1. 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

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

3. 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.

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

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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

11. 2- Interpersonal Theories
It concentrates on the factors at interpersonal level on assumption that other people affect our behavior.

12. 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

13. Example of these theories
Social cognitive theory

14. 3- Community Level Theories
It focuses on factors within social systems:
Communities
Organizations
Institutions
Public policy (roles, regulations, legislation, norms, and policies)

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

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

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

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

20. 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

21. 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.

22. 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.

23. 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.

24. 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)

25. 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)

26. 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

27. 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.

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

29. 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.

30. 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.

31. 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

32. 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.

33. 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.

34. 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.

35. 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.

36. 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.

37. 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.

38. 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.

40. 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

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

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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

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

50. 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

51. Questions? Comments?