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Original Article

Patient Prototypes

Perceptions of Others Who Have an Illness and Associations With Other Health Cognitions and Behavior

Published Online:https://doi.org/10.1027/2512-8442/a000041

Abstract. Despite large bodies of research examining perceptions of illnesses and perceptions of people who engage in various health behaviors, very little research has examined perceptions of people who have a specific illness. The aims of this research were to create a measure of “patient prototypes,” mental representations of the type of person who has a specific illness, and to examine their associations with other health cognitions and behaviors. Two survey studies (Study 1: N = 208 and Study 2: N = 246) assessed patient prototype favorability for three illnesses (skin cancer, Human papillomavirus (HPV), and type 2 diabetes) as well as constructs from the common-sense model and prototype willingness model. Patient prototypes for the three illnesses were distinct in terms of specific traits and overall favorability. Generally, patient prototype favorability was unrelated to illness representation dimensions in the common-sense model but was positively associated with some constructs in the prototype/willingness model. All three prototypes were positively correlated with perceived vulnerability. The skin cancer prototype was positively correlated with measures of behavioral willingness, behavioral intention, and actual health behavior (UV exposure). Limitations include the use of young adult participants who have relatively little experience with the illnesses examined. Measures of patient prototype favorability and health behaviors need to be further examined and refined. The novel construct of patient prototype favorability provides a foundation for future inquiry into the role that patient perceptions play in health behavior and the implications for the prototype/willingness model and the common-sense model.

References

  • Anderson-Lister, G., & Treharne, G. J. (2014). “Healthy” individuals’ perceptions of type 1 and type 2 diabetes cause and management: A “think-aloud” mixed-methods study using video-based vignettes. Journal of Health Psychology, 19, 1371–1381. https://doi.org/10.1177/1359105313490315 First citation in articleCrossrefGoogle Scholar

  • Bonsaksen, T., Lerdal, A., & Fagermoen, M. S. (2015). Trajectories of illness perceptions in persons with chronic illness: An explorative longitudinal study. Journal of Health Psychology, 20, 942–953. https://doi.org/10.1177/1359105313504235 First citation in articleCrossrefGoogle Scholar

  • Broadbent, E., Petrie, K. J., Main, J., & Weinman, J. (2006). The brief illness perception questionnaire. Journal of Psychosomatic Research, 60, 631–637. https://doi.org/10.1016/j.jpsychores.2005.10.020 First citation in articleCrossrefGoogle Scholar

  • Broadbent, E., Wilkes, C., Koschwanez, H., Weinman, J., Norton, S., & Petrie, K. J. (2015). A systematic review and meta-analysis of the Brief Illness Perception Questionnaire. Psychology and Health, 30, 1361–1385. https://doi.org/10.1080/08870446.2015.1070851 First citation in articleCrossrefGoogle Scholar

  • Del Castillo, A., Godoy-Izquierdo, D., Vázquez, M. L., & Godoy, J. F. (2011). Illness beliefs about cancer among healthy adults who have and have not lived with cancer patients. International Journal of Behavioral Medicine, 18, 342–351. https://doi.org/10.1007/s12529-010-9141-6 First citation in articleCrossrefGoogle Scholar

  • Dijkstra, A., Buunk, A. P., Toth, G., & Jager, N. (2008). Psychological adjustment to chronic illness: The role of prototype evaluation in acceptance of illness. Journal of Applied Biobehavioral Research, 12, 119–140. https://doi.org/10.1111/j.1751-9861.2008.00018.x First citation in articleCrossrefGoogle Scholar

  • Dohnke, B., Steinhilber, A., & Fuchs, T. (2015). Adolescents’ eating behavior in general and in the peer context: Testing the prototype/willingness model. Psychology and Health, 30, 381–399. https://doi.org/10.1080/08870446.2014.974604 First citation in articleCrossrefGoogle Scholar

  • Figueiras, M. J., & Alves, N. C. (2007). Lay perceptions of serious illnesses: An adapted version of the Revised Illness Perception Questionnaire (IPQ-R) for healthy people. Psychology and Health, 22, 143–158. https://doi.org/10.1080/14768320600774462 First citation in articleCrossrefGoogle Scholar

  • Gerrard, M., Gibbons, F. X., Benthin, A. C., & Hessling, R. M. (1996). A longitudinal study of the reciprocal nature of risk behaviors and cognitions in adolescents: What you do shapes what you think, and vice versa. Health Psychology, 15, 344–354. https://doi.org/10.1037/0278-6133.15.5.344 First citation in articleCrossrefGoogle Scholar

  • Gerrard, M., Gibbons, F. X., Houlihan, A. E., Stock, M. L., & Pomery, E. A. (2008). A dual-process approach to health risk decision making: The prototype willingness model. Developmental Review, 28, 29–61. https://doi.org/10.1016/j.dr.2007.10.001 First citation in articleCrossrefGoogle Scholar

  • Gerrard, M., Gibbons, F. X., Reis-Bergan, M., Trudeau, L., Vande Lune, L. S., & Buunk, B. (2002). Inhibitory effects of drinker and nondrinker prototypes on adolescent alcohol consumption. Health Psychology, 21, 601–609. https://doi.org/10.1037/0278-6133.21.6.601 First citation in articleCrossrefGoogle Scholar

  • Gerrard, M., Gibbons, F. X., Stock, M. L., Vande Lune, L. S., & Cleveland, M. J. (2005). Images of smokers and willingness to smoke among African American pre-adolescents: An application of the prototype/willingness model of adolescent health risk behavior to smoking initiation. Journal of Pediatric Psychology, 30, 305–318. https://doi.org/10.1093/jpepsy/jsi026 First citation in articleCrossrefGoogle Scholar

  • Gibbons, F. X., & Eggleston, T. J. (1996). Smoker networks and the “typical smoker”: A prospective analysis of smoking cessation. Health Psychology, 15, 469–477. https://doi.org/10.1037/0278-6133.15.6.469 First citation in articleCrossrefGoogle Scholar

  • Gibbons, F. X., & Gerrard, M. (1995). Predicting young adults’ health risk behavior. Journal of Personality and Social Psychology, 69, 505–517. https://doi.org/10.1037/0022-3514.69.3.505 First citation in articleCrossrefGoogle Scholar

  • Gibbons, F. X., Gerrard, M., Blanton, H., & Russell, D. W. (1998). Reasoned action and social reaction: Willingness and intention as independent predictors of health risk. Journal of Personality and Social Psychology, 74, 1164–1180. https://doi.org/10.1037/0022-3514.74.5.1164 First citation in articleCrossrefGoogle Scholar

  • Gibbons, F. X., Gerrard, M., & Lane, D. J. (2003). A social reaction model of adolescent health risk. In J. M. SulsK. WallstonEds., Social psychological foundations of health and illness (pp. 107–136). Oxford, UK: Blackwell. First citation in articleGoogle Scholar

  • Gibbons, F. X., Gerrard, M., Lane, D. J., Mahler, H. I. M., & Kulik, J. A. (2005). Using UV photography to reduce use of tanning booths: A test of cognitive mediation. Health Psychology, 24, 358–363. https://doi.org/10.1037/0278-6133.24.4.358 First citation in articleCrossrefGoogle Scholar

  • Gibbons, F. X., Gerrard, M., Ouellette, J. A., & Burzette, R. (1998). Cognitive antecedents to adolescent health risk: Discriminating between behavioral intention and behavioral willingness. Psychology and Health, 13, 319–339. First citation in articleCrossrefGoogle Scholar

  • Gibbons, F. X., Houlihan, A. E., & Gerrard, M. (2009). Reason and reaction: The utility of a dual-focus, dual-processing perspective on promotion and prevention of adolescent health risk behaviour. British Journal of Health Psychology, 14, 231–248. https://doi.org/10.1348/135910708X376640 First citation in articleCrossrefGoogle Scholar

  • Godoy-Izquierdo, D., López-Chicheri, I., López-Torrecillas, F., Vélez, M., & Godoy, J. F. (2007). Contents of lay illness models dimensions for physical and mental diseases and implications for health professionals. Patient Education and Counseling, 67, 196–213. https://doi.org/10.1016/j.pec.2007.03.016 First citation in articleCrossrefGoogle Scholar

  • Hagger, M. S., Koch, S., Chatzisarantis, N. L. D., & Orbell, S. (2017). The common sense model of self-regulation: Meta-analysis and test of a process model. Psychological Bulletin, 143, 1117–1154. https://doi.org/10.1037/bul0000118 First citation in articleCrossrefGoogle Scholar

  • Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology and Health, 18, 141–184. https://doi.org/10.1080/088704403100081321 First citation in articleCrossrefGoogle Scholar

  • Kaptein, A. A., Bijsterbosch, J., Scharloo, M., Hampson, S. E., Kroon, H. M., & Kloppenburg, M. (2010). Using the common sense model of illness perceptions to examine osteoarthritis change: A 6-year longitudinal study. Health Psychology, 29, 56–64. https://doi.org/10.1037/a0017787 First citation in articleCrossrefGoogle Scholar

  • Karademas, E. C., Bati, A., Karkania, V., Georgiou, V., & Sofokleous, S. (2012). The association between Pandemic Influenza A (H1N1) public perceptions and reactions: A prospective study. Journal of Health Psychology, 18, 419–428. https://doi.org/10.1177/1359105312436765 First citation in articleCrossrefGoogle Scholar

  • Knight, J. M., Kirincich, A. N., Farmer, E. R., & Hood, A. F. (2002). Awareness of the risks of tanning lamps does not influence behavior among college students. Archives of Dermatology, 138, 1311–1315. https://doi.org/10.1001/archderm.138.10.1311 First citation in articleCrossrefGoogle Scholar

  • Kogan, S. M., Brody, G. H., Gibbons, F. X., Murry, V. M., Cutrona, C. E., Simons, R. L., Wingood, G., & Diclemente, R. (2008). The influence of role status on risky sexual behavior among African Americans during the transition to adulthood. Journal of Black Psychology, 34, 399–420. https://doi.org/10.1177/0095798408320716 First citation in articleCrossrefGoogle Scholar

  • Lenz, B. (2001). The transition from adolescence to young adulthood: A theoretical perspective. The Journal of School Nursing, 17, 300–306. https://doi.org/10.1177/10598405010170060401 First citation in articleCrossrefGoogle Scholar

  • Leventhal, H., Phillips, L. A., & Burns, E. (2016). The Common-Sense Model of Self-Regulation (CSM): A dynamic framework for understanding illness self-management. Journal of Behavioral Medicine, 39, 935–946. https://doi.org/10.1007/s10865-016-9782-2 First citation in articleCrossrefGoogle Scholar

  • Leventhal, H., Nerenz, D. R., & Steele, D. J. (1984). Illness representations and coping with health threats. In A. BaumS. E. TaylorJ. E. SingerEds., Handbook of Psychology and Health, volume IV: Social Psychological Aspects of Health (pp. 219–252). Hillsdale, NJ: Erlbaum. First citation in articleGoogle Scholar

  • Mahler, H. I. M., Kulik, J. A., Gibbons, F. X., Gerrard, M., & Harrell, J. (2003). Effects of appearance-based interventions on sun protection intentions and self-reported behaviors. Health Psychology, 22, 199–209. https://doi.org/10.1037/0278-6133.22.2.199 First citation in articleCrossrefGoogle Scholar

  • Mayr, S., Erdfelder, E., Buchner, A., & Faul, F. (2007). A short tutorial of GPower. Tutorials in Quantitative Methods for Psychology, 3, 51–59. https://doi.org/10.20982/tqmp.03.2.p051 First citation in articleCrossrefGoogle Scholar

  • McGrady, M. E., Peugh, J. L., & Hood, K. K. (2014). Illness representations predict adherence in adolescents and young adults with type 1 diabetes. Psychology and Health, 29, 985–998. https://doi.org/10.1080/08870446.2014.899361 First citation in articleCrossrefGoogle Scholar

  • Mo, P. K. H., & Lau, J. T. F. (2015). Illness representation on H1N1 influenza and preventive behaviors in the Hong Kong general population. Journal of Health Psychology, 20, 1523–1533. https://doi.org/10.1177/1359105313516031 First citation in articleCrossrefGoogle Scholar

  • Nelson, M. C., Story, M., Larson, N. I., Neumark-Sztainer, D., & Lytle, L. A. (2008). Emerging adulthood and college-aged youth: An overlooked age for weight-related behavior change. Obesity, 16, 2205–2211. https://doi.org/10.1038/oby.2008.365 First citation in articleCrossrefGoogle Scholar

  • Norman, P., Armitage, C. J., & Quigley, C. (2007). The theory of planned behaviour and binge drinking: Assessing the impact of binge drinker prototypes. Addictive Behaviors, 32, 1753–1768. https://doi.org/10.1016/j.addbeh.2006.12.009 First citation in articleCrossrefGoogle Scholar

  • Ohtomo, S. (2013). Effects of habit on intention and reactive motivations for unhealthy eating. Appetite, 68, 69–75. https://doi.org/10.1016/j.appet.2013.04.014 First citation in articleCrossrefGoogle Scholar

  • Ouellette, J. A., Gerrard, M., Gibbons, F. X., & Reis-Bergan, M. (1999). Parents, peers, and prototypes: Antecedents of adolescent alcohol expectancies, alcohol consumption, and alcohol-related life problems in rural youth. Psychology of Addictive Behaviors, 13, 183–197. https://doi.org/10.1037/0893-164X.13.3.183 First citation in articleCrossrefGoogle Scholar

  • Richardson, E. M., Schuz, N., Sanderson, K., Scott, J. L., & Schuz, B. (2017). Illness representations, coping, and illness outcomes in people with cancer: A systematic review and meta-analysis. Psycho-Oncology, 26, 724–737. https://doi.org/10.1002/pon.4213 First citation in articleCrossrefGoogle Scholar

  • Rivis, A., & Sheeran, P. (2003). Social influences and the theory of planned behaviour: Evidence for a direct relationship between prototypes and young people’s exercise behaviour. Psychology and Health, 18, 567–583. https://doi.org/10.1080/0887044032000069883 First citation in articleCrossrefGoogle Scholar

  • Rivis, A., Sheeran, P., & Armitage, C. J. (2006). Augmenting the theory of planned beahviour with the prototype/willingness model: Predictive validity of actor versus abstainer prototypes for adolescents’ health-protective and health-risk intentions. British Journal or Health Psychology, 11, 483–500. https://doi.org/10.1348/135910705X70327 First citation in articleCrossrefGoogle Scholar

  • Skalle, S., & Rise, J. (2006). The relationship between smoker and nonsmoker prototypes and smoking status among 14-year-old Norwegians. Addictive Behaviors, 31, 57–68. https://doi.org/10.1016/j.addbeh.2005.04.009 First citation in articleCrossrefGoogle Scholar

  • Spijkerman, R., van den Eijnden, R. J. J. M., & Engels, R. C. M. E. (2005). Self-comparison processes, prototypes, and smoking onset among early adolescents. Preventive Medicine, 40, 785–794. https://doi.org/10.1016/j.ypmed.2004.09.025 First citation in articleCrossrefGoogle Scholar

  • Spijkerman, R., van den Eijnden, R. J. J. M., Vitale, S., & Engels, R. C. M. E. (2004). Explaining adolescents’ smoking and drinking behavior: The concept of smoker and drinker prototypes in relation to variables of the theory of planned behavior. Addictive Behaviors, 29, 1615–1622. https://doi.org/10.1016/j.addbeh.2004.02.030 First citation in articleCrossrefGoogle Scholar

  • Stock, M. L., Peterson, L. M., Houlihan, A. E., & Walsh, L. A. (2013). Influence of oral sex and oral cancer information on young adults’ oral sexual-risk cognitions and likelihood of HPV vaccination. Journal of Sex Research, 50, 95–102. https://doi.org/10.1080/00224499.2011.642904 First citation in articleCrossrefGoogle Scholar

  • Thornton, B., Gibbons, F. X., & Gerrard, M. (2002). Risk perception and prototype perception: Independent processes predicting risk behavior. Personality and Social Psychology Bulletin, 28, 986–999. https://doi.org/10.1177/01467202028007011 First citation in articleCrossrefGoogle Scholar

  • Todd, J., Kothe, E., Mullan, B., & Monds, L. (2016). Reasoned versus reactive prediction of behaviour: A meta-analysis of the prototype willingness model. Health Psychology Review, 10, 1–24. https://doi.org/10.1080/17437199.2014.922895 First citation in articleCrossrefGoogle Scholar

  • Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000). The summary of diabetes self-care activities measure: Results from seven studies and a revised scale. Diabetes Care, 23, 943–950. https://doi.org/10.2337/diacare.23.7.943 First citation in articleCrossrefGoogle Scholar

  • van Lettow, B., de Vries, H., Burdorf, A., & van Empelen, P. (2016). Quantifying the strength of the associations of prototype perceptions with behaviour, behavioural willingness and intentions: A meta-analysis. Health Psychology Review, 10, 25–43. https://doi.org/10.1080/17437199.2014.941997 First citation in articleCrossrefGoogle Scholar

  • Weinstock, M. A., Rossi, J. S., Redding, C. A., Maddock, J. E., & Cottrill, S. D. (2000). Sun protection behaviors and stages of change of the primary prevention of skin cancers among beachgoers in southeastern New England. Annals of Behavioral Medicine, 22, 286–293. https://doi.org/10.1007/BF02895664 First citation in articleCrossrefGoogle Scholar