Improving lifestyle is thought to be one of the most effective tools for reducing mortality and morbidity in the developed world. We have done this deliberately – we have not written a book dedicated to any behavior or any approach. However, around a quarter of the UK population still smoke and this has a significant impact on individual and national health.
The key psychological themes that emerged from the exploration of each of the lifestyle behaviors will be discussed and evaluated.
1 Conceptualising lifestyle psychology
One of the key unifying themes between these alternative disease models is prevention rather than cure. These changing demographic and disease parameters have primarily fueled the rise of the lifestyle model of disease. All of these national surveys included a large sample of the population living in the country at the time.
Simply put, a behavioral explanation suggests that most class differences in health can be explained by the choices people make.
2 Theories of change
It is included to respond to growing evidence of the importance of efficacy in behavior change (Milne et al. 2000). Belief in the efficacy of the proposed behavior change and the self-efficacy of the individual contemplating the change. Self-efficacy is one of the best predictors of behavior change, while self-esteem has been found.
Data from longitudinal studies of TTM are similarly difficult to interpret.
3 Eating
In 2002, the National Diet and Nutrition Survey (Henderson et al. 2002) of adults aged 19 to 64 years found that average fruit and vegetable consumption was less than three servings per day. Thus, any association between obesity and health status is likely to be overestimated (Chiolero et al. 2007). Nevertheless, the health gradient persists and some argue that it is increasing (Shaw et al. 2005).
25,000 deaths each year (Unal et al. 2004) which can be achieved by reducing the intake of saturated fats. In another study, Cade et al. 2007) investigated the relationship between dietary fiber and the risk of breast cancer. Furthermore, there is a perception that fruit and vegetables are time-consuming to prepare and this is a frequently cited barrier (Anderson et al. 1998).
Evaluation of the program showed that exposure to the 'Food Dudes' significantly increased fruit and vegetable consumption (Lowe et al. 2001; for example, Birch et al. 1980). Giving children food in conjunction with positive adult attention found that preference because that food has increased. In one follow-up study, increases in fruit and vegetable consumption continued 15 months after the end of the intervention, highlighting the program's long-term effectiveness (Lowe et al. 2007).
In contrast, a Glasgow study using a controlled before and after design found no evidence of an intervention effect on fruit and vegetable consumption (Cummins et al. 2005). Primary care remains the public's preferred source of food and health information (Hiddink et al. 1997).
4 Physical activity
Welsh Assembly Government 2003: 4) The US view on appropriate levels of physical activity is similar to that of the UK. Any change in the downward trend in physical activity levels, however modest, would be encouraging. Consequently, active transport has been argued to be a key factor in achieving healthy levels of physical activity (Jones et al. 2007).
Most people associate physical fitness with a high level of physical activity and inactivity with incapacity. A better understanding of the mechanisms mediating the link between environment and physical activity is needed. The greater success of the more specific variable "social support" in explaining variation in physical activity behavior adds weight to this argument (Rovniak et al. 2002).
1993 have reported that self-efficacy predicts both adoption and maintenance of physical activity. However, the most successful social cognition models rarely predict more than 50 percent of the variation in physical activity found in any population (Rovniak et al. 2002). Enjoyment appears to be key to establishing physical activity habits (Aarts et al. 1997).
A life course perspective may be crucial for effective physical activity promotion (Hendry and Kloep 2002). Levels of physical activity are low in the population and establishing positive physical activity habits is an important health-promoting goal.
5 Drinking
Plant and Plant 2006; HM Government 2007) and binge drinking is now measured in the UK National Health Surveys in England, Scotland and Wales (DoH 2003; Scottish Executive 2005; Welsh Assembly Government 2003). Some indication of the level of intoxication can be extrapolated from the amount of alcohol in the bloodstream, but individual tolerances to alcohol will influence the level of intoxication. Measurement of drinking behavior varied across the English, Welsh, Scottish and Northern Ireland health surveys (DoH 2003; Welsh Assembly Government 2007; Scottish Executive 2003: Department of Health, Social Services and Public Safety 2001 respectively).
A significant minority of people, almost 50 percent of women in Wales, reported not drinking in the past week (Table 5.3). In the English Survey, the total percentages that exceeded the daily limit on at least one day per week (Table 5.4) were more than 10 percent higher than reported in Safe. Plant and Plant (2006) suggest that the high levels of binge drinking reported by young British women are unusual and have not been reported in most other Western countries.
These differential effects reported by Jefferis et al. 2006) are similar to those found in the cross-sectional data from the National Surveys. However, Budd (2003) reported that 39 percent of binge drinkers between the ages of 18 and 24 had committed an offense in the previous year. As with other lifestyle behaviors, it is common that the effectiveness of such intervention programs is not properly evaluated (Foxcroft et al. 2003) and most studies only follow their participants in the short term.
Social norm marketing is derived from social norm theory discussed earlier in the chapter. They reported that there was no difference in the amount, frequency or volume of alcohol consumption or in degree of drunkenness or heavy episodic drinking.
6 Smoking
However, Peretti-Watel et al. 2007) suggests that it is risk denial rather than a lack of information about the health consequences of tobacco smoking. For example, Bauman et al. 1990) found that lifetime parental smoking was highly correlated with adolescent smoking. Evidence suggests that the majority of smokers want to quit (DoH 2003; Brunnhuber et al. 2007), so why are non-smokers lower.
Alternatively, those of lower SES may have less social pressure to quit smoking and less social support to quit (Sorensen et al. 2002). Evidence suggests that lower SES smokers tend to start smoking earlier (Droomers et al. 2002) and may therefore be more heavy smokers than their higher SES counterparts. Low-income smokers may have less access to pharmacotherapy and other treatments that improve smoking cessation (Chesterman et al. 2005).
It may be that the disparity in smoking cessation between social classes may be related to differences in the use of smoking cessation resources (Honjo et al. 2006), whether at home, work or with peers. Methods have been developed (see Willemsen et al. 2006) to promote the selection of appropriate termination methods. This model has been enthusiastically taken up and exported to the community level (eg Moore et al. 2002).
Such interventions promote smoking cessation but have been shown to be generally similar to other programs – most smokers relapse in the long term (Irvin et al. 1999). Although most smokers want to quit, and about 41 percent of current smokers have tried to quit in the previous twelve months (Centers for Disease Control and Prevention (CDC) 2004), success rates are low (Taylor et al. et al. 2005).
7 Sex
Also, an online search for "safe sex" in a popular search engine does not provide a full explanation of safe sex from UK websites. A government definition of 'safe sex' involves taking precautions during sex that can prevent you from getting a sexually transmitted disease (STD) or from passing an STD to your partner. Following on from this American development, the concept of 'safe sex' began to be promoted in the UK with the 'tombstone' HIV/AIDS campaign in 1986, leading to a series of high profile safe sex (demonstrated through condom use) campaigns.
It is possible that individuals who engage in oral sex, but do not consider it to be 'sex', may not associate the acts with the potential health risks they may entail (CDC 2006a; Chambers 2007). Many societies and cultures are intolerant of sex outside marriage and much is made of the effect on sexual health as a result of sex outside marriage (Wellings et al. 2006). Despite this, the correct use of condoms in this way is strongly recommended to provide protection against many of the following STIs (Warner et al. 2006; FFPRCH 2007).
However, only one-fifth do so when asymptomatic, but asymptomatic shedding and thus transmission can occur (Rana et al. 2006). In terms of incidence and frequency, oral sex among university students appears to be increasing (Grunseit et al. 2005). Another reason for the aforementioned increase in STDs may be that many MSM are less consistently practicing safe sex (Jefferson et al.
Similarly, HIV-positive MSM have been shown to report unprotected sex with multiple serodiscordant partners (Hirshfield et al. 2004). Bisexual men have been shown to engage in high rates of unprotected anal intercourse with men and women, as well as unprotected vaginal intercourse (Agronick et al. 2004; Jeffries and Dodge 2007).
