Health Behavior Models

Health Belief Model - Beliefs Shape Behavior

• Developed by Rosenstock, Hochbaum, & Kegels (1950s). Individual's health-related action depends on:
  • Perceived Susceptibility: Belief about chances of getting a condition. "Am I at risk?"
  • Perceived Severity: Belief about seriousness of the condition & its consequences. "How bad would it be?"
  • Perceived Benefits: Belief in efficacy of advised action to reduce risk/seriousness. "Will it help me?"
  • Perceived Barriers: Belief about costs (tangible/psychological) of advised action. "What are the downsides?"
  • Cues to Action: Triggers for readiness (e.g., symptoms, media, doctor's advice).
  • Self-Efficacy: Confidence in one's ability to take action (later addition by Bandura). "Can I do it?"

⭐ Modifying factors like age, sex, ethnicity, personality, socioeconomics, and knowledge influence perceptions within the HBM.

Transtheoretical Model - Stages of Transformation

Describes readiness for behavior change through sequential stages. Also known as Stages of Change Model.

• Precontemplation (Not Ready): No intent to change (next 6 months). Unaware/under-aware of problem.
• Contemplation (Getting Ready): Aware of problem, considers change (next 6 months); ambivalent.

  ⭐ Weighing Pros & Cons (Decisional Balance) is central. Many remain stuck for long periods.

• Preparation (Ready): Intends action (next 30 days). Small steps, has a plan.
• Action: Overt behavior modification (< 6 months). Requires significant commitment.
• Maintenance: Sustained change (> 6 months). Focus on preventing relapse.
• Termination: Change complete. No temptation, 100% self-efficacy. (Not always achieved).
• Relapse: Common; person reverts to an earlier stage (often Contemplation/Preparation).

📌 Mnemonic (Stages): Papa Can Prepare Awesome Meals Tonight (PCPAMT)

TRA & TPB - Intentions Drive Actions

• Theory of Reasoned Action (TRA): Posits behavioral intention as the primary driver of behavior.
  • Intention is shaped by:
    • Attitude towards behavior: Individual's evaluation (e.g., beneficial/harmful).
    • Subjective Norms: Perceived social pressure to perform/not perform the behavior.
• Theory of Planned Behavior (TPB): Extends TRA by incorporating:
  • Perceived Behavioral Control (PBC): Individual's belief in their ability to successfully perform the behavior (self-efficacy).
    • PBC directly influences both behavioral intention and the behavior itself.

⭐ TPB enhances TRA by adding Perceived Behavioral Control, making it more robust for explaining behaviors not entirely under volitional control (e.g., overcoming addiction).

Social Cognitive Theory - Learning & Environment

• Developed by Albert Bandura; emphasizes learning via observation and social interaction.
• Key Constructs:
  • Reciprocal Determinism: Dynamic, ongoing interaction between:
    • Personal factors (cognition, biology)
    • Behavior
    • Environmental influences
  • Observational Learning (Modeling): Learning by watching others (models). Process: Attention → Retention → Reproduction → Motivation.
  • Self-Efficacy: Belief in one's own ability to successfully perform a behavior. Influences choice, effort, persistence.
  • Outcome Expectations: Beliefs about the likely consequences (positive/negative) of a behavior.
  • Self-Regulation: Capacity to control, direct, and manage one's own behavior.
  • Reinforcement: Responses to behavior that ↑ or ↓ likelihood of recurrence (direct, vicarious, self-reinforcement).

⭐ Reciprocal determinism, the three-way dynamic interaction between person, behavior, and environment, is a cornerstone of SCT.

High‑Yield Points - ⚡ Biggest Takeaways

• Health Belief Model (HBM): Behavior driven by perceived susceptibility, severity, benefits, barriers, cues to action, & self-efficacy.
• Transtheoretical Model (TTM): Describes stages of change (Precontemplation, Contemplation, Preparation, Action, Maintenance); relapse is common.
• Theory of Planned Behavior (TPB): Behavioral intention (from attitude, subjective norms, perceived behavioral control) predicts behavior.
• Social Cognitive Theory (SCT): Emphasizes reciprocal determinism (behavior, personal factors, environment) and self-efficacy.
• Diffusion of Innovations Theory: Explains adoption of new health behaviors through adopter categories (innovators to laggards).