Barriers to Communication

environmental barriers

physical barriers, auditory barriers, issues of privacy

pharmacist barriers

low self-confidence, lack of emotional objectivity, discomfort in sensitive situations, negative perception about value of pt interaction

patient barriers

perceptions of pharmacist/staff, perceptions of their condition, emotional state, perception of impersonal medical system

administrative barriers

lack of compensation to RPh for education and counseling, pharmacy policies (staffing, workflow, etc)

time barriers

patient averse to long wait times (over 5 mins)

key to addressing barriers

identify existing barriers and develop strategies to minimize

Internal Locus of Control

thinking one has the ability within him/herself to control their lives and exert control over their illness (general/global belief)

• associated with positive health outcomes (med adherence, reduced use of ED, increased self care/self rated health)

Health Belief Model

patient health behaviors determined by degree to which a patient perceives a certain health threat + whether patient believes the particular behavior will reduce threat

• perceived threat (perceived severity, perceived susceptibility, cue to action, perceived benefit, perceived barriers, knowledge, personality

• likelihood to take action (perceived threat, cues to action, perceived benefit, perceived barriers

Self-Efficacy

confidence in one’s ability to perform an action, learned by performance accomplishments + vicarious experiences (more specific behaviors)

Theory of Planned Behavior

actions/behaviors are evaluated by individuals (their intention) before they are performed - a behavior is attempted when there is a change in beliefs and an individual thinks they should attempt the behavior

Behavioral Change

involves transition from past to a new behavior (changing patient knowledge, beliefs and attitudes about past and new behaviors)

External Locus of Control

Powerful others have control over patient illness/life (providers, family, SO, religion, morals) (general/global belief)

• associated with negative health outcomes (decreased quality of life, increased ED visits, decreased acceptance of illness)

Cues to Action

trigger or exposure that prompts action for the health-promoting behavior 

Components of TPB

• Behavioral intention → behavior

• attitude: beliefs regarding behavior

• subjective norm: what others (esp. friends, family, doctors) think or would do

• perceived behavioral control: facilitators and barriers to behavior that are not controlled by individual (environment, $, laws, etc.)

problems with Health Belief Model

• habit forming component

• non-health related reasons

• economic/environmental factors

• health not always highly valued

• cue to action not always prevalent

Problems with Theory of Planned Behavior

• opportunities + resources to be successful

• factors affecting intention 

• economic/environmental factors 

• decision-making process not linear