Psychological Models of Health Behavior Change

The Rosenstock Hypothesis and Health Beliefs

The Rosenstock Hypothesis states that a person shall not carry out health behaviors unless they possess:

• Minimum levels of motivation.
• Relevant health information.
• A perception of themselves as vulnerable to a threatening disease.
• A conviction in the effectiveness of the intervention.
• A perception of few difficulties in the implementation of the health behavior.

Key Determinants of Health Behaviors

1. Perceived threat to health: This includes health values, beliefs about one's own vulnerability, and beliefs about the severity of the disease.
2. Beliefs about the possibility of reducing the threat: This includes beliefs about the effectiveness of specific measures to reduce threats and the conviction that the benefits outweigh the costs.

Understanding Behavioral Intention

Behavioral intention is driven by:

• Attitudes toward the specific action: Beliefs about the outcome of the conduct and the evaluation of the consequences of that behavior.
• Subjective norms: Normative beliefs and the motivation to act in accordance with them.

The Theory of Planned Behavior

The Theory of Planned Behavior incorporates attitudes and subjective norms alongside perceived behavioral control. This is defined as "the expectations that a person maintains about their capabilities and resources available to successfully carry out a conduct."

A person is predicted to take the decision to change current risk behavior if they value their health positively, have a favorable environment, and feel they have sufficient capacity and resources to successfully overcome the difficulties involved.

Individual Differences in Health Habits

Results from various studies show that health habits differ based on individual locus of control:

• Internal Persons: These individuals seek more information to resolve situations and identify preventive measures. Internals engage in problem-focused coping strategies.
• External Persons: These individuals tend to use more emotion-focused strategies.

Impact on Health Prevention

Internality is strongly associated with the practice of preventive measures. For example, intensive care patients recovering from myocardial infarction with internal expectations were seen as more cooperative and less depressed than outpatients who remained longer in the unit.

Cognitive and Motivational Biases

1. Information Bias: Analyzing a situation by highlighting beneficial effects compared with other people who are in situations imagined to be worse than our own.
2. Motivational Bias: An attempt to maintain self-esteem and confidence in one's competence, thereby avoiding the negative emotional consequences of admitting the risks being run.
3. Underestimation of Personal Vulnerability: This bias is greater and more frequent when the situation is perceived as controllable (perceived control) or when the behavior has been developed over a long period (behavioral experience).

Implementation of Behavioral Intention

The implementation of intention requires the detailed planning of the circumstances under which the behavior will be performed, specifically addressing how, when, where, and for how long the action will take place.