Attitude and Behaviour Change Flashcards
COM-B Model (Michie et al.)
Capability, Opportunity, Motivation –> Behaviour
Model of behaviour change
COM interact with each other and influence behaviour
Behaviour Change Wheel
Synthesis of 19 frameworks of behaviour change
Practical guide for designing and evaluating behaviour change
5 Aspects of Science Denial
FLICC
Fake experts
Logical fallacies
Impossible expectations
Cherry picking
Conspiracy theories
Parallel Argumentation
Way of explaining fallacy
Taking the flawed logic of a situation and extrapolating it out to another parallel
Types of Innoculation
Logic based - explaining the misleading techniques in misinformation
Fact based - showing how misinformation is false through factual explanation (more common)
Information Discernment
The ability to distinguish between misinformation and facts
Passive vs Active Innoculation
Passive - they are just receiving the information (most types from the seminar)
Active - they play an active role, actively engaging or generating answers (e.g. Crazy Uncle video game)
Attitude structure and definition
Structure: Affective, Behavioural, Cognitive, and Social
Evaluations of a social object
Lewin’s Behaviour Equation
Behaviour equation: B = f(P x E)
Behaviour = function of Person and Environment
Lewin’s Field Theory
A Social Ecological System
3-step sequence to change a system:
- Unfreezing: destabilise the quasi-stationary equilibrium
- Moving: develop new sets of behaviours, supported by changes in motivational forces
- Refreezing: facilitate other system changes (beliefs, habits, infrastructure, policies, etc.) to sustain overall system change
How to change a social ecological system
Systems are resilient - you must focus on the channels to a behaviour to know how to change it
Example: Levine convincing the US to eat organ meat during the war
- identified housewives as the gatekeepers (channel) to meal prep, so he targeted them
Deficit Model
People act like the problem is always a deficit of knowledge in the community – not true
o Usual approaches
Change the person (attitudes, identity, beliefs, values, etc.)
Disseminate knowledge, or at least make it available
Engage with community members/stakeholders via ‘action research’
All useful, but not necessary nor sufficient for science adoption, uptake, or influence
Standard Persuasion Frame
Source –> Message –> Recipient –> Context/Situation
Matching comes into play here
These factors, in conjunction with depth of processing (ELM)
Elaboration Likelihood Model
ELM - Petty & Cacioppo
Process occurs via central route (high message elaboration), or peripheral route (low message elaboration)
Path taken is influenced by Motivation (goal, accountability, need for cognition) and Capacity (ability, distraction, repetition)
Knowledge (BCM)
- Know relevant info
- ‘Taking this medication may reduce your cholesterol by X’
Attitudes (BCM)
- Must believe the advantages of changing outweighs the disadvantage/cost of not changing
o “It will feel good to quit smoking” - Emphasise personal relevance
- Provide many arguments and repeat them
- Provide substitutes/alternative behaviours (baby steps) if they are giving us something pleasurable
o E.g. no-sugar cokes
Normative Beliefs (BCM)
- Others’ approval is a strong motivator – social pressure
- “Others will approve if I quit smoking”
- Motivation is higher if there is more social pressure to perform the behaviour than not perform it
- Changing these is difficult when it contradicts the normative behaviours of a group
o E.g. hard to stop smoking if all of your friends smoke - Work with people to overcome these norms
o E.g. hang out at a café, not a pub
o Avoid people who trigger the behaviour – in the early days of change
Identities and Values (BCM)
- Make the behaviour consistent with their self-image/values
o These identify priorities - Highlight discrepancies in this dynamic
o “you want to be a present parent but your alcohol consumption prevents this” - Value-based work can help them identify theirs
o How the current behaviour isn’t aligned
o How behaviour change is aligned
Self-efficacy (BCM)
Belief in your ability to execute the necessary behaviours to achieve the goal
Critical to behaviour change
Four sources - mastery experiences, vicarious experiences, verbal persuasion, emotional regulation
Mastery experiences (self-efficacy)
o Achieving mastery over other things increases self-efficacy (best method) – refine skills, coping mechanisms
o Failure undermines it
o To build
Set achievable challenges
Practice, practice, practice
Graded steps
Attribute success to their abilities
Must be collaborative planning
Vicarious experiences (self-efficacy)
o Learn through observation of similar peopel
o Goes both ways – if others struggle it may reduce it
o To build
“Do you know anyone who…”, “How did they?”
Encouraging meeting people who have succeeded
Copy peers
* Important to ensure the peers overcame difficulties through effort not luck/ease
Support groups
Verbal persuasion (self-efficacy)
Most common used by health professional
o Provide critical feedback/reinforcement increases self-efficacy
o Only works if they believe
o To build
Give good feedback on performance
Give credible feedback
* “Well done, nearly there. Adding X to the plan might help achieve your goal”
* “You did X twice this week, how can we increase that?”
Emotional regulation (self-efficacy)
o Positive mood can boost self-efficacy
o Anxiety can undermine it, especially if they believe arousal will decrease performance
o To build
Normalise anxiety
Remove stressful elements by managing mood before and during performance
Psychoeducation – teach Yerkes-Dodson law
* Optimal performance occurs during physiological arousal
* Challenges their belief that they can’t do something when anxious
Goal Setting (BCM)
Define a goal to guide behaviour
Make it SMART
* May need smaller SMART sub-goals to get there
Action (BCM)
Assessment of skills
* Motor
* Social
* Self-regulatory
* Self-care
Teaching skills
* Instruction
* Demonstration
* Practice
o Roleplay potential scenarios
o Trying out behaviour (e.g. rehab exercises)
* Feedback
If-then planning
If-then planning (Action;BCM)
Key cognitive skill/tool
* ‘Implementation intentions’
o Specify when, where, and how the goal will be achieved
* IF identifies the cue to act. This might be a time/place
* THEN identifies an effective goal-directed response
o IF I find myself in X situation, THEN I will perform goal-directed response Y
* Helps
o Identify situations they can link to engagement with new behaviour
o Protect motivation from unhelpful thoughts and feeling
* Enhances goal-directed action by
o Facilitating cue identification
o Creating automatic association between context and action
o Leading to automation of behaviour – reduced effort
o Increase speed of response
o Mimicking the effects of previous practice
Self-monitoring (BCM)
Monitor behaviour
* Important – otherwise they are driving blind
o Is it really changing
o How much is it changing
o Why isn’t it changing
o Why is it changing
o How it is making them feel
* Things to monitor
o Behaviour patterns in relation to goal
o Immediate reactions
o Changes in wellbeing
Monitor reactions
* Actual experiences acting on or resisting temptation
* Challenge of noticing changes in levels of reaction
* Separate initial ‘automatic’ reactions from those that arise due to thoughts
* Assess reactions to slow progress and potential diminishing self-efficacy
Monitor changes in aspects of wellbeing
* From minutes after behaviour to days and weeks after
* If positive, great
* If negative
o Work out whether linked to the behaviour change
Is the effect temporary? (usually is)
How to minimise the negatives
Summative Evaluation
* Evaluate all 3
* Do regularly in the early days
* Can also be triggered by a crisis
* Celebrate success
o Builds self-efficacy
* Learn from set-backs
o Have a recovery plan
o View them positively (teachable moments)
Goal Review (BCM)
Was the goal too ambitious?
Not specific enough?
Amend goals if needed
Can we make it more challenging?
Avoid reviews when actively facing challenges – less objective then
Habits (BCM-adjacent)
Critical to behaviour change
Formed via repeated matching/associations over time between
* 1. A cue or situation and a behaviour
* 2. The behaviour and a reward (emotional or physiological)
More on this in lecture
Types of evalaution
Process (implementation) and Outcome (effectiveness)
Process evaluation
o Helps to identify intervention strengths, weaknesses, and areas for improvement
o Always done with stakeholders
o Assess
Fidelity
Dose delivered
Dose received
Reach
Recruitment
context
Outcome evaluation
o Cost-effectiveness
o Assess if change occurred, to what extent, and if the changes are associated with the program
o Also done with stakeholders
o Assess
Before implementation