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Section 6. Psychology of decision-making in health behaviour

Psychological models of decision-making in health are numerous and in this section we provide a selective summary of some of the more prominent of them. Models (for which further details are provided in the section on the “Prevention Paradox” elsewhere on this site) include:



Model and description

Evaluating the model


Behavioural Learning Theory, which focuses on the wider environment in which health decisions are made, and encourages skills development to manage health behaviour

  • Ignores subconscious influences on behaviour that are not linked to reward
  • Focus on external influences on behaviour alone

Social Cognitive Theory, focuses on capturing wider interactions between people and their environment, and the ways in which this affects health behaviour(s) – emphasising in particular the importance of social influence

  • Explains the effectiveness of social, peer and role-model influences on health decision-making


Health Belief Model: assumes a rational counter-balancing of facilitators and barriers to action by the person experiencing symptoms, when making the decision of whether or not to seek care

  • Powerful representation of individual-level health decision-making which has proven durable
  • Relationship between the different elements of the model is often unclear

Theory of Reasoned Action assumes a rational evaluation of options on the part of the individual, balancing personal attitudes towards a particular health behaviour, subjective norms, and the degree of behavioural control

  • Behaviour may not always be under the individual’s control – there may be implicit or hidden influences

Theory of Planned Behaviour is similar to the theory of reasoned action but also build in the idea of self-efficacy

Self-regulation theory holds that people form cognitive assessments of health threats on an ongoing basis, incorporating new information as they get it, to inform their decisions

  • Assumes that people are active, and rational problem-solvers – but this may not be the case



                                                          © I Crinson 2007, S Ismail 2017