Deck 4: Adhering to Healthy Behavior

Question 1

Which of these personal characteristics is generally the most accurate predictor of patient adherence?​

A) ​Age is typically the most accurate predictor.
B) ​Sex is generally the most accurate predictor.
C) ​Social class tends to predict most accurately.
D) ​A combination of these is the most accurate.

Answer 1

​A combination of these is the most accurate.

Question 2

Which type of social support is beneficial for adherence?

A) Living with a family
B) Belonging to a large family, even one with a lot of conflict
C) Being married
D) Both a and c

Answer 2

Both a and c

Question 3

Economic factors may exert a negative effect on adherence by

A) limiting access to screening tests.
B) preventing people from getting prescriptions filled or refilled.
C) increasing social support.
D) both a and B

Answer 3

both a and B

Question 4

Using hospital personnel to monitor patient adherence​

A) ​is the only currently approved method of assessing adherence.
B) ​creates an artificial situation that may raise adherence rates.
C) ​violates regulations of the American Medical Association.
D) ​both b and c are true.

Question 5

For individuals who are depressed, their risk of nonadherence is ____ greater than individuals who are not depressed.

A) four times
B) five times
C) two times
D) three times

Question 6

In studies with patients recovering from heart problems and patients with diabetes, _________ was a better determinant of adherence than ______________.​

A) ​practical support; emotional support
B) ​emotional support; invisible support
C) ​emotional support; practical support
D) ​practical support; invisible support

Question 7

_______ is the concept that refers to tangible and intangible help a person receives from friends and family.​

A) ​Self-efficacy
B) ​Self-esteem
C) ​Social support
D) ​Self-concept

Question 8

Those who do not share the cultural beliefs of Western medicine​

A) ​are just as likely as those who do to comply with the advice of a physician.
B) ​may comply not with advice from physicians, but from practitioners of their cultural traditions.
C) ​are likely to be members of ethnic minorities and are less compliant than European Americans.
D) ​are more likely to comply with the advice of a nurse than with that of a physician.

Question 9

Practitioners' accuracy when judging adherence of patients is​

A) ​very valid.
B) ​very reliable.
C) ​only slightly better than chance.
D) ​the best report of patients' adherence.

Question 10

The major advantage of the pill cap microprocessor as a means of assessing adherence is its​

A) ​cost effectiveness.
B) ​ability to count the number of pills removed with each bottle opening.
C) ​ability to count the number of bottle openings and record the time of day for each opening.
D) ​nearly perfect validity.

Question 11

Some chronic conditions, such as HIV and arthritis, show _____ adherence rates where diabetes and pulmonary disease show ______ adherence rates.​

A) ​low; high
B) ​high; low
C) ​low; low
D) ​high; high

Question 12

Patients' self-reports of adherence​

A) ​are valid but not reliable.
B) ​have questionable validity.
C) ​are less valid than physicians' reports.
D) ​are more valid than examination of biochemical evidence.

Question 13

The LEAST accurate method of assessing rate of adherence is to​

A) ​ask the practitioner.
B) ​ask the patient.
C) ​ask the patient's family.
D) ​monitor medication usage.

Question 14

In a study that examined medication adherence in heart failure patients, adherence was measured by both a Medication Event Monitoring System (MEMS) and by patient self-report. ______ predicted survival over a 6-month period, whereas ______ did not.​

A) ​Patient self-report; MEMS
B) ​MEMS; patient self-report
C) ​Practitioner self-report; MEMS
D) ​Exercise; MEMS

Question 15

Patients' records of their own rate of adherence may lack validity because

A) patients sometimes lie to avoid the displeasure of their physicians.
B) patients may be unaware of their own rate of adherence.
C) neither a nor b.
D) both a and b.

Question 16

Older studies found a general rate of nonadherence around _______; more recent studies show a rate of about _______.​

A) ​25% . . . . 50%
B) ​50%. . . . 25%
C) ​75% . . . over 90%
D) ​10% . . . . nearly 40%

Question 17

The pill cap microprocessor is an improved variation of which method of assessing adherence?

A) Physician judgment
B) Patient judgment
C) Examining biochemical evidence
D) Monitoring medication usage

Question 18

Of all methods used to assess patient adherence,​

A) ​only pill count is both reliable and valid as a method.
B) ​examination of biochemical evidence is the most valid.
C) ​examination of biochemical evidence is the least valid.
D) ​no single method alone is sufficiently reliable or valid.

Question 19

Angela is a heavy smoker and knows that smoking increases one's chances of lung disease. However, she believes that she is not at an increased risk for lung cancer. This is because Angela has a(n) _____________.​

A) ​high self-efficacy
B) ​high self-esteem
C) ​optimistic bias
D) ​pessimistic bias

Question 20

​A person's willingness and ability to follow recommended health practice is known as

A) ​behavior.
B) ​intention.
C) ​adherence.
D) ​perceived behavioral control.

Question 21

People who experience high levels of stress

A) become more adherent to medication routines oriented toward controlling their stress.
B) become less adherent to medications for chronic conditions but not for short-term problems.
C) become more likely to adhere.
D) become less likely to adhere.

Question 22

The behavioral model of adherence​

A) ​emphasizes reinforcement of compliant behaviors.
B) ​emphasizes punishment of noncompliant behaviors.
C) ​incorporates the concept of subjective norms.
D) ​has very little research evidence to support it.

Question 23

​The noncompliant personality

A) ​has not been found to exist among groups of people.
B) ​is more common among men than among women.
C) ​is less common among well-educated people.
D) ​is more common among the elderly.

Question 24

If you are a health psychologist administering smoking cessation programs, what do smokers need to believe to be motivated to quit smoking, according to the health belief model?

A) That quitting smoking is worth the effort, in spite of the numerous barriers to quit
B) That smoking can lead to diseases, though these are seldom ever life-threatening
C) That the risks incurred by smoking outnumber the benefits attained from quitting
D) That smoking risks are severe, quitting benefits clear, and barriers to quit are few

Question 25

With regard to age, studies show that nonadherence​

A) ​increases as the ages of the patients increase.
B) ​decreases as the ages of the patients decrease.
C) ​is related to different patient ages on a curve.
D) ​does not have any relationship to patient age.

Question 26

Which of the following most accurately reflects an essential contrast between continuum theories and stage theories of health behavior relative to patient adherence?​

A) ​Continuum theories explain adherence as developing gradually; stage theories explain adherence as developing discretely.
B) ​Continuum theories explain adherence as multifactorial; stage theories explain adherence by a limited number of factors.
C) ​Continuum theories explain adherence as being uniform; stage theories explain adherence as varying by steps in a process.
D) ​Continuum theories explain adherence by classifying people along a continuum; stage theories will not classify individuals.

Question 27

With regard to gender, which of these statements most clearly agrees with research?​

A) ​Women are more likely than men to comply with dietary recommendations.
B) ​Women are generally more likely than men to comply with all medical recommendations.
C) ​Men are more likely to be extremely resistant to taking medication.
D) ​Women are more likely to be extremely resistant to taking medication.

Question 28

Nonadherence rises abruptly when the prescription requires the patient to take one pill​

A) ​once a day.
B) ​twice a day.
C) ​three times a day.
D) ​four times a day.

Question 29

What would be the best way to help motivate a smoker to stop smoking if s/he perceives many barriers to quitting, and you are following the health belief model?​

A) ​Convince the smoker that there are no real barriers to smoking cessation.
B) ​Convince the smoker that risks of smoking outweigh barriers to quitting.
C) ​Offer the smoker a variety of strategies to address the barriers perceived.
D) ​Offer the smoker quitting techniques; they do not see barriers to quitting.

Question 30

The effects of anxiety on failure to comply are ______, and the effects of depression are _____.​

A) ​small . . . also small
B) ​small . . . large
C) ​large . . . also large
D) ​large . . . small

Question 31

The relationship between adherence and age is complex. For example, one study (Thomas et al., 1995) found that age had a(n) ______ relationship with adherence to colorectal screening.​

A) ​inverse
B) ​direct
C) ​curvilinear
D) ​dose-response

Question 32

Negative reinforcement _____ behavior.

A) strengthens
B) weakens
C) punishes
D) both b and c

Question 33

Research has found that which factors of the health belief model predict adherence to health behaviors most accurately?​

A) ​Perceived susceptibility to and severity of disease
B) ​Perceived benefits of and barriers to the behaviors
C) ​Perceived disease susceptibility and behavior benefits
D) ​Perceived disease severity and barriers to the behaviors

Question 34

An adherent patient who reduces her pain by taking prescribed medication as scheduled is an example of​

A) ​classical conditioning.
B) ​negative punishment.
C) ​positive reinforcement.
D) ​negative reinforcement.

Question 35

Research indicates that people who are compliant in one situation​

A) ​tend to be compliant in other situations.
B) ​tend to be noncompliant in other situations.
C) ​may or may not be compliant in other situations.
D) ​discontinue compliance when they change physicians.

Question 36

Women are more likely than men to show higher rates of adherence to a​

A) ​medication for high blood pressure.
B) ​smoking cessation program.
C) ​physical activity program.
D) ​healthy diet.

Question 37

Which of the following have researchers found about the predictive value of the health belief model?​

A) ​The model's prediction varies across factors and ethnic groups.
B) ​The model was not found predictive for ethnic minority groups.
C) ​The model is equally predictive among different ethnic groups.
D) ​The model's prediction is equivalent across factors and groups.

Question 38

What is a common criticism of the health belief model?​

A) ​It emphasizes motivational factors too little
B) ​It emphasizes behavioral factors too heavily.
C) ​It omits beliefs about health behavior control.
D) ​It omits beliefs about health behavior benefits.

Question 39

In the health belief model, which of the following is included among factors that combine to influence health behaviors?​

A) ​Actual barriers, including financial, to health behaviors
B) ​A patient's objective vulnerability to disease/disability
C) ​How severe a patient's disease or disability is in reality
D) ​The benefits of health behaviors perceived by a patient

Question 40

The following disease characteristic is the MOST accurate predictor of patient adherence:

A) severity of the disease as seen by the attending physician.
B) patient's perception of the severity of the disease.
C) severity of the medication's side effects.
D) a medication with no side effects.

Question 41

In the theory of planned behavior, which factor is unique?​

A) ​Subjective norms for behaviors
B) ​Intentions regarding behaviors
C) ​Attitudes concerning behaviors
D) ​Ideas about control of behaviors

Question 42

The transtheoretical model of James Prochaska and his colleagues assumes that people go through five stages in making changes in their behavior. What is the proper order of these changes?

A) Precontemplation, contemplation, preparation, action, and maintenance
B) Preparation, precontemplation, self-efficacy, intention to act, and action
C) Intention to act, contemplation, preparation for action, action, reaction
D) Intention to act, contemplation, preparation for action, action, relapse

Question 43

Which of the following is an assumption of the theory of planned behavior?​

A) ​People generally are not reasonable, and must be taught to plan their behavior.
B) ​People generally use information haphazardly, and must learn to be systematic.
C) ​People consider the consequences before decisions, and then always take action.
D) ​People consider the consequences before decisions, which can involve no action.

Question 44

The influences of environmental and social pressures on health behavior are accounted for better by

A) self-efficacy theory.
B) the health belief model.
C) the theory of planned behavior.
D) all of these theories/models equally.

Question 45

​Research into applications of the theory of planned behavior has found that subjective norms

A) ​were the strongest predictors of behaviors overall.
B) ​were equivalent in predicting all of the behaviors.
C) ​predicted behaviors for adults more than for teens.
D) ​were the weakest to predict most of the behaviors.

Question 46

What have researchers found about self-efficacy theory relative to health behaviors?

A) It is not predictive of adherence or medical results.
B) It is not related to reducing the severity of disease.
C) It is not included in most health behavior models.
D) It is not inclusive of other factors for motivation.

Question 47

Self-efficacy refers to​

A) ​people's belief that they can perform behaviors necessary to control events that influence their lives.
B) ​people's belief that their particular lifestyle is a healthy one even when it is not.
C) ​people's belief that a course of action will result in an ideal state of physical and psychological health.
D) ​people's belief that the processes of disease, and eventually death, are inevitable.

Question 48

Gina smokes two packs of cigarettes a day, but lately she has begun to think seriously about quitting. According to the transtheoretical model, Gina is in the _____ stage.

A) precontemplation
B) contemplation
C) action
D) maintenance

Question 49

​Dawson's dentist calls to remind him of his scheduled appointment in three days. When Dawson arrives at the dentist's office he is permitted to select a lottery ticket as a reward for keeping his appointment. From this information, it appears that Dawson's dentist is using an approach based on the _______ model of adherence.

A) ​health belief
B) ​self-efficacy
C) ​theory of planned behavior
D) ​behavioral theory

Question 50

The theory of planned behavior identifies ________ as immediately determining behavior.​

A) ​attitude toward the behavior
B) ​perceived control of behavior
C) ​intention regarding behavior
D) ​subjective norm for behavior

Question 51

Research on smoking relapse, adherence to an exercise regimen, and adherence to diabetic diet has shown that

A) those who had high self-efficacy were found more likely to relapse.
B) those who had high self-efficacy were found more likely to adhere.
C) self-efficacy has been found to correlate negatively with adherence.
D) self-efficacy prevents smoking relapse but does not affect the others.

Question 52

What is most accurate about evaluating the effectiveness of the health belief model and other continuum theories?​

A) ​Valid and reliable instruments to assess their factors are lacking.
B) ​Instruments for assessing their factors are valid, but not reliable.
C) ​Instruments for assessing their factors are reliable, but not valid.
D) ​There are only a few valid or reliable tests to assess their factors.

Question 53

What is an identified strength of continuum theories?​

A) ​They inform development of individualized interventions.
B) ​They identify a number of universally motivational beliefs.
C) ​They incorporate self-identity as predictive for behaviors.
D) ​They identify anticipated emotions as predicting behaviors.

Question 54

Researchers find American women eat more produce than American men. How does the theory of planned behavior explain this gender difference?​

A) ​By differing attitudes rather than differing perceived control
B) ​By differing perceived control rather than differing attitudes
C) ​By differing subjective norms more than attitudes or control
D) ​By differing subjective norms, but not for all cultural groups

Question 55

What did meta-analysis of many studies find regarding the predictive value of the theory of planned behavior?​

A) ​It best predicts behaviors for abstinence.
B) ​It best predicts use of alcohol and drugs.
C) ​It best predicts diet and physical activity.
D) ​It best predicts all risk-taking behaviors.

Question 56

Morton is 90 pounds overweight and has both high blood pressure and high serum cholesterol. However, it has never occurred to Morton that he might be a candidate for cardiovascular disease if he does not change his lifestyle. According to Prochaska's transtheoretical model, Morton is in the _____ stage.

A) precontemplation
B) maintenance
C) contemplation
D) final

Question 57

Which factor in the theory of planned behavior has most in common with Bandura's concept of self-efficacy?

A) A person's intention whether or not to perform an action
B) A person's belief of how much s/he can control an action
C) A person's assessment concerning outcomes of an action
D) A person's belief about social pressures to take an action

Question 58

Why does the theory of planned behavior vary in its predictive ability by behavior type?​

A) ​Risk-taking behaviors are more predictable than healthy behaviors.
B) ​Situation-specific behaviors are more predictable than planned ones.
C) ​Situation-specific behaviors are less predictable than planned ones.
D) ​The theory was not designed to predict ongoing individual choices.

Question 59

Bandura's notion of reciprocal determinism assumes that human conduct results from an interaction of behavior, person factors (such as cognition), and​

A) ​the environment.
B) ​outcome expectancies.
C) ​subjective norms.
D) ​intention to act.

Question 60

Because of the nature of health habits, what is true about predicting and changing health behaviors?​

A) ​Behaviors are often predicted more by people's beliefs than by their past behaviors.
B) ​Behavior is often best changed by changing people's beliefs about health behaviors.
C) ​Changing beliefs is motivating, but concrete skills and steps change behavior more.
D) ​Beliefs are more ingrained than habits; thus intention guarantees behavior change.

Question 61

According to the transtheoretical model, relapse​

A) ​is most likely during the maintenance stage.
B) ​is most likely during the action stage.
C) ​is equally likely during any stage.
D) ​is more likely in earlier stages.

Question 62

Research by Armitage and colleagues (2004) into Prochaska's health action process approach model found it was harder for people to transition​

A) ​from the contemplation to the preparation stage than other transitions.
B) ​from the action stage to the maintenance stage than other transitions.
C) ​from the preparation stage to the action stage than other transitions.
D) ​from any stage to the next than Prochaska theorized for transitions.

Question 63

The best predictors of health-related behavior in the health belief model are

A) perceived susceptibility and perceived barriers.
B) perceived severity and perceived barriers.
C) perceived benefits and perceived severity.
D) perceived barriers and perceived benefits.

Question 64

The model or theory that includes four beliefs-perceived susceptibility, perceived severity, perceived benefits, and perceived barriers-to predict health-related behavior is the​

A) ​self-efficacy theory.
B) ​health belief model.
C) ​health action process approach
D) ​theory of planned behavior.

Question 65

_____ is an individual's perception of the social pressure to perform or not to perform an action.​

A) ​Self-efficacy
B) ​Perceived behavioral control
C) ​Subjective norm
D) ​Attitude

Question 66

In the volitional phase of the health action process approach model, _________ is a crucial component of whether behavior change will be maintained over time.

A) outcome expectation
B) self-efficacy
C) risk perception
D) planning

Question 67

This model has two general stages: the motivational phase and the volitional phase.​

A) ​The health belief model
B) ​The transtheoretical model
C) ​The health action process approach
D) ​The theory of planned behavior

Question 68

In the health belief model, the belief that relates to whether an individual faces obstacles to health-enhancing behaviors is

A) perceived susceptibility.
B) perceived severity.
C) perceived benefits.
D) perceived barriers.

Question 69

__________ of health behavior take(s) a "one size fits all" approach.

A) Stage theories
B) Continuum theories
C) Response efficacy
D) Stages of change

Question 70

Central to the transtheoretical model is the assumption that both behavior change and relapse take the shape of a​

A) ​triangle.
B) ​rectangle.
C) ​cone.
D) ​spiral.

Question 71

The theory of planned behavior predicts

A) risky health behaviors.
B) intentional health behaviors.
C) unconscious health behaviors.
D) none of the above behaviors.

Question 72

One recent study used the theory of planned behavior to understand gender differences in fruit and vegetable consumption. This study found that men, in comparison to women, have:​

A) ​lower perceived behavioral control and higher subjective norms.
B) ​lower perceived behavioral control and less favorable attitudes.
C) ​less favorable attitudes and lower subjective norms.
D) ​higher favorable attitudes and higher subjective norms.

Question 73

The model or theory that suggests that behavior is shaped by one's intention to act or not act, and that intentions are shaped by attitudes, subjective norms, and perceived behavioral control is the​

A) ​self-efficacy theory.
B) ​health belief model.
C) ​health action process approach.
D) ​theory of planned behavior.

Question 74

For the past three years, Loran has been following his doctor's advice to cut down on his consumption of red meat and to eat more fruits and vegetables. With regard to protecting himself against heart disease, Loran is currently in which stage of the transtheoretical model?

A) Precontemplation
B) Contemplation
C) Maintenance
D) Preparation

Question 75

_____ refer(s) to people's confidence that they can perform a behavior to produce a desired outcome in a particular situation.​

A) ​Self-esteem
B) ​Self-efficacy
C) ​Outcome expectations
D) ​Perceived benefits

Question 76

In operant conditioning, "positive" means something is presented, and "negative" means something is removed. Though part of operant conditioning techniques, ________ is rarely used to modify non-adherent health behaviors.​

A) ​negative reinforcement
B) ​positive reinforcement
C) ​positive punishment
D) ​negative punishment

Question 77

In the health belief model, the belief that relates to an individual's perceived risk of a disease is​

A) ​perceived susceptibility
B) ​perceived severity.
C) ​perceived benefits
D) ​perceived barriers.

Question 78

According to Prochaska and his colleagues, people in which stages of the health action process approach model need strategies for directly changing their behaviors?​

A) ​Precontemplation and Contemplation
B) ​Contemplation and Preparation
C) ​Preparation and Action
D) ​Action and Maintenance

Question 79

_____ is an individual's perceptions of how much control one has over one's behavior, and is one factor that determines intentions in the theory of planned behavior.​

A) ​Self-efficacy
B) ​Perceived behavioral control
C) ​Subjective norm
D) ​Attitude

Question 80

The model or theory that defines five stages individuals move through as they adopt a health-related model is the​

A) ​behavioral theory.
B) ​transtheoretical model.
C) ​theory of planned behavior.
D) ​health action process approach.