Chapter 22-Behavior Modification 2009

General Points to Consider in Modifying Behavior

1. Assessment - problem must be identified and defined in behavioral terms. 2. Self-monitoring 3. Goal setting: characteristics of effective goals - p. 337 4. Reinforcement 5. Behavioral contracts 6. Relapse Prevention

Health Fitness Counseling

1. Communication Skills 2. Characteristics of an Effective Helper: empathy respect concreteness genuineness confrontation Effective listening Attend to verbal and nonverbal messages. Identify overt message and underlying meaning. Practice responsive listening. Empathetic responding Communicate understanding. Maintain nonjudgmental reactions. Don't make assumptions. Be honest and supportive.

Factors Influence Exercise Adoption

1. Individual influences: exercise history, motivation, higher education, higher income, male sex, younger age are positively associated with exercise. Higher adherence for leisure-time activity than for high-intensity exercise. "Participants who set their own goals will have a greater change of success than if goals are assigned to them." 2. Social influences: support from family & friends 3. Environmental influences: easy accessibility, environmental cues, convenience chain or sequence (longer and more complicated = more barriers). Lack OF TIME. Marketing and Motivational Strategies: P. 334-335

Additional Information

1. Precontemplation: sedentary: not considering or do not want to change a given behavior and have no intent to change in the immediate future. May be unaware of a problem and avoid ways to find out about it. Difficult to reach for behavioral change. Need to educate, pressure. 2. Contemplation: acknowledge that they have a problem and begin to seriously think about overcoming it. Education and peer support 3. Preparation: seriously considering and planning to change a behavior within the next month. Goal setting. 4. Action: actively doing things to change the problem behavior or adopt a new health behavior. Relapse is common during this stage. If maintain the action stage for 6 consecutive months, they move into the maintenance stage. 5. Maintenance: continues to maintain the behavioral change for up to 5 years. 6. Termination/Adoption: Once a behavior has been maintained for more than 5 years, a person is said to be in the termination phase and exits from the cycle of change without fear of relapse. Now the change is part of your lifestyle. Figure 22.1 Intervention strategies for various stages of change.

Enhancing Adherence: Methods of Behavior Change

Assess. Physiological (physical fitness, health) Psychosocial (goals, motivation) Evaluate past attempts at change. Self-monitor to identify barriers and supports. Enhance self-efficacy through the following: Set up mastery experiences. Provide verbal encouragement. Provide successful models. Offer information about normal physiological responses to exercise and how to interpret them.

Methods of Behavior Change:Goal Setting

Define goals in behavioral terms (measurable). Set specific goals. Make the goals flexible. Include short-term and long-term goals. Make the goal challenging but achievable. Address physiological factors. Consider environmental influences. Provide timely and specific feedback.

Promoting Exercise:Targeting Precontemplators and Contemplators

Key factors Individual characteristics Social influences Environmental dynamics

Helping Individuals Change Health Behaviors

Knowledge A theoretical model to explain and predict behavior (transtheoretical model) Factors that influence health behaviors: attitudes, beliefs, and behavioral skills Skills Behavior change strategies matched to stage of motivational readiness The ability to listen effectively and respond empathetically

Transtheoretical Model

Model of intentional behavior change: dynamic process that occurs through stages: (1)Stages of Change (2)Concepts Hypothesized to Influence Behavior Change: processes of change, self-efficacy, decisional balance, (3)Level of change needed to be successful A gradual process: involves several stages: psychologists James Prochaska, John Norcross and Carol DiClemente developed the Transtheoretical Model of Stages of Change: Involves 6 stages people go through to change problem behaviors and adopt healthy behaviors.

Methods of Behavior Change:Behavioral Contacts

Principles Contracts should specify goal-directed behaviors. Terms should be very clear. Contracts should be generally positive. Contracts should be fair. Procedures should be systematic and consistent. At least one other person should participate

Considerations for Marketing Exercise

Reduce the perceived costs and increase the perceived benefits of being active. Provide practical support and encouragement. Include motivational prompts suited to the target group. Reduce environmental barriers

Methods of Behavior Change:Relapse Prevention

Relapse occurs when a person stops a healthy behavior and goes back to unhealthy habits. High-risk situations increase the risk of relapse. Relapse prevention attempts to identify and deal with potential high-risk situations.

Methods of Behavior Change:Reinforcement

Temporally close to target behavior Tangible or intangible Meaningful to the participant Addition of something positive or removal of something negative

Transtheoretical Model of Behavior Change

Theoretical foundation: The transtheoretical model of behavior change Behavior change is a dynamic process involving attitudes, decisions, and actions. Individuals progress through distinct, often nonsequential stages of change. Intervention strategies must be matched to the stage a person is in. Stages of change in exercise Precontemplation: inactive, not considering exercise Contemplation: inactive, considering beginning exercise or changing unhealthy behavior within next 6 months Preparation: plan to begin program or take action within 1 month. Action: active at criteria level for less than 6 months Maintenance: active at criteria level for 6 months or more Attitudes, beliefs, and behavioral skills that influence behavior change Self-efficacy (belief in capability to engage in a specific behavior successfully) Decisional balance (evaluating the pros and cons of the target behavior) Processes of change (strategies used to change behavior) Experiential/cognitive Behavioral