1 Behavioral Change

7/30/2019 1 Behavioral Change

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Behavioral Change

Created by Stoy E. Proctor MPH, Mdiv

Edited by Elie S Honore MD MPH MHA

April 2010


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FUNDAMENTAL QUESTION

How do we move people from

point A to point B?

From poor lifestyles to healthy

lifestyles?

A? To B?


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Not by Machiavellian Strategies

Machiavel was a 15th century prince

who conceived of a plan to become a

successful ruler, his strategies were: 1. Looking at good matters more than

being good,

2. If it helps to achieve your goal, lie.3. The end justifies the means. *


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Over the years there has

been several approaches to

behavioral change, some

logical, reasonable and

successful- others not so successful. *


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In the next few minutes I will present thebest approaches that my research hasfound.

1. Principles of behavioral sciences

2. Traditional approaches

3. Biblical Principles

4. Spirit of Prophecy guidelines


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Barriers or enablers tochange


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Pre-disposing or Enabling

factors :The Person:

knowledge

attitudes

beliefs

values

perceptions

cultural norms *

These factors facilitate or hinder a persons

motivations to change.


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The Society

Available health resources

Accessibility

Insurance

Laws

Health Skills - health professions *

Pre-disposing or Enabling

factors :


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Enablers or barriers created by social

forces or systems:

Reinforcing factors:

Friends

Relatives

Peers

Teachers

Employers

Health Providers

Health Professionals*

Health Education Planning 1980, pp. 16-17

Media


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Stages of Change

Levels of Intervention


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Your successful behavioral

change targets the specific

stages of contemplation andmust be adaptable to the stage

of change.


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Pre-Contemplation Phase

Information

Friends

Media:

Newspaper

television

radio*


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Contemplation Phase

Cost

Seriousness of illness

Social pressure

Restrictions*


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Preparation Phase

Physical

Mental

Social

Spiritual *


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Action Phase

Change - success

Positive support

Maintenance

Self support

Family

Peer *


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Negative pressure to return

Relapse

Health Habits

Addiction Peer pressure

Advertisements

Stressors USDHHS, 1991, p. 345 Monograph #5 - NIH

1994


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Behavioral change is dependent

on five characteristics:

1. Attention

2. Comprehension

3. Acceptance

4. Retention

5. Action


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The following slides are to assist

the smokers participating in the

Breathe Free Plan, to refine their

behavioral strategies for better

success in quitting.


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Refining Behavioral Strategies

1. Define your goals in concrete termsEx: Not I would like to stop smoking

Rather my goal is to stop smoking on

Jan. 1, 2006

2. List the details of the problem so

that you understand your problem


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3. Observe your behavior, dont

speculate about it or trust your

memory. 4. Specify not only the situation

and the fact that the desirable

behavior is not occurring, but alsothe behaviors that occurs instead

of the ones you want.


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5. Your strategy should always be to

increase some desirable behavior- one

that is supportive of your primary goal. Ex. An exercise regimen

6. Specify the chain of events that will

lead to the goal.

Ex. Choosing alcohol and caffeine free

beverages are helpful on your way to

becoming tobacco free.


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7. Observe people who aresuccessful at what you are trying

to do, and then try their tacticsyourself

.Ex. Smoking diary

8. Develop several alternativesolutions to the problem and thenselect the best one to implement.

P.32-36 Watson Self Directed Behaviors-2002


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Self-Efficacy Beliefs

1. Believe in your ability and the poweravailable to you to help participantsstop smoking.

2. Believe in the ability, experience, andmotivation of the participants to stopsmoking.

3.Convince the participant that youbelieve they can stop smoking.

4. Help the participant believe they canstop smoking.

EGW Education 281


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How to Increase your Self-Efficacy

Beliefs

1. Choose a goal for whichyou can say yes or a strongmaybe, one in which youbelieve you can reach.

Ex. I can stop smoking.


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2. Focus on the process of change,

not as much on the final goal.

Ex. In preparation for walking amile or running a Marathon you

begins with a few steps. Each step

and each 100 yards you walk overa period of time will increase your

confidence and improve your

chances of success.


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3. Discriminate, between your past

performances and the present

project. In this new project you will develop

new skills and you will be able to

avoid past strategies that did notwork.


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4. In the process of focusing on the

process, not the final goal, keep

good records. Ex. A long list of your recorded

successes

Will help increase your belief inyourself


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5. Endeavor to make these

behavioral changes on rational

reasons rather than on anemotional basis.

Emotions can lower your self-

efficacy beliefs irrationally.


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6. Make a list of the specific kindsof situations which you expect to

have greatest difficulty. Rank in order of difficulty from

the least to the greatest anddevelop strategies to deal with

each.

In Breathe-free we start withExercise, then coffee, then alcohol

and last tobacco.

Prepare for Relapses


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Prepare for Relapses

1. Avoid situations you know may be

tempting. 2. Ask your friends not to tempt you.

3. Try asking your friends for support.

4. Minimize the tempting quality if thesituation.

Ex. Fill up with water and fruit juicesbefore you go to a party that is serving

alcohol or carry around a drink of fruitjuice. Now Pepsi Cola is producing a bluesoft drink to match the color of winecoolers.

P. 40 Watson-Self-Directed Behaviors-2002


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Traditional Approaches

Inspiring

emotional pleas

Rules and regulations

right and wrong


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Setting an example

parents

teachers

Persuading and convincing

arguments

favor

Limiting choice

choices*


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Cultural or religious dogmas.

Society norms.

Doctrines of the church,

our people have always done it this

way,

this is the way we do it. Thus sayeth the Lord,

the Bible says,

Church tradition teaches


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Appeals to conscience

still small voice

Values & Teaching, Ruths, pp. 39 & 40. 1996,Merrill Publishing, Columbus, OH*


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Behavioral change is a process,not an event


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Biblical Behavioral Change

Concepts First Condition; you must believe

that:

1. God is good and is notresponsible for evil. Truly God is

good to the upright, to those who

are pure in heart. Psalm 73:1


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2. You are fully responsible foryour behavior, it is your choice.

Everyone who knows what is theright thing to do and doesnt do it

commits a sin.

JA 4:17 (JB)


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3. You must believe that help is

available 1 Corinthians 10:13

No temptation has overtaken you but

such as is common to man, and God is

faithful, who will not allow you to betempted beyond what you are able,

but with the temptations will

provide the way of escape, also - that

you may be able to endure it.

2 Peter 2:9

The Lord knows how to rescue the

godly from temptation.*


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4. Believe that You can master

anything. Phil 4:13 (TB) There is nothing I can not master

with the help of the one who gives

me strength. Spirit of Prophecy

Principles of Behavioral change.


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TheEnd

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1 Behavioral Change