Health Psychology A2 overview and key studies
- Syllabus
- 9990–2028–2029
- Topic
- —
- Level
- A2
Learning objectives
—Health Psychology overview• Specialist Option 3: Health Psychology- Health psychologists look at the factors that influence behaviours in both health and community settings. For this option, candidates will look at psychological factors that influence health, and will also examine the management and assessment of health-related behaviours linked to stress, pain and non-adherence to medical advice. Candidates should have the opportunity to explore the different issues and debates relevant to the psychological theories and concepts and the research methods used to investigate health-related behaviour. For all topics and studies, candidates should be able to:- describe, evaluate and compare the psychological theories, research, approaches, explanations and treatments/therapies.- describe and evaluate research methods and methodological concepts (for AS and A Level)- consider how the topic area relates to psychological issues and debates (for AS and A Level)- apply the findings of the study and topic area to the real world. After each topic there is a list of issues and debates and research methodology which are most relevant to the topic. This list is not exhaustive and teachers may use other relevant issues and methodology in their teaching.—Health Psychology key studies• Key studies for Health Psychology- Savage, R and Armstrong, D (1990), Effect of a general practitioner's consulting style on patients' satisfaction: a- controlled study. BMJ: British Medical Journal, 301(6758): 968-70- Yokley, J M and Glenwick, D S (1984), Increasing the immunization of preschool children; an evaluation of- applied community interventions. Journal of Applied Behavior Analysis, 17(3): 313-25- Brudvik, C, Moutte, S D, Baste, V and Morken, T (2017), A comparison of pain assessment by physicians,- parents and children in an outpatient setting. Emergency Medicine Journal, 34(3): 138-44- Bridge, L R, Benson, P, Pietroni, P C and Priest, R G (1988), Relaxation and imagery in the treatment of breast- cancer. BMJ: British Medical Journal, 297: 1169-72- Shoshani, A and Steinmetz, S (2014), Positive Psychology at School: A School-Based Intervention to Promote- Adolescents' Mental Health and Well-Being. Journal of Happiness Studies, 15(6): 1289-1311—Health Psychology key-study requirements• For each key study, candidates should know, understand and evaluate- the context of the study and relationship to other studies- the main theories/explanations included in the study- the aim(s) and hypotheses of the study [if stated]- the design of the study, including all methodology as appropriate, such as the research method(s) used, sample size and demographics [if known] and sampling technique [if known], procedure, technique for data collection- the results, findings and conclusions of the study- the main discussion points of the study.- describe and evaluate research methods used in and methodological concepts included in the study (for AS and A Level)- describe and evaluate the psychological issues and debates (for AS and A Level) included in the study.
Health psychology links behaviour, care and community outcomes
| Health-psychology job | Core question | Evidence example |
|---|---|---|
| Explain | Why do people experience/respond to health risk, pain or stress differently? | Cognitive appraisal, learning, social context and biology |
| Assess | How can pain, stress, satisfaction or adherence be measured validly? | Self-report, behavioural record, observation and physiological/objective data |
| Manage/treat | Which psychological or service intervention changes experience/behaviour? | Communication style, relaxation, access, prompts or positive-psychology programme |
| Prevent/community | How can environments increase healthy action before illness worsens? | Immunisation access/incentives and school intervention |
| Recurring Health area | Behavioural relationship to learn |
|---|---|
| Practitioner–patient | Communication and decision style influence satisfaction, information and adherence |
| Adherence/community care | Prompts, access, reinforcement and beliefs alter following medical advice |
| Pain | Pain is subjective; child, parent and clinician ratings may diverge |
| Stress/illness | Appraisal and coping can affect mood and quality of life during treatment |
| Health promotion | School/community systems can build protective behaviour and well-being |
For every claim use the same chain: define the construct → explain the proposed mechanism → identify how it was operationalised → state the observed result → restrict the conclusion to the sample, setting and outcome. An application is justified only when that chain supports it.
| Debate/method lens | Health-specific question |
|---|---|
| Individual–situational | Is behaviour driven by beliefs/person differences, or by practitioner, access and environment? |
| Reductionism–holism | Does one variable isolate a mechanism while omitting social/biological context? |
| Determinism–free will | Does an intervention bias behaviour while preserving informed agency? |
| Ethics | Can treatment, deception, incentives or vulnerable samples be justified and consented? |
| Validity/generalisation | Does a score/clinic/school predict actual health and transfer across groups/cultures? |
Health psychology neither replaces biological medicine nor treats behaviour as blame. It studies how psychological and contextual processes influence health experience and action, and evaluates interventions on the outcomes they actually measured.
Five key studies connect communication, adherence, pain, coping and prevention
| Savage & Armstrong (1990) | Evidence map |
|---|---|
| Question/design | Directing versus sharing GP style; randomised controlled study with one inner-London GP |
| Sample/measure | 359 randomly selected patients; satisfaction with understanding, explanation and help immediately/one week later |
| Result | Directing style produced higher satisfaction overall, especially physical problems/prescriptions; no significant style difference in longer, advice, psychological or chronic consultations |
| Limit | Satisfaction/self-report and one GP are not adherence or health outcome; heavy one-week attrition (58% response) |
| Yokley & Glenwick (1984) | Evidence map |
|---|---|
| Design/sample | 1,133 families of under-immunised preschoolers randomly allocated to general prompt, specific prompt, specific+access, specific+monetary incentive, contact control or no-contact control |
| Result | All except general prompt showed improvement; incentive largest, then access, then specific prompt; specific prompt alone was most cost-effective |
| Limit | Clinic attendance/immunisation is objective and applied; incentives raise equity/ethics and one public-health context may not transfer |
| Brudvik et al. (2017) | Evidence map |
|---|---|
| Design/sample | Cross-sectional Bergen emergency outpatient study, 243 children aged 3–15; age-adapted child scales and independent parent/physician numeric ratings |
| Result | Mean pain: child 5.5, parent 4.8, physician 3.2; child–parent agreement moderate κ=.55, child–doctor .12 and parent–doctor .17 |
| Conclusion/limit | Physicians underestimated pain across conditions; disagreement was smaller for fractures. Subjective pain lacks a single external ‘correct’ observer score |
| Bridge et al. (1988) | Evidence map |
|---|---|
| Design/sample | Six-week randomised controlled trial, 154 women with stage I/II breast cancer during radiotherapy; 15 dropped out |
| Conditions | Weekly supportive talking control; muscle relaxation; relaxation plus peaceful-scene imagery; intervention groups practised ≥15 min/day with tapes |
| Result | Mood disturbance lower in interventions, combined group more relaxed, control worsened; ≥55 benefited most; no group difference on Leeds depression/anxiety scales |
| Limit | Self-report mood benefit does not mean cancer cure; researcher attention/practice and age interaction matter |
| Shoshani & Steinmetz (2014) | Evidence map |
|---|---|
| Design/sample | Two-year repeated-measures comparison: 537 Israeli grade 7–9 students in one-year whole-school positive-psychology programme versus 501 in similar wait-list school |
| Result | Intervention distress, anxiety/depression and interpersonal sensitivity decreased while controls increased; self-esteem, self-efficacy and optimism strengthened |
| Limit | Large longitudinal applied evidence, but schools were not individual-randomised; school/culture/history and self-report constrain causality/generalisation |
Match each conclusion to its outcome: consultation satisfaction, immunisation attendance, pain-rating agreement, mood during radiotherapy, or adolescent well-being. None of these alone proves a universal clinical cure or one best intervention for every person.
A key study is a linked evidence chain, not a fact list
| Reconstruct in this order | What must be connected | Diagnostic question |
|---|---|---|
| 1 Context/theory | Prior problem, mechanism and relation to other work | Why was this study needed? |
| 2 Aim/hypothesis | Exact predicted question/direction if stated | What comparison or association was tested? |
| 3 Design | Method, design, IV/conditions, DV/outcomes, controls | What permits causal or only correlational inference? |
| 4 Sample | Size, demographics, setting, sampling/allocation | Who supplied the evidence and who may it represent? |
| 5 Procedure | Ordered experience, materials, timing, instructions | Could another researcher reproduce it? |
| 6 Results | Direction plus useful numerical evidence/significance | What was observed—not merely expected? |
| 7 Conclusion | Bounded answer to aim | Does it stay within measured outcome? |
| 8 Discussion | Applications, alternative explanations and next questions | What changes after this evidence? |
| Evaluation move | Evidence-linked form | Weak generic form |
|---|---|---|
| Validity | ‘Physician rating may underestimate private child pain; independent child scale improves construct coverage’ | ‘The study is valid’ |
| Reliability | ‘Standardised prompts/ratings improve replication, but consultation context varies’ | ‘It can be repeated’ |
| Generalisation | ‘One London GP/Israeli schools restrict practitioner/cultural transfer’ | ‘Small sample’ |
| Ethics | ‘Children/clinical patients require consent, protection and no denied essential care’ | ‘It may be unethical’ |
| Application | ‘Specific reminders are cost-effective for this under-immunised clinic population’ | ‘It helps society’ |
To compare studies, keep the dimension constant: field realism, control, outcome objectivity, timescale, allocation, vulnerability or application. Then explain the trade-off. For example, Yokley’s random allocation and objective attendance strengthen causal inference; Shoshani’s whole-school longitudinal implementation improves realism but leaves school-level confounds.
| Issue/debate | Evidence question |
|---|---|
| Individual–situational | Does the result arise from person characteristics, consultation, treatment or institutional access? |
| Reductionism–holism | What did isolating one component reveal, and what health system did it omit? |
| Determinism–free will | Does manipulation change probabilities while people retain informed choice? |
| Nature–nurture | Which biological vulnerability and learned/social experience interact? |
| Usefulness | Is benefit clinically/behaviourally meaningful, feasible, equitable and sustained? |
Do not memorise methodology as detachable labels. Random allocation supports causal comparison only for the manipulated contrast; a significant self-report change remains a self-report outcome; an applied field result remains bounded by its sample, setting, implementation and follow-up.