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Health Promotion
Section B essay
(a) Describe what psychologists discovered about health promotion. [10]
Psychologists have investigated many different methods of promoting health.
Some psychologists have suggested that health can best be promoted by
using health education campaigns. For example the health belief model aims
to predict when a person will engage in health behaviour and is used when
developing health education campaigns. According to the health belief model,
the likelihood that individuals will take follow medical advice depends directly
on two assessments that they make;
Firstly people evaluate the threat. That is whether doing or not doing health
behaviour will affect them. Factors that can influence a person's perceived
threat of illness, including; perceived seriousness, perceived susceptibility,
and cues to action.
Secondly people calculate a cost-benefits analysis. The cost-benefit
assessment looks at whether the perceived benefits exceed the perceived
barriers.
Therefore when health professionals design health education campaigns,
according to this model, they should emphasise the threat to the individual
(e.g. lung cancer for smokers) whilst also stressing the benefits of carrying out
the behaviour (e.g. stopping smoking makes you feel better, smell better,
saves you money and so on)
Many psychologists suggest that in order to promote better health practices
(e.g. stopping smoking, wearing seatbelts and so on) the heath education
campaign should arouse fear in the target audience. In an experiment
(Leventhal 1967) demonstrating this, cigarette smokers filled out a
questionnaire on their attitudes about smoking and their desire to quit. Then
they received either a moderate fear or a high fear presentation regarding
smoking. The results showed that the subjects in the high-fear condition
reported being more vulnerable to lung cancer and more eager to stop
smoking than those in the moderate-fear group. The high-fear appeal was
much more effective than the moderate-fear appeal in changing people's
attitudes and intentions regarding smoking.
Psychologists have also studied health promotion in communities. The
Stanford Heart Disease Prevention Programme looked at three similar towns
in the USA. Two of these towns received a massive media campaign
concerning smoking, diet and exercise over a two-year period. This campaign
used television, radio, newspapers, posters and mail-shots. The third town
had no campaign and so acted as a control.
The people in the control group showed a slight increase in risk factors for
heart disease and the people in the campaign groups showed a moderate
decrease. The campaign produced increased awareness of the dangers of
heart disease but produced relatively little change in behaviour. The
exception to this was the people who had been offered one-to-one
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counselling; these showed significant changes in behaviour. This study
suggests that mass media campaigns by themselves produce only small
changes in behaviour, but they can act as a cue to positive action if further
encouragement is offered.
Psychologists have also studied workplace wellness programmes. Workplace
wellness programmes are run by companies, with the goal of attaining and
maintaining employee health. These programmes seek to make the
workplace healthier by making changes in the work environment and in
employees' health behaviours. A smoking ban in Australian ambulance
crews was monitored by self report measures, and also by physiological
measures such as blood and exhaled carbon dioxide. The measures were
taken just before the ban, just after it, and again six weeks later. The self
report results showed that the ambulance crews reported less smoking both
at the start of the ban and after six weeks. The physiological measures,
however returned to the baseline measures after six weeks, suggesting that
the smokers were finding other times to smoke, or were maybe finding secret
places to smoke while at work.
This suggests that worksite smoking bans might well be useful in changing
behaviour at work, and also improving the quality of life for non-smokers, but
their overall effectiveness in reducing smoking is far less clear.
Evaluate what psychologists have discovered about health promotion
[16]
One issue that arises when psychologists study health promotion is ethics.
Ethics are often a problem for psychologists because when we study people
we should not harm them in any way. However in the Leventhal study on
fear arousal the participants who were subjected to the high fear condition
could have been upset by the video and in fact some of the participants were
so distressed they had to leave the room. In comparison we can argue that
studies such as the Stanford Heart Disease Prevention Programme are
unethical because they use a control group who are deprived of the extra
health promotion that the experimental groups receive. However at the same
time we could argue that if the study had not been done the two experimental
groups would not have received the health promotion anyway.
Another issue which arises when we study health promotion is the sample.
For psychologists to make generalisations they should have a representative
sample. The Stanford Heart Disease Prevention Programme interviewed
several hundred people in the three towns between the ages of 35 and 60.
This seems to be a large enough sample to make generalisations although we
should still be cautious generalising the findings to non US citizens. In
contrast Gomel’s study of Ambulance drivers had a much narrower sample of
participants who were all probably from similar backgrounds so we would
have to be careful generalising the findings to other types of workers.
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A further issue which arises when we study health promotion is demand
characteristics. Participants may not tell the truth about their health
behaviour and may give answers the researchers are expecting. For
example, in Leventhal’s study participants in the high fear condition may say
they are not going to smoke because that is what the researchers expect to
hear. They may however simply carry on smoking. In comparison
participants in the Gomel study also demonstrated demand characteristics as
they said they had stopped smoking but physical evidence suggested that
they were still smoking.
Finally we can also evaluate psychological evidence into health promotion by
looking at the issue of reductionism. There are many factors influencing
whether people will follow health promotion and to only focus on one factor
would be reductionist as it would be ignoring these many factors. The Health
Belief Model is good in that it investigates many factors affecting whether
people will follow health promotion. For example it takes into consideration
the persons beliefs, their family and social background and also the cues to
action. In contrast Leventhal’s fear arousal study could be seen to be
reductionist as it only focuses on fear as a motivating factor and ignores other
factors such as the social and financial background of people.