Source: Textbook Ch. 3 / Lecture Notes
Difficulty: Introductory | Prerequisites: None, though a basic understanding of psychology terminology helps.
This material sits at the start of health psychology's applied side. Where earlier weeks covered what health psychology is and how stress works, this week asks the practical question: how do people change their health behaviours, and what helps or hinders that process? The content draws on social psychology, learning theory and public health, so it connects to several areas you may have encountered elsewhere. If you understand the basics of attitudes, motivation and conditioning, you are well placed to absorb this.
Health behaviours are actions people take (or avoid) that affect their physical wellbeing, and many of the leading causes of death in the US trace back to modifiable risk factors such as smoking, diet and inactivity. Changing these behaviours is difficult because habits form early, are maintained by shifting motivations over time, and are shaped by demographics, culture, emotions and social networks. Interventions work best when they target specific populations at the right developmental moment and account for the barriers each group faces.
Health behaviour
Any action undertaken by a person to enhance or maintain their health. Think of it as the deliberate things you do (or choose not to do) because you believe they affect your wellbeing, such as exercising, eating vegetables or wearing a seatbelt.
Health habit
A health behaviour that has become firmly established and is performed automatically, without conscious awareness. In simple terms, it is a health behaviour on autopilot, like brushing your teeth before bed without thinking about it.
Health promotion
The philosophy that good health (or wellness) is both a personal and a collective achievement. It frames health as something actively built, not just the absence of disease.
Primary prevention
Taking measures to combat risk factors for illness before the illness has a chance to develop. In simple terms, this means stopping a problem before it starts, rather than treating it after the fact.
Health locus of control
A scale measuring the degree to which people perceive their health to be under their own personal control. Someone with a strong internal health locus of control believes their actions directly shape their health outcomes.
Teachable moment
A point in time when a person is especially receptive to modifying their health practices. Think of it as a window where someone is more open to change, often triggered by a life event, a health scare or a developmental transition.
Window of vulnerability
The period when a person is first exposed to a risky health behaviour. This is the critical juncture where they may either adopt a bad habit or reinforce a good one.
Social engineering (health context)
Modifying the environment in ways that affect people's ability to practise a health behaviour. A familiar example: schools requiring vaccinations for enrolment.
Changing health behaviour matters at a societal level: diseases become less common and healthcare costs drop when populations adopt healthier habits.
Health promotion treats wellness as something people and communities build together, not a lucky accident.
Health behaviours are most malleable between ages 7 and 12, which is why instilling good habits early is so important.
Once a behaviour becomes a health habit (automatic, without awareness), it is much harder to dislodge later.
Primary prevention has two main strategies:
Getting people to alter existing problematic behaviours.
Preventing poor health habits from forming in the first place.
Several factors determine whether someone practises or changes a health behaviour (p. 142):
Demographic factors: People with higher incomes and more education are more likely to change behaviours for the better.
Age (the "U" shape): Motivation to change is highest very early in life and very late in life. Young adults and middle-aged adults tend to fall in the gap, practising fewer safe health behaviours.
Values: Cultural context matters. Whether exercise is considered desirable, for example, varies across cultures.
Personal control: The health locus of control scale measures how much people feel their health is in their own hands. A stronger sense of personal control is linked to more health-promoting behaviour.
Social influence: The people around you can help or hinder your health behaviours. A running buddy keeps you accountable; friends who smoke may draw you into the habit.
Personal goals and values: Whether someone views personal fitness as an important life goal shapes their willingness to act.
Perceived symptoms: When health problems start creating barriers in daily life, people become more motivated to change.
Access to healthcare: Having reliable access to a health care delivery system affects whether people seek preventive care.
Knowledge and intelligence: Childhood intelligence is associated with better biological profiles and healthier behaviour in adulthood.
Emotional factors: Emotions can drive unhealthy behaviours. Comfort eating, for instance, may escalate into binging.
Instability of health behaviours: Different factors control different health habits, and different factors may control the same habit for different people.
Example: One person smokes to manage stress; another started smoking to fit in with friends. Same behaviour, different drivers.
Shifting control over time: The factors that initiate a behaviour are often not the same ones that maintain it. Smoking may begin from peer pressure but persist as a stress-relief mechanism.
These barriers make it clear that a one-size-fits-all intervention will rarely work. Understanding the individual's specific drivers is essential.
Children and adolescents (p. 152)
Parents act as both teachers and role models (socialisation). Children model the health behaviours they see at home.
Teachable moments are times when someone is especially open to changing health practices.
The window of vulnerability is the point when a person first encounters a risky behaviour. What happens at that juncture matters enormously.
Teachable moments are not confined to childhood. They occur across the lifespan, including among older adults.
Precautions taken during adolescence can affect disease risk well past age 45.
At-risk populations
Benefits of early intervention:
Cheaper to intervene before a chronic illness develops.
Diseases may be prevented entirely or made less severe.
Easier to identify additional risk factors once one is known.
Problems with at-risk intervention:
People struggle to perceive risk accurately. Testing positive for a risk factor can make someone hypervigilant rather than balanced.
Instilling risk-reduction behaviours may cause psychological stress.
For genetic risk factors, no effective intervention may exist.
Discussing inherited risks can complicate family dynamics. Telling an adolescent about a family history of breast cancer during puberty, for instance, may add unnecessary stress at a vulnerable time.
Older adults (p. 155)
Health promotion for older adults focuses on maintaining a balanced diet and exercise programme, reducing accidents, controlling alcohol consumption, eliminating smoking, reducing misuse of prescription drugs, obtaining flu vaccinations, and staying socially engaged.
Ethnic and gender differences (p. 153)
Health promotion efforts should account for social norms within a group, including community health practices, informal communication networks, co-occurring risk factors in ethnic groups, and the combined effects of low socioeconomic status with biological predisposition to certain illnesses.
Students often think health behaviours and health habits are the same thing. They are not. A health behaviour is any action taken to maintain health; a health habit is a health behaviour that has become automatic. The distinction matters because habits are harder to change.
Students sometimes assume that motivation to change health behaviour is highest in middle age, when people "should know better." The evidence shows a U-shaped pattern: motivation peaks in childhood and old age, with a dip among young and middle-aged adults.
It is common to think that identifying someone's risk factors is always beneficial. In some cases (genetic risk factors, sensitive developmental periods), it can cause more harm than good.
Students often overlook that the factor that starts a behaviour is frequently not the factor that maintains it. Treating them as the same leads to poorly targeted interventions.
⚠️ Know the difference between health behaviour and health habit, and be able to give examples of each.
⚠️ Be ready to explain the U-shaped relationship between age and motivation to change health behaviour.
⚠️ Understand why the factors that initiate a health behaviour may differ from those that maintain it (the smoking example is a classic exam prompt).
⚠️ The ethical issues around intervening with at-risk populations are a frequent exam topic, especially the tension between early intervention and potential psychological harm.
⚠️ Be able to list the factors that influence health behaviour change (demographics, age, values, personal control, social influence, goals, symptoms, access, knowledge).
True or False: A health habit requires conscious effort each time it is performed. (False, health habits are automatic.)
Fill in the blank: People are most malleable to forming health behaviours between ages ______ and ______. (7 and 12)
True or False: The factors that initiate a health behaviour are always the same factors that maintain it. (False, they often shift over time.)
Fill in the blank: The relationship between age and motivation to change health behaviour follows a ______ shape. (U)
True or False: Intervening with at-risk populations is always ethically straightforward. (False, it can cause psychological stress and raise family-dynamics issues.)
Q: What is the difference between a health behaviour and a health habit?
A: A health behaviour is any action taken to enhance or maintain health (e.g., choosing to eat a salad). A health habit is a health behaviour that has become automatic and is performed without conscious awareness (e.g., always putting on a seatbelt without thinking about it).
Q: Describe the U-shaped relationship between age and motivation to change health behaviours.
A: Very young people and older adults tend to be the most motivated to change health behaviours. Young adults and middle-aged adults fall in the middle, where motivation dips and unsafe health behaviours are more common.
Q: A person starts smoking because their friends do, but years later they continue smoking to manage stress. What does this illustrate?
A: It illustrates that the factors controlling a health behaviour can shift over time. The initiating factor (peer pressure) differs from the maintaining factor (stress relief). Effective intervention must target the current maintaining factor, not the original cause.
Q: Name two ethical concerns with intervening in at-risk populations.
A: (1) Risk-reduction messaging may cause psychological stress, especially during vulnerable developmental periods. (2) For genetically inherited risks, no effective intervention may be available, and discussing the risk can create complicated family dynamics.
Q: Why is the period between ages 7 and 12 considered critical for health behaviour?
A: This is when people are most malleable. Health behaviours instilled during this window are more likely to become automatic health habits that persist into adulthood.
This material connects directly to the theories and models covered in Part 2 of these notes (Health Belief Model, Theory of Planned Behaviour, Transtheoretical Model), which provide the theoretical frameworks for the practical content here. It also links to stress and coping (Week 2), because stress is both a barrier to health behaviour change and a trigger for unhealthy habits like emotional eating and smoking. The discussion of social influence ties to broader social psychology concepts such as conformity and social norms.
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