Understanding Behavior Change and Health Belief Model

1. Graphic from ilifejourney.files.wordpress.com Behavior Change, One HEALTH MODULES

2. Introduction Behavior Change, One Health Modules

3. Module competencies • Competency #1 • Explain behavior modification theories and change management concepts • Competency #2 • Adapt models for individual behavior change for OH initiatives across a range of stakeholders • Competency #3 • Demonstrate cultural competency and professionalism in leading change • Competency #4 • Design behavior modification strategies for OH interventions in communities

4. Moduleoverview

5. When was the last time you did something for the first time

6. Professional-Directed vs. Patient-Centered Behavior Change Behavior Change, One Health MODUELS

7. Practiceexercise • In trios randomly select a role • Two 10-minute rounds • Patient and Change Agent 1 • Patient and Change Agent 2 • After each round • Patient writes down on a scale from 1 to 10 how likely they are to change their behavior • Discuss what was effective about the Change Agent’s approach • Discuss what was not as effective about the Change Agent’s approach

8. What do you think? • Which approach was most effective? • Which approach is most natural to you? • What skills do both approaches have in common? • What skills did you see Change Agent #1 using? • What skills did you see Change Agent #2 using? • Which from a patient’s point of view is most effective?

9. Health Belief Model Models of Patient-Centered Behavior Change Behavior Change, One Health Course

10. The Health Belief Model • Developed by a group of social psychologists at U.S. Public Health Service in the 1950s. • Derived from psychological and behavioral theory. • Objective was to explain why people were not participating in a tuberculosis screening (disease detection). • One of the first models developed to specifically address health-related behaviors. • The model has been modified to apply to a greater amount of situations.

11. The Health Belief Model Ultimately, an individual’s course of action depends on an individual’s perceptions of the benefits and barriers related to health behavior.

12. Health belief Model Constructs For a patient to change behavior, patient must: • Know that they are susceptible to or have a particular health condition • Believe that having the condition is serious and harmful • Perceive that the benefits of changing their behaviors outweighs the challenges • Feel that there are treatment options • Feels a ‘call to action’ to spark the change • Perceives that s/he can successfully preform the behavior

13. Health belief model: Six Constructs Patients’ perception that they are susceptible to or have a particular health condition. Perceived Susceptibility

14. Health belief model: Six Constructs Patients’ belief that having the condition is serious and harmful. Perceived Severity

15. Health belief model: Six Constructs Patients’ perception that actions will result in a benefit (a reduction in the threat of the illness or disease or the curing if the illness or disease). Perceived Benefit

16. Health belief model: Six Constructs Patients’ perception that the benefits of changing their behavior will outweigh the challenges and obstacles of making the change. Perceived Barriers

17. Health belief model: Six Constructs Patient feels a ‘call to action’ to spark the change process. Cue to Action

18. Health belief model: Six Constructs Perceives, or has the confidence, that s/he can successfully preform the behavior Self-Efficacy

19. Modifying Factors Impacting Likelihood for Change

20. What do you think? • What do you see as the strengthsof the health belief model? • What do you see as the limitations of the health belief model?

22. Models for Patient-Centered Behavior Change Readiness to Change and Motivational Interviewing Behavior Change, One Health Modules

23. Importance Ruler Somewhat Important Very Important Not Important Confidence Ruler Somewhat Confident Very Confident Not at all Confident Readiness to Change Ruler Somewhat Ready Very Ready Not Ready

24. What do you think… Given what you read about Motivational Interviewing: • How do you think asking about readiness or importance or confidence to change will help people change their behavior? • How do you think you might use this?

26. Key skills of Motivational Interviewing Asking Questions Listening Informing Empathizing

27. Motivational interviewing and rule require: • Using open-ended questions to explore patients feelings • Affirming comments and behaviors that show signs of increased interest in change • Exploring the benefits and drawbacks of making the change • Having the patient envision a future and ask what needs to happen to achieve that future

28. Two Models for Organization and Community Change: Kotter and Lewin Behavior Change, One Health Course

29. Kotter’s 8 essential steps for change • Establishing a Sense of Urgency • Creating a Guiding Coalition • Developing a Vision & Strategy • Communicating the Change Vision • Empowering Broad-Based Action • Generating Short-Term Wins • Consolidating Gains & Producing More Change • Anchoring New Approaches in the Culture

30. Lewin’s Three Step Model for Change

31. What do you think? • What they liked about each model. • What they need to study more about each model. • Are the models exclusive of each other? Complimentary?

32. Expanding Patient-Centered Behavior Change Models Beyond the Human Health Context Behavior Change, One Health Course

33. How would the health belief model work in your region, culture, or discipline? How would you modify Motivational Interviewing and RULE to work in your region, culture or discipline?

34. What do you think? • Are there any similarities in your models that we see cutting across regions/cultures or disciplines? • What are the differences across regions, cultures and disciplines that we need to be aware of and sensitive to when working as part of a One Health team? • How do you think understanding these similarities and differences in approach will help you in your work?

35. Build your toolkit • As a member of a One Health Team, what do you feel is your role in changing people’s behaviors?” • Create your model for behavior change in your discipline and as part of a One Health team.

36. Behavior Change in One Health Interventions Behavior Change, One Health Course

37. What do you think? Think of a situation that you have faced or might face that involves changing individual and/or community behaviors. What is your model for change? Directions: • Spend the next 30 minutes reflecting on your ideas from the previous session in which you created your own personal model for behavior change and the two models for community change – Kotter and Lewin. • Summarize your model of a flipchart. At the end of the hour, we will share our models.

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39. Learning Reflections and Evaluation Behavior Change, One Health Course

40. One thing.. • That you liked/felt was a strength of the module. • That you would suggest we change. Thank you.

41. This publication was made possible in part through the support provided by the United States Agency for International Development. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the US Agency for International Development or the US Government. USAID reserves a royalty-free nonexclusive and irrevocable right to reproduce, publish, or otherwise use, and to authorize others to use the work for Government purposes.