1. Motivation and Learning HAS 3190

2. Readiness Teachable moments Readiness to learn Time your teaching

3. Maslow

4. Health Belief Model Susceptibility Seriousness Threat Benefits

5. Health Belief Model Motivation to avoid illness or get well Desire for a level of health Belief that specific action will lead to health

6. Stages of Change Pre-contemplation Contemplation Preparation Action Maintenance

7. Source: alcohol.org.nz

8. Alcohol: Stages of Change (Short Form) Alcohol Stage Item for non-dependent drinkers Males (females use 4 or more in a row) In the last month have you had 5 or more drinks in a row? 1. Yes, and I do not intend to stop drinking 5 or more drinks in a row. 2. Yes, but I intend to stop drinking 5 or more drinks in a row during the next 6 months. 3. Yes, but I intend to stop drinking 5 or more drinks in a row during in the next 30 days. 4. No, but I have had 5 or more drinks in a row in the past 6 months. 5. No, and I have not had 5 or more drinks in a row in the past 6 months. 6. No, I have never had 5 or more drinks in a row.

9. Principles of motivation Use the environment to focus patient’s attention Internal motivation is best Individual must be ready Enhance with instructional material Success is best

10. Principles of motivation Some anxiety is good…too much is bad Set goals Affiliation and approval Behaviors are a combination of motives

11. An enormous gap exists between knowing that health behavior is motivated and identifying the specific motivational components on an particular act.

12. Issues with behavior Individual factors Social factors Environmental factors Medical regimen

13. What would you do… Poison Toilet bowl cleaner Drano or Liquid Plumber

14. Assessment Goal: to foster client self-assessment

15. Four steps… Select the areas to be assessed Gather data Sort and categorize data Summarize

16. Assessment Select the areas to be assessed –Physiologic –Psychosocial –Family system –Cultural issues –Environmental issues –Motivation

17. Assessment of motivation 10 20 30 40 50 60 70 80 90 100 Quite Moderately certain certain Certain Can Do Confidence Walk one block_______ _______ Walk two blocks_______ _______ Walk one mile_______ _______ Walk two miles_______ _______

18. Assessment Gather data –Objective (mostly) –Some subjective –Observation –Interview

19. Assessment Sort and categorize data Write the summary/plan

20. Readiness to Learn Student Needs Assessment Protective Factors Scale

21. SOAP S – (subjective data) O – (objective data) A – (assessment) P – (plan)

22. SOAP … Assessment Functional HA, neck and shoulder pain Poor health habits, caffeine, skipping lunch, poor fitness and body mechanics Situational stress with moderate support system Recent experience with stop smoking positive, possible recidivism now

23. Soap …Plan Eat lunch daily away from desk. Include protein, carbo, veg or fruit. Review time management materials, consider class Increase water and non-caffeine beverages. No caffeine after 6 pm

24. Soap …Plan Keep headache journal including food, activity, feelings and headaches, discuss with husband to analyze Schedule 3 additional appointments over next 6 weeks. RTC 1 week. View headache film. Read headache article Call PRN

25. The Four Habits Invest in the beginning Elicit the patient’s perspective Demonstrate empathy Invest in the end

26. Learning Styles Behavioral – Skinner –Positive reinforcement –Negative reinforcement –Punishment –Extinction –Shaping

27. Cognitive Piaget –Sensorimotor –Preoperational –Concrete Operational –Formal Operational

28. Bandura Social Cognitive Self efficacy

29. Locus of Control

30. Learning Sytles Active vs Reflective Sensing vs Intuitive Visual vs Verbal Sequential vs Global

31. Educational Factors Predisposing Enabling Reinforcing

32. Illiteracy stereotypes Low socioeconomic status Poor grammar Unemployed Uneducated

33. Health Literacy Ability to read, understand and act AMA study (1999) Low literacy = 2 X likely to be hospitalized $73 billion in costs

34. Text… Empathy Trust

35. Combating Health Illiteracy Teach back Try it out Best method… Simple ways handout

36. SMOG 10 consecutive sentences each in –Beginning –Middle –End # of words with 3 or more syllables

37. SMOG 0-2 = 4 th 3-6 = 5 th 7-12 = 6 th 13-20 = 7 th 21-30 = 8 th 31-42= 9 th 43-56 = 10 th 57-72 = 11 th 73-90 = 12 th 91-110 = 13 th 111-132 = 14 th 133-156 = 15 th 157-182 = 16 th 183-210 = 17 th 211-240 = 18 th

38. Coping Styles Denial Compensatory Blocking out idea Retreat Role modeling Regression Ascribing blame Self-blame Rationalization Hiding feelings Redirecting emotions Excess of activity Diverting feelings