Lecture 3: Theories and Behaviour Change Interventions PDF

Lecture 3 Saturday, January 25, 2025 7:41 PM 3.1 - Theories and Behaviour Change Interventions: Personal Responsibility? - Beyond individual behaviours, we need initiatives aimed at promoting good health and preventing illness: health promotion and primary prevention P...

Lecture 3 Saturday, January 25, 2025 7:41 PM 3.1 - Theories and Behaviour Change Interventions: Personal Responsibility? - Beyond individual behaviours, we need initiatives aimed at promoting good health and preventing illness: health promotion and primary prevention Popular Theoretical Frameworks: - Attribution theory - Theory of planned behaviour - Self-efficacy theory - Self-perception models - Achievement goals theory - Goal setting theories - Health belief model - Transtheoretical model - Health action process approach The Health Belief Model: - Health behaviour model: belief that a health threat exists and the belief that action will lessen that threat. - Health threat: personal vulnerability and severity of consequences - The HBM suggests that people are more likely to change their health behaviors if they believe they are at risk of getting sick, and if they believe that taking action will help. - Healthcare professionals and public health experts use the HBM to create programs that help people change their health behaviors. Theory of Planned Behaviour: - The theory of planned behaviour assumes that individuals act rationally, according to their attitudes, subjective norms, and perceived behavioral control. ○ These factors are not necessarily actively or consciously considered during decision-making, but form the backdrop for the decision- making process. - Core components: ○ Attitude towards the behavior: An individual's positive or negative evaluation of performing the behavior. ○ Subjective norm: The perceived social pressure to perform the behavior, based on what they believe important others expect of them. ○ Perceived behavioral control: The belief in one's ability to perform the behavior, considering internal and external factors that may  evaluation of performing the behavior. ○ Subjective norm: The perceived social pressure to perform the behavior, based on what they believe important others expect of them. ○ Perceived behavioral control: The belief in one's ability to perform the behavior, considering internal and external factors that may facilitate or hinder it. Social Cognitive Theory: - Social cognitive theory (SCT) is a psychological theory that explains how people learn and behave by observing others and their environment. - “Self-efficacy is the belief in one’s capabilities to organize and execute the sources of action required to manage prospective situations.” - Bandura - What it explains: ○ How people learn: People learn by observing others, especially in social situations. ○ How people behave: People's behavior is influenced by their personal factors, environment, and the actions of others. ○ How motivation works: Motivation is internal and is made up of processes like self-efficacy, goals, and values. - What it's used for: ○ Health behavior: SCT can help people change their health behaviors by using observational learning and self-efficacy. For example, it can help people learn to wear masks or get vaccinated. ○ Media influence: SCT can help explain how media influences people's beliefs and actions. ○ Global issues: SCT can help address global issues like climate change, population growth, poverty reduction, and gender equality. Implementation Intentions: Implementation Intentions: - Intentions are more likely to be acted upon if a person has IIs – an ‘if/then’ plan – in place. - Desired behaviour – going to the gym – is now part of a specific plan: becomes efficient, immediate, and automatic Intention vs. Behaviour: - Intentions are central to health - Health models are better at predicting behaviour than explaining it - Webb and Sheeran (2006): ○ Relationship between intention and behavior is unstable – ranges from about.3 to.6 ○ Whether we are likely to follow-through with intentions depends on a range of factors… Dual Models: - Reflective mode: slow and is based on rules - is accessed intentionally and draws upon knowledge of values and probabilities, along with self- regulation. - Impulsive mode: associations are acquired over many experiences. Connecting Them: - Reflective Threads: ○ Interventions should be designed to promote positive social cognitions ○ Attitudes about costs and benefits are weighed, as is efficacy to respond positively. ○ We likely need to adapt or adjust interventions to match individuals’ stages of behavior change How can we ensure intentions generate action? How can we prompt health behaviour?  ○ Interventions should be designed to promote positive social cognitions ○ Attitudes about costs and benefits are weighed, as is efficacy to respond positively. ○ We likely need to adapt or adjust interventions to match individuals’ stages of behavior change - Impulsive Threads: ○ Intentions often do not lead to behavior. Even with the best of intentions our executive functioning as well as our conditioned responses hold a lot of sway (e.g., habits) ○ Need to find strategies to account for this, such as: § Highlight short-term benefits of health behaviors § Improve executive function, or at least make it so that we don’t need to use it! COM-B Framework: - The COM-B model is a behavior change framework that proposes three necessary components for any behavior (B) to occur. ○ Through assessing capability (C), opportunity (O), and motivation (M), leaders, policymakers, and behavioral scientists can understand why a specific behavior occurs and how to create targeted interventions that lead to effective change. - Capability refers to an individual’s psychological and physical ability to participate in an activity. - Opportunity refers to external factors that make a behavior possible. - Motivation refers to the conscious and unconscious cognitive processes that direct and inspire change.  targeted interventions that lead to effective change. - Capability refers to an individual’s psychological and physical ability to participate in an activity. - Opportunity refers to external factors that make a behavior possible. - Motivation refers to the conscious and unconscious cognitive processes that direct and inspire change. Motivational Interviewing: - A style of talking with people about health risks that enhances individual’s motivation - Ambivalence is key (uncertainty/hesitation) 1. Establish rapport & elicit change talk (OARS) - Open questions - Affirmations - Reflections - summarize 2. Develop discrepancy to facilitate change talk 3. Offer advice - Change Talk: § Goal - person expresses reason for change ○ Desire - 'I really want to lose weight' ○ Ability - 'I have done it before' ○ Reason - 'My kids really want me to' ○ Need - 'I cant live like this' ○ Commitment - 'I can get this under control' 3.2 - Applications Within Health Promotion and Other Relevant Professions: Careers Promoting Health Behaviour via Interventions: - Clinical health psychologist - Behavioural counsellor/therapist ○ Implementing interventions and supporting individuals ○ Training health care professionals - Applied health psychologists ○ Research, conducted with key public agencies ○ Research conducted in industry related to health promotion - Public health (varying roles) ○ Behavioural insights team (UK) - Occupational health psychology Example - Occupational Health Psychology: - Work redesign, training, ergonomic programs, health programs. - What works?  ○ - Occupational health psychology Example - Occupational Health Psychology: - Work redesign, training, ergonomic programs, health programs. - What works? ○ Health education ○ Supportive social and physical environments ○ Integration of the worksite program into the organization's benefits, human resources infrastructure, and environmental health and safety initiatives. ○ Links between health promotion and related programs like employee assistance. ○ Screenings followed by counseling and education. Reading Saturday, January 25, 2025 7:41 PM Self-Determination Theory: - Many voluntary behaviours/lifestyle influence our health - Why don’t people do these things? (eating healthy, exercise, no alcohol, etc.) ○ Lack of motivation ○ Reasons for change are not always autonomous § Could feel pressure from others - Self-determination theory (SDT) is an empirically based theory of motivation and psychological development that is especially focused on the basic psychological needs that promote high quality motivation and wellness, and how they are supported in social contexts. - SDT details how the styles and strategies of motivators such as parents, teachers, coaches, managers, and health-care professionals can promote or undermine engagement and the positive consequences that follow from it. Motivational Interviewing: - Motivational interviewing (MI) is a counseling style that helps people change their behaviors by increasing their motivation. - How it works: ○ Identify ambivalence: MI helps people recognize the gap between their current situation and their goals. ○ Elicit reasons for change: MI helps people identify their reasons for change and express them. ○ Build confidence: MI helps people feel confident in their ability to change by affirming their strengths and past successes. ○ Resolve ambivalence: MI helps people clarify and resolve their ambivalence about change. Behaviour Change Techniques: What is A BCT? - BCTs refer to the active ingredients in any behavioral intervention (which we refer-to as 'activities' in our earlier lecture). You can think of them as  Behaviour Change Techniques: What is A BCT? - BCTs refer to the active ingredients in any behavioral intervention (which we refer-to as 'activities' in our earlier lecture). You can think of them as essentially being the 'menu' of options that we have to change behaviour. - A BCT is defined as an observable and replicable component designed to change behaviour. - It is the smallest component compatible with retaining the postulated active ingredients and can be used alone or in combination with other BCTs. - To enable interventions to be evaluated and effective interventions (i.e. those which bring about the desired change in the target behaviour or behaviours) to be implemented, a BCT should be well specified. Why Do We Need BCTs? The more specific reasons behind creating a taxonomy of behaviour change techniques are: 1. To allow us to accurately replicate interventions - which is a critical goal for the advancement of science. 2. To communicate more specifically what interventions included so that when people go to use these interventions in the real world, they will know what to do. 3. To allow us to conduct better syntheses of evidence. If we have a common language of intervention components then, when it comes to summing-up the effects of our research and asking questions based on several studies... then we can be way more accurate. 4. To offer a menu to people developing interventions, so they can perhaps develop more diverse (and better) interventions What is The BCT Taxonomy? - It is a grouping of 93 (!) individual techniques, with each technique classified within one of 16 categories. Each of these techniques is a single, observable activity that we could include in an intervention. How Do We Use The BCT Taxonomy? - We use this in a bunch of ways. If researchers are designing an intervention, they will go through this taxonomy to help label and identify all of the things they are doing. - When we are summarizing the effects of past interventions, we can 'code' all of the studies that have been conducted in the past and then we can report: (a) which BCTs do researchers in a certain area 'rely' on? and (b) which BCTs are included in the most effective interventions.  - When we are summarizing the effects of past interventions, we can 'code' all of the studies that have been conducted in the past and then we can report: (a) which BCTs do researchers in a certain area 'rely' on? and (b) which BCTs are included in the most effective interventions. Week 3 - Hagger and Weed: The article "DEBATE: Do interventions based on behavioral theory work in the real world?" presents a discussion between Martin S. Hagger and Mike Weed on the effectiveness of behavior change interventions grounded in behavioral theory. Hagger argues that there is substantial evidence supporting the efficacy of such interventions in promoting health behavior change at the population level. He acknowledges, however, that large-scale effectiveness trials are limited and emphasizes the need for more research utilizing implementation science. Hagger also highlights the importance of sustained investment and advocacy to encourage policymakers to support behavioral interventions. Conversely, Weed contends that there is no evidence demonstrating that these interventions are genuinely effective in real-world settings across entire populations. He argues that focusing on individual behavior change fails to shift population behaviors and suggests a paradigm shift towards understanding and disrupting social practices that influence behavior distribution and acceptance within populations. The authors conclude by acknowledging areas of agreement and disagreement, emphasizing the need for further research and discussion on implementing effective behavior change interventions in real-world contexts.