Perceived Self-Efficacy

1. Perceived Self-Efficacy Ralf SchwarzerFreieUniversitat and Aleksandra Luszczynska University of Sussex, UK Crawford

2. Self efficacy pertains to a sense of control over one’s environment. Self efficacy influences: If a health behavior will change How much effort will be put into changing Duration effort will be sustained Goal selection Self-Efficacy

3. The Theory of Planned Behavior relates self efficacy and behavioral control as similar constructs, and asserts that intention is the most proximal predictor of behavior. Transtheoretical Model defines self efficacy and positive or negative outcomes as the main social-cognitive variables that change across stages. The Health Action Process Approach proposes a division between pre-intentional motivation processes which lead to a behavioral intention, and post intentional volition processes that lead to the actual health behavior. Self-Efficacy Defined by Behavior Theory

4. As defined by the TTI, self-efficacy is an affective/cognitive factor which has a great effect on the most proximal predictors of behavior. Self-Efficacy in TTI

5. The General Efficacy Scale Questions are drawn at random by participants and answers are evaluated on a 1-4 point scale All responses are summed to equal a score between 10-40 Positive coefficients are related to favorable emotions Negative coefficients are related to negative emotions How is Self-Efficacy Measured?

6. General Self-Efficacy Scale

7. People in nutritional intervention programs who had higher levels of nutritional self efficacy were less likely to relapse Diet changes have highest rate of success when combined with lifestyle changes such as physical exercise and social support Positive measures of self efficacy directly related to an actual increase intake of fruits and vegetables Nutritional self efficacy play a role in predicting success in both diabetes and breast cancer patients Nutrition-Related or Dietary Self Efficacy

8. Developing goals for exercise and maintaining those goals are strongly influenced by self-efficacy. Endurance is directly related to exercise efficacy, and compared to behavioral control, is a more reliable predictor of moderate to vigorous activity. Physical Exercise Self-Efficacy

9. Three categories of alcohol self efficacy: Controlled drinking self-efficacy Drinking refusal self-efficacy Abstinence self-efficacy Self efficacy is tested using the Situational Confidence Questionnaire Alcohol Consumption and Self-Efficacy

10. For individuals who would like to regulat their intake of alcohol, the Controlled Drinking Self-Efficacy scale is used. CDSE scale takes into account negative affect, positive mood/social context, how often you consume, and how much you consume in order to evaluate how successful you will be in a treatment program. Controlled Drinking Self-Efficacy

11. The Drinking Refusal Self-Efficacy Questionnaire was designed by Young Oei (1996) to determine an individuals level of resistance to drinking alcohol. Any intervention programs are designed to assist drinkers on how to refuse drinking in social situations etc. Drinking Refusal Self-Efficacy

12. The Alcohol Abstinence Self-Efficacy scale was developed by DiClemente, Carbonari, and Montgomer (1994) in order to evaluate confidence of recovering alcoholics to completely abstain from drinking Scale is a 5-point Likert scale used to determine confidence to abstain Alcohol Abstinence Self-Efficacy

13. Likert Scale

14. Only a few physiological factors can be relied on to predict abstinence from smoking. These factors in include: Lower nicotine dependence Longer duration of previous abstinence A quitter’s self-efficacy can be affected by number of environmental factors including social situations and locations (bars or casinos that allow smoking) In individuals who were trying to quit, self-efficacy was higher in those who had not lapsed in their efforts. Smoking Cessation Self-Efficacy

15. Smoking self-efficacy measurement: a scale developed by Colletti, Supnick and Payne (1985). Uses a 17-item SSEQ to measure self efficacy while trying to quit Relapse Situation Efficacy Questionnaire developed by Gwaltney, Shiffman, and Normal (2001) Evaluated self-efficacy within different situations Ide time, social food situations, low arousal and cravings In one particular study by Dijkstra and De Vries (2000) a combination of 5 different efficacy scales were used Through these measurement methods, it has been determined that smoking cessation self efficacy is higher in people with a higher level of skill in quitting, and in people who have had a lower number of relapses. Measurements of Smoking Cessation Self-Efficacy

16. Smoking Self-Efficacy Measurement Questionnaire

17. Adherence to medication regimens is extremely important when treating any disease, and becomes crucial when treating diseases like HIV, diabetes, and epilepsy Lack of social support, and drug side effects are two factors that decrease self-efficacy in these situations. Difficulty with self injected medications for MS patients (rehabilitation) and diabetes patients can lower self efficacy The medication adherence self-efficacy scale developed by Gbenga, Mancuso, Allegrante, and Charlson (2003) to evaluate hypertensive African American patients, can be applied to other patients in order to assess risks associated with adherence to medical regimens. Adherence to medication Self-Efficacy and Rehabilitation Self-Efficacy

18. Morisky 8-item Medication Adherence Scale

19. The MOST important determinant in condom use self-efficacy in teenage girls is the belief in her ability to communicate effectively with her partner about protection. The Condom Use Self-Efficacy Scale developed by Brafford and Beck (1991) evaluates an individual’s confidence in buying and using condoms correctly. Previous condom use was found to be a predictor of future use and confidence. Subjective norms play a huge role in successful use of condoms Condom Use Self-Efficacy

20. Outcome expectancies and perceived self efficacy are the two best predictors for detective behaviors and screening likelihood. If a person expects a positive outcome from screening or self detection, the individual is more likely to have high self efficacy, and therefore more likely to do it. In a study of relatives to prostate cancer, physician recommendation, knowledge and risk estimation poorly estimated cancer screening probability in comparison to self efficacy values. Detective Behaviors and Self Efficacy

21. Self Concept: Knowledge about yourself “I see myself as a hard worker” Self-Esteem: focuses more on the emotional side of how you see yourself, “I feel that I have good character” Locus of Control: holding yourself responsible for an outcome, “I will lose 10 pounds in the next two months, and this is my plan…” Self-Concept of Ability: a judgment of your personal confidence, “I am a good runner, I will compete in that 5k” Self efficacy differs from these constructs in that SE has both explanatory and predictive power. SE statement “I know I can change my eating habits even if my SO doesn’t” Self efficacy contains the three important elements for success, competency, prospective, and action. Other constructs do not have all three. Constructs Similar to Self-Efficacy

22. “Dispositional Optimism” A general expected outcome Does not explain HOW a goal is accomplished, it assumes that personal effort is the main contributor Optimism is important to both DO and SE Hope (it IS a construct!) Two dimensional construct made up of agency and pathways. Agency: similar to self-efficacy Pathways: similar to outcome expectancies Two more Constructs: Dispositional Optimism and Hope

23. Loci of control can be either internal or external Internal: based on traits or behaviors External: made of other forces or chance While some studies suggest that strong internal control is a strong indicator of health behaviors, is it generally agreed that self efficacy is more reliable Last but not least: Health Locus of Control

24. The description, Theoretical Background and History of,Perceived ControlSuzanne C. Thompson and Michele M. Schlehofer By Ruby Kiker

25. Perceived Control • An individual’s perception of their own ability, resources and opportunities to act, resulting in a desired outcome.

26. Components of personal control • Perceived control - Locus of control + self-efficacy • Locus of control is the general perception that you have the ability to control your behavior and outcomes (internal) or that someone/something else does (external) • Self-efficacy is the perception that you have the skills to carry out the behaviors • Process of control vs. control strategies • Active and passive control related strategies • General vs. Specific • General perceived control vs. the perception in your ability to control behavior in a particular event

27. Components of Personal Control (cont’d) • Realistic vs. unrealistic • Accurate perceptions of control can increase behavior change • unrealistic perception of control can decrease behavior change • Desire for control • A Variation among people’s desire for control • Target of control • Internal vs. external

28. How personal control helps shape theories • An increase in personal control has a direct association with an increase in health behavior change

29. Theories involving perceived control • The two-process model of perceived control (rothbaum, weisz, and Snyder, 1982) • Primary and secondary control • Theory of planned behavior • Shapes behavior intent • Social cognitive theory (bandura, 1986) • Self-efficacy and response efficacy

30. Theories involving perceived control (cont’d) • Protection motivation theory (maddux & rogers, 1983) • Self-efficacy and response efficacy • Self-control theory (Rosenbaum, 1983) • Control over one’s own emotions, thoughts, and behavior

31. Measuring control constructs • Examples: • Multidimensional health locus of control (wallston, wallston, & devellis, 1978) • 18 item, 6 point likert scale measuring internal perceptions, chance, and power over others • Perceived behavioral control (Armitage & connor, 1990) • Most widely used version often adapted for specific studies • Self-efficacy (bandura, 1977) • Widely used and often adapted to suit a specific health behavior

32. THE THEORY OF TRIADIC INFLUENCE Levels of Causation Ultimate CULTURAL SOCIAL BIOLOGY/ Causes ENVIRONMENT SITUATION PERSONALITY 1 2 3 4 5 6 a f Social/ Personal Nexus c d e b Sense of Information/ Interpersonal Others’ Social Interactions w/ Self/Control Opportunities Bonding Beh & Atts Competence Social Instit’s Distal Influences 7 8 9 10 11 12 g r p i q h k n m l j o Expectancies & Evaluations Self Skills: Motivation Perceived Values/ Knowledge/ Determination Social+General to Comply Norms Evaluations Expectancies 13 14 15 16 17 18 s x ATTITUDES SOCIAL SELF-EFFICACY u w v t Affect and Cognitions TOWARD THE NORMATIVE BEHAVIORAL BEHAVIOR BELIEFS CONTROL Proximal 19 20 21 Predictors Decisions A G B H C I D E F 22 K Experiences 23 Related Behaviors J Intrapersonal Stream Social/Normative Stream Cultural/Attitudinal Stream Biological/Nature Nurture/Cultural DECISIONS/INTENTIONS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological 32

33. Quiz • What are a few of the major theories we have discussed in class where perceived control plays an important role? • How are self-efficacy and response-efficacy different? • What is passive control? • Should our perception of control be an accurate one in order to affect change?

34. THANK YOU

35. Social Cognitive Influences on Physical Activity Behavior in Middle-Aged and Older Adults White, Wójcicki and McAuley

36. SCT Review • Five Constructs • Knowledge • Perceived Self-Efficacy • Outcome Expectations • Goal Formation • Sociocultural Factors

37. Self-Efficacy and Physical Activity • Reciprocal relationship • Higher levels of self-efficacy, greater participation in physical activity • Greater levels of physical activity, higher levels of self-efficacy • Do you think self-efficacy alone is enough to predict physical activity participation?

38. Outcome Expectations • Physical – Beliefs about physical experiences resulting from the engagement in PA • Social – Increased opportunities for socialization • Self-evaluative – Feelings of self-worth and satisfaction

39. Goals and Physical Activity • Self-regulating resource • Self-regulation is the ability to monitor behavior in order to achieve goals • Directs effort and guides behavior • Increased goal setting is related to increased self-monitoring • Increased self-monitoring and self-regulation are associated with regular PA patterns

40. Study • Test the utility of Bandura’s SCT to explain PA behavior in community-dwelling middle-aged and older adults • 18 month prospective panel design to determine whether changes in the model constructs were related over time • Test direct and indirect influence of constructs on each other and PA behavior, as well as indirect relationships with PA through other constructs • 227 participants • Self-reported scaled surveys measured demographics, self-efficacy, outcome expectations, physical activity, and impediments

41. Results

42. Exercise Self-Efficacy Scale • http://www.epl.illinois.edu/files/images/measures/EXSE.pdf

43. Social Cognitive Theory of Physical Activity in Older Adults

44. Discussion • Higher self-efficacy associated with greater levels of PA, fewer disability limitations, higher goal-setting and higher outcome expectations • Changes in self-efficacy were associated with changes across SCT constructs • PO and SO changes were related to changes in PA • Emphasis on independence later in life and greater levels of social support • Outcome expectations may influence PA over time, independent of self-efficacy

45. Discussion: Goals • No significant relationship directly between goal setting and physical activity or as a mediator between self-efficacy and physical activity • Support for goals as a mediator between self-efficacy and disability limitations

46. Discussion • Interventions should focus on all constructs • Self-efficacy, realistic outcome expectations, goal-setting, barrier targeting exercises, as well as social support systems • Limitations • Used different measures of physical activity throughout the study • Reciprocal relationship between PA and self-efficacy not shown on the model • Little explanation of the decrease in self-efficacy and increase in outcome expectations over 18 month period

47. THE THEORY OF TRIADIC INFLUENCE Levels of Causation Ultimate CULTURAL SOCIAL BIOLOGY/ Causes ENVIRONMENT SITUATION PERSONALITY 1 2 3 4 5 6 a f Social/ Personal Nexus c d e b Sense of Information/ Interpersonal Others’ Social Interactions w/ Self/Control Opportunities Bonding Beh & Atts Competence Social Instit’s Distal Influences 7 8 9 10 11 12 g r p i q h k n m l j o Expectancies & Evaluations Self Skills: Motivation Perceived Values/ Knowledge/ Determination Social+General to Comply Norms Evaluations Expectancies 13 14 15 16 17 18 s x ATTITUDES SOCIAL SELF-EFFICACY u w v t Affect and Cognitions TOWARD THE NORMATIVE BEHAVIORAL BEHAVIOR BELIEFS CONTROL Proximal 19 20 21 Predictors Decisions A G B H C I D E F 22 K Experiences 23 Related Behaviors J Intrapersonal Stream Social/Normative Stream Cultural/Attitudinal Stream Biological/Nature Nurture/Cultural DECISIONS/INTENTIONS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological