health promotion and behavior change

Health Promotion and Behavior Change

Chapter 17

Objectives

By the end of this discussion, YOU will be able to:

• Discuss the meaning of behavior changes

• Identify human potential for change

• Discuss the health care providers’ role in promoting behavior changes

Objectives

By the end of this discussion, YOU will be able to:

• Identify theories of health promotion

• Discuss the Health Belief Model

• Explain the component of Health Belief Model

Introduction

Behavior change:

• Refers to any transformation

or modification of

human behavior

https://www.pchalliance.org/news/rethinking-quantifying-behavior-change-case-new-uses-measures-and-analysis

Human Potential for Change

Humans have potential for self-change because they have thecapacity for:

• Self-knowledge• Self regulation• Decision making• Creative problem solving

Human Potential for ChangeSelf change:

• It’s the new behavior that client

willingly undertake to achieve self

selected goals or desired outcomes

https://quotesgram.com/quotes-about-change-for-the-better/

Role of Health Care Providers in Promoting Behavior Change

To help others change their behavior, we need to:

Promote a positive climate for change

Serve as a catalyst (role model) for the change

Assist client with various steps of the change

Increase client’s capacity to maintain change

Models/Theories of Health Promotion

Types of models commonly used include:

1. Health Behavior Models /Theories of Behavioral Change:

◼ Social Cognitive Theory ( Bandura 1985)

◼Theory of Planned Behavior

Models/Theories of Health Promotion

1 . Health Behavior Models:

◼ Transtheoretical (Stages of change) Model ( Prochaska & Diclemente

1984)

◼ Health Promotion Model ( Nola Pender , 1982)

2. Disease Prevention Model:

◼ Health Belief Model (Lewin 1960)

Social Cognitive Theory (Bandura, 1985)

• The model has been used to design individual behavior change

interventions

• The key elements include:

• Environmental factors

• Personal factors

• Behavior

Social Cognitive Theory Model

https://educationaltechnology.net/wp-content/uploads/2019/12/social-learning-theory.png


Environmental factor:

• Represents situational influences and environment in which behavior is

preformed

Personal factors:

• Include instincts, drives, traits, and other individual motivational forces

Social Cognitive Theory (Bandura, 1985)The process of human learning and behavior change interfere with:

• Self-efficacy: A judgment of one’s ability to perform the behavior

• Outcome Expectations: A judgment of the likely consequences a

behavior will produce

• Self-Control: The ability of an individual to control their behaviors


• Reinforcements: Something that increases or decreases the likelihood a

behavior will continue.

• Emotional Coping: The ability of an individual to cope with emotional

stimuli.

• Observational Learning: The acquisition of behaviors by observing

actions and outcomes of others’ behavior

Transtheoretical (Stages of Change) Model

Health related behavior change progresses through five stages:

1. Pre-contemplation

2. Contemplation

3. Planning or preparation

4. Action

5. Maintenance

6. Transcendence

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1. Pre-contemplation: قبل التأمل is not thinking about quitting or

adopting a behavior

• Denies having a problem and views other as having problem

• They don’t think about changing behavior

• Some people believe the behavior not under their control

• May feel situation is hopeless

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2. Contemplation:

• Seriously thinking about quitting or adopting (considering

change)

• Acknowledge having a problem

• Research causes and possible solution

• Not ready to commit to action

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3. Planning or preparation:

• Seriously thinking about engage in contemplated change within

next month

• Plans to take action

• Makes the final adjustments before beginning the behavior change

• Some start making small behavioral changes at this stage 11/6/2020


4. Action:

• Action made and persisted behavior change

• Modifies behavior and surroundings

• This stage requires the greatest commitment of time and

energy

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5. Maintenance:

• Continuation and stabilization of change

• Integrates newly adopted behavior pattern into lifestyle

• This stage lasts until the person no longer experiences temptation to

return to previously unhealthy behavior

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6. Transcendence: Long period of maintenance (Kern 2008)

• It’s the final goal where the individual has complete confidence that the

problem is no longer a temptation or threat

• Copes without fear of relapse

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22https://psychcentral.com/lib/stages-of-change/

Health Belief Model

• Proposed in 1960, to explore why some people who are illness-free take

actions to avoid illness, whereas others fail to take preventive action

(Rosentock, 1960)

• Model derived from Lewin’s social psychologic theory which is a cognitive

theory, related to understanding

Health Belief Model

• Originally, the model was designed to predict behavioral response

to the treatment received by acutely or chronically ill patients,

but in more recent years the model has been used to predict

more general health behavior

Health Belief Model

• It proposes individuals’ predisposition قابلية to take action

depends on:

a. Perceived threat to personal health

b. The conviction (confidence) that the benefits of taking action

to protect health outweigh the barriers that will be

encountered

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Health Belief Model

• HBM has been adapted to a variety of long-

and short-term health :

• Preventive behavior

• Illness behavior

• Sick role behavior

Key Constructs/Elements of Health Belief Model

• Perceived susceptibility

• Perceived seriousness/severity

• Perceived benefits

• Perceived barriers

• Cues to action

• Self-efficacy

• Modifying factors (motivation) 11/6/2020

Perceived Susceptibility

• Perceived Susceptibility to future conditions

• Individuals vary widely in their perception of susceptibility to a disease orcondition

• LOW MEDUIM HIGH

• Deny A statistical possibility Real danger

Perceived Seriousness

Individual’s beliefs concerning the effects of disease or condition on his/her health and lifestyle

- Health related:

- Physical: pain and discomfort.

- Emotional burdens

- Social consequences:

- loss of work, time, financial burdens and issues related

to family relationship

Perceived Benefits of Taking Action

• The believed effectiveness of behavior/ strategies designed to

reduce the threat of illness.

• The direction of action that a person chooses will be influenced

by the beliefs regarding the actions

Barriers to Taking Action

• The potential negative consequences that may result from taking particular

health actions, including physical, psychological, and financial demands:

Inconvenient Expensive Unpleasant

Painful Upsetting

• These characteristics may lead a person away from taking the desired

action

Cues to Action

• An individual's perception of the levels of susceptibility and

seriousness provide the force to act. Benefits (minus barriers) provide

the path of action

• However, it may require a 'cue to action' for the desired behavior to

occur.

Cues to Action

• Cues to Action: factors which cause you to change, or want to change.

These cues may be internal or external.

• External influences promoting the desired behavior, may include

information provided or sought, reminders by powerful others,

persuasive communications, and media publicity

Cues to Action

• Environmental (e.g.,) that motivate people to take action.

• Internal influences:

• Bodily (e.g., physical symptoms of a health condition)

• Believes and attitude toward health

• Educational level

Self-Efficacy

• One’s “conviction that one can successfully execute the behavior

required to produce the outcomes” (Bandura, 1977).

• Health motivation

• Value of health

HBM Construct Definition Operationalization

Perceived Susceptibility

Beliefs about the likelihood of getting a disease/condition

A woman believes she is at low risk of getting pregnancy related anemia, so she neglects to swallow iron tablets

Perceived Severity

Beliefs about the seriousness/consequences of the condition

A teenage boy engages in smoking tobacco with his friends because he thinks that getting addicted to smoking is ‘no big deal’


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Perceived Benefits

Belief that a certain action will reduce risk / seriousness of impact

A middle-aged man has a heart condition, but is skeptical that diet and exercise will actually have any impact on his health

Perceived Barriers

Belief about costs/negative aspects of the action

A young mother would like to feed her children healthy meals, but thinks that fruits and vegetables are too expensive and time-consuming to prepare


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Cues to Action Strategies to activate

"readiness"

Provide how-to information, promote

awareness, reminders.

Self-Efficacy Belief in one’s ability to take action to produce desired outcomes

A young man wants to lose weight, but has little belief in his ability to exercise control over his diet and find the motivation to exercise


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Modifying

Factors

(motivation)

An individual’s personal attributes that determine whether they change or not. e.g. age, sex, ethnicity, knowledge, social class, etc.

A young woman want to attend a weight losing session, unfortunately the instructor is a man unknown to her and her religion forbids her from familiarizing with ‘strangers’


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The Health Belief Model

https://pmhealthnp.com/pmhnp-topics/health-belief-model/

Health Belief Model

Researchers have applied the HBM to studies that attempt to explain and predict individual participation in programs for:

• High blood pressure screening

• Smoking cessation

• Seatbelt usage

• Exercise

• Nutrition

• Breast self-examination

• HIV/AIDS & sexual risk behaviors

Thank You

11/6/2020 Suhaila Halasa RN, PhD, CIMI,CPT 42

health promotion and behavior change

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