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d. dose response
25. 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.
26. 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.
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
28. 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.
29. 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.
30. 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.
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31. 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
32. 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.
33. 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.
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.
35. Negative reinforcement _____ behavior.
a. strengthens
b. weakens
c. punishes
d. both b and c
36. 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.
37. 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
38. 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.
39. 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.
40. 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.
41. 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
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42. 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
43. 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
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
45. 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.
46. 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.
47. __________ of health behavior take(s) a “one size fits all” approach.
a. Stage theories
b. Continuum theories
c. Response efficacy
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d. Stages of change
48. 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.
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
50. 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
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
52. _____ 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
53. 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.
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c. health action process approach.
d. theory of planned behavior.
54. _____ 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
55. _____ 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
56. The theory of planned behavior predicts ___________.
a. risky health behaviors
b. intentional health behaviors
c. unconscious health behaviors
d. none of the above
57. 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
58. 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
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59. 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.
60. 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.
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
62. 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.
63. 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.
64. 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.
65. 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.
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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.
66. _______ 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
67. __________ 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
68. __________ 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
69. 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.
True/False Questions
1. In assessing the rate of adherence, physician’s estimates are typically more accurate than the
patients’ judgments.
2. In general, adherence rates average about 75% to 80%.
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3. Contrary to common sense, people with strong social support are less likely to adhere to
medical advice.
4. Women have a higher rate of adherence than men do.
5. Educational approaches and behavioral approaches are about equally successful in improving
adherence.
6. A recent meta-analysis showed that adhering to a medical regime does not make any
difference in physical health outcomes.
7. Rates of non-adherence to medical regimes are around 70%.
8. Adherence is simply a matter of taking the proper pills and following short-term advice.
9. 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.
10. When examining how age relates to adherence, individuals who are young and individuals
who are old have the lowest rates of adherence.
11. Depression is more of a risk factor for nonadherence than anxiety is.
12. Reciprocal determinism is the concept that human action is the result of an interaction of
behavior, environment, and person factors.
13. People’s belief that they can control their environments is called self-efficacy.
14. The first stage of the transtheoretical model is called the precontemplation stage.
15. The theory that includes four beliefs—perceived susceptibility, perceived severity, perceived
benefits, and perceived barriers—to predict health-related behavior is the theory of planned
behavior.
16. One criticism of both stage and continuum theories is that they fail to account for the
demographic and economic factors that may affect people’s health behaviors.
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17. The behavioral model utilizes components of operant conditioning to understand health
behavior change.
18. Intentions have been shown to reliably predict future behavior.
19. Maria decided that she wants to start exercising again and made a plan to “go to the gym
after work on Tuesday and Thursday for 1 hour.” This is an example of implementation
intentions.
Essay Questions
1. Using the transtheoretical model, explain the behavior of a 22-year-old woman who quit
smoking three days ago.
2. What assessment issues have an impact on understanding adherence rates?
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3. How frequent are adherence failures?
4. Evaluate the contribution of personal factors to adherence to medical advice.
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5. Discuss ways to improve adherence.
6. What are stage theories of health behavior change? How do they differ from continuum
theories?
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