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Terms in this set (75)

○ TRA/TPB:
■ Focuses on rational, cognitive decision-making processes
■ Assumption of rational, reasoned behavior that people think about what they do before they do it
■ Behavioral intention follows from:
● A person's attitude toward a specific behavior
● Their perception of the subjective norms associated with that behavior
■ Behavioral intention alone NOT a sufficient predictor of behavior
○ Theoretical constructs:
■ Attitude toward a behavior results from
● 1. A person's belief about what will happen if they do it (expected outcome)
● 2. Their assessment of whether the outcome is good or bad
■ Subjective norm results from
● 1. A person's beliefs about what other people in their social group will think about the behavior
● 2. Their motivation to conform to these social norms
■ Perceived behavioral control
● 1. Control beliefs facilitating or constraining
● 2. Perceived power
■ Theoretical constructs = levers/"pieces of the puzzle" that need to be in place in order to promote a certain behavior
● They provide guidance but are NOT sufficient alone to structure a program
○ Benefits:
■ Better than HBM in terms of accounting for the social context surrounding someone's behavioral decision-making
○ Critiques:
■ 1. Like the HBM, the TRA/TPB assumes that behavior is the output of rational, linear decision-making processes
■ 2. There are a number of issues with the clarity of TPB constructs
● Ex) hard to assess perceived behavioral control construct
■ 3. Time between intent and action is not considered
○ Evolution from the TRA:
■ New element (perceived behavior control) added to address situations in which behavioral intention alone isn't sufficient to predict behavior
○ PAPM: proposed stages occur in order
■ Takes same idea that led to TTM and applies it to taking a precaution against something
○ Theoretical constructs:
■ Stage 1: Unaware of the issue - simple lack of knowledge or awareness
■ Stage 2: Unengaged by the issue - aware of issue but not engaged enough to do anything about it
■ Stage 3: Deciding about acting - people aware of and engaged in a health behavior problem begin to make some decision as to whether they intend to do something about it
● Similar to behavioral intention in TRA/TPB but this also accounts for people who decide they're not going to act
■ Stage 4: Deciding not to act
● Not in TTM
■ Stage 5: Deciding to act - not the same as actually taking action; just decision to do so
■ Stage 6: Acting - taking action but not maintaining it
■ Stage 7: Maintenance - adopted from same stage in TTM
● Continuation of behavior
● Doesn't separate continued effort from "posttemptation" termination stage in TTM
○ Benefits:
■ Distinguishes between being unaware and being unengaged
○ Critiques:
■ 1. People don't always go through a fixed set of stages, in a straight line, as the TTM and PAPM propose
■ 2. How do you measure what stage people are in?
○ How to know when to use TTM or PAPM
■ Step 1: assess what stage your target group is in
■ Step 2: make sure intervention(s) draw on the change processes that are relevant to moving from that stage
■ Step 3: have some assessment criteria for determining whether target group has moved to the next stage(s)
○ Individual approaches
■ HBM
● Perceived barriers include:
○ Mistrust
○ Concern that they won't understand needs or practices of minority culture, family, traditional use of herb medicinals, etc.
○ Physical difficulties (i.e., lack of transportation)
○ Language - health provider doesn't understand patient's language
■ Individual must intend to change behavior, believe there's a positive/valued outcome to changing that behavior, and believe that they're capable of making the behavior change
○ Social, community, and group approaches
■ Community mobilization & advocacy - increases general minority community capacity and empowerment
● Recommended by CDC for tobacco intervention
● Changes in policy and improved access to healthcare facilities can result from this strategy
■ Social marketing/mass media and communications campaigns - focus on disseminating info. to people and maximizing the likelihood that people in a target pop. will adopt healthy behaviors
○ Multilevel programs
■ CDC REACH focuses on linkage among community organizational capacity, targeted action, knowledge and behavior change, and improved health outcomes
■ THRIVE program focuses on building resilient communities
● Based on 4 factors in communities to be strengthened:
○ Environment
○ Social capital
○ Services and institutions
○ Structural factors
○ Organizational theory
■ Focus is on putting pieces together at a local, regional, state, or national level - integrating components that will improve racial/ethnic minority health status
● Characteristics:
○ Clear purpose
○ Committed leadership to keep the organization on track
○ Collaborations that include the participation of all levels of the system, including both public and private