1. Behavior HAS 3150

2. Do People Choose?

3. Leading Causes of Death - 1900 Pneumonia and influenza Tuberculosis Diarrhea Disease of the heart Intracranial lesions Nephritis All accidents

4. Leading Causes of Death - 1996 Diseases of the heart Malignant neoplasms Cerebrovascular Chronic obstructive pulmonary diseases Unintentional injuries Pneumonia and influenza Diabetes

5. Actual Causes of Death in 1990 Tobacco (19%) Diet/activity patterns (14%) Alcohol (5%) Microbial agents (4%) Toxic agents (3%) Firearms (2%) Sexual behavior (1%) Motor vehicles (1%) Illicit use of drugs (<1%)

6. Purpose of the YRBSS Focus the nation on behaviors among youth causing the most important health problems Assess how risk behaviors change over time Provide comparable data

7. Youth Risk Behavior Surveillance System Monitors six categories of health-risk behaviors among high school students –behaviors leading to injuries –tobacco use –alcohol and other drug use –sexual behaviors –unhealthy dietary behaviors –physical inactivity

8. Youth Risk Behavior Surveillance System Survey conducted by CDC National survey, state survey, 16 local surveys -- summary

9. Leading Causes of Death – Utah Youth

10. Leading Causes of Death— Utah Adults

17. Smoking 82% of adults started as teens 50% were regular smokers before 18 Smoking 82% of adults started as teens 50% were regular smokers before 18

18. Advertising Camel’s share before “Joe Camel” 0.5% After “Joe Camel” 32.8% Advertising Camel’s share before “Joe Camel” 0.5% After “Joe Camel” 32.8%

19. Advertising Industry spends $100/second Advertising Industry spends $100/second

29. Mind mapping Substance Abuse Peer Group Maladaptive coping Spirituality Society Biological Modeling genetic Pain Body modification Depression Glamour Movies Media Guilt Boredom Escape Esteem Cover pain Stress Acceptance Pressure Groupthink

30. Resiliency

31. Resiliency Process Comfort Zone Recovery with loss Resilient Reintegration Disruption

32. Spirit Core and expressions INTUITION CHILD-LIKE NATURE MORALITYNOBILITY LOVE Creativity Wisdom Self-worth ConfidencePurpose of life Helpfulness Humor Affect/Emotion

33. Path of Shadows FeelingsAct outGuiltAct Out

34. Shadows to Spirit FeelingsAct outGuiltAct OutSuccessConfidenceEsteemSuccess

35. STAGES OF CHANGE MODEL (Transtheoretical Model) Adaptation of Presentation by Dr. Brad Neiger, Assistant Professor of Health Education, BYU

36. Basic Tenets of Behavior Change Behavior change represents a reciprocal web of biological, sociocultural, and psychological factors. People must believe that they can change. People change over time and they can learn and grow From unsuccessful attempts at change.

37. Basic Tenets of Behavior Change Positive impacts from change can be more influential than the temporary satisfaction derived from the “problem behavior”. People modify behavior most effectively when they see “change” in the context of factors that matter the most to them.

38. Pre-contemplation Contemplation Preparation Action Maintenance (Transtheoretical Model)

39. � There is no intention to change behavior in the foreseeable future (within six months) � Unaware or denial of problem behavior. � Hallmark-resistance to becoming more informed. � Feel coerced into changing. When participate do so because of pressure from others. � Tend to be defensive about habits or behaviors. Not a ghostly chance for change

40. Õ Aware that a problem exists; seriously thinking about overcoming it, but not yet committed to taking action. Õ Considering changing behavior in the next six months. ÕKnowing where you want to go but not quite ready to do so. Õ Serious consideration of how to resolve the “problem” is the central element of contemplation. Õ Can remain stuck in contemplation for long periods. I wanna get out of this place!

41. � Individuals intend to take action in the next month and have unsuccessfully taken action in the past year. � Have a plan for action, but can also have a fair amount of anxiety about change. � Often report some small behavior changes (looking at labels, buying stress management tapes, low fat ice cream instead of regular ice cream). � Although may have made minor or subtle changes they have not reached a criterion for effective action such as a goal to quit smoking or to exercise three t imes a week. I’m starting to move now!

42. � Individuals modify their behavior or environment in order to change. � Movement in the correct direction is not preparation, it is action! � Objectives are those recommended by respected health agencies. It is not just any improvement, it is a high standard. � Stage can last from one day to six months. � This stage is the most demanding.

43. � Remaining free of the addictive or problem behavior for more than six months. � This is the stage in which people work to prevent relapse and consolidate the gains attained during the first six months.

44. PROGRESSION THROUGH THE STAGES OF CHANGE LIFE CYCLE Precontemplation Contemplation Preparation Action Maintenance

45. HEALTH BELIEF MODEL Perceived threat of disease "X" Likelihood of taking recommended preventive health action Individual Perceptions Modifying Factors Likelihood of Action (Factors in perception of illness) (Factors in probability of appropriate action) Past utilization of medical services Perceived benefits of preventive action minus Perceived barriers to preventive action Demographic variables (age, sex, race, religion,) variables (personality, social class, peer and reference group pressure, etc.) Structural variables (knowledge about the disease, prior contact with the disease, etc.) Cues to Action Mass media campaigns Advice from others Reminder postcard from physician or dentist Illness of family member/friend Newspaper or magazine article Importance of the threat to the individual Perceived susceptibility to disease "X" Perceived seriousness (severity) of disease "

46. Consumer Behavior - problem recognition Motivation Attitudes Lifestyle Learning Perception Social class Reference group Culture

47. Consumer Behavior Internal search External search Alternative evaluation Purchase Post-purchase evaluation Influencing decisions

48. Four Ps of Marketing Product Price Place/Access Promotion Partners

49. Psychosocial Factors Minority Populations –Major disparities –Lower SES Stress and Social Support Psychological Models –Health Belief Model –Locus of Control –Self-efficacy

50. Psychosocial Factors Ecological Model –Intrapersonal –Interpersonal –Institutional –Community –Public Policy