Theoretical Models of Health Behavior Change

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Sources: The Handbook of Health Behavior Change by Marisa E. Hilliard et al.

Theoretical Models of Health Behavior Change

Transtheoretical Model (TTM)

TTM includes processes of change such as: counterconditioning, stimulus control and contingency.

Other constructs include decisional balance, self-efficacy and temptation.

Definition: also known as the "Stages of Change" model, this model focuses on behavior change. A person may be in one of six different stages towards a certain behavior:

Precontemplation: a person is not considering a health behavior change in the near future (approx. 6 months).

Contemplation: a person is intending a change towards a behavior in the next 6 months.

Preparation: a person intends to take an action in the immediate future and need to learn skills to do so.

Action: a person is currently making a specific behavior change and needs support to continue.

Maintenance: a person's new behavior becomes a habit and requires less effort to maintain the habit.

Termination: a behavior is now permanently ingrained in a person's routine.

Health Beliefs Model (HBM)

Definition: This model emphasizes personal beliefs and says that behavior depends on two variables- value placed on a particular goal, and a person's belief in the likelihood that doing a certain action will achieve their said goal.

HBM takes into consideration that demographic influences such as personal, social and structural factors can influence health behaviors as well.

HBM has the four dimensions listed below:

Perceived susceptibility: one's perception of the risks and likelihood that they may contract an illness or condition.

Perceived severity: or feelings of the seriousness of catching an illness or not treating it- low seriousness may prove low motivation in a person while high seriousness could spark action towards a behavior to act towards preventing the illness/condition.

Perceived benefits: beliefs regarding the effectiveness an action may have on preventing or reducing the consequences/symptoms of a disease.

Perceived barriers: or potential negative outcomes of a health action that may act as blocks towards performing said behavior.

Example in the context of healthcare/medical behavior: a person will perform a certain behavior if they have a desire to avoid an illness and if they believe that performing a certain action will prevent or lower the symptom of an illness.

Theory of Planned Behavior (TPB)

Definition: the predictors of a person's intended behavior according the this theory are dependent on a person's attitude toward a behavior and the "subjective norm" towards that behavior.

TPB also includes a component that shows a belief one has over their control over a behavior- which includes having a workable and plausible plan, support from peers, skills to do the behavior, knowledge of the behavior, financial ability to perform the behavior, willpower and the opportunity to do the behavior.

"TPB posits that when attitudes and subjective norms are favorable, and perceived control is high, strong intention to perform the behavior should result."

"Subjective norm"

How an individual thinks others may perceive the behavior.

How motivated the individual is to comply with the beliefs or opinions others have on the behavior.

Attitude

Likelihood and desirability of the outcome that comes from doing the behavior.

Social Cognitive Theory (SCT)

Definition: This theory is centered around the influences which produce a certain behavior- personal factors, existing behaviors, and one's social and physical environments all have an influence on shaping a new behavior.

Behavior change and maintenance of a new behavior depend on two factors: one's expectations about the outcome from engaging in said behavior, and the expectations of one's ability to perform the behavior change.

"Efficacy Expectations": "Beliefs about how capable one is of performing the behavior that leads to those outcomes." Efficacy expectations derive from four major sources listed below:

"Performance accomplishments": learning through personal experiences, building efficacy by doing a behavior and learning from it.

"Vicarious experience": learning the behavior by observing other people or models be successful in said behavior.

" Verbal persuasion": encouragement from oneself or another person/source.

"Physiological state": different physiological effects that are produced from thinking about or doing the behavior

"Outcome Expectations": "Beliefs about whether given behaviors will lead to given outcomes."

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