Intrapersonal and Interpersonal Theories of Behavior Change Umm Al-Qura University Faculty of Public Health and Health Informatics Health Education and Promotion Department Intrapersonal and Interpersonal Theories of Behavior Change By: Dr. Ahmed Abdullah

Contents of the Lecture Benefits of Theories in Health Behavior The Types of Theory Intrapersonal Theories Interpersonal Theories Community Level Theories

Students Learning Outcome By the end of these lectures student will be able to: Describe theories and models that used in health behavior change. Explain why theories are used to effect health behavior change Explain concepts, constructs and variables of the theories. Explain how theories are developed.

Relation of Theories and Health Concept Concept Concept Concept Concept Theory and Model Behavior Healthy Behavior Un-healthy Behavior

What is the theory? A theory is a set of interrelated concepts, definitions, and propositions that explain or predict events or situations by specifying relations among variables So, theories explain why do people behave and why do not behave in certain way related to the health.

What are the benefits of theories in health behavior? Used in designing and evaluating health education interventions. Used as foundation for program planning and development as a road map for studying problems.

What are the benefits of theories in health behavior? Used as a guide to help explain the processes for changing health behavior. Used to help planners to identify the most suitable target audiences, methods for change and outcomes for evaluation.

What are the types of theory? Theories and models are divided into three categories: Intrapersonal or individual level theories (within the person) Interpersonal theories (between persons) Community level theories.

1- Intrapersonal Theories It focuses on factors within the person that influence his behavior. Example of these factors: Knowledge Attitudes Beliefs Motivation Self-concept Developmental history Past experience Skills.

Examples of intrapersonal theories Self-efficacy theory Health belief model Theory of reasoned action Attribution theory Trans-theoretical model. The rational model Protection Motivation Theory Theory of Planned Behavior The extended parallel process model (EPPM) The activated health education model

2- Interpersonal Theories It concentrates on the factors at interpersonal level on assumption that other people affect our behavior.

Interpersonal Theories Other people affect our behavior by: Sharing their thoughts Sharing their advices Sharing their feelings Their emotional support and assistance The other people can be: Family Friends Peers Health care providers Co-workers

Example of these theories Social cognitive theory

3- Community Level Theories It focuses on factors within social systems: Communities Organizations Institutions Public policy (roles, regulations, legislation, norms, and policies)

Community Level Theories These theories suggest strategies and initiatives that can be used to change these factors.

Examples of the Community level theories Diffusion of innovation theory Ecological models Social capital theory.

Contents of the Lecture Benefits of Theories in Health Behavior The Types of Theory Intrapersonal Theories Interpersonal Theories Community Level Theories

Relation of Theories and Health Concept Concept Concept Concept Concept Theory and Model Behavior Healthy Behavior Un-healthy Behavior

Examples of intrapersonal theories Self-efficacy theory Health belief model Theory of reasoned action Attribution theory Trans-theoretical model. The rational model Protection Motivation Theory Theory of Planned Behavior The extended parallel process model (EPPM) The activated health education model

Self-efficacy Theory ''I think I can, I think I can'' Self-efficacy is the belief in one's own ability to successfully accomplish something.

Self-efficacy Theory Self-efficacy theory tell us that people generally will only attempt things they believe they can accomplish and would not attempt things that they believe they could fail.

Self-efficacy Theory People with strong sense of efficacy believe they can accomplish even difficult tasks. They see these as challenges to be mastered rather than threats to be avoided.

Self-efficacy Theory The theory introduces the idea that the perception of efficacy is influenced by four factors: Mastery experience (to do something the same like something you are previously did) In direct experience (if they can do it, so I can)

Self-efficacy Theory 3. Verbal persuasion (when people persuaded verbally they can achieve the task) 4. Somatic and emotional state. (Stress, anxiety, worry, and fear) it affects the efficacy negatively. (fear of dentist)

Examples of intrapersonal theories Self-efficacy theory Health belief model Theory of reasoned action Attribution theory Trans-theoretical model. The rational model Protection Motivation Theory Theory of Planned Behavior The extended parallel process model (EPPM) The activated health education model

The Health Belief Model It explains human health decision-making and subsequent behaviour. It explains People’s beliefs about the severity of a disease and their susceptibility to it. And this will influenced their willingness to take preventive action.

The Health Belief Model helps to predict whether people will take action to prevent and control illness.

The Health Belief Model Example 1: Social psychologists during the 1950s wanted to explain why some people refused chest X-rays for detecting tuberculosis even though the service was free.

The Health Belief Model Example 2: A group of social psychologists are working in the field of public health. They were seeking to explain why some people do not use health services such as immunization and screening.

The Health Belief Model Health Believe Model: said that: behavior is outcome of: Perceived susceptibility, Perceived severity, Perceived barriers, Perceived benefits, cues to Action and self-efficacy

The Health Belief Model Perceived susceptibility: the degree to which a person feels at risk for health problem Perceived severity: the degree to which a person believes the consequences of the health will be severe. Perceived benefits: the positive outcomes a person believes will result from action.

The Health Belief Model Perceived barriers: the negative outcomes a person believes will result from action. Cues to Action: an external motivates a person to act. Self-efficacy: A person's belief in his or her ability to take action.

The Health Belief Model Example 2: Health belief model Dengue fever is a growing pandemic health problem. Source reduction of Aedes mosquito breeding sites is critical for its control. These larval mosquito breeding sites include many human-made items (trash) such as cans and tires.

The Health Belief Model Example 2: (continue) The source reduction of these mosquito breeding sites is related to human behaviour. We will design a health education–health behavioral change intervention.

Example 2: Health belief model Dengue fever Construct Message example Perceived susceptibility “So, you don’t think dengue is a real problem. It is here in our community now. Young and old get sick with dengue” Perceived severity “It’s (dengue) a killer!” Perceived barriers “Little time to do a cleanup to reduce mosquito breeding sites. No problem. Use the action plan checklist. Use it once a week” Perceived benefits “If everyone spends just a few minutes each week to clean up stagnant water, throw away unneeded containers, or cover them, it will reduce dengue fever.

Individual's Perception in HBM According to the HBM, the likelihood that someone will take action to prevent illness depends upon the individual's perception that: They are personally vulnerable to the condition. The consequences of the condition would be serious.

Individual's Perception in HBM The precautionary behavior effectively prevents the condition. The benefits of reducing the threat of the condition exceed the costs of taking action.

Examples of intrapersonal theories Self-efficacy theory Health belief model Theory of reasoned action Attribution theory Trans-theoretical model. The rational model Protection Motivation Theory Theory of Planned Behavior The extended parallel process model (EPPM) The activated health education model

The Transtheoretical Model Of Change Behaviour change is viewed as a progression through a series of five stages: Precontemplation Contemplation Preparation Action Maintenance.

The Transtheoretical Model Of Change This model recognizes that people have specific informational needs at each stage of behavioral change.

The Transtheoretical Model Of Change Potential change strategies Examples Definition Stage Increase awareness of need for change; personalize information about risks and benefits “It isn’t that I can’t see the solution; I just can’t see the problem” Has no intention of taking action within the next six months Precontemplation Motivate; encourage making specific plans “I want to stop feeling so stuck” Intends to take action in the next six months Contemplation Assist with developing and implementing concrete action plans; help set gradual goals “I just took out a membership to a fitness facility” Intends to take action within the next 30 days and has taken some behavioral steps in this direction Preparation Assist with feedback, problem-solving, social support and reinforcement “I’ve started exercising and while I enjoy it, sometimes I find it a routine” Has changed behaviour for less than six months Action Assist with coping, reminders, finding alternatives, avoiding slips/relapses “Exercising three times a week has become a part of my lifestyle” Has changed behaviour for more than six months Maintenance

The Transtheoretical Model Of Change Potential change strategies Examples Definition Stage Increase awareness of need for change; personalize information about risks and benefits “It isn’t that I can’t see the solution; I just can’t see the problem” Has no intention of taking action within the next six months Precontemplation

The Transtheoretical Model Of Change Potential change strategies Examples Definition Stage Motivate; encourage making specific plans “I want to stop feeling so stuck” Intends to take action in the next six months Contemplation

The Transtheoretical Model Of Change Potential change strategies Examples Definition Stage Assist with developing and implementing concrete action plans; help set gradual goals “I just took out a membership to a fitness facility” Intends to take action within the next 30 days and has taken some behavioral steps in this direction Preparation

The Transtheoretical Model Of Change Potential change strategies Examples Definition Stage Assist with feedback, problem-solving, social support and reinforcement “I’ve started exercising and while I enjoy it, sometimes I find it a routine” Has changed behaviour for less than six months Action

The Transtheoretical Model Of Change Potential change strategies Examples Definition Stage Assist with coping, reminders, finding alternatives, avoiding slips/relapses “Exercising three times a week has become a part of my lifestyle” Has changed behaviour for more than six months Maintenance

Stages of Change Individuals do not change their behavior all at once. They change it incrementally or stepwise in stages of change.

Precontemplation Currently smoking and `not seriously considering quitting within the next 6 months' Contemplation Currently smoking and `seriously considering quitting within the next 6 months'; `were not considering quitting within the next 30 days, had not made a quit attempt of 24h in the past year, or both' Preparation Currently smoking, `were seriously considering quitting in the next 6 months and were planning to quit within the next 30 days,' and `had made a 24h quit attempt in the past year' Action Currently not smoking; quit in last 6 months Maintenance Currently not smoking; quit >6 months ago

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