CChapter 6: what are the mechanisms and approaches behind changing behavior?

Question 1

PRECEDE-PROCEED model

Answer 1

Predisposing factors: knowledge, attitudes, beliefs, personal preferences and existing skills and self-efficacy in
relation to desired behavioral change
 Enabling factors: characteristics of the environment that can facilitate behavioral changes and the skills or
resources needed to achieve change.
 Reinforcing factors: factors that reward desired behavioral change, for example social support.

Question 2

Precede- model phases

Answer 2

1. Phase 1: social diagnosis: planners get an impression of the health problems that affect the quality of life in a
   community and what the strengths and weaknesses are.
2. Phase 2 : epidemiological, behavioral and environmental diagnosis: the identification and assessment of
   health issues specific to the community and the related behavioral and environmental influences.
3. Phase 3 : educational and ecological diagnosis: setting priorities and determining how behavior from phase 2
   can be changed. Identification of predispositions, enabling and reinforcing factors.
4. Phase 4 : administrative and policy diagnosis: the aim is to ensure that the program is consistent with the
   policy of the organization.
5. Phase 5 : implementation of the program: the implementation of the planned intervention with three
   elements of evaluation:
   a. Process: did the program do what it intended?
   b. Impact: what impact does the intervention have on the outcome?
   c. Outcome: what are the long-term effects on health?

Question 3

Prochaska and di Clemente phase models

Answer 3

Pre-contemplation, contemplation, preparation, change, maintenance or relapse

Question 4

The Elaboration Likelihood Model (ELM)

Answer 4

suggests that attempts to motivate people who are not interested will not
succeed if you use rational arguments. Only individuals who are already interested beforehand pay attention to the
information and may act accordingly. Individuals will centrally process messages sooner if they are motivated to
receive an argument when:
 It is congruent with their pre-existing beliefs
 It is personal relevant to them
 Recipients have the intellectual capacity to understand the message
According to the ELM, peripheral processing takes place when individuals are not motivated for a particular
argument, are not really involved and have incongruent beliefs. Peripheral processing is about maximizing the
credibility and attractiveness of the source of the message through the use of indirect cues and information

Question 5

The protection motivation theory of Rogers (1993)

Answer 5

says that someone behaves adaptively in response to a
fear message if they have evidence that such behavior reduces a threat and if they believe they are capable of doing
so. In conclusion, the most convincing messages are messages that:
 Arouse some degree of fear
 Invoke a sense of severity if no change is made
 Emphasise the ability of the individual to prevent the feared outcome (efficacy)
Both positive and negative framing of messages is sometimes effective.

Question 6

Egan counseling (2001)

Answer 6

Counseling
emphasizes the importance of a proper analysis of the problem and consists of three phases:
1. Problem exploration and clarification
2. Goal setting
3. Facilitating action
An important element of his strategy is a thorough analysis of the problem. This is done by asking direct questions,
descriptive questions and by giving empathic feedback. Then a suitable solution can be found.

Question 7

Beck (1976) introduced the Socratic dialogue

Answer 7

This is a structured conversation in which the therapist asks questions
about the views on, for example, drug use. The intention is that the individual starts to wonder if he has the right
cognitions about the subject. When you ask someone about why he is using something and ultimately summarize it,
the reason for use is not seldom illogical, even in the patient’s ears

Question 8

The health belief model suggests that an environment that encourages healthy behavior should:

Answer 8

 provide cues to engage in healthy behaviors or remove cues to unhealthy behavior
 minimize the costs and barriers associated with engaging in healthy behavior
 maximize the costs of engaging in health-damaging behavior
Environmental strategies are central to the PRECEDE model.

Question 9

In what five groups did Rogers divide the population?

Answer 9

 Innovators = a small group of individuals with usually high status. They test new ideas.
 Early adopters = a larger group that has a wider sphere of influence than innovators. They are also described
as opinion leaders.
 Early majority = this group adopts ideas reasonably early, but does not have the power to influence the rest
of the population
 Late majority = the people who adopt the innovation only after adopting by the early majority. It is a careful
group.
 Laggards = adopt the change as last, or not at all.