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Introduction
A person’s health behavior is closely related to his physical or mental unhealthy days. An unhealthy behavior or lifestyle can highly affect a person’s overall well-being. Unhealthy lifestyle can explain premature mortality and is also associated with chronic diseases. There is a close relationship between risk behavior and mental or physical health. J Am Board Fam Med. 2009 Jul-Aug 22(4):368-74 (Froshauq, Dickinson, Fernald, & Green, 2009).
Smoking, diet, exercise etc are some of the lifestyle aspects, while being impulsive, arrogant etc are the behavioral side. A person’s ability to carry out daily activities is related to his health conditions. The different activity a person is involved in is a clear indication of his mental and physical well-being. Reports say that health practices are closely related to the lifespan of a person. Habits like smoking, alcohol usage, stressful lifestyle etc can lead to chronic diseases and conditions like high blood pressure, arthritis, back pain etc.
Handbook of health behavior research By David S. Gochman (page 41).
Social cognitive models include theory of reasoned action, theory of planned behavior, health belief model and protection motivation theory. – Hand book of health behavior by David S. Gochman (page 42). Social cognitive theory claims that a part of a person’s knowledge acquisition is mainly due to observing his surroundings. This theory is used in psychology, education and communication and is mainly dependent on social interactions, experiences and other sources of information.
Aims and Objectives
The aim of the research is to explore the relationship between health behavior and social cognitive models. This research also seeks different issues which affect the health behavior of a person. This paper also checks the major components of SCM and how it influences health behavior and major components or factors which affect the health behavior of a person. To understand the health behavior and SCM, this study seeks the relationship between personality and health behavior. This research suggests some methods or important matters for maintaining the health behavior of a person. The researcher analyzes the development, evaluation and implementation of different types of treatments or interpretations in health behavior and their limitations. In order to have a thorough knowledge of the influence or interrelationship of health behavior and social cognitive model in a person, this study aims at addressing the following questions:
- What is health behavior and social cognition models?
- How does personality help to form health behavior?
- What one can see as a risk? How these risks can be assessed?
- What is the other Social Cognitive Models (SCM)? What are the utility of SCM?
- How past behavior and habits affect in future health behavior?
- What are the automatic influences in one’s health behavior?
- How one can maintain health behavior? What are the basic components for maintaining the health behavior?
- How far SCM is able or effective for the assessment of health behavior?
- What are the developments of theory based interventions in health behavior?
- What is the evaluation of theory-based intervention of health behavior?
- How theory based intervention is implemented in health behavior?
- What are the reasons for the failure of getting full potential in social cognitive approach to the intervention designs?
Research Methodology
The methodology of the research mainly consists of literature review and the research draws conclusions from the vast number of literature that has been reviewed in the research paper. This literature review contains books, journal articles, survey results and online resources.
The researcher will base the paper on a secondary type of research to complete the research. The paper will be qualitative in type, as the subject of enquiry is extremely debatable. The researcher has been collecting a number of newspaper articles, general literature and other online journals to help gain a focus and evaluate evidences as the researcher develops his paper. Analysis of the data will particularly focus on a national context of predicting health behavior and the implementation of Social Cognition Models (SCM). It will also complement the information gathered from the literature review. The researcher intended to carry out a relatively small content analysis throughout the research paper which would be observing the mass media, particularly journal articles. Some of the data analyzed will be quantitative as they will be used to test the different hypotheses concerning the relation between public health tradition and various social cognitive models.
The researcher will be specifically looking at the following academic books as they are most relevant to the research paper.
Literature Review
Impact of Personality Traits on Health Behavior
Personality traits like anger, anxiety, stress etc affect a person’s health and immunity by speeding or slowing the recovery process and even affect health of the heart. When a person suppresses his negative emotions, it affects his heart in a bad way. It can also lead to cancer. So, suppressing your anger or frustration could lead to serious health issues. Negative personality traits like frustration, anxiety, depression etc can lead to heart ailments. These negative traits give way to high blood pressure, increased cholesterol level, obesity and other problems, which are a clear indication of poor health. People who are more stressed and who take life too seriously are easily prone to various diseases, compared to the others. Studies conducted by Harvard university psychologist Ellen Langer show that the negative or positive effect on health is mainly due to a person’s mindset. It all depends on what the person believes in. It is very important to express your thoughts and feelings and vent out your negative emotions. Physical activities also help in releasing tension and maintaining a fit and healthy body.
The book ‘Personality traits’, by Gerald Matthews, Ian J, Deary, Martha C. Whiteman, Published in the year 2003 is an excellent book that deals in depth about personality traits and the recent surveys and research conducted in this field.
Assessment of Risk Perceptions
Risk perception is the judgment a person makes on the severity of a risk, while undertaking a certain work or way of living. Every activity involves a certain amount of risk. Some of these that are associated with daily living cannot be avoided. But, certain activities like smoking or drug usage, which are dangerous in the long run, can be avoided. In the book ‘Health Psychology’, Vol. 26, No.2, 2007, 136-145, the works done by Noel T.Brewer, Gretchen B. Chapman, Frederick X. Gibbons, Meg Gerrard Kevin D. McCaul and Neil D. Weinstein are combined to understand the relationship between risk perception and health behavior. Most of the studies show a positive relation between risk perceptions and behavior. Different theories like theory of reasoned action (Fishbein & Ajzen, 1975), theory of planned behavior (Ajzen, 1985), utility theory (Ronis, 1992) and so on, make it clear. But individual report shows both positive and negative relation between these two factors. Taking precautions like vaccines or other measures, or giving up a bad habit like drinking or smoking are mainly dependent on the individual and his attitude. In the journal, Health Promotion International, Vol. 18, No. 4, 279-286, December 2003 © Oxford University Press 2003, Mr. Whitelaw and colleagues stated that an individual’s behavior, moral values and lifestyle is closely associated with the society in which he grew. This influences his personality, and in turn the way in which he deals with health related issues. The journal Educational and Psychological Measurement, Vol. 57, No. 2, 197-209 (1997) reports the studies conducted on children and adolescents about risky behavior and its effect on health. Risk assessment helps us in making a decision whether or not to undertake a certain risk, by considering the risk with the benefits from that activity.
Utility of Other SCMs
In the book ’Communication, social cognition and effect’, by Lewis Donohew, Howard E. Sypher, Edward Tory Higgins, it is reported that social cognition started in early 1970s. Social cognition theory is a collection of different theories that are related to psychology, education etc. Social cognitive model is a combination of theories like the theory of reasoned action, theory of planned behavior, health belief model, and protection motivation theory. It mainly emphasizes on the fact that a person’s knowledge depends on his observing skills and what he studies from his surroundings.
Health Psychology in Global Perspective, Frances E. Aboud
SAGE handbook of health psychology, Stephen Sutton, Andrew Baum and Marie Johnston Predictors of successful aging, Encyclopedia of Health & Behavior, Norman B. Anderson Health Maintenance and the family, promoting health in families, Perri J. Bomar Adherence to Treatment in Medical Conditions, Lynn B.Myers, Kenny Midence Understanding Performance appraisal, Kevin R. Murphy, Jeanette Cleveland. These books discussed the various problems that many researchers and educators face today. The authors have introduced various social, cognitive models that are in favor of making effective health behavior among the people.
The secondary research closely verifies the validity of various Social Cognitive Models and their impacts. As it is to get an authenticity for the research, the researcher has collected different samples, such as images, diagrams and quotations of great personalities in support to the topic discussed. The research is focused around the various answers to the topic that are discussed above. The research methodology adopted for the given paper includes methods of measurement and analysis that make the study reasonable.
Automatic Influences on Health Behavior
In the book, Health psychology in global perspective, author Frances E. Aboud says that health behavior is influenced by many psychosocial factors like one’s morality and ethics, education, personality, family background, peer groups, media and so on. There are internal and external influences. Internal influences are emotions, habits which generate automatically without someone’s knowledge, sensitivity, awareness about aftereffect, anticipation of remuneration and method adopted for problem solving. External influences are other person who serves as role model for behavior and attitude of a particular person and guides who tries to agree or disagree to someone’s opinions. Other automatically influencing factors in one’s health are what a person hears in and sees from his surrounding. This factor can affect either consciously or unconsciously in individual’s health. (Aboud, 1998, p.8).
According to the opinion of Stephen Sutton, Andrew Baum and Marie Johnston in their book, The SAGE handbook of health psychology, people’s health behavior is influenced by strong emotions. Person’s attitude about a particular behavior may automatically change when individuals get new knowledge. The external factors influence the health behavior in different ways. External factors may persuade a person’s accessible or underlying behavioral beliefs with or without affecting the attitudes, normative and controlling of the perceived behaviors. Anyway, these kinds of influences are considered as inconsistent because these are dependent on some factors. External factors will affect the behavioral control of a person. Here, the behavioral control and behavior of a person have a close relationship. In three ways, the peripheral factors affect a person’s behavior through actual control. In their book, The SAGE handbook of health psychology, Stephen Sutton, Andrew Baum and Marie Johnston say [those three ways are] (1) from actual control to perceived control to intention to behavior; (2) from actual control to perceived control directly to behavior; and (3) from actual control directly to behavior. (Sutton, Baum, & Johnston, 2004, p.111).
The Predictors of the Maintenance of Health Behavior
Several factors affect the maintenance of health behavior. In the book, Encyclopedia of Health & Behavior, its author Norman B. Anderson says that genetics is an important factor. It plays a vital role in the formation if illness and disability in a person’s life. Lifestyle is a major factor for the maintenance of health behavior. Regular and effective exercise, balanced diet, avoidance of toxic substances like cigarettes and drugs, will help keeping the health behavior of a person in his entire life. These factors affect the physical health more than the mental health. Supportive social relations are the crucial factor for maintaining the mental health behavior. Damage in social relationship may cause depression (Anderson, 2004, p.785).
William Rakowski, Co-Principal Investigator of Memorial Hospital, Pawtucket says in a journal, Age Cohorts and Personal Health Behavior in Adulthood, education and gender are the basic and most significant predictors of health behavior in adulthood. He also says that “Functional health status, income, subjective health, perceived locus of control, a regular source of health care, and group participations were of relative importance in specific cohorts.” (Rakowski, 1988).
Family situation plays a vital role in the maintenance of individual’s health behavior. In the book, Promoting health in families, author Perri J. Bomar says that family’s health maintenance activities help to keep stability of a person’s health. It includes both physical and mental health maintenance activities. The physical part includes the food, shelter, cloths and so on. Nutritional habits and social and economic condition of family members, personal interaction between family members, and relaxation and family-illness are some important predictors of the health behavior. Family composition, social structure and attitude of family regarding health, family and community resources are very important factors.(Bomar, 2003, p.74).
The Use of SCM to Predict Health Behavior?
Health promotion can be achieved only through health education. Through health education, individual’s knowledge about the reasons for illness and importance of health will increase. In the book, Health psychology, its authors David F.Marks, Brain Evans, Michael Murry, and Carla Willig say that the connection between understanding, thoughts and activities is called SCM. This can effectively be used for protective health behavior like vaccination uptake. According to this book, “SCMs aim to predict the performance of behaviors and, by implication, to provide guidance as to how to facilitate their update by manipulating relevant variables (such as beliefs, attitudes and perceptions).” (Marks, Evans, Murray, & Willig, 2005, p.394).
In the book, Adherence to Treatment in Medical Conditions its authors Lynn B.Myers and Kenny Midence say that social cognitive model like TPB is efficient for guessing preventive health behaviors like adherence to medicines for tuberculosis (Myers, & Midence, 1998, p.33).
Development of Theory-Based Interventions
The general issues in the development of predicting the health behavior has been clearly mentioned by the author David S. Gochman in his book ‘Handbook of health behavior research’. Author explains about the theory called protection motivation theory. The main idea behind this theory is to protect oneself from harmful diseases. There are many suggestions from the author to keep away or how to avoid these diseases. Author explains about the two cognitive processes, namely, threat appraisal and coping appraisal. The threat appraisal mentions about practicing unhealthy behavior, for example smoking, sex without using condom etc. The practice of these will increase the chances of getting disease. The coping appraisal explains about the recommended activities one should follow to avoid diseases, that is, by taking regular exercise, using condom etc. To make these happenings, one should be motivated towards the recommended practices. (Gochman, 1997, p.141).
Evaluation of Theory-Based Interventions
The issues in the evaluation of health behavior are explained by the authors Sandra J. Peterson, Timothy S. Bredow in the book ‘Middle range theories’. The self efficacy is one important thing one should develop to evaluate among selves. Self efficacy is certain belief in the people’s mind to achieve something, so that it is very easy for one to be aware of the changes happening in the health behavior (Peterson, &Bredow, 2008, p.143).
Implementation of Theory-Based Interventions
In the book ‘Understanding and Changing Health Behavior’, Charles Abraham, Paul Norman, and Mark Conner clearly specify about the implementation intentions. It specifies the time and place where the necessary action must be taken. Implementation includes essential deeds to be done by the people when they are dealing with problems. Also authors in this book clearly mentioned about the necessary skills the person must need to act without fear when they are in hazard. (Abraham, & Norman, & Conner, 2000, p.20).
Failures of Social-Cognitive Model in Predicting the Health Behavior
In the book named Understanding Performance appraisal written by Kevin R. Murphy, Jeanette Cleveland clearly mentioned about failures of social cognitive model. Social cognitive model is not a good science because it is mainly focused on schema based categorization theory. This theory is very difficult to be put into practice. It is too much concerned with theory, and not with application. It can be practiced only in Laboratory research used by the students. It covers only the limited area of the broader literature on human information. (Murphy, & Cleveland, p.210)
How Do Past Behavior and Habits Effect In Future Health Behavior?
Adrian Furnham’s Book ‘The psychology behavior at work’ describes that past habits predict someone’s future behavior. If someone’s past behavior is bad or good that would automatically deliver in his/her future health activities. The author says that the past behavior is influence by his/her genetics. The article ‘Rynard Law Firm’ points out that a person who was involved in criminal background in his/her past, may become criminal in future. By proving the influence of past behavior on future behavior, Wright defines “In study after study, the variable that emerges as the strongest predictor of future criminal behavior is past criminal and delinquent behavior” (Wright, Chapter 2, pg. 4).” (The Rynard law film, n.d.). The magazine entitled ‘Jet 5 Jul 2004’ explains about the past behavior of cheaters and flirts. The behavior like cheating and flirt cannot change overnight. Tariq Nasheed who is the author of ‘Play or Be Played’ says that if an individual who was a fraud in the past would definitely become a cheater in his future. (Jet, 2004, p.14).
Discussion and Analysis
The discussion and analysis attempted here is from the previous literature review and the research questions with regard to the topic; Predicting Health Behavior and Social Cognitive Models. Analyzing different literatures, researcher has understood the fact that one’s Heath Behavior and Social Cognitive Models are not much discussed topics that need a broad study.
It is clear in Figure 1 that one’s behavior, personal factors (cognitive, effective and biological events), and environmental factors are mutually interrelated. Different studies have shown the relation of these three elements. One of the notable studies was from Bandura, when he put forward his theory/conception of reciprocal determinism. According to him, environment is a physically external factor to a person that provides opportunities and social support. Personal factors are in the form of cognition which affects the biological events. After the evaluation of his diagram which shows their mutual relation, one is sure of the fact that these three elements are complementary and the environmental and personal factors exert their tremendous influence on the behavior formation of a person.
Regarding the scope and application of The Social Cognitive Theory, one can asses it as the one possessing an integral role in health education and health behavior. The online article, entitled, Social Cognitive Theory makes it clear when it says: “The Social Cognitive Theory is relevant for designing health education and health behavior programs. This theory explains how people acquire and maintain certain behavioral patterns.” (Social cognitive theory, 2009, Scope and application, para.1)
Today, people suffer from harmful diseases due to lack of preventive steps. Unhealthy behaviors like smoking, excessive drinking and insecure sex would become threats to one’s life. An insecure sex will cause to infect AIDS and other sex-related diseases which would destruct one’s personal as well as his/her social life. Protection motivation theory states that health related behaviors are a creation of five components such as severity, susceptibility, response effectiveness, fear, and self-efficacy. This health related components forecast health behavioral intentions. Today, this theory has been used for several health linked behaviors. Past behavior can be considered as measurement of future behavior, because it is a repeat in a person’s future performance or actions. Past behavior may influence by birth or surroundings such as caste, religion, beliefs, society, community, education, business, and violence etc. of someone’s life. There are several health promotional tactics, but they are not enough for particular set of behaviors or problems. Health education is very essential for health promotion. If health promotion is applied into education, it would be helpful for the society, and community development. A successful health promotion program can be considered as an effective investment of a nation and it can improve education and fitness. Health program makes awareness about health condition which helps to prevent chronic diseases such as respiratory diseases, cancer, heart and diabetic diseases. It also prevents early death and avoids unnecessary disability due to major chronic diseases. There are various cognition models, but all models have their own practical limitations. In the same way, social cognition model is not sufficient for predicting health behavior in a practical way. Theory of planned behavior, protection motivation theory, and health belief model are the widely accepted cognition models for the prediction of health behavior.
Studies prove that the implementation of social cognitive models has acquired a degree of success in creating a positive health behavior. Major criticisms against the implementation of various social cognitive models are their practical limitations. The issues of stability and validity are not only practical problems, but do something as significant theoretical and practical problems that challenge about the use of social cognition models. Another important defect of social models is that the intentional behavior models cannot fully elucidate the processes by which intentions transform to actions. Generally, people may forget to bear their intentions. Analyzing the result of social cognition models, one can see that there is a difference between cognitions and behavior. There is a possibility to diverge cognition and emotional reactions and often emotional reactions force behavior. The web article entitled ‘Using the Social Cognitive Model to Explain Vocational Interest in Information Technology’ gives valuable information about limitations of social cognition models. The article remarks; “Stress, anxiety, and physical characteristics affect judgments of capabilities” Using the Social Cognitive Model to Explain Vocational Interest in Information Technology Sheiillaa M. Smiitth (Smith, 2002, p.2).
Therefore, one cannot admit the fact that social cognition models promote health behavior. Each and every individual is an effective rational decision-maker, and therefore, cognition models do not permit to understand about the process of decision making among the people. The availability of successful treatments for cognition is limited in case of anxiety and depression. The problem of geopolitical environment and various cultural and ethnic diversities affect the smooth functioning of various social cognition models. Some critics argue that the implementation of social cognition models faces number of practical problems and this theory is based on schema based classification. Its ability to cover a wide area of predicting health behavior also raises some questions. Theory of planned behavior neglects emotional variables.
Conclusions
The discussion and analysis of the paper leads one to the following conclusions. Regarding Health Behavior and Social Cognitive Models, one can see the fact that they are mutually interrelated and complementary. Social cognitive models play a vital role in the formation of an in health behavior. Each person has some personality traits which help for the identification or separation of one from the other. These personality traits influence one’s health behavior. If a person has good traits in his personality, such persons will develop a positive health behavior; otherwise it will negatively affect. There are many kinds of risks associated with individual’s health behavior. To conduct an assessment of the health behavior, the assessments of risks associated with one’s life is very important. The risks will influence either positively or negatively in the health behavior.
A person’s health behavior is influenced by many internal and external factors. Morality and ethics, various automatically generated habits, sensations about the surrounding, knowledge about the consequences of something, influences of peer groups and role models, and so on will affect one’s health behavior. These factors persuade one’s health behavior with or without having his or her mind involvement. Here the external factors have a major role in controlling a person’s behavior. Analyzing these factors may help to predict an individual’s health behavior.
For maintaining health behavior, persons should give conscious attention for doing exercises regularly, keeping balanced diet, and avoiding substances like drugs, alcohol and cigarettes. Instead, persons should maintain a good social and family relationship and keep a pleasant mind. Developing good health habits, and accepting yoga and meditations as part of life are some methods for maintaining positive health behavior. For improving a person’s health behavior, one of the efficient ways is providing awareness through health education. In certain cases, SCM is effectively used for predicting a person’s preventive health behavior.
It is crystal clear that one has to keep a well-balanced life to promote a healthy body and mind. One is sure of the fact that unhealthy behavior leads to immature mortality and chronic diseases. If one is not ready to undertake risks, one cannot maintain a good balancing of health. Different studies have reported the relationship between the mental and physical health of a person, and if one is incapable of maintaining his physical health, there is possibility of his becoming mentally weak. Analyzing the behavior of different persons who are addicted to smoking, one can see some kind of commonness in their behavior.
Another factor that affects the health behavior of a person is the habit of suppressing one’s feelings and emotions. Continuous suppression of feelings and emotions by a person leads to increasing blood pressure, depression, and so on. It has also been identified that it leads to obesity and increase in cholesterol level. Genetics deserves a dominant position in forming the health behavior of a person. Different studies have proved the integral role of genetics in the physical health of a person that it often influences one’s illness and disability. Lifestyle also has assumed as a key factor in determining the health behavior. One can find the influence of society, habits and economic conditions of families affecting health behavior. Nutritional habits of persons sometimes bring to bear their pressure in the building up of a good health behavior. Along with these reasons or elements that form the health behavior, personal interactions within the families and the genetic diseases also play minor roles in this process. Analyzing these factors, one can conclude that it is very difficult to predict health behavior by using social cognitive models. Nevertheless, it has been generally assumed that some of these elements win a vital role in forming the health behavior of a person.
References
Aboud, F E. (1998). Health psychology in global perspective. 2nd edition. SAGE. 8. Web.
Abraham, C., & Norman, P., & Conner, M. (2000). Understanding and changing health behavior: From health beliefs to self-regulation. 2nd edition. Psychology Press. 20. Web.
Anderson, N B. (2004). Encyclopedia of Health and Behavior. SAGE. 785. Web.
Bomar, PJ. (2003). Promoting health in families: applying family research and theory to nursing practice. 3rd edition. Elsevier Health Science. 74. Web.
Froshauq, DB., Dickinson, LM., Fernald DH., & Green, LA. (2009). Personal health behaviors are associated with physical and mental unhealthy days: a prescription for health (P4H) practice- based research networks study. J AM Board Fam Med, 22(4), 368-74. NCBI: Pub Med. Web.
Gochman, D. (1997).Handbook of health behavior research. Springer. 141. Web.
Jet. (2004). Johnson Publishing Company, 106(1), 14. Web.
Marks, D F., Evans, B., Murray, M., & Willig, C. (2005). Health psychology: theory, research and practice: Behavior change approach. 2nd edition. SAGE. 394 Web.
Murphy, K R., & Cleveland, J. (1995). Understanding performance appraisal: social, organizational, and goal based perspective. SAGE. 209. Web.
Myers, L B., & Midence, K. (1998). Adherence to treatment in medical conditions. Taylor 7 Francis. 33. Web.
Pajares, F. (n.d.). Overview of social cognitive theory and of self-efficacy: Social cognitive theory.
Peterson, S J., & Bredow, T S. (2008). Middle rage theories: application to nursing research. Lippincott Williams & Wilkins. Web.
Rakowski, W. (1988). Research on aging: Age cohorts and personal health behavior in Adulthood. SAGE Journal Online, 10(1), 3-35. DOI: 10.1177/0164027588101001
Smith, S M. (2002). Using the social cognitive model to explain vocational interest in information technology: Review of literature: Social cognitive career theory (SCCT). Information Technology, learning, and performance Journal, 20(1). 2.
Social cognitive theory: Scope and application. (2009). TCW: University of Twente.
Sutton, S., Baum, A., & Johnston, M. (2004). The SAGE handbook of health psychology. 111. SAGE. Web.
The Rynard law film. (n.d.). Web.
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