Benyamini / Johnston / Karademas Assessment in Health Psychology
2016
ISBN: 978-1-61334-452-1
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
E-Book, Englisch, 346 Seiten
Reihe: Psychological Assessment - Science and Practice
ISBN: 978-1-61334-452-1
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Assessment in Health Psychology presents and discusses the best and most appropriate assessment methods and instruments for all specific areas that are central for health psychologists. It also describes the conceptual and methodological bases for assessment in health psychology, as well as the most important current issues and recent progress in methods.
A unique feature of this book, which brings together leading authorities on health psychology assessment, is its emphasis on the bidirectional link between theory and practice.
Assessment in Health Psychology is addressed to masters and doctoral students in health psychology, to all those who teach health psychology, to researchers from other disciplines, including clinical psychology, health promotion, and public health, as well as to health policy makers and other healthcare practitioners.
This latest volume in the series Psychological Assessment – Science and Practice provides a thorough and authoritative record of the best available assessment tools and methods in health psychology, making it an invaluable resource both for students and academics as well as for practitioners in their daily work.
Zielgruppe
For Psychology students, professionals and researchers involved in Health Psychology.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
[18][19]Chapter 2 Social Cognitions in Health Behaviour Mark Conner School of Psychology, University of Leeds, UK Introduction The psychological determinants of health behaviours have been an important focus of health psychology for a number of years. The behaviour-specific thoughts and feelings that an individual has about a particular health behaviour have received particular attention (Conner & Norman, 1996, 2005, 2015). These are commonly referred to as social cognitions (or health cognitions). Part of the justification for a focus on social cognitions has been that they represent modifiable determinants of health behaviour that can be targeted in interventions to improve health outcomes. Rather than being examined as individual social cognitions, research has tended to focus on groups of social cognition variables as specified by models such as the theory of planned behaviour, the health belief model, protection motivation theory, and social cognitive theory (Conner & Norman, 2005). These models suggest that the thoughts and feelings I have now about a behaviour will predict whether I perform that behaviour in the future (partly because they inform my current decision or intention to perform that behaviour and partly because that decision plus those thoughts and feelings impact on the performance of the behaviour when the opportunity to act presents itself). This chapter first briefly describes the content of these theories. Second, it focuses on the assessment of key social cognitions as identified by these theories. This is done in relation to general principles guiding the appropriate development of measures rather than highlighting specific existing measures to use. This is because the social cognitions are nearly always developed as behaviour-specific measures that vary as a function of the behaviour being studied (and to some extent based on the population under study). Third, a short conclusion summarises the chapter and discusses future directions. Key Social Cognition Models The key social cognitions models include the health belief model (HBM; e.g., Abraham & Sheeran, 2005; Janz & Becker, 1984), protection motivation theory (PMT; e.g., Maddux & Rogers, 1983; Norman, Boer, & Seydel, 2005), theory of reasoned action/theory of planned behaviour (TRA/TPB; e.g., Ajzen, 1991; Conner & Sparks, 2005), and social cognitive theory (SCT; e.g., Bandura, 2000; Luszczynska & Schwarzer, 2005). These models will be briefly described here (see Chapter 3 in this volume for further details on SCT). There is significant[20] overlap between the models in terms of the key health cognitions they identify, which will become apparent as we consider measures of the key social cognitions. Health Belief Model The HBM posits that health behaviour is determined by two cognitions: perceptions of illness threat and evaluation of behaviours to counteract this threat. Threat perceptions are based on two beliefs: the perceived susceptibility of the individual to the illness (“How likely am I to get ill?”); and the perceived severity of the consequences of the illness for the individual (“How serious would the illness be?”). Similarly, evaluation of possible responses involves consideration of both the potential benefits of and barriers to action. Together these four beliefs are thought to determine the likelihood of the individual performing a health behaviour. The specific action taken is determined by the evaluation of the available alternatives, focusing on the benefits or efficacy of the health behaviour and the perceived costs or barriers of performing the behaviour. Individuals are assumed to be most likely to follow a particular health action if they believe themselves to be susceptible to a particular condition that they also consider to be serious, and believe that the benefits outweigh the costs of the action taken to counteract the health threat. Two further cognitions usually included in the model are cues to action and health motivation. Cues to action are assumed to include a diverse range of triggers to the individual taking action, which may be internal (e.g., physical symptom) or external (e.g., mass media campaign, advice from others) to the individual (Janz & Becker, 1984). Health motivation refers to more stable differences between individuals in the value they attach to their health and their propensity to be motivated to look after their health. Protection Motivation Theory In PMT the primary determinant of performing a health behaviour is protection motivation or intention to perform a health behaviour. Protection motivation is determined by two appraisal processes: threat appraisal and coping appraisal. Threat appraisal is based on a consideration of perceptions of susceptibility/vulnerability to the illness and severity of the health threat in a very similar way to the HBM. Coping appraisal involves the process of assessing the behavioural alternatives that might diminish the threat. This coping process is itself assumed to be based upon two components: the individual’s expectancy that carrying out a behaviour can remove the threat (action–outcome efficacy), and a belief in one’s capability to successfully execute the recommended courses of action (self-efficacy). Theory of Planned Behaviour The TPB specifies the factors that determine an individual’s decision to perform a particular behaviour. Importantly this theory added perceived behavioural control to the earlier TRA (Ajzen & Fishbein, 1980). The TPB proposes that the key determinants of behaviour are intention to engage in that behaviour and perceived behavioural control over that behaviour. As in the PMT, intentions in the TPB represent a person’s motivation or conscious plan or decision to exert effort to perform the behaviour. Perceived behavioural control (PBC) is a person’s expectancy that performance of the behaviour is within his/her control (perceived control) and confidence that he/she can perform the behaviour (perceived confidence) and is similar to [21]Bandura’s (1982) concept of self-efficacy. In the TPB, intention is assumed to be determined by three factors: attitudes, subjective norms, and PBC. Attitudes are the overall evaluations of the behaviour by the individual as positive or negative (and sometimes split into affective and instrumental attitudes). Subjective norms are a person’s beliefs about whether significant others think he/she should engage in the behaviour (and sometimes split into injunctive norms and descriptive norms). PBC is assumed to influence both intentions and behaviour because we rarely intend to do things we know we cannot and because believing that we can succeed enhances effort and persistence and so makes successful performance more likely. Attitudes are based on behavioural beliefs (or outcome expectancies), that is, beliefs about the perceived outcomes of a behaviour. In particular, they are a function of the likelihood of the outcome occurring as a result of performing the behaviour (e.g., “How likely is this outcome?”) and the evaluation of that outcome (e.g., “How good or bad will this outcome be for me?”). It is assumed that an individual will have a limited number of consequences in mind when considering a behaviour. This outcome expectancy framework is based on Fishbein’s (1967) earlier summative model of attitudes. Subjective norm is based on beliefs about salient others’ approval or disapproval of whether one should engage in a behaviour (e.g., “Would my best friend want me to do this?”) weighted by the motivation to comply with each salient other on this issue (e.g., “Do I want to do what my best friend wants me to do?”). Again it is assumed that an individual will only have a limited number of referents in mind when considering a behaviour. PBC is based on control beliefs concerning whether one has access to the necessary resources and opportunities to perform the behaviour successfully (e.g., “How often does this facilitator/inhibitor occur?”), weighted by the perceived power, or importance, of each factor to facilitate or inhibit the action (e.g., “How much does this facilitator/inhibitor make it easier or more difficult to perform this behaviour?”). These factors include both internal control factors (information, personal deficiencies, skills, abilities, emotions) and external control factors (opportunities, dependence on others, barriers). As for the other types of beliefs, it is assumed that an individual will only consider a limited number of control factors when considering a behaviour. Social Cognitive Theory In SCT, behaviour is held to be determined by three factors: goals, outcome expectancies, and self-efficacy. Goals are plans to act and can be conceived of as intentions to perform the behaviour (see Luszczynska & Schwarzer, 2005). Outcome expectancies are similar to behavioural beliefs in the TPB but here are split into physical, social, and self-evaluative depending on the nature of the outcomes considered. Self-efficacy is the belief that a behaviour is or is not within an individual’s control and is usually assessed as the degree of confidence the individual has that he/she could still perform the behaviour in the face of various obstacles (and is similar to PBC in the TPB). Bandura (2000) recently added socio-structural factors to his theory. These are factors assumed to facilitate or inhibit the performance of a behaviour and affect behaviour via changing goals. Socio-structural factors refer to the impediments or opportunities associated with particular living conditions, health systems, and political, economic, or environmental systems. This component of the model incorporates perceptions of the environment as an...
