3 perceptions of disease threat;
4 knowledge about disease;
5 social network characteristics; and
6 demographic factors.
These six groups of correlates may not be independent. For example, there may
be considerable overlap between perceptions of disease threat and knowledge of the
disease. In order to account for such overlaps and describe the relationships between
different influences on health behaviours a number of models have been developed.
Such models have been labelled ‘social cognition models’ because of their use of a
number of cognitive variables to predict and understand individual behaviours,
including health behaviours. It is important to note at the outset that these models
focus on behaviour-specific cognitions as determinants of the relevant behaviour. For
example, on this view healthy eating is best understood in terms of cognitions about
healthy eating rather than more general thoughts and feelings about health. In the
health psychology area these are usually referred to as health cognitions.
142 MOTIVATION AND BEHAVIOUR
How do health behaviours impact on health outcomes?A great many studies have now looked at the relationship between the
performance of health behaviours and a variety of health outcomes (e.g. Doll et al.,
1994). Large-scale epidemiological studies have demonstrated the importance of a
variety of health behaviours for both morbidity and mortality. For example, the
Alameda County study, which followed nearly 7,000 people over 10 years, found
that seven key behaviours were associated with lower morbidity and longer life: not
smoking, moderate alcohol intake, sleeping 7 to 8 hours per night, exercising
regularly, maintaining a desirable body weight, avoiding snacks and eating breakfast
regularly (Belloc and Breslow, 1972; Breslow and Enstrom, 1980).
Health behaviours are assumed to influence health through three major
pathways (Baum and Posluszny, 1999): first, by generating direct biological changes
such as when excessive alcohol consumption damages the liver; second, by
changing exposure to health risks, as when the use of a condom protects against
the spread of HIV; and third, by ensuring early detection and treatment of disease,
as when testicular or breast self-examination leads to early detection of a cancer
that can more easily be treated.
Can you think of further examples of the pathways through which health
behaviours might exert their effects on health?FOCUS 7.2