Models Of Behaviour Change

Submitted to: Submitted by:

Mr. Ashutosh Priya Chaudhary
Tutor M.Sc. Nursing 1st year
Collage of Nursing SGPGIMS, Collage of Nursing SGPGIMS,
Lucknow. Lucknow.
 Topics To Be Discussed

 Introduction
 The Key Elements of Behaviour Change
 Types of Behaviour Change Model and Theories
 Social Cognitive Theory
 Theory of Planned Behaviour
 Transtheoretical ( Stage of Change) Model
 Health Belief Model
 The Cognitive Dissonance Model
 Maslow's Hierarchy of Needs Model
 Theory of Reasoned Action
 Summary
 Conclusion
 References
 Introduction

Behavior change is often a goal for staff working directly

with constituents, organizations, governments, or communities.
Individuals charged with this task can be thought of as
"interventionists" whose goal it is to design and implement
programs or interventions that produce the desired behavioral
changes (Glanz, Lewis, & Rimers, 1990, p. 17). As Glanz, Lewis,
and Rimmers' suggest, designing interventions to yield behavior is
best done with an understanding of behavior change theories,
models an ability to use them in practice (1990, p. 19).
The goal of this Gravitas, therefore, is to introduce three
major theories and models of behavior change, describe the key
variables of behavior change models, and to explore the link
between behavior change and attitude.
 The Key Elements of Behaviour Change

Key Element Definition Strategies for Behavior

change

Threat A danger or a harmful event of Raise awareness that the threat

which people may or may not be exists, focusing on severity and
aware. susceptibility.

Fear Emotional arousal caused by Fear can powerfully influence

perceiving a significant and behavior and, if it is channeled
personally relevant threat. in the appropri- ate way, can
motivate people to seek
information, but it can also
cause people to deny they are
at-risk.

Response Efficiency Perception that a recommended re- Provide evidence of examples

sponse will prevent the threat from that the recommended response
happening. will avert the threat.

Self-Efficiency An individual's perception of or Raise individuals' confidence

confidence in their ability to perform that they can perform response
a recommended response. and help ensure they can avert
 the threat.

Barriers Something that would prevent an Be aware of physical or

individuals from carrying out a cultural barri- ers that might
recom- mended response. exist, attempt to re- move
barriers.

Benifits Positive consequences of performing Communicate the benefits of

recommended response. perform- ing the recommended
response.

Subjective Norms What an individual thinks other Understand with whom

people think they should do. individuals are likely to
comply.

Attitudes An individual's evaluation or beliefs Measure existing attitudes

about a recommended response. before at- tempting to change
them.

Intentions An individual's plans to carry out Determine if intentions are

the recommended response. genuine or proxies for actual
behavior.

Cues to Action External or internal factors that help Provide communication that
individuals make decisions about a might trig- ger individuals to
response. make decisions.

Reactance When an individual reacts against a Ensure individuals do not feel

recommended response they have been manipulated or
are unable to avert the threat.
Types of Behaviour Change Model and Theories

 Social Cognitive Theory

 Theory of Planned Behaviour

 Transtheoretical ( Stage of Change) Model

 Health Belief Model

 The Cognitive Dissonance Model

 Maslow's Hierarchy of Needs Model

 Theory of Reasoned Action

 Behaviour

Personal factors Environmental

Social Cognitive Theory

• This model (Bandura's Social Cognitive Theory) suggests that human functioning can be
explained by a triadic interaction of behavior, personal and environmental factors .

•This is often known as reciprocal determinism. Environmental factors represent situational

influences and environment in which behavior is preformed while personal factors drives,
traits, and other individual motivational forces.

These variables may also intervene in the process of behavior change.

•Self-efficacy - A judgment of one's ability to perform the behavior.

• Outcome Expectations- A judgment of the likely consequences a behavior will produce.
The importance of these expectations (i.e., expectancies) may also drive behavior.

• Self-Control- The ability of an individual to control their behaviors.

•Reinforcements- Something that increases or decreases the likelihood a behavior will

continue.

• Emotional Coping - The ability of an individual to cope with emotional stimuli.

• Observational Learning - The acquisition of behaviors by observing actions and outcomes

of others' behavior.

Attitude towards the Theory of Planned Behavior

behaviour

• The theory of planned behavior suggests that behavior is dependent on one's intention to
perform the behavior.

• Intention is determined by an individual's attitude (beliefs and values about the outcome of
Subjective norm Intention Behaviour
the behavior) and subjective norms (beliefs about what other people think the person should
do or general social pressure).

•Behavior is also determined by an individual's perceived behavioral control, defined as an

individual's perceptions of their ability or feelings of self-efficacy to perform behavior.

• This relationship is typically dependent on the type of relationship and the nature of
Perceived
situation.
Behavioral control
 Transtheoretical ( Stage of Change) Model
•The transtheoretical model proposes change as a process of six stages.

• Precontemplation is the stage in which people are not intending to make a

change in future.

• People in Contemplation stage are aware of the pros of changing but also can
identify the cons.

• Preparation represents the stage where people have a plan of action and intend
to take action in the immediate future (within a month).

• Action is the stage in which people make the behavior change .

• Maintenance represents the stage where people work to prevent relapse.

• Finally, termination represents that stage where individuals have 100 percent
efficacy and will maintain their behavior. This stage is the most difficult to
maintain, so many people remain a lifetime in maintenance.
Precontemplation
 Contemplation

Preparation

Stage of change fig

Action

Health Belief Model

Maintenance

• Health belief model is helpful in predicting the health behaviour of individuals.

• It is a psychological model that attempts to explain and predict health behaviours.

Termination

• It focuses on attitude and beliefs of individuals.

• It was developed in the 1950s by a group of social psychologists, Hochbaum, Rosenstock

and Kegels, working for US Public Health Service with a view to improve the public use of
preventive services.

• This model was developed in response to the failure of the free Tuberculosis Health
Screening Programme.

The principal components of the health belief model are as follows :

1. Individual perception:
Individual perception includes the following aspects:
•Perceived susceptibility: Belief that disease state is present or likely to occur. Family
history may make the individual feel at high risk.
•Perceived seriousness: Perception that the state or condition of disease is harmful
and has serious consequence. For example, HIV/AIDS.
• Perceived threat: Perceived susceptibility and perceived seriousness combined to
determine perceived threat.
 2. Modifying factors:
Modifying factors in the health Belief model includes the following variables:
•Demographic variable: Include age, sex, race and ethnicity, for example, an infant
does not perceive the importance of diet; an adolescent may perceive peer approval as
more important than family approval.
•Sociopsychological variables: Social pressure or influence from peers or other
reference groups may encourage preventive health behaviours even when individual
motivation is low.
•Structural variables: Knowledge about the target disease and prior contact with it are
presumed to influence the preventive behaviour.
•Cues to action: Cues can be external or internal. Internal cues include feelings of
fatigue, uncomfortable symptoms or thoughts.

3. Likelihood of action:

The health Belief model includes the following likelihood of action:

•Perceived benefit: Belief that health action is of some value. For example, refraining
from smoking to prevent lung cancer and eating nutritious foods and avoiding snacks
to maintain weight.

•Perceived barrier: Belief that health action would be associated with hindrance. It
includes cost, inconvenience, unpleasantness and lifestyle changes.

The Cognitive Dissonance Model

• Since dissonance is psychologically uncomfortable, it will motivate an individual to reduce
dissonance to achieve consonance. In addition, the individual will actively avoid situations
tions and information that are likely to
increase the dissonance.
 • The consequences of this are vital for anyone involved in the process of influence.For
example, if a respected role model with whom an individual identifies makes a statement or
declaration with which the individual disagrees, consonance is achieved by either:
(a) Changing the belief,
(b) Changing attitudes of the respected person.

CHANGE ACTION

BELIEF Smoking
cigarettes is
Smoking unhealthy
cigarettes is
unhealthy

I don’t smoke
cigarettes
COGNITIVE anymore
DISSONANCE

CHANGE BELIEF
Unpleasant
Tension, state,
Awareness that belief and The Research on
action are inconsistent smoking is not
conclusive

I smoke s
cigarettes m

I continue to

Maslow's Hierarchy of Needs Model

• Hierarchy of human needs Explains why not everybody responds to the

obviously beneficial and well-meaning Interventions.
• Health needs may be compromised for the sake of satisfaction of low-order needs.Basic
physiological needs Hunger, thirst and related needs.
•Safety needs - To feel secure and safe, out of danger.
•Belongingness and love needs - To affiliate with others, be accepted and being.
• Esteem needs - To achieve, be competent, and gain approval and recognition.
• Self-actualization needs - To find self-fulfilment and realise one's own potential.

Theory of Reasoned Action

• Proposes that voluntary behaviour is predicted by one's intention to perform the behaviour
(e.g. how likely is it that you will take up a quit smoking programme?)
• Attitude towards the impending behaviour (do you feel good or bad about quitting?), and
Subjective norms (do most people who are important to you think you should quit?) •
Attitude is a function of beliefs about the consequences of the behaviour (how important do
you think it is to quit?) weighted by an evaluation of the importance of that outcome (how
important is it to you to quit?)
• Subjective norms are a function of expectations of significant others (does your spouse
think you should quit?) weighted by the motivation to conform (how important is it to do
what your spouse wants?)

Summary
 • All model and Theories of behaviour changing used to describe how people can achieve a
desirable behavior or modify a problem behavior.

•In attempting to change a specific behavior in different situations and environment, these
theories can help in appropriate way and multiple stages.

• Behaviour change models also depends on the variables that are essential to the model. The
variables very common to many behaviour change models.

Conclusion

Behavior change may not always be your goal. It may become a priority to change attitude or
public opinon about some issue. You might also wish to change attitude before behaviors.
Whatever your goal, it is important to understand how individuals adopt attitudes. Existing
research is also helpful in defining the process of attitude change.

References

 https://assets.publishing.service.gov.uk/media/57a08b4bed915d622c000bfd/
BehaviorChangeweb.pdf
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481341/

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9423961/

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545554/

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9398823/

 K.Sharma Suresh l Sharma Reena, communication and Educational
Technology ,Elsevier publishes , 2nd ed,p.400,402,403.
 Basheer P. Shebeer, Khan Yaseen S., Textbook of advance Nursing
Practice ,Emmess Publisher, 3rd edn 2022, Page No. 547,548.