HBHE600_2008_04_Social Cognative Theory

8/14/2019 HBHE600_2008_04_Social Cognative Theory

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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH

Social Cognitive

Theory (SCT)


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Behavioral

Beliefs

Evaluations of

Behavioral

Outcomes

Normative

Beliefs

Motivationto Comply

BehavioralIntention

Behavior

Attitude Toward

Behavior

Subjective Norm

Perceived

Behavioral

Control

Perceived/ Actual

Barriers

Coping skills/

resources

*Slightly modified, and elaborated upon, by Vic Strecher

Theory of Planned Behavior (TPB)*:


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Social Cognitive Theory Efficacy expectations Outcome expectations


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Person Behavior Outcome

Social Cognitive Theory


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Outcomeexpectations:The beliefs about a behavior leading to a certain outcome

Behavior Outcome



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Efficacy expectations:

The beliefs about a persons ability to perform a behavior

Person Behavior


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Efficacy expectations:

The beliefs about a persons ability to perform a behavior

Outcome expectations:The beliefs about a behavior leading to a certain outcome





Mr. Jones Eat less fat Improved health

Outcome expectations:Positive outcome expectation:

Mr. Jones believes that eating less fat will lead to improved health.

Efficacy expectations:High self-efficacy for eating less fat:

Mr. Jones believes he is capable of changing his diet to include less fat.




Social Cognitive Theory Efficacy expectations and outcome expectations are

beliefs, not necessarily truths

Self-efficacy is not a global trait or personality

characteristic; it relates to specific behaviors inspecific settings



Self-efficacy: Why is it important?

In many studies, across a wide range of health-relatedbehaviors, persons with higher self-efficacy are more

likely to change behavior than those with lower self-

efficacy. This includes:

initiation of new behaviors as well as maintenance

putting forth greater effort

greater persistence of effort

performing behavior in a wider range of settings


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Sources of efficacy information:

Which one source is the most important?

Previous performance accomplishments



Concepts related, but not the same

as, self-efficacy: Locus of Control Self-esteem Anxiety

Depression Learned Helplessness Persistence Concentration (focus)



Measurement Efficacy Expectations

How confident are you that you can (change some

behavior)?

Example: How confident are you that you can follow this low sodium

diet once you return home?



Measurement Generality of self-efficacy:

Efficacy beliefs for one type of activity will generalize to

other activities that are governed by similar skills, i.e. within

domains

Distinct from generalized self-efficacy No empirical support that self-efficacy operates across all

situations and domains of functioning



Measurement Measure of self-efficacy must be specifically related to

the behavior in question

Examples: self-efficacy for condom use

self-efficacy for exercise self-efficacy to delay sex



When I feel stressed

After I have just finished a meal

While drinking coffee with friendsWhen I feel sad or lonely

While talking on the telephone

When I am around people who are smoking

When I feel angry or frustrated

When I am happy and feel like celebrating

While driving

When I feel nervous or anxious

When I am bored

When at a bar or a party

Please rate how confident you are that you can keep from smoking cigarettes in the following situations:Not at allconfident

Extremelyconfident

1 2 3 4 5

O

O

OO

O

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OO

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OO

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OO

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OO

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Measurement



Measurement Should include the behavior, the level of situational

demand

Elicitation interviews or focus groups could be used to

identify those conditions that make performance ofdesired behaviors difficult



Measurement Outcome Expectations

If you (change some behavior), how likely do you think it is

that (some specific outcome) will occur ?

Example: If you eat less sodium in your food do you think it is likely

that your risk of serious health problems will be reduced?



Research Findings Self-efficacy may be more important for those who

feel that their personal health actions control health

outcomes

Efficacy perceptions can be manipulated: improved,

reduced



If efficacy expectations are low:



Build self-efficacy by starting with simple, achievable tasks and provide positivereinforcement for task accomplishment

Focus on positive aspects of an incomplete performance

Show your confidence in the persons ability and provide sincere encouragement

Identify similar others who have accomplished the task

Teach specific skills to overcome problem areas

If efficacy expectations are low:



If outcome expectations are low: For health-related outcomes, focus on immediate and tangible

outcomes, not just long-term risk reduction

Explain in lay terms the relationship between the desired

behavior and the outcome; where possible show models or

examples

Focus on outcomes relevant to the person, not you; these may

include other, non-health related, outcomes


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Efforts to enhance efficacy must: Demonstrate the persons relative progress toward the target

behavior

Attribute previous accomplishments to the persons own abilities


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Other methods for enhancing self-efficacy:

Verbal reinforcements and encouragement to enhance efficacy

Relaxation training to reduce anxiety during the behavior change

process


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The Health Belief Model (HBM):

Demographics, SES,Personality

Perceived benefitsminus barriers

Susceptibility and

Severity of Disease

Perceived threat

of disease Likelihood of

behavior change

Cues to action

ModifyingFactors

IndividualPerceptions

Likelihood of Action

Social-Cognitive Theory (SCT):

BehavioralBeliefs

Evaluations ofBehavioralOutcomes

NormativeBeliefs

Motivationto Comply

BehavioralIntention

Behavior

Attitude TowardBehavior

SubjectiveNorm

The Theory of Reasoned Action (TRA):


Efficacyexpectations

Outcomeexpectations

Documents

HBHE600_2008_04_Social Cognative Theory