The Precaution
Adoption Process
Model
Liz McDermott
H 571: Principles of Health Behavior
Overview
• Characteristics of Stage Models
• Stages included in the Precaution Adoption Process Model
• The Precaution Adoption Process Model and the Theory of
Triadic Influence
• Precaution Adoption Process Model and Processes of Change
• Group Discussion
Stage Models
• Change occurs as a result of passing through series of
sequential stages resulting in either:
• Elimination of a health-risk behavior
• Long-term adoption of a health-protective behavior
• To enter a subsequent stage, one must successfully complete
the tasks of the previous stage
• Useful for developing and implementing stage-matched/stagetargeted interventions
Assumptions of Stage Models
• Classification system defining stages
• Ordering of stages
• Common barriers to change experienced by individuals in
same stage
• Different barriers to change experienced by individuals in
different stages
Precaution Adoption Process
Model (PAPM) & Your Health
Behavior
• Keep your health behavior of
interest in mind and think
about the following:
• Does your health behavior of
interest fit with the PAPM
model?
• If so, what aspects of the
model make it a particularly
good fit for your health
behavior?
• If not, why? What are some
of the gaps or limitations of
the model?
Stages of the PAPM
• Composed of 7 stages
• Each stage represents unique patterns of beliefs, behavior, and
experience
• Factors producing stage transitions differ depending on
transition under consideration
Stages of the PAPM cont.
• Stage 1: Unaware of Health Issue
• Stage 2: Unengaged by Health Issue
• Optimistic Bias
Stages of the PAPM cont.
• Stage 3: Deciding about Acting
• Stage 4: Decided Not to Act
• Confirmation Preservation, Hypothesis Preservation
Stages of the PAPM cont.
• Stage 5: Decided to Act
• Stage 6: Acting
• Stage 7: Maintenance
THE THEORY OF TRIADIC INFLUENCE
Levels of
Causation
Intrapersonal Stream
Biological/Nature
BIOLOGY/
PERSONALITY
Ultimate
Causes
1
Social/
Personal
Nexus
2
Sense of
Self/Control
Distal
Influences
7
13
8
h
Skills:
Social+General
14
Proximal
Predictors
b
c
B
C
Others’
Beh & Atts
9
i
k
j
l m
u
d
e
n
16
SOCIAL
NORMATIVE
BELIEFS
o
11
w
20
q
Values/
Evaluations
x
v
6
Interactions w/
Social Instit’s
p
Perceived
Norms
15
5
f
10
Motivation
to Comply
s
CULTURAL
ENVIRONMENT
4
Interpersonal
Bonding
19
A
Nurture/Cultural
3
SELF-EFFICACY t
BEHAVIORAL
CONTROL
Affect and
Cognitions
Cultural/Attitudinal Stream
SOCIAL
SITUATION
a
Social
Competence
g
Self
Determination
Expectancies
& Evaluations
Decisions
Social/Normative Stream
Information/
Opportunities
Knowledge/
Expectancies
17
F
18
ATTITUDES
TOWARD THE
BEHAVIOR
21
DECISIONS/INTENTIONS
D E
12
r
I
22
H
G
Trial Behavior
EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological
Experiences
23
J
K
Related Behaviors
10
PAPM & Processes of Change
• Does not prescribe specific processes of change
• Stage progression may occur as a result of many varied
intervention techniques
• Potential of alternative theories to provide insight into
mechanisms of PAPM stage movement
• Weakness of the PAPM?
Remember…
PAPM & Your Health Behavior
• Does your health behavior of
interest fit with the PAPM
model?
• What aspects of the model
make it a good fit for your
health behavior?
-or-
• What prevents your health
behavior of interest from
fitting with the model?
• What are some of the gaps or
limitations of the model?
PAPM & Potential Processes of
Change
• Using vaccination as your health behavior, what are some
examples of factors that may contribute to an individual’s
stage progression in the PAPM?
• Stage 1 (Unaware of Health
Issue) to Stage 2 (Unengaged
by Health Issue)
• Stage 3 (Deciding about
Acting) to Stage 4 (Decided
Not to Act) -or- Stage 5
(Decided to Act)
Thank You!