Putting the 'teachable moment' in context: A view from critical health psychology.

The concept of 'Teachable Moment' (TM) is an increasingly used term within mainstream health psychology in relation to interventions and health behaviour change. It refers to a naturally occurring health event where individuals may be motivated to change their behaviours from unhealthy ones to healthier choices. Pregnancy is seen as a key time for behaviour change interventions, partly due to the idea that the mother has increased motivations to protect her unborn child. This paper proposes a Critical Health Psychological (CHP) re-examination of the concept and explores the 'teachable moment' within a wider framing of contemporary parenting ideologies in order to offer a more critical, nuanced and contextual consideration of pregnancy and the transition to motherhood. The paper locates these discussions using an example of alcohol usage in pregnancy. In doing so, this paper is the first of its kind to consider the 'teachable moment' from a critical health psychological perspective.

'I wanted to share with you some of my healthy habits': YouTubers' staging of health-related practices.

Professional YouTubers have become highly popular in producing video content through self-mediation. Objective. The present article aimed to study ways in which lifestyle YouTubers construct health practices in their videos within the YouTube media culture. Design. We conducted a narrative and visual analysis across a selection of 15 videos. Results. Results showed that YouTubers' practices and recommendations for a better life were structured around three themes: Eating to live well; Exercising to live well; Resting to live well and, a fourth cross-cutting theme on Practices aimed at self-development to achieve health and happiness. YouTubers were mainly female presenting, as well as middle/upper-class and white appearing. An overall optimistic tone characterised their health stories, as they delivered personal experiences of success on becoming healthy, happy, and better persons, while encouraging viewers to act similarly. Our findings suggested that YouTubers actively contribute to construct unprecedented definitions of health, enhanced by the social media culture and broader societal logics of healthism and postfeminism. Conclusion. Our study constitutes an original contribution to critical health psychology by examining some of the paradoxes raised by social media influencers like YouTubers regarding health and wellbeing.

Psychological distress in relatives of critically ill patients: Risk and protective factors.

The admission to an intensive care unit can result in a significant burden of emotional distress in the family. This study analyzes the psychological distress of 89 relatives of intensive care unit patients and the potential risk/protective factors for such distress. Families show high levels of anxiety, depression, and stress. Regarding risk factors, having steady partner, being a woman, and being a mother are associated with increased risk of anxiety, depression, and stress. Contrarily, being younger and having higher educational level are associated with reduced anxiety and stress. Influencing these trends could change positively the suffering course experienced by relatives and intensive care unit patients indirectly.

Subject positions in screening mammography and implications for informed choice.

OBJECTIVE: Screening mammography has potential benefits as well as harms, but these are not always communicated to women. We therefore explored how women discuss screening mammography, the subject positions made available in their discourse, and the implications of these for informed choice. Design: We conducted 16 individual interviews with women aged 44-72 years who were attenders (n = 11) and non-attenders (n = 5) of screening, and analysed transcripts through Foucauldian Discourse Analysis. Main Outcome Measures: A semi-structured interview guide, informed by literature and researcher expertise, was used to collect data. Results: The women constructed screening mammography as either helpful or potentially harmful. We identified three subject positions-The Responsible Woman (who attends screening), The Irresponsible Woman (who does not attend screening), and the Judicious Woman (who engages in alternate breast health practices). Conclusion: These subject positions have the potential to limit women's choices, constrain shared decision-making with health professionals, and restrict women's engagement in risk-reducing behaviours. An expanded range of options ultimately offers an alternate future in which women's autonomy to control their own bodies is better supported.

Applying critical discursive psychology to health psychology research: a practical guide.

This paper outlines a qualitative methodological approach called Critical Discursive Psychology (CDP), considering its applicability to health psychology research. As applied to health psychology, the growth of discursive methodologies within the discipline tends to be located within a critical health psychology approach where CDP and others enable a consideration of how wider societal discourses shape understandings and experiences of health and illness. Despite the increasing usage of CDP as a methodology, little has been written on the practical application of the method to date, with papers instead focusing on the theoretical underpinnings of a CDP approach. This paper seeks to address that gap and offers a step by step guide to the key principles and analytic stages of CDP before giving a worked example of CDP applied to a health topic, in this case 'baby-led weaning' (BLW). As we discuss, a key strength of CDP, particularly in relation to health psychology, is in its attempts to understand both macro and micro levels of data analysis. By doing so it offers a nuanced and richer understanding of how particular health topics are working within context. Therefore, CDP is a readily applicable analytic approach to contested and complicated topic areas within health research.

A discursive exploration of public perspectives on placebos and their effects.

There is increasing evidence that placebos could be effective in clinical practice. However, knowledge of public perspectives on placebos is underdeveloped. We conducted a discourse analysis of internet comments on news articles related to placebos, aiming to improve this knowledge for clinicians and researchers. We developed two discursive constructs of the placebo. The dominant construct of the 'placebo pill' informs a paradoxical understanding of placebos that closes down treatment. The less-prevalent counter-discursive construct of the 'treatment process' frames placebos as potentially viable within modern evidence-based medicine. We discuss the opportunities and challenges of this alternative understanding of placebos.

Care-ful definition of consent.

This proposal is an attempt to intervene in psychology's violent past and troubling present by calling for notions of "care-ful" practice, compelling us to recognize and celebrate the permeable, porous, and flexible boundaries between bodies and selves. With this heuristic of care, this article hopes to trouble the separation between rigor and relational responsibility, to trouble objectivism, to oust the illusion of cool rationality, and to offer an affective understanding of consent that refuses to deny sexuality in bodies oppressed with the label of intellectually disabled.

Health psychology in Ghana: A review of the multidisciplinary origins of a young sub-field and its future prospects.

This article presents a historical overview of psychology applied to health and health psychology in Ghana. A brief history of health, illness and healthcare in Ghana is introduced. Then, the history of psychology in Ghana is presented, with signposts of the major turns in the field in relation to psychology and other disciplines applied to health and the emergence of health psychology as a sub-field. Selected health psychology studies are reviewed to highlight ideological trends in the field. Finally, future prospects are considered in terms of how the sub-field can transition into an established critical field with unique contributions to make to global health psychology.

Critical health psychology in New Zealand: Developments, directions and reflections.

We examine how critical health psychology developed in New Zealand, taking an historical perspective to document important influences. We discuss how academic appointments created a confluence of critical researchers at Massey University, how interest in health psychology arose and expanded, how the critical turn eventuated and how connections, both local and international, were important in building and sustaining these developments. We discuss the evolution of teaching a critical health psychology training programme, describe the research agendas and professional activities of academic staff involved and how this sustains the critical agenda. We close with some reflections on progress and attainment.

'If they have a girlfriend, they have five girlfriends': Accountability and sexism in volunteer workers' talk about HIV/AIDS in a South African health setting.

Significant challenges remain in tackling the global HIV/AIDS epidemic. Effective action requires both appropriate policy at a global level and informed practice on the local level. Here, we report how workers in a project in Johannesburg, South Africa, make sense of HIV transmission. Discourse analysis of data from interviews with 63 participants shows that project workers routinely attribute transmission to men's sexual relationships with multiple female partners. This explanation is so pervasive that it renders invisible other routes to transmission. Absence of consideration of other routes to infection potentially restricts front-line practice, so hindering local attempts to tackle HIV/AIDS.

Taking a hard look at the Heart Truth campaign in Canada: A discourse analysis.

The Canadian Heart and Stroke Foundation launched the Heart Truth campaign to increase women's awareness of heart disease. However, little is known about how such campaigns intersect with broader understandings of gender and health. This discourse analysis examined the construction of gender, risk, and prevention within campaign material. Two primary discourses emerged: one of acceptable femininity, which outlines whose risk, survivorship, and prevention matters, and another of selfless prevention. Women of diverse ethnic, sexual, and socio-economic background were largely absent. Prevention was portrayed as a personal choice, eclipsing conversations about social determinants of health and the socio-political context of heart disease.

Doing Histor{y/ies} of Health Psycholog{y/ies}.

Academic (sub)disciplines develop in time and place when particular ideas/practices are nurtured within social, gendered, cultural, community, economic and political contexts. Different histories employ different analyses, some with external views of scientific outputs describing research and practice, and others with internal, behind-the-scenes examinations of these developments, through oral histories and personal recollections. This collection, written by historians of (social) science, or practitioners or pioneering participants, uses different historiographical methods to contextualize health-related activities within the sub-discipline of health psychology and the evolving critical and/or community approaches. The papers connect the evolving health psycholog{y/ies} with changing socio-political circumstances in different countries.

How do men's magazines talk about penises?

Constructions of masculinity have shifted and changed but the central role of the penis has remained firm. Yet, despite the implications for sexual health, there has been very little research on discourses around penises. The messages men receive about their manhood is apparent in articles in men's magazines. We conducted a discursive analysis of the ways in which penises were discussed in four market leading UK titles: Loaded, Men's Health, GQ and Attitude. Two broad discourses were identified, termed Laddish and Medicalised, both of which create fear-ridden spaces where men are bombarded with unachievable masculine ideals and traumatic examples of mutilated members. We discuss how health psychologists could use the findings to communicate with men about their sexual health needs using this channel.

Notes on the development of health psychology and behavioral medicine in the United States.

A "standard" historiographical overview of the development of health psychology in the United States, alongside behavioral medicine, first summarizes previous disciplinary and professional histories. A "historicist" approach follows, focussing on a collective biographical summary of accumulated contributions of one cohort (1967-1971) at State University of New York at Stony Brook. Foundational developments of the two areas are highlighted, contextualized within their socio-political context, as are innovative cross-boundary collaboration on "precursor" studies from the 1960s and 1970s, before the official disciplines emerged. Research pathways are traced from social psychology to health psychology and from clinical psychology to behavioral medicine.

'This place is making me more depressed': The organisation of care for suicide attempters in a South African hospital.

People who attend hospital following a suicide attempt represent a well-delineated high-risk group of patients who may be amenable to targeted interventions to reduce the risk of suicidal behaviour. Little is, however, known about how hospitals in South Africa respond to suicide attempters, what quality of care these patients receive or what possibilities exist for hospital-based suicide prevention interventions. We describe an ethnographic study conducted at a large hospital in South Africa to investigate the impact of current procedures and practices on the care received by those who attempt suicide. Findings suggest that the organisation of care within the hospital is a significant barrier to patients receiving optimal care and represents a lost opportunity for suicide prevention. Findings highlight the mismatch between the needs of suicide attempters and current services and call attention to the need for greater psychological input as well as hospital-based suicide prevention interventions that can be offered to patients without necessitating admissions.

Disability and HIV in Africa: Breaking the barriers to sexual health care.

Three decades into the HIV pandemic, the issues affecting people with disabilities remain less known. Increasing attention has been given to this overlooked population when it comes to HIV prevention, treatment and care. This is related to the significant unmet sexual and reproductive healthcare needs facing people with disabilities worldwide. This article discusses the barriers to sexual health for people with disabilities in Africa and presents an argument about how mainstream HIV prevention work and research do not adequately attend to the sorts of systemic barriers that exclude people with disabilities, which a more targeted and critical approach could.

Health psychology: It's not what you do, it's the way that you do it.

Despite the growth in theoretical understandings of health behaviour and standardised approaches to health interventions (e.g. behaviour change taxonomies), health psychology has paid comparatively less attention to the importance of the implementation processes - 'how to' rather than 'what to' of such interventions. The clinical and interpersonal skills that often reflect these implementation processes are poorly defined within the health psychology literature. The level of proficiency in such skills expected of Health and Care Professions Council registered practitioner health psychologists is unclear and poorly documented within the UK training requirements. This article explores the potential impact of this and offers some pragmatic solutions.

'Don't push me aside, Doctor': Suicide attempters talk about their support needs, service delivery and suicide prevention in South Africa.

Few studies have explored the expressed support needs of suicide attempters in developing countries. Data, collected via in-depth interviews with suicide attempters admitted to a South African hospital, were analysed using thematic content analysis. Participants explicitly asked for integrated psycho-social services at a primary health care level and say they require assistance with alleviating psychiatric symptoms, establishing connectedness, interpersonal conflict and solving socio-economic problems. Findings highlight the importance for suicide prevention of (1) considering interpersonal and contextual socio-economic factors in addition to the psychiatric causes of suicidal behaviour; and (2) multilevel strategies, intersectoral collaboration and integrated person-centred primary health care.

Beyond survivorship? A discursive analysis of how people with pancreatic cancer negotiate identity transitions in their health.

We explored how people negotiate, and respond to, identity transitions following a diagnosis of pancreatic cancer. Interviews with 19 people with pancreatic cancer were analysed using thematic discourse analysis. While discursively negotiating two transitions, 'moving from healthy to ill' and 'moving from active treatment to end-of-life care', participants positioned themselves as 'in control', 'optimistic' and managing their health and illness. In the absence of other discourses or models of life post-cancer, many people draw on the promise of survival. Moving away from 'survivorship' may assist people with advanced cancer to make sense of their lives in a short timeframe.

Gratitude and longing: Meanings of health in aging for Puerto Rican adults in the mainland.

Puerto Rican adults in the United States mainland live with socioeconomic and health disparities. To understand their contextual experience of aging, we interviewed participants in the Boston Puerto Rican Health Study. Through a Thematic Analysis we identify themes and tensions: normalization and acceptance of aging; gratitude; the importance of aging within social networks; longing to return to Puerto Rico at older age. We address the tensions between 'acceptance' and fatalismo as a cultural belief, and a function of structural barriers. The experience of aging is discussed in the context of Puerto Rico's history and continued dependence on the United States.