Janet Buckworth chapter 22 Behavior Modification

Learning Objectives Describe the principles of behavior change described in the transtheoretical model. Discuss motivation and other factors that influence exercise adoption and adherence. Describe appropriate behavior change strategies to use with individuals in different stages of motivational readiness. (continued)

Learning Objectives (continued) Describe how relapse prevention can be applied to exercise behavior. Identify effective communication skills necessary to motivate and support health behavior change.

Helping Individuals Change Health Behaviors Knowledge –A theoretical model to explain and predict behavior (transtheoretical model) –Factors that influence health behaviors: attitudes, beliefs, and behavioral skills Skills –Behavior change strategies matched to stage of motivational readiness –The ability to listen effectively and respond empathetically

Transtheoretical Model of Behavior Change Theoretical foundation: The transtheoretical model of behavior change –Behavior change is a dynamic process involving attitudes, decisions, and actions. –Individuals progress through distinct, often nonsequential stages of change. –Intervention strategies must be matched to the stage a person is in. (continued)

Transtheoretical Model of Behavior Change (continued) Stages of change in exercise –Precontemplation: inactive, not considering exercise –Contemplation: inactive, considering beginning exercise within next 6 mo –Preparation: plan to begin program within 1 mo –Action: active at criteria level for less than 6 mo –Maintenance: active at criteria level for 6 mo or more (continued)

Transtheoretical Model of Behavior Change (continued) Attitudes, beliefs, and behavioral skills that influence behavior change –Self-efficacy (belief in capability to engage in a specific behavior successfully) –Decisional balance (evaluating the pros and cons of the target behavior) –Processes of change (strategies used to change behavior) Experiential/cognitive Behavioral

Stages of Behavior Change StageGoal PrecontemplationBegin thinking about becoming more physically active ContemplationPrepare to take action PreparationSet reasonable and realistic exercise goals ActionResist relapse MaintenanceEnhance exercise experience

Promoting Exercise: Targeting Precontemplators and Contemplators Key factors –Individual characteristics –Social influences –Environmental dynamics

Promoting Exercise: Individual Characteristics Exercise history Motivation Perceived behavior control Self-efficacy

Promoting Exercise: Environmental Dynamics Cues or prompts Access to facilities Lack of time (real, perceived, skill related, rationalization) Natural (climate, geography) Constructed (quality of workout facilities, traffic)

Considerations for Marketing Exercise Reduce the perceived costs and increase the perceived benefits of being active. Provide practical support and encouragement. Include motivational prompts suited to the target group. Reduce environmental barriers.

Enhancing Adherence: Methods of Behavior Change Assess. –Physiological (physical fitness, health) –Psychosocial (goals, motivation) Evaluate past attempts at change. Self-monitor to identify barriers and supports. (continued)

Enhancing Adherence: Methods of Behavior Change (continued) Enhance self-efficacy through the following: –Set up mastery experiences. –Provide verbal encouragement. –Provide successful models. –Offer information about normal physiological responses to exercise and how to interpret them.

Methods of Behavior Change: Goal Setting Define goals in behavioral terms (measurable). Set specific goals. Make the goals flexible. Include short-term and long-term goals. Make the goal challenging but achievable. Address physiological factors. Consider environmental influences. Provide timely and specific feedback.

Methods of Behavior Change: Reinforcement Temporally close to target behavior Tangible or intangible Meaningful to the participant Addition of something positive or removal of something negative

Methods of Behavior Change: Behavioral Contacts Principles –Contracts should specify goal-directed behaviors. –Terms should be very clear. –Contracts should be generally positive. –Contracts should be fair. –Procedures should be systematic and consistent. –At least one other person should participate.

Methods of Behavior Change: Relapse Prevention Relapse occurs when a person stops a healthy behavior and goes back to unhealthy habits. High-risk situations increase the risk of relapse. Relapse prevention attempts to identify and deal with potential high-risk situations.

Health Fitness Counseling Communication Skills Effective listening –Attend to verbal and nonverbal messages. –Identify overt message and underlying meaning. –Practice responsive listening. Empathetic responding –Communicate understanding. –Maintain nonjudgmental reactions. –Don’t make assumptions. –Be honest and supportive.