?

it does not have much power to change people's SES, it is hope that understanding how these factors affect Health May prevent more effective interventions to promote healthier behavior.

Public Health interventions aimed at improving the health of minority groups include what? and what understanding does this begin with? and how may they affect people of various groups differently? and what could be effective and modifying these factors?

it includes an effort to influence their health behaviors. these efforts begin with attempts to understand which factors influence health and health behavior, how these factors may affect people of various ethnic and racial groups differently, and which kinds of interventions can be effective and modifying these factors.

describe how access to Medical Care is another Factor that has been blamed for the socioeconomic differences in health?

it is argued that Universal Health Insurance can reduce health inequalities. however the SES differences in mortality are also seen in other countries that have National Health programs.

what is socioeconomic status?

it is the most important predictor of health, a concept that includes income, education, and occupational status, factors that tend to be strongly associated with each other.

how is a sense of control beneficial for health?

it reduces stress

what is the trans theoretical model?

it's envisions change is a process involving progress through a series of five stages which are pre-contemplation, contemplation, preparation, action, and maintenance.

an individuals perception of the stressfulness of an adverse event can be reduced by what two factors

knowledge of when the stressful event will occur in the ability to regulate the timing and intensity of the event. this knowledge and ability give the individual a sense of control known as self-efficacy

what would application of the ecological model at the interpersonal level lead to?

lead to the use of different strategies: such as in teen drug prevention programs depending on the nature of the teens social relationships. a homogeneous Network would be more influenced by norms and values of that group then a teen who relates individually to a number of separate individuals. in the close-knit group, drug prevention programs would have to focus on changing the Norms about drug use within the existing network. when networks are Loosely organized, the program might focus on creating drug free networks and encourage teens to associate with those Networks reducing the desirability of memberships in Drug using Networks

what health disparity in the US among racial and ethnic groups has persisted as the overall health of the US population has improved over the last decades

life expectancy, infant mortality rate, mortality from diabetes, mortality from prostate cancer, the death rate from HIV

what is a ecological model?

looks at how the social environment, including interpersonal, organizational, community, and public policy factors, support and maintains unhealthy behaviors through five levels of influence that determine health related behaviors.

Health disparities may be accounted foreign part by what? and what is the relationship of this to health?

lower socioeconomic status. the reasons for the socioeconomic disparity or complex and somewhat inaccessible to Public Health interventions. the relationship between socioeconomic status and health is not entirely understood but Public Health must find ways to improve the health of groups that have been disadvantaged economically, educationally, and politically.

what main factors help people cope with life stresses?

money. education because it provides the information and skills to solve problems. family and friends can help by providing both emotional and instrumental assistance, in fact this third one is surprisingly significant in determining an individual's health

what did a review of 148 studies on the health effects of social relationships find?

much lower mortality rates for people with strong social connections regardless of age, gender, or the presence of pre-existing conditions.

using the institutional factors of the ecological model, what types of changes would be positive on health behavior?

organizations May provide a corporate culture that supports healthy Behavior change. workplace or School cafeterias could provide health conscious menus, exercise facilities may be available and they're use encouraged. schools and workplaces provide ideal settings for public health intervention

what are reasons why people with higher socioeconomic status are healthier? describe the opioid crisis is modeling this?

people with more education behave and healthier ways. 30% of Americans with a high school education or less smoked, while those with a bachelor's degree, only 70% smoked Americans with more education were more physically active. there's a strong link between STS and drug abuse such as in the opioid crisis being concentrated among Americans with less education, who are less likely to have been married, who have lower ses, and are more likely to be out of the workforce.

what does the environmental perspective force people to think of Public Health as?

social and political issues that require Collective action. this approached me lead to confrontations with very powerful economic interests, and it will not always be successful. however, having whole communities become involved has the potential of being the most effective to bring about major changes in health and behavior

which two psychological factors have been found to influence health, some of which may have a role in the health effects of socioeconomic status?

stress and social support

how does stress play a role in the health effects of socioeconomic status?

stress can be due to the adverse physical and social conditions associated with socioeconomic status. stress may act both directly, by affecting psychological processes, and indirectly, by influencing individual behavior.

what has research found about how to increase people's self-efficacy?

that it is increased by previous successful performance of the behavior in question. it can also be increased by seeing others perform the behavior, especially if the behavior is performed by someone similar to themselves

what was the early excessive AIDS prevention programs attributed to?

that the gay community was in general well educated and politically astute.

what do Public Health workers attribute the Resurgence of high risk sexual behaviors in accordance to the AIDS epidemic?

the Advent of Highly Effective anti retroviral therapy because of the remarkable effectiveness of the new drug treatments, many younger gay men saw HIV infection as a less severe threat then did older gay men, an influence included in the health belief model.

because humans are social creatures, and their behavior is strongly affected by their social environment, what does it account for?

the fact that disease is tend to be distributed in the population according to certain patterns: when individuals in a group change thus it may be more efficient to try and change the social environment that influences people to behave and unhealthy ways rather than try to change people's behavior one individual at a time

describe the data on health status of the different populations compared to white Americans of black americans, hispanics, American indians, and Asian americans?

the health of black Americans constituting of 13.4% of the population is poorer than whites Hispanics are a heterogeneous group, and their health status varies among different subgroups. American Indians have poor health indicators than whites Asian Americans have better health status than whites

describe the fourth level of the ecological model

the larger community. organizations can work together in a community to jointly promote healthy goals. and understanding of community organizations and networks can offer insights into promising avenues for health promotion.

what is learned helplessness?

the lowest of self-efficacy seen in people who have experienced being unable to avoid events especially if they have repeatedly tried and failed. this pattern describes as a numbed acceptance of a negative situation, so that an individual no longer tries to change that situation for the better because he or she does not expect those efforts to make any difference

what is the maintenance stage of the transtheoretical model?

the person has achieved the healthier Behavior but must strive to prevent relapse.

what is the contemplation stage of the trans theoretical model?

the person is more aware of the benefits of change, but very aware of the difficulties and barriers to change and still may not be ready to take action

how can the focus of changing the environment impact the prevention of hiv?

the recognition of same-sex marriage might encourage more stable relationships among gays, reduce the number of sexual partners by each individual, and thereby reduced the individual's risk of being infected. among intravenous drug users public policy affects the risks of HIV by providing access to needle exchange programs, which are illegal in some communities

What is self-efficacy?

the sense of having control over one's life. it is often added as a fifth indicator in the health belief model. people are more likely to adopt healthy Behavior if they are confident that they have the ability to do so

compare and contrast the health belief model and the transtheoretical model?

they are alternate ways of looking at the same psychological factors. they can both be useful in designing Public Health messages aimed at changing Behavior

what did experiments on animals find about psychosocial stress inducing physiological changes?

they found that various psychosocial stresses induced psychological changes such as decreased immune response and increased atherosclerosis

describe the results of an experiment on humans in which investigators measured levels of psychological stress and 420 healthy volunteers and then administered nasal drops containing cold viruses to all but a small control group?

they found the subjects whose stress levels were higher were more likely to be infected with cold viruses more likely to develop colds, was symptoms including sneezing coughing eye-watering nasal discharge sore throat and increase use of tissues. the study demonstrated that stress suppresses the immune response in humans

what is the public health approach to using the health belief model to improve screening rates among low-income minority women who had not had mammograms?

they had many misperceptions about breast cancer such as underestimated susceptibility, embarrassed or afraid of the pain or radiation involved in the mammogram, and didn't know that cancer was curable. screening rates can be improved by counseling that included personally tailored messages that address the woman's beliefs and concerns.

how did gay related organizations help focus on second and third beliefs?

they held training sessions to teach skills and use of condoms as well as interpersonal communication skills such as the ability to negotiate safer sex practices in this helped enhance perceptions of self-efficacy among those at risk.

what do studies show about low and high self-efficacy and health promoting behavior?

those with higher self-efficacy or more likely to engage in health promoting Behavior. an attitude of learned helplessness is common in people who have repeatedly tried and failed to quit smoking or to lose weight for example

during the AIDS epidemic how was the fourth belief achieved?

through messages sought to encourage interpersonal and Community influences that the perception that low risk behaviors could be pleasurable and satisfying

how could efforts focus more on the second and third beliefs of gay men during the AIDS epidemic?

through news and entertainment media aimed at gay men including gay newspapers, comic books, and leaflets, as well as telephone hotlines.

what is the goal of various theories and models made from social and behavioral scientists and an attempt to explain how psychosocial factors affect health related behavior?

to understand the most effective ways to promote healthier Behavior

what is another reason to consider the social environment that has to do with the consequences of focusing on the individual in that which that person is to blame for his or her illness?

unhealthy behaviors may be maintained and reinforced by aspects of the social environment there are beyond the individuals control. thus Public Health intervention programs should focus on the social aspects or at least consider them in designing programs aimed at promoting healthy Behavior

what is the preparation stage of the trans theoretical model?

when a person has decided to make the change in his plan concrete actions they will take such a signing up for a class, discussing the plan with the a physicial or buying a self-help book

how does a focus on changing the environment help influence people's activity patterns?

Federal policies that since World War II a favored as suburban lifestyle they're the blame for Americans lack of exercise since people living their cars because of most places are not within walking distance

describe low and high self efficacy?

High self-efficacy is found in people who are confident that they have control over their lives and people who have low self-efficacy believe their lives are subject to change by external forces

describe the early evidence for influence of social support and health from the epidemiologic cohort study conducted on residents of Alameda County in California?

persons were surveyed on physical, mental, social well-being, health related habits such as exercise and use of cigarettes and alcohols, social networks, marital status, number of close friends and relatives, church membership, and affiliation with other organizations in death certificates were monitored over the next 9 years. they found a strong association between unhealthy behaviors and higher mortality rates. the study found that an individual's health status and risk of dying were associated with the extent in nature of his or her social network in the association remained true even for unhealthy behaviors that were taken into consideration. those with few social contacts had mortality rates two to three times higher than their counterparts with many social connections. ​

what factors of socioeconomic status accounted for the poor more likely to die in the plague epidemic and 1665?

poor nutrition and sanitation and because they could not flee the city to escape infection as the wealthy did.

describe the AIDS prevention program as a design and understanding how people's behaviors affected by their own beliefs and by various levels of influence in their social environment?

prevention of infection through Behavior change is the most effective approach to AIDS control because there is yet no biomedical solution to the problem and no vaccine and no proven cure an intensive media effort was mounted to inform at risk individuals about the practice of safer sex. furthermore they interviewed groups of gay men and identified key beliefs that must be addressed to convince the target population to act on the message which included: 1. belief in personal threat 2. belief in response efficacy 3. belief in personal efficacy 4. believe that new behaviors are consistent with group norms

during the AIDS epidemic how did campaigns Target community influences?

providing educational programs for bartenders. condoms were made widely available and bars in small group meetings and were distributed by volunteers on Street corners.

what new field of research has arisen to study the impact of stress on health?

psychoneuroimmunology

what field seeks to learn about the mind-body connection as it relates to the immune system?

psychoneuroimmunology is the field where a better understanding of the relationship between social support and health may come from

describe the fifth level of the ecological model

public policy. it encompasses the regulations and limitations on behavior that have been discussed. these are the most explicit and controversial measures that local, state, and National governments take to promote healthy behaviors. examples include smoking restrictions, age limits on alcohol sales, seat belt laws and so forth

what is the action stage of the trans theoretical model?

requires that individuals modify their behavior from abstaining from unhealthy health behaviors.

what was found in a study of British civil servants called The Whitehall study?

researchers compared mortality rates over a 10-year period across four employment grades. top administrators were compared with Executives and professionals, the clergy staff, and unskilled laborers. they found that higher employment status was associated with a lower risk of dying.

what is an example of concentrating on changing the environment both social and physical to decrease the deaths that occur among motor vehicle crashes?

safer design of Highways and automobiles.