adherencepart2 Flashcards
• Behaviors undertaken by people to enhance or
maintain their health.firmly est and performed automatically
health behaviors
– Single set of factors to explain adherence for
everyone
Continuum (broad category of theory of adherence)
-diff factors ar eimportant depending on what stage a person is in
stage (2nd category of theory)
– The degree to which the person perceives a personal health threat • Perceived susceptibility • Perceived severity – The perception that a particular behavior will effectively reduce the threat • Perceived benefits • Perceived barriers
whether or not a person practices a health behavior depends on these [Health belief model]
theory that People will adhere to behaviors if they:
1. believe they can initiate and carry out this behavior
(self-efficacy)
2. believe that the behavior will produce valuable
outcomes (outcome expectations)
self efficacy theory
theory of planned behavior:
-link health attitudes directly to behavior
-a health behavior is direct result of a behavior intention
behavioral intentions made up of attitude toward action, subjective norms, and perceived behavioral control
why models arent as good at predicting health behaviors?
- ppl distort msgs (unrealistic optimism)
- diff models needed to explain behaviors to diff diseases/behav
- other factors(public policies, poor health habits, relationships)
- methodolocigal limitations in measurement
- may instil motivation to change but doesnt provides steps/skills to make change
theory of planned behavior:
• Moderate ability to predict health behaviors such
as mammogram use, condom use, physical
activity, illicit drug use, and binge drinking
alcohol
• Past behavior is a better predictor than these
models (e.g., adherence)
• Not a huge improvement over the Health Belief Model
How well do these models predict
health behaviors?
• If the models include self-efficacy, they can
predict perceived behavioral control, subjective
norms, attitudes, and intentions
• Attitudinal approaches don’t explain long-term
behavior change very well
• Don’t explain spontaneous behavior change
• Communications can provoke irrational,
defensive reactions
cognitive-behavioral approaches
- focus to target behavior
- self observation/monitoring
- classical conditioning (pair ucr with cs to produce cr)
stimulus control
Understand antecedents
– Discriminative stimulus signals positive
reinforcement
– Stimulus-control interventions
• Rid environment of discriminative stimuli
• Create new discriminative stimuli for a new
response
• Behavioral Theory: Operant conditioning
– Pairs a voluntary behavior with systematic
consequences
– Key is reinforcement
– Behavior → positive reinforcement or withdraw
punishment → ↑behavior
– Behavior → withdraw reinforcement or punishment→
↓behavior
– Reinforcement schedule (continuous vs. intermittent)
– Often used to modify health behaviors
– Start with continuous & then make it harder
(progressive)
- Positive reinforcement (adds a desired factor)
* Negative reinforcement (removes an aversive factor)
reinforcement
- Positive punishment (adds an unpleasant stimulus)
- Negative punishment (removes a pleasant stimulus)
- Positive works somewhat better than negative
- Works better if coupled with reinforcement techniques
punishment
covert self control
Recognizing internal monologues – Cognitive restructuring: modifying internal monologues – Self-talk: adaptive ways to talk to oneself in stressful situations
behavioral assignments
– Client becomes involved in treatment
– Client analyzes behavior to plan intervention
– Client is committed by contractual agreement
– Client assumes responsibility for behavior change
– Homework increases client’s self-control
Goals
– Reduce social anxiety
– Introduce new skills for dealing with anxiety-provoking
situations
– Provide alternative behavior for poor health habit
associated with social anxiety
Skills Training
– Social skills
– Assertiveness
motivational interviewing
– Interviewer is non-judgmental and encouraging
– Client talks as much as counselor
– Goal: get client to think through reasons for and against
change
– Mixture of techniques from psychotherapy & behavior
change theory
– Works well for those who are wary about change
• Broad-spectrum cognitive-behavior therapy
– Combine multiple behavior change techniques
– Tailored to individual
– Don’t overload
– Most effective
• Relaxation training
– Deep breathing
– Progressive muscle relaxation
More likely when people are depressed, anxious,
under stress
– Particular problem with addictive disorders of
alcoholism, smoking, drug addiction, obesity
(rates between 50% and 90%)
– Abstinence violation effect – feeling loss of control
with one lapse in vigilance
relapse
transtheoretical model stages
- precontemplation
- contemplation
- preparation
- acton
- maintenance
– In this stage, the person is not aware of a problem
– Family and friends may be aware and push for
treatment
– The individual often reverts to old behaviors if
treatment does occur
stage 1) precontemplation
– Aware that a problem exists – No commitment to take action – Weighing the pros and cons of action – If a decision for change is made, then there are favorable expectations
stage2) contemplation
– Intention to change behavior has been made
– May not have begun to change behavior or may have
modified the target behavior somewhat
• smoking fewer cigarettes each day
stage3) preparation
