W3 understanding behavioural nonadherence Flashcards
Behavioural adherence
Behavioural adherence is the extent to which a person/collective acts in accordance with an agreed on, expected, desired or pre-determined standard
Behavioural nonadherence can include
underperformance
overperformance
incomplete performance
different performance
Underperformance - nonadherence
i.e. not doing a behaviour enough or at all e.g., doing no exercise or once/week when recommendations are to exercise three times/week
Overperformance - nonadherence
i.e. doing too much of a behaviour e.g., doing exercise at a higher intensity, higher frequency, or with heavier weights than recommended
Incomplete performance - nonadherence
i.e. not doing all of the behaviour e.g., doing the recommended exercise but without the recommended warm up and cool down
Different performance - nonadherence
i.e., doing the behaviour in a different way e.g., doing aerobic instead of muscle strengthening exercise as recommended
Behavioural nonadherence can be intentional or nonintentional
intentional nonadherence is when the person is aware they are not doing the behaviour as recommended
nonintentional nonadherence is when the person is unaware they are not doing the behaviour as recommended
Assessing behavioural nonadherence
- define required behaviour
- collect related information on behaviour performance
- determine adherence rate
- define adherence criterion
Step 1 in assessing behavioural nonadherence - define behaviour
define frequency, duration, context, etc
Step 2 of assessing behavioural nonadherence - collect related info on behaviour performance
-> frequency, duration, standard etc
Subjective methods (self/other report): survey, interview, diary, rating scale Objective methods: physiological measures, monitors, records
Choice of data collection methods
- person/professional burden
- bias eg recall, social desirability
- cost
- accuracy and reliability
- intrusiveness and acceptability
Step 3 of assessing behavioural nonadherence - determine rate
(Behaviour done in time period / Expected behaviour in time period)
x 100
Step 4 in assessing behavioural nonadherence - define adherence criterion
- > ?%
- partial adherence?
- what constitutes adherence v nonadherence
The COM-B model of behaviour
- Psychological model for explaining individual-level volitional human behaviour
- Intended to capture range of potential change mechanisms
- Starting point to consider interventions
- look up image
COM-B Capability and nonadherence
Psychological: thought processes
- Poor comprehension
- Poor recall
- Poor focus/attention
- Planning problems
Physical: necessary physical processes
- Low physical ability
- Low skill
COM-B Motivation and nonadherence
Reflective: Evaluations & plans
- Low confidence
- Negative outcome expectations
- Beliefs of low need/value
- Cons > Pros
Automatic: Impulses from Associative Learning/Innate Dispositions
- No cues for action
- Negative mood (eg depressed)
- Not a habit, conflicting habit
COM-B Opportunity and nonadherence
Physical opportunities
- Low resources
- Low accessibility/availability
- High cost
- Environmental stressors
Social: cultural milieu
- Stigma
- Clash with cultural values
COM-B promoting adherence - capability
Psychological: thought processes
- Accurate comprehension
- Empower planning, decision making
- Memory/attention aids
Physical: necessary physical processes
- Improve functioning
- Skill demonstration/training
COM-B promoting adherence - Motivation
Reflective: Evaluations & plans
- Improve confidence
- Identify valued consequences
- Perceived need
- Pros > Cons
Automatic: Impulses from Associative Learning/Innate Dispositions
- Cues for action
- Resolve unhelpful mood
- Habit formation/reversal
COM-B promoting adherence - Opportunity
Physical opportunities
- Resources and materials
- Accessibility/Availability
- Provide opportunities
- Affordability
- Reduce barriers/context stress
Social: cultural milieu
- Reduce stigma
- Create/align with positive norms
Motivation
a process that drives and directs behaviour
dimensions of amount and quality
The self determination continuum
*look up image