2. Health Psychology Chapter 6: Staying Healthy Oct 3-5, 2007 Classes #18-19

3. Health Belief Model Predictive model used to predict what a person is going to do Perceptions guide behavior Perceptions are usually inaccurate

4. Health Belief Model Individuals are more likely to take preventive actions to asymptomatic conditions if: 1. They perceive that they are personally susceptible to the disease or condition.

5. Health Belief Model Individuals are more likely to take preventive actions to asymptomatic conditions if: 2. They perceive that occurrence of the disease/condition would severely affect at least some component of their life.

6. Perceived Seriousness Trigger factors such as alarming symptoms, advice from family or friends, messages from the media, disruption of work or play.

7. Health Belief Model Individuals are more likely to take preventive actions to asymptomatic conditions if: 3.They perceive that taking a certain preventive action would be beneficial in either reducing the susceptibility or severity if the disease/condition did occur.

8. Health Belief Model Individuals are more likely to take preventive actions to asymptomatic conditions if: 4.They perceive that taking a given action would not entail overcoming important barriers (Eg. cost, fear, embarrassment, pain, inconvenience)

9. HBM Conclusions The model is most effective when used to predict preventive health behaviors such as obtaining vaccinations to avoid specific illnesses. It is less effective when the preventive action is not associated with a specific threat (Eg. Annual physical exams) The benefits/barriers component of the model seems to have more predictive value than any other single component.

10. HBM Conclusions The model is effective when the preventive behavior is a short term or “one shot” action It is less effective when the preventive behavior requires a long term, established routine (Eg. Hypertension medication) Relatively little research has examined the “cues to action” component of the model

12. The Theory of Reasoned Action and The Theory of Planned Behavior

15. Theory of Reasoned Action Knowledge, attitudes, and behavior Attitudes do effect behavior but not as simple as one might think Developed by Fishbein (1967) Concerned with relations between beliefs, attitudes, intentions, and behaviors Distinguishes between attitude toward an object and attitude toward a behavior Attitude toward breast cancer vs. Attitude toward mammography

16. Behavioral Intention Perceived likelihood of performing the behavior Must be a “firm” indication of intent Affecting “intent” is the goal of a TRA based intervention

17. Attitude Towards Behavior Behavioral Belief Belief that behavioral performance is associated with certain attributes or outcomes Influential factors? Past experience Information received or not received Social influences (family, peers, etc.) Evaluation Value attached to a behavioral outcome or attribute

18. Subjective Norm Normative Belief Belief about whether each referent approves or disapproves of the behavior (Supportive Env.) Most influential referents? (Media, teachers, peers, parents, spouses, etc.) Motivation to Comply Motivation to do what each referent thinks Parents vs. Peers?

19. Theory of Planned Behavior Adds one component to the TRA… Perceived Behavioral Control To account for factors outside the individual’s control that may affect intention and behavior Based on the idea that behavioral performance is determined jointly by motivation (intention) and ability (behavioral control) (skills and resources)

20. Theory of Planned Behavior Perceived Behavioral Control A person’s perception of the ease or difficulty of behavioral performance Similar to self efficacy (Inc. w/ repeated successes What characteristics is the person with a high perceived behavioral control likely to have?

22. Introduction to the Transtheoretical Model (TTM)

23. Transtheoretical Model (TTM) Major Constructs Stages of Change Decisional Balance Self-Efficacy Processes of Change

24. Stages of Change Precontemplation Contemplation Preparation Action Maintenance

25. Applying Stages of Change Program Planning/Needs Assessment Use in needs assessment surveys Behavior is not dichotomous Use stages to form questions Determine the current stage of readiness of population

26. Measuring the Stages Have you quit smoking cigarettes? Check one. ___ Never smoked, or quit for at least 5 years (skip Quest). ____ Yes, I have for more than 6 months. ____ Yes, I have, but for less than 6 months. ____ No, but I intend to in the next 30 days and have tried for at least 24 hours in the past year. ____ No, but I intend to in the next 6 months. ____ No, and I do not intend to in the next 6 months.

27. Applying the Stages of Change Program Implementation Programs for everyone right now?

28. Stages of Change Processes Precontemplation Contemplation Preparation Action Maintenance Consciousness raising Dramatic relief Environmental reevaluation Self-reevaluation self-liberation Contingency Manage. Helping relationships Counterconditioning Stimulus Control

29. Applying the Stages of Change Program Evaluation How do we determine if a program is successful?

30. Applying Stages of Change Program Evaluation Stages of Change can help provide intermediate goals for success Movement thru the stages can be seen as success

31. Prevention Primary Secondary Tertiary

32. Exercise Any age…

33. Message Framing Gain-Framed messages Loss-Framed messages

34. Positive Psychology Martin Seligman APA President 1996 Psychology split into two camps: Academics more interested in science. Clinicians interested in practice of psychotherapy. Hoped to bring science and practice together.

35. Nikki and the weeds Seligman’s inspiration. Weeding garden. 5-year old daughter throwing weeds. Seligman irritated, yelled at Nikki. “Daddy. From when I was 3 until I was 5, I was a whiner. I whined every day. On my 5 th birthday, I decided I wasn’t going to whine anymore. That was the hardest thing I’ve ever done. If I can stop whining, you can stop being such a grouch.”

36. An epiphany Seligman resolved to change. His purpose in life was not to correct his daughter’s shortcomings. Instead, raising her to nurture the strength she displayed (social intelligence). Can psychological science be about identifying and nurturing strengths? His mission as APA president.

37. Seligman (1998) He calls this new orientation “Positive Psychology”… At the subjective level, the field is about positive experience: well being, optimism, etc. At the individual level it is about the character strengths—Love, vocation, courage, aesthetic sensibility, leadership, perseverance, forgiveness, originality, future-mindedness, and genius At the community level it is about the civic virtues and the institutions that move individuals toward better citizenship: responsibility, parenting, altruism, civility, moderation, tolerance, and work ethic

38. Seligman (1998) We’ll have to wait and see if psychology moves in this direction…

39. Credits http://hlth.tamu.edu/Chaney/HLTH415/hbm.ppt http://hlth.tamu.edu/Chaney/HLTH415/tra.ppt http://uwacadweb.uwyo.edu/Kandh/behavior%20change%20theorie s.ppt http://www.psychology.ccsu.edu/engwall/Positive%20Psychology.p pt