Exam 1 Secondary Prevention "Practice Questions"

6. What is the best strategy to increase the impact of Transtheoretical Model programs? a. Proactive versus passive recruitment of participants b. Self-selection of participants c. Revise the definition of efficacy/action so that it is easier to meet d. Do not include any participants in the action or maintenance stage e. Do not offer incentives to participants because they are not likely to complete the intervention steps

a. Proactive versus passive recruitment of participants

3. New theories should: a. Provide an explanation for phenomena unexplained by prior theories b. Work exclusively in controlled settings c. Explain all factors influencing the majority of health behaviors d. Prove other theories wrong Generate income for the developers

a. Provide an explanation for phenomena unexplained by prior theories

3. The Health Belief Model (HBM) recognizes that social and demographic factors influence the relationship between health beliefs and health behaviors. Which of the following is a limitation of the HBM related to socio-demographic variables? a. The model does not specify how socio-demographic factors interact with the other constructs in the model b. Only select demographic variables are considered (age, sex), while others are omitted (race/ethnicity, socio-economic status) c. HBM requires researchers to obtain complete socio-demographic information for the target population before intervention implementation d. The model is most effective with low socio-economic status (SES) populations and less effective with high SES populations e. Self-efficacy, cues to action, and socio-demographic factors are immeasurable constructs

a. The model does not specify how socio-demographic factors interact with the other constructs in the model

1. Which statement describes a recent trend in health behavior research: a. There is an increased interest in the behavioral and social determinants of health b. There is an increased interest in infectious diseases in middle and high income populations c. There is an increased interest in the genetic determinants of health d. There is increased recognition that individuals are responsible for their poor health e. None of the above

a. There is an increased interest in the behavioral and social determinants of health

2. Concern about weight gain as a result of quitting smoking is an example of the construct perceived barriers. a. True b. False

a. True

4. The Health Belief Model recognizes the importance of demographic, structural, and psychosocial variables in influence behavior, yet does not specify how these factors interact with the constructs of the model. a. True b. False

a. True

5. Structural equation modeling testing multiple pathways of the Health Belief Model may provide new insight about the independent effects of perceived benefits and barriers on health behaviors. a. True b. False

a. True

7. The Health Belief Model can be used to explain change of health behaviors and/or as a guiding framework for developing interventions to change health behaviors. a. True b. False

a. True

1. In the United States, increased access to data and surveillance systems to track health have shown improvements in all areas EXCEPT: a. Vaccine coverage b. Blood pressure c. Alcohol-related motor vehicle accidents d. Tobacco use e. Cholesterol

a. Vaccine coverage

1. According to the Transtheoretical Model, temptation represents the converse of self-efficacy. a. True b. False

a. true

5. Further testing of the Transtheoretical Model with diverse populations is needed. a. True b. False

a. true

8. An individual who smoked for twenty years completed a smoking cessation program and reports not smoking for twelve months. She is in the maintenance stage. a. True b. False

a. true

9. The progress of participants in Transtheoretical Model-based health promotion programs is associated with their stage at baseline. a. True b. False

a. true

5. Reliance on commitments, conditioning, environmental controls, and support is most likely to happen among people in which stages of the TTM? a. Precontemplation and contemplation b. Action and maintenance c. Consciousness raising and self-reevaluation d. Decisional balance and self-efficacy e. Temptation and termination

b. Action and maintenance

9. Retention is notoriously difficult in behavior change programs. Which strategy helps increase retention? a. Incentives to join the program b. Carefully match tailored intervention to stage of change c. Only enroll participants in the action stage d. Require participants sign a contract to complete the entire program as part of their informed consent e. Integrate additional Stages of Change models such as the Precaution Adoption Process Model

b. Carefully match tailored intervention to stage of change

1. The Health Belief Model is an extension of Stimulus-Response Theory, which posits that events affect physiological drives that activate behaviors. a. True b. False

b. False

10. The Health Belief Model is more effective for predicting behaviors than explaining behaviors. a. True b. False

b. False

3. The construct perceived susceptibility has not been well defined or systematically studied. a. True b. False

b. False

6. Critical reviews of the HBM have found that perceived severity and perceived susceptibility were the strongest predictors of health behaviors. a. True b. False

b. False

8. Tailored messaging refers all study participants receiving the same health messages to address the most relevant perceived barriers for the population. a. True b. False

b. False

9. Self-efficacy describes internal or external factors that instigate action to modify a behavior. a. True b. False

b. False

1. New health technologies (e.g. eHealth and mHealth): a. Have reduced the need for health behavior research b. Have the potential to cause harm through misleading information and/or interference in the patient-provider relationship c. Spiked in popularity in the early 2000's followed by a sharp decline in use d. Are responsible for bridging the gap between health theory research and practice e. All of the above

b. Have the potential to cause harm through misleading information and/or interference in the patient-provider relationship

7. All of the following are examples of perceived barriers to EXCEPT: a. Loss of work time b. Increased social support c. Increased anxiety d. Pain e. Stigma from peers

b. Increased social support

7. The following are all assumptions of the Transtheoretical Model EXCEPT? a. Specific processes of change should be emphasized at specific stages b. Intentions always lead to behavior change c. Behavior change is a process that unfolds over time d. Many people are not ready for interventions that are action-oriented e. Once people make a behavior change they are considered in action stage

b. Intentions always lead to behavior change

10. Which of the following is TRUE about the historical development of the Transtheoretical Model? a. It is based on a revised Precaution Adoption Process Model b. It was based on a comparative analysis of over twenty theories of psychotherapy c. It was developed to answer the question of why people change at a time when most theories focused on how people change behavior d. Skinner's Stimulus-Response studies were the foundation of the six stages of change e. It was modeled on the Health Action Process Approach

b. It was based on a comparative analysis of over twenty theories of psychotherapy

8. Perceived threat is defined as: a. Risk of disease based on family history b. Perceived susceptibility x perceived severity c. Perceived benefits - perceived barriers d. Genetic predisposition + socio-environmental conditions

b. Perceived susceptibility x perceived severity

5. In studies using the Health Belief Model (HBM) to promote the human papillomavirus (HPV) vaccine, which was found to be an important cue to action in four of six studies? a. Having a friend of family member with HPV b. Physician recommendation of the HPV vaccine c. Parental pressure to receive the HPV vaccine d. Television advertisements for the HPV vaccine e. Free and anonymous HPV vaccine

b. Physician recommendation of the HPV vaccine

The Transtheoretical Model (TTM) includes six stages of change. A person who does not regularly exercise makes a plan to exercise in the upcoming month. He schedules an appointment to speak with his healthcare provider and joins a fitness center. Which stage of the TTM does this best describe? a. Contemplation b. Preparation c. Action d. Maintenance e. Termination

b. Preparation

2. Which of the following is NOT a key construct of the Health Belief Model? a. Self-efficacy b. Socio-demographic variables c. Perceived benefits d. Perceived threat e. Perceived susceptibility

b. Socio-demographic variables

3. As people progress from precontemplation to contemplation and action, which of the following is true: a. It is unlikely that an individual who reaches contemplation will return to precontemplation in the future b. The pros associated with taking action increase c. The cons associated with taking action increase d. The pros associated with taking action decrease e. Once action has been maintained for 6 months, the individual moves to the termination stage

b. The pros associated with taking action increase

1. One critique of evidence-based interventions in the United States is: a. They do not take into account differences between populations b. Their dissemination takes too long to reach the people who could benefit from them c. There are a lack people trained to conduct high quality research d. They overemphasize experiences of individual health care providers e. All of the above

b. Their dissemination takes too long to reach the people who could benefit from them

2. In studies on smoking and weight control, participants in the preparation and action stages were more likely to drop out of the intervention prematurely when compared to participants in precontemplation and contemplation stages. a. True b. False

b. false

3. The number of individuals in the termination stage is a proxy measure for program success. a. True b. False

b. false

4. One benefit of the Transtheoretical Model is that effective intervention strategies are the same for individuals at different stages of the model. a. True b. False

b. false

6. The Transtheoretical Model was originally developed to better understand why childhood immunization rates have dropped in the United States. a. True b. False

b. false

7. People generally move linearly through the six stages of the Transtheoretical Model, progressing from one stage to the next in a forward direction. a. True b. False

b. false

4. One challenge to using the TTM for intervention is: a. It is only effective for drug and alcohol cessation and physical activity interventions b. There are no applied studies, only theoretical studies, demonstrating effectiveness c. It may be difficult to recruit individuals who are in the precontemplation stage d. It is inappropriate with low-literacy populations e. It requires that people in different stages of change receive the same intervention, which may be inappropriate for participants

c. It may be difficult to recruit individuals who are in the precontemplation stage

1. According to the Health Belief Model, all of the following are characteristics that promote positive health behavior change EXCEPT: a. Belief that a person is susceptible to the condition/disease b. Availability of a behavior(s) that reduce susceptibility to the condition c. More barriers than benefits to taking action d. Health outcome has serious consequences e. Serious consequences may result from inaction

c. More barriers than benefits to taking action

10. A woman with a family history of alcohol abuse understands that the disease includes a genetic component and can result in serious health and social consequences. Regardless, she chooses to regularly drink alcohol. This example demonstrates all of the following EXCEPT: a. She believes she is susceptible to the condition b. The condition may have serious consequences c. The benefits of abstaining from alcohol are greater than the barriers d. Action is available and may reduce risk of the condition e. The perceived benefits to taking action are not greater than the perceived barriers

c. The benefits of abstaining from alcohol are greater than the barriers

9. Which of the following is NOT a strength of the Health Belief Model? a. It can be applied to many health behaviors b. It has been widely used by researchers since the 1950's c. The relationships between each of the constructs are well defined d. It can be tailored to individual needs e. The constructs are relatively intuitive and do not require extensive training to understand

c. The relationships between each of the constructs are well defined

4. The Health Belief Model (HBM) was developed in the 1950's. Which of the following statements about the origins of the HBM is NOT true (incorrect)? a. It was developed to better understand why individuals with access to tuberculosis screening were not undergoing testing b. The key constructs were partly based on Cognitive Theory c. The HBM incorporates components of value-expectancy models d. Brenner's stimulus-response experiments directly informed the development of the HBM e. HBM was developed to better understand people's behaviors related to disease detection opportunities

d. Brenner's stimulus-response experiments directly informed the development of the HBM

2. Self-efficacy refers to: a. The weighing of pros and cons of a behavior b. The intensity of urges to engage in a behavior during stressful situations c. Belief that the help of others is not necessary to achieve behavior change d. Confidence about coping with difficult situations without relapse e. Specific overt modifications in lifestyle and resistance of temptation

d. Confidence about coping with difficult situations without relapse

1. Which is NOT an example of a behavioral factor contributing to mortality in the United States: a. Tobacco use b. Diet c. Physical Activity d. Genetics e. Alcohol use

d. Genetics

2. When an existing health policy does not result in measurable changes in behavior or improvements in health, it is recommended that: a. New policies be implemented and the existing policy be discarded b. The existing policy be implemented with a larger population to reach a larger sample size c. No action be taken as the health behavior or condition is either not worth addressing or impossible to change d. More information about the duration and effectiveness of implementation be provided before taking action e. A more homogenous population be selected for policy testing

d. More information about the duration and effectiveness of implementation be provided before taking action

1. Which of the following is NOT a trend in the use and application of health behavior theory? a. Use of models that integrate multiple levels of influence b. Shift away from using techniques that push or pressure individuals to modify behavior c. Use of smaller number of theories than in previous decades d. Shift towards reducing obstacles to promote behavior changee. e. Shift towards increasing informed decision making to modify behavior

d. Shift towards reducing obstacles to promote behavior change

1. Research on effective methods to achieve health behavior change suggests: a. All of the necessary evidence required to modify negative health behaviors already exists, but has not been properly disseminated b. Systematic-reviews and meta-analyses have been overused as sources of evidence c. Interventions should be based on theory and developed from formative research d. Too much time and money has been spent on the development of valid and reliable data collection instruments e. Theory is becoming less relevant and there should be a renewed focus on practice-based research

d. Too much time and money has been spent on the development of valid and reliable data collection instruments

1. Increased global urbanization has: a. Contributed to an increase in unhealthy lifestyles b. Resulted in overcrowding and increased pollution c. Increased access to interventions aimed at improving health d. A and B e. A, B, and C

e. A, B, and C

8. All of the following are characteristics to consider when evaluating tailored interventions EXCEPT: a. Cost-effectiveness b. Frequency of behavior change c. Cost of the intervention d. Impact of different technologies e. Acquisition versus extinction behaviors

e. Acquisition versus extinction behaviors

1. Health behavior theory draws from the following fields of study: a. Sociology, Psychology, Anthropology b. Nursing, Medicine, Statistics c. Chemistry, Physics, Informatics d. A and B e. All of the above

e. All of the above

1. Theory is: a. A set of related concepts, definitions, and propositions that present a systematic view of phenomena b. Used to specify relationships among variables to explain and predict events c. A framework for developing interventions to achieve behavior change d. The basis for a conceptual map for deciding what to measure in research studies e. All of the above

e. All of the above

1. Which statement is NOT an example of the changing scope and tools of health behavior? a. The recognition of the importance of evidence-based methods in health behavior b. An increase in evaluations of theory-based interventions c. Use of new technologies to promote and track healthy behaviors d. Interventions that include diverse populations and levels e. The increased reliance on personal experiences to inform interventions

e. The increased reliance on personal experiences to inform interventions

6. The program Colon Testing: Celebrating Life for Years to Come was a HBM- intervention to increase colon cancer screening among African American men. Which of the following is TRUE about the intervention? a. Men in both groups were equally likely to undergo colon cancer screening b. Researchers concluded that the HBM was not an appropriate theory to promote colon cancer screening c. Study instruments were not tested for validity and reliability, possibly accounting for the limited increase in screening among the intervention group d. Men who watched the videos with their partners were more likely to receive screening than those who watched alone e. Those receiving the tailored intervention were more likely to speak with their healthcare provider about colon cancer screening compared to the non-tailored intervention group

e. Those receiving the tailored intervention were more likely to speak with their healthcare provider about colon cancer screening compared to the non-tailored intervention group