Behaviour change Flashcards
3 targets of IMB
Behaviour skills
Information
Motivation
3 types of behaviour skills
Self-regulatory
Motor skills
Social skills
Describe the IMB model
For a person to do a behaviour, they require knowledge, motivation, and behavioural skills. Behaviour change should address one of these 3 components.
Ecological approach
Behaviour and the environment interact. The environment often sets the range of possible behaviours.
Environmental specificity
People will behave differently in different environments
5 levels of the social ecological model
Intrapersonal, interpersonal, organization, community, policy
Elaboration likelihood model (ELM)
Two processing routes. Central processing and peripheral processing.
Central route to persuasion
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.
Peripheral route to persuasion
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.
Attitude change and processing route in ELM
Central route is associated with longer lasting, more stable attitude change, while peripheral processing is associated with weaker, temporary change.
Essence of dual processing models
People use both automatic and reasoned processing when considering a message.
Describe the two processing systems
System 1 (automatic) - Fast and low effort System 2 (reasoned - Deliberative, slow, and high effort.
Reflective Impulsive Model
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)
3 examples of automatic processes that influence health behaviour.
Habits, Impulses, and Affect
Habits
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.
Impulses
Automatic behaviour to approach things we find rewarding (certain foods).
Affect
Emotions are automatically triggered by environmental cues, and we will automatically do the things that make us experience positive affect.
6 steps of intervention mapping
Needs assessment Intervention objectives Processes and technique Intervention assembly Adoption and implementation Evaluation
Operant conditioning
Behavioural conditioning where associations between behaviour and consequences are developed.
Reinforcer (OC)
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.
Punishment (OC)
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.
3 interventions for changing automatic processing:
Implementation intentions, Evaluative conditioning, and Nudging
Evaluative conditioning
A topic is repeatedly paired with a positive or negative stimuli to change an association. (such as lung cancer pics on cigarette cartons)
Nudging
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.
5 Components of the RE-AIM framework
Reach Effectiveness/efficacy Adherence Implementation Maintenance
Describe Reach
Reach is the absolute number of people the intervention reached, their demographics, and their representativeness of the target population.
Effectiveness and efficacy
The impact of the intervention on outcomes, including potential negative effects, QoL, economic outcomes.
Describe adoption
Intervention agents willing to initiate the program
Describe Implementation
Consistency of the intervention as delivered by agents, time and costs of the intervention.
Describe maintenance
Long term effects of the program on the individual after 6 months or more and organizational implementation of the intervention as intended over time.
About how many people with “symptoms” seek out help from an HCP?
1/3
5 components of illness representation/perception that explain why someone might seek help
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)
How do social influences effect help seeking?
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).
Compliance vs aderence
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.
Non-adherence
When someone does not follow instructions to the point that it is detrimental to health or treatment efficacy.
Rate of non-adherence with medical advice
50%
Lifestyle recommendations non-adherence rate
75%.
What symptoms factors and treatment factors influence adherence?
Symptom factors: Persistence and perception as serious and curable, as well as interference with other activities.
Treatment: Perceived effectiveness, interference with activities, complexity, duration.
Other factors influencing adherence
Individual characteristics (personality, attitudes, self efficacy), characteristics of advice giver, and social norms (descriptive and subjective)
Concordance
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.
Antecedents of adherence
Understanding (why this?), memory (how and when), and satisfaction (enjoyable, or positive outcome).
Event based vs time based recall
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).
What leads to the lowest adherence rates
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.
