Section 2: Fundamentals of Health Behaviour Change Flashcards
What are the three health behaviour change theories?
The health belief model
the social learning theory
the transtheoretical model (TTM),
Describe the health belief model?
Proposes that individual engagement is largely determined by an individual’s beliefs or perceptions
Individual perceptions: perceived susceptibility/perceived severity of disease, perceived benefits of engaging in health behaviour minus perceived barriers, includes self-efficacy
Modifying factors can influence these perceptions eg age, sex, ethnicity, education, personality etc
Cues to action can also influence perceptions eg event happening to family member, receiving an intervention
What is the theory of planned behaviour?
Proposes that behaviour achievement is based on motivation (intention) and ability (behavioural control)
List some of the constructs in the theory of planned behaviour?
o Attitude (positive or negative evaluation of behaviour of interest and its outcomes
o Behavioural intention: motivational factors for behaviour
o Subjective norms: perception of the beliefs of others – whether they approve/disapprove
o Social norms
o Perceived power (over factors that may help or impede)
o Perceived behavioural control: how easy or difficult to complete behaviour and the control needed to do so
What is social cognitive theory?
That behaviour is a product of the influence that personal factors, environment, and human behaviour exert on one another - ‘reciprocal determinism’
Involves observational learning (by watching others’ behaviour) and self-efficacy (confidence to successfully engage in a behaviour)
Describe the transtheoretical model and list the (7) stages:
Describes behaviour change as a process that unfolds over time in stages, not always in linear fashion.
* Precontemplation - not planning to change in next 6 months
* Contemplation - is planning to change in next 6 months
* Preparation - decided to change in next month
* Action - has changed but not for 6 months
* Maintenance - for more than 6 months without relapse, (no formal upper limit but maybe 5 years)
* (Relapse)
* Termination – not tempted to return to previous behaviours
List four common components to all health behaviour models/theories?
- Beliefs about risks/benefits
- Motivation
- Self-efficacy
- Environmental influences
For the transtheoretical model, describe stage-matched responses for the five stages
- Precontemplation (don’t need to or can’t change): discuss health risks
- Contemplation (ambivalent, may change within 6 months): personalise health risk, weight costs and benefits and impact on personal goals
- Preparation (plans to change within next month): assist with commitment, plan specific changes and discuss way to modify environment
- Action (has started change but less than 6 months): Structure the plan, identify supports, problem solve obstacles, reframe non-productive thought patterns
- Maintenance (behaviour sustained 6 months+): continued reinforcement, maintain interest and adherence
What is the proportion of non-adherence for chronic illness medication?
50-80%
What are the two roles of the provider to foster a therapeutic alliance?
Experts: medical assessment, make recommendations, prescribe treatments
Coach: create an inclusive environment, assess readiness for change, empower patients to take ownership of their health
What are some ways to build an effective therapeutic alliance?
- Establish effective relationship – assess readiness for change, stage-matched intervention, empower patients, inclusive environment
- Utilise people-first language
- Take care discussing weight/lifestyle changes, use motivational interviewing
- Collaborate with qualified health coaches
Strategies to foster self-motivation and self-confidence: - Accept baby-steps, affirm the positive, give full attention
- View setbacks or challenges as learning opportunities
What are some ways of promoting behaviour change in patients?
Score out of 10 patient’s confidence and importance level for each area of change
Get patients to summarise goals and resources
Use SMART goals/action plans -review and ask about benefits and learnings
Ask why they chose a higher number to identify strengths and desires etc
What is Motivational Interviewing and who is it useful for?
Useful for individuals who are ambivalent
* Express empathy, Support self efficacy. Respond to sustain talk (reasons why one can’t change) with reflective listening, remaining non-judgemental and emphasising autonomy ‘roll with resistance’, invite them to explore different perspectives
* Develop discrepancy between where the patient is and what the patient wants – allow patient to recognise this.
* Evoking Change Talk: (Open-ended questions to elicit statements about change)
o Use Affirmations, Reflection, Summaries
What is CBT and when is it most useful?
Most useful during preparation, action and maintenance stages
Focuses on how thoughts and feelings influence behaviour
Describe the ABCDE approach to cognitive reframing?
A. What Action or event happened?
B. What Beliefs do you have about what happened
C. What are the Consequences of those beliefs and how does that make you feel?
D. How can you Dispute those beliefs that seem to be unhelpful?
E. What Effect does this new way of thinking have on how you feel and how you move forwards?
