1. Behavioural Change Pippa Luce 27.01.14

3. Behaviour Change Behavior change can refer to any transformation or modification of human behaviour It may also refer to: Behavior change (public health), a broad range of activities and approaches which focus on the individual, community, and environmental influences on behaviour 1 Behavior change (public health), a broad range of activities and approaches which focus on the individual, community, and environmental influences on behaviour

4. Is intervention necessary? Risk behaviours Environmental hazards ( health and safety) Nutritional standards and food safety

5. Introduction to behaviour change http://www.youtube.com/user/change4life

6. What does behavioural change involve? In groups brainstorm ways of creating behaviour change, and try and think of ways that we limit or prevent ourselves from making changes Do we need to intervene in order to promote behavioural change for the sake of health? Identify as many risk behaviours as possible that might require behaviour change Do you know of any theories associated with behavioural change? Discuss.

7. Useful reading Behaviour change: the principles for effective interventions Behaviour change: the principles for effective interventions Public health guidance, PH6 - Issued: October 2007 (previously entitled ‘Behaviour change’. NICE) http://www.nice.org.uk/ph6 http://www.roadsafetygb.org.uk/misc/fckedit orFiles/file/downloads/dh_111694.pdf http://www.roadsafetygb.org.uk/misc/fckedit orFiles/file/downloads/dh_111694.pdf

8. Theories of behaviour change Coping theory – Folkman and Lazarus 1984 Derives from stress theory and research “continually changing behavioural and cognitive efforts to manage external and/ or internal demands that are appraised as exceeding the individual’s resources.” “Coping research is reported to have evolved from stress research, focusing on the processes and mechanisms by which people adapt to stress. This is suggested to be important for understanding health needs and problems, and developing strategies or interventions to prevent problems or improve health and well being.” 2

9. Coping Theory Transactional approach: person / environment inter action Changes over times ( fluctuates in response to need) Situation opposed rather than person specific Dispositional approach Psychoanalytical approach which suggests stable, person based factors underpin the habitual coping efforts e.g. personality, attitudinal and cognitive characteristics

10. Motivational approach According to NICE: “The motivational approach was described in only a small section of the literature. From this perspective stress results from an assault on basic psychological needs of relatedness, autonomy and competence. Coping is therefore seen less about fending off the harmful consequences of stress than about peoples’ efforts to fulfil these needs.”

11. Resilience theory Is the ability to deal with and adapt to change What is resilience? http://www.stockholmresilience.org/21/resea rch/what-is-resilience.html http://www.stockholmresilience.org/21/resea rch/what-is-resilience.html

12. Self Efficacy: Health Belief Model (HBM) First developed in the 1950s, in response to an unsuccessful TB health programme, by social psychologists Hochbaum, Rosenstock and Kegels who were working in the U.S. Public Health Services.

13. HBM Perceived Seriousness Perceived susceptibility Perceived Benefits Perceived barriers Variables e.g. demographic, psychosocial, structural Indirectly influence behaviours relating to health

14. The health belief model has been applied to predict a wide variety of health-related behaviors such as being screened for the early detection of asymptomatic diseases[1] and receiving immunizations.[1] More recently, the model has been applied to understand patients' responses to symptoms of disease,[1] compliance with medical regimens,[1] lifestyle behaviors (e.g., sexual risk behaviors),[5] and behaviors related to chronic illnesses,[1] which may require long-term behavior maintenance in addition to initial behavior change.[1] Amendments to the model were made as late as 1988 to incorporate emerging evidence within the field of psychology about the role of self-efficacy in decision- making and behavior.[4][5]”self-efficacy

15. Intervention Idea that intervention may support complex life style behaviour change by making people aware of: Prevalence and seriousness of disease Risk and consequences Identifying common barriers to making change to behaviour Remind people of why / how to make that change Highlighting the benefits of making that change Encourage people to adopt health promoting behaviours Government intervention may take the form of legislative intervention environmental changes

16. Theory of Reasoned Action assumes that individuals consider the consequences before performing the particular behaviour. “intention is an important factor in determining behaviour and behavioural change. According to Icek Ajzen, intentions develop from an individual's perception of a behaviour as positive or negative together with the individual's impression of the way their society perceives the same behaviour. Thus, personal attitude and social pressure shape intention, which is essential to performance of a behaviour and consequently behavioural change.” http://en.wikipedia.org/wiki/Behavioural_change_theories

18. Janz, Nancy K.; Marshall H. Becker (1984). "The Health Belief Model: A Decade Later". Health Education Behavior 11 (1): 1–47. doi:10.1177/109019818401100101."The Health Belief Model: A Decade Later" doi10.1177/109019818401100101 Rosenstock, Irwin (1974). "Historical Origins of the Health Belief Model". Health Education Behavior 2 (4): 328–335. doi:10.1177/109019817400200403"Historical Origins of the Health Belief Model"doi10.1177/109019817400200403 Carpenter, Christopher J. (2010). "A meta-analysis of the effectiveness of health belief model variables in predicting behavior". Health Communication 25 (8): 661– 669. doi:10.1080/10410236.2010.521906."A meta-analysis of the effectiveness of health belief model variables in predicting behavior"doi10.1080/10410236.2010.521906 Carpenter, Christopher J. (2010). "A meta-analysis of the effectiveness of health belief model variables in predicting behavior". Health Communication 25 (8): 661– 669. doi:10.1080/10410236.2010.521906."A meta-analysis of the effectiveness of health belief model variables in predicting behavior"doi10.1080/10410236.2010.521906 Carpenter, Christopher J. (2010). "A meta-analysis of the effectiveness of health belief model variables in predicting behavior". Health Communication 25 (8): 661– 669. doi:10.1080/10410236.2010.521906."A meta-analysis of the effectiveness of health belief model variables in predicting behavior"doi10.1080/10410236.2010.521906

19. References http://en.wikipedia.org/wiki/Health_Belief_Model