Deck 4: Adhering to Healthy Behavior

Question 1

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 1

both a and b

Question 2

Which type of social support is beneficial for adherence?

A) living with a family
B) belonging to a large family, even one that experiences a lot of conflict
C) being married
D) both a and c

Answer 2

both a and c

Question 3

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.

Answer 3

ability to count the number of bottle openings and record the time of day for each opening.

Question 4

_______ 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 5

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

A) age
B) sex
C) social class
D) A combination of the above factors is more accurate than any one.

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

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

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

Question 8

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

Question 9

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 not comply with a physician's advice but may comply with a practitioner from the same cultural tradition.
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 a physician.

Question 10

Using hospital personnel to monitor patient adherence

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

Question 11

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 12

Practitioners' accuracy when judging adherence of patients is

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

Question 13

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 14

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 15

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 16

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 17

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

A) physician judgment
B) patient judgment
C) examination of biochemical evidence
D) monitoring medication usage

Question 18

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 19

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 20

Of all methods used to assess patient adherence,

A) only pill count is both reliable and valid.
B) examination of biochemical evidence is clearly superior.
C) examination of biochemical evidence is least valid.
D) no single method is sufficiently reliable or valid.

Question 21

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 22

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) a person's subjective norms.
D) intention to act.

Question 23

Research conducted on the adherence of children with asthma revealed that

A) behavioral techniques were largely ineffective.
B) behavioral techniques were effective, but the lack of an educational component was a drawback.
C) the children named rewards as the most effective approach.
D) children responded to rewards but adolescents did not.

Question 24

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 reasoned action
D) behavioral

Question 25

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 26

Negative reinforcement _____ behavior.

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

Question 27

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

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

Question 28

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 29

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

A) those with high self-efficacy quickly relapsed.
B) those with high self-efficacy were more likely to be adherent.
C) self-efficacy has a negative correlation with adherence.
D) self-efficacy is an advantage for smoking relapse but is not important for exercise or diet.

Question 30

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 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

The behavioral model of adherence

A) emphasizes reinforcement of compliant behaviors.
B) emphasizes punishment of noncompliant behaviors.
C) includes the concept of subjective norms.
D) has very little supporting evidence.

Question 33

The noncompliant personality

A) has not been found to exist.
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 34

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) will discontinue compliant behavior when they change physicians.

Question 35

In Stage 2 of the precaution adoption process model,people are aware of a hazard,but they believe that others are at risk,and they are not.This attitude is called

A) an optimistic bias.
B) a pessimistic bias.
C) a rationalization.
D) the ostrich effect.

Question 36

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 37

Self-efficacy refers to

A) people's belief that they can perform those behaviors necessary to bring about control over 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 attitude toward the inevitability of disease and death.

Question 38

With regard to age,studies show that nonadherence

A) increases with age.
B) decreases with age.
C) has a curvilinear relationship with age.
D) is not related to age.

Question 39

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 40

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 41

Though part of operant conditioning tactics,________ is rarely used to modify nonadherent health behaviors.

A) negative reinforcement
B) positive reinforcement
C) punishment
D) implementation intentions

Question 42

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 43

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 44

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 45

_____ 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 46

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 47

The theory of planned behavior predicts ___________.

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

Question 48

_____ is an individual's perceptions of how much control exists 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 49

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

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

Question 50

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

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

Question 51

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

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

Question 52

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 53

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

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

Question 54

__________ 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 55

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

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

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 theory,Morton is in the _____ stage.

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

Question 57

The model that has seven stages that individuals would move through as they adopt a health-related model is the

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

Question 58

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

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

Question 59

According to the transtheoretical model,relapse

A) is most likely during the maintenance stage.
B) is most likely during the action stage.
C) is possible during any stage.
D) is unlikely past the action stage but more likely in earlier stages.

Question 60

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 61

__________ refers to people's motivation at a given moment to engage in a risky behavior.

A) Behavioral willingness
B) Perceived behavioral control
C) Subjective norms
D) Implementation intentions

Question 62

One strategy to improve adherence is tailoring the regimen; an example is

A) a written contract that both patient and practitioner sign.
B) a series of educational lectures that detail the consequences of nonadherence.
C) using text messages to prompt people to take their medication.
D) offering financial assistance to help people pay for medications.

Question 63

Contrary to common sense,people with strong social support are less likely to adhere to
medical advice.

Question 64

61. 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 65

The final stage of Weinstein's precaution adoption process model centers on

A) the optimistic bias.
B) maintaining the precaution.
C) becoming aware of the danger.
D) accepting personal responsibility.

Question 66

Depression is more of a risk factor for nonadherence than anxiety is.

Question 67

In general,adherence rates average about 75% to 80%.

Question 68

Rates of non-adherence to medical regimes are around 70%.

Question 69

Patients who need to take 4-5 pills a day often have lower rates of adherence than those patients who are taking 1-2 pills a day.

Question 70

A recent meta-analysis showed that adhering to a medical regime does not make any difference in physical health outcomes.

Question 71

When examining how age relates to adherence,individuals who are young and individuals who are old have the lowest rates of adherence.

Question 72

Educational approaches and behavioral approaches are about equally successful in improving
adherence.

Question 73

Women have a higher rate of adherence than men do.

Question 74

The technique of motivational interviewing may be applied to adherence

A) but no studies have tested this approach.
B) to alter a client's motivation to enact changes in behavior.
C) and this approach is effective with male but not with female patients.
D) to motivate patients to move from the action to the contemplation stage.

Question 75

Adherence is simply a matter of taking the proper pills and following short-term advice.

Question 76

In Stages 4 and 5 of the precaution adoption process model,people either decide to take action or they

A) decide not to take action.
B) take action without making a decision.
C) skip to Stage 7.
D) deny any personal susceptibility.

Question 77

_______ methods for improving adherence increase knowledge,however ______ approaches have been shown to increase adherence.

A) Educational; behavioral
B) Educational; socioeconomic
C) Behavioral; educational
D) Socioeconomic; educational

Question 78

In assessing the rate of adherence,physician's estimates are typically more accurate than the
patients' judgments.

Question 79

__________ refers to specific plans that individuals can make that identify what,where,when,and how they will engage in a health behavior.

A) Behavioral willingness
B) Perceived behavioral control
C) Subjective norms
D) Implementation intentions

Question 80

Julia,an 18-year old girl,sees many of her friends smoking.Research on risky behaviors in teenagers suggest that Julia is likely to

A) report high perceived behavioral control not to smoke.
B) report more willingness to engage in smoking.
C) report less willingness to engage in smoking.
D) report less favorable attitudes toward smoking.