PAH exam 4

theory

concepts and definitions that present a systemic view of events or situations by specifying relationships among variables in order to explain and predict events or situations

models

they draw concepts from different themes to elp understand a specific problem in a particulra setting or context

what are the levels of influence of the Social Ecological model

• individual

• social

  • interpersonal

  • social environment

• built environment factors

• policy factors

individual level of the SEM

• students, workers, patients

• individual factors that influence PA

  • knowledge, attitude, belief, behavior, motivation

  • self efficacy, readiness to change

  • ability, age, illness/ old age

  • education, income

what is an example of the individual level of the SEM

• a UI student (characteristics of a group of students)

• age, gender, SES, education

• highly motivated to be active, limited skills and knowledge, values health

Social environments of SEM

• interpersonal and cultural level

• friends, calssmates, family, co-worker, neighbor

• influences on PA

  • social support

  • modeling

  • group and counseling norms

  • cultural expectations

what is an example of social environments of SEM

people

• groups= friends, roomate, calssmate

• organization= professors in department, worksite supervisors, religious beliefs

• comunity= people at UI, people in neighborhood

Physical environments of SEM

• created spaces that influence the amount and type of PA (positive or negative)

• positive: parks, trails, rec center

• negative: worksites, schools, homes

what do created spaces include?

• geography

  • weather and topography

• resources

  • availability/access

  • aesthetics

  • safety

• community design

• public transportation

what is an example of physical environments of SEM

places

• apartment, campus, worksite, streets, rec center, sidewalk, cross walk

• a worksite builds a walking trail on campus

Public policy of SEM

• legislation, regulatory or public actions

• local, state, federal government

• informal local policies or rules in organizations

what is an example of public policy in SEM

• urban planning policies

• physical education requirements in schools

• healthcare policies

• workplace policies

requiring firefighters to exercise for 1 hr during each shift

what are the 3 core principles of the SEM

• multiple factors influence behaviors

  • change should occur at all levels

• environments are multidimensional

  • variety or features

  • actual and perceived qualities

  • unique needs for different populations

• interactions occur at varying levels

  • lack of access, limits who can do activity

  • increasing numbers of cyclists and lobbying, making paths and lanes

what are the steps to know which areas to focus on to increase physical activity

• identify factors that are associated with being active

• understand relationship between PA and those factors

  • positive or negative, modifiable

• study if changes in these factors result in an increase in PA behavior

• identify if this is true for all groups

  • men/women, old/young, races,

what is a correlate

reproducible association

• positive

  • one variable inc, other variable inc

• negative

  • one variable inc, other variable dec

what is a mediator

• a casual factor

• changes in this factor cause changes in PA

demographic factors that have positive relationship with PA

• education

• male gender

• income

psycholographic factors that have a positive relationship with PA

• enjoyment

• expected beliefs

• intention to exercise

• self-efficacy

• self-motivation

behavioral factors that have a positive relationship with PA

• active during childhood

• dietary habits

• past exercise program enrollment

social factors that have a positive relationship with PA

• physician influence

• social supports from friends/ peers

• social supports from family/ spouse

environmental factors that have a positive association with PA

• access

• scenery

• observing others exercising

• home equipment

• safety

demographic factors that have negative relationship with PA

• overweight/ obesity

• non white

• age

psycholographic factors that have a negative relationship with PA

• barriers

• lack of time

• mood disturbance

• poor body image

behavioral factors that have a negative relationship with PA

• smoking (weak)

social factors that have a negative relationship with PA

social isolation (weak)

PA characteristics that have a negative association with PA

• high perceived effort

• environment

  • climate/season

what are the steps to determine if a variable has a mediating relationship with PA?

• is the variable modifiable?

• is the relationship positive or negative?

• is there a causal relationship?

  • strong association?

  • does exposure to variable occur before the increase in PA

  • does response?

  • does it make sense this would change PA?

what are the constructs of the transtheoretical model (TTM)

• stages of change (readiness)

• process of change (how we change)

• decisional balance (reason for change)

• self-efficacy (task specific confidence)

what are the stages of change?

• precontemplation

  • inactive

  • not ready to change ( >6 months)

• contemplation

  • inactive

  • considering change ( < 6 months)

• preparation

  • inactive/ some PA

  • not meeting PA guidelines

  • change within month, making some changes

• action

  • active, meeting PA guidelines

  • making changes now

• maintenance

  • active, meeting guidelines for over 6 months

what are the cognitive processes of change

• conscious raising

  • inc knowledge of PA

• dramatic relief

  • risks of current behavior

• environmental reevaluation

  • impacts on others

  • live long to be with family

• social liberation

  • aware of support in society

  • trails and paths

• self- reevaluation

  • self image, how you will feel doing the new behavior

what are the behavioral processes of change

• counter conditioning

  • sub PA for physical inactivity

• helping relationships

  • find social support

• reinforcement management

  • reward yourself

• self liberation

  • commitment (goals and plans)

• stimulus control

  • manage environment (reminders, cues)

what is decisional balance

moving from precontemplation to maintenance you get more pros than cons for PA

what is self- efficacy

confidence in abilities to perform specific behaviors in specific situations

what are sources of self-efficacy

• enactive mastery (have done in past)

• vicarious experience ( watching, pretending you are doing it)

• verbal persuasion ( social support)

• physiological arousal ( how you feel when you do the behavior)

what are the processes to increase self efficacy

• self monitoring

• goals (small and attainable to build success)

• problem solving of barriers

• normalized feelings of experiences

• “I can do this” indicates high self-efficacy

what are outcome expectations

• what we expect to happen as a result as behavior

• outcomes that sustain PA

  • attainable

  • health benefits

  • improved body image

  • psychological benefits

why do individuals enjoy PA

• social interactions

• self perceptions of abilities

• social recognition of PA

• mastery and achievement of skill

• movement sensations

what is self determination theory

basic human need for

• competence

  • skilled at behavior, positive feedback, clear expectations

• autonomy

  • feeling of control in decision making, initiate actions for own reason

• relatedness

  • social interaction, connectedness, emotional support

Amotivation

why do I have to come to class, I dont like it its boring

extrinsic- external regulation

I only go to class because I have to

extrinsic- introjected regulation

I only run because i feel obligated and only if my friend does. I wont run if she does not

extrinsic- identified regulation

personal goal of a grade, i go to class often and try

extrinsic- integrated regulation

I am an athlete, idenifying yourself

intrinsic motivation

you do it because you like it

how does SDT impact PA/ exercise

• autonomy

  • control the decision you make about what type of PA you do

• competence

  • develop skills

  • find the just right fit for abilities

• relatedness

  • active with other

  • support our efforts

  • related to important aspects of our life

what are the social environment dimensions

• interpersonal relationships

  • social support and norms

  • access to social networks

• social inequalities

  • SEP

  • income innequality

  • racism

• neighborhood and community characteristics

  • social cohesion

  • neighborhood factors

  • perceptions of factors

how can you enhance interpersonal support

create social networks, enhance social networks, provide access to social resources

what are positive social support influences

• intention to be active

• cohesiveness in activity groups

• perceptions of norms to be active

• attitudes towards activity

• self- efficacy

• adherence and compliance

what is social support and the different types?

• what other people do to allow PA to occur

• perceived

  • perception one is supported

• received

  • amount of support

• connected

  • degree of social integration

examples of social support

• informational

  • give someone link to gym

• instrumental

  • enroll kids in a sport, drive, pay for someones PA

• emotional

  • watch practice, text and check in

• appraisal

  • feedback, quality and improvements to PA

physical environments

physical aspects of environment that surrounds us

built environment

any aspect of environment which has been created by people

natural environment

physical aspects which weren’t created or altered by people

what are the 5 A’s to physical activity opportunities

• available

  • do resources exist

• accessible

  • can I get there/how

• affordable

  • can I pay for them

• acceptable

  • am I safe/ welcomed

• appropriate

  • suitable for person and occasion

street scale urban design

changes to the built environment, in small demographic areas, limited to a few blocks

community scale urban designs

larger geographic area (several miles) and design elements that address proximity of homes, stores and work, and safety of travel by car or foot

what are the ways to measure PA environments

• self report of perceptions of environment

  • bias

• direct observation (audit)

  • detailed, time consuming, standard analysis of space

• secondary analysis techniques

  • geographic info systems, rely on existing data set

connectivity

how easy it is to get from one place to another within a neighborhood while using hte road network of a city to walk/bike

walkability

the combination of features of the built environment of an urban area that are conductive to walking for transportation

community scale design

• street connectivity

• short blocks

• direct pedestrian route

mixed land use

• <1/2 mi or 10 min walk

• density of residents and employment

• mixed land use

street scale design

• neighborhoods

• sidewalks

• street buffer, lights, speed bump

street scale design

• aesthetics

• clean, maintained, benches, shade areas

recreational resources

• available

• accessible

• parks, tails, open spaces

social and community support

• people seen exercising

• perceived social support

• incentives

what are promising PA policies

• quality PE in schools

• joint use policy

  • shared use of space between community and school

• policies for active transportation to school

  • safe routes to school

• worksite policies

  • allow time and space for PA

• land use policies

• complete streets policy

land use policies

• management, planning, and development of land in defined jurisdictions

• occur at local level to improve well-being of the communities that control the land

• EX: residential density targets, green space mandated

complete streets policy

• accommodations for all users of roadways

• achieved through

  • restructure policies and programs

  • rewrite design manuals and standards

  • training opportunities to engineers

  • make new performance measures like sidewalks

road diet

• reallocation of road space

• often from 4 → 3 lanes to make space for bike lane or sidewalk

• reduces speeds and lessens lanes to cross

the community guide

gold standard for what works to protect and improve population health. provides recommendations for and against and those with insufficient evidence provided. shows benefits, barriers, risk, does it work, cost

what is motivational interviewing

collaborative conversation to strengthen a persons motivation for and commitment to change

what are the 4 processes of motivational interviewing

• ambivalence is high

  • people stuck in mixed feeling about change

• confidence is low

  • doubt abilities to change

• desire is low

  • uncertain they want to change

• importance is low

  • benefits/disadvantages of current situation and change unclear

OARS

• Open questions

  • encourage individual to confront current behavior

• Affirmations

  • recognizes strength and ability

  • amplify reason to change

  • “You seem”

• Reflections

  • repeat what client is saying

  • builds engagement

  • “What I hear you saying is”

• Summarize

  • helps client see problem in new light

  • shows mindful listening

what are the PA mediators

• process of change

• self- efficacy

• decisional balance

• outcome expectations

• enjoyment

• social support