What are the common health behaviour change models?
- Health belief model
- Theory of planned behaviour
- Social learning theory
- Social cognitive theory
- Transtheoretical model (TTM)
- Self determination theory
- Perceived susceptibility
- Perceived severity
- Perceived benefit
- Perceived barriers
- Cues to action
- Self efficacy
Health belief model
6 key constructs
Personal beliefs and perceptions influence
6 main constructs:
- Attitude
- Intention
- Subjective norms
- Social norms
- Perceived power
- Perceived behavioural control
Motivation and ability
Theory of planned behaviour
Learning from observing the behaviours of another person
Social learning theory
Which model?
Personal factors
Environment
Behaviour
Credible role models
Social cognitive theory
Transtheoretical model
Stages?
1&2 - MI
3-5 - CBT
All - Positive Psychology
- Precontemplation
- not ready for change in next 6/12 - Contemplation
- considering in next 6/12 - Preparation
- intends for action in next 1/12 - Action
- made a change for < 6/12 - Maintenance
- sustained change for > 6/12 - Termination
What are these common components of?
- Beliefs about risks / benefits
- Motivation
- Self efficacy
- Environmental influences (social)
Health behaviour models
Health behaviour is influenced by?
Intrapersonal
Interpersonal
Institutional
Community
Public policy
Features of
Precontemplation
No awareness
No interest
No planning
Validate reasons for change
Acknowledge barriers
Listening, open questions
Reflections
Features of
Contemplation
More willing
Ambivalent
Risks vs benefits
Impact on goals
Discuss motivation
Challenges
Strategies
Features of
Preparation
Aware of need
Excitement
Assist with commitment
Build support systems
Help modify environment
Features of
Action
Started specific changes
Needs support
Problem solve
CBT, reframing
Celebrate successes
Features of
Maintenance
Behaviour achieved for > 6/12
Reconnect with their motives
MItigate stress
Coping strategies
Features of
Termination
No temptation to return
What is self efficacy?
A person’s confidence level to perform a behaviour
Score of >=7 meansmore likely to achieve goal
SMART goals?
Specific
Measurable
Achievable
Relevant
Timebound
What is Motivational Interviewing?
- good listening, giving info/advice
- draw out own meaning, importance and capacity to change
- helpful in precont/contemplation
4 general principles of MI?
- Express empathy
- Support self efficacy
- Roll with resistance
- Diff b/w where pt is and where they want to be?
4 core skills of MI?
OARS
1. Open ended qns
2. Affirmations
3. Reflections
4. Summaries
CBT
Most useful during which stages of TTM?
Preparation
Action
Maintenance
Problem solving
Deeper understanding
Basic principles of CBT?
- Recognising and reframing non-productive thinking
- Building awareness of underlying beliefs and emotions
- ABCDE of behavioural change
Examples of cognitive distortions and reframed thoughts
- All or nothing
- Overgeneralisation
- Mental filter (filtering out good)
- Mind reading
- Fortune telling
- Magnification / minimisation
- Personalisation & blame
- Emotional reasoning (feelings)
- Labeling / mislabeling
- Disqualifying the positive
What is the ABCDE method of behavioural change?
- Action - what event occurred?
- Beliefs - about what happened?
- Consequences - of those beliefs?
- Dispute - beliefs that are distorted
- Effects - of new way of thinking
What does positive psychology do?
Shifts from focusing on ‘problems’ to focusing on what is ‘working well’
