HBHE600 Final Review Session 1

8/14/2019 HBHE600 Final Review Session 1

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HBHE 600: PsychosocialFactors in Health-Related Behavior

Dr. Vic Strecher

Kate Hsieh

Sarah Lillie

Final Review Session


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Sample Question for concept,

construct, variable

When a concept is adopted into a modelor theory, it becomes a

_________________, which in the

operational form (i.e. you can measure it)becomes a __________________.

A. variable, construct

B. construct, variableC. question, belief

D. belief, question


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Sample Question for HBM

Which of the following is NOT true for Health

Belief Model?

A.It is a disease-focused model.

B.It has been shown in much research tosuccessfully predict changes.

C. It is also good to predict lifestyle changes

without an addition of the self-efficacy construct.D. It best predicts screening behaviors such as

tuberculosis screening. Demographics, Socialsupport, Personality Traits

Susceptibility and Severity of

DiseasePerceived threat

of disease

Likelihood of behavior change

Cues to action

Perceived benefits

Perceived barriers

minus


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Sample Question for TPB

A doctor is conducting an elicitation interviewwith his patient who is ready to quit smoking.The doctor asks, Who are the people or groupsyou would listen to who are either in favor oropposed to your tobacco use? What TPBconstruct is the doctor trying to assess?

A. Behavioral beliefs.

B. Evaluation of behavioral outcomes.C. Normative beliefs.

D. Motivation to comply.

Behavi


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Sample Question for SCT

Kate believes that getting a mammogram

will lead to early detection of breast

cancer. This is an example of:

A. efficacy expectations.

B. perceived severity.C. outcome expectations.

D. perceived susceptibility.

Person Behavior Outcome

Efficacy

expectations

Outcome

expectations


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Sample Question for TTM

Which of the following are TRUE for theTranstheoretical Model (TTM)?

A. TTM conceptualizes behavior change as a single

event.B. TTM suggests that move people to action stage

is the single most effective outcome.

C. TTM suggests a one size fits all approach for

individuals in different stages.D. A person can get stuck in a stage in TTM for

years.

Precontemplation

Contemplation

Preparation

Action

Maintenance

Pro/cons

TemptationsPro/cons

Temptations

TemptationsPro/cons


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MOTIVATIONAL INTERVIEWING

client-centered, directive method for enhancing

intrinsic motivation to change by exploring and

resolving ambivalence

Rollnick and Miller, 2001


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an egalitarian, empathetic, and client-

centered way of being that manifests

through specific techniques and strategies,e.g. reflective listening, shared agenda

setting

Resnicow et al, 2002

MOTIVATIONAL INTERVIEWING


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Sample Question

Which of the following is NOT a principle

of Motivational Interviewing (MI)?

A. Determining the treatment plan for clients

B. Client-centered

C. enhancing intrinsic motivation to change

D. exploring and resolving ambivalenceE. reflective listening

E t C


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E c t ng C angeTalk

Stage 1: Diagnosis Strategy 1: Willing and Able

Willingness

On a scale of 0 to 10, with 10 being very willing, how willing (interested/motivated)are you to ...... (quit smoking, eat more F & V, exercise more, take your meds)?

0 12 34 56 78 910Not at all Somewhat Very

Confidence

On a scale of 0 to 10, with 10 being very confident, assuming you decided to .......(quit smoking, begin exercising) how confident are you that you could succeed ?

0 12 34 56 78 910Not at all Somewhat Very


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Reflective Listening

Statement, not a question

Ends with a down turn

Hypothesis testing(If I understand you correctly, it sounds like..)

Affirms and validates

Keeps the client thinking and talking


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Sample Questions

You are working with a patient who said he

was a 7 on the scale of 1 to 10 for

willingness to exercise 3 times a week.

What would you ask using the scale to assess his

barriers?

What would you ask to assess his perceived benefit?


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Observing/monitoring

Task analysis

Reinforcement

Shaping

Modeling

Contracting

Action planning

Behavior modification


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Reinforcement: Types

All reinforcement results in increases in

behavior frequency or likelihood

Positive reinforcement applying something

positive following a behavior

Negative reinforcement removing something

aversive following a behavior


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Reinforcement: Schedules and Size

Continuous vs. intermittent

Continuous: Behavior is reinforced each time it occurs

Intermittent: Behavior is reinforced on some occasions

but not others

Variable vs. fixed schedule

Immediate vs. delayed

Large vs. small


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Unconditioned reinforcer: function as reinforcers thefirst time they are presented to most human beings

Conditioned reinforcer: a stimulus that was once

neutral but became established as a reinforcer by

being paired with an unconditioned reinforcer or an

already established conditioned reinforcer

Reinforcement: types

Miltenberger R. Behavior Modification: Principles and Procedures (3rd Edition).

Thomson, Belmont, CA. 2004.


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Putting it all together

Something isgiven

Something istaken away

Behaviorincreases

Positivereinforcement

(give good)

Negativereinforcement

(take away bad)


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Modeling: The art form of imitation

Conditions that enhance effectiveness of

modeling

Similarity of model to subject

Higher status model

Multiple models

Coping vs. mastery models


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RECAP

When a behavior increases because I took

something bad away, its called a ___?

When I give someone something good toincrease a behavior, its a ____?

Should a reinforcement be: Continuous or intermittent?

Immediate or delayed?

Large or small?

Consistent or irregular?


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Sample Question Jean gets into her car and does not put her seatbelt

on. When she starts her car, she hears a loudbeeping noise. This loud beeping noise is:

A. to decrease her barriers to putting on her seatbelt.

B. to change her perceived severity about getting into a caraccident.

C. a cue to action.D. annoying.

E. I cannot tell from the information provided.

After Jean puts on her seatbelt, the loud beepingnoise stops. This is a ___________ for Jean tobuckle up her seatbelt.

A. Positive reinforcement

B. Negative reinforcement


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Sample Question

Sue is trying to quit smoking. Sue was told by herdoctor to keep a daily log of her smoking behaviorincluding what time of day Sue smokes and how Suefeels after smoking. What behavior best describes

what Sues doctor is encouraging her to do?

A. self-regulation

B. behavior contracting

C.action planningD.self-monitoring

E. reinforcing


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Relationship between goal difficulty and goal commitment

Low

Behaviorch

ange

Medium High

Goal difficulty

High goal

commitment

Medium goalcommitment

Low goal

commitment


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Causal attributions

Internal/ external

Stable/ unstable

Uncontrollable/ controllable


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Definition of Relationships among

Variables

Antecedent-background factors that precede

expected relationships.

Mediating-variables that come between predictorand outcome variables.

Moderating-relationship between the predictor and

outcome is influenced by different levels ofanother variable.


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Dependent

Variable

Predictor

Variable

Dependent

Variable

Predictor

Variable

Types of Relationships between Variables

Dependent

Variable

Predictor

Variable


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Elaboration Likelihood Model (ELM)

Message

central route

peripheral route

Cognitive elaboration

Little/no elaboration


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Central processing:

Quality of arguments crucial

Motivationcan depend upon e.g.;

personal relevance

need for cognition

Abilitycan depend upon e.g.;

prior knowledge, message comprehensibility

amount of distraction, repetition

Attitude change following central processing is likelyto be more enduring, resistant to further change

and more likely to be correlated with behaviour


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Peripheral processing:

Involves inferring likely correctness / usefulness of the messagefrom non-issue characteristics or cues

Cues include:

attractive and expert sources

number of messages

inability to process centrally

(e.g. unclear message or distraction)


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Some conclusions regarding attitude change

If strong arguments are available.provide many

repeat a few times

ensure appropriate prior knowledge

emphasise personal relevance

ensure distraction-free presentation

If not..

distract the receiver

use acceptance cues (more messages & source credibility)


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Sample Question

You are creating a new commercial to

encourage young women to wear

sunscreen. You are using Hillary Duff as

your spokeswoman for sunscreen. Whattype of processing are you trying to

achieve?


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Central Processing

Personal Relevance

Quality of arguments

Expertise

Knowledge

Need for Cognition

Timing

Personal Relevance

Quality of arguments

Expertise

Knowledge

Need for Cognition

Timing

Peripheral Processing


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Sensory

Register

Working

Memory

Long Term

Memory

EncodingSelective

Attention

Cognitive Load Theory

Stimuli


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Sample Questions

Which statement(s) tells you that the client you are workingwith has a high need for cognition? (SELECT ALL THATAPPLY.)

A. When I am in a new city, I always rely on other people to figure

out the logistics of what attractions we should see and where weshould eat.

B. I like it when my boss tells me what to do.

C. My favorite thing to do on Sunday mornings is the New York Timescrossword puzzle.

D. I have to read the cereal box when I am eating my breakfastcereal.

E. If someone tells me something cannot be done. I am likely tospend time trying to come up with a new way of doing it.

Using the Cognitive Load Theory, what mediates the sensoryregister and memory?


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Social Cognitive Theory

Transtheoretical (Stages of Change) Model

Health Belief Model

Theory of Planned Behavior

Common health behavior change models:

Person Behavior Outcome

Efficacy

expectationsOutcome

expectations

Precontemplation

Contemplation

Preparation

Action

Maintenance

Pro/cons

TemptationsPro/cons

Temptations

TemptationsPro/cons

Demographics, Social

support, Personality Traits

Susceptibility and Severity of

DiseasePerceived threat

of disease

Likelihood of behavior change

Cues to action

Perceived benefits

Perceived barriers

minus

Motivation Self-efficacy

Behavioral

Beliefs


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Developing a Conceptual Model

Specify an outcome of interest.

Use an existing model as a starting point.

Select potential correlates of the outcome.

Determine the initial relationships among selected

concepts using theory and empirical evidence, as well as

personal knowledge.

Draw linkages among concepts.


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Example 1

This example encompasses a few theories

but the TPB was used as a starting off

point


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Use of prescribed inhaler by

teenage asthmatics

Intention to use

Inhaler

Inhaler Use

Attitudes Towards

Inhaler Use

Self-Efficacy

Subjective Norms

Barriers

(Actual/

Perceived)

Social Support

Coping

Vicarious

experience

Cue to Action


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Health Belief Model

Intention to use

Inhaler

Inhaler Use

Attitudes Towards

Inhaler Use

Self-Efficacy

Subjective Norms

Barriers

(Actual/

Perceived)

Social Support

Coping

Cue to Action

Vicarious

experience


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Theory of Reasoned Action

Intention to use

Inhaler

Inhaler Use

Attitudes Towards

Inhaler Use

Self-Efficacy

Subjective Norms

Barriers

(Actual/

Perceived)

Social Support

Coping

Cue to Action

Vicarious

experience


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Theory of Planned Behavior

Intention to use

Inhaler

Inhaler Use

Attitudes Towards

Inhaler Use

Self-Efficacy

Subjective Norms

Barriers

(Actual/

Perceived)

Social Support

Coping

Cue to Action

Vicarious

experience


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Social Support, Coping

Intention to use

Inhaler

Inhaler Use

Attitudes Towards

Inhaler Use

Self-Efficacy

Subjective Norms

Barriers

(Actual/

Perceived)

Social Support

Coping

Cue to Action

Vicarious

experience


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Self-Efficacy

Intention to use

Inhaler

Inhaler Use

Attitudes Towards

Inhaler Use

Self-Efficacy

Subjective Norms

Barriers

(Actual/

Perceived)

Social Support

Coping

Cue to Action

Vicarious

experience


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Example 2

Here is another example. It is simpler than

the conceptual models we have seen, but

still includes theory.

What are the relationships you see?

Where are the theoretical constructs?


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Safe contact lens-washing routine

Ophthalmologist-patient

communication

Perceived threat

of eye infection

Verbal

reinforcement

Understandingof contact lens

washing routine

Safecontact lens

hygiene

Perceived

Behavioral

Control

Barriers

-

Benefits

Verbal

reinforcement


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Opthamologist-patient

communication

Perceived threat

of eye infection

Verbal

reinforcement

Understandingof contact lens

washing routine

Safecontact lens

hygiene

Perceived

Behavioral

Control

Barriers

-

Benefits

Verbal

reinforcement


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CCulture-based

AAccessible

VValues-based

AAcceptable LLiteracy-based

CConsumer-centric

AAdaptive DData-centric

EEngaging

HBHE600 Final Review Session 1

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