Health psychologists try to explain why people engage in behaviour that is not good for us – or don’t engage in behaviour that is good for us. One of the reasons is because of their health beliefs.  Health psychologists study how one’s beliefs about health problems affect their behaviour with the goal of targeting those beliefs as a form of prevention or intervention.  Two beliefs that are studied by psychologists are “self-efficacy” and “optimism bias.”

Self-efficacy can be defined as one’s belief that they are able to do something. When one does not have self-efficacy, their attitude is to avoid trying since they do not believe that they can be successful.  Lee carried out a study to see how self-efficacy may play a role in exercise. In this experiment there were two conditions – one in which female students were in a group that discussed self-efficacy; the other group was a control group. For each group, their weekly step count was measured with a pedometer, but the self-efficacy group received feedback whereas the pedometers of the control group collected data that could not be downloaded.  After 12 weeks, the self-efficacy group had significantly increased their number of steps compared to the control group, which had actually decreased its steps. The study appears to indicate that self-efficacy may play a role in exercise.

Although the experimental design indicates a cause and effect relationship between self-efficacy and increased exercise, there are limitations to this study.  First, the study is only for 12 weeks.  It could be argued that this is not long enough to determine a real change in behaviour, especially as students were still interacting with the “intervention” team and there may be demand characteristics. The girls may have exercised more because they felt that this was the expectation, rather than due to an actual increase in self-efficacy. This effect is also likely because they were students in a school environment.  This makes it difficult to generalize the findings to other populations.  Although tests were used to measure their level of self-efficacy, it could be argued that self-efficacy is a difficult concept to operationalize and measure.

Another health belief is “optimism bias.”  This is the idea that we tend to believe that we are at lower risk of health problems than others and that our own health behaviours are better than they really are – for example, we tend to believe that we walk more than we actually do.

A Swedish study looked at how one’s perception of risk for skin cancer influences a person’s sun protection behaviour.  The research was carried out with questionnaires to over 700 Swedes.  The questionnaires asked people about how often they sunbathe, their perception of the risk of sun cancer, and whether they would change their current sunbathing behaviour.  The study found that the participants had a good understanding that sun exposure can lead to skin cancer.  However, they seriously underestimated the risk of cancer and over 80% felt that there was no need to change their own sun-tanning behaviour.

The study was done in Sweden in a highly individualistic culture.  It is possible that this had an influence on the results.  It is also possible that the questions on the questionnaire may have influenced the responses; thinking about one’s own cancer risk is rather intimidating, so the lower estimates of risk may have been a way to decrease uneasy feelings about the questions.  Most importantly, however, the study does not show a cause and effect relationship; the data is correlational.  The questionnaire allows the researchers to see trends but does not necessarily predict how an individual will behave at the beach.  

Research on health beliefs is important in order to develop programs that change faulty beliefs.  However, this assumes that humans are rational beings and that our behaviours are the result of rational thought processes – this may not actually be the case.  In fact, the Health Belief Model which argues that perceived risk and self-efficacy are important in determining health behaviours has shown to have low predictive validity. This may be because many of the constructs – perceived risk and self-efficacy – are difficult to operationalize and measure.  The other limitation of health beliefs research is that it does not account for other potential influences on health behaviour   - including biological factors or past experience.

The study of health beliefs may end up being more descriptive than explanatory of people’s behaviour.  Dispositional factors, such as genetics and personality, may, in the end, play a more significant role than health beliefs.

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