Techniques of behaviour change Flashcards
Define health behaviour
“Any activity undertaken by an individual believing himself to be healthy, for the purpose of preventing disease or detecting it at an asymptomatic stage”
Recall the components of COM-B model/behaviour change wheel
Capability
Opportunity
Motivation
What is the changing nature of medicine?
Improving people’s health requires application of behavioural and social sciences
What are behaviour change techniques?
- A systematic strategy used in an attempt to change behaviour
- Techniques vs. interventions
What are examples of behaviour change techniques?
§Providing information on consequences
§Prompting specific goal setting
§Prompting barrier identification
§Modelling the behaviour
§Planning social support
What is a popular health behaviour change technique?
Self-monitoring
An individual keeping a record of target behaviours
Additional information recorded can help to identify barriers e.g. mood, weather
Time-consuming over the long term
Role in increasing physical activity and healthy eating studied (Michie et al., 2009)
How do we choose our Behaviour change taxonomy?
- Behavioural target specification
- Behavioural diagnosis
- Intervention strategy selection
- Implementation strategy selection
- Selection of specific BCTs
Run through and example of how we might do analysis of a behaviour change
Cardiac rehabilitation
Mediteranean diet redues rate of coronary heart disease
Target behaviour to reduce the consumption of non-mediteranean diet type foods in the group
behvaioural diagnosis - who, what, when, how often, where, who with
Who - cardiac event and want minimise risk of another one, reducing consumption of bad food and vice versa, all the time, everywhere (cafe), with families friends
Reflect on barriers in COM-B in our target group, capability - do our patients know what constitutes a good diet, do they have access and mobility to purchase healthy foods. Opportunity - physical opportuntity to obtain healthy foods money, social aspects. Motivation - Reflective aspect, never thought of diet change before cardiac event, automative influences e.g. mental health anxiety about leaving house due to event.
Education and persuasion usually taken for healthy eating.
What is motivational interviewing?
A person-centred counselling style for addressing the common problem of ambivalence about change.
What is the role of the clinician in motivational interviewing?
Clinician: non-judgemental, willing to be flexible, listening for opportunities to enter conversation; avoidance of giving advice; recognising when clients highlights behaviour not working for them - identify MI consistent and inconsistent behaviours
Using specific techniques
What do we want to pick up on the client when they are talking?
Change Talk/Intention
Stage of Change e.g. readiness to change - transtheoretical model try bring client to readiness
Co-operation, engagement or disclosure (client engagement/involvement)
Resistance to change (client resistance)
Self-confidence - positive reinforcement
Sense of discrepancy
Clinician’s approach should be dependent on where the patient is in the transtheoretical model.
What are implementation intentions?
AKA Action Plans
Request an individual to think about critical situations to act and appropriate responses within those situations
IF-THEN
E.g. IF it’s Friday morning at 9am THEN I will go for a run from my house around the park. To assist brainstorming we might ask…
When would be a good time and place to exercise?
What specific exercises would you enjoy?
How do implementation intentions work?
They work by helping the cue to become accessible
By planning in advance the situation in which an individual will act, cues become particularly accessible
Strengthens connection between good situation to act and a suitable action
Thus, behaviour more likely to be enacted on
What are incentives?
A type of positive reinforcement
They once asked 16-24 year olds to take chlamydia tests for a 10 quid HMV voucher.
What are benefits of incentives?
Cost-effective
Raise awareness
Bring individuals into contact with health services allowing earlier screening and treatment of illness
Can be effective in changing health and clinical behaviours, thus preventing disease and reducing costs associated with disease.
