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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:

 

Type

Model and description

Evaluating the model

Learning

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

Cognitive

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