Systematic
the use of systematic methods to collect data (with the goal of reducing bias)
Meta-analysis
the use of quantitative statistical analysis of several but separate experiements
Illness Behavior
action take by one who perceives themselves to be ill and to discover a remedy
preventive health behavior
actions taken by one who perceives themselves to healthy for the purpose of preventing illness
sick-role behavior
receiving treatment from medical providers, dependent behaviors that lead to some degree of exemption from one's usual responsibilities
locations
schools, communities, worksites, health care settings, homes, communication environments
audiences
ethnic and racial backgrounds, life cycle stage, disease and at-risk status
theory
a set of interrelated concepts, definitions and propositions that present a systematic view of events by specifying relations among variables, to explain or predict events
3 types of theory
formal theory, explanatory theory, change theory
formal theory
logistic/interrelationships
(theory of problem) - explanatory theory
describes/identifies why a problem exists and predicts its behavior
change theory (theory of actions)
guide the development of interventions is a basis for evolution
concept
building blocks or primary elements
construct
concepts used in particular theory
variable
how a construct is measure in a specific situation
paradigm
the basic plan that organizes our broadly based view of something
ecology
refers to the interrelationships between organism and their environments. it is derived from biological science
5 principles of ecological perspective
multiple levels of influence of health behavior, environmental contexts are significant determinants, influences on behavior interact across levels, ecological models should be specific, multilevel interventions should be most effective in changing behavior
multiple levels of influence of health behavior
specific factors may influence health behaviors on multipl levels
environmental contexts are significant determinants
behaviors may be predicted from situations rather than individual characteristics
influences on behavior interact across levels
variables work together (sidewalks increase walking)
ecological models should be behavior specific
need to identify environmental and policy variables specific to behavior for best outcomes
multilevel interventions should be most effective in changing behaviors
important influences at all levels of influence
Strengths of Ecological Model
Strength: multiple levels of broaden options for interventions, reach entire pop rather than individually
Weaknesses of Ecological Model
Weakness: lack of specificity, puts burden on health promotion professionals to identify critical factors, lack of info about broader levels of influence and construct interaction across levels
Challenges of Ecological Model
develop more sophisticated models leading to testable hypotheses, intervening on multiple levels
Complex System Models
have feedback loops and are adaptive to challenges in context - predict weather patterns/climate change
Health Belief Model (HBM)
assumes people will engage in health behavior or take recommended action when they believe they are reducing a threat that would have severe consequences
Theory of Planned Behavior (TPB)
assumes that all attitudes, subjective norms and perceived behavioral control all affect behavioral interventions - which are linked to behavior
Transtheoretical Model (TTM)
evolved from theories of psychoanalysis to consolidate varied approaches and how people change health behavior such as smoking
Most widely used behavioral model
TTM
How do you know what theory to use
Think about specific behavior; HBM: symptom promoted behaviors (vaccinations); TTM: habitual behaviors (smoking); TPB: deliberative behaviors (condoms prevent HIV)
value-expectency
a person's behavior is determined by how highly a goal is valued and by the degree they expect to succeed
Perceived susceptibility
likelihood of getting a disease or condition
Perceived severity
belief or seriousness of contracting an illness or condition or of leaving it untreated, including physical/social consequences
perceived threat or risk
combination of susceptibility and severity
Perceived benefits
beliefs about positive features and advantages of recommended action to reduce a threat; tangible and social benefits
Perceived barriers
possible obstacles to taking action, which can include negative consequences resulting from an action
cues to action
external or internal cues trigger actions (HBM model)
Self-efficacy
beliefs that one can perform the recommended health behavior
TRA/TPB - Behavioral Intention
perceived likelihood of performing a behavior
TRA/TPB - Attitude (proximal)
Behavioral Beliefs/Evaluation of Behavioral Outcomes
TRA/TPB - Behavioral beliefs (distal)
belief that behavioral performance is associated with certain positive/negative feelings
TRA/TPB - Evaluation of Behavioral outcomes (distal)
value attached to a behavioral outcome or attribute
TRA/TPB - Subjective Norm (proximal)
Normative beliefs/motivation to comply
TRA/TPB - Normative beliefs (distal)
belief about whether each referent approved or disapproves of the behavior
TRA/TPB - Motivation to comply (distal)
motivation to do what each referent thinks
TPB - Perceived Control (proximal)
Control beliefs/perceived power
TPB - Control beliefs (distal)
perceive likelihood of occurrence of each facilitating or constraining condition
TPB - Perceived power (distal)
Perceived effect of each condition in making behavioral performance
personal agency describes what two constructs
self efficacy and perceived control
direct vs. indirect
direct: performance of identified skills (assessments)
indirect: opinions/thoughts of knowledge, skills and attitudes
TTM Stages of Change
process that unfolds over time, progressing through a series of 6 stages (not linear)
TTM Process of Change
Covert and overt activities used to progress through stages
TTM Decisional Balance
Recognizing pros and cons of choices before completing a behavior
TTM Self-Efficacy
People's beliefs and capabilities to finish out a certain behavior
TTM Stages of change
pre-contemplation, contemplation, preparation, action, maintenance, termination
Stage of Change - precontemplation
no intention to change action in the next 6 months
Stage of Change - contemplation
intentions to take action in the next 6 months
Stage of Change - preparation
intends to take action within the next 30 days, has taken some behavioral steps in this direction
Stage of Change - Action
changed overt behavior for less than 6 months
Stage of Change - maintenance
changed overt behavior for more than 6 months
Stage of Change - termination
no temptation to relapse, 100% confidence
TTM - process of change
consciousness raising, dramatic relief, self-reevaluation, environmental reevaluation, self liberation, helping relationships, social liberation, counterconditioning, stimulus control, reinforcement management
Process of Change - consciousness raising
increased awareness about cause, consequences and cures for a problem behavior (nutrition)
Process of Change - dramatic relief
increase negative or positive emotions to motivate taking appropriate action (personal testimonies)
Process of Change - self-reevaluation
cognitive and affective reassessment of one's self image, with or without an unhealthy behavior (value clarification)
Process of Change - environmental reevaluation
cognitive and affective assessment on how the presence or absence of a behavior affects one's social environment (empathy)
Process of Change - self liberation
belief that one can change the commitment/recommitment to act on that belief (NYE resolution)
Process of Change - helping relationships
caring, trust, openness, acceptance, and support for healthy behavior change
Process of Change - social liberation
increase in healthy social opportunities or alternatives (access to walking paths)
Process of Change - counterconditioning
learning healthy behaviors that can substitute for problems (relax instead of alc)
Process of Change - stimulus control
removing cues for unhealthy habits and adding prompts for healthier alternatives
Process of Change - reinforcement management
rewarding oneself or being rewarded by others for improvement
TTM Decisional Balance
Pros vs Cons - benefit of changing vs cost of changing
TTM Self efficacy
confidence vs. temptation - one can engage in healthy behaviors across different challenging situations vs strong urge to engage in unhealthy behavior across different challenging situations
TTM Precontemplation
consciousness raising, dramatic relief, environment reevaluation
TTM contemplation
reevaluation
TTM preparation
reevaluation
TTM Action
self liberation
TTM maintenance
counterconditioning, helping relationships, reinforcement management, stimulus control
HBM developed because
to explain why people were not participating in disease prevention and detection even though it was available. TB
TRA developed because
to understand relationships and interactions between attitudes, intentions, and behavior
TPB developed because
to modify TRA to address lack of volitional control. Adds perceived control construct comprised of control beliefs and perceived power
TTM developed because
to study how people change their behavior rather than why they do. Includes temporal component
IBM developed because
to identify a critical set of variables that serve as the key determinants of behavior. Incorporates constructs of the TRA/TPB
PAPM
Precaution adoption process model. Allows individual to choose not to act
HAPA
Health action process approach
reciprocal determinism
human agency and the environment interact and influence each other, resulting in individual and social changes
personal cognitive factors
ability to self determine behavior and reflect upon and analyze the experience
self-efficacy
a person's confidence in his or her ability to perform a behavior that leads to an outcome
collective efficacy
belief in the ability of a group of individuals to perform concerted actions to achieve an outcome
self-evaluative outcome expectations
the anticipated feelings that arise from a comparison between a person's behavior and his or her internal standards
knowledge
the understanding of the health risks and benefits of different health practices and the information necessary to perform a behavior
socio-environmental factors
aspects of the perceived and/or physical environment that promote or discourage engagement in a behavior
observational learning
a type of learning in which a person learns new information and behaviors by observing the behaviors of others and the consequences of others' behaviors
normative beliefs
cultural norms and beliefs about the social acceptability and perceived prevalence of a behavior
social support
the perception of encouragement and support a person receives from his or her social network
barriers and opportunities
attributes of the social or physical environment that make behaviors harder or easier to perform