The precaution adoption process model (PAPM) attempts to explain how individuals make decisions to take action regarding health issues and translate those decisions into actions. The PAPM outlines 7 stages that individuals may go through when considering a health behavior change: unaware, unengaged, deciding about acting, deciding not to act, deciding to act, acting, and maintenance. Case studies on miners and cyberbullying among adolescents demonstrate how the PAPM can be used to understand barriers to behavior change at different stages and inform interventions to promote precautions. While the PAPM focuses on a single threat, it recognizes that there may be different barriers to change for different stages, unlike some other health behavior theories.

1. HEALTH PSYCHOLOGY
GENERAL APPROACHES TO HEALTH AND
PSYCHOLOGICAL APPROACHES TO HEALTH
UNIT 2
K. Sandhiya
1st MSc Applied psychology
Bharathiar university
The precaution adoption process
model ( PAPM)

2. The precaution adoption process model
 PAPM
The PAPM attempts to explain how a person comes to
decisions to take action and how he or she translates
that decision into action.
Neil D. Weinstein
Peter M. Sandman
Susan J. Blalock

3. History
Formulation and finalization
 Initial discussions in 1977 by Irving Janis & Leon
Mann.
 Later proposals presented in 1988
 Final and present formulation, published in 1992
(Weinstein & Sandman,1992).

4. Assumptions
PAPM is a STAGE THEORY with 4 principal elements:
1. Category system to define stage
2. An ordering Of the Stages
3. Common barriers to change by stage
4. Different barriers to different stages

5. 7 Stages
Unaware
of issue
Unengag
-ed by
issue
Deciding
about
acting
Deciding
to act
Acting
Maintena
nce
Deciding
not to
act
Stage 1 Stage 2 Stage 3
Stage 4
Stage 5 Stage 6 Stage 7
• There is no defined amount of time on
individual must stay in each stage.
• Both Forward and backward movements are
possible.

6. Stage 1
Unaware of issues
Person does not know
there is a problem

7. Stage 2
Unengaged by Issue
Person become aware of the problem
but not worried about it.

8. Stage 3
Decided about to act
Person is deciding whether or
not to make changes.

9. Stage 4
Decided not to act
Person does not feel compelled
to make changes.

10. Stage 5
Decided to act
Person decides to make
changes

11. Stage 6
Acting
The person starts taking action

12. Stage 7
Maintenance
Has maintained changed
behaviour for 6 months

14. Case study 1
 Miners study
1. Precaution adoption process model (PAPM) used to explain precautions behaviour to
avoid external hazards/health threats.
2. 21 miners & 19 manager interviewed regarding usage of new technologies to improve
and encourage safe work environment.
3. Implications of PAPM assist organizational management to understand how to
-Promote protective technologies
-Provide skill based training
-Raise awareness and knowledge and encourage adoption of safe practices.

15. Case study 2
Cyber bullying in the adolescent population.
Upto 75%of middle school Facebook users have experienced some form of cyber
bullying.
 1st use of the PAPM to address cyber bullying and first study using PAPM for the
adolescent population.
 PAPM used to evaluate adolescents protective behaviour to seek to understand
lack of precaution in the electronic environment
 Anti bullying techniques should focus on more critical thinking skills to help
students advance from stage 2 (aware of problem but not thinking about if ) to
understanding dangers of cyber bullying and connect with available resources.

16. Benefits & Drawbacks
Benefits:
 Promotes risk reducing behaviors.
 Positive outcome expectancies.
Drawbacks:
 Focuses on a single threat/preventive responses.
 Transition barriers between stages.
- Unlimited measures.
 Lack of key variables between stages.

17. Critics of PAPM
The PAPM does not provide
detailed information about barriers
at each stage.

18. Think
What is one aspect
the PAPM explicitly
recognized that
many other theories
do not ?

19. Reference
Ajzen, I. “From Intentions to Actions: A Theory of Planned Behavior.” In J. Kuhl and J. Beckmann(eds.),
Action Control: From Cognition to Behavior. Heidelberg: Springer Verlag, 1985, pp. 11–39.
Ajzen, I., and Madden, T.J. “Prediction of Goal-Directed Behavior: Attitudes, Intentions, and Perceived
Behavioral Control.” Journal of Experimental Social Psychology, 1986, 22, 453–474.
Anderson, C. A. “Abstract and Concrete Data in the Perseverance of Social Theories: When Weak Data
Lead to Unshakable Beliefs.” Journal of Experimental Social Psychology, 1983, 19, 93–108.
Bandura, A. “Moving into Forward Gear in Health Promotion and Disease Prevention.” Address presented
at the Annual Meeting of the Society of Behavioral Medicine, San Diego, CA, March 1995.