4.1 Behavioral Change Theories Flashcards
Theories
- 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
Why use theories
- Theories help explain why an intervention is necessary, how to intervene, and how to evaluate success
Behavioral Change Theories
- Explain why people do or do not adopt certain health behaviors
Self Efficacy and Motivation are common elements
Behavioral Change Theories
- Health Belief Model (HBM) - 1966
- Theory of Reasoned Action (TRA) - 1975
- Social Cognitive Theory (TTM) - 1997
- Stages of Change Model (SCM ) - 1997
Health Belief Model
- Disease prevention model and cognitive model
- Weighs cost and benefits of action
Cognitive Theories and Models
- Mental processes such as hypothesizing, thinking, and reasoning
Health Belief Mode
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
Perceived Susceptibility
- 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.
Self-Efficacy
- Persons belief in their ability to change a behavior
- Long term changes such as smoking or poor eating habits require more confidence or efficacy
Health Belief Model Critiques
- Not all health behavior is based on rational thought
- The model is too negative, not focusing on positive
- There is no economic consideration
Health Belief Model Applications
- Hispanic women are less likely to perceive themselves as susceptible to breast cancer therefor they are less likely to seek screenings
Theory of Reasoned Action
- 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
Social Cognitive Theory
- People can learn by observing others, modeling behavior (imitation) and receiving positive reinforcement.
- Self-Efficacy is the key idea that supports all behavior change.
Reciprocal Determinism
- Assumes that person, behavior, and environment are mutually influential
Reinforcement
- Assumes there are particular responses to behavior that will predictably increase or decrease the likelihood of reinforcement
Expectation and Anticipated Outcomes
- 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”
Social Cognitive Theory
- 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.
Transtheoretical Model (Stages of Change Model)
- Health-related behavior change through 5 stages as self-efficacy increases
Stage 1 - Precontemplation
- There is no intent to make a change
Stage 2 - Contemplation
- A change is under serious consideration
Stage 3 - Planning/Preparing
- Small changes start to be made
- Large changes in coming months are under consideration
Stage 4 - Action
- Behavior change has consisted for more than 6 months
Stage 5 - Maintenance
- The change has been sustained for at least 6 months
Nursing Interventions
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.
