chapter 4-Health Behavior Change models/theories

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Theories and Models Focusing on Health Behavior Change
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-First need to decide on what level to intervene -Consider the ecological perspective
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ecological perspective levels
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-Intrapersonal level -Interpersonal level -Community levels -Institutional factors -Community factors -Public policy
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Change Process Theories – Intrapersonal Level
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-Continuum theories -Stage theories
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Continuum theories
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– use an approach that identifies variables that influence action & combines them into a prediction equation
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Stage theories
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– are comprised of an ordered set of categories into which people can be classified, & which identifies factors that could induce movement from one category to the next
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Models and theories w/ intrapersonal level
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-Health Belief Model -Theory of Planned Behavior -Transtheoretical Model -Precaution Adoption Process Model -Health Action Process Approach
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Health Belief Model (HBM)
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-\”addresses a person’s perceptions of the threat of a health problem and the accompanying appraisal of a recommended behavior for preventing or managing a problem\” -History – Developed by a group of psychologists in 1950 to help explain why people used or did not use health services -Theory of Planned behavior subgroup
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Constructs of HBM
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-Perceived susceptibility -Perceived seriousness -Perceived barriers -Perceived benefits -Cues to action -Self-efficacy
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Transtheoretical Model (TTM)
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-\” is an integrative framework for understanding how individuals and populations progress toward adopting and maintaining health behavior change for optimal health\” -has been useful explaining gradual development habitual patterns, e.g., diet & exercise
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Has four major constructs -TTM
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1) Stages of change (this is why some call it the \”Stages of Change Model\”), 2) Processes of change, 3) Self-efficacy, 4) Decisional balance
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Precaution Adoption Process Model (PAPM)
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-explains how people come to the decision to take action, & how they translate that decision to action -Most useful when a deliberate action is required, e.g., screening or immunization
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Stages (7)
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1-Unaware of Issue 2-Unengaged by Issue 3-Deciding about Acting 4-Decide not to act 5-Decided to Act 6-Acting 7-Maintenance
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Change Process Theories – Interpersonal Level
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-This group of theories is comprised of theories that \”assume individuals exist within, and are influenced by, a social environment. The opinions, thoughts, behavior, advice, and support of people surrounding an individual influence his or her feelings and behavior, and the individual has a reciprocal effect on those people\” -Examples Social learning, social power, interpersonal communication, social networks, & social support
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Type of Change Process Theories – Interpersonal Level
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Social Cognitive Theory (SCT)
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Social Cognitive Theory (SCT)
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– describes learning as a reciprocal interaction among an individual’s environment, cognitive processes, and behavior -People are thinkers; expectations of consequences
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Types of Reinforcement-SCT
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-Direct reinforcement -Vicarious reinforcement (observational learning or social modeling) -Self-reinforcement
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Often used constructs
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Behavior capability Expectations Expectancies Locus of control Reciprocal determinism Self-control or self-regulation Emotional coping response Self-efficacy
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Change Process Theories – Community Level
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-This group of theories includes three of the ecological perspective levels- institutional (e.g., rules & regulations), community (e.g., social networks & norms), & public policy (e.g., legislation). -Examples Theories associated with these factors include theories of community organizing and community building -Diffusion theory
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Diffusion Theory
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-by Rogers – it explains the pattern of adoption of the innovations
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Diffusion Theory graph-
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-bell-shaped curve -Population Innovators (-2 sd from mean) (2-3%) Early adopters (-2 to -1 sd from mean) (14%) Early majority (-1 sd to mean) (34%) Late majority (mean to +1 sd) (34%) Laggards (> +1 sd) (16%)
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Community Readiness Model
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-Edwards -A stage model for communities -Like individuals, communities are at various stages of readiness for change
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Nine stages-Community Model
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1) No awareness, 2) Denial, 3) Vague awareness, 4) Preplanning, 5) Preparation, 6) Initiation, 7) Stabilization, 8) Confirmation/Expansion, and 9) Professionalism

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