Lay Theories of Health: Multidimensional Conceptualizations of What Comprises Health in Young and Middle-Aged Adults.

Abstract

The present research sought to identify the content, structure, and conceptual and behavioral correlates of lay theories of health in young and middle-aged adults. Lay theories of health are the unarticulated beliefs of laypeople about what it is to be healthy. These theories were assessed in a Prestudy through open-ended survey questioning of 262 adults at four community sites, as well as nationally over the Internet. After an initial coding and judgment process by trained research assistants, 325 distinct responses to the item asking participants to describe a “very healthy person” were identified. Further judgment resulted in an item pool of 259 items to be studied in the next stage of the research. These responses were then rated on their importance to health by laypeople and by experts in separate studies (Studies 1 and 1b). Lay and expert theories about dimensions of health were compared, and some differences were revealed. Items which were rated as most important to health by laypeople (95 items) were administered to a third sample of adult laypeople over the Internet (Study 2), along with some other reliable and valid wellness measures. Participants also rated a set of five empirically-derived profiles of fictional individuals on their healthiness and unhealthiness. These profiles were comprised of items which had been rated as important to health in Study 1 (e.g., by laypeople). Ratings of these profiles showed the hypothesized pattern of increasing with higher correspondence to an “ideal” health profile. Responses to the 95 layperson-generated items were analyzed through exploratory factor analytic procedures, and five dimensions of health were identified. These were labeled Social-Emotional Health, Positive Health Practices, Absence of Illness, Absence of Stress and Anxiety, and Adequate Rest. A new measure of lay theories of health was created measuring these dimensions, as well as a summary score called Multidimensional Health. Initial validation of this measure was conducted through comparing it to the other measures of well-being administered in Study 2, and through its associations with self-reports of selected health behaviors. Findings were discussed in relation to clinical practice, research in other disciplines, and various theories of health behavior.