1. Jana Corbett, Ph.D. Facilitating Change Using theory- and evidence- based strategies for effective Behavior Change Interventions

2. Overview Public Health vs. Health Psychology Theories of Behavior Change Stages of Change Predictors of Change Evaluation of Effectiveness Facilitating Change, Jana Corbett jana.m.corbett@gmail.com

3. Public Health vs. Health Psychology Facilitating Change, Jana Corbett jana.m.corbett@gmail.com Targeting the environment –Laws –Taxes –Bike lanes –Bus schedule –Increasing availability –Increasing safety Targeting the individual –Regardless of the environment –Target the cognitions and emotions of the individual Cues to Action

4. Theories of Behavior Change

5. Linear Continuum Models Facilitating Change, Jana Corbett jana.m.corbett@gmail.com

6. stage theories assume that individuals differ in mindsets towards behavior change those with maximally similar cognitions are in the same stage predictors driving transitions towards behavior change are differential  interventions need to be stage appropriate (Sutton, 2000; Weinstein, Rothman, & Sutton, 1998) The notion of stage theories of behavior change

7. 7  to ensure receipt of appropriate interventions, stages need to adequately represent individuals’ mindsets towards behavior change (Armitage, 2009) Validity of Stage Allocation

8. Validity of stage allocation 8  to ensure receipt of appropriate interventions, stages need to adequately represent individuals’ mindsets towards behavior change (Armitage, 2009)

9. For your commute to work in the past week, have you used alternative modes of transit (Walk, Bike, Trimet) at least once*? No, and I don‘t intend to. No, but I‘m thinking about it. No, but I have the intention to. Yes, but it is difficult for me. Yes, and it‘s easy for me. * This should be a meaningful criterion. Stage Diagnostic Non-intenderIntenderActor

10. Non-Intender Intender Actor Risk-communication Resource Communication „Alternative Transit?“ Planning „I want to, but how?“ „Keeping at it“ Relapse Prevention Stage-Tailored Interventions

11. Resource-Communication

12. Self-Efficacy - sources Mastery Experience (reminder) Vicarious Experience / Role Models Verbal Persuasion Physiological Cues

13. Which modes of transit have you ever used? Write down what modes of transit you‘ve used: Mode 1Mode 2Mode 3 Now, you‘ll plan what to do in the coming week!

14. “I always thought that it was impossible for me to take anything other than my car to work, but when I finally tried it, I realized it was a lot easier than I thought. I found a bus route that takes me straight to work and now I have the time to relax and not worry about traffic and I can even read books or knit.” Role Models

15. Some positive effects are immediate, others might take a while to materialize. Using alternative modes of transit has many positive effects! Write down three immediate effects, e.g., saving money for gas.

16. Now think about the positive long term effects! Write down three long term effects:

17. …I feel good about my contribution to keep our environment clean!...Then I save money that I can spend on self- care!...then I have more time to read! Other people say: When I use alternative modes of transit, … ……I feel good about my contribution to keep our environment clean! !...Then I save money that I can spend on self- care!...then I have more time to read.

18. Using alternative modes of transit might also have negative effects. Which negative consequence might the new behavior have for you? Write down what you are afraid of:

19. ...it would take me a lot longer....I would have time to read on the bus. This is what other people say: If I used alternative modes of transit,... I would have time to read on the bus.. Mental Contrasting

20. Seeing things in a new way So, at second glance? What advantage / what positive twist might you see in the new behavior? -------------------------------------------------------------- Facilitating Change, Jana Corbett jana.m.corbett@gmail.com

21. Action Plans

22. Your Plan: What? (e.g., bike, Trimet) When? (e.g., daily, Mondays) How? (e.g. rideshare) Where? (e.g., route 9, Tillikum) With whom? (e.g., with spouse) Strategic Planning – Action Plans

23. Let‘s combine your plan into a working statement: When I leave my house to go to work in the morning, I will ride my bike from N Portsmouth to Powell Blvd. Try it out for yourself. Fill in the blanks. When I ________________________________________________________ (Describe the situation) I will ____________________________________________________ (Insert your specific plan). Strategic Planning – Action Plans

24. Write down what might keep you from realizing your plan! What could you do to overcome this barrier? Barrier 1 Write down up to 3 Strategies! Your personal Barrier Managment: View Examples here! Coping Planning

25. Let‘s combine your plans into a working statement: When I am running late in the morning, I will take the bus #75 at 7.15am from N Portsmouth to Powell Blvd. Try it out for yourself. Fill in the blanks. When I ________________________________________________________ (Describe the barrier) I will ____________________________________________________ (Insert your specific plan). Strategic Planning – Coping Plans

26. Effektive Interventionsdesigns, Jana Richert Evaluation of Programs 0 20 40 60 80 100 120 t0t0 t2t2 Intervention A Control-Intervention Wait Control- Group

27. Take home messages? Facilitating Change, Jana Corbett jana.m.corbett@gmail.com

28. Q & A Facilitating Change, Jana Corbett jana.m.corbett@gmail.com

29. YOU are not active enough. Your risk of arteriosclerosis is increased! We would like to visualize this with this tool: Move the knob from left to right to see how exercise affects the health of your blood vessels. Little exercise Enough exercise The Relationship between a physically active lifestyle and the health of blood vessels Risk Communication

30. 1 in 5 people has high blood pressure.

31. Among sedentary people, it is 1 in every 2!

32. This is how pysical Activity affects our organs! Check the effects that are most important to you personally: Physical Activity… …increases Oxygen. (Fitness).... creates muscle mass. …improves metabolism and digestion. …improves lung capacity and ability to breathe. …decreases body weight. …lowers blood pressure. …improves memory and learning. …increases well-being and lowers risk of depression.... slows down aging.

33. What barriers do other people perceive and what solutions work for them? I am running late in the morning I take a different bus route that morning. OR I remind myself of the sattisfaction and pride I feel when I bike to work. OR I call a colleague who lives close by and ask if they can give me a ride. Barrier Thomas Baker, Sales Representative Solution

34. Facilitating Change, Jana Corbett jana.m.corbett@gmail.com John Smith, Accountant

35. Little Plans – Huge effect! Why? Plans… … build mental connections between situations and goals … increase attention to cues to action … make translating intentions into actions easier (Gollwitzer & Sheeran, 2008; Gollwitzer, 2009) Psycho-education

36. Role Model – Vicarious Experience Identification Competence Attractiveness Authenticity