Two Key Studies of Health Promotion (DP IB Psychology)

Key study one: Quist-Paulsen et al. (2003)

Aim: 

• To investigate the effect of fear arousal on rates for quitting smoking

Participants:

• 240 smokers below the age of 76 who had been admitted to the cardiac ward of a Norwegian hospital

Procedure: 

• Field experiment with random allocation of participants to either:

  • the ‘fear arousal’ (FA) condition - 118 participants 

  • the control condition - 122 participants 

• The FA condition:

  • hospital nurses recruited by the researchers gave the FA participants a booklet on the benefits of quitting smoking 

  • the booklet included graphs of mortality rates for smokers compared to non-smokers

  • participants were told that the likelihood of them having another smoking-related heart attack was high (the FA element of the intervention)

  • the FA participants were also given:

    • information on quitting smoking and remaining cigarette-free 

    • advice about nicotine replacement therapy 

    • an action plan to help deal with relapses

    • instructions not to smoke while in the hospital

    • advice on using nicotine patches

  • If their partners smoked, they were also asked to quit

• The control condition:

  • the same hospital nurses offered the control participants twice-weekly group sessions

  • in these sessions, a range of topics was discussed including quitting smoking

  • the control participants also watched a video

  • these participants were given a booklet on heart disease that included advice on quitting smoking

• The nurses then contacted the FA participants by phone nine times after they went home, to encourage them to stop smoking 

Results:

• After one year, 57% of the FA group had stopped smoking compared to 37% of the control group

Conclusion:

• Fear arousal may be an effective way of motivating smokers who are in danger of having a further heart attack to quit smoking

Fear arousal helps those who have suffered a heart attack to give up smoking to prevent relapse

Evaluation of Quist-Paulsen et al. (2003)

Strengths

• The use of a sample of real smokers who had already experienced cardiac problems gives the results of this research high ecological validity

• The fact that the FA was only used in the intervention group increases the validity of the claim that fear arousal makes the difference in smokers’ quitting rates 

Limitations

• It may have been the extra attention and support that the FA group was given that motivated the higher quitting rates rather than the FA element

• The control group participants did not experience the FA and subsequently showed a 20% lower incidence of quitting, which is an ethical concern

Key study two: Lowe et al. (2004)

Aim: 

• To investigate if social cognitive theory could be used to promote healthy eating in British schoolchildren

Participants: 

• 749 children, aged 5 - 11 years old 

• Participants attended one of two inner-city London primary schools. 

• One school served as the control group and the other school engaged in the healthy eating intervention called the Food Dudes Programme

Procedure: 

• This was a longitudinal field experiment 

• A baseline of consumption of fruit and vegetables eaten in both school and at home was taken:

  • children in both schools were given the option of consuming fruit and vegetables at lunchtime and the amount they ate was measured

  • younger children (aged 5 - 7) received fruit at snack time and the weight of this was recorded  

  • questionnaires were given to parents regarding their children’s eating behaviours  

• For 16 days children in the experimental school watched six-minute videos featuring the Food Dudes who:

  • are seen enjoying a range of fruit and vegetables

  • show that eating fruit and vegetables is the key to their power in defeating the evil ‘Junk Punks’ who eat junk food and want to destroy the world  

• This is how social cognitive theory is used in the experiment - to give the children role models whose behaviour they may imitate

• After each video, teachers read the children a letter from the Food Dudes, explaining: 

  • the need to fight the Junk Punks

  • the benefits of eating a healthy diet

  • how they could get prizes for eating well

• Each child in the experimental condition was given a ‘Food Dudes’ Home Pack’ 

• This home pack encouraged them to eat more fruit and vegetables at home 

• Their parents were encouraged to record what they were eating  

• This is the next step of social cognitive theory: explaining to them that they can ‘help,’ and giving them a plan to increase their self-efficacy

• After 16 days, the videos ended and the rewards for eating healthily were less frequent 

• Fruit and vegetable consumption levels were measured four months after the completion of the programme 

Results:

• Children in the experimental condition significantly increased their fruit and vegetable  consumption both at school and at home

• The greatest increase was seen in the children who at the beginning of the study had shown the lowest baseline consumption rates of fruit and vegetables 

• Four months later, they were still eating twelve times as much fruit as they had originally, and four times the quantity of vegetables 

• In the control school there was no change in the children’s fruit and vegetable consumption

Conclusion:

• This healthy eating programme based on the principles of  social cognitive theory was successful in changing the eating behaviour of young London schoolchildren

Evaluation of Lowe et al. (2004)

Strengths

• The study had a large sample size and the programme was highly standardised, allowing for potential replicability and suggesting the findings have high reliability 

• The longitudinal design, baseline measurements and use of a control group, allow for a cause-and-effect relationship to be demonstrated between the intervention and the increase in fruit and vegetable consumption

Limitations

• The findings of the study may not be generalised outside the target population of young schoolchildren aged between 5 and 11 years old

• The four-month follow-up may not be long enough to be sure of the long-term effects of the programme - a six-year follow-up of other schoolchildren who had taken the programme found no lasting effect  (Martin et al., 2017)