1. 1 Value-Expectancy Theories of Behavior Ron D. Hays, Ph.D. drhays@ucla.edu November 23, 2004, 11:00am

2. 2 Theories n Health Belief Model u http://www.etr.org/recapp/theories/hbm/ http://www.etr.org/recapp/theories/hbm/  Irwin Rosenstock. Historical Origins of the Health Belief Model. Health Education Monographs. Vol. 2 No. 4, 1974.  M.H. Becker. The Health Belief Model and Personal Health Behavior. Health Education Monographs. Vol. 2 No. 4, 1974. n Theory of Reasoned Action/Theory of Planned Behavior u http://www-unix.oit.umass.edu/~aizen/tpb.html http://www-unix.oit.umass.edu/~aizen/tpb.html

3. 3 Why do some people…? n do things that are bad for their health such as smoke cigarettes?

4. 4 Health Belief Model Developed in 1950s by social psychologists (Godfrey Hochbaum, Irwin Rosenstock, Stephen Kegels) working in the U.S. Public Health Services in response to the failure of a free tuberculosis health screening program. Focus is on individual’s decision to avoid a negative health consequence. n Susceptibility n Severity n Costs/Benefits n Barriers

5. 5 Susceptibility n How likely one thinks a bad outcome (e.g., get sick or a disease) is if behavior persists (doesn’t change).

6. 6 Severity n The consequence is perceived to be severe as opposed to mild.

7. 7 Benefits of Behavior n The new behavior will reduce the likelihood of the negative consequence (e.g., disease). & n Benefits are perceived to outweigh costs.

8. 8 Barriers to behavior n There are not significant psychological, financial, or other barriers to engaging in the behavior.

9. 9 Smoking Susceptibility Severity Costs/Benefits Cues/motivation d1d1 Barriers

10. 10 Jan is not likely to continue smoking because… n She thinks that she might get lung cancer if she continues to smoke (susceptibility). n She believes that dying from lung cancer is terrible (severity). n Jane does not find smoking to be very pleasurable (cost/benefits). n Her friends are supportive of her quitting (absence of barrier)

11. 11 Jon is likely to continue smoking because n He agrees with the tobacco industry-- smoking doesn’t cause lung cancer (susceptibility). n He believes that dying from lung cancer is not any worse than any other way of dying (severity). n Jon feels that smoking relaxes him (cost/benefits). n His friends offer him cigarettes (barrier to quitting)

12. 12 Theory of Reasoned Action n Attitudes u Beliefs (outcome expectancies) u Values n Subjective Norms u Beliefs (about what others think you should do) u Motivation to comply n Intentions

13. 13 Attitudes n One’s positive or negative evaluation of performing a behavior u Beliefs: about the consequences of performing the behavior (outcome expectancies) u Values: appraisal (importance) of the consequences

14. 14 Subjective Norms n One’s perception of the social pressures to perform or not perform a behavior. u Beliefs: about whether specific individuals or groups think one should perform the behavior. u Motivation to comply with these people.

15. 15 Intentions n “Barring unforeseen events, a person will usually act in accordance with his or her intentions” (Ajzen & Fishbein, 1980, p. 5).

16. 16 Smoking Attitudes Intentions Subjective Norms d4d4 Beliefs Values Beliefs Comply d3d3 d2d2 d1d1

17. 17 Someone likely to smoke n ATTITUDE: Bob feels positive about smoking because he expects it will relax him and being relaxed is important to him (beliefs about the consequences and values) n SUBJ NORM: Other students encourage Bob to smoke (belief) and he wants them to like him (motivation to comply) n INTENTION: Bob intends (expects) to smoke with friends after school (intentions).

18. 18 Theory of Planned Behavior n Behavioral Control/Locus of Control/Self-Efficacy u Intention to behavior link is problematic when not fully under the individual’s control n Past Behavior u Always the best predictor of future behavior

19. 19 Self-Efficacy n Perceived ability to perform a task. n Self efficacy predicts future behavior if there are adequate incentives and skills.

20. 20 Smoking Attitudes Intentions Subjective Norms d4d4 Behavioral Beliefs Values Normative Beliefs Comply Past Smoking Control Beliefs d2d2 d3d3 d1d1

21. 21 Questions?