* PREVENTION SCIENCE * Differences: high – low income countries
- Interdisciplinary * DEFINITIONS *
- Psychological prevention
• Promote well-being
• Prevent: metal & physical illnesses * RISK FACTORS *
- Evidence based - Tabacco & alcohol use
- High blood pressure,
• Advancing health: individual & societal level
- Dietary risks & fasting plasma glucose
• Inform policymakers
- Context matters: knowing where/ what to intervene Metabolic, environmental & behavioral risks!
* TYPES OF PREVENTION *
Psychology of prevention and health
* PREVENT * promotion
- Illnesses ~ risk behavior
- Infectious diseases
1. Introduction
- Cancer (40% of all types)
Pos. correlation: spending on health & life expectancy.
CHANGING RISK BEHAVIORS * TARGET GROUPS *
- Smoking: Price increases = very effective (esp. youth);
- Alcohol: Campaigns (e.g. Dry January); impact varies by gender/age
- Eating habits: 5 fruits/veg per day; sugary drinks peak at 15–34 y/o
- Sedentary life: Highest:15–24 & +75; recommendation= 150 min/week
+ which determinants
* Rose (1981) – Strategies of Prevention*
“Prevention paradox” → big benefit for many, small for each
CAUTION IN MASS PREVENTION
- Large-scale medication: Small risks of side effects, high
Framingham and Whitehall studies: Greatest mortality from CHD harm in large populations.
mild (not the extreme) caused risk factors. - Natural solutions (cf. diet, exercise) = safer
RISK: RELATIVE vs ABSOLUTE
- Relative risk: chance compared to control group KEY TAKEAWAYS
- Absolute risk: actual change of illness (>> public health decisions) - Prevention is crucial → esp. for chronic illness
- High-risk strategy = useful but limited
- Population strategy = long-term impact
WHAT DRIVES BEHAVIOR CHANGE? - Behavior change needs social & economic incentives
- Social motivation (cf. anti-smoking norms) - Avoid overreliance on medical correction
- Economic/practical reasons (cf. margarine cheaper & healthier)
, * FEAR DRIVE MODEL * (1) * DIFFERENT HEALTH BEHAVIORS * * DETERMINANTS OF BEHAVIOR *
Mechanism: Fear-based messages to induce fear. - Health: prevent illness cf. eating healthy, not smoking Often: interact & non-linear.
- Type: Naive/ common sense/ implicit - Illness: seek remedy cf. visiting doctor, resting more Risk but also protective factors!
- Inform/ educate, fear appeals, disgust, - Sick role: recover/ get well cf. taking medication, staying home with flu - Biological:
repression and shame; • Genetics
- Criticism: Habituation, short-lived effect, often HEALTH IMPAIRING HABITS (gezondheid schadelijk gedrag) vs
• Metabolic traits
fails to truly change behavior, defensive reactions HEALTH-PROTECTIVE BEHAVIORS (gezondheid bevorderend gedrag)
- Often habitual (automatic), not always addiction-related - Personal:
Intervention implications: Fear appeals are used to - Risk factors for non-communicable diseases: • Personality
elicit behavior change, eg. with shock images on cigarette • : cardiovascular, diabetes, cancer, chronic respiratory • Learning history
packs or campaigns that evoke disgust, shame/ guilt. • Knowledge, attitudes, expectations
• , , : cardiovascular, diabetes, cancer
- Environmental:
* SOCIAL COGNITIVE THEORY * (2)
• Availability
Mechanism: Beliefs/ perception about risk. Psychology of prevention and health • Socio-cultural norms (peers, family)
- Types: ((a)social) (b)cognitive model.
promotion • Economic status & education
• (a) Weighing the pros and cons;
• (b) Attitudes/ beliefs (risk& efficacy, 2. Determinants of behavior
* THEORY OF (REASONED ACTION AND)
personal control & social beliefs);
PLANNED BEHAVIOR (TRA/TPB) * (5)
More than only cognition! Emotional
* PROTECTION MOTIVATION THEORY (PMT) * (4) Mechanism: People usually do things they think
(fear/ anxiety) & social components
Mechanism: Behavior based on threat + coping appraisal. about first - so behavior starts with intention.
- Criticism: People are not completely rational
- Threat appraisal: evaluation of maladaptive response. - TRA (original): attitude + norm
thinkers, anchoring & automatic thinking;
- Coping appraisal: evaluation of adaptive response. - TPB (extended): perceived behavioral control
Unrealistic optimism:
- Protection motivation: intention to perform a behavior - Weaknesses social-cognitive models: too
• Lack personal experience
• Egocentric perspective - Sources of information: environmental/ intrapersonal rational, static, limited environmental and
• If it doesn't happen now, it will never happen; - Strengths: Evaluated on 2 levels (manipulating components persuasive social scope, intention ≠ behavior, weak
• Infrequent problem. communication & perceived behavioral control the same as self-efficacy?) predictions, lack of guidance.
Risk perception, not crucial for all behaviors; - Criticism: Habituation, short-lived effect, often fails to truly change
Intervention implications: Work on attitudes (e.g.
Motivation to change ≠ change itself. behavior. through education), social norms (through influencers,
peer pressure), and self-efficacy (through skills
Intervention implications: Increase self-efficacy Intervention implications: Communicate clear risks and effective ways to deal with
training). Important: combine this with behavioral
through modeling, positive feedback, practicing them. Strengthen coping beliefs through training or guidance. Provide balance: enough
goals and action plans.
behavior in a safe context. Use peers or role models. threat to generate motivation, but not too much (avoid paralysis).
* HEALTH BELIEF MODEL (HBM) * (3) * TRANSTHEORETICAL MODEL (TTM) * (6)
Mechanism: Beliefs determine likelihood of engaging in health Mechanism: Behavior change= process over time, not one event.
behavior (= perceived threat (-) + effectiveness (+)). Stages:
- Engage health behavior: - (1) Precontemplation Not thinking about change
• Susceptible to condition - (2) Contemplation Considering change in next 6 months
• Serious consequences - (3) Preparation Planning change, small steps
• Effective behavior - (4) Action Actively changing behavior
• Benefits outweigh the costs - (5) Maintenance Sustaining change (6m+)
- Strengths: associations between expected direction - (6) Termination Behavior fully integrated; no risk of
- Weaknesses: lack of social components, weak prediction relapse
Intervention implications: Inform about seriousness and susceptibility Intervention implications: Interventions should be tailored to the stage of
of conditions, emphasize benefits of behavior, lower thresholds. For behavior change. E.g. in precontemplation: raise awareness. In action: provide
example, use flyers, videos or consultations to influence perception. support, remove obstacles.
- Interdisciplinary * DEFINITIONS *
- Psychological prevention
• Promote well-being
• Prevent: metal & physical illnesses * RISK FACTORS *
- Evidence based - Tabacco & alcohol use
- High blood pressure,
• Advancing health: individual & societal level
- Dietary risks & fasting plasma glucose
• Inform policymakers
- Context matters: knowing where/ what to intervene Metabolic, environmental & behavioral risks!
* TYPES OF PREVENTION *
Psychology of prevention and health
* PREVENT * promotion
- Illnesses ~ risk behavior
- Infectious diseases
1. Introduction
- Cancer (40% of all types)
Pos. correlation: spending on health & life expectancy.
CHANGING RISK BEHAVIORS * TARGET GROUPS *
- Smoking: Price increases = very effective (esp. youth);
- Alcohol: Campaigns (e.g. Dry January); impact varies by gender/age
- Eating habits: 5 fruits/veg per day; sugary drinks peak at 15–34 y/o
- Sedentary life: Highest:15–24 & +75; recommendation= 150 min/week
+ which determinants
* Rose (1981) – Strategies of Prevention*
“Prevention paradox” → big benefit for many, small for each
CAUTION IN MASS PREVENTION
- Large-scale medication: Small risks of side effects, high
Framingham and Whitehall studies: Greatest mortality from CHD harm in large populations.
mild (not the extreme) caused risk factors. - Natural solutions (cf. diet, exercise) = safer
RISK: RELATIVE vs ABSOLUTE
- Relative risk: chance compared to control group KEY TAKEAWAYS
- Absolute risk: actual change of illness (>> public health decisions) - Prevention is crucial → esp. for chronic illness
- High-risk strategy = useful but limited
- Population strategy = long-term impact
WHAT DRIVES BEHAVIOR CHANGE? - Behavior change needs social & economic incentives
- Social motivation (cf. anti-smoking norms) - Avoid overreliance on medical correction
- Economic/practical reasons (cf. margarine cheaper & healthier)
, * FEAR DRIVE MODEL * (1) * DIFFERENT HEALTH BEHAVIORS * * DETERMINANTS OF BEHAVIOR *
Mechanism: Fear-based messages to induce fear. - Health: prevent illness cf. eating healthy, not smoking Often: interact & non-linear.
- Type: Naive/ common sense/ implicit - Illness: seek remedy cf. visiting doctor, resting more Risk but also protective factors!
- Inform/ educate, fear appeals, disgust, - Sick role: recover/ get well cf. taking medication, staying home with flu - Biological:
repression and shame; • Genetics
- Criticism: Habituation, short-lived effect, often HEALTH IMPAIRING HABITS (gezondheid schadelijk gedrag) vs
• Metabolic traits
fails to truly change behavior, defensive reactions HEALTH-PROTECTIVE BEHAVIORS (gezondheid bevorderend gedrag)
- Often habitual (automatic), not always addiction-related - Personal:
Intervention implications: Fear appeals are used to - Risk factors for non-communicable diseases: • Personality
elicit behavior change, eg. with shock images on cigarette • : cardiovascular, diabetes, cancer, chronic respiratory • Learning history
packs or campaigns that evoke disgust, shame/ guilt. • Knowledge, attitudes, expectations
• , , : cardiovascular, diabetes, cancer
- Environmental:
* SOCIAL COGNITIVE THEORY * (2)
• Availability
Mechanism: Beliefs/ perception about risk. Psychology of prevention and health • Socio-cultural norms (peers, family)
- Types: ((a)social) (b)cognitive model.
promotion • Economic status & education
• (a) Weighing the pros and cons;
• (b) Attitudes/ beliefs (risk& efficacy, 2. Determinants of behavior
* THEORY OF (REASONED ACTION AND)
personal control & social beliefs);
PLANNED BEHAVIOR (TRA/TPB) * (5)
More than only cognition! Emotional
* PROTECTION MOTIVATION THEORY (PMT) * (4) Mechanism: People usually do things they think
(fear/ anxiety) & social components
Mechanism: Behavior based on threat + coping appraisal. about first - so behavior starts with intention.
- Criticism: People are not completely rational
- Threat appraisal: evaluation of maladaptive response. - TRA (original): attitude + norm
thinkers, anchoring & automatic thinking;
- Coping appraisal: evaluation of adaptive response. - TPB (extended): perceived behavioral control
Unrealistic optimism:
- Protection motivation: intention to perform a behavior - Weaknesses social-cognitive models: too
• Lack personal experience
• Egocentric perspective - Sources of information: environmental/ intrapersonal rational, static, limited environmental and
• If it doesn't happen now, it will never happen; - Strengths: Evaluated on 2 levels (manipulating components persuasive social scope, intention ≠ behavior, weak
• Infrequent problem. communication & perceived behavioral control the same as self-efficacy?) predictions, lack of guidance.
Risk perception, not crucial for all behaviors; - Criticism: Habituation, short-lived effect, often fails to truly change
Intervention implications: Work on attitudes (e.g.
Motivation to change ≠ change itself. behavior. through education), social norms (through influencers,
peer pressure), and self-efficacy (through skills
Intervention implications: Increase self-efficacy Intervention implications: Communicate clear risks and effective ways to deal with
training). Important: combine this with behavioral
through modeling, positive feedback, practicing them. Strengthen coping beliefs through training or guidance. Provide balance: enough
goals and action plans.
behavior in a safe context. Use peers or role models. threat to generate motivation, but not too much (avoid paralysis).
* HEALTH BELIEF MODEL (HBM) * (3) * TRANSTHEORETICAL MODEL (TTM) * (6)
Mechanism: Beliefs determine likelihood of engaging in health Mechanism: Behavior change= process over time, not one event.
behavior (= perceived threat (-) + effectiveness (+)). Stages:
- Engage health behavior: - (1) Precontemplation Not thinking about change
• Susceptible to condition - (2) Contemplation Considering change in next 6 months
• Serious consequences - (3) Preparation Planning change, small steps
• Effective behavior - (4) Action Actively changing behavior
• Benefits outweigh the costs - (5) Maintenance Sustaining change (6m+)
- Strengths: associations between expected direction - (6) Termination Behavior fully integrated; no risk of
- Weaknesses: lack of social components, weak prediction relapse
Intervention implications: Inform about seriousness and susceptibility Intervention implications: Interventions should be tailored to the stage of
of conditions, emphasize benefits of behavior, lower thresholds. For behavior change. E.g. in precontemplation: raise awareness. In action: provide
example, use flyers, videos or consultations to influence perception. support, remove obstacles.
