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HSC4211 Health, Behavior and Society
Theories and Concepts in Public Health
Part 2
o Individual (Intrapersonal) level theories
o Interpersonal level theory
o Community level theory
Lecture Outline
o Health Belief Model (HBM)
o Transtheoretical Model (TTM) – Stages of Change
o Theory of Planned Behavior (TPB)
Individual (Intrapersonal) level theories
o Health Belief Model (HBM)
- Developed in 1950’s by social psychologists
- Value-expectancy theory
- Main constructs
Individual (Intrapersonal) level theories
Construct Definition
Perceived susceptibility feeling about the chances of experiencing a risk
Perceived severity belief about how serious a condition is and what its
consequences are
Perceived benefits beliefs about benefits of the advised action
Perceived barriers beliefs about negative aspects of the advised action
cues to action Factors that activate “readiness to change”
self-efficacy confidence in one’s ability to take action
o Health Belief Model (HBM)
- Main concepts and its application (TSE)
Individual (Intrapersonal) level theories
Concept Measurement example Perceived susceptibility
My chances of getting testicular cancer are great if I fail to perform testicular self-examination Perceived severity The thought of testicular cancer scares me Perceived benefits I have a lot to gain by doing testicular self-examinations
Perceived barriers Testicular self-examinations can be painful cues to action Campaigns (e.g. posters, media -press, TV, radio etc) prompted me to do testicular self-examination. Symptoms (e.g. soreness, size/shape change) prompted me to do testicular self-examination self-efficacy If you are going to do testicular self-examination how easy is it for you to do it correctly?
Health Belief Model
Individual Perceptions Modifying Factors Likelihood of Action
Age, sex, ethnicity Personality Socioeconomics Knowledge
Perceived benefits minus perceived barriers to behavior change
Perceived severity/susceptibility of disease
Perceived threat of disease
Likelihood of behavior change
Cues to action:
- Education
- Symptoms, illness
- Media information
(Janz & Becker, 1984) 6
o Transtheoretical Model (TTM) – Stages of Change
- Generated based on an analysis of major theories
- Assess a person's readiness to change
- Identify the processes and principles of human behavior change
- Main constructs
- Stages of change
- Processes of change
- Decisional balance
- Self efficacy
Individual (Intrapersonal) level theories
o Transtheoretical Model (TTM) – Stages of Change
Main concepts
Individual (Intrapersonal) level theories
Stage Definition Precontemplation No intention to take action within the next 6 months Contemplation Intends to take a specific action within the next 6 months Preparation Intends to take the action within the next 30 days and has taken some behavioral steps in this direction Action stage Has changed overt behavior for less than 6 months Maintenance the person Changed overt behavior for less than 6 months Termination No temptation to relapse
o Transtheoretical Model (TTM) – Stages of Change
Example
Individual (Intrapersonal) level theories
Drinking and driving (Drunk driving) is defined as operating a motor vehicle while under the influence of alcohol. Have you ever engaged in drinking and driving according to this definition?
Stage Question example Precontemplation No intention to take action within the next 6 months Contemplation Intends to take a specific action within the next 6 months
Preparation Intends to take the action within the next 30 days and has taken some behavioral steps in this direction Action stage Has changed overt behavior for less than 6 months Maintenance the person Changed overt behavior for less than 6 months Termination No temptation to relapse 10 8/24/
Trans-theoretical Model
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Trans-theoretical Model
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Regular Exercise is any planned physical activity (e.g., brisk walking, aerobics, jogging, bicycling, swimming, rowing, etc.) performed to increase physical fitness. Such activity should be performed 3 to 5 times per week for 20-60 minutes per session. Exercise does not have to be painful to be effective but should be done at a level that increases your breathing rate and causes you to break a sweat.
Question:
Do you exercise regularly according to that definition?
Yes, I have been for MORE than 6 months. Yes, I have been for LESS than 6 months. No, but I intend to in the next 30 days. No, but I intend to in the next 6 months. No, and I do NOT intend to in the next 6 months.
o Social Cognitive Theory (SCT)
Interpersonal level theory
Concept Definition
Reciprocal determinism The dynamic interaction of the person, behavior, and the environment in which the behavior is performed. Behavioral capability Knowledge and skill to perform a given behavior Expectations Anticipated outcomes of a behavior
Self efficacy Beliefs about personal ability to perform behaviors that bring desired outcomes Observational learning (modeling)
Behavioral acquisition that occurs by watching the actions and outcomes of others’ behavior
Reinforcement Responses to a person’s behavior that increases or decreases the likelihood of reoccurrence
o Social Cognitive Theory (SCT)
Interpersonal level theory
Concept Application
Behavioral capability Teaching healthy cooking and exercise skills Expectations Healthy diet and exercise will benefit Self efficacy Create contracts to set incremental goals Observational learning Respected congregation members as roll models Reinforcement Incentives and relaxing time
Reciprocal determinism People bring healthier foods to church, reinforcing their healthy habits.
21 8/24/
•Situation •Behavioral Capability •Expectations •Expectancies •Self‐control •Observational learning •Self‐efficacy •Emotional coping responses •Family members •Friends •Peers •Physical environment •REWARDS
Social Cognitive Theory
22 8/24/
Social Cognitive Theory
HSC4211 Health, Behavior and Society
Community level theory
• Diffusion of Innovation
o Diffusion of Innovations – Key concepts
Community level Theory
25 8/24/
Diffusion of Innovation
Innovators Early
Adopters
Early
Majority
Late
Majority
Laggards
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Diffusion of Innovation: Target Group
Categories
o Innovators – venturesome; shortest time
between awareness and adoption; reached by
media
o Early adopters – opinion leaders
o Early majority – deliberators; reached by
interpersonal channel
o Late majority – skeptical; reached by
interpersonal channel and increased outreach
o Laggards – traditional; need more potent
outreach and incentives
Characteristics of Individual
Adopters
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o Characteristics of innovations
Community level Theory
o Theory is important in understanding health behaviors.
o You have now learned how to apply theory at the
individual, intrapersonal, and community levels.
Conclusion
“There is nothing so practical
as a good theory”.
-Kurt Lewin, 1951
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