Presentation on theme: "U14634: Motivating Health Behaviour"— Presentation transcript:
1U14634: Motivating Health Behaviour Mary GottwaldPrincipal Lecturer Student ExperienceFebruary 2013Oxford Brookes UniversityFaculty of Health and Life Sciences
2Predicting Health Behaviours – Behavioural change models
3Learning Outcomes By the end of the module you will be better able to: Understand the factors involved in predicting and explaining behaviourUnderstand the role of social cognition and stage models in predicting and explaining health behaviourExplore and understand in detail specific modelsBe able to critique models and apply to case scenarios.
5Predicting & explaining health behaviour Complete the following:I feel healthy when……..I feel healthy because…..To stay healthy I need………I do not feel healthy when…….My health improves when……….
6Predicting health behaviours So….How do we account for variability in behaviours?How do we account for variability in health?
7Predicting and explaining health behaviour Individual differencesLocus of control (Rotter 1996)InternalExternalMultidimensional health locus of control (Wallston and deVellis 1978)External / chancePowerful othersModest predictor of behaviour
8Health-promoting / risky health behaviours What are risky healthy behaviours?What are health promoting behaviours?8
9Risky health behaviours Global risks:Highest global risks to mortality = tobacco use, physical inactivity, being overweight and obesity(World Health Report 2012).Diet –high fat diet / being underweightExcessive alcoholUnsafe sexNot getting enough sleepDangerous sports9
10Health-promoting behaviours Alameda-sevenSleeping 7-8 hours a nightNot smokingConsuming no more that 1-2 alcoholic drinks per dayGetting regular exerciseNot eating in between mealsEating breakfastBeing no more than 10% overweight(Breslow 1983, cited in Morrison and Bennett 2006:61)
11Individual differences and health Younger, wealthier, better educated individuals with low stress levels and high social support are more likely to engage in health-enhancing behaviours (exercise, nutrition, non-smoking, low alcohol intake).If a person experiences high stress, fewer social, emotional and economic resources, they are more likely to be engaged in health compromising behaviours (smoking, high alcohol intake, sedentary lifestyle or poor nutrition).
12Understanding cognition Cognitive factors:Shape health behaviourPredict behaviour through self-regulationSocial cognition models describe key cognitions and their interrelationships in the regulation of behaviour.
13Social Cognition Cognitions: Represent our thoughts, beliefs and knowledge towards a behaviour.Are intrinsic to us.Are modifiable determinants of behaviour.Give rise to social behaviour.Behaviours have an impact on morbidity and mortality.
14Social Cognition Models Help us to understand and predict health behaviours:Knowledge, perceived social norms, beliefs, attitudes and self-efficacy are linked to behavioural intentions and health related behaviour.Help us to explore the extent to which cognitions predict and explain behaviour.Continuum v stage models
15Self-efficacy - Bandura ‘The belief that you can carry out a specific behaviour in a specific situation’ (Bandura 1997 cited in Upton and Thirlaway 2010:21)i.e. if you believe that you can do it then you will! ‘I can’t do it’ ‘I can’So, self-efficacy beliefs directly determine behaviour (or action)15
16Enhancing self-efficacy Observational learning / participatory learning.Verbal persuasionsPerception of psychological and affective states.(Davis and Macdowell 2006)
17Continuum v stage models Health Belief ModelTheory of Reasoned Action / Planned behaviourHealth Action ModelPrototype Willingness ModelDual-Process ModelsIndividuals are likely to perform a (health related) behaviour based on their position on a continuum.17
18Continuum v stage models Stage model Transtheoretical Stages of Change Model (TTM) Individuals move through ‘stages’ before achieving a change in their (health related) behaviour18
19Behaviour change models Models help us to explain and predict health behaviour.However, the decision we make about whether we decide / don’t decide to change our health related behaviour is based on cues and information we have in relation to our social, physical and cultural environment.Motivation also impacts on our decision making.All models have strengths and limitation.(Edberg 2007, Marks et al 2011, Gottwald and Goodman-Brown 2012)
20Health Belief Model 1950s Hochbaum, Rosenstock, Becker Focuses on understanding an individual’s perception of reality rather than how they respond to a situation.Considers a number of factors that may predict the likelihood of changing health related behaviours.Initial research linked to motivation.
21Health Belief Model (Goodman-Brown and Gottwald 2008) PerceivedsusceptibilitySelf efficacyLikelihood of taking actionPerceived successPerceived severityPerceived benefitsCues to action21
22Theory of Reasoned Action Ajzen and Fishbein 1980Behaviour is dependent on two variables:Attitudes – beliefs about the consequences.Subjective norms – how much the individual wants to conform and be like ‘significant others’.Attitudes + norms = an intention to change.
24Theory of Reasoned Action Beliefs about the consequences of taking action and judgement of those consequencesAttitudeBehaviouralintentionBehaviouralchangeBeliefs whetherOthers in theirnetworks wouldapprove and motivation to comply with othersSubjectiveNorm
25Theory of Planned Behaviour Ajzen added another variable:Behaviour is a consequence of perceived controlInternal locus of controlExternal locus of controlThere is some correlation between PBC and intention.Attitudes + PBC + intention = influence behaviour(e.g. uptake of exercise)
26Theory of Planned Behaviour Beliefs about the consequences of taking action and judgement of those consequencesAttitudeBeliefs whether0thers in theirnetworks wouldapprove and motivation to comply with othersBehaviouralintentionBehaviouralchangeSubjectiveNormInternal controlfactorsExternal controlPerceivebehaviouralcontrol
27STAGES OF CHANGE (TTM) (Prochaska and DiClemente 1984) Pre-contemplationnot thinking of change / not aware of a need to changeContemplationconsidering change – advice neededCommitmentready to change – practical support and achievable goals neededActionmaking the change – support and encouragement still neededMaintenancemaintaining the change in their lifestyle – developing coping strategiesRelapsesupport needed to return to contemplation27
28Preparation Long term change Action Contemplation Maintenance Relapse (Adapted from Prochaska and DiClemente, 1984)Pre-contemplation28
29STAGES OF CHANGE (TTM) Exit Exit Exit Exit Action Maintenance Commitment RelapseExitExitContemplation(Gottwald, cited in Davis 2006)Pre-contemplation29
30STAGES OF CHANGE (TTM)Pre-contemplation: denial / low self-efficacy / barriers to changeContemplation: Seek information. Reduced barriers / increased benefitsPreparation: Set goals, prioritise, concrete plans (join a gym)Action: Realistic goals essential / social support.Maintenance: Need to self monitor / need positive reinforcement.30
31Health Action Model (Gottwald and Goodman-Brown 2012:79) Belief, motivation and normative systemsTranslating behavioural intentionActionKnowledge and skillsPersonality factors: self- concept and self-sentimentBarriers, facilitating and environmental factors: social, physical, cultural and socio-economic
32Summary Behavioural models enhance our understanding. Can be used to predict all behaviours.These models focus on individual cognitions – need to remember socio-economic factors, culture, religion and so on.Models help to explain and understand complex situations and suggest approaches to take to ensure effective health promotion.32
33Exam questionDescribe and critically evaluate one Social Cognition Model and its application to predicting and explaining a specific health related behaviour.33
34References - Also see references in module guide Bennett P and Morrison V (2006) An introduction to health psychology London: Prentice HallConner M and Norman P (2005) Predicting health behaviour Maidenhead: OUPEdberg M (2007) Essentials of health behaviour. Social and behavioural theory in public health London: Jones and Bartlett PublishersGottwald M (2006) Health promotion models in S Davis (2006) Rehabilitation. The use of theories and models in practice London: ElsevierGottwald M and Goodman-Brown J (2008) Public health interventions. In J Mitcheson (2008) Expanding nursing and health care practice Cheltenham: Nelson ThornesGottwald M and Goodman-Brown J (2012) A guide to practical health promotion Maidenhead: OUPDavies M and Macdowall W (2006) health promotion theory Maidenhead: OUPRotter J (1966) generalised expectations for internal versus control of reinforcements Psychological Monographs 80:69Rutter D and Quine L (2010) Changing health behaviour Maidenhead: OUPUpton D and Thirlaway K (2010) Promoting healthy behaviour London: Pearson