Health Communication
Lecture notes
LECTURE 1: INTRODUCTION
- In the past few decades an increase in numbers of chronic diseases
- Partly due our population ageing
- But health behaviour is also an important predictor
- Unhealthy lifestyles are a cause à not being physically active, consuming
saturated fats, not enough fruits, alcohol, smoking, salt intake
- Emphasized by the WHO à targets for 2025 (salt intake, alcohol, tobacco,
physical activity)
FROM THEORY TO PRACTICE
- Why theories?
- Many behavioral determinants are already known
o At the individual level à e.g. knowledge, attitude, subjective norms,
self-efficacy, intention
o At the environmental level à e.g. services, funding, policy
- Theories are still valuable in current scientific research; no need to reinvent
the wheel
- Helps us identify why some individuals do take part in health promoting
actions and some don’t
- Theory can:
o Help us identify reasons why ppl do or do not take health promoting
actions
o Explain behaviour and suggest how to achieve behavioral change
o Help pinpoint what you need to know before developing or organizing
an intervention program
o Provide insight into how you can shape effective programs
o Identify what should be monitored, measured, ad/or compared in
program evaluation
- Three kinds of theories:
1. Intervention planning (e.g. Intervention Mapping)
2. Explaining and/or predicting behaviour (e.g. TRA, TPB)
3. Diffusion of interventions (e.g. Diffusion of Innovations)
a) Theory of reasoned action
1
, o It is important that the behavioral outcomes are in turn evaluated
b) Theory of planned behaviour
o An extension of theory of reasoned action
o They realized there is a third concept
o Ppl should feel like they are in control of performing the behaviour
o Control beliefs
o Perceived power = believe they have power over the difficult situation
c) The I-Change Model
o Comprehensive, complete, complex
o It considers intention to be the most important predictor of behaviour
2
, o Intention separated into different stages of change
à it considers ppl to be in precontemplation = ppl are not considering
to change their behaviour within the next 6 months
à … contemplation = ppl are thinking of changing behaviour within 6
months
à … preparation = willing to change behaviour within next month
o It also considers several motivational factors to be influencing
intention (similar to TPB)
à attitudes (specifically subdivided into pros & cons of the desired
behavioral change AND rational vs. emotional pros & cons)
à social influence beliefs (social norms = what do ppl think I should do;
social modelling beliefs = what do ppl in my environment do; social
pressure)
à efficacy beliefs (routine – e.g. smoking, social, emotional, stress
related)
o Predisposing factors
à already having experience with a similar behavior in the past =
behavioral factors (e.g. those who already tried quitting smoking)
à psychological factors
à biological factors = gender, age, etc.
à socio economic status = socio cultural factors
o Awareness factors
à knowledge
à cues to action = e.g. someone in your environment dying from
cancer
à risk perception = e.g. do you feel vulnerable of experiencing the
consequences
o Information factors = scientists can have an effect here
à concerns the content of the message
à the channel (e.g. print materials/online)
à source (e.g. will we present ourselves, etc.)
o Ability factors = the gap between intention and behaviour can be
closed with these
à plans = planning beforehand helps succeed
à performance skills = you need necessary skills to perform the
behaviour
o Barriers = they enlarge the gap between the intention and behavior
à e.g. financial issues à can't afford a gym membership
All models
- Intention = the most important predictor of behaviour
- Intention= result of conscious consideration of:
o Pros and cons
3
, o Important others’ opinion
o Perceived control (except the TRA)
- TACT principle (target, action, context, time)
o By Ajzen
o E.g. walking on a treadmill in a physical fitness center for at least 30
minutes each day in the forthcoming month
o Be specific about what you want to achieve in the target group
- Compatibility principle
o It is important that the theoretical concepts are referring to the same
behaviour that you want to measure
o E.g. intention to walk on the treadmill in a fitness center for at least 30
minutes daily for a month à attitude to walk on the treadmill in a fitness
center for at least 30 minutes daily for a month
o You can’t just measure the intention of walking on the treadmill, you
have to include all the specifics
- Behaviour isn’t always rational
ONLINE HEALTH COMMUNICATION
- Health related websites à can be researched based
- Healthy living blogs à often very questionable
- Fitspiration
- Online computer tailoring
o An online questionnaire that assesses their behaviour
o More evidence based
o Relevant feedback based on the person’s individual answers
o Behaviour, pros and cons, self-efficacy
o Automatic process
o MyDrinkAware, QSense à online computer-tailored eHealth
o People are not aware of the enormous number of algorithms that are
running behind the scenes
o Working mechanisms:
à increases sense of personal relevance of the message
à that enhances the information processing
à this increases their use of the materials and their engagement
à ultimately this leads to more behavioral change
o Public health impact = effect * reach
4
Lecture notes
LECTURE 1: INTRODUCTION
- In the past few decades an increase in numbers of chronic diseases
- Partly due our population ageing
- But health behaviour is also an important predictor
- Unhealthy lifestyles are a cause à not being physically active, consuming
saturated fats, not enough fruits, alcohol, smoking, salt intake
- Emphasized by the WHO à targets for 2025 (salt intake, alcohol, tobacco,
physical activity)
FROM THEORY TO PRACTICE
- Why theories?
- Many behavioral determinants are already known
o At the individual level à e.g. knowledge, attitude, subjective norms,
self-efficacy, intention
o At the environmental level à e.g. services, funding, policy
- Theories are still valuable in current scientific research; no need to reinvent
the wheel
- Helps us identify why some individuals do take part in health promoting
actions and some don’t
- Theory can:
o Help us identify reasons why ppl do or do not take health promoting
actions
o Explain behaviour and suggest how to achieve behavioral change
o Help pinpoint what you need to know before developing or organizing
an intervention program
o Provide insight into how you can shape effective programs
o Identify what should be monitored, measured, ad/or compared in
program evaluation
- Three kinds of theories:
1. Intervention planning (e.g. Intervention Mapping)
2. Explaining and/or predicting behaviour (e.g. TRA, TPB)
3. Diffusion of interventions (e.g. Diffusion of Innovations)
a) Theory of reasoned action
1
, o It is important that the behavioral outcomes are in turn evaluated
b) Theory of planned behaviour
o An extension of theory of reasoned action
o They realized there is a third concept
o Ppl should feel like they are in control of performing the behaviour
o Control beliefs
o Perceived power = believe they have power over the difficult situation
c) The I-Change Model
o Comprehensive, complete, complex
o It considers intention to be the most important predictor of behaviour
2
, o Intention separated into different stages of change
à it considers ppl to be in precontemplation = ppl are not considering
to change their behaviour within the next 6 months
à … contemplation = ppl are thinking of changing behaviour within 6
months
à … preparation = willing to change behaviour within next month
o It also considers several motivational factors to be influencing
intention (similar to TPB)
à attitudes (specifically subdivided into pros & cons of the desired
behavioral change AND rational vs. emotional pros & cons)
à social influence beliefs (social norms = what do ppl think I should do;
social modelling beliefs = what do ppl in my environment do; social
pressure)
à efficacy beliefs (routine – e.g. smoking, social, emotional, stress
related)
o Predisposing factors
à already having experience with a similar behavior in the past =
behavioral factors (e.g. those who already tried quitting smoking)
à psychological factors
à biological factors = gender, age, etc.
à socio economic status = socio cultural factors
o Awareness factors
à knowledge
à cues to action = e.g. someone in your environment dying from
cancer
à risk perception = e.g. do you feel vulnerable of experiencing the
consequences
o Information factors = scientists can have an effect here
à concerns the content of the message
à the channel (e.g. print materials/online)
à source (e.g. will we present ourselves, etc.)
o Ability factors = the gap between intention and behaviour can be
closed with these
à plans = planning beforehand helps succeed
à performance skills = you need necessary skills to perform the
behaviour
o Barriers = they enlarge the gap between the intention and behavior
à e.g. financial issues à can't afford a gym membership
All models
- Intention = the most important predictor of behaviour
- Intention= result of conscious consideration of:
o Pros and cons
3
, o Important others’ opinion
o Perceived control (except the TRA)
- TACT principle (target, action, context, time)
o By Ajzen
o E.g. walking on a treadmill in a physical fitness center for at least 30
minutes each day in the forthcoming month
o Be specific about what you want to achieve in the target group
- Compatibility principle
o It is important that the theoretical concepts are referring to the same
behaviour that you want to measure
o E.g. intention to walk on the treadmill in a fitness center for at least 30
minutes daily for a month à attitude to walk on the treadmill in a fitness
center for at least 30 minutes daily for a month
o You can’t just measure the intention of walking on the treadmill, you
have to include all the specifics
- Behaviour isn’t always rational
ONLINE HEALTH COMMUNICATION
- Health related websites à can be researched based
- Healthy living blogs à often very questionable
- Fitspiration
- Online computer tailoring
o An online questionnaire that assesses their behaviour
o More evidence based
o Relevant feedback based on the person’s individual answers
o Behaviour, pros and cons, self-efficacy
o Automatic process
o MyDrinkAware, QSense à online computer-tailored eHealth
o People are not aware of the enormous number of algorithms that are
running behind the scenes
o Working mechanisms:
à increases sense of personal relevance of the message
à that enhances the information processing
à this increases their use of the materials and their engagement
à ultimately this leads to more behavioral change
o Public health impact = effect * reach
4
