¶ … Health Behavior The "Theories At A Glance" manual discussed a variety of healthy behaviors. Select two theories that can be used to explain why people behave the way they do. Discuss the basic premise and constructs of the theories you choose. Cite two examples of how each theory could be used to explain a health behavior.

Theory of Planned Behavior (TPB)

The relationship that exists between behavior and attitudes, beliefs and intention is studied under TPB (Theory of Planned Behavior). TRA (Theory of Reasoned Action) is also associated with TPB. According to TRA and TPB, behavior is mainly determined by behavioral intention. These models show that the attitude of an individual affects behavioral intention. Hence, the behavior of a person towards the performance of some particular behavior is also influenced. In addition to this, beliefs concerning individuals who have close association (these people have the decision making power of approving or disapproving the exposed behavior) also affects behavioral intention. In view of TRA and TPB, all other relevant social or behavioral factors cannot work in the absence of models' constructs. Moreover, these models do not provide any explanation about the possibility of an individual's action in a particular situation (NCI, 2011).

TRA and TPB are not similar. TPB is comprised of perceived behavioral control construct too. According to this construct, people have the belief and power to control certain behavioral actions or responses. This construct was included by Azjen and Driver when they observed individuals in certain situations when they were unable to control their behavior. The reason for such behavioral intention or people's behavior was attributed to factors not in control. According to them, if people think that they can control a specific behavior, they tend to perform it more often (refer to Table 4). Situations cannot restrict the applicability of this model; nevertheless, it is clear that behavior is also affected by the people's perception of controllability (NCI, 2011).

According to surveillance data, there is a higher possibility that acculturated Hispanic women would undergo Pap tests, in comparison to the older, less acculturated ones. A cervical cancer screening program was initiated by the health department, targeting older Hispanic women. This would include a survey, via which the intentions, attitudes and beliefs of the population would be figured out. The survey asked when had the women taken their Pap test last (behavior); the likelihood of them taking one (intention); the general attitude about the test (attitude); whether we'd recommend this test to someone we know (subjective norm); and whether the choice to get the test or not, is under the individual's control (perceived behavioral control). All this would be considered, when carrying out the survey, so that the intentions, attitudes, beliefs could be noted. This would enable the researchers to identify the ones seeking a Pap test (NCI, 2011).

The TPB's explanation for the intention behind any determined behavior is shown in Figure 3 (above). It also shows the way, perceived behavioral control, subjective norm and behavior influence behavioral intention. The model states that the attitudes of behavior are molded via the belief of motivation and social standards which are derived from the outcome and the performance of the behavior itself and that they comply with the subjective norms affect. The ease of performing any behavior would depend on the presence or lack of things, when talking about the perceived behavioral control. Thereby, behavior is derived from a chain of intentions, attitudes and beliefs (NCI, 2011).

Precaution Adoption Process Model

Seven distinct stages of the journey are specified in the Precaution Adoption Process Model (PAPM). This ranges from the lack of awareness of maintenance and/or adoption of a behavior. This is a newer model that has been applicable to various health behaviors, including: home testing for radon gas, hepatitis B vaccination, mammography, colorectal cancer screening and osteoporosis prevention (NCI, 2011).

There are a number of stages through which an individual goes through as far as the process of PAMP is concerned. Stage one is the phase of ignorance, when the person does not have any knowledge about the danger (for example he is not aware of hazards like HIV, radon exposure and sex without protections being used). Within the second phase the individual gets aware of the hazard but is not engaged in it. The next four stages (i.e. from stage three to six) are concerned with acting, stage 3 includes the decision of acting, and then they decide whether they have to act (stage 5) or they do not have to take any action (stage 4). Stage six is also concerned with acting but primarily the act of maintenance (See figure 4). Individuals...

After the completion of the first two phases the individuals never move back, like for instance an individual cannot move from an all knowing stage to the age of ignorance. But apart from the starting two stages, people can move form a forward stage to the previous one (NCI, 2011).
Similarities can be seen between PAPM and Stages of Change in Model but there exist huge differences as well. Changes in the model focus on bringing change in the behavior of the individuals, like for instance it asks for quitting smoking and overeating. But this kind of an approach is less meaningful when handling a newly detected danger and precautions that are lately accessible. According to PAMP, the individuals who are at the starting stage of unawareness undergo hurdles of different nature as compared to those persons who are on the acting decision making stage and have decided not to respond. PAPM appeals the practitioners to work on the strategies relating to the starting phase i.e. prior to the active decision making stage (NCI, 2011).

2. A variety of factors (determinants) that influence healthy behavior were outlined on the videos. Discuss the determinants of healthy behavior in general and describe the three determinants you believe are most influential in shaping the behaviors of adults.

A number of factors in combination affect the health of people and communities. There are numerous factors that affect the health of an individual; a few factors are as follows; the area in which people live, the state of environment, genetics, the income and educational level, and the relationships with friends and family. Through this we get to know that the health of an individual is greatly affected by the atmosphere in which he lives and the situations which surround him. If we compare the above factors with the health care services, we acknowledge that, there is rather a lesser degree of impact of health care service on an individual. Health can be determined by the following factors:

Individual behaviors and characteristics of the people

Nature of physical environment

Economic and social system (NCI, 2011)

An individual's health is largely the function of his lifestyle hence he should be appreciated for good health (Eddy, Module 1). On the same note, he should not be blamed for poor health either. There are many factors which directly or indirectly affect the individual's health and not all the factors fall in his controllable domain. In addition to above mentioned factors, there are many other determinants as well.

Culture - beliefs, traditions and customs prevailing in the family and society at large affect general health of the people in that society

Supportive social networks - the degree of health is directly related with level of support from family members, friends and social circle

Physical environment - clean air and safe water, congenial workplace, safe housing and transportation infrastructure add to better health.

Working conditions and environment - employed people enjoy good health especially the ones having authority at workplace as compared to the unemployed people

Education - people with high education levels enjoy good health, more confidence and less stress.

Social status and income group - upper class generally enjoy better health conditions. The degree of health disparity is directly proportional to income disparity.

Coping skills and personal behavior - drinking, smoking, stress management, balanced diet and challenges largely affect the health conditions.

Genetics - healthiness, probability of disease and lifespan are the function of inherited characteristics.

Gender - both genders are prone to different diseases at different ages

Health services - use and access of health services determine the health of individual particularly prevention and treatment of diseases (NCI, 2011)

3. Describe the Social Ecology of Health Promotion approach to addressing a health problem. How would this model reduce victim blaming in Health Promotion? How would this model assist you with the design of a particular health issue / problem that you identify? Review possible interventions and applicable theories on all levels of the model.

The behavior of physical activity is a complex mechanism and the influencing factors are also multifaceted. At times these factors and behaviors lead to blocking physical activity. There are many models explaining such factors and their roles. They throw light upon the particular problem taking place in a specific background. The detailed study of the problem and related factors in the light of particular settings help the experts to design interventions accordingly. The intervention is…