adherencepart2

Question 1

• Behaviors undertaken by people to enhance or

maintain their health.firmly est and performed automatically

Answer 1

health behaviors

Question 2

– Single set of factors to explain adherence for

everyone

Answer 2

Continuum (broad category of theory of adherence)

Question 3

-diff factors ar eimportant depending on what stage a person is in

Answer 3

stage (2nd category of theory)

Question 4

– The degree to which the person perceives a 
personal health threat
• Perceived susceptibility
• Perceived severity
– The perception that a particular behavior will 
effectively reduce the threat
• Perceived benefits
• Perceived barriers

Answer 4

whether or not a person practices a health behavior depends on these [Health belief model]

Question 5

theory that People will adhere to behaviors if they:
1. believe they can initiate and carry out this behavior
(self-efficacy)
2. believe that the behavior will produce valuable
outcomes (outcome expectations)

Answer 5

self efficacy theory

Question 6

theory of planned behavior:

Answer 6

-link health attitudes directly to behavior
-a health behavior is direct result of a behavior intention
behavioral intentions made up of attitude toward action, subjective norms, and perceived behavioral control

Question 7

why models arent as good at predicting health behaviors?

Answer 7

1. ppl distort msgs (unrealistic optimism)
2. diff models needed to explain behaviors to diff diseases/behav
3. other factors(public policies, poor health habits, relationships)
4. methodolocigal limitations in measurement
5. may instil motivation to change but doesnt provides steps/skills to make change

Question 8

theory of planned behavior:

Answer 8

• Moderate ability to predict health behaviors such
as mammogram use, condom use, physical
activity, illicit drug use, and binge drinking
alcohol
• Past behavior is a better predictor than these
models (e.g., adherence)
• Not a huge improvement over the Health Belief Model

Question 9

How well do these models predict

health behaviors?

Answer 9

• If the models include self-efficacy, they can
predict perceived behavioral control, subjective
norms, attitudes, and intentions
• Attitudinal approaches don’t explain long-term
behavior change very well
• Don’t explain spontaneous behavior change
• Communications can provoke irrational,
defensive reactions

Question 10

cognitive-behavioral approaches

Answer 10

• focus to target behavior
• self observation/monitoring
• classical conditioning (pair ucr with cs to produce cr)

Question 11

stimulus control

Answer 11

Understand antecedents
– Discriminative stimulus signals positive
reinforcement
– Stimulus-control interventions
• Rid environment of discriminative stimuli
• Create new discriminative stimuli for a new
response

Question 12

• Behavioral Theory: Operant conditioning

Answer 12

– Pairs a voluntary behavior with systematic
consequences
– Key is reinforcement
– Behavior → positive reinforcement or withdraw
punishment → ↑behavior
– Behavior → withdraw reinforcement or punishment→
↓behavior
– Reinforcement schedule (continuous vs. intermittent)
– Often used to modify health behaviors
– Start with continuous & then make it harder
(progressive)

Question 13

• Positive reinforcement (adds a desired factor)

* Negative reinforcement (removes an aversive factor)

Answer 13

reinforcement

Question 14

• Positive punishment (adds an unpleasant stimulus)
• Negative punishment (removes a pleasant stimulus)
• Positive works somewhat better than negative
• Works better if coupled with reinforcement techniques

Answer 14

punishment

Question 15

covert self control

Answer 15

Recognizing internal monologues
– Cognitive restructuring: 
modifying internal monologues
– Self-talk: adaptive ways to talk to oneself in stressful 
situations

Question 16

behavioral assignments

Answer 16

– Client becomes involved in treatment
– Client analyzes behavior to plan intervention
– Client is committed by contractual agreement
– Client assumes responsibility for behavior change
– Homework increases client’s self-control

Question 17

Goals
– Reduce social anxiety
– Introduce new skills for dealing with anxiety-provoking
situations
– Provide alternative behavior for poor health habit
associated with social anxiety

Answer 17

Skills Training
– Social skills
– Assertiveness

Question 18

motivational interviewing

Answer 18

– Interviewer is non-judgmental and encouraging
– Client talks as much as counselor
– Goal: get client to think through reasons for and against
change
– Mixture of techniques from psychotherapy & behavior
change theory
– Works well for those who are wary about change

Question 19

• Broad-spectrum cognitive-behavior therapy
– Combine multiple behavior change techniques
– Tailored to individual
– Don’t overload
– Most effective

Answer 19

• Relaxation training
– Deep breathing
– Progressive muscle relaxation

Question 20

More likely when people are depressed, anxious,
under stress
– Particular problem with addictive disorders of
alcoholism, smoking, drug addiction, obesity
(rates between 50% and 90%)
– Abstinence violation effect – feeling loss of control
with one lapse in vigilance

Answer 20

relapse

Question 21

transtheoretical model stages

Answer 21

1. precontemplation
2. contemplation
3. preparation
4. acton
5. maintenance

Question 22

– In this stage, the person is not aware of a problem
– Family and friends may be aware and push for
treatment
– The individual often reverts to old behaviors if
treatment does occur

Answer 22

stage 1) precontemplation

Question 23

– Aware that a problem exists
– No commitment to take action
– Weighing the pros and cons of action
– If a decision for change is made, then there are 
favorable expectations

Answer 23

stage2) contemplation

Question 24

– Intention to change behavior has been made
– May not have begun to change behavior or may have
modified the target behavior somewhat
• smoking fewer cigarettes each day

Answer 24

stage3) preparation

Question 25

– Commitment of time and energy
– Stopping the behavior
– Modifying lifestyle and environment to get rid of cues
associated with the behavior

Answer 25

stage 4) action

Question 26

– Works toward preventing relapse
– Consolidating gains that have been made
– Has been free of the addictive behavior for more than
6 months
– Relapse may occur, causes the cycle to repeat before
the behavior is successfully eliminated
– Conceptualized as a spiral

Answer 26

stage5) maintenance

Question 27

importance of transtheoretical model:

Answer 27

Captures the process that people actually go 
through
• Illustrates that change
– Doesn’t happen all at once
– May not occur on the first try
• Explains why many interventions aren’t 
successful
– People are not in the “action” phase

Question 28

The Precaution Adoption Process

Model (PAPM)

Answer 28

• 7 Stages
• Each stage represents a qualitatively different
pattern of experience, beliefs, and behaviors
• The transitions between stages are predicted
by different factors that depend on the stage

Question 29

1. unaware of issue
2. unengaged by issue
3. deciding about acting/not to act
4. decided to act
5. acting
6. maintenance

Answer 29

precaution adoption process model stages (weinstein and sandman)

Question 30

• Combines continuum and stage theories
• Two general stages:
– Motivational Phase - includes outcome expectations,
risk perceptions, self-efficacy, and intention
– Volitional Phase - includes planning and action

Answer 30

Health action process approach (schwarzer)

Question 31

• Some health behavior theories suggest that
people’s intentions are predictive of people’s
behaviors
– However, research has shown that people often
intend to behave in one way but do not

Answer 31

intention-behavior gap

Question 32

-ppl may intend to behave in one way but forget about their intentions in the moment
- a person’s motivation at a given moment to engage in a risky behavior
– Teens especially may be prone to engage in risky
behaviors due to their social image

Answer 32

behavioral willingness

Question 33

• Planning is an important factor for translating
intention into behavior
– _____ _____ are specific plans that
people make that identify what, where, when, and
how they intend to engage in a behavior
• May help people’s pursuit of their goals become more automatic
• May help people be less likely to forget their intentions

Answer 33

implementation intentions

Question 34

Behavioral Strategies to Improve

Adherence

Answer 34

• Prompts
– Reminders to initiate health-enhancing behaviors
• Tailoring the regimen
– Fit the treatment to habits and routines in daily life
• Pill organizers, simplify dosage regimen, match to stage of change
– Motivational interviewing
• Graduated regimen implementation
– Shaping of desired behavior like exercise, diet, smoking
cessation, etc.
• Contingency contract