HSES 403 Exam 2

1971 - Bernard Weiner combined the 4 characteristics related to success and behavior:

- Ability - Effort - Difficulty of task - Locus of control

SCT: Expectations

- Anticipated outcomes of a behavior

Observability

- Are the results of the innovation visible and easily measurable?

SCT: Observational Learning is influenced by:

- Attractiveness of model - Circumstances of observation - Personal motivation to learn behavior - Importance of learning behavior - Complexity of behavior

Maintenance

- Begins 6 months after Action Stage - Avoidance of relapse - Most difficult stage

Preparation

- Begins as soon as decision to change has been made - Plan for making change is developed - Last less than 1 month - Person gets things ready to make the change

Theory Essence Statement of Social Cognitive Theory (SCT)

- Behavior, personal factors, and environmental factors interact with each other, and changing one changes them all - Reciprocal determinism - One of the most frequently used theories

By knowing the cause of an outcome:

- Can be repeated if outcome is desirable - Changed if outcome is undesirable

Trialability

- Can the innovation be tried before making a decision to adopt?

Bernard Weiner later added what 2 characteristics to develop the foundation of Attribution Theory

- Causal Stability - Control

Cognitive Processes

- Cognitive Raising - Dramatic Relief - Self Re-Evaluation - Environmental Re-Evaluation - Social Liberation

Decision

- Decision to try innovation depends on: knowledge, attitude - Knowledge + Positive Attitude usually leads to trial, but not always

SCT: Locus of Control

- Degree to which people believe they have the ability to control what happens to them - Degrees of ability: Internal locus of control, external locus of control

Compatibility

- Does the innovation fit with the intended audience?

Internal, unstable causes of behavior often can be willfully changed:

- Effort - Boredom - Motivation

1950s - Behavior acquisition resulted from:

- Environmental stimuli - Consequences - Rewards - Punishments

Response cost

- Expense associated with adopting health-protective behavior - If cost is too high, it is unlikely to be adopted even if response efficacy and self-efficacy are present

Interpersonal Theories

- Explain behavior by looking at how external factors influence behaviors - Individuals exist within, and are influenced by, a social environment - Reciprocal interaction

Community-Level Theories

- Explore behavior by looking at social systems in a variety of settings - Represents an ecological perspective: - Individual, group, community

Locus of Control

- Extend to which people believe they have control over their lives

Stability

- Extent to which a cause is permanent or temporary (decided not to run outside because it is too cold) - Causes are either stable or unstable and internal or external

Response self-efficacy

- Extent to which a person believes they have the ability to carry out the health-protective action - Person believes they have the ability to eliminate soda from their diet --- Adoption of behavior

Controllability

- Extent to which cause can be willfully changed - Some causes can be changed and other cannot - Can serve as a starting point to help explain behavior and identify appropriate interventions

Response efficacy

- Extent to which the recommended action is believed effective in preventing or reducing the threat - Belief flu vaccine is effective --- Vaccination more likely to occur

Social environmental includes:

- Family members - Coworkers - Friends - Health Professionals

How are community-level theories defined?

- Geographical regions - Shared interests - Collective identity - Critical to learn about community's unique characteristics

SCT: Reinforcement Example:

- Giving extra vacation days for maintaining healthy weight more likely to support healthy eating and PA vs. taking days away from those who are overweight

Community Theory

- Grounded from rural sociology and USDA research - Used to determine the effectiveness of different methods of informing farmers about innovative farming practice

Early Adopters

- Have complex network of friends and colleagues - Influential - Characteristics: Opinion leaders Well respected Role models Highly educated High SES

Processes of Change

- Helps understand how change occurs

Theoretical Constructs

- Innovation - Communication channels - Time - Social system

Implementation

- Innovation tried and results in: adoption, rejection, re-invention of innovation - If trial implementation results are: positive - innovation adopted negative - innovation rejected mixed- innovation modified

Time

- Innovation-Decision process - Adoption rate characteristics

4 Aspects of Diffusion

- Innovation-decision process - Role and source of communication channel - Adoption rate - Characteristics of people adopt an innovation at various rates

Internal, stable causes of behavior often cannot be willfully changed:

- Intellectual ability - Physical coordination - Athleticism - Cultural identity

Relative Advantage

- Is the innovation better than what was there before?

Complexity

- Is the innovation easy to use?

SCT: Behavioral Capability

- Knowledge and skills to perform behavior - Before doing something you have to know: what it is you're going to do, how to do it

Practical application of causation is seen in stereotypes associated with obesity

- Lack of willpower, laziness, overeating, physical inactivity - Other "uncontrollable" factors often not considered - heredity, body type, hormones, diseases

Early Majority

- Largest segment of population - Characteristics: Be greatly influenced by opinion leaders and mass media, deliberate, need evidence, adopt things over time - Once adoption begins - mainstream

SCT: Observational Learning

- Learning by watching others - Impact depends on extent of attention given to individual modeling behavior - Ex. Diabetes camp

Fear appeal works by:

- Making us afraid something terrible will happen - Threatening us with impending harm

SCT: Self-Efficacy

- Most important determinant of behavior - Plays role in other theories - People will only try to do what they think they can do and won't try what they think they can't

External, stable, controllable causes of behavior:

- Neighborhood safety (children can play outside) - Having a car (drive instead of walk)

SCT: External Locus of Control

- No control over what happens to self - Results from fate, destiny, luck

SCT: Expectations is influenced by:

- Past experiences - Observing other or hearing about others - Emotional or physical response

Threat Probability

- Perception of personal risk or vulnerability - Ex. What is my risk of liver damage from taking acetaminophen?

Contemplation

- Person begins to think about changing - Cues to action move people to this stage - Moving from thinking to doing (requires a decision to be made) - Pros must outweigh cons - Contemplation >6 months = Procrastination

Threat Severity

- Personal perception of the seriousness of a threat - Ex. How terrible to liver damage to someone taking acetaminophen

Action

- Plan is put into motion - Goal to behavior change

Theory Essence Statement of Community Level Theories

- Process by which innovations are diffused and adopted by society - Behavior changes as innovations are adopted

Prior to the 1980s - Research on addiction treatment showed behavior could be changed successfully through:

- Psychotherapy - Self-change

SCT: Reinforcement

- Rewards and punishment - Doing something to get a rewards (positive reinforcement): quitting smoking = reduced insurance premiums - Doing something to avoid punishment (negative reinforcement): quitting smoking = avoid higher insurance premiums for smokers - Using reward to maintain positive health behaviors are more likely to result in repeated positive behaviors - Punishment tends not to lead to positive behavior

SCT: Self-Regulation

- Self efficacy + Expectations + Goal-Setting = Self-Regulation - Self control - Exam question

Self-efficacy

- Self-efficacy critical component in Maintenance Stage - Confidence in ability to cope with situations that may cause relapse - Supports behavior change by helping to move people through stages and sustaining change

Innovation

- Something new or novel - Characteristics that increases likelihood of adoption: Relative Advantage Compatibility Trialability Complexity Observability

Ryan & Gross (1943)

- Spread and adoption of an innovation is a social process that occurs over time

Behavioral Processes

- Stimulus Control - Helping Relationships - Counter Conditioning - Reinforcement Management - Self Liberation

Health Locus of Control

- The perception that one's health is under personal control - Controlled by powerful others, such as physicians; or is determined by external factors, including chance.

Time: Innovation-Decision Process

- Time it takes for a decision to be made to adopt or reject an innovation - Steps in the decision process: Knowledge Persuasion Decision Implementation Confirmation

Precontemplation

- Time up to 6 months before a person starts to think about change - Individual has no thoughts about changing behavior (uninformed or under-informed)

SCT: Internal Locus of Control

- Total control over what happens to self - Results from personal decisions and behaviors

Innovators

- Try everything as soon as possible - Characteristics: risk rakers, tech savvy, independent

SCT: Expectancies

- Values the person places on the outcomes - Is the anticipated outcome viewed as: Good/bad, positive/negative, useful/useless, healthy/unhealthy

External, unstable, uncontrollable causes of behavior:

- Weather (too cold/hot to walk) - Traffic

Stages of Change

1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance

Which of the following would be an example of the Transtheoretical Model counter-conditioning process of change? - A smoker choosing a quit date - A soda drinker switching to water - An overeater using a smaller plate for his food - A runner walking part of the time

A soda drinker switching to water

The Social Cognitive Theory concept of reciprocal determinism explains behavior as being the result of: - Following individual principles of fairness and reciprocity - The back and forth relationships we have with those in our social networks - An interaction between people, their environment, and their behavior - A combination of internal and external locus of control

An interaction between people, their environment, and their behavior

Treat appraisal

Assessing personal vulnerability to and seriousness of a treat

Coping appraisal

Assessment of the recommended health-protective behavior

Persuasion

Attitude toward innovation - "Try it on"

Knowledge

Before people can think about adopting something new, they have to know it exists

Theory Essence Statement of Transtheoretical Model

Behavior change is a process that occurs in stages

The underlying concept of Attribution Theory is that: - Behavior has a cause or explanation for why it happened - Behavior results from intention - The relationship between a person and the environment determines behavior - Personal beliefs drive behavior

Behavior has a cause or explanation for why it happened

The underlying concept of Attribution Theory is that: - Behavior results from intention - Personal beliefs drive behavior - Behavior has a cause or explanation for why it happened - The relationship between a person and the environment determines behavior

Behavior has a cause or explanation for why it happened

The construct of observational learning in Social Cognitive Theory explains that: - Behavior is learned by watching other people. - Only simplistic behaviors are learned through observation - A one-way mirror should be used to observe behavior in a clinical setting - Behavior has to be demonstrated in order to be learned

Behavior is learned by watching other people.

The findings of Albert Bandura

Behavior results form an interplay of environmental factors, personal factors, and behavior

Social System

Can be: - Individuals - Informal group - Formal group - Organizations Interrelated and engaged in solving joint problem to accomplish a goal Diffusion takes place through these social systems

Laggards

Characteristics: - Conservative and traditional - Less Education - Lower SES - Suspicious - Adverse to risk-taking -Geographically mobile and detached from social environment Wait until very late, even when innovation is clearly advantageous

Late Majority

Characteristics: - Question change - Have modest financial resources - Wait until innovation is an established norm or it becomes a necessity - Be greatly influenced by peers

Diffusion of Innovation is a(n): - Intrapersonal-level theory - Interpersonal-level theory - Community-level theory - Explanatory theory

Community-level theory

Protection Motivation Theory has its roots in health communication where it is used to: - Provoke debate between public health agencies and the general public on health behavior change - Create fear campaigns to get people to adopt recommended behaviors - Change behavior by intimidation - Threaten people with legal action to make changes known to reduce the spread of disease

Create fear campaigns to get people to adopt recommended behaviors

When a woman shares that she is afraid to join a gym because people will be watching her exercise and they will laugh because she is so out of shape, this is consistent with which of the following processes of change seen in the Transtheoretical Model? - Counter-conditioning - Dramatic relief - Environmental re-evaluation - Social liberation

Dramatic relief

Which of the following statements is consistent with an internal locus of control? - I do whatever my doctor tells me to regarding my health - During flu season, I wash my hands more often to avoid getting sick - Luck has been on my side this year, I didn't catch on cold - There is no sense in wearing a seat belt. If you're meant to get hurt in an accident, you will.

During flu season, I wash my hands more often to avoid getting sick

You are developing an innovative program to increase fruit and vegetable intake of preschool children. According to the construct of communication channels in Diffusion of Innovation, the best way to inform the people for whom this program is intended is to: - Enlist a group of parents to help you spread the word among their peers - Post information about the program on Facebook - Do a mass mailing to all parents who have children in daycare - Have the physicians in the community inform their patients

Enlist a group of parents to help you spread the word among their peers

Internal Locus of Control

Events are the result of something within the person that he/she/they has control over (skill, knowledge, motivation)

External Locus of Control

Events are the result of things outside the person that he/she/they does not have control over (fate, luck, chance)

The low rate of flu immunization among students living in residence halls at KU is cause for concern. When surveyed to find out the underlying reason for this, the health office staff discovered a large number of students were afraid the flu shot would actually give them the flu. Which construct of Social Cognitive Theory would this be an example of? - Reinforcement - Expectancies - Expectations - Observational learning

Expectations

Dramatic Relief

Expressing feelings about or reacting emotionally to behavior and possible solutions

According to the Social Cognitive Theory of behavioral capability, before people can change their behavior, they have to believe they can. T or F

False

According to the Transtheoretical Model, using the process of environmental re-evaluation means that people look at their new behavior in light of how it will impact community-level policies. T or F

False

Community level theories are considered to be explanatory theories. T or F

False

During the preparation stage of the Transtheoretical Model is when people make plans for how they are going to avoid relapses. T or F

False

In Protection Motivation Theory, it is the extent of the seriousness of the health threat more than the extent of personal vulnerability to it that leads to behavior change. T or F

False

People in the preparation stage of the Transtheoretical Model are actively changing their behavior and preparing ways to sustain it once the change is complete. T or F

False

Response self-efficacy is the process in the Protection Motivation Theory concerned with community-level ability to adopt recommended changes. T or F

False

The Attribution Theory construct of stability tells us that internal stable causes cannot be changed. T or F

False

The construct of stability in Attribution Theory refers to the extent to which the underlying cause of a behavior can be predicted. T or F

False

The more complex an innovation is, the more likely it is to be adopted. T or F

False

Theory Essence Statement of Fear Appeal

Fear motivates people to change attitudes and behaviors

Self Liberation

Freedom from behavior

The first step in the innovation-decision process of Diffusion of Innovation is: - Having knowledge of the innovation - Determining the cost of the innovation - Identifying need for the innovation - Trying the innovation

Having knowledge of the innovation

Counter Conditioning

Healthy behavior substituted for unhealthy one

Communication Channels

How an innovation is spread through a society - Social process - Most rapid and effective means is through mass media (e.g., internet, TV, newspapers, radio) - Interpersonal communication also effective

Reinforcement Management

Identification or rewards and punishments

If you are using Protection Motivation Theory to promote behavior change, why is response self-efficacy important? - If people expect the change will make them healthier, they are more likely to try it. - If people expect the change to result in immediate self-improvement, they are more likely to try it. - If people don't expect the new behavior will work, they won't try it. - If people don't expect they will be able to do the new behavior, they won't try it.

If people don't expect they will be able to do the new behavior, they won't try it.

Using the Transtheoretical Model as the basis for a behavior change intervention entails: - Implementing the stages and processes of change to enable change to occur - Identifying the beliefs known to underlie the problem behavior - Determining the stages and processes of change to enable the change to occur - Identifying the beliefs known to underlie the problem behavior

Implementing the stages and processes of change to enable change to occur

Which of the following is an internal, stable cause of behavior? - Intelligence - Attitude - Skill - Desire

Intelligence

The Social Cognitive Theory construct of self-regulation explains that behavior: - Changes incrementally - Is the result of self-efficacy, expectations, and goal setting - Results when a person has an internal locus of control - Changes when the barriers to change can be regulated by the person

Is the result of self-efficacy, expectations, and goal setting

Environmental Re-Evaluation

Looking at behavior's impact or effect on social and physical environment

Self Re-Evaluation

Looking at self with or without problem behavior and assess differences in self-esteem

Which of the following would be consistent with tasks in the preparation stage of the Transtheoretical Model? - Making plans for how the change will be implemented - Isolating possible relapse triggers - Identifying rewards that would support maintenance of the new behavior - Gathering information about the health problem

Making plans for how the change will be implemented

Albert Bandura's Research (1950s)

Observation, social learning, and aggressive behavior

Consciousness Raising

Obtain information about self and problem behavior

Social Liberation

Options or alternatives sought to support new behavior

Time - Adoption Rate

People tend to adopt innovations at a reasonably predictable rate depending on certain characteristics - Innovators - Early adopters - Early majority - Late majority - Laggards

If you wanted to encourage someone to develop a positive attitude toward an innovation, during which stage of the innovation-decision process of Diffusion of Innovation would you focus your efforts? - Awareness - Persuasion - Trial - Reinforcement

Persuasion

Response self-efficacy of the Protection Motivation Theory impacts behavior change in that it: - Describes the skills needed to accomplish the suggested behavior change - Allows for individual adjustments to the desired behavior - Supports maintenance of the unwanted or unhealthy behavior - Reflects belief in personal ability to perform the recommended behavior

Reflects belief in personal ability to perform the recommended behavior

Confirmation

Reinforcement from other that adoption was good decision

Stimulus Control

Removal or cues or triggers from environment

Much of the research focused on _________________ relative to a specific behavior and the internal or external factors that influenced the outcome

Success or failure

Helping Relationships

Support System

Diffusion

The process by which theoretical constructs take place

In some situations, the Protection Motivation Theory construct of threat appraisal isn't effective in changing behavior because: - The reward from continuing the old behavior is greater than from the new - The consequences of not changing aren't severe enough to change the behavior - The likelihood of the threat happening is remote - The perception of danger is inconsistent

The reward from continuing the old behavior is greater than from the new

Theory Essence Statement of Attribution Theory

There is a cause or explanation for things that happen

Stable External

Things outside the person that are stable from day to day - Safety of environment - Access to healthcare - Access to healthy food

Unstable External

Things outside the person that can and do change from day to day - Luck - Weather - Variety/price of fresh fruits and vegetables at the store

Stable Internal

Things within a person that are constant from day to day - Athletic ability - Creativity - Intelligence

Unstable Internal

Things within the person that can and do change from day to day - Mood - Motivation - Energy level

Adoption of health-protective behavior is unlikely if:

Threat is perceived as not severe and/or personal risk is low

Adoption of health-protective behavior is likely if:

Threat is perceived as severe and personal risk is high

According to the Social Cognitive Theory construct of behavioral capability, before people can change their behavior, they have to know what the new behavior is and have the skill to perform it. T or F

True

An innovation has a greater likelihood of being adopted if it can be tried or sampled before a commitment to it is made. T or F

True

In the Diffusion of Innovation construct of Time--The Innovation-Decision Process, the implementation stage occurs when an innovation is tried. T or F

True

The construct of expectations in Social Cognitive Theory is demonstrated when people buckle their seat belts in anticipation of reducing injury in an accident. T or F

True

The construct of stability in Attribution Theory tells us that internal stable causes cannot be changed. T or F

True

The two processes of threat appraisal are severity and vulnerability. T or F

True

Unstable

When the cause of an outcome is believed to the behavior - Less helping behaviors result

Stable

When the cause of the outcome is thought to be biological (permanent) - More helping behaviors result

Theories are used as the basis for health behavior change interventions because they identify: - The root cause of a population's health problem - Factors for evaluation - The intervention group most likely to be successful - Why people do what they do

Why people do what they do