健康行为改变的理论I(yan20141029)解读

理论假设：


人们的行为是受意识支配的，是合乎理性的； 行为发生与否的最重要和最直接的影响因素是人们 的行为意向，即是否有意图或打算采取行动。
Behavioral Belief Evaluation of Outcomes
Attitude towards Behavior
weight
Intention


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Socio-demographic characteristics: Age, gender, income, knowledge
Perceived benefits
Perceived barriers Self-efficacy
Perceived susceptibility Perceived severity

Believe the condition has serious consequences
Believe behavior change can reduce the susceptibility and seriousness Believe the costs of behavior change are outweighed by the benefits
PRECEDE Model
Predisposing Factors Behavior
Reinforcing Factors
Enabling Factors
Health
Environment

倾向因素（Predisposing Factors）:又称前置因素，指能促 进或阻碍人们行为改变动机的因素，包括知识、态度、信念、 价值观等； 促成因素(Enabling Factors)又称实现因素，指促成或阻碍 健康行为动机得以实现的因素，包括实现健康行为所必须的
Why is theory useful?

Theory helps us to determine:

Factors affecting behavior To expose the changing pattern of health related behavior in a population Guiding behavior intervention
(Glanz & Rimer, 1997)

Applicable to a broad variety of populations and situations

Abstract and don’t have a specified content or topic area
Major types of theories

Common Health Behavior Change Theories

Cognitive & KAP Model


Health Belief Model
Theory of Reasoned Action /Theory of Planned Behavior Social Learning Theory PREDECE Model Socio-ecological Framework


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HBM Components NhomakorabeaPerceived Benefits: perceived effectiveness of behavior change Perceived Barriers: things that stop one from taking action Cues to Action: Internal or external (environmental) events that trigger behavior
健康相关行为改变的理论
Theories of Health-related
Behavior Changing I
社会医学与健康教育系 常春
What is theory?

“Set of interrelated concepts and constructs that present a systematic view that shows relationships between variables in order to explain or predict situations or outcomes”

技术、物质基础、社会力量等，如卫生机构的可及性、家庭
收入、健康保险、政策、法律法规。

强化因素（Reinforcing Factors）指目标人群在行为改变后 所获得的各种正向或负向反馈。强化因素包括社会支持、同 伴赞许、亲属肯定与鼓励、医务 人员激励、个人感受 等。
Socio-ecological framework

行为结果评价 Evaluation of outcomes
对行为结果重要性的评价
2. 主观行为准则
Subjective Norms
• 准则信念Normative belief
对特定个体的想法的信念 • 遵从动机 Motivation to comply 是否愿意遵从特定个体的想法
B ~ I = [Ab + SN]
Perceived threat
Action/behavior
Cues to action: mass media medical doctor family member/friends
Health Belief Model
Theory of Reasoned Action，TRA

Fishbein于1967年首次提出理性行动理论,1975 年以后Fishbein和Ajzen对该理论进行多次调整 和修正。
Strategies that are used by a person to deal with emotional stimuli
Reciprocal determinism
The dynamic interaction of the person, behavior and the environment in which the behavior is performed
Social Learning Theory，SLT

行为是一个动态过程，受个人因素和环境因素 的交互影响。 理论假设：


人们有能力判别行为的“象征意义”，并预见 行为后果 人们会从观察他人中学习 人们会基于自身经验进行行为调整

Social Learning Theory
Behavior
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HBM Components

Perceived Susceptibility: perceived risk of contracting a health condition Perceived Severity: perceived seriousness of a health condition if left untreated Perceived susceptibility + perceived severity = perceived threat of the health condition
Attitude toward behavior
Behavioral intention
Perceived behavioral control
Behavior
行为控制能力（Behavioral control）

控制信念（ Control beliefs ）：指个体对采 纳某种行为的自信心；

感知能力（ perceived power ）：指个体对 采纳行为过程中困难和难度的察觉能力。
Ab = Bb· E
SN = M· Nb
B: Behavior
I: Intention
Ab: Attitude towards behavior
SN: Subjective norms
Theory of Planned Behavior

Intentions are shaped by: Attitudes toward the behavior: beliefs that the behavior will lead to positively/negatively valued outcomes. Subjective norm: perception of the social pressure to act/not act and motivation to comply with the norm. Perceived behavioral control: the ease or difficulty of achieving desired behavioral outcomes.
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认知过程
人们听说某种行为
人们知道采纳该行为的益处
人们认为该行为值得采纳
人们决定采取行动
KAP Model
Knowledge
Belief (Attitude)
Practice
Health Belief Model

Believe they are susceptible to a condition
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The theory of planned behavior
Behavioral belief
Evaluation of behavioral outcome Normative belief Motivation to comply Control belief Perceived power Attitude toward behavior