BNR150

HEALTH & HUMAN BEHAVIOUR

Lecture
Understanding Health Behaviour

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 LEARNING CONTENT
1. Demonstrate a beginning understanding of health
psychology
2. Demonstrate a beginning understanding of health behaviour
theory
3. Explain the determinants of health model
4. Define health literacy and numeracy
5. Differentiate between health promoting behaviours, health
risk behaviours, and harm minimisation.

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 HEALTH BEHAVIOUR
• “an action taken by a person to maintain, attain, or regain
good health and to prevent illness. Health behavior reflects a
person's health beliefs”
(Mosby’s Medical Dictionary, 2009)
• Any behaviour that influences health:
– Alcohol and other drug use
– Physical activity
– Nutrition
– Sun protection
– Health screening, Vaccination
– STI protection
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 HEALTH PSYCHOLOGY
A sub field of psychology that applies psychological principles to
the scientific study of health, illness, and health-related
behaviors. It specialises in how biological, psychological and
sociocultural factors contribute to health and illness. Health
psychology is also concerned with the prevention of illness and
injury through health promotion and health policy development.

(American Psychological Association, 2016)

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 HEALTH BEHAVIOUR THEORY
• Help to explain, predict and understand health behaviour
• Help health professionals to understand:
– What makes a person engage in a health damaging behaviour
– What make a person engage in health risk taking behaviour
– What makes a person engage in a health promoting behaviour
– How to support people to engage in health promoting behaviour
– How to design and deliver health education
– How to design and implement health promotion programs
• Provide frameworks for research and evidence based practice

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 HEALTH BEHAVIOUR THEORIES
EXAMPLES

• Intrapersonal:
– Health Belief Model (Rosenstock, 1974)
– Self-Efficacy Theory (Bandura, 1977)
– Transtheoretical Model – Stages of Behaviour Change (Prochaska & Diclimete, 1983)
– Protection Motivation Theory (Rogers, 1975)
– Cognitive Dissonance Model (Festinger, 1957)

• Interpersonal:
– Social Cognitive Theory / Social Learning Theory (Bandura, 1977)

• Community level:
– Diffusion of Innovation Theory (Rogers, 1983)
– Ecological Models (Bronfenbrenner, 1970’s)

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 SELF-EFFICACY THEORY
BANDURA 1977

“people will only try to do what they think they can do,
and won’t try what they think they can’t do”
(Hayden, 2014, p.13)

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 SELF-EFFICACY THEORY
BANDURA 1977
Vicarious Verbal
Experience Persuasion
(observation of self (feedback &
& others) coaching)

Mastery Physiological
Experience State
(previous results & (physical &
experience) Self- emotional state)

Efficacy

Behaviour and Performance

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 DETERMINANTS OF HEALTH
• Circumstances and environment in which people are born,
grow, live, work and age, that affect health and contribute to
broader health inequalities
– Social, physical, economic environment
– Individual characteristics and behaviours
• The context of people’s lives determine their health
• Blaming individuals for having poor health is inappropriate
• Individuals may not be able to directly control many of the
determinants of health

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DETERMINANTS OF HEALTH

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DETERMINANTS OF HEALTH Psychological
•Stress
•Coping skills
•Mental health Health System
•Mental disorders •Acceptability
Economic • Accessibility
•Affordability
•Income •Use
•Employment •Appropriateness
•Poverty •Competence,
•Prosperity Continuity
•Effectiveness, Efficiency
•Safety

Social
•Social status
•Politics, Power
Health Biological
•Intrinsic factors
•Genetics
•Physical health
•Development
•Education
•Culture , Religion •Functional status
•Social support •Nutritional status
•Social stability •Immunity
•Gender

Behavioural Environmental
•Health promoting •Built environment
behaviour •Natural environment
•Health risk behaviour •Sustainability

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DETERMINANTS OF HEALTH
AIHW, 2014

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 HEALTH LITERACY

“Individual health literacy is the skills, knowledge, motivation

and capacity of a person to access, understand, appraise and
apply information to make effective decisions about health and
health care and take appropriate action.“ (ACSQHC, 2014)

“The knowledge gained from experiences, values and beliefs,

attitudes that promote recognition and appropriate help-
seeking, knowledge of health related issues including factors that
create health and how to seek health information, the ability to
recognise specific disorders, or self-treatments; and how to find
professional help.” (Keleher & MacDougall, 2011, p.235)
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 HEALTH LITERACY
• More than being able to read pamphlets and make appointments
• Health literacy is critical to empowerment
• Targets environmental, political and social determinants of health
• Health education should aim to influence not only individual
lifestyle decisions, but also raise awareness of the determinants
of health, and encourage individual and collective actions which
may lead to a modification of these determinants
• Health education is achieved therefore, through methods that go
beyond information diffusion and entail interaction, participation
and critical analysis in order to improve health literacy

(WHO, 2016)
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 HEALTH
NUMERACY

“the degree to which individuals have the capacity to access,

process, interpret, communicate, and act on numerical,
quantitative, graphical, biostatistical, and probabilistic health
information needed to make effective health decisions.”
(Golbeck et al., 2005)

“the individual-level skills required to obtain, interpret, and

process quantitative information for health behavior and
decisions.” (Ancker & Kaufman, 2007, p.719

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 HEALTH PROMOTING BEHAVIOURS
personal actions that sustain or increase health & wellness

• Eating fruit & vegetables • Physical activity

• Eating fibre • Sun protection
• Eating wholegrains • Safe sex
• Eating lean meat • Socialisation
• Eating fats in moderation • Immunisation
• Eating sugars in moderation • Health surveillance e.g.
• Drinking water – Pap smears
• Good hydration – BSE / TSE
– Mammograms
– Bowel cancer

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 HEALTH RISK BEHAVIOURS
personal actions that increase risk to health & wellness
• Poor nutrition & hydration
• Physical inactivity
• Alcohol use
• Other substance use
• Tobacco smoking
• Other smoking
• Lack of socialisation
• Unsafe sex
• Carbonated drink
consumption
• Fast food consumption
• Poor dental hygiene
• Lack of sun protection
• Physical risk taking e.g.
– Driving too fast
– No seat belt, no helmet
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 HARM MINIMISATION

• Harm minimisation involves strategies to address alcohol and

other drug (AOD) problems by reducing their harmful effects
on individuals and society through :
1. Harm Reduction: aim to reduce the harm from drugs for
individuals and communities. These strategies do not
necessarily aim to stop drug use e.g. needle syringe services,
methadone maintenance, brief interventions, peer education.
2. Supply Reduction: aim to reduce the production and supply of
illicit drugs, e.g. legislation, law enforcement.
3. Demand Reduction: aim to prevent the uptake of harmful drug
use e.g. community development projects, media campaigns.

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 HARM MINIMISATION
• Approach is based on the following:
– Drug use (licit and illicit) is an inevitable part of society.
– Drug use occurs across a continuum, ranging from
occasional use to dependent use.
– A range of harms are associated to different types and
patterns of AOD use.
– A range of approaches can be used to respond to these
harms.
• The principles of harm minimisation can be applied to other
health behaviours.

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 REFERENCES
Ancker, J., & Kaufman, D. (2007). Rethinking health numeracy: A multidisciplinary literature review. Journal of the American
Medical informatics Association, 14(6), 713-721. doi: 10.1197/jamia.M246
Australian Commission on Safety and Quality in Health Care. (2014). National statement of health literacy. Canberra, ACT:
ACSWHC retrieved from http://www.safetyandquality.gov.au/our-work/patient-and-consumer-centred-care/health-literacy/
Australian Government Department of Health. (2016). The stages of change model. Canberra, ACT: Commonwealth of Australia.
Retrieved from (http://www.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front9-wk-
toc~drugtreat-pubs-front9-wk-secb~drugtreat-pubs-front9-wk-secb-3~drugtreat-pubs-front9-wk-secb-3-3
Australian Institute of Health and Welfare. (2014). Australia’s health. Canberra, ACT: AIHW retrieved from
https://www.aihw.gov.au/getmedia/d2946c3e-9b94-413c-898c-aa5219903b8c/16507.pdf.aspx?inline=true
Golbeck, A., Ahlers-Schmidt, C., Paschal, A., Edwards Dismuke, S. (2005). A definition and operational framework for health
numeracy. American Journal of Preventative Medicine, 29(4), 375-376. doi:10.1016/j.amepre.2005.06.012 Retrieved from
http://www.sciencedirect.com/science/article/pii/S0749379705002576
Kelleher, H., & MacDougall, C. (2011). Understanding health. (3rd ed.). South Melbourne, Victoria: Oxford University Press.
Talbot, L., & Verrinder, G. (2010). Promoting health. A primary health care approach (4th ed.). Chatswood, NSW: Elsevier Australia.
World Health Organization. (2016). Health literacy and health behaviour. Geneva, Switzerland: WHO. Retrieved from
http://www.who.int/healthpromotion/conferences/7gchp/track2/en/
World Health Organization. (2016). The determinants of health. Geneva, Switzerland: WHO. Retrieved from
http://www.who.int/hia/evidence/doh/en/

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