What is science?
-Evidence based knowledge and practice gained from rigorous research
What is scienciness?
-Opinions about science based on some fact but extrapolated beyond available evidence and supported mostly by belief rather than data
Problems with health behaviour change?
- Why should I do it? (outcome expectation)
- I don’t want to/I don’t like it (affective attitudes)
- How bad is my behaviour anyways? (Attitudes towards own behaviour)
- How hard will the change be? (Costs)
- Can I do it? (self-efficacy)
- Who will help me? (social support)
- I want to, but can’t get going (Implementation intention gap)
Motivation is not always enough. So we need to target and be precise with…
- Be precise about target behaviour because meanings can be different for different people
- Be precise about target audience because groups differ in knowledge, cognitions, motivation, skills, and understanding
What are effect sizes?
-How much of the behaviour can we explain because of a particular intervention?
What approach leads to bigger effect size?
- Behavioural approaches have bigger effects than informational approaches
- Reward and punishment have bigger effects than just giving information (information and knowledge is necessary but not sufficient)
What is the risk reduction approach?
- Focusing only on the individual to move into normal level of risk
- Can be labor intensive, expensive, and hard
What is the population level intervention approach?
- Encouraging EVERYONE in a population to change their behaviour
- Moving an entire population into lower or less risk
- Can use taxation or restrictions on negative health behaviours
- Can get a bigger effect size by moving an entire population into lower level risk
Acquiring new behaviours is a process, not an event. What are the implications?
- entails learning by performing successive approximations of the behaviour
- Emphasize gradual change because too much too soon is harder
- Expect individual differences in readiness to change because some are in thinking process and some are ready
- Develop program elements specific to each step in the behaviour change process (motivational and volitional phases)
What is the motivational phase?
- Someone starting to think about change
- Trying to move them forward to set a goal
What is the volitional phase?
-They are ready and have made a goal but what do they need to get the motivation to make the change?
The more beneficial or rewarding an experience, the more likely it is to be repeated; more punishing and unpleasant, the less likely it is to be repeated. What are the implications?
- Make things positive for people
- Think about what is immediately reinforcing or punishing about a behaviour
- Program components that cause people to experience personal control, success or social recognition (to reinforce)
- Teach individuals to be self-reinforcing (goal-setting, self-talk, creating own experiences)
- Make sure fear components can be resolved
- Even if you are trying to get someone to stop a poor health behaviour, make the alternative behaviour positive
Individuals are not passive responders, but have a proactive role int he behaviour change process. What are the implications?
- Engage people as much as you can
- Involve members of the target audience in developing messages, programs, and interventions
- Use a bottom up approach instead of top down
What is a top down approach?
- Someone thinks they are an expert and tells someone what to do
- Does not work well
What is a bottom up approach?
- Talking to people, collaboration and working with them
- More effective because people feel invested
Social relationships and social norms have substantial and persistent influence on how people behave. What are the implications?
- Use modelling of behaviours by significant others so behaviours become normalized
- Know what the person’s social motive for change is (e.g. changing for family time)
- Create social pressure and contracts to stay accountable
- Changing health practices within social groups = increased potential for sustained behaviour change
Behaviour is not independent of the context in which it occurs. What are the implications?
- People are influenced by and influence their physical and social environments
- Influenced by = nudging
- Influence on = advocacy groups trying for change
- What needs tp be changed within the environment to promote and facilitate individual change?
- Environmental changes are needed
- Comprehensive, ecological interventions are needed at multiple levels
Social Ecological models. What are the levels?
- Various levels of social influence
- To promote health, the ecosystem subsystems must offer conditions conducive to health! (easier to engage in health behaviours if your environment allows for that)
- Individual, Interpersonal, Organizational, Community, Policy
What is the individual level of social ecological models?
- Self-efficacy, attitudes, knowledge, skills, motivation
- Intervention: implementation intentions
What is the interpersonal level of social ecological models?
- individual’s relationship with others
- subjective and injunctive norms
- people who care about you or support = easier to change
- Intervention: peer support groups, family programs
What is the organizational level of social ecological models?
- Rules and regulations of organizations
- Intervention: ERS, programs in universities or work-places
What is the community level of social ecological models?
- Resources that promote social norms
- Access?
- Intervention: Edmonton’s bike plan
What is the policy/societal level of social ecological models?
- Local, state, federal, government policies
- Where is money being spent?
- How will policy decisions trickle down?
- Intervention: Tax credits/breaks for sports programs enrolment, dentist access for low income
The process of applying behavioural science theories in practice situations should be guided by research and evaluation methods. What are the implications?
- Guided by research even if it is not you conducting it
- Know how to read empirical literature
- Know what has worked in the past and what hasn’t
- Appropriate designs to provide evidence of cause-effect relationships (use intervention mapping to provide evidence)
