Lecture 2 - Changing Health Behavior

Question 1

Theories (6)

Answer 1

• Health Belief Model
• Social Cognitive Theory
• Reasoned Action Approach
• Self-Determination Theory
• Health Action Process Approach
• Reflective Impulsive Model

Question 2

What are these theories for?

Health Belief Model, Social Cognitive Theor, Reasoned Action Approach & Self-Determination Theory

Answer 2

Getting motivated

Question 3

What are these theories for? (Self-Determination Theory & Health Action Process Approach)

Answer 3

Preparing for action

and starting to change

Question 4

What is this theory for? (Reflective Impulsive Model)

Answer 4

‘Interference’ from

impulsive processes

Question 5

COM-B From theory to
intervention
(3 stages)

Answer 5

stage 1. Understand the behavior.
stage 2. Identify intervention options
stage 3. Identify content & implementation options

Question 6

COM-B From theory to
intervention
- stage 1. Understand the behavior.

Answer 6

1. Define problem in beh. terms
2. Select target beh.
3. Specify target beh.
4. Identify what needs to change.

Question 7

COM-B From theory to
intervention
- stage 2. Identify intervention options

Answer 7

5. Intervention functions

6. Policy categories

Question 8

COM-B From theory to
intervention
- stage 3. Identify content & implementation options

Answer 8

7. Beh. change techniques

8. Mode of delivery

Question 9

Model of stage of change (circle w. 6 parts)

Answer 9

• Precontemplation: no intention of changing beh.
• Contemplation: Aware a problem exists, no commitment to action.
• Preparation: intent upon taking action.
• Action: active modification of beh.
• Maintenance: Sustained change - new beh. replaces old.
• Relapse: Fall back into old patterns of beh.

= upward spiral (learn from each (re)lapse.)

Question 10

The Rubicon Model of Action Phases (adapted from Heckhausen & Gollwitzer, 1987)

Answer 10

Choosing > Planning > Acting > Evaluating

• choosing = motivation (pre-decisional)
• planning = volitional (pre-actional)
• acting = volitional (actional)
• evaluating = motivation (post-actional)

choosing –> planning = intention formation
planning –> acting = intention initiation
acting = intention implementation
actng –> evaluating = intention deactivation

Question 11

Information provision (NICE guideliness 2014, book p.163)
(7 parts)

Answer 11

• outcome expectancies
• personal relevance
• positive attitude
• self-efficacy
• descriptive norms
• subjective norms
• personal and moral norms

Question 12

which theory is self-efficacy part of…

Answer 12

Social Cognitive Theory (Bandura, 1977, 1989)

Question 13

Norms

Answer 13

• majority norm
• identification with the norm referent group
• injunctive vs. descriptive norms (see example in book ‘research focus p.
140-142).

Question 14

Fear Appeal

Answer 14

• a persuasive communication
• scare ppl into changing attitude
• conjuring negative consequences which will happen when not complying with recommendation

Question 15

Defensive responses

Answer 15

Threat without good RECOMMENDATIONS or EFFICACY = defensive responses

Question 16

“The Intention-Behavior Gap”

Answer 16

wanting ≠ doing

• Intentions are necessary (most of the time), but
  not sufficient for behavior change

Question 17

Implementation intentions (Gollwitzer,
1993; 1999)

Answer 17

• Motivational phase = setting goals/ intentions

* Volitional phase = translate intentions into behavior

Question 18

Implementation intentions =

Answer 18

• When
• Where
• How

“If situations X arises, then I will perform goaldirected behavior Y”

Question 19

“If situations X arises, then I will perform goaldirected behavior Y” (Implementation intention)

_ effective because?

Answer 19

• Increased activation of the specified cue.
• Automatic activation of the specified response.

e.g. “If I enter the hallway coming home after work, then
I will immediately put on my running shoes and go
for a run”

Question 20

Behavior is determined by 2

systems:

Answer 20

Dual process theories (Theories
of Automatic Beh., Impulsive Beh., and
Habits)
–>Associative system/ impulsive system/ system 1
–> Reasoned system/ reflective system/ system 2

Question 21

Promoting health-protective behaviors:

Answer 21

→ initiation of a desired response (e.g. attending a

cancer screening)

Question 22

Decreasing (habitual) health-risk behaviors:

Answer 22

→ suppression of an undesired response (e.g. quit
smoking)
→ substitution of unwanted response by wanted
response (e.g. eating an apple instead of a candy bar).

Question 23

Insight into one’s behavior
- Unfortunately people may lack insight into (the causes of)
their own behavior, e.g.,:…

Answer 23

• In a neutral or cold state the impact of hot cues (hunger,

emotions etc) is underestimated.

Question 24

Disrupting unwanted habits

Answer 24

- Remove or avoid cue
➢ Getting ahead of unwanted habits
➢ Changing the environment/removing the cue
- Utilizing (creating?) new situations:
➢ New house
➢ New job
➢ Corona?

Question 25

Nudging

Answer 25

• Strategic use of mental shortcuts
(biases, heuristics)
• We do what most people do (social
norms)
• We favour the status quo (loss
aversion, inertia)
• ‘Libertarian Paternalism

Question 26

Nudging (salience)

Answer 26

nudge that draws attention to an aspect of the decision-making process so that it plays a more important role.

Question 27

Nudging (social proof)

Answer 27

a psychological and social phenomenon wherein people copy the actions of others in an attempt to undertake behavior in a given situation.

Question 28

Nudging (default)

Answer 28

option which choosers end up with if they do not make an active choice

Question 29

Nudges

+++

Answer 29

\+ No need for cognitive
resources
\+ No need for strong motivation
\+ Overall considered as highly
acceptable, especially by those
who are (intrinsically) motivated
to change