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Theories and Models for Health Promotion Interventions. Build a solid foundation for the house. Definitions.
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Theories and Models for Health Promotion Interventions Build a solid foundation for the house
Definitions • Theory: A theory is a set of interrelated concepts, definitions, and propositions that presents a systematic view of events or situations by specifying relations among variables in order to explain and predict the events of the situations. Glanz, Lewis & Rimer, 1977, p. 21
Definitions • Concepts: the primary elements of theory (ideas or propositions) • Construct: synthesized thoughts of key concepts or specific theories • Variables: the operational or practical form of a construct • Model: a subclass of theory. May utilize a number of theories to help people understand a specific problem in a particular setting
Confused? • See page 145
Still Confused? • Don’t worry about it. You aren’t alone.
Theories • The backbone of the processes used to plan, implement, and evaluation health promotion interventions • A theory-based approach provides direction and justification for program activities and serves as a basis for processes that are to be incorporated into the health promotion program
Program Minnesota Heart Health Program Theories Used Social Learning Theory Communication-persuasion model Model of innovation diffusion Community development Problem-behavior theory Theories and HP Programs
Program Stanford Five-City Project Theories Used Social Learning Theory Theory of Reasoned Action Communication-persuasion model Model of innovation diffusion Theories and HP Programs
Behavior Change Theories Stimulus-Response (SR) Theory: • Classical conditioning • Instrumental conditioning • Reinforcement • Punishment • Positive reinforcement • Negative reinforcement • Positive punishment • Aversive stimulus • Negative punishment
Behavior Change Theories Social Cognitive Theory (SCT) • A.k.a. Social Learning Theory (SLT) • Albert Bandura • Learning occurs primarily through modeling and reinforcement • Self-efficacy • Efficacy expectations • Outcome expectations
Behavior Change Theories Theory of Reasoned Action (TRA) • Fishbein & Ajzen, 1975 • Attitude, belief, behavioral intention, and behavior • Incorporates the notion that individuals will behave, in part, because of how they believe significant others would have them behave (subjective norm)
Behavior Change Theories Theory of Planned Behavior (TPB) • Extension of TRA • Incorporates the dimension “perceived behavioral control” as a determinant of intention. Can I do this? Am I in control? • What would Bandura call this? • Self-efficacy
Behavior Change Theories Theory of Freeing (TF) • Friere (1973, 1974) • Empowerment • The task of health education should be to free people so they may make health-related decisions based upon their needs and interests
Health Behavior Models Health Belief Model (HBM) • Frequently used • Based on Lewin’s decision making model • Probability of behavior change (likelihood of action) is based on perceived threat of a particular disease which depends on a number of factors • See p. 154
The Elaboration Likelihood Model of Persuasion (ELM) • Petty, Barden & Wheeler, 2002 • Designed to explain how persuasion messages (communications) aimed at changing attitudes were received and processed by people • Elaboration = the amount of effortful processing people put into receiving messages • See p. 160
Transtheoretical Model (TTM) Transtheoretical Model (TTM) • Stages of Change Precontemplation, contemplation, preparation, action, maintenance • Decisional Balance Pros, cons of changing • Self-Efficacy Confidence to change; temptation to engage in unhealthy behaviors • Processes of Change Consciousness raising; Self-reevaluation; Self-liberation; Reinforcement; Stimulus control; etc.
Transtheoretical Model (TTM) Cognitive-Behavioral Model of the Relapse Process • For most people, relapse is a part of change • Relapse is a failed attempt to change or modify a particular habit pattern or adopt a new optimal health behavior • Lapse is a single slip or mistake • Relapse prevention (RP) training helps people anticipate and cope with the problem of relapse in the habit-changing process (see pp. 161-163)