Kin 467
What is meant by autonomy support?
Autonomy → encouragement for individuals to decide what is important to them, recognition that they have the right to choose available options, and minimize pressure to choose behavior client is in control of decision making process, with the counselor offering guidelines when necessary
According to Duhigg, what are the best ways to change a habit?
Attribute cue to something else to still receive the same reward CHANGE ROUTINE Nail biting example: instead of biting when nervous push on nails to still get the same reward of relief
Why is reflective listening important?
Allows client to come up with their own ideas to make change Shows the client that they are being heard Validates their thoughts about change Makes them more comfortable about speaking in professional settings
In your own words describe the phenomenon of ambivalence and give a behavior change-related example of ambivalence that demonstrates your understanding?
Ambivalence → state of mind in which a person has conflicting feelings about something Someone is unsure if they are ready or want to make a change Might want to make the change but aren't sure if they are able too Signs: when someone what a person says and does is different, signs and actions don't match
What is meant by "awareness training" and "competing response"? Be able to give an example of these concepts that is different from the one presented in the book
Awareness training happens when the patient is consciously aware of the cue that stimulates the desired behavior. An example of this would be laying your running shoes out every morning, so when you see them you go for a run. Asking the client to describe what triggers their habitual behavior Allows them to recognize cues, which is the first step to change Example: not having sweets in the house to avoid cheating on diet. A competing response in a behavior that you teach yourself to do instead of the habitual act. In Mandy's case her habitual act was putting her fingers in her mouth and her competing response was putting her hands in her pockets to stop her from putting her hands in here mouth. A behavior that gets in the way of performing a habitual behavior is a competing response. Want to replace their known routine with a new, healthier one Example: snapping fingers every time someone has the urge to crack their fingers.
In your words, define the term 'built environment'.
Build Environment → anything human made or human altered that influences how people move or don't
How can you know about an individual's level of readiness to change?
Change talk → particular kind of speech to evoke change and reinforce it, client makes argument for change Change talk shows they are more likely to be ready to make a change You can tell someone isn't ready based off ambivalence
What is change talk?
Change talk → particular kind of speech to evoke change and reinforce it, client makes argument for change Indicates readiness to change and start a new behavior Motivational interviewing is meant to evoke change talk and reinforce it
What is motivational interviewing? How does it embody the basic needs of autonomy, competence, and relatedness from Self-Determination Theory?
Clinical technique associated with SDT. Non-confrontational, empathetic style. Promotes client ownership of behavior change. Supports intrinsic motivation and decision making. Open-ended questions Puts choices on the patient rather than the professional Encourages autonomy by having the client come up with behavior changes on their own Confidence in their ability to change (competence) Repeating what the client says using empathetic tone aids in relatedness
What are co-benefits? Give an example of a policy decision that could have a co-benefit related to physical activity and explain how the co-benefit could occur.
Co-benefits → a single activity or policy resulting in multiple benefits Personal, local and global benefits
Describe the 3 components of the MI Spirit.
Collaboration - creates partnership Evocation - drawing out ideas Autonomy - client decision making
Describe the 3 basic needs included in self-determination theory.
Competence → able to do something Autonomy → able to to it on your own Relatedness → the need to feel close to others
Describe the 3 methods of habit change we discussed in class that involve cue control. Which of these methods are more or less likely to result in successful habit change and why?
Control cue exposure - due to life experiences Effortful suppression - ineffective, provides negative effects Replacement of cue response - most effective
According to self-determination theory, what is the role of the environment in behavior change?
Creating a positive environment is a piece of the collaboration component It is important for change to take place functioning , nurturing environment necessary for psychological needs Allows clients to make decision that most benefit them
According to Duhigg what are the 3 components of the habit loop? Be able to give an example of each component for a habit in your own life.
Cue Routine Reward Habit Examples: Brushing teeth, checking phone when you get a message
Differentiate between habits that are cued directly from habits that involve motivated cuing and provide another example of each type.
Direct Cueing → more simplistic, memory as direct context response associations Develop from co-activation Ex: always capitalize the first letter in a sentence Motivated Cueing → arise through pairing of the reward value of the behavior with the contextual cues Ex: movies with popcorn, the smell of the popcorn
Explain how dopamine is involved in motivated cuing for habits.
Dopamine is responsive to rewards and is involved in learning Where cravings come from Body gets excited because it know the cue is coming
Explain how mHealth technology can improve upon more traditional methods for conducting observational research and implementing behavior change interventions. NOTE:consider the limitations of traditional theories that we discussed in class and the specific ways that mHealth can address these limitations.
Gives objective measures No social desirability bias Gives real-time, natural data not just "snapshots" Better recollection
In your own words define habit and differentiate it from other types of behavior.
Habit → subset of behaviors that is automatic, typically unconscious and occurs in response to cue Learned from past responses
Describe the 3 principles of habit.
Habits are cued by context Behavior becomes automatic and unconscious Habit context response associations are not mediated by goals Once argued, habit is performed without goal Habits interface with goals
Explain how habits and goals influence one another
Habits may be goal directed but are not goal dependent Goals can be achieved in many ways while habits always occur in the same fashion due to the loop (cue, routine, reward) Goals can encourage habit development Recognition of habits can influence goals
What are the key differences between intrinsic and extrinsic motivation? Be able to come up with a concrete example that demonstrates your understanding of each type.
Intrinsic motivation → doing something because you want to/ doing it because you enjoy it. Driven by internal rewards Engage in behavior that is naturally satisfying Ex: going to school because you enjoy learning Extrinsic motivation → doing something because there is another factor, like being paid. Driven by external rewards Arises from outside the individual Ex: getting more education because you'll get paid more
In what key ways does it differ from other approaches to behavior change?
It is empathetic to the client's individual situation. Offers encouragement, support and information. Validates experiences and feelings. Makes change the responsibility of the client. Does not tell the client how to accomplish a lifestyle change or try to convince them to make a change Does not diagnose or prescribe Should all come from the clients own ideas
What is a keystone habit? Be prepared to give an example and explain why it would qualify as a keystone habit?
Keystone Habit → habit that leads to other habits Chain reaction and have the ability to change other habits Important because they affect other portions of our lives
Familiarize yourself with the principles of behavioral economics from the MINDSPACE framework and the behavioral economics cheat-sheet.
M- messenger → who communicates it I-incentives → predictable, avoid losses N-norms → strongly influenced by others D-defaults → "go with the flow" opt in opt out S-salience → pack clothes in advance, attention drawn out on what's relevant P-priming → subconscious cues A-affect → emotions shape actions C-commitment → consistent E-ego → act to feel better about yourself
Describe the 4 foundational skills of MI (e.g. OARS) and be prepared to give an example of each skill including when and why it would be used?
O - open ended questions → what questions do you have? How has said change been going? Should be used in a 2:1 ratio with reflections, 2 reflections and 1 question Allows empathy to be built and allows client to talk more A - affirmation → "You are someone who really cares about your health" Should be used throughout the session after a client shares something about themselves in regards to behavior change Helps build the clients self-efficacy Gives statements of approval R - reflection → "You are a person who puts the needs of others in front of your own" Should be used after a client speaks about their experience or gives an idea for the behavior change Meant to repeat what the client says in a slightly different way Used to reflect deeper meaning in what they are trying to say S - summary → "So lets go over what we talked about.." Used to collect information and link clients statements Help organize clients thoughts and feelings
Provide examples of built environment variables that influence physical activity
Park locations Sidewalks Safe for bikers/pedestrians
Describe the MI Principles (e.g. RULE).
R - resist the righting reflex U - understand motivation [comes within] L - listen to your client E- empower your client
What is meant by "the righting reflex"?
Righting Reflex → natural tendency to try and actively fix problems, comes from one's desire to help others Reduces the likelihood of your client to make a change
What are the major strengths and limitations of this theory?
Strengths: Broad theory for human motivation Recognizes impact of sociocultural environment on behavior Has a positivist perspective Limitations: Assumes individual have inherent evolved tendencies toward growth Does not directly include many factors that may influence behavior Broad base of the theory elements can be difficult to operationalize
Explain at least two potential limitations of mHealth for promoting behavior change (i.e., for diverse populations, for initial and/or long-term behavior change, for making valid conclusions from observational research).
Technology is difficult for the older generations, technology is expensive, which can leave out lower income families. 80-90% of apps only used once Maintenance of behavior tied to maintenance of technology
Define mHealth in your own words and give two distinct examples of how mHealth can be used to promote behavior change.
The use of mobile devices to encourage healthy lifestyles, research and health outcomes
Understand the theoretical difference between behavioral economic theory and more traditional theories (e.g., Theory of Planned Behavior). What is the fundamental difference? Can you describe the assumptions of the traditional theories that distinguish them from behavioral economic theory?
Traditional Theories → assume we are rational, stick to plans and are deliberate Behavioral Economics → takes into account that we are irrational, need to be nudged to make correct/healthy decisions, knows that we are more likely to go with the easy choice rather than the healthy one
Give an example of how urban design influences behavior.
Walkability Bikeability Locations of stores Active transportation