3b - Techniques of Behaviour Change Flashcards
1
Q
Health Behaviour
A
“Any activity undertaken by an individual believing himself to be healthy, for the purpose of preventing disease or detecting it at an asymptomatic stage”
2
Q
COM-B: The Behaviour Change Wheel
A
Behaviour is influenced by:
- capability
- opportunity
- both of those influence motivation
- all three interact with behaviour
3
Q
What are behaviour change techniques?
A
- A systematic strategy used in a deliberate attempt to change behaviour
- Techniques (more specific) vs. interventions (more broad) -> rewatch
Examples Providing information on consequences Prompting specific goal setting Prompting barrier identification Modelling the behaviour Planning social support
4
Q
EXAMPLES OF BEHAVIOR CHANGE TECHNIQUES
A
Examples
- Providing information on consequences
- Prompting specific goal setting
- Prompting barrier identification
- Modelling the behaviour
- Planning social support (e.g. people that live with the patient can help with making sure that they take medications by e.g. putting them on the breakfast table)
5
Q
BCT Clusters
A
- Goals and Planning
- Feedback and monitoring
- Social Support
- Shaping Knowledge
- Natural Consequences
- Comparison of Behaviour
- Associations
- Repetition and substitution
- Comparison of outcomes
- Reward and threat
- Regulation
- Antecedents
- Identity
- Scheduled Consequences
- Self-belief
- Covert Learning
6
Q
Which BCT is the most effective?
A
- depends on health behavior you want to target
7
Q
How do we choose our BCT?
A
- Behavioural target specification
- Behavioural diagnosis
- Intervention strategy selection
- Implementation strategy selection
- Selection of specific BCTs
8
Q
Behavioural Diagnosis
A
- Who? who is the population? (e.g. individuals undergoing cardiac rehabilitation)
- What? What would the behaviour change be? (e.g. shift to Mediterranean diet type foods)
- When? when will this happen? (e.g. dinner at home, breakfast, lunch at work)
- How Often? Every day
- Where? e.g. cafe where they grab their lunch every day, grocery store, home environment.
- Who With? Family members, friends that have an influence on the types of food that the patients in cardiac rehab would eat.
9
Q
Popular Behaviour Change Techniques
A
- self monitoring
- motivational interviewing
- implementation intentions
- incentives
10
Q
Self monitoring
A
- An individual keeping a record of target behaviours
- Additional information recorded can help to identify barriers e.g. mood, weather
- Time-consuming over the long term
- Role in increasing physical activity and healthy eating studied (Michie et al., 2009)
11
Q
Motivational Interviewing
A
- A person-centred counselling style for addressing the common problem of ambivalence about change.
- developed by psychologists but now doctors are increasingly asked to embody these techniques
- type of questioning style about any problems the client may have in making behavioral change
- It’s a style rather than something that you do.
Clinician: non judgemental stance, not focusing on educating or telling the client what to do.
- MI ‘Spirit’
- MI-consistent behaviours
- MI-inconsistent behaviours
- Using specific techniques
Clients
- Change Talk/Intention (recognise when the patient mentions something negative about the behaviour that should change)
- Stage of Change e.g. readiness to change
- Co-operation, engagement or disclosure (client engagement/involvement)
- Resistance to change (client resistance)
- Self-confidence (positive reinforcement to making the change)
- Sense of discrepancy
12
Q
Implementation Intentions
A
- AKA Action Plans
- Request an individual to think about critical situations to act and appropriate responses within those situations
- IF-THEN
- E.g. IF it’s Friday morning at 9am THEN I will go for a run from my house around the park
- When would be a good time and place to exercise?
- What specific exercises would you enjoy?
- How do they work?
- By planning in advance the situation in which an individual will act, cues become particularly accessible
- Strengthening connection between good situation to act and a suitable action
- Therefore behaviour is more likely to be enacted
- association?
13
Q
Incentives
A
- Cost-effective
- Raise awareness
- Bring individuals into contact with health services allowing earlier screening and treatment of illness
- Can be effective in changing health and clinical behaviours, thus preventing disease and reducing costs associated with disease.
Are they effective?
Mixed across reviews although there are some positive findings
Unclear:
Which rewards work best?
14
Q
What are the limitations of reinforcement programmes?
A
- Lack of generalization (only affects behaviour regarding the specific trait that is being rewarded).
- Poor maintenance (rapid extinction of the desired behaviour once the reinforcer disappears)
- Impractical and expensive.
15
Q
Is it better to change multiple behaviours at one time?
A
- Targeting multiple behaviours at the same time may lead to greater overall change but sub-additivity is an issue
- effect for each individual behaviour is diminished
