Abstract
Lay representations of illness and treatment are too often ignored because of the preconception that lay concepts are inherently unscientific and/or of interest only to anthropologists. The subtitle of this chapter, “A Framework for Action,” defines lay representations as perceptions and concepts that generate and specify the behavioral environment for action. The behavioral environment provides the affordances, or targets and pathways, for patients’ self-management (Gibson, 1977). Our approach addresses the details of the perceptual framework in which behavioral management of current and future illness threats is performed (i.e., primary, secondary, and tertiary prevention). It is focused on the mechanisms underlying expertise in self-management by patients and the expertise needed by practitioners to assist patients and families in improving self-management. These processes are pointed to but not described in operational detail by concepts such as “perceived control,” “self-efficacy,” “medical literacy,” and “shared decision-making.” Focusing on underlying mechanisms means identifying the perceptual cues involved in initiating and validating whether one is well or ill, deciding how and when to perform treatment, and how and when to evaluate whether it is working. These apply to practitioners (clinicians and interventionists) as well as to patients and families.
The main sections of our chapter will (1) provide a brief description of the common-sense model of illness representations and its key features; (2) discuss the main challenges faced by behavioral medicine researchers; and (3) spell out some basic principles for using lay representations of illness and treatment for cross-sectional and longitudinal studies, and for the design of interventions.
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Acknowledgments
We would like to thank Drs. Linda Cameron, Michael Diefenbach, and Robert Horne for helpful comments. We recommend readers contact them if they have special interest in dynamic visual models (Dr. Cameron), risk perception (Dr. Diefenbach), and treatment representations (Dr. Horne). Preparation was supported by grant R24 AG023958 from the NIH.
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Leventhal, H., Breland, J.Y., Mora, P.A., Leventhal, E.A. (2010). Lay Representations of Illness and Treatment: A Framework for Action. In: Steptoe, A. (eds) Handbook of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-09488-5_11
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