HTH 351 Baller FInal

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