Health
Change
Behavior change is not easy!
What does it take to make a behavior change program work?
Communication: raise awareness
For changes at the community or institutional level
Education: teach people how and increase self-efficacy
Policy: regulate or mandate healthy behaviors
Environment: changes to facilitate healthy behaviors
It’s original meaning: “forcing” behavioral compliance by making the�undesirable behavior less desirable…
Gain-framed: focus on benefits
work best for people who
are approach oriented
Loss-framed: focus on the negative
work best for people who are
avoidance oriented
Message Framing
Cues to action
The focus is on attitudes
Perceived susceptibility
Perceived severity
Perceived benefits of preventative action
Perceived barriers of preventative action
Individual
Perceptions
Odds are I will (or won’t) get into an accident
Odds are that if I do get into an accident, it will (or won’t) be�a serious one.
Wearing a seatbelt will make me safer (or less safe)
Wearing a seatbelt is a quick and easy behavior vs.
�Wearing a seatbelt is a hassle, not cool, uncomfortable
Demographic Variables
Psychosocial Variables
age sex religion SES
�rural vs urban setting state/country
personality social norms IQ past experiences
Modifying Factors
Information
pamphlet on the statistics
Reminders
warning sounds when not used
Persuasive Communications
encouragement from significant others
Experience
recent car accident
Cues to Action
Ecological Model
Behavior has multiple levels of influences, often including intrapersonal (biological, psychological), interpersonal (social, cultural), organizational, community, physical environmental, and policy.
local, state, and federal policies and laws
rules, regulations, policies
Social Cognitive
Learning Theory
Both vicarious and direct reinforcement contribute to behavior change
Reinforcement
Increase Behavior
The Transtheoretical Model
What problem? Or…I’d rather Not go there right now
I’ve made it, and I’m going to maintain the change
I’m committed
I’ve made up my mind and I’m ready
I’m thinking about it
People can go back & forth through
the stages in a non-linear manner
This theory allows a more
Individualized treatment regime
Which model is better?
Is it the case that different models fit different cultures better?
attitudes, beliefs, norms
differ by culture
Cues to action
differ by culture
health values
differ by culture
But the basic relationship are the same
Know what you value when it comes to personal well-being
Which aspects of your well-being do you value the most?
Are you willing to take action consistent with your values?
Are you willing to make sacrifices? If not, maybe this is not something you �truly value?
STEPS TOWARD HEALTH INTERVENTION
1. Select a health behavior to modify
You don’t have to start with a behavior related to what you value most. You might want
choose something easier to increase self-efficacy first
STEPS TOWARD HEALTH INTERVENTION
2. Use a model of health behavior
What is influencing the behavior in its current form?
Beliefs Personality variables
Attitudes Social variables
Norms Physical variables
All of the above may be facilitating or impeding the behavior.
Which of these can you change?
think, observe, reflect
STEPS TOWARD HEALTH INTERVENTION
3. Identify your goals once you have a baseline
Where you want to be
Objectives are strategies
to reach your goal
Goal Setting
Help us to stay focused – and to know whether we’ve succeeded
set a small, realistic goal to enhance chances of success, ↑self esteem
Your goal should be flexible
�should have a time frame attached to your goal & make
your goal public…. this will ↑commitment
how do you know if you met your goal?
set concrete, measurable objectives
STEPS TOWARD HEALTH INTERVENTION
4. Plan your intervention – theory driven, evidenced based
reinforcers and punishers mild aversion
Sign a self-contract and get a witness behavior substitution
Obtain social support environmental restructuring
Make changes to the antecedents incentivization
Change behavioral cues that get in the way create graded tasks
Positive cues to action consequences for non-adherence
Objective feedback & record keeping periodic review of health consequences
5. Take action
STEPS TOWARD HEALTH INTERVENTION
Stay committed but don’t stress out
Keep monitoring and make tweaks to your plan as you go
STEPS TOWARD HEALTH INTERVENTION
6. Long term maintenance
Assuming you’ve succeeded, how will you maintain the change?
Periodic self-observation.
Have a relapse prevention plan!
Relapse Prevention Model
Skills training Cognitive reframing Lifestyle rebalancing
Designing Your Intervention
Change at an individual level
Behavior Change Wheel Model
Sources of Behavior: Identify Key Factors that Facilitate or Impede Behavioral Change
CAPABILITY | OPPORTUNITY | MOTIVATION |
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Beliefs and attitudes that may be helpful
Psychological & Physical factors that may be helpful
Environmental and Social factors that may be helpful
Psychological & Physical factors that may be obstacles
Environmental and Social factors that may be obstacles
Beliefs and attitudes that may be obstacles
What do you know and understand about the behavior and the intervention? Do you have good organization, time management and problem-solving skills? Is your physical health adequate? etc… |
From the micro to the macro level, what is in your physical environment that can help you? Do you have individuals, groups, and institutions that can help you? etc… |
See the health belief model and address all four of the individual perception categories that might be helpful. etc… |
What do you not know or understand about the behavior and the intervention? Do you have poor or weak organization, time management, and problem- solving skills? Is your physical health inadequate? etc…
From the micro to the macro level, what is in your physical environment that are obstacles? Do you have individuals, groups, and institutions that are getting in your way? etc… |
See the health belief model and address all four of the individual perception categories that might be unhelpful or get in the way. etc… |