BehaviourChangePresentation_CHodgson_Part2

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Behaviour Change
Past & current theories of how to get people from thinking
to doing
Part 2 of 3
Corinne Hodgson
Corinne S. Hodgson & Associates Inc.
November, 2013
Overview
 Part 1
 Traditional theories such as Transtheoretical Model,
Model of Reasoned Action/Planned Behaviour, and
Social Cognitive Theory
 Opportunities from other areas of psychology:
achievement theory, self theory, and self-determination
theory
 Part 2: Health Action Process Approach and SelfRegulation
 Part 3: New models from interactive health (Fogg,
Eyal)
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Health Action Process Approach
(Schwarzer, 2008)
There are 2 phases:
 Motivational – development of intention
 Volitional – moving from intention to behaviour
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Task
Self-Efficacy
Action
Planning
Outcome
Expectancies
Recovery
Self-Efficacy
Action Control
INTENTION
Coping
Planning
Risk
Perception
PREINTENDERS
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ACTION
Barriers & Resources (e.g., Social Support)
INTENDERS
The Motivation
Phase
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ACTORS
The Volitional Phase
Disengagement
Maintenance
Self-Efficacy
Step 1: Intentional
 Paint a positive picture of benefits so expectancies are high
 To be effective, expectancies shouldn’t conflict with
personal or societal norms
 Support feelings of self-efficacy (“I can do that!”)
 Risk messaging (i.e., need for prevention) may contribute
but research suggest approach goals may be more effective
than avoidance goals
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Step 2: Volitional
 Volitional phase consists of different groups of people:
 Those who intend to change but haven’t started yet
 Motivated to change but don’t act because they lack skills to
get started
 Key strategy to help them is action planning
 Those who have translated intentions into action
 Face two key challenges:
 Coping – need to plan how to anticipate & dealt with barriers
 Recovering -- how to get back on track after relapse/failure
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Key volitional factors
 Action planning
 Most proximal predictor of behaviour
 Involves developing a precise mental representation of when,
where and how
 Self-efficacy
 Confidence that you can cope
 Confidence that you can recover from set-backs
 Action control or self-regulation
 Ability to control your behaviour (e.g., delay gratification & stick
to intentions)
 Can involve self-monitoring, automaticity & willingness to make
effort
Sniehotta ff et al. Psychology & Health 2005;10:143-60
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Promoting “optimistic self-beliefs”
(action/task self-efficacy)
1. Promote growth mindset – you’re not stuck with the way
you are but have the capacity to change. Help users to
challenge negative assumptions about their ability to change.
2. Explain rationale for & benefits (expectancies) of change.
3. Position change as the desirable or societal default.
 Jeni Cross – Three Myths of Behavior Change – What You Think You Know That You
Don’t TED Talk
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Support action planning
 People need choice so they feel they have control (autonomy)
BUT
 Too much choice can be detrimental:
 Analysis paralysis as people try to compare opportunity costs of
acting/not acting or between different options
 Buyer’s remorse or fear of buyer’s remorse: no choice can ever meet
high expectations
 Self-blame (“I made a mistake; made wrong choice.”)
Barry Schwartz, The Paradox of Choice, Why More is Less
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Action planning (cont.)
 Action plan should address user’s basic psychological need for
 Relatedness
 Autonomy
 Competence
 Note: balance between psychological needs may vary between
individuals – everyone is different
 Promote integrating behaviour into personal belief system – from
“I should” to “I want to because…”
 Action plan should include strategies for maintaining self-efficacy
& willpower even when faced with challenges & ego depletion
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Promote coping self-efficacy
1. As with intention, promote growth mindset – change is possible.
2. Promote self-regulation & ability to delay gratification.
3. Start with the understanding that relapse is likely & normal so you
need to develop a plan for when it occurs. Use cognitive
behaviourial theory (CBT) strategies to help people change their
perceptions (e.g., relapse is not failure), identify triggers, & develop
strategies for avoiding high-risk situations. Use strategies such as
self-monitoring, modeling, role playing, and brainstorming – but
don’t use a “super achiever” as a model.
4. Build incrementally on achievable goals (e.g., it is common for
people to set unrealistic weight loss goals).
Schwarzer & Fushs in Predicting Health Behaviour: Research and Practice with Social Cognition Models,
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Conner & Norman, eds. (1995)
doing
Self-regulation & willpower
 Self-regulation theory states personal health management includes
skills such as impulse control and being able to delay immediate
gratification for long-term gain
 Being conscientious in health reflection of larger construct of
conscientiousness
 Elements of self-regulation:
 Standards (norms) that you want to meet
 Motivation to meet standards
 Monitoring of situations & thoughts that could lead to breaking
standards
 Willpower or internal strength to control urges
Baumeister et al. Losing Control: How and Why People Fail at Self-Regulation (1994)
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Willpower
 Willpower as a muscle – Beaumeister & Tierney
 If you use it, you wear it out >> ego depletion
 But at the same time, you can strengthen it through regular
training
Baumeister & Tierney. Willpower, Rediscovering the Greatest Human Strength (2011)
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Ego Depletion
 Making changes (esp. dieting) imposes a high decisional
burden so is mentally tiring
 A variety of factors consume mental energy, makes it harder
to concentrate, & leave you more vulnerable to relapses:
 Having to pretend or ignore something: “White Bear effect”;
trying to pretend you like someone you don’t
 Repeated exposure to temptations (same or different)
 Physical fatigue – low blood glucose, lack of sleep
 Poverty (UBC/Princeton study in Science, 2013)
 Goal-conflict (more)
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Goal Conflict
 People have goals in multiple areas of life (health, career, family, social
life) – sometimes goals can facilitate one another but other times they
can conflict (e.g., dinner out with friends vs. going to gym)
 Even negative behaviours may address a variety of needs (e.g., smoking
may enhance sense of relatedness with other smokers)
 A short term-goal is typically easier to choose over a long-term goal,
particularly if you have a short-term temporal orientation << Philip
Zimbardo The Time Paradox
 In our obesogenic environment, there is lots of negative goal priming in
your environment (e.g., advertising for high-fat foods)
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Goal Conflict (2)
 How people experience & handle goal conflict varies with:
 Personality traits (e.g., conscientious people shape environment to avoid
temptation, although they may not be any better at resisting temptation)
 Situational factors such as setting or alcohol
 Interpersonal factors -- people around you can be good or bad models or
remind you of social norms
 Study found people feel desires all the time and 47% of the time they
conflict with some goal, value or motivation
 Strong self-regulatory skills & being able to resist desires can decrease
giving in to them from 70% to 17%
Hoffman et al J Personality & Social Psychology 2012; Bourdreax et al Motivation & Emotion 2013
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Goal conflict as barrier to regular
physical activity
 11 studies by Dan Bailis, University of Manitoba
 In studies, subjects were 1) asked to commit to exercising and then 2)
primed with either conflict (e.g., academic) or consistent (exercise) goal
messaging
 Goal conflict increased negative affect (guilt, shame) and decreased
positive affect, perceived ability and amount of exercise – when inactivity
is due to goal conflict, intentions lead to frustration rather than action
 You can reduce goal conflict by:
 Action planning (e.g., scheduling time to exercise)
 Framing messages that stress benefits of exercising and costs of not doing
it
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Reducing ego depletion & building
your willpower muscle
 Experiments have shown that making even simple changes (sitting up
straight, using your left hand) for 2 weeks can build willpower as
measured by ability to concentrate on a task or hold hand-grip
strength
 Order in one part of life (e.g., exercise) has been shown to affect
other areas of life (diet or housecleaning) - Peter Walsh, Does This
Clutter Make My Butt Look Fat? (2008)
 Adequate sleep and keeping blood glucose in healthy range can help
to shore up willpower
 “Public information has more impact than private information” –
mirrors, self-monitoring & knowing that you are being watched
increases self-regulation/willpower << Quantified Self movement
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But .. Is willpower a muscle or a
neural signal?
 Experiments have shown that even those who are ego-depleted can
get a “second wind”
 Decision-making involves analysis of prospect for pain or pleasure by
two neural systems:
 Reactive system for immediate prospects (amygdala)
 Reflective system for future prospects (prefrontal cortex)
 Ego-depletion may represent our own perception of our limits –
signals from the amygdala hijack goal-driven cognitive resources
needed for reflective system
 Exercises to “build” willpower may actually reinforce reflective
neural pathways that allow reflective system to resist reactive system
McGonigal The Willpower Instinct (2012); Noel et al. Psychiatry (Edgmonet) 2006;3(5):30-41
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