Exam 4: Adhering to Healthy Behavior

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A. Continuum theories explain adherence using one set of factors that apply universally to
all people. They were the first class of theories developed for understanding heath behavior.
B. The Health Belief Model (Becker and Rosenstock) – Assumes four beliefs contribute to predict health behaviors:
1. Perceived susceptibility to disease/disability
2. Perceived severity of the disease/disability
3. Perceived benefits of health-enhancing behaviors
4. Perceived barriers to health-enhancing behaviors, including financial expenses
C. Self-Efficacy Theory (Albert Bandura) – part of Bandura’s social-cognitive or social learning theory – Assumes people pursue goals they find achievable and important by using their cognitive (thinking and learning) processes.
1. Reciprocal determinism = Behavior, environment, and person factors, particularly beliefs, interact—illustrated as a triangle—to influence people’s actions.
2. Self-efficacy = “People’s beliefs in their capability to exercise some measure of control over their own functioning and over environmental events” (Bandura). Self-efficacy is not global, but situation-specific, i.e. one’s confidence that one can perform specific behaviors for specific situations.
3. Ways to acquire, increase, or decrease self-efficacy:
(1) performance;
(2) vicarious experience;
(3) verbal persuasion;
(4) physiological arousal states (e.g. stress, anxiety).
4. Outcome expectations = people’s beliefs that valuable outcomes will result from their health behaviors.
D. The Theory of Planned Behavior (Ajzen) – Assumes people behave in ways to achieve goals important to them. Also assumes people are generally reasonable, use information systematically, and consider consequences before acting or not acting.
Intention is the immediate factor determining behavior. Three factors influence intentions:
1. The person’s attitude toward the behavior
2. The person’s perceived control over the behavior
3. The person’s subjective norm, i.e. social pressure to act/not act
A. Behavioral Theory – Operant Conditioning (Skinner) – Assumes behaviors are strengthened—i.e. increases their probability of recurring—when reinforcement immediately follows (contingency).
1. Positive reinforcement = Presenting a pleasantly valued stimulus.
2. Negative reinforcement = Removing an unpleasantly valued stimulus.
3. Punishment = Presenting an unpleasantly valued stimulus; far less effective than reinforcement and seldom useful for improving adherence.