Health promotion, resilience and wellness

Transcript

RyanIn Alameda County, California, researchers followed nearly seven thousand residents for nine years. At the start, some people said they lacked social and community ties. Nine years later, those people were more likely to have died.

SoheeThe OpenStax psychology textbook reports the numbers. Compared with people with the most social contacts, isolated men were 2.3 times, and isolated women 2.8 times, more likely to die. And the pattern held after controlling for smoking, drinking, initial health, and physical activity.

RyanWelcome to EPPP Prep, the podcast. I'm Ryan.

SoheeI'm Sohee. Today is health promotion, risk reduction, resilience, and wellness. Three blueprint spots. It's the most hopeful topic in the domain, and it's full of names and numbers worth knowing.

RyanStart with the field. The textbook defines health psychology as a subfield devoted to understanding the importance of psychological influences on health, illness, and how people respond when they become ill. It emerged as a discipline in the 1970s.

SoheeNow one of the most widely applied models of health behavior. The health belief model. A paper by Jones and colleagues in Health Communication says it posits six constructs that predict health behavior.

RyanPerceived susceptibility: do I think I'm at risk? Perceived severity: would it be serious? Perceived benefits: would acting reduce the risk or bring other good outcomes? Perceived barriers: what's in the way? Self-efficacy. And cues to action.

SoheeCues to action can be internal or external, from experiencing symptoms to seeing a health campaign. And self-efficacy, the belief you can do the behavior despite the barriers, was added to the model later.

RyanHere's the testable finding. In the first of four meta-analyses the paper describes, by Becker and by Janz and Becker, perceived barriers were the most powerful single predictor of preventive health behavior, and perceived severity was the least powerful.

SoheeWith a qualifier: the paper says the findings across those four meta-analyses have been inconsistent. But barriers coming out on top is worth remembering.

RyanPause and think. A woman knows she's at high risk for diabetes, and she believes it would be serious. But she says, I can't afford the gym and I work two jobs. Which health belief model construct is the target?

SoheePerceived barriers. Her susceptibility and severity beliefs are already high. A program that keeps emphasizing how dangerous diabetes is misses her. Reducing barriers, like walking plans that fit her schedule, matches the model.

RyanAnd notice the overlap with the transtheoretical model from episode two. Health promotion borrows both: where people are in readiness, and what they believe about the threat and the action.

SoheeNow stress and coping, because so much of risk reduction is stress management. The textbook describes Lazarus and Folkman's two kinds of coping.

RyanProblem-focused coping tries to manage or change the problem causing the stress. Like a student failing statistics who meets the professor, sets study time, and gets tutoring.

SoheeEmotion-focused coping tries to change or reduce the negative emotions. Avoiding, distancing, positive comparisons, or reappraisal, construing the stressor differently without changing its actual threat.

RyanWhich is better? The textbook says problem-focused coping is more likely with stressors we see as controllable. Emotion-focused coping predominates when we believe we're powerless, and it's more effective for uncontrollable stressors, like the death of a loved one.

SoheeSo the better answer isn't that problem-focused coping always wins. It's matching coping to controllability.

RyanWhich brings us to perceived control. The textbook quotes Albert Bandura: the intensity and chronicity of human stress is governed largely by perceived control over the demands of one's life.

SoheeAnd perceptions of personal control are associated with better physical and mental health and greater psychological well-being. Longitudinal studies of British civil servants found those in low-control, low-status jobs were considerably more likely to develop heart disease.

RyanBack to social support. A review of 148 studies with over 300,000 participants concluded people with stronger social relationships had a 50 percent greater likelihood of survival than those with weak relationships.

SoheeAnd the researchers said that effect is comparable with quitting smoking, and exceeds many well-known risk factors like obesity and physical inactivity.

RyanHow might it work? The textbook says social support appears to work partly by boosting the immune system, especially under stress. It's been shown to lower blood pressure during stressful tasks. And it may also lead to better health behaviors, like diet, exercise, quitting smoking, and following medical regimens.

SoheeNow exercise. The textbook says it's well established that exercise, both aerobic and anaerobic, benefits physical and mental health, and physically fit people are more resistant to the adverse effects of stress.

RyanThe Centers for Disease Control and Prevention, CDC, adds specifics. Some brain benefits happen right after a session of moderate-to-vigorous activity, including reduced short-term feelings of anxiety in adults. And regular activity can reduce the risk of depression and anxiety and help you sleep better.

SoheeAnd CDC suggests working up to 150 minutes a week of moderate-intensity activity, for example thirty minutes a day, five days a week.

RyanTwo classic relaxation techniques. Herbert Benson, a cardiologist, developed the relaxation response technique in the 1970s. It combines relaxation with transcendental meditation and has four components.

SoheeSitting upright and relaxed, a quiet environment with eyes closed, repeating a word or phrase, a mantra, and passively letting the mind focus on pleasant thoughts. It reduces sympathetic arousal and has been used to treat people with high blood pressure.

RyanAnd biofeedback, developed by Gary Schwartz at Harvard in the early 1970s. Electronic equipment measures a person's neuromuscular and autonomic activity and feeds it back as visual or auditory signals, so the person can gain some voluntary control over normally involuntary processes.

SoheeThe textbook says it has been applied successfully with tension headaches, high blood pressure, asthma, and phobias.

RyanNow wellness. Positive affect means pleasurable engagement with the environment: happiness, joy, enthusiasm, alertness, excitement. The textbook says positive affect is associated with greater social connectedness, adaptive coping, lower depression, longevity, and favorable physiological functioning.

SoheeOne striking study: in a ten-year study of Nova Scotians, the rate of heart disease was 22 percent lower for each one-point increase on a five-point positive affect measure.

RyanAnd optimism is related but different. Positive affect is about feeling states. Optimism is a generalized tendency to expect good things to happen. The textbook says optimism has been linked to longevity, healthier behaviors, fewer postsurgical complications, and better treatment adherence.

SoheeNow resilience. A panel article by Southwick and colleagues says most of us think of resilience as the ability to bend but not break, bounce back, and perhaps even grow in the face of adverse life experiences.

RyanAnd it warns that resilience can be defined differently for individuals, families, organizations, societies, and cultures. It's important to specify whether resilience is being viewed as a trait, a process, or an outcome, and it's tempting to treat it in a binary way, as present or absent.

SoheeMost of the panelists' definitions shared one idea: healthy, adaptive, or integrated positive functioning over time in the aftermath of adversity.

RyanSo on the exam, if an answer treats resilience as all or nothing, present or absent, be careful. The panel calls that binary approach tempting, and treats resilience as a complex construct, viewed as a trait, a process, or an outcome. It also asks how resilience can be enhanced.

SoheeCDC's suicide prevention guidance puts resilience into practice. It says everyone can help prevent suicide by learning warning signs, promoting resilience, and supporting people at risk. And schools can teach communication, problem-solving, emotional regulation, and resilience.

RyanFinally, workplaces. The National Institute for Occupational Safety and Health defines Total Worker Health as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention, to advance worker well-being.

SoheeAnd it prioritizes a hazard-free work environment. So in this model, workplace wellness isn't only yoga classes. It starts with making the job itself safe.

RyanPause and think. A company offers a meditation app to employees but ignores dangerous overtime schedules. What would Total Worker Health say is missing?

SoheeThe integration. It asks employers to address hazards in the conditions of work, not only individual health promotion. The app alone isn't the model.

RyanRecap. Health belief model: susceptibility, severity, benefits, barriers, self-efficacy, cues to action. Barriers were the strongest single predictor in the first meta-analysis.

SoheeProblem-focused coping for controllable stressors, emotion-focused for uncontrollable ones. Perceived control matters for health.

RyanSocial support: in Alameda County, isolated men and women were 2.3 and 2.8 times more likely to die. Across 148 studies, stronger relationships meant a 50 percent greater likelihood of survival.

SoheeExercise, Benson's relaxation response, and biofeedback reduce stress. Positive affect and optimism link to better health. Resilience: bending without breaking, defined as trait, process, or outcome. And Total Worker Health integrates safety with health promotion.

RyanSo, a prescription from the sources, for you. Move your body a little today. Call someone who's on your side. And notice that preparing again after a hard result is resilience in action. You're bending, not breaking.

SoheeThanks for listening to EPPP Prep.

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