4.1 Behavioral Change Theories

Question 1

Theories

Answer 1

• Set of concepts organized to explain or predict outcomes
• Provides a roadmap and factors to be considered in design, implementation, and evaluation of health promotion programs
• Purpose is to simplify the complexities of basic concepts

Question 2

Why use theories

Answer 2

• Theories help explain why an intervention is necessary, how to intervene, and how to evaluate success

Question 3

Behavioral Change Theories

Answer 3

• Explain why people do or do not adopt certain health behaviors
  Self Efficacy and Motivation are common elements

Question 4

Behavioral Change Theories

Answer 4

• Health Belief Model (HBM) - 1966
• Theory of Reasoned Action (TRA) - 1975
• Social Cognitive Theory (TTM) - 1997
• Stages of Change Model (SCM ) - 1997

Question 5

Health Belief Model

Answer 5

• Disease prevention model and cognitive model

- Weighs cost and benefits of action

Question 6

Cognitive Theories and Models

Answer 6

• Mental processes such as hypothesizing, thinking, and reasoning

Question 7

Health Belief Mode

Answer 7

People will take action to prevent or screen for diseases if they..

• Are susceptible to the condition
• Could have severe consequences
• Anticipated barriers are outweighed by the benefits

Question 8

Perceived Susceptibility

Answer 8

• Perception is the main construct of the health belief model
• They account for how a person acts in face of perceived threats, barriers, susceptibility, severity, or benefits.

Question 9

Self-Efficacy

Answer 9

• Persons belief in their ability to change a behavior

- Long term changes such as smoking or poor eating habits require more confidence or efficacy

Question 10

Health Belief Model Critiques

Answer 10

• Not all health behavior is based on rational thought
• The model is too negative, not focusing on positive
• There is no economic consideration

Question 11

Health Belief Model Applications

Answer 11

• Hispanic women are less likely to perceive themselves as susceptible to breast cancer therefor they are less likely to seek screenings

Question 12

Theory of Reasoned Action

Answer 12

• People routinely consider consequences of their behaviors before engaging in them. Voluntary behavior is predicted by ones own attitude and what people think if the behavior were not performed
  CRITIQUES
• Not all behaviors are under individual control (such as cravings)
• Theory does not consider environment, economics, or politics

Question 13

Social Cognitive Theory

Answer 13

• People can learn by observing others, modeling behavior (imitation) and receiving positive reinforcement.
• Self-Efficacy is the key idea that supports all behavior change.

Question 14

Reciprocal Determinism

Answer 14

• Assumes that person, behavior, and environment are mutually influential

Question 15

Reinforcement

Answer 15

• Assumes there are particular responses to behavior that will predictably increase or decrease the likelihood of reinforcement

Question 16

Expectation and Anticipated Outcomes

Answer 16

• People learn certain events are likely to occur in response to certain behaviors
• They expect this event to happen again when same situation occurs
  EXAMPLE
  Teens learn smoking is “fun”
• Expectation - “smoking is fun”
• Intervention - Education classes conducted about consequences of smoking
• Outcome - “Smoking is gross”

Question 17

Social Cognitive Theory

Answer 17

• Environment, personal factors, and behaviors all interact simultaneously (reciprocal determinism ) to determine whether a person will engage in health promotion activities. People listen by noticing benefit of action.

Question 18

Transtheoretical Model (Stages of Change Model)

Answer 18

• Health-related behavior change through 5 stages as self-efficacy increases

Question 19

Stage 1 - Precontemplation

Answer 19

• There is no intent to make a change

Question 20

Stage 2 - Contemplation

Answer 20

• A change is under serious consideration

Question 21

Stage 3 - Planning/Preparing

Answer 21

• Small changes start to be made

- Large changes in coming months are under consideration

Question 22

Stage 4 - Action

Answer 22

• Behavior change has consisted for more than 6 months

Question 23

Stage 5 - Maintenance

Answer 23

• The change has been sustained for at least 6 months

Question 24

Nursing Interventions

Answer 24

Stage 1-2 - Education on ideas and tips that promote healthy behavior, or helping patient realize the negative impact of unhealthy behavior. (Family Interventions)
Stage 2-3 - Provide patient options on how they can change. Patient needs good role model to help with self-evaluations so they can see themselves as a healthy person
Stage 4 - Patient is ready for traditional programs. Interventions need to be individualized for the patient, it is not a one size fits all.