Lecture 8 Process of change.pptx

Umm Al-Qura University Faculty of Public Health and Health Informatics Health Promotion and Education Department Health Behavior Change Course Lecture 8 Process of Change Presented by: Dr. Sallah Alawneh By the end of this lecture the students will be able to: Identify the Process of Change throu...

Umm Al-Qura University Faculty of Public Health and Health Informatics Health Promotion and Education Department Health Behavior Change Course Lecture 8 Process of Change Presented by: Dr. Sallah Alawneh By the end of this lecture the students will be able to: Identify the Process of Change through transtheortical theory of change. Contents of the Lecture The Trans theoretical Model (TTM) The Stages of Change Processes of Change The Transtheoretical Model (TTM) • The Trans theoretical Model is an integrative, bio-psychosocial model to conceptualize the process of intentional behavior change. The Trans theoretical Model (TTM) • It includes and integrate constructs from other theories into a comprehensive theory of change. • It can be applied to a variety of behaviors, populations, and settings hence, the name Trans theoretical. The Stages of Change • People move through a series of stages when modifying behavior. • Certain principles needed at each stage. • The processes are needed to reduce resistance, facilitate progress, and prevent relapse. • The (TTM) represents a temporal dimension. • The change phenomena will occur over a period of time. The Stages of Change Precontemplation Not Ready Contemplation Getting Ready Preparation Ready Action Doing Maintenance Preservation Pre contemplation (Not Ready) • People do not intend to take action in the coming future. • Usually the time is measured as the next six months. • Being uninformed or under informed about the consequences of one’s behavior may leave the person in Pre contemplation stage persistently. • Multiple unsuccessful attempts to change can lead to demoralization about the ability to change. Contemplation (Getting Ready) • People intend to change in the next six months. • They are more aware of the pros and cons of changing. • If the pros and cons of changing are equal, people will remain in this stage for long periods of time. Preparation (Ready) • People intend to take action in the immediate future. • Usually it measured as the next month. • Typically, they have already taken some significant action in the past year. • These individuals have a plan of action, such as joining a health education class, consulting a counselor, talking to their physician or buying a self-help book. Action • People have made specific overt modifications in their lifestyles within the past six months. • For example: Reduction in the number of cigarettes.  Switching to low-tar. Low-nicotine cigarettes. Maintenance • People have made specific overt modifications in their lifestyles and are working to prevent relapse. • People are less prone to relapse. • People have more confident that they can continue their changes. • The Maintenance stage lasts from six months - five years. The Temporal Dimension as the Basis for the Stages of Change Processes of Change • The Stages of Change explain: When the changes in cognition, emotion, and behavior will take place. • The processes of change explain: How those changes occur. Processes of Change • There are ten covert and overt processes need to be implemented successfully through the stages of change to attain the desired behavior change. Processes of Change • The first five processes are classified as Experiential Processes. • They are used primarily for the early stage transitions. • The last five processes are known as Behavioral Processes. • They are used primarily for later stage of change. Experiential Processes Consciousness Raising (Get the Facts). Dramatic Relief (Pay Attention to Feelings). Environmental Reevaluation (Notice Your Effect on Others) Self-Reevaluation (Create a New Self-Image). Social Liberation (Notice Public Support). Experiential proce Finding and learning new facts, ideas, and tips Consciousness that support the recommended behavior raising change. Experiencing the negative emotions (fear, anxiety, worry) that go along with risky Dramatic relief behavioral. Realizing the negative impact of the unwanted Environmental behavior or the positive impact of the reevaluation recommended behavior on environment. Realizing that the behavior change is an Self-reevaluation important part of one’s identity as a person. Experiential Processes Consciousness Raising • It involves increased awareness about the consequences, and cures for a particular problem. • Interventions include: Feedback. Interpretations. Reading books. causes, Experiential Processes Dramatic Relief • If appropriate action is taken: It produces increase in emotional experiences followed by reduced affect or anticipated relief. • Interventions include: • Fear = arousing feedback on health risks. • Success stories =to move people emotionally. Experiential Processes Environmental Reevaluation • Assessments of how the presence or absence of a personal habit affects one’s social environment. • Example: • The effect of smoking on the other people. • It can be positive or negative towards others. Experiential Processes Self-Reevaluation • It assesses one’s self-image with and without a particular unhealthy habit. • such as one’s image as having potato versus an active person having an apple. Experiential Processes Social Liberation • Social liberation requires an increase in social support. • Use the procedures which can help populations to change. • By advocacy and empowerment procedures. • For examples: • Smoke-free zones. • Healthy food at schools and work. Behavioral Processes Stimulus Control (Manage Your Environment) Reinforcement Management (Use Rewards) Helping Relationships (Get Support) Counter Conditioning (Use Substitutes) Self-Liberation (Make a Commitment) Description Processes Increasing the rewards for the positive Reinforcement behavior change and decreasing the management rewards of the unwanted one. Seeking and using social support for the recommended behavior change. Helping relationships Substitute of unwanted recommended behavior. Counter conditioning behavior with Making a strong commitment to change. Self-liberation Behavioral processes Removing reminders to engage in unwanted behavior and adding reminders Stimulus control to engage in the recommended one. Behavioral Processes Stimulus Control • It removes reasons for unhealthy habits and adds the healthier one. • Example: Removing all the ashtrays from the house and car or removing high-fat foods. Behavioral Processes Reinforcement Management • It provides consequences for taking steps in a positive direction. • It includes reward and punishment. • We use reinforcement to increase the chance that healthy responses will be repeated. • Example: Self-statements like: “Nice going”. you overcome the unhealthy behavior.” Behavioral Processes Helping Relationships • It combines caring, trust, openness, and acceptance, as well as support for healthy behavior change. • For example: Supportive calls and friends meeting can be sources of social support. Behavioral Processes Counter Conditioning • It requires learning healthy behaviors as substitutes of unwanted behaviors. • Examples: Recommendations for use of nicotine replacement as a safe substitute for smoking. Use walking as a healthier alternative than “comfort foods” as a way to cope with stress. Behavioral Processes Self-Liberation • Self-liberation includes: • 1- Belief that you can change, and you are committed • 2- The recommitment to act on that belief. • Example: Make New Year’s decisions. Enhancing willpower. Telling others about your commitment to take action.