Within the discipline of health psychology there are varying theories and models which have been developed to inform and predict relevant health behaviours and practically improve health care systems Conceptualising a definition of positive health behaviours may be controversial A definition from Kasl and Kobb 1966 reinforces health behaviour as an activity undertaken by a healthy individual who is at an asymptomatic stage in order to detect and prevent diseases This definition however does not take into consideration individuals who may be ill as positive health behaviours are often carried out by people with a diagnosed condition French et al 2014 pg 18 Key components within theories guide the way in which decisions are made within policy and practice both on an individual and community level Theories often have distinct features as well as overlapping characteristics that aim to facilitate health behaviours In order to critically appraise the application of health psychology models the prevalent theories in relation to targeting tobacco use with regards to smoking cessation on an individual scale that will be focussed on are the transtheoretical model and the health belief model A distinction will be drawn from both models through assessing their multi dimensional aspects and constructs that impact the practicality of an initiative
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The biopsychosocial model plays a part in both theories suggesting their interconnectedness and consideration of other social and psychological factors associated with health behaviours White 2005 The appraisal of different models and theories addressing smoking cessation will enable a deeper insight of how the theories may be operationalised or limited based on empirical evidence and how they may act as a hindrance to the effectiveness of an initiative The importance of the prevention of smoking in the Western world was followed by research in to the causes of premature death Connor and Norman 2005 This initiated numerous epidemiological studies and mediated contemporary health initiatives and approaches to behaviour change in relation to specific health outcomes across various contexts internationally and in the United Kingdom In order to change health behaviours there is a necessity for governments organisations and individuals to work in a coordinated way in order to understand risky behaviours such as tobacco use and promote holistic health and well being of individuals
The Make Every Contact Count 2012 is a behavioural initiative that reinforces a whole systems approach which is heavily encouraged by the World Health Organisation as it creates an environment that supports people s health decisions aiming to avoid chronic disease and promote positive health and well being in the work force by targeting individuals before tackling a wider population WHO 2017 In terms of health psychology research behavioural interventions are often associated with smoking cessation Roberts et al 2013 The National Health Service Forum 2012 made the recommendation that every health care organisation should deliver MECC and promote healthy living and the prevention of poor health The MECC mirrors the NICE 2007 public health guidance reinforcing its prevalence in tackling health inequalities in England such as tobacco use which MECC recognises to be one of the biggest contributors to health inequalities Through the dissemination of information and the encouragement of a multidisciplinary team the MECC aims to support continuous health improvement through the links it has with individuals Both the transtheoretical model Prochaska DiClemente 1982 and the health belief model Hochbaum 1958 are heavily behaviour orientated They can be viewed as successful theories focussing on the facilitation of behavioural change in individuals particularly in relation to smoking cessation The application of both models has seen to be effective in the planning and implementation of health initiatives due to their commonalities and wide use across cognate disciplines Glanz Lewis and Rimer 1997 The transtheoretical model posits five stages of change Pre contemplation contemplation preparation action and maintenance The model also acknowledges that individuals may shift back and forth through stages therefore features the informal stage of recidivism DiClemente 2003 cited in Gerard et al 2015 p25 described that the stages represent the motivational and dynamic fluctuations of the process of change over time The health belief model uses two aspects of individual s representations of health behaviour in response to the threat of illness The first one being Perception of illness threat and the evaluation of behaviours to counteract the threat An element of the health belief model which differs from the transtheoretical model is the perceived threat The first aspect of the health belief model focuses on an individual's perception to the susceptibility of an illness how susceptible they may be to a condition The second element focuses on the perceived severity of the consequences of the illness which may consider if the benefits outweigh the cost In turn both aspects combined can lead to a cue of action determining an individual's likelihood of following a health behaviour action Norman and Connor 2005
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