Behavior Change Models: Understanding Patient Behavior

1. Behavior Change Models: Understanding Patient Behavior

2. To be able to identify Components of behavior change models Barriers to Change Examples of positive health behavior changes Objectives

3. Why Do People Change? • Why do you think people change?

4. Change Models • Prochaska Stages of Change • Bandura Social learning Theory/Self-Efficacy • Erikson Stages of Development • Thorndike Laws of Learning

5. Prochaska’s Theory of Change • Six (6) Stages of Change • Series of tasks that must be completed before moving to the next stage • Timing is very important

6. Termination Pre- Contemplation Maintenance Contemplation Action Preparation The Six (6) Stages of Changes

7. A Different Perspective

8. Stages One to Three • Pre-contemplation (Not Ready) – Not intending to take action, can be unaware that their behavior is problematic • Contemplation (Getting Ready) -Beginning to recognize their behavior is problematic, start to look at the pros and cons of their continued actions • Preparation (Ready) - Intending to take action in the immediate future, may begin taking small steps toward behavior change

9. Stages Four to Six • Action – Specific overt modifications in their problem behavior or in acquiring new healthy behaviors • Maintenance –Sustained action, working to prevent relapse • Termination – Zero temptation, sure they will not return to their old, unhealthy habit as a way of coping

10. If nothing ever changed, there would be no butterflies

11. Bandura’s Social Learning TheorySelf-Efficacy • Self-Efficacy • A person’s belief in their own capability • Goal of Health Coaching: Empower patients so they increase their self-efficacy • Education increases self-efficacy

12. Self-Efficacy Behavior • More inclined to act if they believe they can succeed • Avoid tasks when they perceive their self-efficacy is low • Optimum level of self-efficacy is slightly above actual ability I CAN DO IT! - BEHAVIOR

13. Self-Efficacy and Motivation • High self-efficacy, high motivation • More effort • Sustain behavior longer • Low self-efficacy, low motivation • Have to study a situation and learn more about a subject before they activate I CAN DO IT! - MOTIVATION

14. Self-Efficacy: Thought Processes • High Self-Efficacy • Encouraged by obstacles • See the big picture • Low Self-Efficacy • Believe tasks are harder than they actually are • Poor planners • Stressed by new tasks • Failure related to low ability

15. Each person’s task in life is to become an increasingly better person I CAN DO IT! – HEALTH BEHAVIOR

16. Erikson’s Stages of Development • Eight stages through which a healthy developing human should pass from infancy to late adulthood • In each stage the person confronts and, hopefully, masters new challenges

17. Erikson’s Stages Seven and Eight • CareGenerativity vs. Stagnation • Middle adulthood 40-64 years of age • WisdomIntegrity vs. Despair • Late adulthood 65 years of age-death

18. Generativity vs. Stagnation • Generativity: Guiding the next generation • Socially-valued work • Contribution and accomplishment • Little to no contribution results in stagnation and dissatisfaction Will I produce something of real value?

19. Integrity vs. Despair • Older adults are slowing down and exploring life as a retired person • Contemplate accomplishments • Those that feel they did not accomplish their goals feel a sense of despair • Retrospection is the key task in this stage Have I lived a full life?

20. Courage doesn’t always roar. Sometimes courage is the little voice at the end of the day that says I’ll try again tomorrow.

21. Thorndike’s Learning Theory • Thorndike was a pioneer in behaviorism and in studying learning. • Readiness • Desire to learn • Emotionally and physically ready • Exercise • Repetition/Practice makes perfect • Effect • Learn better when there is a sense of satisfaction or accomplishment

22. Readiness • The principle of readiness indicates that individuals learn best when they are physically, mentally, and emotionally ready to learn, and they do not learn well if they see no reason for learning. • Basic needs of the student must be satisfied before they are ready or capable of learning.

23. Exercise • The principle of exercise states that those things most often repeated are best remembered • Practice makes perfect • Student recall, review and summary, and manual drill and physical applications

24. Effect • The principle of effectis based on the emotional reaction of the student and has a direct relationship to motivation • Positive reinforcement is more apt to lead to success • One of the important obligations of the instructor is to set up the learning situation in such a manner that each trainee will be able to see evidence of progress and achieve some degree of success

25. Questions? This material was produced by eQHealth Solutions, the Medicare Quality Improvement Organization for Louisiana, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. LA10SoW3C12-2647