Health Psychology. Fifth Edition by unknow

Author:unknow
Language: eng
Format: epub
Published: 2018-02-10T14:30:57.156096+00:00

Critique of Behaviour Change Approaches to Health Promotion

The behaviour change approach has attracted many criticisms. First, it is unable to target the major causes of ill health. Individual behaviour change, even when successfully implemented, cannot address socio-economic factors such as poverty, unemployment or environmental pollution. Its objective is change within the individual rather than change in the individual’s environment. Neglecting wider determinants of health poses the risk of generating further inequalities in health. As discussed in Chapter 4, there is an association between unhealthy behaviours and socio-economic status (SES). It can be argued that this can be explained by a wider intention–behaviour gap among lower SES groups. However, there is no evidence to support this. In a meta-analytic review of five studies, Vasiljevic et al. (2016) found that the intention–behaviour gap did not vary with deprivation on health behaviours such as diet, exercise or medication adherence in smoking cessation. However, there was a significant gap between self-efficacy and behaviour in more deprived groups. This implies that improving self-efficacy would be needed to promote healthier behaviours in lower SES groups. This can be achieved by developing individual-level interventions and more widely in community-level contexts through participation, capacity building and empowerment.

Second, the choice of which behaviour to target lies with ‘experts’ whose task it is to communicate and justify this choice to the public. As a result, recommendations and advice provided ‘from above’ can be seen as incompatible with community norms. Receiving health advice in a top-down fashion can be disempowering, as Ayo (2012: 104) argued:

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