Behavioural Medicine: Research and Development in Disease Prevention

Abstract

Behavioural medicine has become a popular, important and distinct field of research and clinical practice. One of the more exciting areas of behavioural medicine has been in the application of behavioural techniques to reduce cardiovascular risk-factors on a community-wide basis. Work conducted in this area highlights a key issue for the development and support of behaviour analysis and modification activities in Australia: to what extent should behavioural practitioners and their interest groups pursue a specialised, behaviour-analytic approach to the areas in which they are involved, as opposed to adopting interdisciplinary frameworks and approaches. We describe some of the activities of the Stanford Center for Research in Disease Prevention, which has been able to operate as a large, interdisciplinary organisation, guided by behavioural approaches. We also discuss some setting, provider, program and client variables relevant to research and development on health promotion and disease prevention in Australia and elsewhere.

Teaching the principles of behaviour change to medical students: evaluation of a programme

“…whether to increase adherence to treatment (Rosentstock 1985; Richards et al 1989; McCaul et al 1992), for health promotion (Mayer & Kellogg 1989; Epstein et al 1994; Fisher et al 1994), or to improve recovery from illness (Richmond & Heather 1990; Kaplan et al 1994), familiarity with behaviour change processes becomes more important. Systematically applied in appropriate ways, behaviour change processes have a demonstrated efficacy as is clear from the numerous studies reporting successful outcomes (Leventhal et al 1988; Taylor & Owen 1989; Shadel & Mermelstein 1993; Epstein et al 1994). A few studies (Bandura et al 1977; Biran & Wilson 1981) have explicitly contrasted a form of behaviour modification with instruction or encouragement to change and have shown that the latter processes produce less change and do not raise the individual's self‐efficacy.…”

Population versus Clinical Perspectives on Smoking Behaviour

“…Accelerating the decline in smoking prevalence requires intervention methods which may be delivered in a cost-effective fashion on a community-wide basis (Chapman, 1985). Such methods include mass-media campaigns (Flay, 1987), self-help methods (Owen, Ewins & Lee, 1989), the use of school settings (Flay et al, 1989) and worksites (Hallett, 1988), public-policy innovations such as bans on smoking in the workplace (Borland, Chapman, Owen, & Hill, 1990), legislation to increase cigarette prices (Warner, 1986), and multifaceted community-wide interventions (Taylor & Owen, 1989). As some Australian states are now spending millions of dollars on anti-smoking activities, it is important that such interventions are designed using sound theoretical principles, and are carefully evaluated (Owen & Lee, 1986a, 1986b.…”

Regulatory influences on health-related behaviours: The case of workplace smoking-bans

“…Mass-media campaigns are used to inform the public, to raise awareness, and to prompt attempts at behaviour change (Flay, 1987). The initiation and maintenance of behaviour change is then facilitated through the provision of personal advice group programs, community events such as smoke-outs or fun runs, the provision of self-help materials (e.g., Owen, Ewins, & Lee, 1989), and a variety of community activities (see Puska et al, 1985;Taylor & Owen, 1989) While this preventive-health research may suggest that knowledge, attitudes, and intentions about smoking and otha healthrelated behaviours would precede changes in behaviour, this need not always be the case. Cognitive dissonance theory (Festinger, 1957) and self-perception theory (Bem, 1972) suggest that individuals are likely to adjust their attitudes to conform with their actual behaviour, even if that behaviour is one that is enforced.…”