Summary HEP4211 Changing Health Behaviour

HEP4211 Changing Health Behaviour: summary of (mini)
lectures

Attitude
Attitude is an important determinant of behaviour, which is used in many
theories (Theory of Planned Behaviour, I-Change Model, Reasoned Action
Approach etc.). Several strategies can be used to change attitude.

Gain vs loss framing
Framing: several forms of framing can be distinguished:
- Risky choice framing: subjects are presented with two options in a forced
choice task. The two options are typically gambles which can be described in
terms of proportions and probabilities of gains or losses. Usually, one of these
options is a sure thing (in which an intermediate outcome is specified as
certain), while the other is a risky gamble (in which extreme good and bad
values are both assigned non-zero probabilities). The gamble and sure thing
are both described either in terms of gain outcomes and probabilities or else
in terms of equivalent loss outcomes and probabilities.
- Attribute framing: A single attribute of a single object is described in terms
of either a positively valued proportion or an equivalent negatively valued
proportion. The subject is then required to provide some evaluation of the
object thus described. Objects described in terms of a positively valued
proportion are generally evaluated more favorably than objects described in
terms of the corresponding negatively valued proportion.
- Goal framing: the goals of an action or behaviour is framed
o Gain framing  the benefits of engaging in a healthy behaviour. Focus
is on (1) good things that will happen and (2) bad things that will not
happen
o Loss framing  the costs of failing to engage in a healthy behaviour.
Focus is on (1) bad things that will happen and (2) good things that will
not happen.
- Both promote the same outcome: healthy behaviour

When to use which type of framing?
Depends on:
- The behaviour: according to the message framing theory (Rothman):
o Preventative health behaviour  gain, low risk option (sunscreen)
o Detection health behaviours  loss frame, risky option (cancer
screening)
- Risk implications: the effectiveness of framed messaged hinges on how the
individual thinks and feels about the behaviour and not the behaviour type
per se  attitude concerning the behaviour, uncertainty about the outcome
of the behaviour will make the behaviour more risky.
- Dispositional factors: the effectiveness of framed messages hinges on
individual’s tendency to orient his or her behaviour toward favourable or
unfavourable outcomes  if you are more likely to focus on the positive of
negative things that will happen once you perform the behaviour
- Issue involvement (how involved are you in the behaviour)  low evidence
for this though
- Perspective of orientation (promotion (gain) vs prevention (loss) , on which
one are you more focused)  low evidence
- Self-efficacy  high SE (gain) vs low SE (loss)  low evidence

, Affective vs cognitive arguments
Attitude consists of a cognitive part and an affective part:
Cognitive: perception you have on a certain behaviour  unhealthy, safe, bad 
instrumental beliefs
Affective: affective or emotional beliefs  feel better, unpleasant, fear,
pleasant, happy, stressful  affective beliefs

These constructs are used in many theories (TPB, ICM, RAA) and can be
measured separately. Because there is a difference between cognitive and
affective attitudes, both types of arguments should be used to change this
attitude

Which arguments to use?
Depends on:
- The level of need for cognition/affect  personal
o Need for cognition (cognitive arguments): tendency for an individual
to engage in and enjoy effortful cognitive activity
o Need for affect (Affective arguments): tendency for an individual to
see emotions as desirable and feel a need to pursue them
- Attitudinal base  how do you form your attitude, based on cognitive or
affective beliefs?  personal.
o Matching: (attitudinal base = cognitive  cognitive arguments).
o Mismatching: (attitudinal base = cognitive  affective arguments)
 there is evidence for both, depends on how you measure it
 Meta-bases: you ask the person  self-assessment of attitude
base.
 Matching the meta base leads to higher levels of appreciation
 Structural bases: statistical story, you don’t ask the person directly
but you measure it objectively  objective assessment of attitude
base
 Mismatching the structural base leads to attitude change

Elaboration likelihood model of persuasion
ELM: how arguments are processed by a person
Dual model: two routes to persuasion
1) Central route: involves careful consideration of the issue-relevant
information relating to the attitude object  if you like to think about all
the options and the pro's and the cons
2) Peripheral routes: reliance on simple cues available in the persuasion
context as well as mental short-cuts called heuristics  if you are not likely
to elaborate on things for a longer time, you rely on simple cues (someone
tells you, you see it somewhere etc.)
 it is a continuum, you can switch between the two

Which route to take:
Depends on:
- Motivation: are you motivated to elaborate (content interest)
- Ability: are in a position to elaborate? (time, intelligence, peace of mind)
Central route:
- High motivation and high ability
- Arguments content and relevance is important
- Results: careful consideration of the message and stable attitude change