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Conflit et comportements de santé : le rôle des cognitions compensatrices et du contrôle de soi chez des individus atteints de cardiopathies

Abstract : In 2015, cardiovascular diseases caused 18 million deaths per year worldwide, which makes it the leading cause of death attributed to non-communicable diseases. Multiple health behaviors change in terms of physical activity, diet, tobacco consumption, and medication adherence represent one of the best ways to prevent cardiovascular diseases emergence on global population, and to prevent relapses on individual with cardiovascular diseases. To understand behaviors determinants, social and health psychology relies on two conceptual frameworks: socio-cognitive models and dual-process theories. These models identified several behavioral determinants, but two reasons could make their application difficult in the multiple health behavior change framework. First, these approaches proposed behavior-specific determinants that do not permit to understand what determines the simultaneous adoption of several behaviors. On the other hand, they do not consider behaviors characteristics. However, behavior characteristics could be different and unhealthy behaviors could confront healthy behaviors, and thus generate conflicts on an individual. Within the multiple health behavior change process, poor conflict-coping strategies could explain unhealthy behavior prevalence. This doctoral work has investigated role of two processes of conflict reduction within multiple health behavior change: compensatory health beliefs, and self-control. Specifically, they evaluated (1) to what extent compensatory health beliefs, a between-behavior belief, could harm intentions toward healthy behaviors; and (2) if self-control could be an unspecific determinant of multiple health behavior change. We conducted four empirical studies merged in three manuscripts to answer these questions. The first manuscript evaluated compensatory health beliefs harmful influences (by dissociating them according with behaviors nature) on intentions formation process toward several health behaviors, within individual with cardiovascular diseases. Results showed that these beliefs could harm intentions depending on certain self-efficacies and risks perception levels. The second manuscript presented a study that investigated to what extent the self-control model, with a measure of state self-control capacity, predicted health behaviors. Results highlighted different prediction patterns depending on behaviors domain: physical/sedentary activity, healthy/unhealthy diet, tobacco consumption. More precisely, results suggest that self-control effort predicted unhealthy behaviors, and state of self-control capacity predicted healthy ones. The third manuscript attempted to confirm these results on two populations. The first one was composed of students, and the second one was composed of individual with cardiovascular diseases, by testing self-control model on ecological context and with a longitudinal design. Despite differences within predictions patterns, depending on the population observed, results confirmed the role of self-control effort on unhealthy behaviors (sedentary time and unhealthy diet), and of state self-control capacity on healthy behavior (physical activity). Taking together, all these results pave the way to the development of interventions on these two self-control model components, in order to improve health behaviors adherence of individual with cardiovascular diseases.
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Cyril Forestier. Conflit et comportements de santé : le rôle des cognitions compensatrices et du contrôle de soi chez des individus atteints de cardiopathies. Santé. Université Grenoble Alpes, 2018. Français. ⟨NNT : 2018GREAS032⟩. ⟨tel-02393699⟩

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