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Health 2400 Test 2: Theory

by: Grace Stewart

Health 2400 Test 2: Theory HLTH 2400_002

Grace Stewart

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Here is a guide I made using the powerpoints provided but I put everything into my own words! I hope y'all find this useful! Happy studying!
Determinants of Health Behaviors
Mrs. Amelia Clinkscales
Study Guide
health, Determinants
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This 10 page Study Guide was uploaded by Grace Stewart on Thursday March 10, 2016. The Study Guide belongs to HLTH 2400_002 at 1 MDSS-SGSLM-Langley AFB Advanced Education in General Dentistry 12 Months taught by Mrs. Amelia Clinkscales in Spring 2016. Since its upload, it has received 111 views. For similar materials see Determinants of Health Behaviors in Health Sciences at 1 MDSS-SGSLM-Langley AFB Advanced Education in General Dentistry 12 Months.


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Date Created: 03/10/16
Exam 2 Expectancy Value Theories ­ people behave according to the personal benefits an action can provide, considering the  costs or advantages of the alternatives  ­ Cognitions ­ knowledge­ verifiable truth ­ perception­ interpretation of information belief­ whats considered to be true ­ ­ attitude­ evaluation about the goodness or badness of an object or thing ­ social norms­ the prevalence of behaviors within a society or group value­ evaluation of the relative importance of various factors, concepts, and actions  ­ ­ Health Belief Model (under expectancy value theories) ­ Most widely used and broadest of health behavior theories ­ Has roots in behaviorist and cognitive psychology ­ emphasis on the decision making process ­ also known as a VALUE EXPECTANCY THEORY, where BEHAVIOR is related to: ­ the subjective value of the outcome ­ the subjective probability that an action will achieve the outcome Key Constructs ­ ­ Belief that they are susceptible to the conditions  ­ Believe the condition and consequences are  severe  ­ Believe that taking some action has some  benefit  ­ Believe that the  barriers to taking action are low ­ There are  cues to action  ­ Self efficacy ­ the person believes that they can do the behavior that will produce the  desired outcome ­ Perceived threat ­ perception of  susceptibility ­ perception of  severity ­ influences the readiness to  take action  ­ Perceived expectations perceived  ­ benefits of action ­ perceived  barriers to action ­ perceived  self­efficacy  ­ Cues to action  ­ increases the likelihood that a behavior will occur by influencing perceptions of threat  and benefits ­ Demographic Factors ­ Also influence perceptions ­ Ethnicity­ cultural norms Psychological makeup ­ ­ locus of control ­ Sociological background ­ level of education ­ Critiques of HBM ­ Focus is on  individual decisions­ doesn't account well for social and environmental  factors  ­   HBM believes that everyone has equal access to, and equal levels of information to  make rational calculations. So, the model  doesn't account for disparities in knowledge. ­ provide information= increased knowledge  Theory of Reasoned Action and Theory of Planned Behavior (under expectancy value theory) ­ ­   Individual­oriented ­ 2 versions:  Theory of Reasoned Action which was later replaced by the ­ … ­ Theory of Planned Behavior  ­ One of many of theoretical attempts to pin down the relationship between one ’s attitudes  and their behavior  ­ similarities with the HBM: focuses on rational, cognitive  decision­making processes ­ Ajzen and Fishbein Behavior is predicted by intention  ­ ­ Intentions are predicted by attitudes ­ attitudes are made up by beliefs  ­ beliefs­> attitudes­> intentions­> behavior  ­ ***Motivational factors drive intentions. Intention is a measure of motivation*** Theory of Reasoned Action (TRA) ­ ­ Beliefs, attitudes, social normative perceptions, behavior ­ argues that an individual will perform action X based on: their attitude towards the behavior ­ ­ the norm associated with the behavior ­ There is a  “linear chain” linking behavioral and normative beliefs to behavioral intention  and the behavior itself  ­ ex. if i quit smoking, i will gain weight= low intent to quit smoking  ­ Theory of Planned Behavior ­ TRA + Perceived Behavioral Control over behavior  ­ does not account for external factors that might prevent someone from taking a specific  action  ­ new element was added to TRA:  “perceived behavioral control”, consists of 2 parts ­ control beliefs­ concerning the presence or absence of facilitators and barriers to  performing the behavior  ­ perceived power of these factors to facilitate or inhibit the behavior  ­ A person ’s perception of how much they can control their behavior is combined with  intention, attitude and norms to determine or predict behavior  Must be under volitional control­ a behavior that the person is able to engage in or not ­ ­ Constructs for TRA and TPB ­ TRA and TPB Behavioral intention ­ ­ perceived likelihood of performing the behavior  ­ Attitude ­ Behavioral belief: that behavior is associated with outcomes ­ Evaluation: value attached to outcome ­ Subjective Norms ­ Normative belief: belief about others ’ approval or disapproval of behavior  ­ Motivation to comply: with what others think ­ Perceived behavioral control ­ Control belief: perceived likelihood that influential conditions exist ­ Perceived power: weighted influence of each condition  ­ Attitude towards the behavior ­ How important is this behavior to me? ­ Subjective norm Do others think i should behave this way? ­ ­ Perceived behavioral control ­ Do I have any control over this behavior? **Added to TRA** ­ ­ Critiques of TRA/TPB ­ TRA/TPB assumes that behavior is the output of rational, linear decision making processes The TPB construct  ­ “perceived behavioral control” is very unclear, and so is the  relationship to the actual control a person might have over his/her behavior  ­ Time between intent and action is not often considered  ­ Self Regulation ­ The process by which people manage their own goal­ directed behavior to achieve  personal goals ­ Also known as: Self­management and/or Self­control ­ Self­regulation is the goal of behavior modification which applies operant conditioning  methods  ­ Self­regulation is a product of … ­ childhood development ­ psychological maturity ­ individual personality ­ Prerequisite for conventional acceptance and achievement  ­ willpower? ­ Self­regulated behavior is goal directed ­ Desire to improve or change behavior  ­ awareness of goals ­ conflicting goals Process of managing goal­directed behavior ­ ­ resisting impulses to satisfy immediate needs  ­ managing short­term desires Self­monitoring ­ ­ Self­evaluation ­ Self­reinforcement  Self­regulation and self­efficacy ­ ­ What is self­efficacy? ­ How do you build self­efficacy? ­ Relationship between self­regulation and self­efficacy ­ Social Cognitive Theory ­ Goal: to explain how people regulate their behavior ­ Originator: Albert Bandura  ­ First called “Social Learning Theory”­ key principle was learning by observation of others  (vicarious learning) SLT grew to include other constructs related to an individual ­ ’s interaction with an  environment. One of the most important of these is self­efficacy  ­ Self­efficacy: the idea of self­efficacy as a key element in how people change behavior  moves beyond the mechanistic conditioning process of change ­ The idea of reciprocal  determinism was added­ where behavior is part of a continuous  interactive cycle that includes individuals and their social environment  SCT ­ ­ Self regulation ­ reciprocal determinism social influence­ modeling ­ ­ cognitions ­ self­efficacy Reciprocal Determinism  ­ ­ Environment ­ Includes both physical and social elements ­ Provides context ­ Provides opportunity ­ Provides consequences and feedback ­ Person ­ Personality ­ Cognitions ­ Behavior Generates environmental responses ­ ­ Goal directed ­ Frequency depends on reinforcement  ­ Social Influence ­ Socially­mediated expectations ­ Social context influences behavior ­ Norms ­ Expectations and Expectancies ­ Processes ­ Socialization: influence of others on one ’s behavior ­ Selection: tendency to associate with others with similar behavior  ­ Cognitions Behavioral capability: essential knowledge and skills ­ ­ Expectations ­ Efficacy­ about one ’s ability to behave in a certain way Outcomes­ about the likelihood of outcomes ­ ­ Intervention Implications ­ Alter the environment Provide reinforcement ­ ­ Facilitate goal setting ­ Create opportunities for observational learning ­ Establish expectations ­ Improve self efficacy ­ Alter or interpret social norms  ­ SCT Constructs ­ Changing a behavior is a function of the interactive process of the following kinds of  factors: ­ Individual (internal) characteristics ­ Self­efficacy ­ Behavioral capability ­ Expectations ­ Expectancies ­ Self control­ goal setting  ­ Emotional coping ­ Environmental (external) factors Vicarious learning ­ ­ Situation (social and physical context) ­ Reinforcements (positive or negative responses) Social Norms  ­ ­ Critiques of SCT ­ SCT is very complex; it can be viewed as less of a theory than a related  “grab­bag” of  constructs ­ SCT has gone through a number of evolutions; as it evolved, it retained earlier constructs,  increasing the general complexity of SCT and reducing its clarity as theory  ­ Transtheoretical model  ­ stages of change  ­ Change theory­ describes the change process as opposed to the constructs (determinants  influencing change) ­ There IS NOT  a 1­size fits all plan for changing behavior  ­ People differ in their level of motivational readiness to change ­ The most appropriate strategies for changing behavior depends on one ’s “stage of  readiness” to change mismatched strategies result in ­ ­ Higher dropouts of program ­ Lower likelihood of reaching goals if they stay in the program Lower likelihood of regular participation ­ ­ Stages of Change Theory ­ Research shows: ~ 5 stages of motivational readiness for change ­ ­ Specific strategies exist for each stage of change ­ The majority of health behavior change programs that fail use strategies that are  inappropriate for the participants given their stage to change ­ The 5 stages of motivational readiness for change ­ 1: Precontemplation ­ Inactive and not thinking about becoming more active ­ Have NO intention of changing ­ Get defensive at suggestions to change ­ resist efforts to change (most resistant) ­ Believe cons (negatives) outweigh the pros (benefits) of change ­ 2: Contemplation ­ Inactive and thinking about becoming more active ­ Thinking about changing ­ lack commitment to change  ­ Believe cons (negatives) and pros (benefits) of change are equal ­ Temptation is too great to overcome 3: Preparation ­ ­ Doing some activity but not at adequate levels ­ Want to change and making efforts Behavior is performed inconsistently ­ ­ Don ’t know how to effectively do the behavior ­ Believe pros (positives) outweigh the cons (negatives) Lack confidence in their ability to perform the new behavior ­ ­ 4: Action ­ Doing adequate levels of activity for less than 6 months ­ Have begun performing the behavior consistently within the past 6 months ­ Have a plan of action for doing the behavior  ­ committed to the new behavior  ­ pros outweigh cons! ­ can get discouraged easily ­ Greatest risk for “relapse” ­ 5: Maintenance ­ Doing adequate levels of activity for more than 6 months ­ Have been performing the behavior consistently for more than 6 months ­ enjoy the benefits of change ­ confidence is high ­ the behavior is part of their lifestyle ­ temptation for relapse is low ­ less thinking about pros and cons ­ Stages of Change Theory ­ Additional concepts of this theory movement through stages is cyclical v. linear ­ ­ “relapse” is real (but, not total relapse/lapse) ­ skipping stages can be less effective need to learn  ­ “skills” related to stage ­ dealing with competing time demands ­ dealing with health issues dealing with life events ­ ­ coming to terms with the importance of behavior  ­ Processes of Change ­ Consciousness raising­ finding and learning new facts ­ dramatic relief­ experiencing the negative emotions of unhealthy behavior environmental­reevaluation­ realizing the impact of health behavior on environment ­ ­ self­reevaluation­ realizing behavior change is important  ­ self­liberation­ making a firm commitment to change helping relationships­ seeking and using social support ­ ­ counterconditioning­ substituting healthy for unhealthy ­ contingency management­ increasing and decreasing rewards for healthy and  unhealthy behavior  ­ stimulus control­ adding or removing cues to behavior ­ social liberation­ realizing social norms are changing to support healthy behavior  Strategies for behavior change ­ ­ precontemplation to contemplation  ­ become aware of the benefits of change (pros) ­ Identify supports­ (pros that will result) social support, monetary support, improved  health, etc. ­ Become more aware of the barriers of change (cons)­ factors that would need to be  overcome before the new behavior is adopted  ­ Contemplation to preparation ­ increase health awareness ­ increase peer pressure ­ increase desire to change ­ goal setting­ create specific simple goals to focus on, identify factors that are  positively or negatively associated with achieving goals  ­ set long and short term goals ­ goals should: consider current status, include specific plan of action, include time  frame, include measures of progress ­ goal achievement leads to increased confidence! ­ Preparation to action ­ develop a plan of attack (strategies)­ based on knowledge of supports, barriers,  relapse ­ breaking the chain of events leading up to a negative behavior (antecedents) ­ substituting, avoidance behaviors  ­ Measure your progress­ for awareness of success and relapse ­ ongoing evaluation, reflection, adjustment ­ Action to maintenance support relapse prevention­ to combat initial enthusiasm and changing motivations ­ ­ internalize the behavior ­ intrinsic motivation­  extrinsic motivation ­ ­ Strategies must be tailored to the  “specific” behavior ­ with many health behaviors­ all strategies tend to help at all stages but … cognitive strategies work best with earlier stages (knowledge) ­ ­ Behavioral strategies work best with later stages (lifestyles) ­ “The process of change” Cognitive ­ ­ Increase knowledge on benefits of behavior ­ Be aware of risks of inactivity ­ Care about consequences to others ­ comprehend personal benefits of behavior ­ increase awareness of healthy opportunities  ­ Behavioral ­ Use  “desired behavior” as a substitute for alternative behaviors ­ Enlist social support for behavior ­ reward yourself for doing behavior ­ commit yourself to the behavior ­ remind yourself to do the behavior  ­ Finally, ­ some of the most effective strategies include … increasing self­efficacy to deal with issues related to doing behavior ­ ­ developing skills to overcome barriers in behaviorally specific situations  ­ multiple strategies at one time!


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