HLTH 315 Test - Behaviour Change Theories

Define a ‘theory’

“a set of concepts, definitions, and propositions that presents a systematic view of events or situations by specifying relations among variables in order to explain and predict events or situations”

Why use theory to guide intervention?

• summarize the cumulative knowledge of a topic

• target meaningful determinants of change

• understand why (or why not) the intervention worked

• tests theory

elements of a quality theory

1. clarity of constructs

2. clarity of relationships between constructs

3. measurability

4. testability

5. being explanatory

6. describing causality

7. achieving parsimony (choose the simplest scientific explanation that fits the evidence)

8. generalizability

9. evidence based

Summarize the key concepts of Social Cognitive Theory (SCT)

• individuals learn by observing others, direct experience, and media influence

• cognitive processes, behaviours, and environmental factors interact and influence each other (reciprocal determinism)

• observational learning, self efficacy, and outcome expectancies influence behaviour

reciprocal determinism

• an individual’s behaviour (ie. actions, words), personal factors (ie. beliefs, attitudes, self efficacy), and environment (ie. social stimuli, social support, physical surroundings) constantly reciprocally influence each other

self efficacy

one’s confidence in their ability to perform a task/behaviour

perceived self efficacy

beliefs in one’s capacity to organize and execute courses of action required to produce given attainments

task self efficacy

belief in one’s ability to perform a task/behaviour

self-regulatory self efficacy

belief in one’s ability to self regulate (organize) oneself to make a task/behaviour possible

what are the 4 factors that contribute to self efficacy?

Mastery: direct, successful experiences at a task

Vicarious experiences: observing others who are similar succeed at similar tasks

Verbal Persuasion: encouragement from others ie. positive feedback or words of confidence

Emotional & physiological arousal: the physical and emotional states experienced when performing a task

ie. stress, anxiety, joy, enthusiasm

outcome expectancies

individuals’ beliefs about the likely consequences of a particular behaviour

sociocultural facilitators and barriers

Facilitators:

• positive role models, supportive communities, accessible information, supportive environment, opportunities and resources

Barriers:

• negative role models, unsupportive environments, lack of access to resources

describe the key points of the Health Action Process Approach (HAPA)

• a process oriented, social-cognitive model that explains how people adopt, initiate, and maintain health behaviours through a process divided into a motivational phase (forming intentions) and a volitional phase (acting on intentions)

Motivational Phase:

• risk perception - understanding the risks of current behaviours

• outcome expectancies - believing that the new behaviour will have positive outcomes

• action self efficacy - confidence in one’s ability to perform the new health behaviour

• intention - a decision to engage in the new health behaviour

Volitional Phase:

• planning - developing concrete plans, including action and coping plans

• action control - self regulatory efforts to execute the plans and overcome obstacles

• maintenance self-efficacy - continued confidence in one’s ability to maintain the behaviour over time

• recovery self-efficacy - confidence in one’s ability to resume the healthy behaviour after a lapse

action self efficacy

confidence in ones ability to perform a new health behaviour

maintenance self efficacy

confidence in one’s ability to maintain a new health behaviour

recovery self efficacy

confidence in one’s ability to return to a new health behaviour after a lapse

action planning

• a plan for behavioural enactment that includes specific situational details and delineates a sequence of action

action plans include:

• what

• when

• where

• with whom

• how

coping planning

• a plan that identifies anticipated barriers to action and includes strategies to overcome the barriers

coping plans include:

• potential barriers

• solutions to overcome barriers

Describe the key points of Self Determination Theory (SDT)

• a psychological framework explaining human motivation, personality, and wellbeing; proposing that people are naturally driven to grow and develop when 3 innate needs are met: autonomy, competence, and relatedness

intrinsic motivation

doing an activity for its inherent satisfactions rather than for some separable consequence.

when intrinsically motivated, a person is moved to act for the fun or challenge entailed rather than because of external prods, pressures, or rewards

extrinsic motivation

doing something because it leads to a separable outcome (ie. the behaviour is instrumental)

describe the motivation continuum

Amotivation: lack of intention to act

Extrinsic Motivation:

• external regulation - for external reinforcement (gaining rewards, avoiding punishment)

• introjected regulation - for internal reinforcement (avoid anxiety, boost self esteem)

• identified regulation - identified the personal value of the behaviour

• integrated regulation - behaviours are congruent with personal needs, but outcome directed

Intrinsic Motivation:

• self regulation - for enjoyment, pleasure; no discernable reinforcement

autonomy

Desire to be a causal agent; for actions to reflect one’s self

the desire to feel that one’s actions are self-endorsed, chosen, and congruent with one’s values and identity

competence

the experience of mastering challenges, developing skills, and feeling effective in one’s environment

relatedness

the need to feel a sense of belonging, connecion, and care with other people

describe the key points of the Transtheoretical Model (stages of change model)

• a framework that describes the process of intentional behaviour change through 6 stages

Precontemplation: individuals are not considering making a change

Contemplation: individuals are considering making a change but have not yet committed to taking action

Preparation: individuals are intending to take action and are making plans to change their behaviour soon

Action: individuals have made a specific, overt modification in their behaviour

Maintenance: individuals work to prevent relapse and sustain the new behaviour over time

Termination/Relapse: the new behaviour becomes a part of their life or they revert to old habits and restart the cycle

list the pre and post action stages of the transtheoretical model

pre action:

• precontemplation

• contemplation

• preparation

post action:

• action

• maintenance

Relapse:

• re-starts the cycle