Health Behaviors And The Human Health Experience PDF

HEALTH BEHAVIORS AND THE HUMAN HEALTH EXPERIENCE TOPICS Theory of Reasoned Action and Planned Behavior Integrated Theory of Health Behavior Change - Polly Ryan HEALTH BEHAVIORS AND THE HUMAN HEALTH EXPERIENCE INTENDED LEARNING OUTCOME...

HEALTH BEHAVIORS AND THE HUMAN HEALTH EXPERIENCE TOPICS Theory of Reasoned Action and Planned Behavior Integrated Theory of Health Behavior Change - Polly Ryan HEALTH BEHAVIORS AND THE HUMAN HEALTH EXPERIENCE INTENDED LEARNING OUTCOME Knowledge Understand motivational influences on behavior that is not under the individual’s volitional control. Understand that engagement in self-management behaviors will lead to positive health status. Skill Identify how and where to target strategies for changing behavior. Explain virtually how and why people change an unhealthy behavior to healthier ones. Attitude Acknowledge the importance of theory on an individual’s decision to change. HEALTH BEHAVIORS AND THE HUMAN HEALTH EXPERIENCE THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION History: Developed in 1967 by Martin Fishbein. Revised and expanded by Fishbein and Ajzen after a decade. The theory was used to study human behaviour and to develop appropriate intervention in 1980. Focus: Person’s intention to behave a certain way. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION Assumptions: Human beings are rational and make systematic use of information available to them. People consider the implications of their actions before they decide to engage or not engage in certain behaviors. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION BEHAVIOR - The way in which one acts or conducts oneself, especially toward others. BEHAVIORAL INTENTION - A plan or a likelihood that someone will behave in a particular way in specific situations – whether or not they actually do so. - Main determinant of behavior - The best predictor of action THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION - Looks at a person’s attitudes towards a behaviour as well as the subjective norms of influential people or groups that could influence those attitudes. ATTITUDE Main influences of NORMS BEHAVIORAL INTENTION Main motivator of BEHAVIOR THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION ATTITUDE - A person’s feeling about performing a specific behaviour. Aspects of Attitude POSITIVE - An action that leads to a desirable outcome NEGATIVE - An action that leads to an undesirable outcome NEUTRAL THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION ATTITUDE - Influenced by a combination of two (2) related factors 1. BELIEFS about the outcome of behavior (BEHAVIORAL BELIEF) - A belief that behavioural performance is associated with certain attributes or outcome. (Is the behavior likely or unlikely?) 2. EVALUATION of the behavioral outcome - The value attached to a behavioral outcome or attribute (Is the behavior beneficial or harmful?) THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION SUBJECTIVE NORMS - Belief about what others will think about the behaviour 1. NORMATIVE BELIEFS - Belief about whether key individuals and groups approve or disapprove of the behaviour. 2. MOTIVATION TO COMPLY - Whether or not the person’s intentions or behavior will be affected by what others think. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR  THEORY OF REASONED ACTION Behavioral Beliefs Attitude toward behavior Evaluation of Behavioral Outcomes Behavioral BEHAVIOR Intention Normative Beliefs Subjective Norm Motivation to Comply THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION EXAMPLE EXERCISE SMOKING (Weight Loss) CESSATION Is having an active lifestyle Is quitting smoking enjoyable Behavioral Belief likely or unlikely? or not? Is having an active lifestyle Is quitting smoking benefits a Evaluation of beneficial or harmful? person or can cause a negative Behavioral Outcome effect? An individual’s family and Physician approves or Normative Beliefs friends approve or disapprove approves person’s attempt on an active lifestyle. smoking cessation. Approval of significant others Physician believes that Motivation to about an active lifestyle will person’s decision to quit Comply help to attain weight loss. smoking is the best for health. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION - Provides a framework for identifying and measuring the underlying reasons for a person’s intent to behave a certain way (or not). EXPECTANCY VALUE - Concept that an attitude is the result of one’s expectations or beliefs about the attributes of an object or action, and of how that attributes are assessed or evaluated by the person contemplating the behavior. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR History: In 1988, this theory was added to the existing Model of Reasoned Action to address the inadequacies identified through research. (One of the greatest limitations was with people who have little or feel they have little power over their behaviors and attitudes.) THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR - This is used to design interventions that target health- enhancing individual behaviour that may be socially unacceptable but have a varying levels of social acceptability. (Example: Condom use, Smoking cessation and Medication Adherence) - This explains Volitional Behaviors we perform. Volitional Behavior - A behavior that we have or had control over. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR Additional Element: PERCEIVED BEHAVIORAL CONTROL This indicates that a person's motivation is influenced by how difficult the behaviors are perceived to be, as well as the perception of how successfully the individual can, or can not, perform the activity.. Determined by two (2) factors: - Control Belief - Perceived Power THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR THREE (3) TYPES OF BELIEFS 1. Behavioral Beliefs 2. Normative Beliefs 3. CONTROL BELIEFS - Produce a BEHAVIORAL CONTROL by impacting performance of the behavior Attitude - (good-bad) Subjective Norm - (approves-disapproves) Perceived Behavioral - (easier-harder) Control THEORY OF REASONED ACTION AND PLANNED BEHAVIOR  THEORY OF PLANNED BEHAVIOR Attitude toward behavior Subjective Behavioral BEHAVIOR Norm Intention Perceived Behavioral Control THEORY OF REASONED ACTION AND PLANNED BEHAVIOR  Behavioral Beliefs THEORY OF REASONED ACTION/ Attitude toward behavior PLANNED BEHAVIOR Evaluation of Behavioral Outcomes Normative Beliefs Subjective Behavioral BEHAVIOR Norm Intention Motivation to Comply Control Beliefs Perceived Behavioral Control Perceived Power THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF REASONED ACTION EXAMPLE EXERCISE SMOKING (Weight Loss) CESSATION An individual perceives that Person believes that quitting Control Belief having exercise is easy or hard smoking is easy or difficult to (physical ability/time to do so). perform (presence of Withdrawal Syndrome). If an individual joins a club or If a person heard a testimony Perceived Power group or some kind of social with good outcome, he/she thing, he/she will develop a will be encouraged about confidence on achieving his/her own capability to stop weight loss. smoking. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR Individuals are much more likely to intend to have healthy behaviours if they have positive attitudes about the behaviours, believe that subjective norms are favourable towards those behaviours and believe that they are able to perform those behaviours correctly. A person’s intentions will be stronger when they have all three (3) than when they have only one (1). The stronger a person’s intentions to have a healthy behaviour, the more likely that person will actually perform that behaviour. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR Attitude Subjective Perceived Intention Behavior Norms Behavioral Control Good Approved Easier Favorable Positive Intention Behaviour Bad Disaproved Harder Unfavorable Negative Intention Behaviour THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR Many outside factors and restrictions can prevent an individual from performing a behaviour, even when they have intention to do so. Understanding barriers to positive behaviour and considering additional skills that individuals might need to succeed in taking action is extremely important for behaviour change program design. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR THEORY OF PLANNED BEHAVIOR External Behaviours POSITIVE INTENTION BEHAVIOUR Skills THEORY OF REASONED ACTION AND PLANNED BEHAVIOR INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Personal behavior influences one's health. Many people can improve their health by managing their chronic condition or engaging in health promotion behaviors. Persons with chronic conditions improve their health by managing specific health behaviors, a process that requires behavior change. Healthy people, as well as persons with chronic conditions, have opportunities to improve their health by regularly engaging in health promotion activities, a behavior change process similar or identical to the process used to manage chronic conditions. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Major Role of Health Education & Promotion Officers in Identifying Behavior Critical to Health Assessing the needs of individuals and groups and recommending specific health behaviors. Preparing and delivering interventions designed to enhance engagement in health behaviors. Evaluating the effectiveness of interventions for individuals, groups, communities and the nation. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Health Behavior Change Day-to-day management of chronic conditions - Is the responsibility of a patient and his/her family. Indicators that people need more help: - Repeated admission to acute care facility. - Failure to reach targeted outcome. - Continued need for unscheduled outpatient services. Health behaviour required to manage chronic conditions. People who successfully manage chronic conditions manage negative emotions associated with chronic conditions and fulfill responsibilities to their concomitant life roles. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Health Behavior Change Health Promotion also requires people to initiate and maintain health behaviour change. - Activity and exercise - Good nutrition - Stress management - Limited alcohol consumption - Smoking cessation Enactment of prevention behaviour is needed. Healthy lifestyle will improve and maintain positive health behaviour. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE History: Developed and emerged from systematic review of the literature. Ryan Folly developed this theory by integrating concepts that had been foundational to interventions resulted in changing health behaviors. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Assumptions: Behavior change is dynamic, iterative process. Desire and motivation are prerequisites to change, and self-reflection facilitates progress. Positive social influences sway one's interest and willingness just as positive relationships help to support and sustain change. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Health Behavior Change can be enhanced by: - Fostering Knowledge and beliefs. - Increasing self regulation skills and abilities. - Enhancing social facilitation. PROXIMAL OUTCOME – engagement in self-management behaviors specific to a condition of health behaviors. DISTAL OUTCOME – long term impact of personal behavior on health status. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE KNOWLEDGE AND BELIEFS Enhancement of knowledge and beliefs results in increased understanding of a specific condition or behavior. SELF–EFFICACY – confidence in ones’ ability to successfully engage in a change in normal and stressful conditions. OUTCOME EXPECTANCY – ones’ belief that engagement in a behavior will result in desired result. GOAL CONGRUENCE – resolution of confusion and anxiety occurring from apparent contradictory and competing demands associated with health goals. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Knowledge and Beliefs INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE SELF-REGULATION SKILL AND ABILITY This is a process that people use as they incorporate a behavior change into their daily routines and lifedtyle. This requires: - Goal setting - Self-monitoring and reflective thinking - Decision making - Planning and plan enactment - Self-evaluation - Management of emotional response INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Knowledge and Beliefs Self-Regulation Skill and Ability INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE SOCIAL FACILITATION SELF–EFFICACY – happens when a knowledgeable person in a position of perceived authority sways their thinking and motivation. SOCIAL SUPPORT – consists of emotional, instrumental, or informational support, which facilitates engagement in a health behavior. INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Knowledge and Beliefs OUTCOMES Proximal Distal Engagement in Self-Regulation Self-Management HEALTH STATUS Skill and Ability Behavior Social Facilitation INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE Middle-age women are prone to fracture and Osteoporosis associated with low bone density. OUTCOMES (Knowledge and Beliefs) Proximal Distal Performing behaviour such Women learn and apply as increase Calcium intake Prevention of interventions through goal setting, decision making, and having weight bearing FRACTURE and exercises. planning and evaluation. (Engagement in Self- OSTEOPOROSIS (Self-Regulation Skill and Ability) Management Behavior) (HEALTH STATUS) They will collaborate with health professionals. (Social Facilitation) INTEGRATED THEORY OF HEALTH BEHAVIOR CHANGE THEORY OF REASONED ACTION Conclusion The Theory of Reasoned Action and Planned Behavior gist that behavior of an individual is influenced by different factors to develop an intention to perform an acceptable behavior. Integrated Theory of Health Behavior Change depicts that health behavior change of a person can be enhanced by knowledge and belief, self-regulation skills and abilities and social facilitation that will lead to ones’ engagement in self-management behavior thus, resulting to an improved health condition. THEORY OF REASONED ACTION AND PLANNED BEHAVIOR REFERENCES Lesin, N., Theory of Reasoned Action. Resource Center for Adolescenct Pregnance Prevention; http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.TheoriesDetail&PageID=517 Ryan, P., Integrated Theory of Health Behavior Change. Background an Intervention Development; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778019/ RYAN P., WEISS M., TRAXEL N. & BRONDINO M. (2011) Testing the Integrated Theory of Health Behaviour Change for postpartum weight management. Journal of Advanced Nursing 67(9), 2047–2059. Theory of Planned Behavior. An HC3 Research Primer; Health Communication Capacity Collaborative; www.healthcommcapacity.org/wp- content/uploads/2014/theoryofplannedbehavior HEALTH BEHAVIORS AND THE HUMAN HEALTH EXPERIENCE