Final Flashcards
What is the basic premise of stage models?
- Subset of value-expectancy theories
- Behaviour change occurs as a result of individuals passing through stages
What is a “stage-matched” intervention? When are they deemed successful?
- Interventions must be “stage-matched/targeted” to individual’s stage of change
- Asking them to move 1 stage forward is easier than asking them to change
- Stage-matched interventions are deemed successful if stage progression is achieved (even without behaviour change)
What are the types of stage models?
- Transtheoretical Model of Change (Prochaska)
2. Precaution Adoption Process Model (Weinstein & Sandman)
How was the TTM developed? What makes it different from other theories?
- Originally developed for smoking
- Borrows concepts from many theories
- Explains how people change; more prescriptive than previous causative theories
What are the assumptions of the TTM?
- No single theory can account for behaviour change
- Behaviour change is a gradual process that unfolds over time through stages
- Stages of behaviour change are both stable and open to change
- No inherent motivation to progress through stages of change
- We need an intervention to have behaviour change - Majority will not be served effectively by traditional action-oriented behaviour change programs as they are not prepared for action
- Specific processes and principles of change need to be applied at specific stages of readiness
- Stage-matched interventions have been designed mainly to enhance self-control over behaviours (self-regulation)
- Behaviour change typically consists of several attempts where individual may progress, backslide, and cycle/recycle through changes a number of times
- Stages of change are characterized as a spiral staircase
What are the stages of change for TTM?
- Precontemplation (PC)
- No intention to take action within the next 6 months (“resistant”, “not ready”)
- May be uninformed about consequences of behaviour
- 3 Ds ⟶ in denial, defensive, or demoralized - Contemplation (C)
- People are ambivalent and have reasons for not adopting behaviour
- Intends to take action within the next 6 months - Preparation (PR)
- People intend to adopt a new behaviour within the next month (30 days)
- May have taken some steps in this direction (eg. trying to get informed, walking 15 minutes a day) - Action (A)
- People have made specific modifications in their lifestyles for less than 6 months
- Not all behavioural changes count as action; must be sufficient enough to reduce risk of disease (eg. 150 minutes of MVPA/week) - Maintenance (M)
- Defined as sustaining behaviour for 6+ months
- People must work to prevent relapse - Termination
- No temptation to relapse and is 100% confident (eg. brushing your teeth)
- Makes sense for cessation behaviours (eg. smoking), however there are many factors influencing PA
- *Removed from the model
List the processes of change for TTM. Include short phrases to capture their essence.
- Consciousness Raising (learning)
- Dramatic Relief (emotions about unhealthy behaviour)
- Self re-evaluation (ones’ identity)
- Environmental Reevaluation (impact on others and environment)
- Self-Liberation (commitment)
- Helping Relationships (social support)
- Counter-Conditioning (healthier substitutes; problem-solving)
- Reinforcement (Contingency) Management (rewards)
- Stimulus Control (reminders or cues)
- Social Liberation (social norms changing)
What is consciousness raising in the TTM?
- Increasing awareness of health-damaging effects of behaviour and ways to reduce consequences
- Finding and learning new facts, ideas, and tips that support the healthy behaviour change
- Eg. having students to count their steps, exposure to information on internet
What is dramatic relief in the TTM?
- Increasing emotions/affect about unhealthy behaviours, followed by decreased affect if appropriate action is taken
- Eg. highlighting consequences of sedentariness, but alleviate that anxiety by discussing what they can do about it
What is self re-evaluation in the TTM?
- Realizing that behaviour change is an important part of one’s identity/life
- Visualizing yourself as healthy and with the behaviour
What is environmental reevaluation in the TTM?
- Realizing negative impact of the unhealthy behaviour or positive impact of the healthy behaviour on one’s social and/or physical environment
- Eg. how does your being sedentary affect you as a role model for the rest of the family?
What is self-liberation in the TTM?
- Making a firm commitment to change
- Setting up contracts, goals, dates, and making it known to people in your life
What is helping relationships in the TTM?
Seeking and using social support from relevant SOs to promote healthy behaviour change (eg. planning on going to the gym with buddy)
What is counter-conditioning in the TTM?
- Learning and substituting healthier alternative behaviours and cognitions for unhealthy ones
- Eg. you like watching TV in the evening, so you exercise in the morning instead
What is reinforcement management in the TTM?
Increasing rewards for positive behaviour change and decreasing rewards of the unhealthy behaviour
What is stimulus control in the TTM?
- Removing reminders or cues to engage in the unhealthy behaviour and adding cues or reminders to engage in the healthy behaviour
- Eg. putting fruits and vegetables out in the front of the fridge
What is social liberation in the TTM?
- Realizing that social norms are changing in direction of supporting the healthy behaviour change
- Eg. recognizing that there are more biking paths, or trend of affordable gym memberships
Which POCs are more effective during preparation in the TTM?
- Self re-evaluation
- Self-liberation
- Helping relationships
- Counter-conditioning
Which POCs are more effective during pre-contemplation in the TTM?
- Consciousness raising
- Dramatic relief
- Environmental re-evaluation
- Social liberation
Which POCs are more effective during contemplation in the TTM?
- Consciousness raising
- Dramatic relief
- Self re-evaluation
- Environmental re-evaluation
- Social liberation
Which POCs are more effective during action in the TTM?
- Self-liberation
- Helping relationships
- Counter-conditioning
- Reinforcement management
- Stimulus control
Which POCs are more effective during maintenance in the TTM?
- Helping relationships
- Counter-conditioning
- Reinforcement management
- Stimulus control
What are the 2 categories of POC effectiveness when staging?
- Experiential (early stages)
- Consciousness raising
- Dramatic relief
- Self re-evaluation
- Environmental re-evaluation
- Social liberation - Behaviour (later stages)
- Self-liberation
- Helping relationships
- Counter-conditioning
- Reinforcement management
- Stimulus control
What is decisional balance in the TTM? What is the strong/weak principle? Which is the best stage?
- Mental weighing of importance of pros/cons associated with changing behaviour
- Similar to IMBP’s outcome evaluations
- Best for C stage
• Strong principle of progress: pros of health behaviour change must increase by 1 SD from PC to A
• Weak principle: cons of health behaviour change must decrease by ½ SD from PC to A
What is a T-score?
- Helps you evaluate decisional balance in the TTM
- Score of your perception of pros compared to cons
• PC ⟶ low T-score for pros, high T-score for cons
• C ⟶ higher T-score for pros, same T-score for cons
• PR ⟶ higher T-score for pros, lower T-score for cons
• A ⟶ high T-score for pros, low T-score for cons
• M ⟶ high T-score for pros, very low T-score for cons
What is self-efficacy in the TTM? What is resilient self-efficacy?
- Added later to TTM
- Important to move individuals from PC to M (confidence)
- Resilient self-efficacy: term used to describe people with high self-efficacy, such that behaviour can be performed despite challenging circumstances