PHLT 303: Exam 2

Define change theory

(the "how") suggest how change occurs and are used to develop more effective ways to influence and change behavior example: The Transtheoretical Model (focusing on stages of change construct )

Define explanatory theory

(the "why") help explain behavior - example: The Health Belief Model

What are the adopter categories?

-Innovators - first to want to try the innovation; take risks -Early Adopters - represent opinion leaders. They enjoy leadership roles, and embrace change opportunities. -Early Majority - are rarely leaders, but they do adopt new ideas before the average person. -Late Majority - are skeptical of change, and will only adopt an innovation after it has been tried by the majority. -Laggards - are bound by tradition and very conservative. They are very skeptical of change and are the hardest group to bring on board.

Why does process take time?

-Knowledge (exposed, but lacks information) -Persuasion (interested, actively seeks information) -Decision (weighs pros/cons, decides to accept/reject) -Implementation (employs, then determines usefulness) -Confirmation (finalizes decision, considers full use)

What are the different levels of influence of the Social Ecological Model?

-individual (knowledge, attitude, skills) -interpersonal (social network) -organizational (environment, ethos) -community (cultural values, norms) -public policy

Strategies for increasing self-efficacy include:

-setting incremental goals (e.g., exercising for 10 minutes each day) -behavioral contracting (a formal contract, with specified goals and rewards) -monitoring and reinforcement (feedback from self-monitoring or record keeping).

What are the three terms of the three way dynamic in the STC?

1. Cognitive Factors (personal factors): knowledge, expectations, and attitudes 2. Behavioral Factors: skills, practice, self- efficacy 3. Environmental Factors: social norms, access in community, influence in others (ability to change own environment)

What are the five theories that are most often used in public health interventions?

1. Diffusion of Innovations (DOI) 2. The Health Belief Model (HBM) 3. The Transtheoretical Model/Stages of Change (TTM) 4. Social Cognitive Theory (SCT) 5. The Social Ecological Model

What are the three ways that time is involved?

1. First, time is involved in the innovation-decision process 2. Time affects the innovativeness 3. Time affects rate of adoption

What are the core constructs of the HBM?

1. Perceived susceptibility and perceived severity 2. Perceived benefits and perceived barriers 3. Cues to action 4. Self-efficacy (added more recently)

What are the stages of change in the transtheoretical model?

1. Pre-contemplation: No recognition of need for or interest in change 2. Contemplation: Thinking about changing 3. Preparation: Planning for change 4. Action: Adopting new habits 5. Maintenance: Ongoing practice of new, healthier behavior

What are the four main elements of the DOI?

1. an innovation 2. social systems 3. time 4. communication process and channels

What is the Social Cognitive Theory?

A basic premise of SCT is that people learn not only through their own experiences, but also by observing the actions of others and the results of those actions. There is a dynamic interplay among personal factors, the environment, and behavior. It was developed by Albert Bandura.

Define counter-conditioning

A healthy behavior substitutes an unhealthy behaviors. Ex: doodle as supposed to smoking

Define self-efficacy.

A person's confidence in his or her ability to successfully perform a behavior

Define perceived barriers.

A person's feelings on the obstacles to performing a recommended health action.

What is perceived severity?

A person's feelings on the seriousness of contracting an illness or disease (or leaving the illness or disease untreated).

Define perceived benefits.

A person's perception of the effectiveness of various actions available to reduce the threat of illness or disease (or to cure illness or disease.

What is perceived susceptibility?

A person's subjective perception of the risk of acquiring an illness or disease

Define social system

A set of interrelated units that are engaged in joint problem solving to accomplish a common goal.

Define theory

A theory is a set of interrelated concepts, definitions, and propositions that explains or predicts events or situations by specifying relations among variables.

Which construct or constructs from Social Cognitive Theory could be used as a key part of a program to increase hand-washing among elementary school children? You can choose more than one. A. Observational learning B. reinforcement C. Self-efficacy D. Behavioral Contracting

A, B, and D

Which of these examples describes how low-self-efficacy can be used to help improve health-related behavior? A. Breaking down a large goal of reducing fat intake into small weekly goals that are more easily attainable B. Providing free condoms at nightclubs C. Showing diabetic adolescents a video of youths like themselves who are successful at managing their blood glucose levels D. Holding a rally to show community member's support for reducing violence in their neighborhoods

A. Breaking down a large goal of reducing fat intake into small weekly goals that are more easily attainable

According to the diffusion of innovation theory, which of the following is a NOT a characteristic of innovation? A. observational learning B. relative advantage C. trialability D. observability

A. observational learning

In the construct of reciprocal determinism, which of the following would be considered environmental factors that could play a role in influencing health behavior? (You can choose more than one) A. A brother or sister who has type 2 diabetes B. A popular professional athlete doing public service announcements encouraging kids to exercise C. A person's knowledge about his or her own risk for diabetes D. A high school's "healthy lunch" policy

B and D

One day, John's best friend said to him: "Hearing about the flu from experts like you reminds me to go for a flu shot." What John's best friend said describes which of these constructs of the Health Belief Model? A. perceived susceptibility B. cues to action C. perceived severity D. self-efficacy

B. cues to action

When public health professionals became convinced that smoking could harm the health of the smoker and another person nearby who may inhale the smoke, they issued laws to prevent smoking in designated places. Such laws reflect what type of construct of the social ecological model? A. community B. public policy C. organizational D. interpersonal

B. public policy

Which of the following constructs is present in both the Health Belief Model and the Social Cognitive Theory? A. self-control B. self-efficacy C. reinforcement D. cues to action

B. self-efficacy

Two years after Bernice had tried to persuade John to stop smoking in vain, she met John at a friend's wedding. To Bernice's surprise, John said to her: "Thank you very much. I have stopped smoking. I now want to remain in my current position as a non-smoker!" Which of the following stages of change of the transtheoretical model illustrate the term "I now want to remain in my current position as a non-smoker"? A. preparation B. action C. maintenance D. precontemplation

C. maintenance

Define self-liberation

Commitment to change behavior based on the belief that achievement of the healthy behavior is possible. Ex: choosing not to drink tonight.

Define self-control

Controlling oneself through self-monitoring, goal-setting, feedback, self-reward, self-instruction, and enlistment of social support.

Which of the following is correct about the social cognitive theory? A. It started as a health belief model B. According to this theory, only environmental and behavioral factors continually interact to explain a human behavior C. Observational learning and self-control are not key constructs of the social cognitive theory. D. It can be readily applied to counselling interventions to prevent and manage diseases

D. It can be readily applied to counseling interventions to prevent and manage diseases.

In the Health Belief Model, what is the construct that describes the degree people deem a particular diseases or condition to be serious? A. perceived susceptibility B. perceived barrier C. perceived benefit D. perceived severity

D. perceived severity

Describe the Diffusion of Innovation Theory (DOI)

DOI is the process by which an innovation is communicated among the members of a social system over time through certain channels

Define dramatic relief.

Emotional arousal about the health behavior, whether positive or negative arousal. "I am so upset with fast food commercials,"

(T/F) Anyone is ready to make changes in health behavior.

False

(T/F) According to the TTM, the progression through stages of changes must be linear

False

(T/F) People alway moves through the stages of change in the TTM in a linear manner

False, they do not always move in a linear manner. They often recycle and repeat certain stages, for example individuals may relapse and go back to an earlier stage depending on their level of motivation and self-efficacy.

Define helping relationships

Finding supportive relationships that encourage the desired change. Ex: having a roommate that eats vegetables and fruits.

The key constructs, cues to action, perceived benefits and barriers, perceived susceptibility, and self-efficacy all belong to which model?

Health Belief Model

What is health behavior?

Health behavior includes all of those things we do that influence our physical, mental, emotional, psychological, and spiritual self.

Define consciousness raising.

Increasing awareness about the behavior. "I did not realize fast food was bad for me until I saw Fast Food Nation"

Define environmental reevaluation

It is looking at the behavior in light of its impact or effect on the physical environment "Does my smoking habit affect the environment?"

Define reciprocal determinism.

It means that a person can be both an agent for change and a responder to change. It is the dynamic interplay among personal factors, environment and behavior. Changing one of this factors may affect the others, a core construct also central to social ecological models.

Define observational learning.

Learning by watching others and copying their behavior. Think back to when you were a child. How do you learn to ride a bike or tie your shoes? A lot of our behaviors results from observational learning that the list may be endless.

What are the limitations of the DOI?

Much of the evidence for this theory did not originate in public health and it was not developed to explicitly apply to adoption of new behaviors or health innovations. It does not foster a participatory approach to adoption of a public health program. It works better with adoption of behaviors rather than cessation or prevention of behaviors. It does not take into account an individual's resources or social support to adopt the new behavior (or innovation).

What are the 4 P's of marketing that make up a target customer?

Product, price, place, and promotion

What are the characteristics of innovation?

Relative advantage, compatibility, complexity, trial-ability, and observability

Define stimulus control

Removing the cues that leads to the unhealthy behavior. Example?

Define reinforcement management.

Rewarding the positive behavior and reducing the rewards that come from negative behavior. Ex: getting a new workout outfit.

Define self-reevaluation.

Self reappraisal to realize the healthy behavior is part of who they want to be. "If I stop eating fast food, what would happen?"

The key constructs, self-efficacy, reinforcement, self-control, observational learning, and reciprocal determinism all belong to which model?

Social Cognitive Theory

The key constructs, organizational factors, individual level influences, public policy, community, interpersonal influences belong to which model?

Social Ecological Theory

What is the Social Ecological Model?

Social ecological models emphasize multiple levels of influence and the idea that behaviors both shape and are shaped by the social environment. It Helps to understand factors affecting behavior and also provides guidance for developing successful programs through social environments.

What factors influence health behavior?

Socioeconomic Status (education) Skills (knowledge) Culture Belief: Series of beliefs=Attitudes Values Religion Gender

Where is the HBM most often applied?

The HBM has been most often applied for health concerns that are prevention-related and asymptomatic, such as early cancer detection and hypertension screening - where beliefs are as important or more important than overt symptoms. The HBM is also clearly relevant to interventions to reduce risk factors for cardiovascular disease.

What does the HBM theorize?

The HBM theorizes that people's beliefs about whether or not they are at risk for a disease or health problem, and their perceptions of the benefits of taking action to avoid it, influence their readiness to take action.

Why was the Health Belief Model (HBM) developed?

The Health Belief Model (HBM) was developed to help understand why people did or did not use preventive services offered by public health departments in the 1950's, and has evolved to address newer concerns in prevention and detection (e.g., mammography screening, influenza vaccines) as well as lifestyle behaviors such as sexual risk behaviors and injury prevention.

Define innovativeness

The degree to which an individual or other unit of adoption is relatively earlier in adopting new ideas than other members of a social system.

Define compatibility.

The degree to which an innovation is perceived as being consistent with existing values, past experiences, and needs of potential adopters.

Define relative advantage.

The degree to which an innovation is perceived as better than the idea it supersedes.

Define complexity.

The degree to which an innovation is seen as difficult to understand and use.

Define observability.

The degree to which results are viewable to others.

Define trail-ability.

The degree to which the innovation may be experimented with on a trial basis.

Define social liberation

The process whereby options or alternatives are sought that support the new behavior. Ex: Ordering a salad at a fast food restaurant.

Define the rate of adoption.

The relative speed with which an innovation is adopted by members of a social system

Define reinforcement.

The rewards or punishments for doing something. Behaviors occurs because people either want the reward or want to avoid the punishment.

Define cue to action.

The stimulus needed to trigger the decision-making process to accept a recommended health action.

Why was the Transtheoretical Model (TTM) developed?

The was developed in early 1Transtheoretical Model (TTM)980s as a way to understand behavior change, in particular, changes associated with addictive behaviors. TTM proposes that behavior changes is a process that occurs in stages.

The key constructs, readiness to change, contemplation, and maintenance belong to which model?

Transtheoretical/ Stages of Change Model

(T/F) Diffusion of innovation works better with adoption of good behaviors rather than cessation or prevention of bad behaviors.

True

(T/F) Stages of change help us understand when people change behavior, the processes of change help understand how change occurs .

True

(T/F) The TTM can be used to explain or predict changes in health behavior

True

T/F The members or units of a social system may be individuals, informal groups, organizations, and/ or subsystems.

True

Theories can guide the search to:

Understand why people do or do not practice health promoting behaviors; Help identify what information is needed to design an effective intervention strategy; and Provide insight into how to design a program so it is successful.

What are the two broad types of theory?

explanatory theory and change theory

Key constructs of social cognitive theory that are relevant to health behavior change interventions include:

observational learning, reinforcement, self-control, and self-efficacy

The principles of ________________ are consistent with social cognitive theory concepts which suggest that creating an environment conducive to change is important to making it easier to adopt healthy behaviors.

social ecological models