Facilitating Health Behavioural Change - Report Example

Facilitating health behavioural change Introduction Behaviour change is an important aspect of health and social care services, more so in this era where people adopt a number of unhealthy behaviours. From a health perspective, there are a number of behavioural patterns, such as drug abuse especially in critical stages such as during pregnancy that need to be addressed within a short time. This is due to the consequences of such behaviours that may be detrimental to an individual’s health. As a result, various theories and models have been formulated to address this problem. The paper will use a number of theoretical models to help bring about a health behaviour change in a hypothetical case involving adult smokers. Curry and Fitzgibbon in Shumaker, Ockene and Riekert (eds) (2009, p. 2) observe that for behaviour change to be effectively accomplished, there is a need to explain the cause-effect relationships and help provide a basis for understanding and predicting behaviour, behaviour change and maintenance. This is an important aspect that should be given much consideration in developing intervention measures for behaviour changes. There are a number of theories formulated that can be applied to guide the process of behaviour change. Health behaviour theory of prevention There is a need to understand the concept of theory in order to have a greater perception of these theories. Theory simply put implies a statement about causal relationships (Hyden, 2009, 54). Therefore, from the above definition, theories of prevention are statements about causal relationships between exposures or risk factors and disease incidence (Shumaker et al (eds.), 2009, p. 4). From the definition given by Shumaker et al (2009) health behaviour theory of prevention is concerned with the causal relationships between health behaviours and disease incidence and progression. The theory identifies the behavioural problems that may lead to higher incidence of disease. For example, a woman smoking during pregnancy may expose her to higher risks of disease than is the non-smoker. It is observed by Curry and Fitzgibbon in Shumaker et al eds. (2009) that health behaviour theory of prevention gained prominence in the years following the Second World War. The epidemiological evidence for an association between cigarette smoking and lung cancer received the attention as a behavioural risk factor. This led to studies that helped understood the importance of behavioural changes in health matters. Taking the example of the behavioural risk factor of smoking in relation to lung cancer, it was discovered that smoking as a single behaviour was linked to a large number of chronic disease outcomes such as lung and laryngeal cancer as well as chronic bronchitis. Once the causality and the relationship between behaviour and disease incidence are established, there is a need to develop solutions that if applied would lead to a reversal of the condition. The paper discusses a number of such solutions that can be put in place by medical practitioners and other stakeholders to bring about behaviour change amongst adult smokers. High-risk and population based prevention strategies This approach advocates for the identification of individuals or groups known to be at high risk for disease and concentrate prevention and intervention efforts on reversing or reducing their risk level. This approach does not take in to account individuals with mildly elevated risk. The method, when put in to use for adult cigarette smokers, would consider helping reduce the vulnerability of the tobacco addicts. The approach adopted includes the use of a group of tobacco addicts to help them overcome their problems as a group. The method can be easily integrated into the existing health care organisation and provides for a cost-effective use of resources. Much as it is easily applicable, the approach has a number of limitations. The major limitation comes from labelling, where individuals enrolled in to the programme are labelled as addicts in the society. This may lead to many people hide their tobacco addiction hence cannot be identified for help. The other limitation comes from the approach adopted which leaves out low-risk individuals. These may include casual smokers, who face the risk of addiction, but the method does not take them in to account, it only considers the high-risk individuals in the society. This may lead to future addicts rising out of the group that was not taken into account. For the high-risk population based approach to prevention to be effective, there is a need to incorporate all those who are suffering the risk of disease due to their behaviour. Based on the example of cigarette smokers, the approach should account for all smokers at different levels, and target potentials smokers especially the youth who are likely to pick up the habit. The approach should also enhance the participation of all members of the society in bringing about a change in behaviours considered risky. This will facilitate the adoption of the method and individuals faced with such problems will voluntarily enrol in to the programme without fear of labelling. Models of adherence and disease management For effective behavioural change to take place, major consideration should be given to the individual affected. This will ensure the behaviour change effectively occurs once the individual impacted by the negative behaviour, in this case smoking, should take the major responsibility of bringing about the desired behaviour change. The model of adherence and disease management takes into account the voluntary measures taken by an individual to engage in health-directed activities (Thomas & Bishop, 2007). There are three major reasons why individuals opt to take that responsibility as stated by Shumaker et al (2009): 1. To prevent illness or to detect it at an asymptomatic stage (health behaviour). 2. In the presence of symptoms, to obtain a diagnosis and discover suitable treatment. 3. In the presence of defined illness, to undertake or receive treatment aimed at restoration of health or at halting disease progression. The health behaviour has been categorized as the model of adherence and disease management. This approach may be most effective in bringing about the desired behaviour change since it is voluntarily taken by the individual. The health professional provides the necessary assistance to such an individual such as the required information and other therapies that may be required. Health belief model This was a model developed in the early 1950s by a group of social psychologists at the United States Public Health Service (Shumaker et al, 2009)). This was an attempt to understand the widespread failure of people to accept disease screening tests for the early detection of asymptomatic disease. The model takes into consideration a number of factors, including the value given by an individual to a particular goal; and the individual’s estimate of the likelihood that a given action will achieve that goal. The goal in this case can be taken to be the desire to avoid illness and the belief that a certain health action will prevent or ameliorate illness. Health practitioners may use such information on a willing adult smoker. For example, a cigarette smoker addicted to the habit may be told of the risk involved with smoking and the potential solution to that problem. The individual should be guided in a manner that he comes up with his own decision and sets his goals. The health practitioner will then guide him in achieving the goals set. This model can also be adopted by adults voluntarily once the person identifies the risks he is exposed. The person then sets his goals and finds the best means to achieve them through behaviour change. Theory of planned behaviour Another approach that can be adopted by the health practitioners is contained in the theory of planned behaviour also referred to as the theory of reasoned action adopted by Fishbein, Ajzen and Hornik, (2007). This theory assumes that the intention to perform an action is the central determinant of that behaviour. This takes in to account a person’s belief that certain behaviour leads to a certain outcome. The theory also assumes that intention is not the exclusive determinant of behaviour where an individual’s control over the behaviour is imperfect. The theory proposes that factors outside an individual’s control can affect both intention and behaviour. The external factors may include having a workable plan, skills, social support, knowledge, time, willpower, and opportunity. The intention to perform certain behaviour still plays a fundamental role in the adoption of such behaviour. Taking the example of the tobacco addict, the individual may have the intention to bring about behaviour change, in this case quit smoking, but may lack the will power and social support to do so. The health practitioner or the social worker’s role come into play by helping the addict achieve the desired behavioural change. This may be through motivation and social support, linking that person to others with similar intentions and the necessary knowledge that would help the smoker quit smoking. Conclusion Behaviour change may be a prerequisite to health matters, especially when a particular behavioural pattern may have a higher incidence of disease. From the example adopted in the discussion, of cigarette smoking which increases the chances of lung cancer can be overcome through behaviour change. The process of behaviour change may sound simple to implement but requires much willpower and determination. This is more so from the person affected who desires behaviour change to ameliorate his problems. Health practitioners and other social workers can adopt a number of models discussed above in initiating effective behaviour change in an individual. The methods require the input and support of the affected person and the health practitioner as well as the general society. Being targeted at adults, it is assumed they are rational and can take responsibility and decide to either voluntarily adopt behaviour change measures, or seek assistance from professionals such as medical practitioners or social workers. References Fishbein, M., Ajzen, I., & Hornik, R.C. (2007). Prediction and change of health behaviour: Applying the reasoned action approach. New Jersey: Lawrence Erlbaum Publishers. Hayden, J. (2009). Introduction to health behaviour theory. Toronto: Jones & Bartlett Learning. Shumaker, S.A., Ockene, J.K. & Riekert, K.A. (eds) (2009). The handbook of health behaviour change. (3rd ed.) New York: Springer Publishing Company Thomas, B., & Bishop, J. (eds.) (2007). Manual of dietetic practice. (4th ed.). Oxford: x Facilitating health behaviour change. Read More