Health behavior change - theory in a nutshell
How is the desire for change formed in a person? Why is a person addicted to nicotine able to quit smoking? What needs to happen for this to be possible? What phases does everyone have to go through to change anything in their lives, and is it even possible to distinguish such universal stages?
Here are the three main theoretical approaches to
changes in health behavior
:
PAPM model
A model of the risk perception process (
Precaution Adoption Process Model
) was constructed in 1992 by Weinstein and Sandman. It explains the process of change by noticing risks and reducing them. Each person must go through successive phases, none of which can be skipped, for effective behavioral change to occur. Unfortunately, regression, a return to the previous stage, is possible.
Ignorance of danger
Lack of commitment
Deciding on action
Deciding to change or Deciding not to change behavior
Action
Maintaining operations
The most important role in this model is to perceive the danger. So, according to the researchers, in order to (for example) quit smoking, one must first realize what danger lies behind this addiction. You can't self-deceive that it may be an addiction that leads to cancer, but after all, "it won't happen to us" or "no one has died from half a packet yet." You have to honestly assess the danger yourself in front of yourself, and only when you really notice it can you move on.
TTM model
In the transtheoretical model (
Transtheoretical Model
) Prochaska and DiClemente (1983, 1998) distinguished five phases of behavior change. Each phase takes about six months to complete and, as in the PAPM model, regression is possible and the phases follow one after the other.
Precontemplation
Contemplate
Preparing for change
Action
Maintaining the shift
In the first phase, a person does not even consider changing behavior, only from phase two onward are there any thoughts about stopping harmful behavior or starting health. In the second phase, the highest level of expectations for the results of the action occurs, after which, in the following phases, expectations decrease. In turn, self-efficacy increases after each subsequent phase. In this model, unlike the previous one, a sense of threat is not important. The individual must first realize that change is possible at all, and then consider whether it is desirable. The motive for change, then, is not the perception of threats, but rather the realization that change is possible at all, which is completely out of reach for many people. Addicts often can't even imagine a day without the substance that causes their addiction. In order to initiate a change, therefore, one must first realize that one's existing daily life can be changed.
HAPA model
A processual approach to health behavior change (
Health Action Process Aproach
) most fully describes the impact of the social and cognitive variables that occur for change to occur in an individual. The HAPA model (Schwarzer, 1992, 2001) assumes that there are two distinct stages of behavior change: the motivational (pre-intentional) phase and the volitional (post-intentional) phase. In the first phase, a person develops an intention to change behavior, which is influenced by such cognitive-social factors as perceived risk, expectations about the results of behavior change, and perceived self-efficacy (optimistic assumptions about one's own abilities). After formulating intentions, the person moves to the volitional phase, in which planning and, again, self-efficacy play a primary role. The creator of the model showed in his research that the factor of relatively least importance for making intentions was perceived risk, which is definitely at odds with the PAPM model. One can easily find both similarities and differences in the above models. However, all of their creators were concerned with the same thing - to isolate the successive stages of behavioral change, and thus help people struggling with this difficult process. Because, after all, one of the most difficult changes, is to change the everyday life to which one has sometimes been accustomed for years. So perhaps it is worthwhile to dwell on the stages and relate them to your plans. Find which stage you are currently at, what its difficulties are and what stages will follow. It is easier to face known obstacles, because only for such can you plan a coping strategy.
Author: Martyna Wrona - Marchel
