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Health Beliefs and Health Behaviors
411 Promoting Healthy Behavior Promoting Healthy Behavior 䉴 Who is most likely to adopt a healthy lifestyle? Despite physicians’ instructions, many patients fail to take their blood pressure medication and continue to eat an unhealthy diet. Noncompliance with medical advice is especially common when cultural values and beliefs conflict with that advice. Aware of this problem, health psychologists are developing culture-sensitive approaches to health promotion and disease prevention (Kazarian & Evans, 2001). DOCTOR’S ORDERS Health psychologists are deeply involved in the development of smoking cessation programs, in campaigns to prevent young people from taking up smoking, in alcoholeducation efforts, in the prevention of skin cancer through sun-safety education, and in the fight against the spread of HIV and AIDS (e.g., Buller, Buller, & Kane, 2005; Carey et al., 2004; Durantini et al, 2006; Latkin, Sherman, & Knowlton, 2003; Taylor, 2002). They have also helped promote early detection of disease. Encouraging women to perform breast self-examinations and men to do testicular self-examinations are just two examples of health psychology programs that can save thousands of lives each year (Taylor, 2002). Health psychologists have also explored the reasons behind some people’s failure to follow doctors’ orders that are vital to the control of diseases such as diabetes, heart disease, AIDS, and high blood pressure (Bartlett, 2002; Gonzalez et al., 2004). Understanding these reasons and finding ways to encourage better adherence to medical advice could speed recovery, prevent unnecessary suffering, and save many lives (Simpson et al., 2006). Efforts to reduce, eliminate, or prevent behaviors that pose health risks and to encourage healthy behaviors are called health promotion (Smith, Orleans, & Jenkins, 2004). For example, health psychologists have developed programs that teach children as young as nine to engage in healthy behaviors and avoid health-risky behaviors. School systems now offer a variety of these programs, including those that give children and adolescents the skills necessary to turn down cigarettes, drugs, and unprotected sex. Health psychologists also go into workplaces and communities with the goal of helping people to adopt healthier lifestyles by altering diet, smoking, and exercise patterns. They teach stress-management techniques, too (Langenberg et al., 2000; Tuomilehto et al., 2001). These programs can create savings in future medical treatment costs (Blumenthal et al., 2002; Schneiderman et al., 2001) and better health for those who participate (Lisspers et al., 2005). Health Beliefs and Health Behaviors Health psychologists are also trying to understand the thought processes that lead people to engage in health-endangering behaviors and that can interfere with efforts to adopt healthier lifestyles (Klepp, Kelder, & Perry, 1995). Their research has led to intervention programs that seek to change these patterns of thinking, or at least take them into account. In one study, for example, women who avoid thinking about the risks of breast cancer were more likely to get a mammogram screening after receiving health information that was tailored to their cognitive styles (Williams-Piehota et al., 2005). This cognitive approach to health psychology can be seen in various health-belief models. Irwin Rosenstock (1974) developed one of the most influential and extensively tested of these models (e.g., Aspinwall & Duran, 1999). He based his model on the assumption that people’s decisions about health-related behaviors (such as smoking) are guided by four main factors: 1. Perceiving a personal threat of risk for getting a specific illness. (Do you believe that you will get lung cancer from smoking?) 2. Perceiving the seriousness of the illness and the consequences of having it. (How serious do you think lung cancer is? What will happen to you if you get it?) 3. Believing that changing a particular behavior will reduce the threat. (Will stopping smoking prevent you from getting lung cancer?) health promotion The process of altering or eliminating behaviors that pose risks to health and, at the same time, fostering healthier behavior patterns. 4. A comparison of the perceived costs of changing a health-risky behavior and the benefits expected from making that change. (Will the reduced risk of getting cancer in the future be worth the discomfort and loss of pleasure from not smoking?)