Social Cognitive Theory

1. Social Cognitive Theory Applied to Health Behavior Chase Cameron

2. Background • Social Cognitive Theory • Albert Bandura and Social Learning Theory

3. Tenants of Social Cognitive Theory (SCT) • Lends itself nicely to public health! • “Interaction among person, environment and behavior” - Bandura • Five Key Constructs • Reciprocal Triadic Causation • Threefold Stepwise Implementation Model

4. Five Key Constructs • Knowledge • Perceived Self-Efficacy • Outcome Expectations • Goal Formation • Sociostructural Factors

5. First Two Key Constructs: Knowledge Perceived Self-Efficacy “A precondition for behavior change” - Bandura Confidence and ability to adopt behavior

6. Knowledge • Necessity vs. Sufficiency • Content knowledge vs. procedural knowledge

7. Knowledge: • Necessity vs. Sufficiency • Is knowledge necessary for behavior change? • Is knowledge sufficient for behavior change? • Notable public efforts devoted to this idea! • Your examples of effective efforts? • Your examples of ineffective efforts?

8. Knowledge: • Content knowledge • Understandings of benefits and drawbacks of health behavior. • Procedural knowledge • Understandings of how to engage in health behavior. • Examples?

9. Five Key Constructs • Knowledge • Perceived Self-Efficacy • Outcome Expectations • Goal Formation • Sociostructural Factors

10. Perception-based Perceived Self-Efficacy • Task-Specific

11. Perceived Self-Efficacy • Critical to Adoption and Maintenance of health behaviors • Programs must accommodate differences in self-efficacy. • Requires Resiliency • Many health promoting behaviors: • occur under difficult circumstances. • include multiple steps of varying complexity

12. Building Self-Efficacy • Methods Given: • Physiological State (overcoming fear/negativity) • Verbal Persuasion (convincing) • Vicarious Experiences (demonstrating) • Enactive Attainment (guiding and coaching)

13. In- Class Activity: (Front of Room) 1. Break into groups as shown 2. For the selected health behavior, develop an example program using each step: (pg 170) Physiological State (overcoming negativity/fear) Verbal Persuasion (convincing) Vicarious Experiences (demonstrating) Enactive Attainment (guiding and coaching)

14. Final Point about Self Efficacy: • Behavioral Capacity: • “Actual” ability to perform health behavior • May be misaligned!

15. Five Key Constructs • Knowledge • Perceived Self-Efficacy • Outcome Expectations • Goal Formation • Sociostructural Factors

16. Outcome Expectation • Knowledge is a necessary gateway to action • How to engage in behavior • Perceived self-efficacy will determine whether or not action takes place • Ability to engage in behavior • Outcome expectation is equally responsible in motivating behavior. • Must be a belief the behavior will pay off! • Also based on perceptions.

17. Outcome Expectations • Related Concepts • Net gain - weighing pros and cons • “Ulysses contracts”

18. Outcome Expectations Gauging the Difficulty of behavior change Easier . . . More intensive...

19. Outcome Expectations • Expectancies vs. Expectations • Expectancies: “the expectation that Y will occur following X and a positive or negative value attached to Y.”

20. Outcome Expectations • Reinforcement: • Positive or Negative it leads to an increase! • Take something bad away = Negative • Add something good = Positive • Extrinsic or intrinsic • Socially structured reinforcement = extrinsic • Not socially structured = intrinsic

21. Five Key Constructs • Knowledge : Necessary Condition • Perceived Self-Efficacy • Outcome Expectations • Goal Formation • Sociostructural Factors Level of Motivation

23. Last Two Constructs of SCT, Reciprocal Triadic Causation, Implementation John Ruyak

24. Goal Formation • -According to by Social Cognitive Theory goals are best achieved by being broke down into a progressive series of sub-goals • Easier to obtain long term, more complex goals • Long term goals may be hard for individual to envision, making behavior change difficult • Setting smaller goals that are easier to obtain and will build up to accomplishing bigger goal • Setting smaller easily obtained goals increases self-efficacy • Little success increase belief that individual can obtain the larger goal • Increases expectancies • Outcome of continued pursuit will be positive • Increased desire to obtain behavior change

25. Sociostructural Factors • -The environment that an individual lives in affects ability to engage in behavior • Built environment, policy, culture • Supporting factors for change • Increase self efficacy • Examples: gyms that are close, stores that supply healthier foods, free vaccination clinics, local norms support healthy behavior • Impeding factors for change • People may have content knowledge on health behavior but… • Examples: no source for healthy foods, lack of health care facilities, reference groups are performing bad behavior • Self-efficacy is lowered • -To counteract impeding factors • Alter perception to individuals can defy norms • provide procedural knowledge

26. Reciprocal Triadic Causation • -This model is an important connection between the SCT and health promotion • -Reciprocality= mutual influence ENVIRONMENT BEHAVIOR PERSON

27. Reciprocal Triadic Causation ENVIRONMENT BEHAVIOR PERSON

28. Reciprocal Triadic Causation ENVIRONMENT BEHAVIOR PERSON

29. Reciprocal Triadic Causation ENVIRONMENT BEHAVIOR PERSON

30. Reciprocal Triadic Causation ENVIRONMENT BEHAVIOR PERSON

31. Activity: Reciprocal Triadic Causation ENVIRONMENT BEHAVIOR PERSON

32. Three Fold Stepwise Implementation Model • -Level One: High levels of self-efficacy and strong outcome expectations • very little, if any, intervention needed before they adopt behavior • They have a high level of readiness • Self-efficacy and outcome expectations are only related to specific behavior • Will move from level one to action easily • Does not mean they will stick with behavior long term • -Level Two: Doubts about self-efficacy and weak outcome expectations • More intense interventions needed than level one • Multiple intervention points needed (these correspond with Reciprocal Triadic Causation • -Level Three: Belief that personal control over behavior is lacking • Intense intervention needed to establish personal agency • May have universal lack of belief • Without personal agency, individuals may not even try

33. PERSON Goal Formation ENVIRONMENT (sociocultural factors)

34. THE THEORY OF TRIADIC INFLUENCE GENETICS ENVIRONMENT IntraPersonal Environment Social Situation Attitudes Toward Behavior Self-Efficacy Social Normative Beliefs Intentions/Decision BEHAVIOR 34

35. Bandura, 2004: Primacy of SEYou can see why Bandura and Fishbein could never quite agree! Attitudes Intentions Social Influences  SNB ??

36. SCT aligned with the TTI 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 l 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 Role Models g r p i q h k n m j o Why not Norms?? Expectancies GOALS/MOTIVATION Socio-structural factors = behavioral control, and are influenced by self-efficacy - really? Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological 36