UNIT – 2

Characteristics of Health Behaviour

Health behaviour refers to the everyday actions and decisions people make that influence their health (e.g.,
eating, exercising, smoking, seeking medical care).

These behaviours are shaped by learning, social context, cognition, motivation, and emotions.

Understanding these characteristics helps explain why people adopt or avoid health-promoting actions.

1. Learning Principles

 Health behaviours are influenced by reinforcement, punishment, and modelling.

 Positive reinforcement (praise, rewards) strengthens healthy habits, while modelling shows the value
of good health.

 Example: A child praised for brushing teeth daily develops the habit into adulthood.

2. Social and Personality Influences

 Family, peers, and cultural norms shape health behaviours (e.g., diet, exercise, smoking).

 Personality traits like conscientiousness promote preventive health, while stress-prone individuals
may struggle.

 Example: A teenager starts smoking because friends do, while another avoids it due to being
disciplined and health-conscious.

3. Perception and Cognition

 People act based on how they perceive symptoms and their knowledge of health.

 Severe symptoms push people to seek help, while mild ones are often ignored.

 Example: A person rushes to the hospital for chest pain but ignores frequent headaches thinking it’s
“normal stress.”

4. Barriers: Unrealistic Optimism & False Hope

 Unrealistic optimism: Believing one is less at risk than others (e.g., “I won’t get lung cancer even if I
smoke”).

 False hope: Unrealistic repeated attempts to change, often leading to relapse.

 Example: A person tries crash diets every month, loses weight temporarily, but regains it, yet still
believes “this time it will work.”

5. Motivational and Emotional Factors

 Motivation guides how health information is interpreted (sometimes with bias).

 Emotional states like stress or anxiety led to unhealthy coping (e.g., overeating, drinking, smoking).
  Example: An office worker justifies overeating junk food by saying “I need energy under stress,”
ignoring long-term health risks.

6. Healthy vs. Risky Health Behaviours

Healthy Behaviours Risky Behaviours

Balanced diet & exercise Smoking, excessive drinking

Regular medical check-ups Ignoring symptoms

Stress management techniques Overeating / unhealthy coping

Preventive habits (vaccines) Risk-taking due to peer pressure

Case Example (Integrated)

Ravi, a 20-year-old student, smokes occasionally because his friends encourage it (social influence). He
believes nothing will happen to him because he is “too young” (unrealistic optimism). During exams, he tries
quitting but relapses (false hope) due to stress (emotional factor). His case shows how social, cognitive,
motivational, and emotional factors combine to maintain risky health behaviours.

Learning → Social & Personality → Perception & Cognition → Motivation → Emotions

↓ ↓ ↓ ↓

Habits form social approval Optimism/Fear Stress/Conflict

Barriers to Health Behaviour

Barriers to health behaviour are obstacles that prevent individuals from maintaining healthy practices.

These barriers may exist at individual, social, cultural, environmental, or psychological levels.

Even when people know the benefits of healthy actions, such barriers can block real behaviour change.

Identifying them is crucial for health psychologists in order to design effective interventions.

1. Individual-Level Barriers

 Lack of knowledge about risks and prevention.

 Unhealthy habits (smoking, overeating, screen time) are hard to break.

 Stress, procrastination, and low self-discipline reduce motivation.

 Example: A person delays medical check-ups because work feels “more important” than health.

2. Social and Cultural Barriers

 Peer pressure encourages risky behaviours (smoking, alcohol).

 Family traditions shape diet and lifestyle (e.g., high-sugar foods, sedentary living).

 Stigma around illness discourages timely treatment.

  Example: A young adult avoids therapy for depression due to social stigma.

3. Environmental Barriers

 Lack of healthcare access and affordability.

 Unsafe neighbourhoods discourage physical activity.

 Pollution, poor infrastructure, and absence of healthy food options.

 Example: A woman wants to jog daily but avoids it because her area lacks safe parks.

4. Psychological Barriers

 Fear of diagnosis prevents medical tests.

 Denial of health risks → postponing preventive actions.

 False Hope → Low self-efficacy and past failures reduce confidence.

 Unrealistic optimism → belief that “it won’t happen to me.”

 Example: A smoker avoids cancer screening, telling himself “I’m still young; nothing will happen.”

Case Examples

1. Smoking Cessation

 Smokers know risks but feel powerless due to nicotine addiction (individual).

 Peer groups normalize smoking (social).

 Stress triggers smoking (psychological).

 Lack of affordable programs (environmental).

2. Exercise Adherence

 People want to exercise but lack time (individual).

 Sedentary jobs discourage activity (environmental).

 Lack of group support (social).

 Low motivation from not seeing immediate results (psychological).

3. Vaccination Uptake

 Fear of side effects (psychological).

 Misinformation (social).

 Religious/cultural resistance (cultural).

 Accessibility issues & cost (environmental).

Health Belief Model (HBM)

The Health Belief Model (HBM) is a psychological framework developed in the 1950s by social psychologists
(Rosenstock, Hochbaum, Kegels, Leventhal) to explain why many people do not engage in preventive health
behaviours (e.g. screening) despite the availability of services.

It proposes that whether an individual takes a health-related action depends on their beliefs about health
risks, benefits and barriers, and a few modifying factors.

The HBM is widely used in health promotion, disease prevention, and designing health education
interventions.

Six Key Constructs

1. Perceived Susceptibility

 How much a person believes they are personally at risk of getting a condition or disease.

 If someone thinks “I’m unlikely to get X disease,” they are less motivated to take preventive action.

 Example: A young adult believes “I’m healthy, so I won’t get COVID-19” → less likely to get vaccinated.

2. Perceived Severity

 How serious a person believes the condition and its consequences would be (medical, social,
financial).

 Greater perceived severity increases motivation to act.

 Example: A person thinks “If I develop type 2 diabetes, I may suffer heart disease, kidney failure,
lifelong medication” → sees it as severe.

3. Perceived Benefits

 The belief that a recommended action will reduce the threat (or its severity) or yield positive
outcomes.

 The action must be seen as effective.

 Example: Someone trusts that quitting smoking will reduce lung cancer risk and improve lung function

4. Perceived Barriers

 The obstacles (physical, mental, financial, convenience) the individual sees in doing the action for it.

 Barriers often have strong influence; perceived benefits must outweigh perceived barriers.

 Example: A person feels mammogram is painful, expensive, time-consuming → these barriers

discourage screening.

5. Self-Efficacy

 The confidence that one can successfully perform the health behaviour (sustained behaviours).

 Added later to the original model (in ~1988) because behaviour change often depends on belief in
one’s ability.

 Example: A diabetic patient believes, “I can follow my diet plan and monitor glucose daily” → more
likely to adhere.

6. Cues to Action
  Internal or external triggers that prompt people to act (symptoms, reminders, media campaigns,
advice).

 Without a cue, even someone who is motivated may not act.

 Example: A poster campaign saying “Get your flu shot now” or a friend’s illness acts as a cue to go for
vaccination.

Strengths and Limitations of Health Belief Model

Strengths Limitations

1. Provides a simple and logical framework 1. Overemphasizes cognitive factors

2. Flexible and can be applied to a wide range 2. Does not account for structural/environmental factors

3. Highlights the role of individual perceptions 3. Weak in explaining long-term behaviour maintenance

Case Example (Vaccination Decision)

 Meera is 30 years old and is considering whether to take the HPV vaccine.

 Perceived Susceptibility: She thinks, “I’m young and healthy, so my risk is low.”

 Perceived Severity: She knows cancer is serious, but believes HPV-related disease is rare.

 Perceived Benefits: She learns vaccine reduces risk of cervical cancer — she sees clear benefit.

 Perceived Barriers: She worries about cost, side effects, and access to vaccine center.

 Self-Efficacy: She is unsure whether she can schedule and follow through with vaccine doses.

 Cues to Action: Her doctor recommends it and she sees an awareness ad in clinic.

Because her perceived barriers (cost, side effects) are high and susceptibility is low in her mind, she delays.
After her doctor explains risks clearly and offers a subsidized rate (reducing barriers), and gives her an
appointment SMS reminder (cue), she follows through and gets vaccinated.

Modifying Factors (e.g. demographics, personality, knowledge)

Perceived Susceptibility + Perceived Severity → Perceived Threat

↓ ↓

Perceived Benefits & Perceived Barriers

Self-Efficacy

Cues to Action → Likelihood of Health Behaviour Action

Theory of Planned Behaviour (TPB)

The Theory of Planned Behaviour (TPB), proposed by Icek Ajzen (1985), explains how health-related
decisions are influenced by attitudes, social pressure, and perceived control.

It is an extension of the Theory of Reasoned Action (TRA), which focused on attitudes and subjective norms
but ignored external constraints.
TPB adds Perceived Behavioural Control (PBC) to account for situations where people may intend to act but
face obstacles.

Key Constructs

1. Attitudes toward Behaviour

 Evaluation of the behaviour as positive or negative, based on beliefs about outcomes.

 Example: Believing exercise improves health and appearance → positive attitude → higher intention.

2. Subjective Norms

 Perceived social pressure from significant others (family, peers, society).

 Stronger in collectivist cultures where group approval matters.

 Example: A teenager uses condoms because friends and partner support safe sex practices.

3. Perceived Behavioural Control (PBC)

 Belief in one’s ability to perform the behaviour despite obstacles (similar to self-efficacy).

 Reflects both internal confidence and external barriers (time, cost, facilities).

 Example: Someone confident about managing time is more likely to stick to exercise routine.

4. Behavioural Intention

 The immediate predictor of actual behaviour.

 Strong intentions usually lead to behaviour, but the intention–behaviour gap exists due to habits,
emotions, or barriers.

 Example: A smoker intends to quit but relapses during stress → gap between intention and action.

Strengths and Limitations of TPB

Strengths Limitations

Considers attitudes, social influence, and perceived Overemphasizes rational thinking, neglects emotions
control (broader than TRA) & habits

Flexible and applicable to many health behaviours Struggles with the intention–behaviour gap

Provides measurable constructs for research &

Limited in explaining impulsive or habitual behaviours
interventions

Case Example (Smoking Cessation)

Ravi, a 25-year-old smoker:

 Attitude: He knows quitting improves his health and saves money → positive attitude.
  Subjective Norms: His family and friends encourage quitting → supportive norms.

 PBC: He doubts his ability to resist cravings due to stress and lack of coping skills → low control.

 Intention & Behaviour: Despite intending to quit, he struggles to act because low PBC weakens his
intention–behaviour link.

Stages of Change Model (Transtheoretical Model)

The Stages of Change Model, developed by Prochaska & DiClemente (1983), explains health behaviour
change as a gradual, cyclical process rather than a single event.

People move through stages of readiness to change, and relapse is seen as a natural part of the cycle.

The model is applied in areas like smoking cessation, exercise adoption, weight loss, and addiction recovery.

Stages

1. Precontemplation Stage

 No intention to change behaviour soon; denial or lack of awareness.

 Perceive costs of change as higher than benefits.

 Example: A smoker insists “I don’t have a problem; smoking helps me relax.”

2. Contemplation Stage

 Recognizes the problem and considers change within ~6 months.

 Ambivalence: weighing pros vs cons of behaviour change.

 Example: The smoker thinks, “Quitting would improve my health, but it’ll be really hard.”

3. Preparation Stage

 Ready to act soon; small initial steps or planning.

 May reduce unhealthy habits or gather resources.

 Example: The smoker cuts down cigarettes, researches nicotine patches, and sets a quit date.

4. Action Stage

 Overt, observable modification of behaviour.

  Requires strong effort, strategies to cope with relapse triggers.

 Example: The smoker stops completely, avoids high-risk situations, and uses coping skills.

5. Maintenance Stage

 Focus on sustaining new behaviour, preventing relapse.

 The new behaviour is integrated into daily life.

 Example: The ex-smoker celebrates one year smoke-free, builds habits like exercise instead of
smoking.

6. Termination Stage

 Individual has full confidence and no temptation to relapse.

 New lifestyle is permanent; very few reach this stage.

 Example: After 10 years smoke-free, the person no longer desires cigarettes at all.

Strengths & Limitations

Strengths Limitations

Recognizes change as a gradual, cyclical process Relapse patterns are hard to predict

Tailors’ interventions to stage of readiness Not everyone moves through stages linearly

Widely applicable (smoking, diet, exercise) Overemphasizes conscious decision-making

Case Example (Exercise Adoption)

Anita, 28 years old wants to improve her health:

 Precontemplation: “I’m too busy; I don’t need exercise.”

 Contemplation: Starts reading about fitness benefits.

 Preparation: Buys workout clothes, joins a gym.

 Action: Attends gym 4 times a week.

 Maintenance: After 1 year, integrates exercise into lifestyle.

 Termination: Years later, she cannot imagine life without physical activity.
Contextualized Health Promoting Behaviour

Exercise

Exercise is a key health-promoting behaviour that benefits both physical and psychological health.

Regular exercise reduces the risk of chronic diseases (cardiovascular disease, diabetes, obesity), while also
improving emotional well-being by reducing stress, anxiety, and depression.

It is considered a cornerstone of holistic health promotion.

1. Types of Exercise

 Aerobic (walking, running, cycling) → improves heart and lung capacity.

 Strength training (weights, resistance) → enhances muscles, bones, metabolism.

 Flexibility & balance (yoga, stretching, tai chi) → prevents injuries, vital for older adults.

 Example: Yoga improves flexibility and reduces stress for office workers.

2. Physiological Benefits

 Regulates blood pressure and cholesterol.

 Strengthens immune system and weight management.

 Endorphin release provides natural pain relief.

 Example: Regular jogging lowers risk of hypertension in middle-aged adults.

3. Psychological Benefits

 Reduces stress, anxiety, and depressive symptoms.

 Improves sleep, focus, memory, and overall mood.

 Builds self-esteem and sense of achievement.

 Example: A student who jogs daily feels calmer and performs better in exams.

4. Barriers to Exercise
  Individual: Lack of time, motivation, or low self-efficacy.

 Environmental: Unsafe neighbourhoods, lack of gyms or parks.

 Cognitive: Misconceptions (e.g., “exercise only matters for weight loss”).

 Example: A working mother skips exercise because of long job hours and family duties.

5. Strategies to Promote Exercise

 Set realistic, specific goals (SMART goals).

 Encourage social support (exercise groups, family involvement).

 Use enjoyable activities to increase adherence.

 Example: A corporate office introduces a “30-min daily fitness break” to support employees.

Case Example (Health Promotion through Exercise)

Ramesh, 40 years old, has high blood pressure:

 Initially avoids exercise, thinking he has no time (barrier: time constraint).

 Doctor explains risks and benefits; he sets a small goal: 20 min brisk walk daily. (strategy: realistic
goals).

 Joins a walking group in his neighbourhood (social support).

 After 3 months, Ramesh’s BP improves, he feels less stressed, and he maintains exercise as part of his
daily routine.

Exercise

Physiological Benefits + Psychological Benefits

Disease Prevention + Emotional Well-being

Improved Quality of Life

Sleep

Sleep is a restorative process vital for physical health, immune system functioning, and psychological well-
being.

Adequate sleep improves mood, concentration, and emotional resilience, while chronic deprivation
increases risks of obesity, diabetes, cardiovascular disease, and depression.

1. Sleep and Cognitive Functioning

  Sleep consolidates memory and supports learning/problem-solving.

 Poor sleep impairs attention, reaction time, and decision-making.

 Example: A student pulling all-nighters struggles to recall concepts during exams.

2. Sleep and Emotional Regulation

 Quality sleep stabilizes mood and reduces irritability/anxiety.

 Deprivation increases stress reactivity and emotional instability.

 Example: After just 4 hours of sleep, a worker feels irritable and stressed at the office.

3. Sleep Disorders and Health Risks

 Common issues: insomnia, sleep apnea, restless leg syndrome.

 Poor sleep increases vulnerability to obesity, hypertension, diabetes, depression.

 Example: A middle-aged man with untreated sleep apnea develops high blood pressure.

4. Factors Affecting Sleep Quality

 Lifestyle: irregular schedules, caffeine, screen time.

 Environmental: noise, light, temperature.

 Psychological: stress, anxiety.

 Example: A teenager using their phone till late at night suffers from poor-quality sleep.

5. Strategies for Improving Sleep

 Maintain consistent bedtime routine.

 Practice sleep hygiene (dark, quiet room, no stimulants).

 Use relaxation methods: meditation, deep breathing.

 Example: A woman improves her insomnia by meditating before bed and switching off devices early.

6. Role of Exercise and Nutrition in Sleep

 Moderate daily exercise improves restorative sleep.

 Avoid heavy meals and late-night vigorous workouts.

 Example: A man who jogs in the morning reports deeper, uninterrupted sleep.

Case Example (Sleep & Health)

Meena, 35 years old, works long hours and uses her phone late into the night:

 She sleeps only 5 hours, feels irritable and unfocused (cognitive + emotional effects).

 She develops frequent headaches and rising blood pressure (health risks).

 After adopting sleep hygiene practices (consistent routine, reducing screen time, morning yoga), her
mood, concentration, and overall health improve.

Adequate Sleep
 ↓

Physical Repair + Immune Function + Cognitive Performance

Better Mood, Learning, Emotional Regulation

Reduced Risk of Chronic Illness

Nutrition

Nutrition is fundamental to physical health, mental well-being, and disease prevention.

A balanced diet ensures energy, growth, and immunity, while poor nutrition is linked to obesity, diabetes,
heart disease, and other chronic illnesses.

1. Components of a Balanced Diet

 Includes carbohydrates, proteins, fats, vitamins, minerals, and hydration.

 Micronutrients (iron, calcium, magnesium) are vital for metabolism and immunity.

 Example: Calcium-rich foods (milk, curd) prevent osteoporosis.

2. Physical Health Benefits

 Reduces risk of hypertension, diabetes, high cholesterol.

 Supports bone health, muscle repair, cardiovascular function.

 Strengthens immunity for faster recovery.

 Example: A high-fiber diet lowers cholesterol and protects heart health.

3. Nutrition and Mental Health

 Diet affects neurotransmitters → influences mood, memory, and concentration.

 Omega-3 fatty acids and complex carbs improve emotional stability and energy regulation.

 Example: Eating oily fish (rich in omega-3) improves concentration in students.

4. Barriers to Healthy Eating

 Economic: Limited access to fresh, nutritious food.

 Cultural: Preferences or misconceptions affect choices.

 Social: Fast food marketing, convenience eating.

 Example: A college student relies on instant noodles due to cost and convenience.

5. Strategies to Promote Healthy Nutrition

 Education: Informed food choices, portion control, mindful eating.

 Policy: Food labeling, subsidies for fruits/vegetables.

  Practical: Meal planning, cooking skills, healthier substitutes.

 Example: Government food labeling helps consumers choose low-sugar cereals.

Case Example (Nutrition & Health)

Ravi, 22 years old, is a busy engineering student:

 Eats mostly instant food and sugary drinks due to lack of time (barrier: convenience & cost).

 He gains weight, feels tired, and has frequent colds (physical + mental effects).

 After attending a nutrition awareness program, he switches to meal prepping with fruits, vegetables,
and whole grains.

 Over time, his immunity, mood, and concentration improve.

Balanced Nutrition

Physical Health (energy, growth, immunity)

+ Mental Health (mood, cognition, memory)

Disease Prevention + Longevity + Well-being