Behavior Change Theories

Transcription

1 Behavior Change Theories Neetu Purohit Indian Ins(tute of Health Management Research, India h8ps:// h8p:// project.org

2 Understanding and Changing Health Behavior Despite the obvious risks, many people con(nue to engage in unhealthy behaviours. Important is to know what mo(vates one to engage in healthy and unhealthy behaviours and how one can be mo(vated to behave in a manner more likely to keep him/her healthy. It is important to determine the factors that underlie a person's decision to perform or not perform a behaviour.

3 Behavior Change How to understand behavior change? A number of theories to comprehend behavior across cultures, diseases/condi(ons, and disciplines. A few widely used

4 Theories of Behavior Change Behaviorist Approach Social Learning Approach Cogni(ve Approach

5 Behaviorist Approach Almost all behaviour is learned, developed through experience with and feedback from our environment. Mentalis(c events (such as thoughts and ideas) and mys(cal concepts (such as ins(nct, will, feeling) which cannot be observed or measured, cannot form part of an objec(ve, scien(fic explana(on of human behaviour.

6 Classical Condi?oning Learning by associa(on Phobia Development of condi(oned response Eg.: Ea(ng behavior Role of environmental cues S(mulus Control and Response Subs(tu(on

7 Diagram

8 Operant Condi?oning Learning which occurs by trail and error and is dependent on the environmental response to the behaviour A teenage smoking Inhibi(ons for male steriliza(on, colostrums feeding

9 Diagram

10 Albert Bandura Social Learning Theory Reac(on against behaviorism (behavior condi(oned to environmental s(muli) Recogni(on of reciprocal influences and media(ng effects of (social) cogni(on Studies of origins of aggressive behavior

11 Social Learning Theory People learn how to behave by: observing the ac(ons of others observing the apparent consequences of those ac(ons evalua(ng those consequences for their own life rehearsing, then a8emp(ng to reproduce those ac(ons themselves Applica'on: modeling desirable behaviors Children/young adults watching adults smoking Aggression/temper tantrums Celebrity endorsement

12 Angelina Jolie underwent a double mastectomy Jolie had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer before undergoing a double mastectomy Dr. Jay Orringer, (her surgeon) opines that her opera(on has saved dozens of other women's lives as she is a role model

13 Cogni?ve theories Cogni(ve approach lays great emphasis on the central role of mental process such as memory, a8en(on, percep(on, language, thinking in determining behavior

14 Health Belief Model Perceived Suscep?bility: subjec(ve percep(on of the risk of contrac(ng a health condi(on Perceived Severity: feelings concerning the seriousness of contrac(ng an illness or of leaving it untreated Perceived Benefits: believed effec(veness of strategies designed to reduce the threat of illness Perceived Barriers: poten(al nega(ve consequences that may result from taking par(cular health ac(ons (physical, psychological, and financial)

15 Health Belief Model Cues to Ac?on: Events, either bodily (e.g., physical symptoms of a health condi(on) or environmental (e.g., media publicity) that mo(vate people to take ac(on. Other Variables: Diverse demographic, socio- psychological, and structural variables that affect an individual's percep(ons and influence behavior.

16 Health Belief Model

17 Theory of Planned Behaviour Research using the Theory of Reasoned Ac(on (TRA) has explained and predicted a variety of human behaviors since With the addi(on of perceived behavioral control the theory was called the theory of planned behavior (TpB). (Ajzea, 1991) Based on the premise that humans are ra(onal and that the behaviors being explored are under control, the theory provides a construct that links individual beliefs, actudes, inten(ons, and behavior. Social Environment is given prominence in its ability to influence behaviour

18 Theory of Planned Behaviour ATtude: A person's posi(ve or nega(ve feelings toward performing the defined behavior. Depends on a person's beliefs regarding the outcomes of a defined behavior and the person's evalua(on of poten(al outcomes Subjec?ve Norms: Are a combina(on of a person's beliefs regarding other people's views of a behavior and the person's willingness to confirm to those views.

19 Theory of Planned Behaviour Perceived Behaviour Control: The belief in being able to successfully execute the behavior required to produce the desired outcomes. Inten?on: The intent to perform a behavior is the best predictor that a desired behavior will actually occur.

20 Reasoned Ac?on/ Theory of Planned Behavior

21 Transtheore?cal Model Transtheore(cal or Stages of Change model was developed by Prochaska and DiClemente (1986) Combines the mo(va(on and ac(on stage within one model

22 Transtheore?cal Model I PRECONTEMPLATION: Not considering that change in behavior is required or it might not be of interest to them.

23 II CONTEMPLATION: Transtheore?cal Model Something happens to prompt the person to start thinking about change. Perhaps hearing that someone has made changes - or something else has changed resul(ng in the need for further change. Starts weighing up the pros and cons of changing their behaviour

24 III PREPARATION: Transtheore?cal Model Person prepares to undertake the desired change. Start gathering informa(on, finding out how to achieve the change, deciding when change should take place. May include talking with others to see how they feel about the likely change Start making some small changes

25 Transtheore?cal Model IV ACTION: People make changes, ac(ng on decisions, informa(on, new skills, and mo(va(ons for making the change.

26 V MAINTENANCE: Transtheore?cal Model Prac(ce the new behaviour to be consistently maintained

27 Determinants of Health Ac?on Have reached the prepara(on stage, have weighed up the pros and cons of their current behaviour Believe in their own ability to make a change Change with the support of family and friends Are able to avoid cues to the previous unhealthy behaviours Are able to find rewarding alterna(ve behaviors Are rewarded by themselves and others for maintaining the change

28 Sources MPH course on Health Communica(on Program: Planning And Strategic Design and Implementa(on & Evalua(on by Douglas Storey, Center for Communica(on Program, Johns Hopkins Bloomberg School of Public Health Hubley, John (1994): Communica(ng Health- An Ac(on Guide to Health Educa(on and Health Promo(on, McMillan. Piotrow, Phyllis, Kincaid, Lawrence D, Reunion II, and Rinehart, Ward (1997): Health Communica(on; Lessons from FP and RCH, Johns Hopkins School of Public Health h8p://newsnextbd.com/tag/angelina- jolie/ 28