The document discusses the transtheoretical model of behavior change, also known as the stages of change model. It outlines the six stages that individuals progress through when adopting healthy behaviors or quitting unhealthy ones: precontemplation, contemplation, preparation, action, maintenance, and termination. Key aspects of each stage are described. The model also identifies ten processes of change that help individuals progress from one stage to the next, including consciousness raising, dramatic relief, and self-reevaluation. The stages of change model has been successfully applied to understanding behavior changes in various health domains like smoking cessation and weight control.
One of the best-known approaches to Behavior change is known as the "Stages of Change" model, which was introduced in the late 1970's by researchers James Prochaska and Carlo DiClemente who were studying ways to help people quit smoking.
The Stages of Change Model has been found to be an effective aid in understanding how people go through a change in behavior.
Transtheoretical Model (Stages of Change Model)Rozanne Clarke
The Transtheoretical Model (TTM) speaks on suggested strategies for public health interventions to address people at various stages of the decision-making process. Acknowledgements of this and other behavioural change models will resulting in social marketing campaigns being implemented as they're tailored to suit the target audience.
Prochaska and DiClemente's Trans-theoretical Model of Change. By Theresa Lowr...Theresa Lowry-Lehnen
The document summarizes the Trans-theoretical Model of Change proposed by psychologists James Prochaska and Carlo DiClemente. The model outlines five stages of change that people progress through when trying to change an addictive behavior: pre-contemplation, contemplation, preparation, action, and maintenance. It also includes the possibility of relapse. The model can be used by therapists and coaches to assess what stage a client is at and determine appropriate strategies to help them progress to the next stage of change.
The Transtheoretical Model (TTM) posits that health behavior change involves progressing through six stages: precontemplation, contemplation, preparation, action, maintenance, and relapse prevention. It assumes that people move through these stages of change and that different processes of change are involved at each stage. The ten processes of change include consciousness raising, dramatic relief, self-reevaluation, environmental reevaluation, social liberation, self-liberation, helping relationships, counter conditioning, reinforcement management, and stimulus control. The TTM aims to understand intentional behavioral changes like quitting smoking and recognizes that falling back to earlier stages is part of the process of change.
The document discusses the Transtheoretical Model of Behavior Change, also known as the Stages of Change Model. It describes the five stages of change that individuals progress through when making behavioral changes: pre-contemplation, contemplation, preparation, action, and maintenance. The stages are not always linear, as people may relapse and recycle through the stages before reaching sustained change. Understanding that change is a process involving different tasks at each stage allows helpers to meet people where they are and provide the most effective support.
This document discusses eliciting individual behavior change. It outlines the stages of change model and strategies for each stage. The five stages are pre-contemplation, contemplation, preparation, action, and maintenance. Motivational interviewing aims to determine readiness for change. Strategies depend on the individual's stage and can include increasing motivation, setting goals, addressing barriers, and providing support and positive reinforcement. Desirability, likelihood of outcomes, and counterarguments must be addressed to influence attitudes. Social norms and perceived abilities also impact behavior and can be addressed through modeling, rehearsal, and removing obstacles.
5STAGES AND PROCEsSES OF HEALTH BEHAVIOR CHANGE 113 inter.docxstandfordabbot
5/STAGES AND PROCEsSES OF HEALTH BEHAVIOR CHANGE 113
intervention should increase the effectiveness, assist the client in progress-ing to the next SOC because of enhanced motivation and readiness, and reduce the likelihood of dropping out of treatment because the intervention was not appropriate.
Stages of Change
Change is not viewed as a single event, such as "I will eat less sodium start ing today,
"
but as an unfolding process over time requiring more than one
attempt. The model in Table5-1 shows the how, not the why, people change either with counseling or without it on their own. To make changes, people progress through six identified stages. The tasks at each stage vary, and
movement through the stages represents personal progress for the client.
Precontemplation
In stage 1, Precontemplation, a person is unaware or underaware that a
health problem exists, denies that there is a problem, or has no intention
to take action to change. Thus, the individual has no plans, for example, to modify eating practices to lose weight or start exercising in the next
6 months.34 The person may have tried a change previously and failed,
such as to lose weight, and may be resistant to the health professional's efforts to suggest possible changes. Perhaps a visit to the doctor initiated
a referral to see the nutrition and dietetics counselor for weight loss, even
if the patient was not concerned with his or her weight.
Because these clients are unaware, uninformed, or unconcerned about the
health problem, the counselor needs to assess the client's views on making
a change and address the reasons for not wanting to change rather than
providing dietary information. Educating the client about food changes
not appropriate at this stage. To identify this stage, the counselor may
asAre you seriously intending to change (name the problem behavior)
in the next 6 months?"
1. Precontemplation
No intention of changing in the next 6 mno.
2. Contemplation
Intending to change, but not soon.
3. Preparation
Small changes are made, intending to change in 30 d.
4. Action
Changes are made in food choices regularly.
5. Maintenance
Behavior changes maintained for 6 mo.
6. Termination
Occurs only if changes are maintained for a year or more.
Tahl
2/COUNSELING
FOR HEALTH
BEHAViOR CHANGE
-fat diet ande Cotoa
114
less fat (or more fruits and vegetables) in the near futur2DOUl e
Droblem andi
a person with a heart problem may need to know the health benelits
this.
The client needs to "own or acknowledge the health i
For people ignoring the relationship between a high-fat :
ght about eatin
heart disease, for example, one may ask: "Have you tho
re"
and
At this stag
change as well as the risks of not addressing the problem Denef
ofene
negative aspects."** These individuals are not ready for act and
idensith
interventions. Knowing the person' s SOC helps the counelene
the appropriate type of interv.
This document provides an overview of Module B: Fitness Management which focuses on making and continuing positive lifestyle changes. It discusses the importance of goal setting using the Stages of Change model. The module contains 5 lessons that challenge thinking about health trends, exercise myths, fitness advertising, and becoming an informed consumer. The first lesson reviews goal setting and the Stages of Change model to help students identify and implement personal fitness goals.
One of the best-known approaches to Behavior change is known as the "Stages of Change" model, which was introduced in the late 1970's by researchers James Prochaska and Carlo DiClemente who were studying ways to help people quit smoking.
The Stages of Change Model has been found to be an effective aid in understanding how people go through a change in behavior.
Transtheoretical Model (Stages of Change Model)Rozanne Clarke
The Transtheoretical Model (TTM) speaks on suggested strategies for public health interventions to address people at various stages of the decision-making process. Acknowledgements of this and other behavioural change models will resulting in social marketing campaigns being implemented as they're tailored to suit the target audience.
Prochaska and DiClemente's Trans-theoretical Model of Change. By Theresa Lowr...Theresa Lowry-Lehnen
The document summarizes the Trans-theoretical Model of Change proposed by psychologists James Prochaska and Carlo DiClemente. The model outlines five stages of change that people progress through when trying to change an addictive behavior: pre-contemplation, contemplation, preparation, action, and maintenance. It also includes the possibility of relapse. The model can be used by therapists and coaches to assess what stage a client is at and determine appropriate strategies to help them progress to the next stage of change.
The Transtheoretical Model (TTM) posits that health behavior change involves progressing through six stages: precontemplation, contemplation, preparation, action, maintenance, and relapse prevention. It assumes that people move through these stages of change and that different processes of change are involved at each stage. The ten processes of change include consciousness raising, dramatic relief, self-reevaluation, environmental reevaluation, social liberation, self-liberation, helping relationships, counter conditioning, reinforcement management, and stimulus control. The TTM aims to understand intentional behavioral changes like quitting smoking and recognizes that falling back to earlier stages is part of the process of change.
The document discusses the Transtheoretical Model of Behavior Change, also known as the Stages of Change Model. It describes the five stages of change that individuals progress through when making behavioral changes: pre-contemplation, contemplation, preparation, action, and maintenance. The stages are not always linear, as people may relapse and recycle through the stages before reaching sustained change. Understanding that change is a process involving different tasks at each stage allows helpers to meet people where they are and provide the most effective support.
This document discusses eliciting individual behavior change. It outlines the stages of change model and strategies for each stage. The five stages are pre-contemplation, contemplation, preparation, action, and maintenance. Motivational interviewing aims to determine readiness for change. Strategies depend on the individual's stage and can include increasing motivation, setting goals, addressing barriers, and providing support and positive reinforcement. Desirability, likelihood of outcomes, and counterarguments must be addressed to influence attitudes. Social norms and perceived abilities also impact behavior and can be addressed through modeling, rehearsal, and removing obstacles.
5STAGES AND PROCEsSES OF HEALTH BEHAVIOR CHANGE 113 inter.docxstandfordabbot
5/STAGES AND PROCEsSES OF HEALTH BEHAVIOR CHANGE 113
intervention should increase the effectiveness, assist the client in progress-ing to the next SOC because of enhanced motivation and readiness, and reduce the likelihood of dropping out of treatment because the intervention was not appropriate.
Stages of Change
Change is not viewed as a single event, such as "I will eat less sodium start ing today,
"
but as an unfolding process over time requiring more than one
attempt. The model in Table5-1 shows the how, not the why, people change either with counseling or without it on their own. To make changes, people progress through six identified stages. The tasks at each stage vary, and
movement through the stages represents personal progress for the client.
Precontemplation
In stage 1, Precontemplation, a person is unaware or underaware that a
health problem exists, denies that there is a problem, or has no intention
to take action to change. Thus, the individual has no plans, for example, to modify eating practices to lose weight or start exercising in the next
6 months.34 The person may have tried a change previously and failed,
such as to lose weight, and may be resistant to the health professional's efforts to suggest possible changes. Perhaps a visit to the doctor initiated
a referral to see the nutrition and dietetics counselor for weight loss, even
if the patient was not concerned with his or her weight.
Because these clients are unaware, uninformed, or unconcerned about the
health problem, the counselor needs to assess the client's views on making
a change and address the reasons for not wanting to change rather than
providing dietary information. Educating the client about food changes
not appropriate at this stage. To identify this stage, the counselor may
asAre you seriously intending to change (name the problem behavior)
in the next 6 months?"
1. Precontemplation
No intention of changing in the next 6 mno.
2. Contemplation
Intending to change, but not soon.
3. Preparation
Small changes are made, intending to change in 30 d.
4. Action
Changes are made in food choices regularly.
5. Maintenance
Behavior changes maintained for 6 mo.
6. Termination
Occurs only if changes are maintained for a year or more.
Tahl
2/COUNSELING
FOR HEALTH
BEHAViOR CHANGE
-fat diet ande Cotoa
114
less fat (or more fruits and vegetables) in the near futur2DOUl e
Droblem andi
a person with a heart problem may need to know the health benelits
this.
The client needs to "own or acknowledge the health i
For people ignoring the relationship between a high-fat :
ght about eatin
heart disease, for example, one may ask: "Have you tho
re"
and
At this stag
change as well as the risks of not addressing the problem Denef
ofene
negative aspects."** These individuals are not ready for act and
idensith
interventions. Knowing the person' s SOC helps the counelene
the appropriate type of interv.
This document provides an overview of Module B: Fitness Management which focuses on making and continuing positive lifestyle changes. It discusses the importance of goal setting using the Stages of Change model. The module contains 5 lessons that challenge thinking about health trends, exercise myths, fitness advertising, and becoming an informed consumer. The first lesson reviews goal setting and the Stages of Change model to help students identify and implement personal fitness goals.
This document outlines the stages of behavior change and the role of health educators at each stage. It discusses:
1) The six stages of behavior change - precontemplation, contemplation, preparation, action, maintenance, and relapse.
2) Factors that influence health behaviors like predisposing, reinforcing, and enabling factors.
3) How health educators can support behavior change at each stage through communication, skills building, and reinforcement.
The document introduces three major theories of behavior change: social cognitive theory, theory of planned behavior, and the transtheoretical model. Social cognitive theory proposes that behavior is influenced by personal factors, environmental factors, and the interactions between them. The theory of planned behavior suggests behavior is determined by intentions, attitudes, and perceived behavioral control. The transtheoretical model proposes behavior change as a process through six stages of change. The document discusses how each theory can inform designing interventions to promote behavior change.
This document discusses promoting healthy aging through lifestyle changes for people with developmental disabilities. It describes shifting from a prevention focus to evaluating and improving individual health. Poor lifestyle choices like inactivity and unhealthy diets can lead to diseases over time. Regular physical activity and improved nutrition are presented as solutions. Barriers like lack of knowledge, motivation and skills are addressed. Strategies to increase self-efficacy like setting achievable goals, using role models, understanding symptoms, and having social support are outlined to help facilitate behavior changes. Relapses are also discussed as common, and techniques are provided to help people continue progressing with their goals after a setback.
Recovery- Oriented System of Care ,Motivational Approach , in Substance Use D...احمد البحيري
This document discusses recovery-oriented treatment for substance use disorders. It defines treatment as direct medical interventions, while recovery is a sustained process of change addressing biological, psychological, social, and spiritual disturbances from addiction. Recovery aims to improve quality of life through pursuing abstinence and dealing with cravings. The document outlines motivational interviewing techniques including engaging patients, eliciting change talk, and negotiating plans for change. It emphasizes that recovery requires ongoing care beyond initial medical detoxification.
Change Process of Human Health behaviourdr natasha
- The document discusses attitudes, the change process, and resistance to change in the context of health promotion and education.
- It defines attitude as a tendency to react in a particular way, and identifies three components: cognitive, feeling, and action tendency.
- Two models of the change process are described: Rogers' five stages of awareness, interest, evaluation, trial, and adoption. Lewin's three phases of unfreezing old attitudes, moving to new attitudes, and refreezing the change.
- Resistance to change is said to come from threats to social structures, vested interests, or individuals. Late adopters also resist change.
The document discusses theories of organizational change including Lewin's three-stage theory of change (unfreezing, moving, refreezing) and Lippitt's seven stages of change. It also discusses principles of organizational change including the principle of self-creation and binary modes of existence. Resistance to change is discussed as being caused by the energy required to adapt or resist change and the uncertainty about outcomes of change initiatives. Planned change is described as occurring in three stages - unfreezing, moving, and refreezing.
The document discusses the Stage Based Model (SBM) of behavior change. It explains that the SBM was developed in the 1970s to understand smoking cessation. The SBM posits that people progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Ten processes of change help people progress through the stages. The document also outlines some limitations of the SBM, such as that it ignores social context and sets arbitrary criteria for stages.
The document discusses readiness for change and the transtheoretical model of change. It defines readiness as a combination of previous experience, skills/knowledge, and attitude. It explores using the readiness ruler to assess motivation and lists questions to ask at different stages. People progress through stages using cognitive, affective and evaluative processes and later rely on commitments, conditioning and support. The goals of system change and 10 processes for moving through stages are outlined.
Health behaviour and health education for family medicine postgraduatesChai-Eng Tan
This document discusses several health behavior theories that can be used to understand health behaviors and design interventions to promote behavior change. It provides an overview of the Health Belief Model, Transtheoretical Model of Change, Theory of Reasoned Action, and Theory of Planned Behavior. For each theory, it describes the key constructs and provides examples of how the theories can be applied to design health education programs around behaviors like condom use and STI screening. It also notes some limitations of each theory.
The document discusses motivational interviewing (MI) and the transtheoretical model of health behavior change (TTM). The TTM proposes that behavior change involves progress through six stages: precontemplation, contemplation, preparation, action, maintenance, and termination. MI is a counseling approach used to help people progress through the stages by expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. The document provides examples of questions counselors can ask and behaviors to watch for at each stage to support movement toward behavior change.
Brief intervention can range from 5 minutes to 2 hours and involves an informal assessment of the client's situation, thoughts, and developing a strategy for change. It is based on harm minimization principles and can be used to discuss personal health, substance use, mental health issues, and their effects on family. The most important factor is developing a relationship with the client. Brief intervention may not be appropriate if the client is resistant, intoxicated, unwell, or has complex chronic issues. In those cases, referral or postponing may be necessary. Brief intervention can help clients develop a sense of power, identity, purpose, self-acceptance, and management of social issues.
Practical hints and tips for assessing readiness to change - Dr Bronwen BonfieldMS Trust
Aims:
To have increased awareness of the factors that affect an individuals readiness to change.
To explore the theoretical models that underpin change behaviour
To develop awareness of skills and strategies to support individuals and their families.
Learning and regularly practicing self-management skills can help people adopt and maintain healthy lifestyles. Self-management skills include self-assessment, self-monitoring, and goal-setting. These skills can help influence factors like knowledge, beliefs, attitudes, and access to resources that promote making changes to diet, physical activity, stress management, and other healthy behaviors. While it takes time to develop unhealthy habits, self-management skills allow people to progress through stages of change to eventually maintain healthy lifestyles long-term.
An overview of evidence-based therapeutic components that aid in the reduction of the rate of return or recidivism of ex-offenders going back to prison.
Human Behavior And Psychosocial AssessmentKayla Muth
This document provides an overview of psychological theories and their application to health behavior change and counseling. It discusses theories like learning theory, the health belief model, the transtheoretical model of change, and social cognitive theory. It also covers topics like the stages of change, cognitive-behavioral principles, common psychological issues like stress, anxiety, and depression, and tools for measuring health behavior change.
Influencing Attitudes and Changing Behaviours in the Work PlaceEmeka Anazia
This document discusses attitudes and behaviors in the workplace and how they can be influenced for change. It begins by defining attitudes and behaviors. It then discusses several theories of behavior change, including social cognitive theory and the theory of planned behavior. Key variables that can impact behavior change like self-efficacy, outcome expectations, and perceived behavioral control are explained. The stages of change model is also summarized. The document provides tips on how to effectively influence attitudes in the workplace by matching interventions to stages of change and considering communicator credibility and argument order.
1. The document discusses strategies for promoting physical activity, including theoretical models like the stages of change model. It describes the stages of change model and gives examples of strategies like counseling, environmental approaches, and mass media campaigns.
2. Cognitive and behavioral strategies are described for each stage of change to help individuals increase their physical activity levels. These include increasing knowledge, social support, and goal-setting.
3. Population-based promotion strategies are compared to individual-based approaches. Environmental and policy interventions can promote activity for whole communities, while counseling uses models of behavior change for individuals.
Change and the Social System by Rose, Sharon & Marilou (Group 9)Jay Gonzales
This document discusses various aspects of managing organizational change. It begins by defining organizational change and describing common reasons for change. It then outlines different types of changes including anticipatory, reactive, incremental, and strategic changes. It discusses both external and internal forces that can drive organizational change. The document also summarizes Kurt Lewin's three-stage model of change - unfreezing, changing, and refreezing. It provides details on each stage and how to manage change. Finally, it discusses common responses to change and strategies for facilitating change adoption.
Epidemiologists measure disease frequency and health status in populations using various metrics. Morbidity is measured using incidence rates which describe new cases over time. Incidence can be calculated as cumulative incidence from a stable population or incidence density using person-time. Mortality is measured using rates like crude death rate from the total population or age-adjusted rates to control for demographic factors. Rates express the probability of an event and are calculated by dividing the number of events by the population at risk over a specified time period.
The document provides guidance on critically appraising research articles. It defines critical appraisal as carefully analyzing research methodology to assess validity, results, and relevance. The process examines bias and evaluates internal/external validity. Critical appraisal is important for literature reviews, program evaluation, policymaking, and more. It involves reading the abstract, introduction, methodology, results, and discussion sections to evaluate study design, measures, sample size, analysis, conclusions, and comparison to prior research. The example shows how to appraise a cohort study by assessing exposure and outcome definitions, follow up time, measurement methods, attrition, confounding, results, and applicability.
This document outlines the stages of behavior change and the role of health educators at each stage. It discusses:
1) The six stages of behavior change - precontemplation, contemplation, preparation, action, maintenance, and relapse.
2) Factors that influence health behaviors like predisposing, reinforcing, and enabling factors.
3) How health educators can support behavior change at each stage through communication, skills building, and reinforcement.
The document introduces three major theories of behavior change: social cognitive theory, theory of planned behavior, and the transtheoretical model. Social cognitive theory proposes that behavior is influenced by personal factors, environmental factors, and the interactions between them. The theory of planned behavior suggests behavior is determined by intentions, attitudes, and perceived behavioral control. The transtheoretical model proposes behavior change as a process through six stages of change. The document discusses how each theory can inform designing interventions to promote behavior change.
This document discusses promoting healthy aging through lifestyle changes for people with developmental disabilities. It describes shifting from a prevention focus to evaluating and improving individual health. Poor lifestyle choices like inactivity and unhealthy diets can lead to diseases over time. Regular physical activity and improved nutrition are presented as solutions. Barriers like lack of knowledge, motivation and skills are addressed. Strategies to increase self-efficacy like setting achievable goals, using role models, understanding symptoms, and having social support are outlined to help facilitate behavior changes. Relapses are also discussed as common, and techniques are provided to help people continue progressing with their goals after a setback.
Recovery- Oriented System of Care ,Motivational Approach , in Substance Use D...احمد البحيري
This document discusses recovery-oriented treatment for substance use disorders. It defines treatment as direct medical interventions, while recovery is a sustained process of change addressing biological, psychological, social, and spiritual disturbances from addiction. Recovery aims to improve quality of life through pursuing abstinence and dealing with cravings. The document outlines motivational interviewing techniques including engaging patients, eliciting change talk, and negotiating plans for change. It emphasizes that recovery requires ongoing care beyond initial medical detoxification.
Change Process of Human Health behaviourdr natasha
- The document discusses attitudes, the change process, and resistance to change in the context of health promotion and education.
- It defines attitude as a tendency to react in a particular way, and identifies three components: cognitive, feeling, and action tendency.
- Two models of the change process are described: Rogers' five stages of awareness, interest, evaluation, trial, and adoption. Lewin's three phases of unfreezing old attitudes, moving to new attitudes, and refreezing the change.
- Resistance to change is said to come from threats to social structures, vested interests, or individuals. Late adopters also resist change.
The document discusses theories of organizational change including Lewin's three-stage theory of change (unfreezing, moving, refreezing) and Lippitt's seven stages of change. It also discusses principles of organizational change including the principle of self-creation and binary modes of existence. Resistance to change is discussed as being caused by the energy required to adapt or resist change and the uncertainty about outcomes of change initiatives. Planned change is described as occurring in three stages - unfreezing, moving, and refreezing.
The document discusses the Stage Based Model (SBM) of behavior change. It explains that the SBM was developed in the 1970s to understand smoking cessation. The SBM posits that people progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Ten processes of change help people progress through the stages. The document also outlines some limitations of the SBM, such as that it ignores social context and sets arbitrary criteria for stages.
The document discusses readiness for change and the transtheoretical model of change. It defines readiness as a combination of previous experience, skills/knowledge, and attitude. It explores using the readiness ruler to assess motivation and lists questions to ask at different stages. People progress through stages using cognitive, affective and evaluative processes and later rely on commitments, conditioning and support. The goals of system change and 10 processes for moving through stages are outlined.
Health behaviour and health education for family medicine postgraduatesChai-Eng Tan
This document discusses several health behavior theories that can be used to understand health behaviors and design interventions to promote behavior change. It provides an overview of the Health Belief Model, Transtheoretical Model of Change, Theory of Reasoned Action, and Theory of Planned Behavior. For each theory, it describes the key constructs and provides examples of how the theories can be applied to design health education programs around behaviors like condom use and STI screening. It also notes some limitations of each theory.
The document discusses motivational interviewing (MI) and the transtheoretical model of health behavior change (TTM). The TTM proposes that behavior change involves progress through six stages: precontemplation, contemplation, preparation, action, maintenance, and termination. MI is a counseling approach used to help people progress through the stages by expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy. The document provides examples of questions counselors can ask and behaviors to watch for at each stage to support movement toward behavior change.
Brief intervention can range from 5 minutes to 2 hours and involves an informal assessment of the client's situation, thoughts, and developing a strategy for change. It is based on harm minimization principles and can be used to discuss personal health, substance use, mental health issues, and their effects on family. The most important factor is developing a relationship with the client. Brief intervention may not be appropriate if the client is resistant, intoxicated, unwell, or has complex chronic issues. In those cases, referral or postponing may be necessary. Brief intervention can help clients develop a sense of power, identity, purpose, self-acceptance, and management of social issues.
Practical hints and tips for assessing readiness to change - Dr Bronwen BonfieldMS Trust
Aims:
To have increased awareness of the factors that affect an individuals readiness to change.
To explore the theoretical models that underpin change behaviour
To develop awareness of skills and strategies to support individuals and their families.
Learning and regularly practicing self-management skills can help people adopt and maintain healthy lifestyles. Self-management skills include self-assessment, self-monitoring, and goal-setting. These skills can help influence factors like knowledge, beliefs, attitudes, and access to resources that promote making changes to diet, physical activity, stress management, and other healthy behaviors. While it takes time to develop unhealthy habits, self-management skills allow people to progress through stages of change to eventually maintain healthy lifestyles long-term.
An overview of evidence-based therapeutic components that aid in the reduction of the rate of return or recidivism of ex-offenders going back to prison.
Human Behavior And Psychosocial AssessmentKayla Muth
This document provides an overview of psychological theories and their application to health behavior change and counseling. It discusses theories like learning theory, the health belief model, the transtheoretical model of change, and social cognitive theory. It also covers topics like the stages of change, cognitive-behavioral principles, common psychological issues like stress, anxiety, and depression, and tools for measuring health behavior change.
Influencing Attitudes and Changing Behaviours in the Work PlaceEmeka Anazia
This document discusses attitudes and behaviors in the workplace and how they can be influenced for change. It begins by defining attitudes and behaviors. It then discusses several theories of behavior change, including social cognitive theory and the theory of planned behavior. Key variables that can impact behavior change like self-efficacy, outcome expectations, and perceived behavioral control are explained. The stages of change model is also summarized. The document provides tips on how to effectively influence attitudes in the workplace by matching interventions to stages of change and considering communicator credibility and argument order.
1. The document discusses strategies for promoting physical activity, including theoretical models like the stages of change model. It describes the stages of change model and gives examples of strategies like counseling, environmental approaches, and mass media campaigns.
2. Cognitive and behavioral strategies are described for each stage of change to help individuals increase their physical activity levels. These include increasing knowledge, social support, and goal-setting.
3. Population-based promotion strategies are compared to individual-based approaches. Environmental and policy interventions can promote activity for whole communities, while counseling uses models of behavior change for individuals.
Change and the Social System by Rose, Sharon & Marilou (Group 9)Jay Gonzales
This document discusses various aspects of managing organizational change. It begins by defining organizational change and describing common reasons for change. It then outlines different types of changes including anticipatory, reactive, incremental, and strategic changes. It discusses both external and internal forces that can drive organizational change. The document also summarizes Kurt Lewin's three-stage model of change - unfreezing, changing, and refreezing. It provides details on each stage and how to manage change. Finally, it discusses common responses to change and strategies for facilitating change adoption.
Epidemiologists measure disease frequency and health status in populations using various metrics. Morbidity is measured using incidence rates which describe new cases over time. Incidence can be calculated as cumulative incidence from a stable population or incidence density using person-time. Mortality is measured using rates like crude death rate from the total population or age-adjusted rates to control for demographic factors. Rates express the probability of an event and are calculated by dividing the number of events by the population at risk over a specified time period.
The document provides guidance on critically appraising research articles. It defines critical appraisal as carefully analyzing research methodology to assess validity, results, and relevance. The process examines bias and evaluates internal/external validity. Critical appraisal is important for literature reviews, program evaluation, policymaking, and more. It involves reading the abstract, introduction, methodology, results, and discussion sections to evaluate study design, measures, sample size, analysis, conclusions, and comparison to prior research. The example shows how to appraise a cohort study by assessing exposure and outcome definitions, follow up time, measurement methods, attrition, confounding, results, and applicability.
This document discusses causation and causal inference in epidemiology. It outlines concepts of single and multiple causes of disease. The Bradford Hill criteria are presented as guidelines for making causal inferences, including strengths like temporal relationship, plausibility, consistency, and dose-response relationship. Finally, it emphasizes that no single criterion proves causation but evaluating the totality of evidence using these guidelines can help strengthen causal judgments.
The document summarizes HIV/AIDS in Ethiopia across multiple topics:
1) HIV incidence in adults is estimated at 0.06% annually, corresponding to around 7,000 new cases, though a lower estimate is 0.05% or 6,000 new cases using a different method. Incidence is highest in those aged 50-64.
2) Ethiopia has made progress toward global 90-90-90 targets, with an estimated 82% of people with HIV knowing their status, 74% on antiretroviral treatment, and 66% virally suppressed.
3) Key populations include female sex workers, prisoners, divorced/widowed urban women, and long-distance drivers.
09 Predictors of Comprehensive Knowledge of HIV AIDS Among People Aged 15 49 ...AMANUELMELAKU5
This study used data from the 2016 Ethiopian Demographic and Health Survey to identify individual- and community-level predictors of comprehensive knowledge of HIV/AIDS among people aged 15-49 years in Ethiopia. The study found that at the individual level, factors such as male sex, higher education levels, media exposure, ever being tested for HIV, and employment were associated with greater comprehensive knowledge. At the community level, living in urban areas and regions with more development were associated with greater comprehensive knowledge. The study concludes that both individual characteristics and community contexts influence levels of HIV/AIDS knowledge in Ethiopia.
07 Trend in ethiopia for last 26 years.pdfAMANUELMELAKU5
After declining for decades, HIV infection rates in Ethiopia have begun to rise again in recent years. While new HIV infections declined by 81% between 1995 and 2016, the rate of decline has slowed and infections have increased by 10% since 2008. Current estimates indicate that 67% of people living with HIV know their status, and Ethiopia is on track to meet treatment targets but may fall short of the first 90% diagnosis goal by 2020. Regional disparities remain, with higher infection rates in some areas like Gambela compared to the national average. Continued efforts are needed to accelerate diagnosis and avert further increases in new infections.
Ethiopia has made progress toward achieving the 90-90-90 targets but gaps remain. As of 2019:
- 87.4% of people living with HIV knew their status nationally, though some regions fell below 90%.
- 74.7% of those diagnosed were accessing treatment.
- 91.2% of those on treatment had suppressed viral loads, meeting the third 90 target.
More work is needed to improve HIV testing, linkage to care, and treatment adherence to achieve the first two 90 targets in all regions by 2020. Investing in community health services could help close remaining gaps.
The HIV epidemic in Ethiopia remains heterogeneous, with urban areas, large cities, and areas near major transport corridors experiencing higher prevalence rates than rural areas. While national HIV prevalence has remained stable at around 1.5% according to surveys, prevalence is increasing slightly in some large urban areas. HIV incidence appears to have declined based on falling prevalence in younger age groups and ANC surveillance. AIDS-related mortality has also decreased sharply. Behavioral factors like high male circumcision rates and low rates of premarital and extramarital sex have helped keep prevalence low. However, HIV transmission within marriage represents a major source of new infections. The HIV response in Ethiopia has expanded treatment coverage significantly but prevention programs need to be strengthened,
This document discusses the concept of Kaizen, a Japanese philosophy of continuous improvement. It defines Kaizen as focusing on continually improving all aspects of life and work through small, ongoing changes. The document outlines the history and dissemination of Kaizen in Ethiopia, starting with a pilot project in 2009 and the establishment of the Ethiopian Kaizen Institute in 2011 to promote Kaizen nationwide. It describes the three pillars of Kaizen as the philosophy of continuous improvement, Kaizen systems like Toyota Production System and Total Quality Management, and Kaizen tools and techniques. The document provides examples of categorizing and identifying types of waste or Muda in processes.
This document provides guidance on problem solving techniques and tools for health extension workers. It discusses defining problems, measuring their magnitude, generating alternative solutions, and setting objectives. Key steps in the problem solving process include identifying and prioritizing problems, analyzing causes, examining countermeasures, and assessing solutions. Tools that can be used include fishbone diagrams, brainstorming, line graphs and tree diagrams to help analyze problems and their root causes in a systematic way. The overall goal is to implement measurable solutions to identified challenges in healthcare.
This document provides an overview of adolescent and youth reproductive health (AYRH). It begins by defining adolescence and discussing the physical, cognitive, social, and emotional changes that occur during this period. It then outlines some of the sexual and reproductive health challenges faced by many young Ethiopians, including gender inequality, coercion, early marriage, teenage pregnancy, unsafe abortion, and sexually transmitted infections. The document emphasizes the importance of providing appropriate information, services, and community support to address AYRH issues. It discusses vulnerabilities, risk behaviors, and life skills among adolescents and young people. Finally, it outlines the reproductive health rights of adolescents and services that should be available to them.
Oxygen therapy involves administering oxygen at concentrations greater than in the atmosphere to treat hypoxemia. It is used for conditions like respiratory failure, heart failure, shock, and anemia. Oxygen can be delivered via nasal cannula, face masks, venturi masks, or mechanical ventilation. Proper monitoring and precautions are needed due safety risks like fire and oxygen toxicity. Oxygen therapy aims to improve tissue oxygenation and decrease workload on the heart and lungs.
This document discusses various methods for managing time and health facilities. It describes preparing schedules, program charts, and year calendars to plan activities and ensure they occur on time. It also discusses maintaining infrastructure and equipment through a maintenance department, and addressing common issues like lack of funding and skilled workers. Finally, it touches on managing referrals between different levels of facilities, the roles of focal persons, and regional coordination of the referral system.
This document discusses a study on the role of leadership in implementing organizational change in public sector organizations. It begins with an introduction that notes the prevalence of change in public management research but lack of focus on how change is implemented in individual public organizations. The study aims to address this gap by exploring the role of leadership in change implementation and processes of organizational change in public sector contexts.
This document summarizes the conceptual foundations and development of the Balanced Scorecard approach to performance measurement. It discusses:
1. The origins of the Balanced Scorecard in the 1990s as a way to measure intangible assets and drive improvements, building on prior work studying performance measurement.
2. The evolution of the Balanced Scorecard framework from its original focus on financial and three non-financial perspectives (customers, internal processes, learning and growth) to also link measures to strategy and become a strategic management system.
3. Key thinkers and works in the 1950s-1980s that influenced the Balanced Scorecard concept, including efforts at GE to use non-financial measures, Simon's work
Long-term organizational transformations require addressing change at the individual employee level. Successful change starts with leadership committing to the change from day one and modeling the desired behaviors. Real change happens when responsibility is pushed down through the organization to line managers and individual contributors. Leaders must confront reality, demonstrate faith in the organization's future, and craft a compelling vision to guide behavior during the transformation.
This document provides a guide for auditors to assess business process reengineering projects in federal agencies. It discusses how business process reengineering began in the private sector to improve customer service and cut costs, and how federal agencies are now pursuing it to improve performance and reduce costs. The guide outlines a framework for assessing reengineering projects covering strategic planning, process analysis and redesign, implementation, and results evaluation. It aims to help auditors determine if projects are well-managed and identify actions needed for successful reengineering.
This document discusses managing readiness for change to overcome resistance to change. It begins by noting that while there is extensive literature on managing change, many change efforts still fail due to a failure to properly create readiness for change among organizational members. The document then discusses specific reasons why people may resist change and defines readiness for change as creating awareness, acceptance and capability for change. It identifies five key elements of an effective change message to create readiness: establishing a need for change, demonstrating the appropriateness of the proposed change, gaining support from principals, developing confidence that change can be successfully implemented, and communicating benefits of change for individuals. Creating readiness through an effective change message can help address resistance and increase likelihood of successful change implementation.
The document provides information on ETAT (Emergency Triage Assessment & Treatment), which aims to reduce child deaths in the first 24 hours of admission to hospital. It describes the objectives of ETAT training as teaching triage of children into emergency, priority, and non-urgent categories based on airway, breathing, circulation, coma/convulsions, and dehydration (ABCD) signs. The document outlines the triage process and categories, emphasizing that any child exhibiting emergency signs should receive immediate treatment. It provides guidance on assessing priority signs and directing non-urgent cases to wait.
2- Nutritional Assmalnutritin and intervention.pptxAMANUELMELAKU5
This document provides an overview of human nutrition for midwifery students. It defines key terms, classifies nutrients, and describes the six major nutrients and their functions. Carbohydrates are discussed in depth, including simple and complex forms. Malnutrition causes and consequences are also reviewed. The document aims to equip students with foundational knowledge of nutrition.
This report explores the significance of border towns and spaces for strengthening responses to young people on the move. In particular it explores the linkages of young people to local service centres with the aim of further developing service, protection, and support strategies for migrant children in border areas across the region. The report is based on a small-scale fieldwork study in the border towns of Chipata and Katete in Zambia conducted in July 2023. Border towns and spaces provide a rich source of information about issues related to the informal or irregular movement of young people across borders, including smuggling and trafficking. They can help build a picture of the nature and scope of the type of movement young migrants undertake and also the forms of protection available to them. Border towns and spaces also provide a lens through which we can better understand the vulnerabilities of young people on the move and, critically, the strategies they use to navigate challenges and access support.
The findings in this report highlight some of the key factors shaping the experiences and vulnerabilities of young people on the move – particularly their proximity to border spaces and how this affects the risks that they face. The report describes strategies that young people on the move employ to remain below the radar of visibility to state and non-state actors due to fear of arrest, detention, and deportation while also trying to keep themselves safe and access support in border towns. These strategies of (in)visibility provide a way to protect themselves yet at the same time also heighten some of the risks young people face as their vulnerabilities are not always recognised by those who could offer support.
In this report we show that the realities and challenges of life and migration in this region and in Zambia need to be better understood for support to be strengthened and tuned to meet the specific needs of young people on the move. This includes understanding the role of state and non-state stakeholders, the impact of laws and policies and, critically, the experiences of the young people themselves. We provide recommendations for immediate action, recommendations for programming to support young people on the move in the two towns that would reduce risk for young people in this area, and recommendations for longer term policy advocacy.
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
Presentation by Julie Topoleski, CBO’s Director of Labor, Income Security, and Long-Term Analysis, at the 16th Annual Meeting of the OECD Working Party of Parliamentary Budget Officials and Independent Fiscal Institutions.
AHMR is an interdisciplinary peer-reviewed online journal created to encourage and facilitate the study of all aspects (socio-economic, political, legislative and developmental) of Human Mobility in Africa. Through the publication of original research, policy discussions and evidence research papers AHMR provides a comprehensive forum devoted exclusively to the analysis of contemporaneous trends, migration patterns and some of the most important migration-related issues.
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
How To Cultivate Community Affinity Throughout The Generosity JourneyAggregage
This session will dive into how to create rich generosity experiences that foster long-lasting relationships. You’ll walk away with actionable insights to redefine how you engage with your supporters — emphasizing trust, engagement, and community!
Presentation by Rebecca Sachs and Joshua Varcie, analysts in CBO’s Health Analysis Division, at the 13th Annual Conference of the American Society of Health Economists.
1. The Stages of Change
The stages of change are:
ƒ Precontemplation (Not yet acknowledging that there is a problem behavior that needs to
be changed)
ƒ Contemplation (Acknowledging that there is a problem but not yet ready or sure of
wanting to make a change)
ƒ Preparation/Determination (Getting ready to change)
ƒ Action/Willpower (Changing behavior)
ƒ Maintenance (Maintaining the behavior change) and
ƒ Relapse (Returning to older behaviors and abandoning the new changes)
Stage One: Precontemplation
In the precontemplation stage, people are not thinking seriously about changing and are not
interested in any kind of help. People in this stage tend to defend their current bad habit(s) and do
not feel it is a problem. They may be defensive in the face of other people’s efforts to pressure
them to quit.
They do not focus their attention on quitting and tend not to discuss their bad habit with others. In
AA, this stage is called “denial,” but at Addiction Alternatives, we do not like to use that term.
Rather, we like to think that in this stage people just do not yet see themselves as having a
problem.
Are you in the precontemplation stage? No, because the fact that you are reading this shows that
you are already ready to consider that you may have a problem with one or more bad habits.
(Of course, you may be reading this because you have a loved one who is still in the pre-
contemplation stage. If this is the case, keep reading for suggestions about how you can help
others progress through their stages of change)
Stage Two: Contemplation
In the contemplation stage people are more aware of the personal consequences of their bad
habit and they spend time thinking about their problem. Although they are able to consider the
possibility of changing, they tend to be ambivalent about it.
In this stage, people are on a teeter-totter, weighing the pros and cons of quitting or modifying
their behavior. Although they think about the negative aspects of their bad habit and the positives
associated with giving it up (or reducing), they may doubt that the long-term benefits associated
with quitting will outweigh the short-term costs.
It might take as little as a couple weeks or as long as a lifetime to get through the contemplation
stage. (In fact, some people think and think and think about giving up their bad habit and may die
never having gotten beyond this stage)
On the plus side, people are more open to receiving information about their bad habit, and more
likely to actually use educational interventions and reflect on their own feelings and thoughts
concerning their bad habit.
2. Stage Three: Preparation/Determination
In the preparation/determination stage, people have made a commitment to make a change.
Their motivation for changing is reflected by statements such as: “I’ve got to do something about
this — this is serious. Something has to change. What can I do?”
This is sort of a research phase: people are now taking small steps toward cessation. They are
trying to gather information (sometimes by reading things like this) about what they will need to do
to change their behavior.
Or they will call a lot of clinics, trying to find out what strategies and resources are available to
help them in their attempt. Too often, people skip this stage: they try to move directly from
contemplation into action and fall flat on their faces because they haven’t adequately researched
or accepted what it is going to take to make this major lifestyle change.
Stage Four: Action/Willpower
This is the stage where people believe they have the ability to change their behavior and are
actively involved in taking steps to change their bad behavior by using a variety of different
techniques.
This is the shortest of all the stages. The amount of time people spend in action varies. It
generally lasts about 6 months, but it can literally be as short as one hour! This is a stage when
people most depend on their own willpower. They are making overt efforts to quit or change the
behavior and are at greatest risk for relapse.
Mentally, they review their commitment to themselves and develop plans to deal with both
personal and external pressures that may lead to slips. They may use short-term rewards to
sustain their motivation, and analyze their behavior change efforts in a way that enhances their
self-confidence. People in this stage also tend to be open to receiving help and are also likely to
seek support from others (a very important element).
Hopefully, people will then move to:
Stage Five: Maintenance
Maintenance involves being able to successfully avoid any temptations to return to the bad habit.
The goal of the maintenance stage is to maintain the new status quo. People in this stage tend to
remind themselves of how much progress they have made.
People in maintenance constantly reformulate the rules of their lives and are acquiring new skills
to deal with life and avoid relapse. They are able to anticipate the situations in which a relapse
could occur and prepare coping strategies in advance.
They remain aware that what they are striving for is personally worthwhile and meaningful. They
are patient with themselves and recognize that it often takes a while to let go of old behavior
patterns and practice new ones until they are second nature to them. Even though they may have
thoughts of returning to their old bad habits, they resist the temptation and stay on track.
As you progress through your own stages of change, it can be helpful to re-evaluate your
progress in moving up and down through these stages.
(Even in the course of one day, you may go through several different stages of change).
And remember: it is normal and natural to regress, to attain one stage only to fall back to a
previous stage. This is just a normal part of making changes in your behavior.
3. Stage of Change Characteristics Techniques
Pre-contemplation Not currently considering
change: "Ignorance is bliss"
Validate lack of readiness.
Clarify: decision is theirs
Encourage re-evaluation of
current behavior
Encourage self-exploration, not
action
Explain and personalize the risk
Contemplation Ambivalent about change:
"Sitting on the fence"
Not considering change
within the next month
Validate lack of readiness
Clarify: decision is theirs
Encourage evaluation of pros and
cons of behavior change
Identify and promote new, positive
outcome expectations
Preparation Some experience with
change and are trying to
change: "Testing the waters"
Planning to act within
1month
Identify and assist in problem
solving re: obstacles
Help patient identify social support
Verify that patient has underlying
skills for behavior change
Encourage small initial steps
Action Practicing new behavior for
3-6 months
Focus on restructuring cues and
social support
Bolster self-efficacy for dealing
with obstacles
Combat feelings of loss and
reiterate long-term benefits
Maintenance Continued commitment to
sustaining new behavior
Post-6 months to 5 years
Plan for follow-up support
Reinforce internal rewards
Discuss coping with relapse
Relapse Resumption of old behaviors:
"Fall from grace"
Evaluate trigger for relapse
Reassess motivation and barriers
Plan stronger coping strategies
4. The transtheoretical model (TTM) of change in health psychology explains or predicts
a person's success or failure in achieving a proposed behavior change, such as developing
different habits. It attempts to answer why the change "stuck" or alternatively why the
change was not made.
The transtheoretical model (TTM) — currently, the most popular stage model in health
psychology (Horwath, 1999) — has proven successful with a wide variety of simple and
complex health behaviors, including smoking cessation, weight control, sunscreen use,
reduction of dietary fat, exercise acquisition, quitting cocaine, mammography screening,
and condom use (Prochaska, et al., 1994). Based on more than 15 years of research, the
TTM has found that individuals move through a series of five stages (precontemplation,
contemplation, preparation, action, maintenance) in the adoption of healthy behaviors or
cessation of unhealthy ones. TTM research on a variety of different problem behaviors
has also shown that there are certain predictors of progression through the stages of
change (e.g., Prochaska & DiClemente, 1983), including decisional balance (Prochaska,
1994); self-efficacy (e.g., DiClemente, Prochaska, & Gibertini, 1985); and the processes
of change (Prochaska & DiClemente, 1983).
The Stages of Change
The TTM (for review, see Prochaska & Velicer, 1997) explains intentional behavior
change along a temporal dimension that utilizes both cognitive and performance-based
components. Based on more than two decades of research, the TTM has found that
individuals move through a series of stages—precontemplation (PC), contemplation (C),
preparation (PR), action (A), and maintenance (M)—in the adoption of healthy behaviors
or cessation of unhealthy ones (Prochaska & Velicer, 1997).
Pre-Contemplation is the stage in which an individual has no intent to change behavior
in the near future, usually measured as the next 6 months. Precontemplators are often
characterized as resistant or unmotivated and tend to avoid information, discussion, or
thought with regard to the targeted health behavior (Prochaska et al., 1992).
Contemplation stage. Individuals in this stage openly state their intent to change within
the next 6 months. They are more aware of the benefits of changing, but remain keenly
aware of the costs (Prochaska, Redding, & Evers, 1997). Contemplators are often seen as
ambivalent to change or as procrastinators (Prochaska & DiClemente, 1984).
Preparation is the stage in which individuals intend to take steps to change, usually
within the next month (DiClemente et al., 1991). PR is viewed as a transition rather than
stable stage, with individuals intending progress to A in the next 30 days (Grimley,
Prochaska, Velicer, Blais, & DiClemente, 1994).
Action stage is one in which an individual has made overt, perceptible lifestyle
modifications for fewer than 6 months (Prochaska et al., 1997).
Maintenance: these are working to prevent relapse and consolidate gains secured during
A (Prochaska et al., 1992). Maintainers are distinguishable from those in the A stage in
that they report the highest levels of self-efficacy and are less frequently tempted to
relapse (Prochaska & DiClemente, 1984).
5. The TTM uses the stages of change to integrate cognitive and behavioral processes and
principles of change, including 10 processes of change (i.e., how one changes; Prochaska,
1979; Prochaska, Velicer, DiClemente, & Fava, 1988), pros and cons (i.e., the benefits
and costs of changing; Janis & Mann, 1977; Prochaska, Redding, Harlow, Rossi, &
Velicer, 1994; Prochaska, Velicer, et al., 1994), and self-efficacy (i.e., confidence in
one’s ability to change; Bandura,1977; DiClemente, Prochaska, & Gibertini, 1985)—all
of which have demonstrated reliability and consistency in describing and predicting
movement through the stages (Prochaska & Velicer, 1997).
Prochaska's Model stipulates six stages:
1. Precontemplation - lack of awareness that life can be improved by a change in
behavior;
2. Contemplation - recognition of the problem, initial consideration of behavior
change, and information gathering about possible solutions and actions;
3. Preparation - introspection about the decision, reaffirmation of the need and desire
to change behavior, and completion of final pre-action steps;
4. Action - implementation of the practices needed for successful behavior change
(e.g. exercise class attendance);
5. Maintenance - consolidation of the behaviors initiated during the action stage;
6. Termination - former problem behaviors are no longer perceived as desirable (e.g.
skipping a run results in frustration rather than pleasure).
Processes of Change are the covert and overt activities that people use to progress
through the stages. Processes of change provide important guides for intervention
programs, since the processes are the independent variables that people need to
apply, or be engaged in, to move from stage to stage. Ten processes (Prochaska &
DiClemente, 1983; Prochaska, Velicer, DiClemente, & Fava, 1988) have received the
most empirical support in our research to date. The first five are classified as
Experiential Processes and are used primarily for the early stage transitions. The last
five are labeled Behavioral Processes and are used primarily for later stage
transitions. Table 1 provides a list of the processes with a sample item for each
process from smoking cessation as well as alternative labels.
I. Processes of Change: Experiential
1. Consciousness Raising [Increasing awareness]
I recall information people had given me on how to stop smoking
2. Dramatic Relief [Emotional arousal]
I react emotionally to warnings about smoking cigarettes
3. Environmental Reevaluation [Social reappraisal]
6. I consider the view that smoking can be harmful to the environment
4. Social Liberation [Environmental opportunities]
I find society changing in ways that make it easier for the nonsmoker
5. Self Reevaluation [Self reappraisal]
My dependency on cigarettes makes me feel disappointed in myself
II. Processes of Change: Behavioral
6. Stimulus Control [Re-engineering]
I remove things from my home that remind me of smoking
7. Helping Relationship [Supporting]
I have someone who listens when I need to talk about my smoking
8. Counter Conditioning [Substituting]
I find that doing other things with my hands is a good substitute for smoking
9. Reinforcement Management [Rewarding]
I reward myself when I don’t smoke
10. Self Liberation [Committing]
I make commitments not to smoke
Consciousness Raising involves increased awareness about the causes, consequences
and cures for a particular problem behavior. Interventions that can increase
awareness include feedback, education, confrontation, interpretation, bibliotherapy
and media campaigns.
Dramatic Relief initially produces increased emotional experiences followed by
reduced affect if appropriate action can be taken. Psychodrama, role playing,
grieving, personal testimonies and media campaigns are examples of techniques that
can move people emotionally.
Environmental Reevaluation combines both affective and cognitive assessments of
how the presence or absence of a personal habit affects one's social environment. It
can also include the awareness that one can serve as a positive or negative role
model for others. Empathy training, documentaries, and family interventions can
lead to such re-assessments.
7. Social Liberation requires an increase in social opportunities or alternatives especially
for people who are relatively deprived or oppressed. Advocacy, empowerment
procedures, and appropriate policies can produce increased opportunities for minority
health promotion, gay health promotion, and health promotion for impoverished
people. These same procedures can also be used to help all people change such as
smoke-free zones, salad bars in school lunches, and easy access to condoms and
other contraceptives.
Self-reevaluation combines both cognitive and affective assessments of one's self-
image with and without a particular unhealthy habit, such as one's image as a couch
potato or an active person. Value clarification, healthy role models, and imagery are
techniques that can move people evaluatively.
Stimulus Control removes cues for unhealthy habits and adds prompts for healthier
alternatives. Avoidance, environmental re-engineering, and self-help groups can
provide stimuli that support change and reduce risks for relapse. Planning parking
lots with a two-minute walk to the office and putting art displays in stairwells are
examples of reengineering that can encourage more exercise.
Helping Relationships combine caring, trust, openness and acceptance as well as
support for the healthy behavior change. Rapport building, a therapeutic alliance,
counselor calls and buddy systems can be sources of social support.
Counter Conditioning requires the learning of healthier behaviors that can substitute
for problem behaviors. Relaxation can counter stress; assertion can counter peer
pressure; nicotine replacement can substitute for cigarettes, and fat free foods can
be safer substitutes.
Reinforcement Management provides consequences for taking steps in a particular
direction. While reinforcement management can include the use of punishments, we
found that self-changers rely on rewards much more than punishments. So
reinforcements are emphasized, since a philosophy of the stage model is to work in
harmony with how people change naturally. Contingency contracts, overt and covert
reinforcements, positive self-statements and group recognition are procedures for
increasing reinforcement and the probability that healthier responses will be
repeated.
Self-liberation is both the belief that one can change and the commitment and
recommitment to act on that belief. New Year's resolutions, public testimonies, and
multiple rather than single choices can enhance self-liberation or what the public
calls willpower. Motivation research indicates that people with two choices have
greater commitment than people with one choice; those with three choices have
even greater commitment; four choices do not further enhance will power. So with
smokers, for example, three excellent action choices they can be given are cold
turkey, nicotine fading and nicotine replacement.