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

2. 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

3. 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

4. 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

5. 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?

6. 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

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

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

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

10. 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

11. 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?

12. 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?

13. 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)

14. Thank You!