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6. Health-behavior change techniques

6. Health-behavior change techniques. Łukasz Kaczmarek, IP UAM, 2010-2011. Provide information about behavior-health link General information that a behviour may be linked to poor health outcomes. Provide information on consequences

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6. Health-behavior change techniques

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  1. 6. Health-behaviorchangetechniques Łukasz Kaczmarek, IP UAM, 2010-2011

  2. Provideinformationaboutbehavior-health link General information that a behviourmay be linked to poor health outcomes. Provideinformation on consequences Information about the benefits and costs of action or inaction, focusing on what will happen if the persondoes or does not perform the behavior

  3. STOP SMOKING: Medical advice - methods • Types of intervention: • Minimal advice with 20 minut consultation+ optional leaflet) < 20 minut • Complete + 1 follow up visit • Intensive Advice with longer consultation + leaflet + further resources (demonstrations, self-help manuals) + follow up

  4. STOP SMOKING: Medical advice - effects Odds ratio: Minimal intervention vs no advice: 1.69 : 1 Among people at risk: 1.82 Among people without risk: 1.20

  5. STOP SMOKING: Intervention by nurses Verbal instruction to stop smoking (regardless of giving information about risk) Low intensity: advice + leaflet High intensity: contact > 10 minutes + further materials (manuals) + follow ups. Effective smoking cessation 1.43 Most effective for patients with CHD 2.14 No effect for patients with other somatic ilness

  6. Provideinformationaboutothers’ approval Information about what others think about the person’s behavior and whether others will approve ordisapprove of any proposed behavior change Promptintentionformation Encouraging the person to decide to act or set a general goal, for example, to make a behavioral resolutionsuch as “I will take more exercise next week‘

  7. Promptbarrieridentification Identify barriers to performing the behavior and plan ways of overcoming them Michie, S., Abraham, Ch. (2008)

  8. A brief discussion • Pickup a behaviouryouwouldlike to change. • Whatwould be thebadsides (costs) and goodsides (benefits) of thechange? • Costs: ……………………………………………………………………………………… • benefits: .…………………………………………………………………………………… • Whatmight be thebarriersinmaking YOUR change? • A. _____________b. __________c. _______________ • PLAN HOW YOU MIGHT OVERCOME THE BARRIERS: • A.………………………………………………………… • B.………………………………………………………… • C.…………………………………………………………

  9. Provide general encouragement Praising or rewarding the person for effort or performance (not theresults) Set gradedtasks Set easy tasks, and increase difficulty until target behavior is performed

  10. „Flow„ (optimal challange) and starting new behaviours

  11. „Flow„ (optimal challange) and starting new behaviours

  12. Provideinstruction Telling the person how to perform a behavior and/or preparatory behaviors Model or demonstrate the behavior An expert shows the person how to correctly perform a behavior, for example, in class or on video Marzipan penguin www.marthastewart.com […] Break off a piece of blue marzipan, and roll into a 1/2-inch ball for the head; pinch to form a beak. Use black marzipan to make eyes; attach to head. Shape white marzipan ball into a body (about 1 by 1 1/4 inches). Use orange marzipan to make 1/2-inch-long feet. Roll out remaining blue marzipan to 1/4 inch thick. Cut out shape for wings (pictured below) […]

  13. Consequently and corectlyusingcondoms Buy condoms Carry condomsorhavecondomseasilyavailable Negotiatetheuse of a condomwith a partner Locatecondomdisplaysindrugstore Chosecondomsthatareproducttested Carry condomsinwalletorpurse for no longerthan a month Carry orstorecondomsin place far from hot places State sharedgoalssuch as pregnancyor AIDS prevention State clearlythatusing a condomisnecessary for you Listenpartner’sconcerns Proposesolutions to partners worriesthatreference mutual goals and personalexpectations Correctlyusecondoms Maintainuseover time Usewater-solubelubricants Use a newcondom for eachintercourse Followsinstructions on packeage for use Followsinstructions on packeage for disposal

  14. Provideconditionalrewards Praise, encouragement, or material rewards that are explicitly linked to the achievement of specifiedbehaviors Teach to use prompts or cues Teach the person to identify environmental cues that can be used to remind them to perform a behavior,including times of day or elements of contexts.

  15. Agree on contract Agreement (e.g., signing) of a contract specifying behavior to be performed so that there is a writtenrecord of the person’s resolution witnessed by another Promptself-talk Encourage use of self-instruction and self-encouragement (aloud or silently) to support action

  16. Controll y – output (presentbehaviour) r – target (zachowanie prozdrowotne) e – difference– between Y and r(presentbehaviourvs target behaviour) C – regulator (regulatory cognitiveprocesses) u – input(% healthyfood, time spent jogging) P – subject(person)

  17. ? Promptspecificgoalsetting Detailed planning of what the person will do, including a definition of the behavior specifyingfrequency, intensity, or duration and specification of at least one context, that is, where, when, how, orwithwhom Prompt review of behavioral goals Review and/or reconsideration of previously set goals or intentions Promptself-monitoring of behavior The person is asked to keep a record of specified behavior(s) (e.g., in a diary) Providefeedbackon performance Providing data about recorded behavior or evaluating performance in relation to a set standard or others’performance, i.e., the person received feedback on their behavior.

  18. Plan socialsupportorsocialchange Prompting consideration of how others could change their behavior to offer the person help Promptidentificationas a role model Indicating how the person may be an example to others and influence their behavior or provide anopportunity for the person to set a good example

  19. STOP SMOKING: self-help Individualattemptswithoutthe help of health careexperts: Written materials, Audio & video recordings, Telephonehotlines, Computer programs. No effect on abstinence.

  20. R. Schwarzer, 2006

  21. R. Schwarzer, 2006

  22. Provideopportunitiesfor socialcomparison. Facilitate observation of nonexpert others’ performance for example, in a group class or using video orcasestudy

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