PSYC6002 – Psychology and the Delivery of Health Care

Module Profile

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Overview

The module will consider key factors in the delivery of health care, including health promotion, and care for primary and tertiary based patients and their families. It will include consideration of interpersonal skills, information transmission and other influences on patient behaviour.

Assessment

Formative feedback is provided in class through learning activities including small group work and discussions.

The learning outcomes for this module are assessed through one exam and two pieces of coursework:

• Exam (40 %) 2-hours
• Cousework (60 %)
• Skills porfolio (0%)

Exam

In the 2-hour exam you will choose 2 essay questions to answer out of 4 options.  Further details will be provided in class.

Coursework

A 3000 word ‘mini’ systematic review.  This will be discussed in class (systematic review lecture and separate tutorial), further details are available on Blackboard.

Skills portfolio

In order to complete the Skills Portfolio PSYC6002, you will attend a number of specific sessions on the MSc Health Psychology Skills Training Programme. You will also upload specific documentation regarding these sessions, typically a short reflective log. A complete portfolio must be submitted in order to Pass this module.  For details about the portfolio, please see the MSc Health Psychology Skills Programme module on Blackboard.

Note on Referrals

Students who fail the exam will take a resit.  Students who fail the coursework will redo the coursework.

Lecture Outlines

Week 1: The Real-World Relevance of Health Psychology (Felicity Bishop)

Can health psychology give answers to important real-world problems and, in particular, can it make significant analytical observations that contribute to the identification of solutions to such social problems? Can it offer theories supported by evidence to make the world a better place? After millions of published words in books and articles, underwritten by major research spending, can health psychology tell us anything valuable about a range of the major issues confronting global society today? What are the arguments for a problem-driven as opposed to a methods-driven approach to the agenda of health psychology? Does a focus on relevance undermine the independence of research and lead health psychology into an unholy alliance with power-holders? Does it move us from the role of experts to activists?  What is the role of critical health psychology and action research in health psychology?

Essential class readings:

Crossley, M.L. (2000). Rethinking Health Psychology. Open University Press. (chapters 3, 4 and 5).  Chapters 1 and 2 also recommended.

Hunt, K., McCann, C., Gray, C.M., Mutrie, N., & Wyke, S. (2013). “You’ve got to walk before you run”: Positive evaluations of a walking program as part of a gender-sensitized, weight-management program delivered to men through professional football clubs. Health Psychology, 32, 57-65.

Prilleltensky, I., & Prilleltensky, O. (2003). Towards a Critical Health Psychology practice. Journal of Health Psychology, 8, 197-210.

Reason, P. & Riley, S. (2008).  Co-operative inquiry: an action research practice.  In J.A. Smith (Ed). Qualitative psychology: a practical guide to research methods.

Additional background readings:

Flyvbjerg, B. (2001). Making Social Science Matter. Cambridge: Cambridge University Press.

Hepworth, J. (2006) The emergence of Critical Health Psychology: Can it contribute to promoting public health? Journal of Health Psychology, 11, 331-341.

Horrocks C., Johnson S. (Eds.). (2012). Advances in Health Psychology: Critical Approaches. Basingstoke: Palgrave Macmillan.

Marks, D.F., Murray, M.P., Evans, B., & Estacio, E.V. Health Psychology: Theory, Research and Practice (3^rdEd).  London: Sage.

Mielewczyk F., Willig C. (2007), Old clothes and an older look. The case for a radical makeover in health behaviour research. Theory & Psychology, 17(16), 811-837.

Murray M. (Ed.). (2014) Critical Health Psychology, 2^nd edition. Basingstoke: Palgrave Macmillan.

White, J., Woodward, J., & South, J. (2013).  Addressing inequalities in health – what is the contribution of health trainers?  Perspectives in Public Health, 133, 2013-20.

Journal of Health Psychology (lot of papers on Critical Health Psychology) https://journals.sagepub.com/home/hpq

International Society of Critical Health Psychology website.

 

Week 2: Systematic Reviews (Felicity Bishop & Vicky Fenerty)

This session focuses on systematic literature reviews as a tool in health psychology. The session will discuss why psychologists conduct and use systematic reviews. It will also give an overview of how systematic reviews are conducted and reported. The session will be helpful for preparing students for the 6002 mini systematic review assignment and will conclude with a briefing about this assignment.

 The practical library session covers skills which will help support students conducting literature searches for their mini systematic review assignments, and indeed any other academic work. Vicky Fenerty will demonstrate strategies and share tips for conducting comprehensive and focused searches within electronic databases.

Essential class readings:

Moher D, Liberati A, Tetzlaff J, Altman D. Preferred reporting items for systematic reviews and meta-analysis: the PRISMA statement. BMJ 2009;339 (doi:10.1136/bmj.b2535).

Petticrew, M. & Gilbody, S. (2004). Planning and conducting systematic reviews (Ch. 8). In Susan Michie & Charles Abraham (Eds) Health Psychology in Practice, UK: BPS Blackwell.

Additional background readings:

Barnett-Page E & Thomas J. (2009). Methods for the synthesis of qualitative research: a critical review. BMC Medical Research Methodology 9, 59. DOI: 10.1186/1471-2288-9-59

Boutron, I., Moher, D., Altman, D., Schulz, K., Ravaud, P. (2008). Extending the CONSORT statement to randomized trials of nonpharmacological treatment: explanation and elaboration. Annals of Internal Medicine, 148, 295-309.

Gough, D., Oliver, S., & Thomas, J. (2012). An introduction to systematic reviews. Sage Publications.

Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.handbook.cochrane.org.  Other chapters in Part 2 of the Cochrane Handbook also provide useful information on systematic review methods.

 

Week 3: Communication in Health Care (Christina Liossi)

In this session we will explore communication between health care professionals and their patients. We will explore styles of communication and how these effect patient participation in decision making, satisfaction with treatment, and the individual’s subsequent self-care. The breaking of bad news, communicating differential risk data and supporting patient decision making will all be considered. The session will consider factors that influence communication between patient and provider, both in the external and internal environment of the communicator. The core skills of good communication will be reviewed. You will evaluate your own communication skills and consider how they could develop these further. This will lead into the examination of the development of training programmes for health care professionals.

Essential class readings:

Lewin, S., Skea, Z., Entwistle, V.A., Zwarenstein, M., Dick, J. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD003267. DOI: 10.1002/14651858.CD003267.

Bensing, J. (2000). Bridging the gap. The separate worlds of evidence-based medicine and patient-centred medicine. Patient Education and Counselling, 39(1), 17-25.

Additional background readings:

Pedersen, R. (2009). Empirical research on empathy in medicine-A critical review. Patient Education and Counseling, 76(3), 307-322.

Roter, D. (2000). The enduring and evolving nature of the patient-physician relationship. Patient Education and Counselling, 39(1), 5-15.

 

Week 4: Screening in Health Care (Cynthia Graham)

Psychological issues and ethical implications of screening will be discussed. Screening is “any intervention that involves providing information about the chances that an asymptomatic individual will develop a particular disease.” This includes genetic testing for conditions such as hereditary breast cancer, or assessing current medical history and lifestyle factors that could lead to conditions such as diabetes and high blood pressure. The session will present and discuss the psychological issues involved in the various aspects of screening, e.g. invitations for screening tests, whether or not people attend for the tests, waiting for and receiving the results, and the impact of results on emotional, cognitive and behavioural outcomes. Different theoretical frameworks for understanding behavioural responses to screening will also be discussed.

Essential class readings:

Cooke, R., & French, D. P. (2008). How well do the theory of reasoned action and theory of planned behaviour predict intentions and attendance at screening programmes? A meta-analysis. Psychology & Health, 23, 745-765.

Marteau, T. M. & Weinman, J. (2006). Self-regulation and the behavioural response to DNA risk information: A theoretical analysis and framework for future research, Social Science & Medicine, 62, 1360-1368.

Hagger, M. S. & Luszczynska, A. (2014). Implementation intention and action planning interventions in health contexts: state of the research and proposals for the way forward. Applied Psychology: Health and Well-being, 6, 1-47.

Additional background readings:

Anandan, A., Kirby, S., Lykins, A., & Graham, C. A. (2014). Predictors of intentions to have pelvic examinations among a U.K. sample of young Asian and non-Asian women.International Journal of Sexual Health, 26, 258-267.

Brett, J. et al. (2005). The Psychological Impact of Mammographic Screening. A Systematic Review. Psycho-Oncology, 14, 917-938.

Gaff, C. L., Clarke, A. J., Atkinson, P., Sivell, S., Elwyn, G., Iredale, R., et al. (2007). Process and outcome in communication of genetic information within families: A systematic review. European Journal of Human Genetics, 15, 999-1011.

Goldsmith, M. R., Bankhead, C. R., Kehoe, S. T., Marsh, G., & Austoker, J. (2007). Information and cervical screening: A qualitative study of women’s awareness, understanding and information needs about HPV. Journal of Medical Screening, 14, 29-33.

Lerman, C., Croyle, R. T., Tercyak, K. P., & Hamann, H. (2002). Genetic testing: Psychological aspects and implications. Journal of Consulting and Clinical Psychology, 70, 784-797.

Ready, K., Haque, I. S., Srinivasan, B. S., & Marshall, J. R. (2012). Knowledge and attitudes regarding expanded genetic carrier screening among women’s healthcare providers. Fertility & Sterility, 97, 407-413.

Ringwald et al. (2016) Psychological distress, anxiety, and depression of cancer-affected BRCA1/2 mutation carriers: a systematic review. Journal of Genetic Counseling, 1 April 2016- 1-16.   

Spencer,  A.M., & Roberts S. A., Brabin L et al. (2014). Sociodemographic factors predicting mother’s cervical screening and daughter’s HPV vaccination uptake. Journal of Epidemiology and Community Health, 68, 571-577.

Wardle J., Williamson, S., McCaffery, K., Sutton, S., Taylor, T., Edwards R. et al. (2003). Increasing attendance at colorectal cancer screening: Testing the efficacy of a mailed, psychoeducational intervention in a community sample of older adults. Health Psychology, 22, 99-105.

 

Week 5: Designing and Evaluating Complex Interventions (Felicity Bishop)

In this session you will be introduced to the MRC framework for complex interventions as a framework to guide the development of health psychology interventions. We will critically discuss issues around the design of studies in behavioural medicine including treatment fidelity and the control group dilemma. We will discuss the use of CONSORT guidelines for reporting results from RCTs.

Essential class readings:

Boutron, I. Moher, D. Altman, D. G. Schulz, K. F., & Ravaud, P. (2008). Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine, 148(4), 295-309.

Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008). Developing and evaluating complex interventions: The new Medical Research Council guidance. British Medical Journal, 337, 979-983.

Additional background readings:

Bellg, A. J. et al. (2004). Enhancing treatment fidelity in health behaviour change studies: Best practices and recommendations from the NIH behaviour change consortium. Health Psychology, 23, 443-451.

Bishop FL, Fenge-Davies AL, Kirby S & Geraghty AWA. (2015) Context effects and behaviour change techniques in randomised trials: A systematic review using the example of trials to increase adherence to physical activity in musculoskeletal pain. Psychology & Health, 30:1, 104-121, DOI: 10.1080/08870446.2014.953529

Hardeman, W., Michie, S., Fanshawe, T., Prevost, A., McLoughlin, K., & Kinmonth, A. L. (2008). Fidelity of a physical activity intervention: predictors and consequences.Psychology and Health, 23, 11-24.

 

Week 6: Stress Management Approaches (Christina Liossi)

In this primarily experiential session you will learn different stress management techniques including relaxation, cognitive restructuring and problem solving. You will experience these interventions by practicing in couples during class. The effectiveness of stress management approaches in the management of various chronic conditions will also be critically appraised.

Essential class readings:

Rees, K., Bennett, P., West, R., Davey Smith, G., & Ebrahim S. (2004). Psychological interventions for coronary heart disease. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD002902. DOI: 10.1002/14651858.CD002902.pub2

García-Vega, E., & Fernandez-Rodriguez, C. (2004). A stress management programme for Crohn’s disease. Behaviour Research and Therapy, 42(4), 367-383.

 

 

Week 7: Hospital Based Interventions (Christina Liossi)

This session will evaluate a range of psychological interventions applicable to the hospital arena. It will focus primarily on evidence based interventions used to prepare children for medical procedures and surgery.

Essential class reading:

Chundamala, J., Wright, J. G., & Kemp, S. M. (2009). An evidence-based review of parental presence during anesthesia induction and parent/child anxiety. Can J Anaesth, 56(1), 57-70.

 

 

Week 8: Behaviour change interventions (Katherine Bradbury)

This session will consider interventions designed to change health behaviours, drawing on examples of interventions to modify a range of health behaviours, including hand hygiene, eating and physical activity. We will consider how and why we need to draw on evidence, psychological theory and user-centred development to develop and evaluate behavoiur change interventions. We will review the use of approaches such as the PRECEDE-PROCEED framework, the Behaviour Change Wheel, the RE-AIM framework, and the ‘Person-Based Approach’. You will gain experience of applying elements of these frameworks to the design and evaluation of interventions.

Learning outcomes:

By the end of this session students should: be able to identify theory-based components of published lifestyle interventions; be familiar with some current frameworks and approaches used in the design and evaluation of lifestyle modification interventions; understand the core issues surrounding the development and evaluation of evidence, theory and person-based interventions.

Essential class readings:

O’Cathain, A., Croot, L., Sworn, K., Duncan, E. A. S., Rousseau, N., Turner, K., … Hoddinott, P. (2019). Taxonomy of approaches to developing interventions to improve health: a systematic methods overview. Pilot and Feasibility Studies, 5, [41]. DOI: 10.1186/s40814-019-0425-6

Yardley L, Morrison L, Bradbury K, Muller I (2015). The Person-Based Approach to Intervention Development: Application to Digital Health-Related Behavior Change Interventions.  Journal of Medical Internet Resesearch;17(1):e30.

Additional Background Readings:

Bradbury, K., Steele, M., Corbett, T., Geraghty, A., Krusche, A., Heber, E. D., … Yardley, L. (2019). Developing a digital intervention for cancer survivors: An evidence, theory and person-based approach. npj Digital Medicine, 1-13. DOI: 10.1038/s41746-019-0163-4

Glasgow, R. E., Klesges, L. M., Dzewaltowski, D. A., Bull, S. S., & Estabrooks, P. (2004). The future of health behavior change research: what is needed to improve translation of research into health promotion practice? Annals of Behavioral Medicine, 27, 3-12.

Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J. & Wood, C. E. (2013). The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions. Annals of Behavioral Medicine, 46(1), pp. 81-95.

O’Cathain, A., Croot, L., Duncan, E. A. S., Rousseau, N., Sworn, K., Turner, K., … Hoddinott, P. (2019). Guidance on how to develop complex interventions to improve health and health care. BMJ Open, 9(8), 1-9. [e029954]. DOI: 10.1136/bmjopen-2019-029954

 

Week 9: Understanding and Improving Adherence (Felicity Bishop)

We will begin this session by considering what is meant by adherence, and how this relates to similar concepts in the literature such as compliance and concordance. The empirical and theoretical rationale for the validity of these concepts will be reviewed and the concepts of self-care and self-management considered. The latter half of the session will focus on doctor and patient factors which influence adherence to medical regimes. Interventions for improving adherence will be discussed.

Essential class readings:

DiMatteo MR , Haskard-Zolnierek KB & Martin LR. (2012). Improving patient adherence: a three-factor model to guide practice. Health Psychology Review, 6(1), 74-91. http://dx.doi.org/10.1080/17437199.2010.537592.

Horne R, Chapman SCE, Parham R, Freemantle N, Forbes A, et al. (2013) Understanding Patients’ Adherence-Related Beliefs about Medicines Prescribed for Long-Term Conditions: A Meta-Analytic Review of the Necessity-Concerns Framework. PLOS ONE 8(12): e80633. doi: 10.1371/journal.pone.0080633

Nieuwlaat R, Wilczynski N, Navarro T, Hobson N, Jeffery R, Keepanasseril A, Agoritsas T, Mistry N, Iorio A, Jack S, Sivaramalingam B, Iserman E, Mustafa RA, Jedraszewski D, Cotoi C, Haynes RB. Interventions for enhancing medication adherence. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD000011. DOI: 10.1002/14651858.CD000011.pub4.

Additional background readings:

Anderson, R. M. (1995). Patient empowerment and the traditional medical model: A case of irreconcilable differences? Diabetes Care, 18, 412-415.

Berry, D. Michas, I. & Bersellini, E. (2002). Communicating information about medication side effects: Effects on satisfaction, perceived risk to health,and intention to comply. Psychology & Health, 17, 247-267.

Bersellini, E. & Berry, D. (2007). The benefits of providing benefit information: Examining the effectiveness of provision of simple benefit statements on people’s judgements about a medicine. Psychology & Health, 22, 61-82.

Bishop, F. L., Yardley, L., Cooper, C., Little, P., & Lewith, G. (2017). Predicting adherence to acupuncture appointments for low back pain: a prospective observational study. BMC Complementary and Alternative Medicine, 17, 5. http://doi.org/10.1186/s12906-016-1499-9

Clifford, S., Barber, N., Horne, R. (2008): Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework. Journal of Psychosomatic Research, 64, 41-46.

DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23, 207-218.

Garber, M. C., Nau, D. P., Erickson S.R., Aikens, J. E., Lawrence, J.B. (2004): The concordance of self-report with other measures of medication adherence: a summary of the literature. Medical Care. 42, 649-652.

Haskard-Zolnierek, K.B. DiMatteo, M.R. (2009) Physician communication and patient adherence to treatment: A meta-analysis. Medical Care. 47(8):826-834

Horne, R., Weinman, J., & Hankins, M. (1999). The Beliefs about Medicines Questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology and Health, 14, 27-43.

 

Week 10: Developing Tailored Digital Interventions (Kate Greenwell)

This session will explore issues related to the design of digital interventions for changing health-related behaviour.  In the first part of the session we will look at how digital interventions can be defined, their advantages and disadvantages, and critically discuss their effectiveness using empirical and theoretical evidence. We will also examine issues around designing interventions for different types of user such as patients versus healthcare professionals. In the second part of the session we will consider more practical issues related to conducting research on digital interventions – how do you build digital interventions? What methods can you use to evaluate them? What opportunities and challenges are posed by rapid technological advancement?

Essential class readings:

Michie, S., Yardley, L., West, R., Patrick, K., & Greaves, F. (2017). Developing and evaluating digital interventions to promote behaviour change in health and health care: Recommendations resulting from an international workshop. Journal of Medical Internet Research, 19(6), e232. doi: 10.2196/jmir.7126

Lustria, M. L. A., Cortese, J., Gerend, M., Schmitt, K., Kung, Y. M., & McLaughlin, C. (2016). A model of tailoring effects: A randomized controlled trial examining the mechanisms of tailoring in a web-based STD screening intervention. Health Psychology, 35(11), 1214-1224. doi:10.1037/hea0000399

Additional background readings:

Theme issue on “Digital health: Leveraging new technologies to develop, deploy, and evaluate behaviour change interventions” in American Journal of Preventive Medicine, 2016, Vol 51, issue 5, see: https://www.ajpmonline.org/issue/S0749-3797(16)X0010-4

Dennison, L., Morrison, L., Conway, G., & Yardley, L. (2013). Opportunities and challenges for smartphone applications in supporting health behaviour change: Qualitative study. Journal of Medical Internet Research, 15(4), e86.

Hawkins, R. P., Kreuter, M., Resnicow, K., Fishbein, M., & Dijkstra, A. (2008). Understanding tailoring in communicating about health. Health Education Research, 23(3), 454-466. doi: 10.1093/her/cyn004

Lupton, D. (2014). Critical perspectives on digital health technologies. Sociology Compass, 8(12), 1344-1359. doi: 10.1111/soc4.12226

Nahum-Shani, I., Smith, S. N., Spring, B. J., Collins, L. M., Witkiewitz, K., Tewari, A., & Murphy, S. A. (2018). Just-in-time adaptive interventions (JITAIs) in mobile health: Key components and design principles for ongoing health behaviour support. Annals of Behavioral Medicine, 52(6), 446-462. doi:10.1007/s12160-016-9830-8

Petty, R. E., & Cacioppo, J. T. (1986). The elaboration likelihood model of persuasion. Advances in Experimental Social Psychology, 19, 123-205. doi:10.1016/S0065-2601(08)60214-2

Yardley, L., Spring, B. J., Riper, H., Morrison, L. G., Crane, D. H., Curtis, K., … & Blandford, A. (2016). Understanding and promoting effective engagement with digital behaviour change interventions. American Journal of Preventive Medicine, 51(5), 833-842. doi: 10.1016/j.amepre.2016.06.015

Week 11: Leadership, Policy and Strategic Development in Health Care (Sarah Kirby)

In this session you will consider some of the professional issues involved in health care and health psychology. The session will introduce and explore theories and issues relating to the areas of leadership and collaboration with others, the management of change, and the development of policy and strategic development in health care.

Essential class readings:

DeLeon, P. H., Kazdin, A. E. (2010). Public Policy: Extending Psychology’s Contribution to National Priorities. Rehabilitation Psychology, 55(3), 311-319.

Additional background readings:

Duddle, M. & Boughton, M. (2007). Intraprofessional relations in nursing. Journal of advanced nursing, 59(1), 29-37.

Government Public Health White paper (2004). Choosing Health: Making healthy choices easier. Published by the Department of Health http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4094550

Iles V., & Cranfield, S. (2004). Managing change in the NHS: Developing change management skills. A resource for healthcare professionals and managers. http://www.netscc.ac.uk/hsdr/-management-developing-skills.pdf *this is a 280 page report – you only need to skim through it in part to get a feel for how the authors approach the topic.

Kripalani, S., LeFevre, F., Phillips, C. O., Williams, M. V., Basaviah,P., & Baker, D. W. (2007). Deficits in Communication and Information Transfer Between Hospital-Based and Primary Care Physicians Implications for Patient Safety and Continuity of Care. JAMA, 297, 831-841.

Munir F., Nielsen, K., & Carneiro, I. G. (2010). Transformational leadership and depressive symptoms: A prospective study. Journal of Affective Disorders,120(1-3), 235-9.

Week 12:  Tutorial (Felicity Bishop)

This session will review the module, provide guidance on the exam, and offer an opportunity to meet individually with the module co-0rdinator for feedback on the coursework.