3018PSY EOT EXAM

An element or factor with the capacity to have an effect on behaviour. they can:

- enable or deter

- be direct or indirect

- can be proximal (factors in immediate situation)

- or distal (factors from past situations)

What are influences?

it is an approach that motivate and support people to:

- understand consequences of behaviour

- feel postive about benefits of changing

- plan change overtime

- recognise how social relationships and contexts affect behaviour.

- plan explicit coping strategies.

What are individual approaches?

They identify and build on strengths of individual communities and relationships within the community to:

- promote skills to facilitate behaviour change

- develop and maintain supportive social networks and relationships.

- support organisations and institutions that promote participation

- promote access to financial and material resources to facilitate behaviour change.

what are community/organisation approaches?

- change the context

- try to impact behaviour change by changing the setting

- these approaches should be consistent with individual ad community interventions.

What are population approaches?

- Down stream (Micro level): biological and physiological.

- midstream (intermediate level): behavioural attributes, psychological factors, and social factors.

- upstream (macro level): physical, economic, political and cultural environment.

THINK OF ACRONYM

What are the levels of influence?

- Complexity

- demand effort

- variety

- novelty

- habit

- consequences

- skill and time required

- resources required

What are the behavioural attributes that impact behaviour?

- self esteem

- goals

- emotions

- motivations

- beliefs

- attitudes

What are the psychological factors that impact behaviour?

The types are

- emotional

- material

- informational

- network

the sources are

- family

- friends

-professions

- others

What are the types and sources of social support?

Factors at a social level such as support, norms and values, role models, conflict, stigma, social pressure, power.

What are social factors?

Availability is having the resource available.

Accessibility is having access to the resource.

e.g. cars are available everywhere, but you need the resources such as money to have access to one.

What is the difference between availability and accessibility?

The resources, infrastructure and aesthetics.

What is the physical environment?

- costs

- education

- employment

- occupation (working conditions, income ect)

- housing

- area of residence

What is the economic environment?

- health

- welfare

- housing

- transport

- taxation

- legal

- safety

- organisations

- code of ethics

- professional practise.

what is the political environment?

- Belief systems

- practises

- values

- norms

- roles and boundaries

What is the cultural environment?

it aims to provide a comprehensive theory informed approach to identify determinants of behaviour.

has four clusters of influence

1. Nature of behaviour

2. Knowledge, skills, beliefs/capabilities, consequences

3. social/professional roles, identity, social influence, environment context and resources

4. motivations, goals and intentions, memory, attention, decision process, behaviour regulation and emotions.

What is the theoretical domains framework?

pre-contemplation, contemplation, preparation, action and maintenance.

What are the stage of change?

The extent to which a person acts in accordance with an agreed on, expected, desired or pre determined standard. e.g. following medical advice.

What is adherence?

Behaviour that is inconsistent with advice recommendations or standards.

can be under or over perfromance, incomplete and qualitatively different perfromance and intentional and non intentional.

What is non adherence?

- define the behaviour

- collect related info

- determine rate of behaviour

- define criterion

How to assess behaviour?

- the nature of behaviour( is it difficult, lots of effort, long?)

- knowledge (poor knowledge of behaviour causes non adherence)

- capability/belief (do i have the capability to do behaviour?)

- consequences (is there consequences stopping me from adherence visa versa)

- unrealistic optimism (it wont happen to me)

- reinforcement (will i be punished for doing this behaviour visa versa)

- lack of intentions

- stage of change (am i ready to change)

- goals (is this a goal for me, does it conflict with my other goals)

- memory (do i remember to do this, or how to do it)

- attention (can i focus on the issue)

- decisions (have i weighted the pros and cons)

- regulation

- emotions

- social identity (will doing this compromise my identity)

- power

- resources

What can impact adherence?

non adherence is due to

- lack of knowledge, and memory.

- low attention

- lack of decisions

- considering consequences.

What does the health belief model say adherence is due to?

is due to lack of intention with a behaviour gap that be due to negative social norms

What does theory of planned behaviour say causes non adherence?

capability beliefs impacted by social influences and environment context. if i have high internal locus of control then i believe what i am doing is making a difference which impacts adherence.

What does theory of locus of control says causes non adherence?

If asked to perform a behaviour that will compromise personal freedoms then i will experience negative emotions and will therefore not adhere.

how does psychological reactance impact adherence?

e.g. Its the patients role to apply to doctor. however, if the doctor doesn't consider me as a person then i am more likely to be non adherence as i resent the authority.

How does power and authority impact adherence?

fear can be a very dominant influence of adherence.

can be postive or negative and may cause someone to adhere due to fear or non adhere.

how does fear impact adherence?

Understanding representations of health and illness can impact adherence.

What does the self regulatory model say impacts adherence?

People may choose to behave a certain way because it is consistent with their identity .

e.g if i am a health advocate and am told to perform a behaviour that compromises this then i am more likely to not adhere.

How can identity control impact adherence?

Because people are aware it exists, therefore they may assume this instruction is also an error so they dont adhere.

How does professional error impact adherence?

- empowerment: empowering the individual

- motivation motivating the individual

What are the main responses to try and address non adherence?

Extrinsic is no motivation at all e.g. doing PE because i am forced to not because i want to.

External is having the reasons to do something but not really wanting to do it. e.g. i go to work because i get paid not because i want to.

Whats the difference between extrinsic and external motivation?

- Action planning

- social support and connections

- understanding readiness and relevance

- context

- competing demands

- coping plans

- efficacy

- self regulation

- satisfaction

How to promote behavioural adherence?

It suggests 5 key dimensions of impact that we need to considering when evaluating and planning an intervention.

- Reach: who is the target

- Effectiveness: what are the outcomes

- adoption: where is the intervention used

- implementation: what actually will be done

- maintenance: what will happen in the long run

What is the REAIM framework?

The strengths

- The impact is not just effectiveness

- considers real world application

- considers individuals and settings

- means of standardised reporting

the limitations

- its a framework not a theory

- reach vs adoption

- dimension not weighted equally

- info not always available across all dimensions

What are the strengths and weaknesses of the REAIM framework?

1. understand and engage in target audience

2. assess needs of target audience

3. set goals and objectives

4. develop intervention

5. implement intervention

6. evaluate intervention

What is the generalised model for intervention development?

Goals are overarching target such as increase exercise. Objectives are the precise steps you need to make that goal happen.

What is the difference between goals and objectives?

- education

- training

- persuasion: Eliciting feelings to promote action)

- incentiisation: expectation or delivery of reward.

- coercion: expectation of punishment

- restriction: restricting behaviours

- modeling

- environmental reconstructing: changing physical and social context of behaviour.

- enabling (increasing conditions to promote behaviour).

What are the intervention functions?

The observable, replicable and irreducible components of an intervention.

designed to alter or redirect processes that regulate behaviour.

What are behaviour change techniques?

A heretically structured classification system of techniques used in behaviour change interventions

What is the BCT Taxonomy?

To identify active components within interventions so we have a common understanding and language.

Why do we need behaviour change techniques?

- singularly or in combination

- face to face or distance

- individuals or in groups

- individual or population level

- different modes of delivery such as online or an app ect.

how can behaviour change techniques be used?

Go through the theory domain frame work influences and match them up to the BCT they would link too.

will help understand the links and how all connect.

week 5 slides.

How do different BCTs link to TDF influences?

- goals and planning

- feedback and monitoring

- social support

- shaping knowledge

- natural consequences

- comparison of behaviour

- associations

- repetition and substitution

- comparison of outcomes

- reward and threat

- regulation

- antecedents

- identity

- scheduled consequences

- self belief

- covert learning

What are the BCT of BCT Taxonomy?

- information on consequences

- goal setting

- review goals

- problem solving

- incentives

- material reward

- monitoring by self and others

- feedback on behaviour/outcomes

- credible source

- instruction on behaviour

- demonstrating behaviour

- behavioural rehearsal

- social comparisons

- social supports

- restructuring physical environment

- add objects

- prompts/cues

write these out and look at reading from week 5 for examples

What are the most common BCT of the BCT taxonomy?

one of the major principles to behaviour change counselling. it is eliciting and understanding personal perspectives.

it is understanding the person in his or her unique psychosocial and cultural perspectives.

it is developing a shared understanding of the persons problems and management.

it is a balance between task oriented behaviours (drawing out info) and affective behaviours (socioemotional exchanges.)

what is person centered communication?

- specific

- some repetition

- minimise jargon

- check understanding

What are the basic principles of person centered communication?

- fostering the relationship

- gathering information

- providing information

- making decisions

- enabling relevant behaviour

- responding to emotions

what are the communication core process?

role and responsibility

- build rapport

- appear open and honest

- discuss mutual roles and responsibilities

- respect statements

- engage in partnership building

- express caring and commitment

- acknowledge mistakes

skills

- greet appropriately

- eye contact

- active listening

- appropriate language

- encourage participation

- show interest

when trying to foster a relationship, what is the interventionist role and responsibility, and what skills are needed?

role and responsibility

- understand persons needs

- elicit descriptions including psychosocial perspective

skills

- open ended questions

- allow complete responses

- active listening

- elicit outcomes

- elicit persons perspectives

- clarify and summarise information

- ask about additional concerns

when gathering infromation, what is the interventionist role and responsibility, and what skills are needed?

Role Responsibility

- understand persons informational needs

- share information

- overcome barriers to persons understanding

- facilitate understanding

- provide information resources and help use and evaluation.

skills

- explain issue and approach to assessment and management.

- uncomplicated explanations and instructions

- avoid jargon and complexity

- encourage questions and check understanding

- emphasise key messages

when trying to provide information, what is the interventionist role and responsibility, and what skills are needed?

role and responsibility

- prepare for deliberation and enable decision making

- outline collaborative action plan

skills

- encourage participation in decision making

- outline choices

- explore persons preferences and understanding

- reach agreement

- identify and enlist resources and support

- discuss follow up and plan for unexpected outcomes

when decision making, what is the interventionist role and responsibility, and what skills are needed?

roles and responsibilities

- assess interest in self management

- provide advice

- assist person towards autonomy and self management

- arrange for needed support

- advocate for and assist person with systems

- respond to emotions

skills

- assess readiness to change

- elicit goals, ideas and decisions

- acknowledge and explore emotions

- express empathy and reassurance

- provide help managing emotions

- assess distress

when trying to enable relevant behaviour, what is the interventionist role and responsibility, and what skills are needed?

when interventionist and person make decisions together using best available evidence.

what is shared decision making?

is a counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior. It is a practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes.

what is motivational interviewing?

- Assess

- Advise

- Agree

- Assist

- Arrange

what are the 5 As of behavioural counselling?

organisations reply on this. it is exchange relationship between the employee and employer including

- psychological contracts: an unwritten contract between employee and organisation with implicit and explicit promises.

- perceived organisation support

- leader member exchange: what happens between the leader and the member.

What is an Employee-organisation relationship?

Change that occurs at the organisation level

what is organisational change?

1st: diagnosis: what needs to change. Use of Mckinseys 7s is useful.

2nd: planning: how can change occur? a group change not individual. can use drivers of change to facilitate change.

3rd: intervention

4th: evaluation

what is the change cycle

- perfromance

- team work

- leadership

- communication

- motivation

- extra role behaviours

- bullying ect

what are employees often encouraged to change?

advantages

- clear line of sight

- attractive to high performance

disadvantages

- reduces group perfromance by reducing cooperation

- reduced group cohesion by increasing competition

- can reduce intrinsic motivation in some cases

- difficult to implement in many work places and roles.

What are the advantages and disadvantages of perfromance related pay?

it is part of an overall reward system to attract, engage and retain. a salary or wages paid system based on positioning the individual, or team, on their pay band according to how well they perform.

what is perfromance related pay?

- hug: incentivising employees to engage or refrain from engaging in a certain behaviour.

- nudge: changing organisational cultural norms to elicit behaviour change.

- shove: creating new policies or adopting practises to encourage behaviour change.

- smack: punishing employees for engaging or not engaging in certain behaviours.

- perfromance related pay

- executive coaching

in organisations how are behaviours attempted to change?

change drivers are events, activities or behaviours that facilitate the implementation of change.

different types

- accepted change vision: employees agree a vision is postive for the organisation

- leaders change related actions: supporting the change through their commitment

- change related communication: building and understanding for why change is needed.

- change related training: understanding of the change and what it embodies.

- employee participation: involved in the planning of the implementation

- aligned human resource management practices: individual adopting change and sustaining momentum

- aligned structure and control process: moving and sustaining momentum for change.

what is drivers of change?

it tries to look at 7 critical parts of an organisation in order to do an assessment of whats happening at each component and how these interrelate.

hard factors

- stratergy

- systems

- structure

soft factors

- shared values

- skills

- staff

- style of leadership

What is Mckinseys 7s?

tailored sessions designed to improve a leaders perfromance.

what is executive coaching?

- resistance to change

- openness to change

- support for change

- readiness for change

- commitment for change

what do people react to change?

an individual or group engaging in acts intended to block or disrupt management attempt to introduce change

has three dimensions

- cognitive dimension - belief whether change is pos or neg.

- emotional dimension- emotional response to change

- intentionality - support for change or oppose change.

what is resistent to change in organisations?

essential step process for successful organisational transformation.

1. education and communication

2. participation and involvement

3. facilitation and support

4. negotiation and agreement

5. manipulation and co-optation

6. explicit and implicit coercion

what is kotters strategies for change?

advantages

- can boost self efficacy

- opportunity to focus on skill development

- attractive to high performers

disadvantages

- may be difficult to find a suitably qualified coach to suit the needs and requirements of the leader requiring coaching.

- can be concerns about confidentiality

- can be expensive and not available to everyone

what are the advantages and disadvantages of mentoring?

1. ensuring justice

2. cultivating a climate of change

how can organisations be proactive?

- formative/developmental

- process

- summative

- scientific

- goals based.

what can evaluations be in organisation change?

strengths

- personalised tailoring

- relationship based: collaboration with individual

- potential for large magnitude of change

limitations

- required identification and action of those people at risk

- limited reach

- individual stigmatisation and blaming

- de-emphaises contextual factors.

what are the strengths and limitation for individual (downstream) approaches?

Ecological models of behaviour which emphasis the interrelationship between people and environments and that there is multiple levels of influence on behaviour.

what are population approaches consistent with?

it is providing sources of information and education relevant to the behaviour. has three approaches

1. Educate (consequences, benefits, misconceptions, salience ect)

2. motivate (reinforce desired behaviour, generate emotional arousal, increase norms awareness ect)

3. advocate (increase community awareness of issue and point of view, create favourable attitudes, validate and legitimise issue, generate mood ect)

what is the informational environment?

- Limited reach: pamphlets and brochures, booklet, newsletters, DVDs, posters, t shirts, stickers.

- mass reach: Tv, radio, newspaper, internet, social media.

- mass media: advertising, publicity, edutainment, civic journalism

choose based on cost, reach, effectiveness, time, complexity, availability ect.

what are the information environment communication options? how do we choose which one to use?

- cues and prompts: signs that prompt you to do action.

- shaping knowledge: nutritional labels.

- persuasion antecedents/consequences: signs that

show consequences 'Take a break, tried drivers drive'

- instruction on how to perform behaviour: signs telling you how to perform a behaviour e.g. what is recyclable and what is not.

what are some information environment interventions?

presence, characteristics and location of facilities relevant to behaviour.

resources and infrastructure

the accessibility, availability, functionality, structure and quality.

what is the physical environment?

- adding objects: e.g. bins for rubbish.

- improving accessibility and availability

- increase relevant resources and infrastructure

- improve characteristics

e.g. objects such as stop signs to the environment to improve road safety behaviours.

what are some interventions for reconstructing the physical environment?

it is the cost and affordability of relevant behaviour.

includes things such as taxes, fines, discounts, rebates ect.

e.g. sugar tax

e.g. reward of if you pay your bill on time its cheaper.

what is the economic environment?

Policies, procedures, rules, regulations, relevant to behaviour.

such as 'no hat no play' policy to increase sun safety behaviours.

Not wearing a seat belt and getting a fine, to increase road safety.

what is the policy environment?

conditions and circumstances in which people are born, grow up, learn, work, play, age and live relative to others.

influenced by distribution of power, wealth and resources.

contributes to inequalities.

what are social determinants?

Reducing inequalities to enable behaviour for good health and wellbeing for all.

what are some social determinant interventions?

Strengths

- target average levels of behaviour in large numbers of people

- potentially radical and powerful

- may not require active engagement

- move beyond individual blaming

- acknowledge upstream influences.

limitations

- paternalism

- passive exposure

- complex, extensive commitment and resources and uncertainty.

- low control over intervention activities

- time for implementation and change

what are the strengths and limitations of population approaches?

morals - the beliefs of the individual or group as to what is right or wrong.

ethics - guiding principles which help the individual or group to decide what is good or bad.

values - whats important to use. Values guide our actions can never fully trick off a value e.g. being a loving parent.

what is the difference between ethics, morals and values?

- autonomy: the capacity to make an informed uncoerced (unforced) decision.

- beneficence: welfare of the research participant as a goal

- non maleficence: non-harming or inflicting the least harm possible to reach a beneficial outcome

- justice

- respect

what are the ethical principles?

says our three basic needs are

- competence (need to be effective in dealing with enviro)

- autonomy (need to control the course of our lives),

- relatedness (close relationships with others).

what is the social determination theory?

most effective to least effective.

- elimination: physically removing the hazard.

- substitution: replace the hazard.

- engineering controls: isolate people from the hazard

- administrative controls: change the way people work

- PPE: protect the worker with person protective equipment e.g. helmet.

what are the hierarchy of controls?

- Acknowledge feelings

- create social norms

- talk about climate change

- inspire postive visions

- value it

- act personally

- time is now

- engage.

what are 8 strategies from psychology to tackle climate change?

- what are the ultimate foals for public health practise

- how should this good be distributed in the population

- wht means can be used to dispute this good

what are three main ethical issue to health promotion?

- behaviourist conditioning

- communicative persuasion

- group pressure

- direct instrumental power.

what are the approaches to changing behaviour in regards to health promotion?

- are they cost effective or ineffective

- what counts as success

- how is success measured

- is changing attitude sufficient, or do we want to see behaviour change?

- over what time frame?

- who can rightly claim success, or who can be blamed.

what are the efficacy based considerations in regards to interventions?

- when does persuasion become coercion

- shaping of existing norms, or shaping new norms?

- manipulation of individuals to reach goals?

- deception?

- coercion

- where does values and morals come into this?

- legitimacy of the state in shaping behaviour?

what are autonomy based concerns of behavioural intervention?

it is the process of enabling people to increase control over and to improve their health.

aims to make the healthy choice the easiest choice and the unhealthy choice the difficult choice.

what is health promotion?

Strengthens the whole, whether the individual, group or community.

strengthens autonomy, skills and general control.

What is the empowerment approach?

- context/situational factors: culture, lack of monitoring, out of date rules ect.

- social norms

- historical factors

- tradition

- individual

why do people persist in undesirable behaviour?

- undesirable behaviour: why do people persist with this behaviour? (moral psychology)

- intervention: how to narrow the gap in an ethically acceptable way (design ethics)

desirable behaviour: what is the desired behaviour (philosophical ethics)

what are some ethical issues in designing interventions for behaviour change?

- correct the misconception about risk or benefits

- specifically recognise the potential harm

- balance the influence that physicians have over patients

- avoid the evangelical fervour

- provide clear concise information

how to enable patients to be part of the decision making?

- thinking that It is just common sense: which is not true as behaviour is a result of the interplay of many individual factors.

- thinking that It is just about getting the message across: which is not true Messaging can be effective but is only one part of a broad multi-level approach

- Knowledge and information drive behaviour so lack of this is issue: not true Other things in life constrain behaviour change

- People act rationally: not true Behaviours may not be the result of reflective processes, and social and environmental factors can cue behaviour

- people act irrationally

- It is possible to predict behaviour accurately: Predicting behaviour and behaviour change is hard, particularly over time

what are the common errors to behaviour change that make it difficult?

need to Understand:

- specifics of behaviour and impact: different expressions

- patterns of behaviour: who is behaving where (time and place)?

- preceding conditions: including meaning of behaviour

- automatic and reflective processes of behaviour

social and environmental factors: norms, settings, physical features, culture, economics

- interactions between people and groups and

institutions

- mechanisms of change

what needs to be done to make behaviour change affective?

we need to think about

- what is affected by the type of behaviour

- what are the interests of those affected

- what are the conflicts between those interests

- in light of those conflict, what is collectively desirable?

how do we work out what is desirable behaviour?