Friday 10 May 2019

Models of Behavioural Change

Models of Behavioural Change

There are three theories of behaviour change that are used to help promote participation in sport and exercise, especially in cases where people are living in sedentary lifestyles, with poor diet choices and when lack of physical activity are having a big risk to their health. 

The Theory of Planned Behaviour (Ajzen, 1985)
The Theory of Planned Behaviour (TPB) is a theory that estimates a person's desire to behave or act in certain way in a specific place and a specific time, in this case, that person's desire to participate in exercise. This theory explains how behaviour towards exercise is driven by behaviour intentions, which is influenced by three factors. These factors are:
  • Perceived Behavioural Control - This is where an individual will have a certain increase in confidence and that they have a basic understanding about exercise, thus they will either find it easy or difficult to be able to perform the behavior. If a person doesn't have a strong perception of their behavioural control, this can cause an individual not to perform exercise. A way to be able to help their intention to exercise is through education. Teaching people the benefits of exercise can persuade people that exercise would be ideal for them, therefore people will become more likely to intend to exercise and would find it easier to be able to do so. 
  • Social Support - This is where how much an individual believes how much support that they have from significant others to be able to perform or not to perform the behaviour, in this case, to participate in exercise. If a person doesn't have that social support to be able to help them, they may feel that they won't know what to do or they may feel that they can't do exercise without the help from others, therefore they can become discouraged from doing so. A way to be able to prevent this from happening is by teaching the benefits of exercising on their own to other people. If people can learn how exercising on their own can have their own benefits (e.g. gives them peace and quiet from others, able to concentrate and not feel pressured to exercise etc), this can give them the belief that they are able to exercise on their own and that they won't feel the pressure from others, which will strengthen their intent to exercise. 
  • Attitude Behaviour - This is where how much positive or negative feelings that an individual has of the behaviour interested, in this case exercise. It also includes what they perceive the outcomes will be as a result of their behaviour. If a person has too many negative feelings towards exercise, this will prevent them from participating ion exercise because of their negative perception of it. A strategy that can be used in order to increase sport participation and change their attitude behaviour is by developing positive feelings towards exercise. People can be educated on how exercise can have a huge amount of positives, for instance, they're fun and exciting to engage in, they improve physical and mental health, allows you to socialise with other people, etc. If people are able to learn about how much positive exercise can be instead of how negative they belief it to be, this can help them to develop strong positive feelings towards exercise, which will therefore increase their intention to exercise. 
These three determinants together and how strong each determinants are, will decided a person's intention to exercise. The stronger that these determinants are, the greater the intent is to exercise, which will result in the participant exercising. 

Later versions of the model have added an extra determinant to the model, that being - Exercise Self-Efficacy. This refers to a person's belief in their ability to exercise and achieve their goals. If a person had high exercise self-efficacy, this would mean that they have great believes in their ability to exercise and therefore would strengthen their intention to exercise. However, if a person had low exercise self-efficacy, this means that they don't have much faith in their ability, which means that they would become less likely to exercise as a result. 

The theory states that the entire model can be affected by other factors. One of the factors that can affect the model is Past Exercise Behaviour. This refers to a person's previous experience with exercise. If an individual had a positive experience with exercise before, then this means that they are more likely to participate in exercise. Conversely, if they had bad experience with exercise, then this means that their desire to exercise will decrease and therefore are less likely to participate in exercise. 
Another factor that can affect the model is personality variables. The purpose of the model is to predict the level of intent that a person has on exercise, therefore the model measures that person's level of predictability. However, depending on the level of neuroticism, extroversion and conscientiousness, the model's ability to measure that person's intent can be affected. If a person had high level of unstable and neurotic characteristics, this means that a person's behavior can easily change and may act despite their interests and beliefs. For example, a person may have great intent to exercise, yet they may choose not to take part in exercise because they're not in the mood to do so. 

The Transtheoretical Model of Behaviour Change (Prochaska, 1994)

The Transtheoretical Model of Behaviour Change (TTM) is an integrative model that gives us an idea of the process of intentional behaviour change. The model is split into five phases that explains the behaviour and behaviour intentions that a person has at each stage.

The first stage of TTM is Pre-contemplation. This stage is where an individual is not performing a behaviour, neither do they intend to in the future, which in this case is exercising on a regular basis. The reason as to why people are on this stage is either because they are uneducated or ill-informed about the importance of exercise, or it maybe because they have failed many times to change their behaviour that they have become discouraged from being able to do so. A way of being able to help people further into the next changes of behavioural change is by using education. If they are informed about the importance of exercise, then the individual may consider about taking part regularly in exercise. Another method that can be used to encourage exercise is through gamification, whereby treating exercise as sort of a game or using elements of exercise a game for the individual, this can help develop interest and enjoyment for exercise, therefore they will intend to exercise, and this can be intensified further by adding extrinsic rewards, as this can develop further joy and satisfaction for exercising.

The second stage of TTM is Contemplation. This stage is where an individual is not exercising yet on a regular basis, but they are considering to do so and are committed to do so in the future, normally within six months of contemplation. People at this stage are aware of the benefits and drawbacks of exercising and will weigh the two out, but this balance can cause the person to contemplate for a long period of time, known as chronic contemplation. A way of being able to help further their intent to exercise is by using the same methods for people at the pre-contemplation stage, where education can be used to help teach people the benefits of exercise and that using gamification and extrinsic rewards can be used to make exercise interesting and fun in order to improve motivation for exercise. Additionally, another method that can be used is increasing people's awareness of their behavioural patterns. If a person is aware of how they are behaving, then the person has the ability to be able to change their ability consciously, therefore an increase in their awareness allows that individual to be able to change their own behaviour in quicker and more efficient succession.

The third stage of the TTM is Preparation. This stage is where a person is seriously considering to exercise and even to the point where they have already taken steps in order to meet those targets. These people will have already made an action plan to carry out, such as joining a gym, speaking to a personal trainer, or using guides online etc. These people are normally the ones who would be recruited for programmes, such as quit smoking, weight loss and exercise. In order to help these people move further up in the TTM stages, some strategies can be used, such as education, where people can be taught what gyms to sign up to, what personal trainers they can speak to, or what exercise programmes they can follow on their own. These things can help the individual to take action and begin exercising on a regular basis. They can also use gamification and extrinsic rewards in order to develop joy and satisfaction for exercising, which can therefore encourage people to take part in exercise.

The fourth stage of the TTM is Action. This stage is where an individual has began exercising and is doing it on a regular basis. According to the model, not all change in behaviour would be classed as action, but when a scientist or a professor is able to prove that they have been able reduce the risk of disease. For example, a person has managed to lose weight in order to reduce cholesterol levels and reduce the risk of coronary heart disease. In order to make sure that the person is able to maintain this behaviour, they can use strategies, such as constant feedback that is checking on an individual's fitness levels and the level of progress that they have made. This will give an idea of how well an individual is doing and if they have done well, this will give them pride and therefore they will have the motivation to maintain their exercise regime. Another strategy that can be used is by using social influence to help maintain their exercise regulation. If significant others and people's social circle can help to push a person into exercising and helping their motivation to keep exercising, this can be an effective method of maintaining exercise for those individuals. They can also use gamification as a possibility to help maintain exercise, as by providing elements of joy and entertainment to exercise can increase a person's motivation for exercise.

The fifth and final stage of the TTM is Maintenance. This stage is where an individual has been regularly exercising for more than six months. Unlike those who are in the action phase, people at the maintenance phase are less likely to relapse by stop taking part in exercise, and are more confident that they are able to continue their exercise programme. To ensure that people are able to maintain their exercise participation, they should be monitored and made aware on how much they achieved their results, because this can show how well they have done, which will not only develop a sense of pride for them but this will also give them an increase in intrinsic motivation, which means that they will keep participating in exercise. Should a person be facing problems that are preventing them from exercising, a person should be looking at ways of being able to overcome those barriers. For instance, if a person has too much work or they are committed to family, they can look at ways of being able to use time management where they spend time with family and get the opportunity to exercise. Or, if a person's car had broken down and couldn't get to the gym, they could look at what other sources of transportation they can use, or they can jog to the gym as a warm up etc. They can also use gamification as a possibility to help maintain exercise, as by providing elements of joy and entertainment to exercise can increase a person's motivation for exercise.

The Health-Belief Model (HBM)

The Health-Belief Model (HBM) is a theory that is based upon how people change their behaviours due to health-related factors. The model explains that depending how people perceive health problems that they can develop and the benefits of action, this can lead to the likelihood of that person making efforts into taking part in exercise and improving their health and fitness.

The model states that depending on the demographic factors (e.g. age, sex, race etc) and sociopsychological factors (culture, lifestyle, family and friends etc), these can influence how people perceive health-related problems that can occur. For example, if a male was 22 years old and quite healthy and fit with no pressure at all from their family, they may not feel susceptible from illnesses and wouldn't need to exercise, but if a older women who is quite obese, realises that her health is in danger, this means she is very susceptible to illnesses and realises she needs to do something about it.

There are four pathways, which can influence the likelihood of people going to exercise.

The first pathway is perceived susceptibility. This is where how much a person believes they are likely to suffer from illnesses or health related problems, such as obesity, overweight, lifestyle, genetics and family problems. These are affected by how serious that person believes it to be (Perceived Seriousness), for example will they stop them from doing any physical activity, will it affect their appearance, will they get mocked for the way they look etc. If a person was to have a high perception of susceptibility and seriousness of health problems, this can increase their perception of how much of a threat it is to them (Perceived Threat). For example, they become afraid of becoming obese, of becoming ill and suffering from conditions. If the perceived threat is higher to the individual, this means that the individual is more likely to try and do something about it, and  therefore are more likely to take part in exercise and try to improve their health.

The second pathway is perceived benefits of being at a healthy weight. This is how good that person thinks being at a healthy weight is and what benefits they get for being healthy and fit, such as how good they feel, how they look, do they suffer from illnesses, do they have more energy and how much of a role model will they become. This perception of benefits can be weighed in against on how a person perceives the barriers that they face (Perceived Barriers). This could be barriers, such as low motivation, low priority, lack of self-control, little reliable information, lack of support and no time for exercise. If the barriers were to outweigh the benefits, this means that the person is less likely to make any efforts to improve their health and fitness. However, if the benefits outweigh the barriers, then the individual will become more likely to try to improve their health.

The third pathway is Cues to Action. This is where certain events that have happened in an individual's life that has caused concern for the individual and would act as triggers in order for that person to take action. For example, they may have become succumbed to illness and health problems, such as joint pain, high cholesterol levels, injuries etc. They may have such lack of energy that its effecting their job, or they are being targeted by others for their weight or lifestyle choice. Or it could be that something has happened to friends, family or associates of theirs, that they are very worried that it could happen to themselves. If that cue to action has made the individual become more worried in regards to their health, this may increase that person's motivation in order to try to improve their health, so that they don't or no longer suffer from any illnesses and conditions.

The fourth pathway is Self-Efficacy. This refers to how much confidence a person has in their ability to be able to take action and be able to improve their health, such as being able to join a gym, work with a personal trainer, using a weight loss programme, sticking with a diet etc. The greater a person's self-efficacy, the more likely that they are able to make efforts in order to improve their health and fitness.

In conclusion, these four pathways (factors) will determine the likelihood of a person making any efforts in order to improve their health and fitness. The greater these factors are, the greater chance that somebody is likely to try and improve their health and fitness.