The Precaution Adoption Process Model Liz McDermott H 571: Principles of Health Behavior

Overview Characteristics of Stage Models Stages included in the Precaution Adoption Process Model The Precaution Adoption Process Model and the Theory of Triadic Influence Precaution Adoption Process Model and Processes of Change Group Discussion

Stage Models Change occurs as a result of passing through series of sequential stages resulting in either: Elimination of a health-risk behavior Long-term adoption of a health-protective behavior To enter a subsequent stage, one must successfully complete the tasks of the previous stage Useful for developing and implementing stage-matched/stage-targeted interventions

Assumptions of Stage Models Classification system defining stages Ordering of stages Common barriers to change experienced by individuals in same stage Different barriers to change experienced by individuals in different stages

Precaution Adoption Process Model (PAPM) & Your Health Behavior Keep your health behavior of interest in mind and think about the following: Does your health behavior of interest fit with the PAPM model? If so, what aspects of the model make it a particularly good fit for your health behavior? If not, why? What are some of the gaps or limitations of the model?

Stages of the PAPM Composed of 7 stages Each stage represents unique patterns of beliefs, behavior, and experience Factors producing stage transitions differ depending on transition under consideration

Stages of the PAPM cont. Stage 1: Unaware of Health Issue Stage 2: Unengaged by Health Issue Optimistic Bias

Stages of the PAPM cont. Stage 3: Deciding about Acting Stage 4: Decided Not to Act Confirmation Preservation, Hypothesis Preservation

Stages of the PAPM cont. Stage 5: Decided to Act Stage 6: Acting Stage 7: Maintenance

THE THEORY OF TRIADIC INFLUENCE Distal Influences Proximal Predictors Levels of Causation Ultimate Causes Social/ Personal Nexus Expectancies & Evaluations Affect and Cognitions Decisions Experiences Intrapersonal Stream Social/Normative Stream Cultural/Attitudinal Stream Biological/Nature Nurture/Cultural BIOLOGY/ PERSONALITY SOCIAL SITUATION CULTURAL ENVIRONMENT Values/ Evaluations Knowledge/ Expectancies Perceived Norms Information/ Opportunities Interpersonal Bonding Social Competence Interactions w/ Social Instit’s Others’ Beh & Atts Motivation to Comply Skills: Social+General Sense of Self/Control Self Determination 1 2 3 7 8 9 10 11 12 13 14 15 16 17 18 l 4 5 6 a b c d e f C F I B E H A D G g h i j k m n o p q r s t u v w x SELF-EFFICACY BEHAVIORAL CONTROL SOCIAL NORMATIVE BELIEFS ATTITUDES TOWARD THE BEHAVIOR Very briefly since our last presenter already touched on this. 19 20 21 22 23 DECISIONS/INTENTIONS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological Related Behaviors J K 10

PAPM & Processes of Change Does not prescribe specific processes of change Stage progression may occur as a result of many varied intervention techniques Potential of alternative theories to provide insight into mechanisms of PAPM stage movement Weakness of the PAPM?

Remember… PAPM & Your Health Behavior Does your health behavior of interest fit with the PAPM model? What aspects of the model make it a good fit for your health behavior? -or- What prevents your health behavior of interest from fitting with the model? What are some of the gaps or limitations of the model?

PAPM & Potential Processes of Change Using vaccination as your health behavior, what are some examples of factors that may contribute to an individual’s stage progression in the PAPM? Stage 1 (Unaware of Health Issue) to Stage 2 (Unengaged by Health Issue) Stage 3 (Deciding about Acting) to Stage 4 (Decided Not to Act) -or- Stage 5 (Decided to Act)

Thank You!