Health Behavior Models - Research Paper Example

Health Promotion al Affiliation) Health behavior refers to behaviors that influence the physical outcomes of health, by either decreasing or increasing their severity or risk. There are numerous models or theories to explain, predict, and modify health behaviors. These models include: Health belief model, Trans-theoretical model, social cognitive theory, Theory of planned behavior, Theory of reasoned action, Ecological approaches, Organizational change theory, Community organization model, and finally Diffusion of innovations theory (Alcalay & Bell 2000). The analysis of the theories determines why individuals begin and eventually stop behavior certain behavior. Moreover, the consideration of the change programs and the various initiatives implemented to reduce these factors in a health promotion program. Health belief model The health belief model (HBM) was developed in the 1950s by some social psychologists to explain why some individuals do not use health services such as screening and immunization. The theory has advanced to address newer concerns in detection and prevention (for instance influenza vaccines and mammography screening) as well as lifestyle mannerisms such as injury prevention and risk behaviors associated with sexual tendencies (Noar, Chabot & Zimmerman, 2008). The HBM hypothesizes that individuals beliefs on whether or not they are at risk for a health problem or disease, and their acumens on the benefits of taking action to avoid the risk, influences their willingness to take action. For instance, if an individual feels that their lifestyle may lead to diseases such as obesity, or diabetes, they may take the necessary actions such as eating healthier foods or becoming physically active to prevent those risks from occurring. The key concepts of the theory are: perceived severity and susceptibility, perceived benefits obtained from the action, perceived barriers to the action, cues to action and self-efficacy. HBM is often applied to asymptomatic and prevention-related health concerns such as the early detection of cancer and hypertension screening where opinions are as important as or more important than obvious symptoms. It is also relevant to interventions to lessen risk factors for cardiovascular disease. According to the theory therefore, people indulge in health programs only if the perceived risks and problems are severe. They then stop the health programs once the risks have reduced. Trans-theoretical model The Trans-theoretical model (TTM) was developed from studies of the processes of change in psychotherapy and smoking cessation (De Vries & Mudde2008). The model has however been applied to a wide range of other health behaviors including exercise, condom use, healthy eating, and sunscreen use. Multiple actions and adaptations over time are required to obtain changes in health behavior that are long-term. The TTM model outlines five processes that individuals undertake when adopting healthy behaviors or eliminating unhealthy tendencies: Pre-contemplation - where they do not recognize the need for or are not interested to change. Contemplation is the stage where they start thinking about changing. The next step is preparation, where an individual starts planning for change. Followed by the third step, this is taking actions when they adopt new habits. Finally, maintenance; where the individuals stick to the adopted habits and practice healthy behavior. The processes are not sequential since the individual may relapse then go back to the previous process (Prochaska, & Velicer, 2007). People start these processes because they want to change an aspect of their lives. They may be doing activities that are harmful to their health like excessive alcohol consumption. They therefore decide to change these tendencies to avoid the health implications that may result from their bad tendencies. They may stop the five processes if they are not strong enough to resist temptation, if they do not have people supporting them and cheering them on and if the people they hang out with partake in the activities that they are trying to stop. Social Cognitive Theory The Social cognitive theory (SCT) describes human behavior in terms of a reciprocal, dynamic, three-way model where behavior, environmental influences, and personal factors continually interact (Bandura, 2006). The model can be voluntarily applied to psychotherapy interventions for disease management and prevention. A basic principle of SCT is that individuals learn through their own personal experiences and by also observing other people’s actions and the results from those actions. It therefore comprises of learning from observation, reinforcing what one has learnt, self-control to prevent one from committing the same mistakes and self-efficacy on their ability to undertake actions and persist in those actions despite the challenges they may face along the way. Individuals can then modify their behavior from those aspects by setting goals, monitoring themselves and behavioral contracting. People therefore start behavior change programs after observing the behaviors of other people and the implications of that behavior. They do so in order to prevent those implications from happening to them or to obtain the benefits that other individuals in the health program have obtained. The same people may stop participating in these programs if they witness other individuals in the health program not benefitting from those programs. The programs may then look like a waste of time that may prompt them to leave. Theory of reasoned action The theory of reasoned action (TRA) was developed from social–psychological study on attitudes and attitude–behavior relationship. The model assumes that most behaviors of social relevance including health behaviors are under volitional control, and that an individual’s intention to do a behavior is both the immediate determinant and the single best predictor of that behavior. Intention in turn is held to be a function of two basic determinants: their attitude towards the specific behavior (their overall assessment of executing the behavior) and the subjective norm (the alleged expectations of others with regard to the person doing the behavior in question). Generally, people will have strong intentions to perform a given action if they assess it positively and if they trust that other people think they should perform it. People therefore indulge in health programs because they know that the programs are good for them. They also join these programs if other people who they view as important expect them to join the programs. For instance, a patient may join a health program if the doctor expects them to join the program. They stop attending the programs once they feel that they are not good for them and that no benefits will come from the health programs. They can also stop attending them if the people who expected them to join stop supporting the idea that health programs are beneficial. Theory of planned behavior (TPB) The theory of planned behavior (Ajzen, 2001) was an attempt to extend the TRA to include behaviors that are not entirely under volitional control, for example giving up smoking or using a condom. To accommodate similar behaviors, Ajzen added perceived control of behavior to the TRA, which refers to the supposed ease or struggle of performing the behavior, and is presumed to show past experience in addition to anticipated obstacles. According to him, the perceived control of behavior is a function of control norms in just the same way as subjective beliefs is a normative beliefs function. It is assumed to have a direct influence on intention. For behaviors that are desirable, perceived control of greater behavior should lead to sturdier intentions. Perceived control of behavior may have a direct prognostic effect on mannerisms through two diverse mechanisms. First, by holding the intention constant, an individual with higher perceived behavioral control is likely to try harder and to persevere for longer as compared to an individual who has a lower perceived control. Second, people may have accurate perceptions of the amount of actual control they have over the behavior. People therefore join health programs to achieve certain goals then leave them once they have achieved those goals. Social Ecological Approaches Social ecological theory helps to comprehend issues affecting behavior and offers guidance for developing fruitful programs through social surroundings. Social ecological theory emphasizes numerous influence levels, which include individual influence from the individual’s attitude, knowledge, and skills. In addition to the interpersonal influence from the social network, organizational influence from the environment and ethos, community influence from norms and cultural values and finally, public policy influence from the various laws and regulations, and the notion that behaviors mold and are molded by the social setting. The principles of social ecological models are consistent with social cognitive theory concepts that suggest that creating an environment conducive to change is important to making it easier to adopt healthy behaviors. These levels therefore influence people to start health programs (McLeroy, Bibeau, Steckler, & Glanz, 2002). Individuals’ thoughts and knowledge on health programs may encourage them to join them. Their social support, the organization, and community they belong to, may also influence them. The same happens when individuals leave these programs. They are influenced by these factors to leave the program. Community, Organizational Change and Diffusion of innovation theory Public health workers identify social and health problems, and they plan and implement strategies to address these problems. The strategies can be in form of starting health programs and coming up with ways to promote and attract the program to potential members. The active participation of the community is required in the community model. Certain strategies and processes might increase the chances of adoption of the healthy policies and programs in formal organizations. It therefore becomes fundamental for every organizational member to participate in those programs and policies. Finally, the diffusion of invention theory states that people, organizations, or societies adopt new products, ideas, or behaviors at different rates, and the rate of adoption is affected by some predictable factors. It therefore affects the rate at which people join health programs, adapt to them, and then decide to leave or stay depending on the value obtained from the programs. Initiatives Some initiatives that can be used to reduce the above named factors include: the program educating members about the importance of physical exercise and other preventive measures. The teachings can be useful in that they will discourage people from leaving health programs once the risks they were facing are over. The teachings will also educate them on the importance of practicing a healthy lifestyle even after the risks or health problems are over. Participants who joined the program due to the perceived severity and susceptibility of the risks will therefore continue attending the program even after the getting rid of the perceived risk. Persons beginning regular physical activity programs can be aided by interventions that assist them anticipate hurdles or factors that can contribute to relapse. They can be in the form of Skills training, Lifestyle rebalancing and Cognitive reframing. The program can come up with supporting groups that assist individuals going through the five stages of the TTM model. The support groups will contain members diligent to change who are also partaking the steps and mentors who succeeded in the process who will encourage them and provide them with ideas that can help in making the process easier. These people will also be advised on ways to resist temptation and to avoid company that will make them relapse (Glanz & Rimer, 2005). The program can come up with ways to create awareness to members of the programs and nonmembers interested in joining the health program. Persuasive ways that are easily seen and memorable can be used to attract people to the program. They can be in form catchy phrases, advertisements, banners, and use of the social media. The use of role models and reinforcements can be vital in promoting members to stay in the health program. Teachers and instructors should therefore be people that the members admire who will encourage them to stay in the program. People learn from others so the program should contain mentors who will act as real life examples of people who used the program and succeeded. Reinforcements such as a board that acknowledges members who have succeeded in attaining their targets or awards to the most improved members can be used to motivate members. Management should however exercise caution when providing these reinforcements since the reinforcements may overshadow the main objective that brought members to the program. The participants should therefore receive reinforcements moderately and periodically. One other way to promote people to join and stay in health programs is to make them believe that the program is good and beneficial to them. They will join the programs once they believe that the programs are good for them. Managers of the program should also ensure that the members always remember their reasons for joining the program. They can ensure this by issuing a vision notebook to all their members where each will write their objectives and reasons for joining the program. They should then read those notebooks daily - an act that will remind them daily their reasons for joining the program. It will therefore be hard to forget the reasons why they joined the programs and will reduce the number of members who leave the program after other people have influenced them to leave. The health program managers should give the people who have achieved the goals they wanted to achieve from the health program more reasons to stay. They can give them other important goals that are not related to the previous reasons. For instance if an individual who joined a program to stop smoking achieves that goal, they can introduce that individual to another program like a weight program to work on their weight. The program will have retained that individual even after achieving the initial goals (Gollwitzer, 2003). In conclusion, social support can also be instrumental when encouraging people to join and stay in health programs. Support from family and friends can encourage individuals to join programs due to certain health reasons like obesity. The support system will provide solace and endurance to continue with program even as it becomes increasingly challenging. Management can incorporate family days in the program whereby families and friends of members come together and interact through games, and other outdoor activities. These family days can provide seminar forums where attendees will be educated on the benefits of the program and the various ways they can support their family members as they undergo the program. Such meetings will enable them understand what the members are going through and the family members can therefore provide emotional, informational, instrumental and appraisal support to their loved ones in the health programs. References Ajzen, I., (2001). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, pp. 179–211. Alcalay, R., & Bell, R. (2000). Promoting Nutrition and Physical Activity Through Social Marketing: Current Practices and Recommendations. Davis, CA: Center for Advanced Studies in Nutrition and Social Marketing. University of California, Davis. Bandura, A., (2006). Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall. De Vries, H., and Mudde, A. N., (2008). Predicting stage transitions for smoking cessation applying the attitude–social influence–efficacy model. Psychology and Health, 13, pp. 369– 385. Glanz K., Rimer B. K., (2005). Theory at a Glance: A Guide to Health Promotion Practice. Bethesda MD: National Cancer Institute. 2nd edition 2005. NIH Publ. 05-3896. Gollwitzer, P. M., (2003). Goal achievement: the role of intentions. European Review of Social Psychology, 4, pp. 141–185. McLeroy K. R., Bibeau D., Steckler A., Glanz K., (2002). An ecological perspective on health promotion programs. Health Educ. Q. 15:351-77 Noar S. M., Chabot M., Zimmerman R. S., (2008). Applying health behavior theory to multiple behavior change: considerations and approaches. Prev. Med. 46:275-80 Prochaska, J. O., & Velicer, W. F., (2007). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, pp. 38–48. Read More