Features of adherence to
medical regimes
1. Reasons for non adherence Bulpit
2. Measuring non adherence Lustman
3. Improving adherence – Watt
Health Booklet E – Healthy Living
Theories of health belief
1. Health Belief Model Becker
2. Locus of Control Rotter
3. Self efficacy Bandura & Adams
Methods of health Promotion
1. Media Campaigns Cowpe
2. Fear arousal Janis & Feshbeck
3. Legislation Dannenberg
Theories of health belief
• Health Belief Model Becker
• Locus of Control Rotter
• Self efficacy Bandura & Adams
Key Terms Bingo
Health Belief
Model
Internal Locus
of Control
External Locus
of Control
Correlation
Asthma
Review
Socio
demographic
variables
Self efficacy
Verbal
persuasion
Cognitive
appraisal
Systematic
desensitisation
Vicarious
experiences
Health Belief Model - Becker
Sociodemographic
variables
Benefits vs. costs
Healthy
Behaviour
Perceived
seriousness
Cues to
Action
Perceived
threat
Perceived
susceptibility
Becker Study Method
• Aim – use HBM to explain mothers adherence to
drug regime for asthmatic children
• Pts – 111 mothers (17-54 yrs) responsible for
giving asthma medication to children (9 months
– 17 yrs)
• Method – correlation between beliefs reported
during interviews and compliance with self
reported administration of medicine (confirmed
with blood tests for some pts)
Becker Study Results
• + correlation belief about susceptibility to asthma
attack and adherence to medicine
• + correlation perception of seriousness of
asthma and adherence to medicine
• - correlation between costs of adherence and
adherence
• increased compliance – married mothers and
higher level of education
• Conclusion – HBM is a useful model to predict
compliance with taking medication
Locus of Control - Rotter
• Locus Latin for place
• Where a person thinks the control of his or
her health lies influences whether they
adopt a health behaviour
• Internal Lof C – they control their own
health
• External L of C – health is seen as being in
someone else’s hands
Rotter Study
• Method review article
• Sample 6 pieces of research into
individual perceptions of ability to control
outcome
• Findings – Pts who felt they had control
over the situation were more likely to show
behaviours that would enable them to
cope with potential threats
Rotter - Conclusions
• L of C can be useful in predicting whether
people will adopt health behaviours
• Those with internal L of C are more likely
to adopt health behaviours
• Backed up by James et al male smokers
who gave up and did not relapse had
higher L of C
• (not true for women where factors such as
weight gain were influential)
Self Efficacy – Bandura & Adams
• Self efficacy – how successful a person
thinks they will be in adopting a health
behaviour
Outcome expectancy / efficacy expectation
Vicarious experiences
Verbal persuasion
Emotional arousal
Bandura study
• Aim – to assess the self efficacy of
patients undergoing systematic
desensitisation for snake phobia
• Method – RMD
• Pre test assessment – avoidance bhr, fear
(1-10) and efficacy expectations
• Systematic desensitisation
• Post test assessment
Bandura results
• Higher levels of post test self efficacy were
correlated with higher levels of interacting
with snakes
• SD enhanced self efficacy which in turn
led to a belief that the person was able to
cope with the snake