Behaviour Change Flashcards
What are four common features of behaviour change?
- Protection motivation
- Self efficacy
- Reasoned action
- Decisional balance
Discuss protection motivation
Using protection for motivation: i.e Being motivated to increase PA to prevent CVD
Discuss self efficacy
The confidence to perform a given et of behaviours under specific circumstances (i.e. I will make healthy choices to prevent CVD on vacation)
Discuss reasoned action
having reasons for change and weighing the pros and cons (i.e. If i eat heathy, i will lose weight, look better and reduce CVD risk)
Discuss decisional balance
Weighing the pro and cons (i.e. the advantage of eating less fat outweighs the inconvenience of CVD disease)
Define self efficacy
The confidence to perform a specific behaviour
What is notable about self-efficacy?
It is situational specific, for example we can have high-SE in some life domains but low SE in other area
What is SE built on?
Experience, largely learned and shaped by life experience
What is SE a pre-ude to?
Planning for change
(T/F) A persons SE is more important than actual skill
In most cases, T
(T/F) SE is a behaviour change theory
F, SE is incorporated into all major theories of behaviour change
Why is it easy to spot those with high SE?
Those with high SE are those who achieve, accomplish and often succeed more often than others
What are the three roles counselors have to promote SE?
- Help client identify their past successes
- Encourage clients to make an inventory of their strengths and resources
- Look for opportunities to affirm clients efforts, strengths and successes.
What is the health belief model theory based on?
Theory which is based on level of aspiration, in which the individual sets the target of future performance based on past-performance.
–> Originally developed to predict preventative healthy behaviour
What does the HBM state?
That people’s beliefs influence their health-related actions or behaviours
What does HBM state about perception?
Perception of the health problem and appraisal of benefits and barrier of adopting health behaviour are central to a decision to change
Based on the HBM, what are 5 perception which will dictate change (or not)
-Severity of potential condition or disease
-Susceptibility to that condition or disease
(Leads to perceived threat)
-Benefits of taking preventative action
-Perceived barrier to taking that action
(Leads to outcome expectations)
–> Perceived threats, and outcome expectations ultimately lead to perceived ability to make required changes (SE)
Which perception of the HBM is the MOST powerful?
-Perceived barriers to taking action
Define perceived susceptibility
Subjective belief that a person may acquire a disease or enter a harmful state as a result of a particular disease
Define perceived severity
Belief in the extent of harm that ca result form the acquired disease or harmful state of a particular behaviour
Define perceived benefits
Belief in the advantages of the method suggested for reducing the risk or seriousness of the disease or harmful state from a particular behaviour
What are perceived barriers?
- Concern that the new behaviour will take too much time
- Note that this belief could be actual or imagined
What are cues to action?
To cause a force that would make a person feel the need to take action
In sum, what will predict change in the HBM?
Change will occur if (1) behaviour puts health at risk and (2) if perceived benefits outweigh perceived barriers
In HBM, the combination of what constitutes a threat?
Combination of perceive susceptibility and severity
In HBM, readiness to action is based on what 4 beliefs/convictions?
- The threat to health is serious
- Perception that the benefits of the recommended actions outweighs barriers/costs
- Confidence in carrying out action successfully
- Curs to action present
When is HBM useful?
In designing nutrition education activities to enhance awareness and motivation to take action to reduce risk of health-related conditions
–> Mainly used in public health settings
What may modifying factors, such as demographics, sociopsychological variables and structural variables (knowing about disease) influence?
- Perceived susceptibility
- Perceived benefits
- Perceived threat of disease
What does cues to action influence
-Perceived threat of disease
Examples of cues to action?
- Raised awareness (social media)
- Personal advice (i.e. from HCP)
- Personal symptoms
- Illness of family member/friend
What is the Social Cognitive Theory? (SCT)
Proposes that behaviour is the result of personal, behavioural and environment factors that influence each other
Personal factors in SCT?
-People, thoughts and feelings
Behavioural factors in SCT?
-Food, nutrition and health related knowledge and skills
Environmental factors in SCT?
PA and social environment
What else could be included in environment in SCT?
- Social networks
- Media
- Social support, family
- Cultural practices
- Worksite
- Food production, marketing
- Food accessibility
In SCT, what three scenarios increase likelihood of change?
- Short term and long term benefits are valued
- There is positive support from family and friends
- Self-efficacy is high
What is the most important factor in SCT?
SE
What is the theory behing SCT?
-That people learn by observing social interactions and media, personal factors, behaviour and the environment, and those interact continuously, each influencing each other
What is CT widely used in?
Health promotion, given the emphasis on the individual and the environment
Discuss the reasoned action and planned behaviour theories (RAPB)
-People’s behaviour is determined by their intentions, which in turn are influenced by attitudes, social norms and perception of control over behaviour
What does RAPB assume?
That people make decisions in a reasonable manner, and people are more likely to engage in a behaviour if they intend to do so
What does theRABP use?
A social psychological approach to understanding and predicting determinants of health behaviour.
What are the three major factors that determine intention to act/change, according to RABP?
1) Attitude towards the behaviour
2) influence of social environment
3) Perceived behavioural control
Discuss attitude towards behaviour in RABP
- beliefs about the outcome (will it make a difference?)
- beliefs about the value of outcomes (doe that difference matter?)
Discuss influence of social environment in RABP
- What other people think
- Motivation to comply with opinions of others
Discuss perceived behavioural control in RABP
-Opportunities, resources and skills
In RABP, what three things ultimately funnel into intention?
- Behavioural attitudes
- Subjective norms
- Perceived behavioural control
Once intention is established, what influenced adoption of health behaviour?
- Perceived barriers
- Perceived behavioural control
Intention to take action in RABP is based on what 5 beliefs and feelings?
1) Taking the action will lead to outcomes I desire
2) Positive outcomes of taking action will outweigh negative outcomes
3) Positive feelings about taking this action, and taking action = feeling good about oneself
4) People important to me think that I should take this action
5) SE
What is that stages of change transtheoretical model based on? (TTM)
From a large comparison of behaviour modification series, showing that change is realized through a series of stages
Is TTM cyclical?
Yes, and is not a single event. It is an on-going cyclical process.
What is TTM based on?
Assumption that individuals have varying levels of motivation or readiness to change, and that behaviour change does NOT happen in one step
What are the two purposes of TTM?
- Helps us understand the process of behaviour change
- Helps us develop and select effective intervention strategies
What are the two mediators of change in TTM?
- Decisional balance based on pros and cons
- Self-efficacy
How does motivation develop in TTM?
Perception of pros an cons (decisional balance) changes
In TTM, when will new behaviour develop?
Only when SE is high
(T/F) In TTM, it is inevitable to relapse to previous changes
T
What are the 5 stages of change in the TTM model?
- Pre-contemplation
- Contemplation
- Preparation
- Action
- Maintenance
Discuss pre-contemplation
-Consciously intending not to change. The client often denies having a problem, is resistant and reluctant. Makes excuses, blames other people for the problem, feeling hopeless after attempting to change (past failures)
(T/F) Those who have tired and failed may be included in the pre-contemplation stage
T
What is effective in the pre-contemplation stage?
- Empathetic and sensitive listening to encourage clients to examine their situation and it’s consequences
- Provide information, offer feedback, encourage reflection
What are the counselling goals in the pre-contemplation stage?
- Increase awareness of the need for change
- Personalize information on risks and benefits
- Help patient develop a reason for changing
- Validate the patients experience
- Encourage further self-exploration
Discuss contemplation in TTM
-The client is often “on the fence”, they are considering a change but not yet right away. They usually know that the behaviour is a problem, but not ready to make change yet. Often very ambivalent
At wha stage are most clients when they come to consult with an RD?
At contemplation stage
What are some key struggles of patients at the contemplation stage?
- Perception that the longterm health benefits do not compensate for short-term cot
- Many perceived barriers
- May be burned out form previous attempts, lack SE and skills
How can counselor assist clients in contemplation?
- Assist them in thinking through risks of behaviour, benefits of change and highlighting that change is still possible
- Need motivational activities, and NOT yet action orientated
- Maybe open to new information as they self-assess their problems and advantages/disadvantages of change
What are the 5 counseling goals during the contemplation stage?
- Remove ambivalence, engage in the change process
- Validate the patients experience
- Clarify patients perceptions of pros/cons
- Encourage further self-exploration
- Leave the door open for moving to preparation stage
Discuss preparation stage in TTM
-Client is often “testing the water”, and they are ready to make a change soon. They already realize that taking action is important, and they might have started taking a few changes already.
How can counselors assist clients in the preparation stage?
- When advantages outweigh disadvantages
- Need to sustain energy for change through support
- Realize that clients may be ready to try a new recipe or taste new foods
- Assist them to develop concrete goals and action plan strategies
What are the five counselling goals during the preparation stage?
1) Develop concrete strategies for action
2) Praise the decision to change behaviour
3) Prioritize and assist in problem solving re: obstacles
4) Encourage small, initial steps
5) Encourage identification of social supports
Discus action stage in TTM
-Has a “go for it” attitude, and the patient has taken steps towards initiating change.
What % of clients will be in the action stage upon first consult?
Usually only 15%
What is important to consider about the client during the action stage?
- Clients are actively involved in the process
- Clients are working on the goals and implementing the plans developed in the preparation stage
- Client may miss their old lifestyle and have conflicting feelings about the change
What are the four counseling goals in action stage?
1) Implement change and sustain momentum
2) increase SE for dealing with obstacles
3) Combat feelings of loss and re-iterate long-term benefits
Discuss the maintenance phase of stages of change
- Client has made a change and has been successfully worked on it for the past 6-months to 5 years
- Clients might still be insecure/nervous about being able to maintain changes
- Clients must work on modifying the environment to maintain the changed behaviour and prevent relapse
What is the counseling goal of the maintenance phase?
Sustain and accept relapse –> Develop new strategies for dealing with stress points and triggers
When is the most common time for relapse?
Between the first 3-6 months
Discuss relapse
- returning to the old behaviour, often followed by feelings of failure and self doubt
- It’s important to discuss lapses and relapses early with our clients
How can counselors counsel with relapse?
- Help clients accepts
- Help clients identify the decision or action which got them into the high-risk situation in the first place
- Recovery often required re-learning skills from earlier stages, and learning new skills to “get back on the horse”
What is the final stage of TTM?
- Termination
- When the individual has no temptation to return to his previous unhealthy behaviour, and no longer succumbs to any temptation and feel total Self efficacy
