Behaviour change

Question 1

3 targets of IMB

Answer 1

Behaviour skills
Information
Motivation

Question 2

3 types of behaviour skills

Answer 2

Self-regulatory
Motor skills
Social skills

Question 3

Describe the IMB model

Answer 3

For a person to do a behaviour, they require knowledge, motivation, and behavioural skills. Behaviour change should address one of these 3 components.

Question 4

Ecological approach

Answer 4

Behaviour and the environment interact. The environment often sets the range of possible behaviours.

Question 5

Environmental specificity

Answer 5

People will behave differently in different environments

Question 6

5 levels of the social ecological model

Answer 6

Intrapersonal, interpersonal, organization, community, policy

Question 7

Elaboration likelihood model (ELM)

Answer 7

Two processing routes. Central processing and peripheral processing.

Question 8

Central route to persuasion

Answer 8

Used when you have time to think about the message and background knowledge of the issue. Decision is made on the strength of the argument and its fairness.

Question 9

Peripheral route to persuasion

Answer 9

Used when the decision is quick or when you are uncapable of evaluating the message (lacking knowledge, poor presentation). Decision based on consensus, expertise, multiple arguments, and peripheral cues.

Question 10

Attitude change and processing route in ELM

Answer 10

Central route is associated with longer lasting, more stable attitude change, while peripheral processing is associated with weaker, temporary change.

Question 11

Essence of dual processing models

Answer 11

People use both automatic and reasoned processing when considering a message.

Question 12

Describe the two processing systems

Answer 12

System 1 (automatic) - Fast and low effort
System 2 (reasoned - Deliberative, slow, and high effort.

Question 13

Reflective Impulsive Model

Answer 13

Automatic processes reflect an interaction between pre-existing associations and the message. Reflective processes involve reasoned reflection about the automatic association (degree to which we think our initial process is fair and accurate)

Question 14

3 examples of automatic processes that influence health behaviour.

Answer 14

Habits, Impulses, and Affect

Question 15

Habits

Answer 15

Behaviour done with little thinking due to repeatedly performing a goal directed behaviour (such as taking the stairs). People fall back on habits when under stress or cognitively impaired. People are often aware of a habit but not the environmental cue that causes it.

Question 16

Impulses

Answer 16

Automatic behaviour to approach things we find rewarding (certain foods).

Question 17

Affect

Answer 17

Emotions are automatically triggered by environmental cues, and we will automatically do the things that make us experience positive affect.

Question 18

6 steps of intervention mapping

Answer 18

Needs assessment
Intervention objectives
Processes and technique
Intervention assembly
Adoption and implementation
Evaluation

Question 19

Operant conditioning

Answer 19

Behavioural conditioning where associations between behaviour and consequences are developed.

Question 20

Reinforcer (OC)

Answer 20

A consequence that promotes the behaviour it follows. Positive reinforcement is the addition of a positive stimulus while negative reinforcement is the removal of a bad stimulus.

Question 21

Punishment (OC)

Answer 21

A punishment decreases a behaviour that it comes after. Positive punishment would be the addition of a negative stimulus, while negative punishment would be the removal of a positive stimulus.

Question 22

3 interventions for changing automatic processing:

Answer 22

Implementation intentions, Evaluative conditioning, and Nudging

Question 23

Evaluative conditioning

Answer 23

A topic is repeatedly paired with a positive or negative stimuli to change an association. (such as lung cancer pics on cigarette cartons)

Question 24

Nudging

Answer 24

Making subtle changes in the environment to encourage people to make a certain behavioural choice without reducing their options or changing the costs of a behaviour. Nudging utilizes cognitive flaws/heuristics.

Question 25

5 Components of the RE-AIM framework

Answer 25

Reach
Effectiveness/efficacy
Adherence
Implementation
Maintenance

Question 26

Describe Reach

Answer 26

Reach is the absolute number of people the intervention reached, their demographics, and their representativeness of the target population.

Question 27

Effectiveness and efficacy

Answer 27

The impact of the intervention on outcomes, including potential negative effects, QoL, economic outcomes.

Question 28

Describe adoption

Answer 28

Intervention agents willing to initiate the program

Question 29

Describe Implementation

Answer 29

Consistency of the intervention as delivered by agents, time and costs of the intervention.

Question 30

Describe maintenance

Answer 30

Long term effects of the program on the individual after 6 months or more and organizational implementation of the intervention as intended over time.

Question 31

About how many people with “symptoms” seek out help from an HCP?

Answer 31

1/3

Question 32

5 components of illness representation/perception that explain why someone might seek help

Answer 32

Identity (name or label of threat)
Cause (causal mechanism - hereditary, internal, external)
Consequences (Minor or major)
Timeline (acute, chronic, cyclical)
Controllability (will an intervention help)

Question 33

How do social influences effect help seeking?

Answer 33

Are services nearby? Do friends and family encourage seeking help? What are the norms around help seeking? Does seeking help interfere with other activities (time constraints) or have costs (costs of seeking help directly, indirectly through missed income from work, transport).

Question 34

Compliance vs aderence

Answer 34

Compliance is performing a behaviour as desired but without believing in the necessity of that behaviour, while adherence involves actively agreeing that the behaviour is valuable.

Question 35

Non-adherence

Answer 35

When someone does not follow instructions to the point that it is detrimental to health or treatment efficacy.

Question 36

Rate of non-adherence with medical advice

Answer 36

50%

Question 37

Lifestyle recommendations non-adherence rate

Answer 37

75%.

Question 38

What symptoms factors and treatment factors influence adherence?

Answer 38

Symptom factors: Persistence and perception as serious and curable, as well as interference with other activities.
Treatment: Perceived effectiveness, interference with activities, complexity, duration.

Question 39

Other factors influencing adherence

Answer 39

Individual characteristics (personality, attitudes, self efficacy), characteristics of advice giver, and social norms (descriptive and subjective)

Question 40

Concordance

Answer 40

A deeper collaboration between the HCP and the patient. Requires more time for discussion and an interest of the HCP in the person’s wellness. Generally produces better adherence.

Question 41

Antecedents of adherence

Answer 41

Understanding (why this?), memory (how and when), and satisfaction (enjoyable, or positive outcome).

Question 42

Event based vs time based recall

Answer 42

People remember treatments better if given event based instruction (take meds at breakfast and dinner) rather than time based (every 4 hours, twice a day).

Question 43

What leads to the lowest adherence rates

Answer 43

Chronic diseases, or other situations were the treatment will have to be done long-term without obvious immediate impacts. Life style changes are also low adherence, as are prevention (often the same). If you have immediate discomfort you are more likely to adhere then if discomfort is down the road.