Lecture_3_Intrapersonal_and_interpersonal_theories_of_behavior_change.pptx

Umm Al-Qura University Faculty of Public Health and Health Informatics Health Promotion and Education Department Health Behavior Change Course Lecture 3 Intrapersonal and Interpersonal Theories of Behavior Change Presented by: Dr. Sallah Alawneh By the end of this lecture the students will be abl...

Umm Al-Qura University Faculty of Public Health and Health Informatics Health Promotion and Education Department Health Behavior Change Course Lecture 3 Intrapersonal and Interpersonal Theories of Behavior Change Presented by: Dr. Sallah Alawneh By the end of this lecture the students will be able to: Describe theories and models that used in health behavior change. Explain why theories are used to effect health behavior change Explain concepts, constructs and variables of the theories. Explain how theories are developed. Contents of the Lecture The Types of Theory Intrapersonal Theories Interpersonal Theories Community Level Theories Relation of Theories and Health Concept Concept Concept Concept Concept Theory and Model Behavior Un-healthy Healthy What is the theory? Definitions: •• AA theory theory is is aa set set of of interrelated interrelated concepts, concepts, definitions, definitions, and and propositions propositions that that explain explain or or predict predict events events or or situations situations by by specifying specifying relations relations among among variables. variables. •• So, So, theories theories explain explain why why do do people people behave behave and and why why do do not not behave behave in in certain certain way way related related to to the the health. health. What are the benefits of theories in health behavior? • Used in designing and evaluating health education interventions. • Used as foundation for program planning and development as a road map for studying problems. • Used as a guide to help explain the processes for changing health behavior. • Used to help planners to identify the most suitable target audiences, methods for change and outcomes for evaluation. What are the types of theory? • Theories and models are divided into three categories: 1. Intrapersonal or individual level theories (within the person) 2. Interpersonal theories (between persons) 3. Community level theories. 1- Intrapersonal Theories It focuses on factors within the person that influence his behavior. Example of these factors: Knowledge 1 3 5 7 Beliefs  Selfconcept Past experience 2 Attitudes 4 Motivation 6 8 Developmental history Skills Examples of intrapersonal theories Self-efficacy theory Health belief model Theory of reasoned action Attribution theory Trans-theoretical model. Precaution Adoption Process Model (PAPM) The rational model Protection Motivation Theory Theory of Planned Behavior The extended parallel process model (EPPM) The activated health education model Relation of Theories and Health Concept Concept Concept Concept Concept Theory and Model Behavior Un-healthy Healthy Examples of intrapersonal theories Self-efficacy theory Health belief model Theory of reasoned action Attribution theory Trans-theoretical model. Precaution Adoption Process Model (PAPM) The rational model Protection Motivation Theory Theory of Planned Behavior The extended parallel process model (EPPM) The activated health education model Self-efficacy Theory • ''I think I can, I think I can‘’. • Self-efficacy is the belief in one's own ability to accomplish something successfully. • It tell us that: • People generally will only attempt things they believe they can accomplish and would not attempt things that they believe they could fail. Self-efficacy Theory • People with strong sense of efficacy believe they can accomplish even difficult tasks. • They see these tasks as challenges to be mastered rather than threats to be avoided. Self-efficacy Theory • The theory introduces the idea that the perception of efficacy is influenced by four factors: 1.Mastery experience (to do something the same as something you are previously did). 2. Vicarious experience (if they can do it, so I can). 3. Verbal persuasion (when people persuaded verbally, they can achieve the task). 4. Somatic and emotional state (Stress, anxiety, worry, and fear) it affects the efficacy negatively (e.g. fear of dentist). The Health Belief Model • It explains human health decision-making and subsequent behaviour. • It explains People’s beliefs about the severity of a disease and their susceptibility to it. • And this will influence their willingness to take preventive action. • It helps predicting whether people will take action to prevent and control illness. The Health Belief Model • Example: • A group of social psychologists are working in the field of public health. • They were seeking to explain why some people do not use health screening. services such as immunization and The Health Belief Model Selfefficacy alth Believe Model said that Behavior is outcome of: 1 Perceived susceptibil Perceived barriers Cues Action 6 5 4 HB M Perceived benefits 3 2 Perceived severity to The Health Belief Model • Perceived susceptibility: the degree to which a person feels at risk for health problem. • Perceived severity: the degree to which a person believes the consequences of the health will be severe. • Perceived benefits: the positive outcomes a person believes will result from action. The Health Belief Model • Perceived barriers: the negative outcomes a person believes will result from action. • Cues to Action: an external motivates a person to act. • Self-efficacy: A person's belief in his or her ability to take action. The Health Belief Model • Example: • Dengue fever is a growing pandemic health problem. • Source reduction of Aedes mosquito breeding sites is critical for its control. • These larval mosquito breeding sites include many human-made items (trash) such as cans and tires. The Health Belief Model • Example: (continue) • The source reduction of these mosquito breeding sites is related to human behaviour. • We will design a health education–health behavioral change intervention. Example: Health belief model Dengue fever Construct Message example Perceived susceptibility “So, you don’t think dengue is a real problem. It is here in our community now. Young and old get sick with dengue” Perceived severity “It’s (dengue) a killer!” Perceived barriers “Little time to do a cleanup to reduce mosquito breeding sites. No problem. Use the action plan checklist. Use it once a week” Perceived benefits “If everyone spends just a few minutes each week to clean up stagnant water, throw away unneeded containers, or cover them, it will reduce dengue fever. Individual's Perception in HBM • According to the HBM, the likelihood that someone will take action to prevent illness depends upon the individual's perception that: They are personally vulnerable to the condition. The consequences of the condition would be serious. The precautionary behavior effectively prevents the condition. The benefits of reducing the threat of the condition exceed the costs of taking action. The Transtheoretical Model (TTM) Behaviour change is viewed as a progression through a series of five stages: Precontemplation Contemplation Preparation Action Maintenance. The Transtheoretical Model (TTM) • It is an integrative framework for understanding how individuals and populations progress toward adopting and maintaining health behavior change for optimal health”. • Has been useful explaining gradual development habitual patterns, e.g., diet & exercise. The Transtheoretical Model (TTM) Has four major constructs: Therefo re it called "Stages of Change Model" 01 02 03 04 Stage s of change Proces ses of change Selfefficac y Decisio nal balance The Transtheoretical Model of Change • This model recognizes that people have specific informational needs at each stage of behavioral change. The Trans theoretical Model of Change Potential change strategies Examples Definition Stage Increase awareness of need for “It isn’t that I can’t see the Has no intention of taking change; personalize information solution; I just can’t see the action within the next six Precontemplation about risks and benefits problem” months Motivate; encourage making specific plans Assist with developing and implementing concrete action plans; help set gradual goals “I want to stop feeling so stuck” “I just took out a membership to a fitness facility” Intends to take action in the next six months Intends to take action within the next 30 days and has taken some behavioral steps in this direction Contemplation Preparation Assist with feedback, problem- “I’ve started exercising and Has changed behaviour for less solving, social support and while I enjoy it, sometimes I than six months reinforcement find it a routine” Action Assist with coping, reminders, “Exercising three times a Has changed behaviour for more finding alternatives, avoiding week has become a part of than six months slips/relapses my lifestyle” Maintenance The Transtheoretical Model of Change Examples Definition “It isn’t that I can’t see the solution; I just can’t see the problem” Has no intention of taking action within the next six months Stage Precontemplatio Potential change strategies Increase awareness of need for change; personalize information about risks and The Transtheoretical Model of Change Potential change strategies Examples Definition Contemplation Motivate; “I want to stop Intends to take encourage making feeling so action in the next specific plans stuck” six months Stage The Transtheoretical Model of Change Potential change strategies Examples Definition Preparation Assist with “I just took out a Intends to take action developing and membership to a within the next 30 implementing fitness facility” days and has taken concrete action plans; some behavioral steps help set gradual goals in this direction Stage The Transtheoretical Model of Change Potential change strategies Definition “I’ve started Has changed exercising and behaviour for less while I enjoy it, than six months sometimes I find it a routine” Stage Action Assist with feedback, problem-solving, social support and reinforcement Examples The Transtheoretical Model of Change Potential change strategies Definition “Exercising Has changed three times a behaviour for more week has than six months become a part of my lifestyle” Stage Maintenance Assist with coping, reminders, finding alternatives, avoiding slips/relapses Examples Stages of Change • Individuals do not change their behavior at one time. • They change it stepwise through stages of change. The Transtheoretical Model of Change example Precontemplat Currently smoking and `not seriously considering ion quitting within the next 6 months' Currently smoking and `seriously considering quitting Contemplatio within the next 6 months'; `were not considering n quitting within the next 30 days, had not made a quit attempt of 24h in the past year, or both' Currently smoking, `were seriously considering quitting in the next 6 months and were planning to quit within Preparation the next 30 days,' and `had made a 24h quit attempt in the past year' Currently not smoking; quit in last 6 months Action Maintenance Currently not smoking; quit >6 months ago Precaution Adoption Process Model (PAPM) • It explains how people come to the decision to take action, & how they translate that decision to action. • Most useful when a deliberate action is required, e.g., screening or immunization. 2- Interpersonal Theories • It concentrates on the factors at interpersonal level. • It assume that other people affect our behavior. Interpersonal Theories • Other people affect our behavior by:  Sharing their thoughts  Sharing their advices  Sharing their feelings  Their emotional support and assistance • The other people can be:  Family  Friends  Peers  Health care providers  Co-workers. Example of Interpersonal theories • Social cognitive theory. Social Cognitive Theory (SCT) • It describes learning as a reciprocal interaction among an individual's environment, cognitive processes, and behavior. • People are thinkers; expectations of consequences. Social Cognitive Theory (SCT) • It aims to explain how people regulate their behavior by controlling and reinforcement. • It often used constructs: • Behavior capability. • Expectations. • Self-control or self-regulation. • Emotional coping response. • Self-efficacy. 3- Community Level Theories • This group of theories includes three of the ecological perspective levels: • Institutional (e.g., rules & regulations). • Community (e.g., social networks & norms). • Public policy (e.g., legislation). • Examples: • Theories associated with these factors include theories of community organizing and community building. Examples of the Community level theories 1. Diffusion of innovation theory. 2. Ecological models. 3. Social capital theory. 4. Community Readiness Mode. 5. Nine stages-Community Model. Community Readiness Mode • A stage model for communities. • Like individuals, communities are at various stages of readiness for change. Nine stages-Community Model No awareness Denial Vague awareness Preplanning Preparation Initiation Stabilization Confirmation/ Expansion Professionalism Questions? Comments?