What is theory? • “… a set of interrelated concepts, definitions, and propositions that presents a systematic view of events or situations by specifying relationships among variables in order to explain and predict the events or the situations.” • (Glanz, Rimer, and Lewis, p. 25)
Concepts & Constructs • Concepts: • Major ideas • Constructs: • Concepts that have been developed and defined for use in a particular theory
The Ecological Model • Emphasizes the links and relationships among multiple factors (or determinants) affecting health
Ecological Model Public Policy Community Institutional or Organizational Interpersonal Individual
Ecological Model NIH, Theory at a Glance
Behavior Change Theories • The specific route(s) you will take to reach your destination – they suggest a road to follow.
Behavior change theories with individual focus • The Health Belief Model (HBM) ** • The Transtheoretical Model (TTM) ** • Theory of Planned Behavior (TPB) ** • Other Theories: • Elaboration Likelihood Model of Persausion • Information – Motivation – Behavioral Skills Model • Health Action Process Approach
Health Belief Model (HBM) • Developed in the early 1950’s by social psychologists in the U.S. Public Health Service. • Hochbaum & Rosenstock • TB screening
Health Belief Model Modifying Factors: age, race, ethnicity, SES, personality Outcome Expectations: Perceived Benefits vs. Perceived Risks/Barriers Perceived Susceptibility & Perceived Seriousness Perceived Threat Likelihood of taking recommended action Cues to Action Self-efficacy
Health Belief Model Outcome Expectations: Perceived benefits: no HTN medication, delay or prevent heart disease/stroke, live longer, better quality life. Perceived barriers/risks: time, money, injury? 45 y/o Caucasian male, married, 2 children, works full-time, desk job, does not seek health information Strong family history of heart disease / strokes; feels it could “happen to him” and ultimately lead to serious disability/death Perceived Threat Likelihood of taking recommended action Doctor diagnosed him as hypertensive, started on medication Self-efficacy: moderate
Health Belief Model NIH, Theory at a Glance
Theory of Planned Behavior (TPB) • Developed by Fishbein & Ajzen • An extension of the Theory of Reasoned Action (TRA)
TPB Attitude toward the behavior Intention Behavior Subjective Norm Perceived Behavioral Control Actual Behavioral Control
TPB Healthy eating takes time, extra money and a lot of energy Friends / family do not exercise and junk food is always abundant Intention Eating healthier/exercise Nearby grocery stores often have good sales, lives near farmer’s market. Lives near park and walking trails “Not much I can do”
Theory of Planned Behavior NIH, Theory at a Glance
Transtheoretical Model (TTM) • AKA: Stages of Change • Developed by Prochaska & DiClemente • Major Constructs: • Precontemplation • Contemplation • Preparation • Action • Maintenance • Decisional Balance • Self-Efficacy
Transtheoretical Model (TTM) Precontemplation Decisional Balance Contemplation Self-Efficacy Between every stage, the client needs to have decisional balance and self-efficacy Preparation Decisional Balance Action Self-Efficacy Maintenance
Stages of Change (TTM) NIH, Theory at a Glance Groups with this theory: don’t forget a relapse plan!
Behavior change theories with interpersonal focus • Social Cognitive Theory (SCT) ** • Social Network Theory (SNT) • Social Capital Theory
Social Cognitive Theory (SCT) • A behavior change theory with an Interpersonal / Social network focus.
Reciprocal Determinism Characteristics of the Person Environment in which the behavior is performed Behaviorof the person
Social Cognitive Theory NIH, Theory at a Glance
Summary of Theories NIH, Theory at a Glance
Summary of Theories continued NIH, Theory at a Glance
Writing Objectives • Objectives start with the word “to” followed by an action verb. • Specify a single, key action to be accomplished • The What / how much • Specifies a target date • The When • Avoids the How and Why • Realistic and attainable
Objectives • S: specific • M: measurable • A: attainable • R: realistic • T: timely
Examples of objectives • To decrease soda intake by one soda a week and be soda free by June 1st, 2017. • To increase running distance 1 mile every week in order to run a marathon on August 31, 2017. • To cook a new vegetable recipe once a week through June 30, 2017. • To decrease texting-related car accidents among 16-25 y/o 20% by December 31st, 2020. • To increase meningitis vaccines in in-coming freshmen to 80% by September 30th, 2021.