Models and theories of health behaviour change Flashcards Preview

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Flashcards in Models and theories of health behaviour change Deck (22):

What are the 8 models / theories of behaviour change?

1. Health belief model (HBM)
2. Theory of planned behaviour (TPB)
3. Stages of change / transtheoretical model (TTM)
4. Social norms theory
5. motivational interviewing
6. social marketing
7. Nudging
8. financial incentives


What is the health belief model based upon?

In order to change someones health behaviours if you influence these 4 perceptions/beliefs (perceived barriers):
1. Believe that they are susceptible to the condition
2. believe that it has serious consequences
3. believe that taking action reduces susceptibility
4. believe that the benefits of taking action outweigh the costs

These will ^ the chances of the patient engaging in health promoting behaviours


What is the HBM adapted from?

Becker 1974


Use the the health belief model to change someone's belief about smoking

They need to (1) perceive that they could get lung cancer, (2) that lung cancer is bad for them, (3) that by stopping smoking they will reduce their risk of lung cancer/cough less etc, and (4) that there are smoking cessation services to help them remove the barriers


What are the 4 perceived barriers discussed by the HBM?

In order for someone to change their health behaviours, these 4 barriers need to be overcome:
1. Believe that they are susceptible to the condition
2. believe that the behaviour has serious consequences
3. believe that taking action reduces susceptibility
4. believe that the benefits of taking action outweigh the costs


What has the HBM been successful in?

A range of health behaviours: cancer screening, medication adherence. breast self-examination, DM Mx, vaccinations


In Becker (1974) original health belief model, what is included?

Cues to action (internal or external)


What are some disadvantages of the HBM?

Doesn't differentiate between first time and repeat behaviour

Cues to action often missing in HBM research

Doesn't consider influence of emotions on behaviour

Other perceived barriers (to the four) may predict health behaviour: e.g. pt's belief in their ability to carry out preventative behaviour


Describe the theory of planned behaviour (what does it say in terms of changing health behaviours?)

Proposes the best predictor of behaviour is 'INTENTION'

Intention is determined by:
1. persons attitude to the behaviour
2. subjective norms (social pressure)
3. perceived behavioural control (person's appraisal of their ability to perform the behaviour)


Using the theory of planned behaviour, explain how someone may change their behaviour of smoking

1. Attitudes – believing that smoking is bad for you
2. Subjective norm – most people who are important to me want me to give up smoking
3. Perceived behavioural control – thinking that they are in control of their smoking, that if they want to quit they will be able to

These 3 determine the INTENTION to change: 'I intend to give up smoking' --> quit smoking (behaviour)


What 5 things determine whether someones intention leads to behaviour change?

1. perceived control
2. anticipated regret
3. preparatory actions (e.g. dividing task into sub-goals)
4. implementation intentions
5. relevance to self

The theory of planned behaviour doesn't consider the barriers from intentions to actual behaviour


What are some disadvantages of theory of planned behaviour?

Assumes that attitudes, subjective norms and perceived behavioural control can be measured

relies on self reported behaviour

Model doesn't explain how attitudes, intentions + perceived behavioural control interact

Useful for predicting intentions but not for actual behaviours (there are barriers between intentions and behaviours)


Describe the stages of change model (Transtheoretical model)

5 stages of change:
1. Pre-contemplation (not ready) --> 2. contemplation --> 3. planning / getting ready --> 4. action --> 5. maintenance

(can relapse - go back 1-5 steps)


Explain the 5 stages of change in terms of smoking behaviours

1. pre-contemplation: no intention of quitting
2. contemplation: beginning to consider quitting (probably at ill-defined time in future)
3. preparation: getting ready to quit in the near future
4. action: engaged in quitting now
5. maintenance: steady non-smoker


Does the transtheoretical model work?

Studies have shown stage-based intervention has worked in smoking

Not in other things: e.g. obesity (weight loss), eating disorders


What are some advantages of the transtheoretical model?

- Acknowledges individual stages of readiness - allowing interventions to be tailored to the individual based on the stage they are at
- accounts for relapse
- temporal element


What are some disadvantages of the transtheoretical model?

- not all people move through every stage (some stages missed)
- change might operate on a continuum rather than discrete stages
- doesn't account for culture, values, habits. social and economic factors


How does transtheoretical model differ from HBM and theory of planned behaviour?

Examines the PROCESS OF CHANGE rather than factors that determine behaviour


How does motivational interviewing to change health behaviours work?

Counselling approach (resolves ambivalence) --> doesn't work for HIV-risk behaviour or smoking behaviour


How does nudge theory work?

'Nudging' the environment making the best option the easiest (E.g. placing fruit next to checkout)

Weak evidence that it works in changing/sustaining good health behaviours


What other factors should you consider in changing health behaviours?

- impact of personality traits on health behaviour
- assessment of risk perception
- impact of past behaviour/habit
- social environment


What needs to be explored before developing a plan for behaviour change?

Explore a person's beliefs + reasons why they engage in particular behaviours