Compliance

What is adherence

The extend to which a person’s behavior corresponds with agreed recommendations from a healthcare provider

Greater adherence to PT is associated with (better/worse) outcomes

Better

True or False: generally adherence is very high

False

List of compliance strategies

Loss-framed approach
Gain-framed approach
Default behaviors
Planning prompts
Habit stacking
Temptation bundling
Careful selection
Streak tracking
Stimulus control
Support systems
Self-identification

Loss framed approach

Focusing on potential negative consequences
In PT - focusing on the harms of noncompliance

Gain framed approach

Focusing on potential positive consequences
In PT - focusing on the benefits of compliance

Which is better at changing behavior

Gain framed

What should you do when dealing with loss or gain framed approaches

Start positive and try and help set up reminders of what is important for the patient

Default behaviors

Making behaviors the “default” option
Behaviors are the primary option and you need to “opt out” of them
In PT - how can we make behaviors easier to do so they can be the primary option

Planning prompts

Discussing strategies to help make sure individuals can perform their exercise
Develop an exercise plan
Increases physical activity

Habit stacking

Linking behaviors with contextual factors
“Stacking” desirable activities onto an already formed habit
If-then statements

Temptation bundling

Connecting a “should” with a “want”
Trying an activity that someone should do, but doesn’t like to do with an activity they like to do but don’t need to do
Has been shown to improve physical activity

Careful selection

Collaborative efforts to help with exercise selection
Purposeful selection to achieve goals but include patient input
Active choice in activity selection can improve self-efficacy and self-determination

Streak tracking

Keeping a log to track successes
Allows confidence to build and involves self-monitoring

Stimulus control

Understanding the external stimuli that trigger certain behaviors
Some stimuli trigger undesirable and others can trigger desirable behaviors

Undesirable behavior triggers should be (added/removed)

Removed

Desirable behavior trigger should bed (added/removed)

Added

Support systems

Involvement of social support system can increase positive behavior
Start from a place of unconditional acceptance

Self-identification

Altering the self perception of an individual to improve compliance

Prescheduled activities on a calendar is an example of what behavior

Default behavior

Questions like when to do exercises? where to do exercises? and how will they be performed/tracked? is an example of what behavior

Planning prompts

Doing your stretches while you brush your teeth or while you make your coffee in the morning are examples of what behavior

Habit stacking

Listening to an audiobook only when walking is an example of what behavior

Temptation bundling

Wearing fun socks while performing exercises is an example of what behavior

Temptation bundling

Prompting questions such as 'out of the 5 exercises we did today, which 2-3 would be the ones that work best for you" are an example of what behavior

Careful selection

Providing a printout calendar that can be marked when activities are performed is an example of what behavior

Streak tracking

Leaving a tray of cookies out on the counter increases the amount eaten so put them out of sight is an example of what behavior

Stimulus control

Laying out clothes you use for exercise the night before to help trigger an exercise program is an example of what behavior

Stimulus control

Help patient set up a check system with a close friend to help promote their exercise compliance is an example of what behavior

Support system

Help patient reframe goals and reason behind goals is an example of what behavior

Self-identification