Developmental differences in health behaviours

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Developmental differences in health behaviours

• Health Psychology

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Illness cognitions among children

• Several researchers have used the cognitive
  perspective to explore the development of illness
  concepts among children. Bibace and Walsh (1980)
  interviewed children of different ages about
  their concepts of illness. They then coded the
  childrens replies into Piagets (1930) stages of
  cognitive development. Children between the ages
  of 2 and 6 years provided more pre-logical
  explanations. At this age the most common
  explanation for illness was contagion. People
  became ill because they were close to certain
  contagious objects or persons.

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Illness cognitions among children

• Between 7 and 10 years children offer more
  concrete-logical explanations. At this age the
  children explain illness in terms of
  internalisation and contamination. The person is
  required to come into physical contact with the
  source of the illness and possibly to ingest it.

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Illness cognitions among children

• Finally, 11-year-olds explanations were more
  formal-logical. The children offer a more
  physiological explanation referring to internal
  physiological processes. Kister and Patterson
  (1980) also referred to Piagetian concepts and
  suggested that young children explain illness in
  terms of immanent justice a form of
  punishment for a transgression.

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Illness cognitions among children

• Several commentators (e.g. Burbach and Peterson,
  1986) have questioned the methodological adequacy
  of these and comparable studies. Siegal et al.
  (1990) found that young children were reluctant
  to use contagion to explain toothache but
  correctly used it to explain getting a cold. They
  suggested that in previous work rather than
  lacking knowledge of the causes of illness, the
  children may simply have misunderstood the
  procedural requirements of the interview.

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Illness cognitions among children

• They also found no evidence that illness is
  described in terms of immanent justice. They
  suggested that in previous research the children
  may have attempted to comply with the suggestion
  of an adult interviewer that adults may be so
  powerful that children who are naughty will be
  inevitably punished (p. 160).

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EXERCISE AMONG CHILDREN

• There are substantial variations in the extent of
  participation of children in physical activity.
  Sex, socio-economic and ethnic variations are
  apparent from an early age. Simons-Morton et al.
  (1997) conducted a large survey of over 2,400
  third grade (8- to 9-year-old) children in four
  US states. They found that not only did boys
  participate significantly more in moderate to
  vigorous physical activity but they also
  participated more in sedentary activities.
  Specifically, boys spent more time than girls
  watching television and playing video games.

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EXERCISE AMONG CHILDREN

• The ethnic differences in physical activity were
  not significant after controlling for other
  demographic variables.

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EXERCISE AMONG CHILDREN

• Gottlieb and Chen (1985) considered the character
  of physical activity among a sample of 2,695
  seventh and eight grade students (1214 year
  olds) in Texas. They found that the female
  students were more likely than the males to
  participate in running, swimming, dancing,
  skipping, tennis, roller-skating and volleyball.
  These activities were largely classified by
  sporting experts as individual, non-competitive
  and potentially aerobic activities. The male
  students preferred team, competitive, non-aerobic
  activities.

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EXERCISE AMONG CHILDREN

• Gottlieb and Chen also found evidence of ethnic
  differences. After controlling for fathers
  occupation, Anglos were more likely to engage in
  individual, non-competitive, aerobic type
  activities (bicycling, swimming, tennis,
  Frisbees, roller skating and golf). Blacks
  favoured competitive team sports such as
  basketball and also dancing, while
  Mexican-Americans preferred baseball. Gottlieb
  and Chen suggest that children choose sports that
  older members of their own race (role models)
  have been successful in.

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Predictors of childrens participation

• Initial attempts to explain childrens
  participation in sporting activities focused on
  parental modelling. Moore et at. (1991) found
  that more active parents are more likely to have
  more active preschool children. SimonsMorton et
  at. (1997) found that a generalized measure of
  support for physical activity from parents,
  teachers and peers predicted extent of physical
  activity among the children.

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Predictors of childrens participation

• In an attempt to distinguish between parental
  influence and childrens attributes Stucky-Ropp
  and DiLorenzo (1993) conducted a study in a
  Midwestern American town which involved
  structured interviews with over 200 10- to
  12-year-old children and their mothers.
  Statistical analysis of their findings showed
  that the childrens reported enjoyment of
  physical activity was the most salient predictor
  of exercise behaviour. In addition, the mothers
  perceptions of barriers to exercise (e.g. lack of
  time) and mothers reports of family support were
  important.

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Predictors of childrens participation

• There were also some sex differences. Boys
  activity was also predicted by their perception
  of modelling and support of exercise behaviour by
  family and friends, whereas girls activity was
  more predicted by presence of exercise-related
  equipment at home and parental modelling. These
  results confirm the central role of family
  environment in establishing an interest in
  physical activity among children.

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Predictors of childrens participation

• As children move into adolescence it would be
  expected that the influence of parents would
  decline. Reynolds et at. (1990) explored this
  issue with longitudinal data on 743 14- to
  16-year-old students from the control condition
  of the Stanford Adolescent Heart Health Program.
  They collected baseline data on these teenagers
  and then followed them up four and 16 months
  later. At four months the best predictor of
  physical activity for both males and females was
  baseline activity.

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Predictors of childrens participation

• For boys, self-efficacy (confidence that they
  could exercise despite obstacles) was a
  nonsignificant predictor but not social
  influence, which included the activity levels of
  family and friends. This would suggest the
  development of a more independent lifestyle. For
  girls social influence was important as was
  perceived stress and intention. At 16 months
  baseline activity remained important for boys but
  not self-efficacy, perhaps another indicator of
  their changing lifestyle and the conflicting
  influences. For girls, self-efficacy was
  important.

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Social meaning of sport for young people

• Much psychological research into the development
  of physical activity has adopted a deterministic
  model such that it is assumed that participation
  is caused by a combination of social and
  psychological variables. This approach ignores
  the active role of the young person in deciding
  whether or not to become involved and the social
  context within which physical activity occurs. A
  limited number of studies have adopted this more
  social perspective.

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Social meaning of sport for young people

• Kunesh et at. (1992) conducted a detailed
  investigation of the school play activities of a
  sample of 11- to 12-year-old girls in central
  USA. In interviews the girls reported that they
  found physically active games at home and at
  school enjoyable. However, in the school
  playground the girls preferred to stand in a
  group and talk while the boys participated in
  various games. When the girls did participate in
  games the boys often criticized them for their
  supposed inferior skill performance.

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Social meaning of sport for young people

• To avoid this negative treatment the girls
  excluded themselves. The girls reported that when
  playing at school they felt nervous and
  embarrassed. These findings would suggest that
  while at an early age boys and girls both enjoy
  physical activities by the time they reach
  puberty the girls feel that they are being
  excluded.

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Young peoples decisions about sport
participation (based on Coakley and White, 1992)

•         Consideration of the future, especially
  the transition to adulthood certain sports are
  accepted and others rejected depending upon their
  perceived adultness. Teenagers reject those
  games, which they perceive as childish. Young
  women in particular become less involved in
  sporting activities, which they perceive as
  having little connection with the female role.

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Young peoples decisions about sport
participation (based on Coakley and White, 1992)

• Desire to display and extend personal competence
  and autonomy young people become involved in
  sporting activities to the extent to which it
  extends their feeling of competence and autonomy.
  Again, there are gender differences with the
  young women being less likely to define
  themselves as sportspersons even if they are
  actively involved in physical activities. For
  them, sport is often perceived as a more
  masculine activity.

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Young peoples decisions about sport
participation (based on Coakley and White, 1992)

•         Constraints related to money, parents
  and opposite-sex friends access to material
  resources is an important factor in explaining
  whether young people participate in certain
  sporting activities. In addition, the young
  women emphasize the importance of parents who
  seem to adopt a much more controlling influence
  on their general social lives.

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Young peoples decisions about sport
participation (based on Coakley and White, 1992)

•       Further, the extent of participation in
  sporting activities is affected by whether or not
  the young women have a boyfriend. It is often the
  boyfriend who initiates leisure activity and
  restricts or encourages participation in sporting
  activities. Indeed, the young women seem to give
  their own interests a low priority in order to
  maintain their relationships with their
  boyfriends.

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Young peoples decisions about sport
participation (based on Coakley and White, 1992)

•         Support and encouragement from parents,
  relatives, and/or peers young people report that
  they are often actively encouraged by family or
  friends to participate in certain physical
  activities. The young women in particular note
  the importance of having a friend to accompany
  them to sporting activities.

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Young peoples decisions about sport
participation (based on Coakley and White, 1992)

•        Past experiences in school sports and
  physical education many young people report
  certain negative school experiences, which colour
  their attitudes to physical activities. In
  particular, young women comment on how school
  physical education was associated with feelings
  of discomfort and embarrassment. Young men seem
  to have more pleasant memories of school sport.

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Foetal alcohol syndrome

• Health issues for children start before they are
  born. It is important for the developing child to
  have a good level of nutrition and be relatively
  free from drugs and alcohol. An example of the
  consequences of early disadvantage is foetal
  alcohol syndrome (FAS). The symptoms of FAS are
  head and facial abnormalities, brain damage, low
  birth weight, hearing problems and impairment of
  growth.

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Foetal alcohol syndrome

• The syndrome is commonly associated with the
  children of alcoholic mothers, and there may well
  be other issues as well as alcohol that create
  the problems. For example, the alcoholic mother
  might not be eating well, sleeping well, or
  attending antenatal clinics. Research studies
  with animals, however, can use controlled
  experiments to estimate the effect of alcohol on
  the young.

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Foetal alcohol syndrome

• Studies on rats have found that one
  binge-drinking episode early in pregnancy is
  enough to create a measurable effect in 50 per
  cent of births (Sulik et al., 1981), and also
  measurable differences in brain structure in the
  regions associated with long-term memory (Dumas,
  1994).

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Foetal alcohol syndrome
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Child survival

• An application of psychology outside the Western
  world has been in the UNICEF strategy to improve
  the rates of child survival. The strategy is
  called GOBI which is an acronym of the first
  words of the four points listed below (Harkness
  at al., 1988)

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Child survival

• 1. Growth monitoring to identify early cases of
  malnutrition and failure to grow.
• 2. Oral re-hydration therapy for infants and
  children with severe diarrhoea. Diarrhoea is a
  major cause of death in poor countries, and was
  in fact the major cause of infant death in
  British cities until the turn of the 20th
  century. The therapy reduces the high rate of
  death from fluid loss.

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Child survival

• 3. Breast-feeding promotion, because breast milk
  is high in nutrition, and also helps to immunise
  the baby from some common diseases.
  Breast-feeding also reduces the chances of
  infection from un-sterilised bottles.
• 4. Immunisation against the major childhood
  infectious diseases. 

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Child survival

• Psychology can make a major contribution to this
  programme, especially in the promotion of
  breast-feeding. This behaviour is full of social
  meanings and it is not enough to present a direct
  message in the terminology of Western medicine.
  Fernandez and Guthrie (1983, cited in Berry at
  al., 1992) suggest that it is important to take
  account of lay beliefs about health when
  education programmes are designed. If the
  programme describes traditional behaviours and
  beliefs as harmful, then it is unlikely that
  local people will respond to the message.

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Child survival

• There is also the counter pressure from
  multinational companies who encourage women to
  buy their baby milk, despite the lack of
  available money and the health risks of
  bottle-feeding in poor communities. Fernandez at
  al. (1983, cited in Berry at al., 1992) were able
  to make a successful intervention to encourage
  breast-feeding in the Philippines. Their success
  was based on the behavioural idea of rewards, and
  they offered women praise, health coupons and
  lottery tickets as incentives to breast-feed,
  plant leafy vegetables and visit the health
  centre every month.

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Bullying

• A modern concern for childrens health, although
  it is probably an old problem, is the experience
  of bullying. Many children experience bullying at
  school and this may well have an effect on their
  general health. Natvig et al. (2001) surveyed 850
  schoolchildren between 13 and 15 in Norway and
  asked about their general symptoms of health.

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Bullying

• They found that some symptoms such as
  irritability, headache, backache (boys), and
  nervousness and sleep disturbance (girls) were
  more common in children who had some recent
  experience of bullying. It appears that children
  who experience frequent bullying report
  substantially more symptoms, some of which might
  have a long-term negative effect on their health.

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The health of older people

• The proportion of older people in the European
  population is higher than it has ever been and it
  is expected to grow further (Walters et al.,
  1999). People over 65 made up 9 per cent of the
  population in the 1950s and are likely to make up
  18 per cent of the population in 2020. These
  figures can be used to spread alarm about the
  ability of the welfare state to support older
  people, but what is sometimes overlooked is the
  level of good health and independence that older
  people might well enjoy.

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The health of older people

• If our society promotes good health in older
  people, they will remain fit and active for
  longer. In the UK, research suggests that
  physical activity declines sharply at 55 with a
  third of people over 55 doing no exercise at all,
  compared with a tenth of people aged 3354
  (Walters et al., 1999). A reasonable target for
  health promotion, then, is to increase the level
  of activity in older people.

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The health of older people

• One of the issues to consider when designing a
  health promotion for a group of people is that
  they will have a range of individual needs. Older
  people are as diverse as any other group in the
  population the main feature they share is the
  length of time they have survived. So it you
  wanted to promote healthy eating in older people
  it would not be appropriate to use a simple
  message like reduce the intake of calories and
  fat because some older people need to deal with
  dietary deficiencies.

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The end