1. Health Behavior Assessment
Mr. Lema, Isaac
Clinical Psychologist
23rd November 2015

2. Health Behavior Assessment
Learning Objectives
Understand the meaning of assessment and principle of measurement
Familiarize with different methods used in behavioral assessment
23 November 2015
Health Behavior Assessment

3. Health Behavior Assessment
Outline
Introduction
Behavioral Assessment Context in Clinical Setting
Assessment Tools
Principles of Measurement
Assessment on Learning Theories
Skinner’s Analysis of Behavior
Problems in Assessment
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Health Behavior Assessment

4. Health Behavior Assessment
Introduction
Assessment is the process of gathering information about peoples symptoms and the possible causes of those symptoms
Information to inform diagnosis
Diagnosis label attached to a set of symptoms that tend to occur with one another
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Health Behavior Assessment

5. Behavioral Assessment Context in Clinical Setting
Differs from traditional assessment in 3 ways
Interested in samples of behavior, not behavior as a sign of internal processes
In behavioral assessment, test / interview responses are interpreted as “samples” of behavior that are thought to generalize to other situations
In traditional assessment, interpret test data as “signs” of internal processes
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Health Behavior Assessment

6. Behavioral Assessment Context in Clinical Setting …
Functional Analysis, a very concrete method, is employed to understand behavior
Assessment is an ongoing, active part of all phases of treatment
Not just always in the back of clinician’s mind, as in other types of treatment
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Health Behavior Assessment

7. Functional Behavioral Analysis / Functional Analysis
Derived from Skinner’s work with SR learning
SORC model
ABC model (very similar)
Isolates a target behavior for analysis and understanding in a very concrete, prescript manor
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Health Behavior Assessment

8. SORC Model for Conceptualizing a Behavior
S = stimulus or “antecedent” factors which occur before target behavior
O = organismic variables relevant to target behavior
Physical / medical / cognitive / psychological aspects of the client; that are relevant to treating the target behavior
R = the response; the target behavior
C = consequences of target behavior
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Health Behavior Assessment

9. Health Behavior Assessment
Example of SORC model
S – Stimulus: a child is ignored by her peers in class
O – Organismic: the child has previously been diagnosed with ADHD)
R – Response: She increases the volume of her voice (i.e., yells)
C – Consequences: her peers pay attention to her, some role their eyes
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Health Behavior Assessment

10. Skinner’s Analysis of Behavior
ABC of operant conditioning
Antecedents (the stimulus conditions)
Behaviors (or operant)
Consequences (what happens as a result of the operant behavior – reinforcement or punishment)
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Health Behavior Assessment

11. Health Behavior Assessment
Assessment Tools
Clinical interviews or initial interview
Unstructured
Structured
Test / screening tools
Checklists, rating scales, self rating scale
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Health Behavior Assessment

12. Method Studying Behavior
Observation
Naturalistic or Controlled Observation
Assess deficits in skills or way of handling situations
Controlled Performance Techniques
Self-Monitoring
Role-playing
Inventories, Checklists
Cognitive-Behavioral Assessments
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Health Behavior Assessment

13. Method Studying Behavior …
Self monitoring
Keep track of the number of times per day s/he engages in a specific behavior and the conditions under which this behavior happens
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Health Behavior Assessment

14. Behavioral Interviews
Behavioral interviews: ask questions focused on target behaviors
Goal: help clinician gain general perspective of problem behavior and the variables that perpetuate it
Understand antecedent factors
May use structured diagnostic interview
Not different from traditional interview in format, only in focus
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Health Behavior Assessment

15. Principles of Measurement
Reliability
Consistency of an individual’s score on repeated testing provided that the property being tested has not changed (Sims & Hume,1984)
Validity
Ability of a test to measure what is claimed to measure (Sims & Hume,1984)
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Health Behavior Assessment

16. Principles of Measurement …
Prevalence
The total number of existing cases among the whole population
Incidence
Number of new cases of a disease during a specified period of time related to the number of persons at risk of contracting the disease
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Health Behavior Assessment

17. Principles of Measurement …
Prevalence
A single point in time (point prevalence) or
Over a period of time (period prevalence) and expressed as a percentage or when very small, as per 1000 population
Prevalence is expressed as a percent, e.g. the prevalence of smoking in the S.A. in 1999 was 24%, or as a decimal, 0.24
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Health Behavior Assessment

18. Principles of Measurement …
Prevalence is a “cross-sectional” measure, i.e. it is measured at one point in time
Prevalence includes both “old” and “new cases”, i.e. both people who began smoking prior to 1999 and those who just began in 1999
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Health Behavior Assessment

19. Principles of Measurement …
Prevalence is a measurement of the burden of illness
Unlike incidence, it provides an estimate of the burden of disease
If the prevalence of Type II diabetes is 3% in the U.S, that suggests that 7.65 million (0.03 X 255 million) people have this disease, a substantial number
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Health Behavior Assessment

20. Principles of Measurement …
Incidence
It may be measured either as a risk or as a rate
Is the probability that a person initially free from the disease develops it at some time during the period of observation
Expressed as a percentage or per 1000 persons .
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Health Behavior Assessment

21. Principles of Measurement …
The incidence rate is the rate of contracting the disease among those still at risk e.g. diarrhea
Because the incidence measures the number of NEW events, it provides an index of the speed or velocity of propagation of a disease in a population
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Health Behavior Assessment

22. Principles of Measurement …
Changes in incidence over time, either up or down, suggest that a disease may be waxing or waning in importance.
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Health Behavior Assessment

23. Challenges to validity and Reliability
Reliability & validity influenced by
complexity of behavior observed
level of training, experience of observer(s)
unit of analysis chosen & coding system used
influence of observation on target (problematic) behavior
generalizability of observations to other settings/situations
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Health Behavior Assessment

24. How to Study Child Behavior
Chart method
Plotting a misbehavior
Graph method
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Health Behavior Assessment

25. Problems in Assessment
It is often difficult to obtain accurate information on children’s problems because children are unable to report their thoughts and feelings
Parents and teachers may provide information about children
They can be biased in their own assessment of children’s symptoms and needs
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Health Behavior Assessment

26. Problems in Assessment …
When the clinician and patient / client are from:
Different culture
Language difficulties
Cultural expectations
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Health Behavior Assessment

27. Health Behavior Assessment
Conclusion
Grows from Behavior Theory / Learning Theory
Aspects of it can be easily combined with other forms of assessment
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Health Behavior Assessment

28. Health Behavior Assessment
References
Gross, R. (2010) Psychology the Science of Mind and Behaviors 6th edition; Macmillan Company
Richard, G (2010) Psychology The Science of Mind and Behaviour; 6th Edition. Hodder education
Santrock John W. (2006) Educational Psychology; second edition. Mc Graw Hill Publisher
Sims, ACP & Hume, WI (1984) Lecture Notes on Behavioral Sciences
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Health Behavior Assessment