Chapter 5: Stages and Processes of Health Behavior Change

8. Stimulus Control

removes environmental cues

Action stage may include

stimulus control and reinforcement mgmt

Preparation stage may include

stimulus control, reinforcement control, and self-liberation

Contemplation

Aware problem exists, will change eventually

3. Self-reevaluation

Both cognitive and affective reassessment of self-image

Preparation

Determined to make a change and intends to take action soon (w/in 30 days)

Precontemplation

Unaware of a problem; denies the problem. No intention to change

4. Environmental Reevaluation

affects on social climate

5. Self-liberation

belief that one can change and commit to act

7. Counterconditioning

changing behavior in response to activities

Contemplation stage may include

continued consciousness raising and environmental reevaluation

Goal setting

1. Identification 2. Importance and acceptance 3. Analysis and overcoming obstacles 4. Goal Implementation

Stages of Change

1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance 6. Termination 7. Recycling

How many processes of change are there?

10

Self-Efficacy

Belief that one can cope with temptations in high-risk situations w/out giving in or relapsing

Termination

Changes have been maintained for years (usually 5 years)

Precontemplation stage may include

Consciousness raising and self-reevaluation

1. Consciousness raising

Increase awareness to risks and consequences

2. Dramatic Relief/Catharsis

Increases emotional awareness

6. Social Liberation

Increases social alternatives and opportunities

Maintenance

Integrates new health behaviors into lifestyle over several months (6 months)

Recycling

Most people proceed through the stages in a spiral, not a linear fashion. Lapses and relapses are common

9. Reinforcement management

Positive reinforcement and rewards

Decisional Balance

Process of weighing pros of changing with cons to changing (grid pros, negatives to changing and pros, negatives to not changing)

Goal Identification: SMART

Specific Measurable Attainable Realistic Time Specific

10. Helping relationships

Support for behavior change

Action

Takes action to implement plan and overcome health problem

Documentation standards are set by whom?

The Joint Commission