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Health Promotion and Wellness > Theories in Health Promotion and Health Behavior > Flashcards

Theories in Health Promotion and Health Behavior Flashcards

1
Q

Programs most likely to achieve their desired outcomes are those based on?

A

based on a clear understanding of targeted health behaviors and the
environmental context in which they occur

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2
Q

Purpose of theories?

A

Theories give the planner the necessary tools for designing and evaluating health promotion interventions based on an understanding of behavior

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3
Q

The ecological approach emphasizes? Behavior affects and is affected by? What is reciprocal causation?

A
  • Emphasizes the interaction & interdependence between individual and environmental factors at all levels of a health problem.
  • Behavior affects and is affected by multiple levels of influence
  • Reciprocal Causation : a person’s behavior both influences and is influenced by personal factors and the social environ
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4
Q

3 levels that influence a health behavior? What are 3 factors of the third?

A
  1. Individual/Intrapersonal Level – Individual characteris0cs that influence behavior
  2. Interpersonal Level – Interpersonal rela0onships – family, friends, peers
  3. Community Level:
    - Institutional factors: rules, regula0ons, policies
    - Community factors: social norms or standards
    - Public policy: local, state, federal
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5
Q

Individual/Intrapersonal Level & Interpersonal Level – Theories are categorized as?

A

Cogni0ve-Behavioral

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6
Q

Individual/Intrapersonal Level & Interpersonal Level – 3 key concepts - behavior is controlled by? What’s needed for change? Key influences on behavior? (4)

A
  • Behavior is controlled by what people know and think
    • Knowledge is needed for behavior to change
    • Perceptions,
  • motivations,
  • skills &
  • the social environment
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7
Q

At the community level, theories offer frameworks for?

A

implementing multi-dimensional approaches for the promo0on of healthy behaviors

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8
Q

3 Individual/intrapersonal level theories?

A
  • Health Belief Model
  • Theory of Planned Behavior
  • Transtheore0cal Model (TTM) - Stages of Change Model
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9
Q

Interpersonal theory?

A

social cognitive theory

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10
Q

Community level theories? (5)

A
  • Community Organization
  • Diffusion of Innovations
  • Communication Theory
  • Media Effects
  • Agenda Setting
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11
Q

Why are theories important? (3)

A
  • Evidence based practice
  • Allows for the design & development of programs based on an understanding of behavior
  • PROGRAMS BASED ON THEORY ARE MORE LIKELY TO SUCCEED
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12
Q

Decision begins with a thorough assessment of the situation for? (4)

A
  • Health problem
  • Target population
  • Type of behavior to be addressed
  • Environment
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13
Q

The health belief model is based on…? Of? (3)

A
  • An individual’s readiness to act and the decision to participate are based on an individual’s perceptions of:
  • the threat posed by a health problem
  • the benefits of avoiding the threat
  • factors influencing the decision to act (barriers, self-efficacy, etc)
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14
Q

HBM - What Six constructs influence one’s decision to act to prevent, screen for, or control disease?

A
  1. Perceived susceptibility
  2. Perceived severity
  3. Perceived benefits
  4. Perceived barriers
  5. Cue to action
  6. Self-efficacy
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15
Q

Theory of Planned Behavior (TPB) focuses on? It explores? (4) What determines behavior?

A
  • It focuses on individual motivational factors as determinants of the likelihood of performing a specific behavior.
  • It explores the relationship between behavior and beliefs, attitudes, and behavioral intention.
  • Behavioral intention determines the behavior
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16
Q

TPB - behavioral intention and behavior are influenced by? (3)

A
  • Attitude toward behavior
  • Subjective norm – social perception of the behavior
  • Perceived control over the behavior
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17
Q

Transtheoretical Model (TTM) Stages of Change states? (3)

A
  • Behavior change is a process.
  • Based on an individual’s motivation and readiness to change a behavior.
  • Five stages of change – interventions should be designed for each stage.
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18
Q

TTM 5 stages of change?

A
  1. Precontemplation (not ready – have not thought about it)
  2. Contemplation (getting ready)
  3. Preparation (ready)
  4. Action
  5. Maintenance
  6. Termination
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19
Q

The Transtheoretical Model uses stages of? To?

A

change to integrate processes and principles of change from across major theories of intervention.

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20
Q

TTM 5 stages of change? (6)

A
  1. Pre-contemplation: no intention to act in the near future (six months), due to lack of information or demoralization from past attempts.
  2. Contemplation: intention to change in the near future (3-6 months); aware of pros and cons of changing.
  3. Preparation: intention to take action in the immediate future (1 month); have a plan of action.
  4. Action: overt action taken within the last 6 months.
  5. Maintenance: has changed behavior for more than 6 months. Working to prevent relapse; less temptation and more confidence.
  6. Termination: no temptation with 100% self efficacy.
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21
Q

4 things to note about TTM?

A
  • Stages are always the same – how one goes through them depends on the behavior to be changed.
  • It is a circular model – NOT LINEAR – one does not have to progress through the stages systematically.
  • Process may repeat itself.
  • Process may arrest at any stage.
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22
Q

Core Constructs of TTM? (4)

A
  • Stages of Change: temporal dimension – a process that unfolds over time.
  • Processes of Change: covert and overt activities people use to progress through the stages – they are important guides for intervention programs.
  • Decisional Balance: weighing pros and cons of changing.
  • Self-Efficacy: ability to successfully do something.
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23
Q

TTM - What is consciousness raising? Example?

A

– increasing awareness of facts related to the behavior.

Ø I recall information people had given me about risks related to obesity and low activity levels.

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24
Q

TTM - What is dramatic relief? Example?

A

– experiencing negative emotions related to the unhealthy behavior.
Ø I react emotionally to warnings about heart attacks.

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25
Q

TTM - What is environmental re-evaluation? Example?

A

Environmental Reevaluation – realizing implications of the behavior on one’s social & physical environment.
Ø I consider the view that smoking can be harmful to the people around me.

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26
Q

TTM - What is social libation? Example?

A

– realizing that social norms are changing to support the healthy behavior.
Ø I find society changing in ways that make it easier for me to be more active.

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27
Q

TTM - What is self re-evaluation? Example?

A

– realizing that the behavior change is an important part of one’s identity
Ø My need to sit and watch TV for hours every night makes me feel disappointed in myself

28
Q

TTM - What is stimulus control? Example?

A

– removing reminders of unhealthy behavior & adding reminders of healthy behavior.
Ø I gave away my TV.

29
Q

TTM - What is helping relationships? Example?

A

– using social support for behavior change.

Ø I have someone who meets me at the gym 2x/week to work out with me.

30
Q

TTM - What is counter conditioning? Example?

A

– substituting a healthy behavior for the unhealthy one.

Ø I find that doing other things with my hands is a good substitute for smoking.

31
Q

TTM - What is reinforcement mgmt? Example?

A

– increasing rewards for positive behavior & decreasing those for unhealthy behavior
Ø I reward myself when I exercise.

32
Q

TTM - What is self liberation? Example?

A

– making a firm commitment to change

Ø I make a commitment to eat better and exercise regularly.

33
Q

Which processes of change fall under precontemplation? (3)

A
  • consciousness raising
  • dramatic relief
  • environmental reevaluation
34
Q

Which processes of change fall under contemplation? (4)

A
  • consciousness raising
  • dramatic relief
  • environmental reevaluation
  • self- reevaluation
35
Q

Which processes of change fall under preparation? (1)

A

self-liberation

36
Q

Which processes of change fall under action? (4)

A
  • reinforcement mgmt
  • helping relationships
  • counterconditioning
  • stimulus control
37
Q

Which processes of change fall under maintenance?

A
  • reinforcement mgmt
  • helping relationships
  • counterconditioning
  • stimulus control
38
Q

TTM - Motivating an Individual to Change Requires?

A

Different Information at Different Stages

39
Q

TTM - What is decisional balance? Derived via?

A
  • the relative weight people assign to the pros and cons of a behavior influences their decisions about behavior changes
  • Decisional balance is derived via a comparison of the strength of perceived pros of the target behavior with the perceived cons.
40
Q

TTM - What is self-efficacy? What is confidence? Temptation?

A

• Def: the belief that one can successfully execute the behavior required to produce the outcomes.
• Confidence: situation-specific confidence people have that they can cope with high-risk situations without relapsing to their unhealthy or high-risk habits.
• Temptation: the intensity of urges to engage in a specific habit when in the midst of difficult situations, including:
– Negative effect or emotional distress
– Social occasions
– Cravings

41
Q

TTM - What leads to individual behavioral acts? Self-efficacy leads to?

A
  • decisional balance

- individual behavioral acts

42
Q

Critical Assumptions of TTM - no? Behavioral change is? Stagers are?

A
  • No single theory can account for all the complexities of behavioral change.
  • Behavioral change is a process that unfolds over 8me through a sequence of stages.
  • Stages are both stable and open to change just as chronic behavioral risk factors are both stable and open to change.
43
Q

Critical Assumptions of TTM - there are a? Without planner interventions…? The majority of at-risk population aren’t…? What needs to be applied at specific stages?

A
  • There are a common set of change processes that people apply across a broad range of behaviors.
  • WITHOUT PLANNED INTERVENTIONS, POPULATIONS WILL REMAIN STUCK IN THE EARLY STAGES. There is no inherent motivation to progress through the stages of change
  • The majority of at-risk populations are not prepared for action and will not be served by traditional action-oriented prevention programs.
  • Specific processes and principles of change need to be applied at specific stages if progress through the stages is to occur. Intervention programs must be matched to each individual’s stage of change.
44
Q

Critical Assumptions of TTM - chronic behavioral patterns are? Stage-matched interventions have been designed to?

A
  • Chronic behavioral patterns are under some combination of biological, social, and self-control.
  • Stage-matched interventions have been designed primarily to enhance self-control.
45
Q

TTM limitations #1

A

Literacy level & socio-demographic characteristics may impact the types of resources individuals will need.

46
Q

TTM limitations #2

A

• When behaviors are strongly associated with socio-economic and educational status it is important to address the behavior’s role in the broader social and physical context:
– Single parent and smoking cessation
– stressors related to smoking
– Stress management programs
– Work/rest breaks and productivity
– Improving diet and low socioeconomic power

47
Q

TTM limitations #3

A

• Model may be of limited utility in populations where behaviors are contingent on severe external restrictions.

48
Q

TTM limitations #4

A

• The behavioral criterion are often difficult to measure for each stage:
– How do you know when people change?

49
Q

TTM limitations #5

A

People often use a piece, one part, of the model.

50
Q

TTM limitations #6

A

• Model is not linear and has no sense of how much time is reasonable within each stage.
– Smokers hospitalized for MI quit smoking (6ti%) – going directly from precontemplation to action
– The 6 month window for contemplation??

51
Q

TTM limitations #7

A

Intention to change (decisional balance) is a good predictor of change, BUT … past behavior is a better predictor of future behavior.

52
Q

Social cognitive theory states behavioral change is a? It is use successfully where? The likelihood of behavioral change is determined by what 3 factors?

A

• A dynamic, on-going process in which personal factors, environmental factors, and human behavior exert influence on each other.
• It is used successfully in areas ranging from dietary change to pain management.
• The likelihood of a behavior change is determined by 3 factors:
1. Self-efficacy
2. Goals
3. Outcome expectations

53
Q

Social Cognitive Theory Constructs - what is reciprocal determinism?

A

Dynamic interaction between person, behavior, and environment in which the behavior is performed.

54
Q

Social Cognitive Theory Constructs - behavioral capability?

A

– Knowledge & skill to perform a behavior.

55
Q

Social Cognitive Theory Constructs - expectations?

A

anticipated outcomes of a behavior

56
Q

Social Cognitive Theory Constructs - self-efficacy?

A

Confidence in one’s ability to take action.

57
Q

Social Cognitive Theory Constructs - observational learning?

A

behavior acquisition that comes from watching the actions and outcomes of others.

58
Q

Social Cognitive Theory Constructs - reinforcements?

A

Responses to the behavior that influence the likelihood of the behavior reoccurring.

59
Q

Community Organization and Other Participatory Models emphasizes? Community groups are used to?

A
  • Emphasizes community-driven approaches to assessing and solving health and social problems.
  • Community groups are used to identify problems, mobilize resources, and implement strategies to reach the collective goal.
60
Q

Community Organization constructs - define empowerment?

A

A social action process through which people gain mastery over their lives and their communities.

61
Q

Community Organization constructs - define community capacity?

A

– Characteristics of a community that affect their ability to identify, mobilize and address problems.

62
Q

Community Organization constructs - define participation?

A

Engagement of community members as partners.

63
Q

Community Organization constructs - define relevance?

A

Knowing what is important to the community and where they stand on the issue.

64
Q

Community Organization constructs - define issue selection?

A

Identifying immediate, specific and realistic targets.

65
Q

Community Organization constructs - define critical consciousness?

A

Awareness of social, political and economic factors that influences the issues of concern.

66
Q

Social cognitive theory is based on what six constructs?

A
  • self-efficacy
  • behavioral capability
  • observational learning
  • reinforcement
  • reciprocal determinism
  • expectations

Health Promotion and Wellness (6 decks)

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