Assessment of health behaviors

Abstract

Health behaviors belong to the broader category of health-directed activities. They are aimed at preventing or detecting illnesses at an asymptomatic stage. They include a wide range of behaviors, from dieting and exercising to condom use and smoke cessation. Health behaviors differ on a number of dimensions. For example, some require the avoidance of harmful activities, whereas others require that a person actively engages in desired behaviors. Some are relatively simple and are performed only occasionally. Others, however, are repeated, and they are embedded in important habit patterns. Therefore, the practice of one health behavior is often only weakly related to the practice of others. There are various methods to assess health behaviors. In rare occasions, physiological methods can be used. Since health behaviors are difficult to observe, their assessment often relies on self-reports. These reports generally take the form of statements about past behavioral frequencies. Sampling as well as nonsampling errors could decrease the internal and external validity of a survey. For example, seasonal effects may lead to superficial behavioral changes. In addition, the target population should be selected carefully, for instance, because health behaviors have different meanings or connotations for adolescents and adults. Furthermore, leading or loaded questions as well as respondents' knowledge and ‘nonattitudes’ can elicit distorted reports of health behaviors. Respondents may not recall the actual events, employing instead various cognitive heuristics (rules of thumb) to estimate frequencies. This could result in certain biases, such as time span effect or illusory superiority. These robust biases have important theoretical and practical implications.