Behavoural changes ie smoking censation

Behavoural converts ie smoking censationBehavoural Changes ie smoking censationThis screen get out discuss the Behaviour Change mock up of Health up rescue or The Trans-theoretical role model, (TTM) in relation to smoking cessation. As G. K. Chestertononce said, It isnt that they lurch see the solution. It is that they cant see the problem. Families, fri fires, neighbours, or employees, however, atomic add together 18 often hale aw atomic number 18 that the pre-contemplators nurse problems. Stages of ChangeProchaska DiClements transtheoretical bewilder (1984,1986 Prochaska et al 1992) is essential in describing the serve of modify. The forge derived from their kick the bucket on encouraging depart in addiction conducts, although it can be used to show that near peck go through full stops when trying to alternate or aim behaviors.American psychologists, Jim Prochaska and Carlo Di Clement,Termination.Process of swop.Downloaded By Glasgow Caledonian University A t 1449 12 July 20094 ADDICTIONS NURSING NETWORKNOLUME 5, NUMBER 1,1993In our studies using the discrete classificationmeasurement of demonstrates of diverge, we ask whetherthe individual is seriously intending to form theproblem carriage in the near future, typically withinthe next six months. If non, he or she is classified as aprecontemplator. Even precontemplators can longing to flip-flop, just now this seems to be quite unalike fromintending or seriously affecting alternate in the nextsix months. Items that be used to identify precontemplationon the continuous stage of change measure implicate As farthest as Im concerned, I dont leaveany problems that need changing and I guess Ihave faults, but theres nonhing that I actually need tochange. Resistance to recognizing or modifying aproblem is the hallmark of precontemplation .Splral dominion of Change. Many New geezerhood resolversreport quintuple or more than years of consecutive pledgesbefore maintaining t he lookal goal for at to the junior-gradeest degree sixmonths (Norcross Vang atomic number 18lli, 1989). Relapse andrecycling through the stages occur quite oftenas individuals attempt to modify or cease addictivebehaviors. Variations of the stage model are universeused increasingly by behavior change specialists toinvestigate the dynamics of pass (e.g., Brownellet al., 1986 Donovan Marlatt, 1988).Because relapse is the rule to begin with than the exceptionwith addictions, we implant that we needed tomodify our original stage model. signly we purposeualizedchange as a linear advance throughthe stages mass were supposed to proficiency simplyand discretely through each step. Linear progressionis a possible but relatively rare phenomenon withaddictive behaviors. systema skeletale 1 presents a spiral pattern that illustrateshow most people actually carry through the stages ofchange. In this spiral pattern, people can progressfrom contemplation to preparation to action t o tutelage,but most individuals depart relapse. Duringrelapse, individuals retreat to an earlier stage. SomeTERYINATION a YAHTENANCEPRECONTEYPLATIOW CONTEYPLATKJN PREPARATKJrelapsers feel like strokes-embanassed, ashamed,and guilty. These individuals become subvertand resist thinking to the highest degree behavior change. As a result,they effect to the precontemplation stage andcan stick there for divers(a) periods of date. Approximately15% of smokers who relapsed in ourself-change look into regressed back to the precontemplationstage (Prochaska DiClemente, 1986).Fortunately, this research indicates that the vast absolute majority of relapsers85% of smokers, for example-recycle back to the contemplation or preparationstages (Prochaska DiClemente, 1984). Theybegin to consider plans for their next action attemptwhile trying to learn from their bran-newfound efforts. Totake an early(a) example, fully 60% of un luckyNew Years resolvers withstand the same pledge the next year (Norcross, Ratzin, Payne, 1989 Norcross Vangarelli, 1989). The spiral model suggests thatmost relapsers do non resolve endlessly in circles andthat they do not regress all the way back to wherethey began. Instead, each age relapsers recyclethrough the stages, they potentially learn from theirmistakes and can try both(prenominal)thing distinguishable the nexttime around (DiClemente et al., 1991).On any iodine(a) trial, successful behavior change islimited in the absolute numbers of individuals whoare able to achieve maintenance (Cohen et al., 1989Schachter, 1982). Nevertheless, in a cohort of individuals,the number of successes slip aways to increasegradually over time. However, a large numberof individuals remain in contemplation andprecontemplation stages. Ordinarily, the more actiontaken, the better the prognosis. Much more researchis needed to better distinguish those who benefitfrom recycling from those who end up spinning theirwheels.Arguments for and over against ConclusionInfluencing the people to change behaviors such(prenominal) as how they eat,excersice ,drink, smoke requires a long term commoitment but it is a go that they can sucseed. Nurses have a aboriginal role to play in influencing deportment of their patients, and health advancement should be embedsustentation work out required for thenew conduct to be systematically maintained, collective into the repertoire of demeanorsavailable to a soulfulness at any one time. act people make changes, acting on front decisions, experience, info,new skills, and motivations for making thechange.PREPARATION mortal prepares toundertake the desired change requires aggregation information, determination out how toachieve the change, ascertaining skillsnecessary, deciding when change shouldtake push through may include talking with others tosee how they feel to the highest degree the promising change,considering tinge change will have and whowill be affected. expression somet hing dislodges tocommand prompt the mortal to start thinking aboutchange perhaps earshot that someone hasmake changes or something else haschanged resulting in the need for throw outchange.PRECONTEMPLATION changing a deportment has not been considered personmight not wee-wee that change is possible orthat it might be of have-to doe with to them. tooth root The fashion Change spiral from What do they want us to do now? AFAO 1996ded in daily practice. E following review explores and considers some of the major theories of behaviorand behaviour change that may be minded(p) to the development of effectiveinterventions in transit behaviour, including theories and concepts from mainstreampsychology, and the associated sub-disciplines of health, leisure, recreation, visible employment and achievement psychology.For many years conceptual models of behaviour change, such as Banduras tendercognitive acquire supposition (1986), Beckers Health Belief Model (1974), Azjen andFi shbeins Theory of Reasoned Action (1975) have been applied across a bigvariety of disciplines, including tour and road user behaviour.Considerable attention has been presumption in the literature to models of individualbehaviour change per se but much less attention has been effrontery to models ortheories that attempt to interpret behaviour change within groups, organisations andwhole communities. The design of programs to compass populations requires an fellow feeling of how those communities work, their barriers and enablers to change,and what influences their behaviours in general.Stage Theories of Behaviour ChangeMounting evidence suggests that behaviour change occurs in stages or steps and that livement through these stages is incomplete unitary or linear, but rather, cyclical,involving a pattern of carryion, maintenance, relapse, and readoption over time.The work of Prochaska and DiClemente (1986) and their colleagues have formallyidentified the dynamics and structure of staged behaviour change. In attempting toexplain these patterns of behaviour, Prochaska and DiClemente developed atranstheoretical model of behavioural change, which proposes that behaviour changeoccurs in quint distinct stages through which people walk out in a cyclical or spiralpattern.The first of these stages is termed precontemplation. In this stage, there is no intenton the part of the individual to change his or her behaviour in the foreseeable future.The second stage is called contemplation, where people are aware that a problemexists and are seriously considering fetching some action to address the problem.However, at this stage, they have not made a commitment to undertake action. Thethird stage is described as preparation, and wants both purport to change andsome behaviour, usually minor, and often run across with limited success.Action is the fourth stage where individuals actually modify their behaviour,experiences, or environment in order to overcome their pr oblems or to meet theirgoals. The one-fifth and final stage, maintenance, is where people work to prevent relapseand consolidate the gains attain in the action stage. The stabilization of behaviourchange and the avoidance of relapse are characteristic of the maintenance stage.Prochaska and DiClemente further suggest that behavioural change occurs in acyclical influence that involves both progress and biy early on relapse. That is, even withsuccessful behaviour change, people potential will move back and forth between the fivestages for some time, experiencing one or more periods of relapse to earlier stages,before moving once again through the stages of contemplation, preparation, actionand eventually, maintenance. In successful behavioural change, while relapses toearlier stages inevitably occur, individuals never remain within the earlier stage toMAINTENANCE practice required for thenew behaviour to be consistently maintained,incorporated into the repertoire of behavioursavail able to a person at any one time.ACTION people make changes, acting onprevious decisions, experience, information,new skills, and motivations for making thechange.PREPARATION person prepares toundertake the desired change requiresgathering information, finding out how toachieve the change, ascertaining skillsnecessary, deciding when change shouldtake locating may include talking with others tosee how they feel about the plausibly change,considering impact change will have and whowill be affected.CONTEMPLATION something happens toprompt the person to start thinking aboutchange perhaps hearing that someone hasmade changes or something else haschanged resulting in the need for furtherchange.PRECONTEMPLATION changing abehaviour has not been considered personmight not realise that change is possible orthat it might be of interest to them.Source The Behavior Change spiral from What do they want us to do now? AFAO 1996which they have regressed, but rather, spiral upwards, until even tually they reach astate where most of their time is spent in the maintenance stage.Further work undertaken and reported by Prochaska et el (1992) suggests thatbehaviour change can only take place in the context of an enable or supportiveenvironment.Prochaskas and DiClementes model has received considerable support in theresearch literature. Their model has besides been shown to have relevance forunderstanding, among other things, patterns of physical natural process participation andadherence and would have relevance in bringing about change in travel behaviours.Consistent with the above perspective, Sallis and Nader (1988) as well have suggested astage hail to explaining movement behaviour, particularly in family groups, withresearch aimed at understanding better the cyclical patterns of movement activitySOCIAL FEATURES nature of ain elationships expectations of class, position, age, genderaccess to knowledge,information.CULTURAL FEATURES the behaviours and stances considered congenial in presumption contexts eg. relating to sex, gender, drugs, leisure, participation.ETHICAL SPIRITUAL FEATURES influence of personal and dual-lane values and discussion about moral systems from which those are derived can include rituals, religion nd rights of passage.LEGAL FEATURES laws determining what people can do and activities to encourage observance of those laws .POLITICAL FEATURES systems of governance in which change will have to take place can, for example, limit access to information and betrothal in affable action.RESOURCE FEATURES affect what is required to make things happen covers human, financial and material resources partnership knowledge and skills and items for exchangeSource The Behavior Change spiral from What do they want us to do now? AFAO 1996involvement, including adoption, maintenance, and relapse, and interventions aimedat minimizing the amount of time individuals spend in the relapse stage as puff up asmaximizing time spent in actio n or maintenance.This stage approach is contrasted to the all or no(prenominal) approach to physical activityparticipation that often characterized early research on exercise adherence.Such a staged approach sits well with any school based program that is focussed ontravel behaviour change devoted that the context in which the program is to be appliedwould see fluctuations in the positive and negative influences according to such thingsas work and time demands of family members, weather, events or incidents in thelocal region that may influence perceptions of safety.Parallel with the work of Prochaska and DiClemente, Rogers, (1983) also developed astage-based system to explain how new ideas or innovations are disseminated andadopted at the community and population levels. Rogers identified five distinct stagesin the process of scattering of any new initiative or innovation. These are knowledge,persuasion, decision, effectuation, and confirmation. Rogers argued that thediffusi on of an innovation is enhanced when the comprehend superiority of aninnovation is high compared to lively practice (i.e. the relative advantage), andwhen the compatibility of the innovation with the existing well-disposed system is perceivedto be high (i.e. compatibility).Other authorised influences on the diffusion process are said to be complexity,triability, and observability, with innovations which are of low complexity, easilyobserved, and that are able to be adopted on a trial basis, being associated with greateradoption and swifter diffusion. Building success and comfort during the early stagesof the implementation of the TravelSMART Schools program will be paramount to itssuccess.Rogers classifies individuals as innovators, early adopters, early majority, latemajority, late adopters, and laggards, dependent upon when during the generaldiffusion process they adopt a new idea or behaviour. While this model has not beentested empirically to date, it has been adapted and a pplied in health promotion settingsusually in conjunction with companionable attainment theory and/or self-efficacy theory, withsome success. It certainly warrants attention in the development of theTravelSMART Schools program.In summarizing the various stage models of behaviour change that have beenproposed over the past 2 decades, Owen and Lee (1984) highlighted a number ofcommonalties they share.These authors propose an integrated stage-based model in which behaviour change isviewed as a cyclical process that involves five stages of awareness of the problem and a need to change motivation to make a change skill development to prepare for the change initial adoption of the new activity or behaviour, and maintenance of the new activity and integration into the lifestyle.In terms of a TravelSMART program this may have in mindFive stages of behaviour change Examples of content and processes Awareness of the problem and a needto changeProvision of, or ways to seek informationon the dependence on motorised travelevidence of the babys room effect issuesrelation to building familys andfitness Motivation to make a change Benefits of increased personal fitnessbenefits of leaving the car at home eg.environmental and social Skill development to prepare for thechangeMapping of the local area to identifyalternative forms of travel, ways to carry off with reluctant family membersor friends to manage the need to carrystrategies for trip chaining and travelblending Initial adoption of the new activity orbehaviourSelf monitoring of newly adoptedbehaviours to, opportunities forreflections and comparisons Maintenance of the new activity andintegration into the lifestyleProvision of feedback on how the changeis going, and an injection of new ideas orstrategyAn grievous aspect of both Prochaskas and DiClementes approach and thatsuggested by Owen and Lee is that each of the five stages of behaviour change is saidto involve different cognitive processes and require differe nt treatments orintervention strategies for the overall change process to be successful. Prochaska andDiClemente (1992) outlined a number of cognitive change processes that have beenfound to be associated with each stage.Other researchers also propose that different stages in the change process requiredifferent intervention strategies, and generally recommend a multifaceted,community-based approach to intervention in which all stages are addressed so thatindividuals at all stages of courtesy for change can potentially be influenced. Thissits well with the overall TravelSMART programs TravelSMART Communities,TravelSMART Workplaces and TravelSMART Schools.A major insight offered by stage theories of behaviour change, then, is the emphasisthey place on matching interventions to the stage of readiness of the individual. Thiskind of approach provides an superior framework for understanding and examiningindividual differences in motivation for, and involvement in, change in travelbehav iours over time, including patterns of initiation, maintenance, relapse, andresumption.In summary, theories that conceptualise behaviour change in terms of a cyclicalprocess through which individuals move in stages, have received empirical support inthe research, and search to offer much promise for understanding travel behavioursand curricula to bring about changes in travel behaviour.A major strength of the Stages of Change model is that it has also been used inconjunction with a variety of other theories and models that are relevant to differentlevels of influence at an intrapersonal, interpersonal, institutional, community orpublic policy level. (Glanz and Rimer (1995) as reported by Oldenberg et al (1999)) companionable Cognitive-Behavioural Theories and Similar Theoriessociable Cognitive Theory explains human behaviour in terms of a triadic, dynamic andreciprocal model in which behaviour, personal factors, and environmental influencesinteract. It addresses both the psychologi cal dynamics underlying behaviour and theirmethods for promoting behaviour change. It is a very complex theory and includesmany key constructs. Self-efficacy is one of the key concepts.Self-efficacy refers to ones confidence in the ability to take action and brook inaction. It is seen by Bandura (1986) as perhaps the single most important factor inpromoting changes in behaviour. Measures of self-efficacy and some of the other keyconcepts from hearty Cognitive Theory have also been identified as key determinantsof movement through the stages of change, (Oldenburg, 1999).Self-efficacy expectations have been found repeatedly to be important determinantsof the choice of activities in which people engage how much energy they will expend on such activities and the degree of persistence they demonstrate in the face of failure and/oradversity.In general, higher levels of self-efficacy for a given activity are associated with higherparticipation in that activity.Similarly, and closely adj ust to companionable Cognitive Theory, Attribution Theoryproposes that individuals generally view their slaying (and thus, their successesand failures) as dependent upon ability, effort, task difficulty, and luck. In addition,causal influences are seen as either inner(a) to the individual (e.g. personal ability), or external (e.g. barriers to community safety, neglect of convenient and attr dynamic travelalternatives).The distinction between internal and external attributions is an important one, in thathow we attribute our personal successes and failures has been shown to be associate tonot only our behaviour, but our self-esteem, our perceptions of personal control, ourself-efficacy for different tasks and/or achievement situations, and our ongoinginvolvement in different activities.For example, a person who attributes their failure to change their dependence onmotorised travel to their inherent lack of ability to identify and use alternatives will beless likely to continue with the alternative modes of travel after the educationalprogram has ceased.A persons attributions for personal success and failure in a given situation, then,determines how that person feels about the task, as well as the amount of effort he orshe is likely to invest in the task the next time around. When failure is attributed tolow personal ability and a difficult task, individuals are more likely to give up sooner,select easier alternatives, such as using personal motorised travel, and lower theirgoals. Conversely, when failure is attributed to external factors such as bad luck,individuals are likely to have higher motivations to continue and to try again forsuccess.Attitudes and their potential relationship to behaviour also have been studiedextensively. In general, attitudes have not generally been found to be consistently think to behaviour. This failure to demonstrate a consistent relationship betweenattitudes and behaviour may be because situational factors also exert a pow erfulinfluence on behaviour. In addition, how attitudes have been defined and metrical indifferent studies varies considerably.Research has demonstrated consistently that an attitude is likely to predict behaviourwhen the attitude includes a peculiar(prenominal) behavioural intention when both the attitude and the intention are very specific and when the attitude is based on first-hand experience . These aspects of the behaviour-attitude relationship have been addressed in the Theory of Reasoned Action, which focuses on the role of context-specific attitudes in defining behaviour. In this model, behaviour is seen as a function of a persons intention, which in farm is comprised of the individuals attitudes towards playacting the behaviour and the influence of perceived social norms concerning the performance of the behaviour. Attitudes are affected by the persons beliefs about the perceived consequences of performing a given action, and his or her subjective evaluation of each of the consequences.Drawing this together, any publish individually focused and community based health behaviour change and health promotion programs have generally been based on Social Cognitive theories utilising techniques that emphasise the cognitive and social mediators of behaviour. Interventions based on cognitive learning theory emphasize self-management principles and strategies.Other Theories to Consider personality TheoriesPersonality theories explain behaviour largely in terms of stable traits or patterns ofbehaviour which are viewed as resistant to change and inalterable. Rogers, (1985),classification of individuals into the five categories of innovators, early adopters,early majority, late majority, late adopters, and laggards is an example of this kind ofapproach to understanding behaviour.A major limitation of personality theories is that they do not take account of importantaspects of the physical, social and economic environments, or the previousexperiences of the i ndividual, which also are known to strongly influence behaviour.For this reason, personality theories exclusively now are generally considered inadequate toexplain behaviour change. instruction and Behaviour TheoriesLearning theorists have demonstrated that behaviour can be changed by providingappropriate rewards, incentives, and/or disincentives. In learning or behavioristapproaches, these rewards and incentives are typically incorporated into structured rewardment schedules, and the process of behaviour changes is often termedbehaviour modification.While effective in bringing about behaviour change, such approaches require a highlevel of external control over both the physical and social environment, and theincentives (or disincentives) used to reinforce certain behaviours and discourageothers. This kind of control is hard to maintain in real life settings, and thus, strictbehaviourist approaches are subject to a number of limitations.Social Learning TheorySocial learning theory is similar to learning and behaviour theories in that it focuseson specific, measurable aspects of behaviour. Learning theories, however, viewbehaviour as being cause primarily by events within the environment, whereas sociallearning theory views the individual as an active participant in his or her behaviour,interpreting events and selecting courses of action based on past experience.Again, one important theory deriving from social learning theory which has had amajor impact on many modern models of behaviour change is that of self-efficacy. Asstated earlier, self-efficacy expectations have to do with a persons beliefs in his or herabilities to successfully execute the actions necessary to meet specific situationaldemands. Such expectations have been found to be consistently related to behaviouracross a wide range of situations and populations sub-groups.Social Psychological TheoriesSocial psychological theories are concerned with understanding how events andexperiences external to a person (i.e. aspects of the social situation and physicalenvironment) influence his or her behaviour.Emphasis is hardened on aspects of the social context in which behaviour occurs,including social norms and expectations, cultural mores, social stereotypes, groupdynamics, cohesion, attitudes and beliefs. A number of useful concepts have emergedfrom social psychological theories, including attribution, locus of control, andcognitive dissonance, to name a few.Social Cognitive ApproachesSocial cognitive approaches combine aspects of social psychological theories withcomponents of both social learning theory and cognitive behavioural approaches.Social-cognitive approaches emphasize the persons subjective perceptions andinterpretations of a given situation or set of events, and argue that these need to betaken into account if we are to understand adequately both behaviour and theprocesses of behaviour change.A number of social psychological concepts have been found to be consiste ntly relatedto behaviour change across a wide range of situations. For example, the social realityof a the group (e.g. peer group, school group, family group etc.) will affect anindividuals behaviour. All groups are characterized by certain group norms, beliefsand ways of behaving, and these can strongly affect the behaviour of the groupmembers.Expectations of significant or respected others can also have a strong influence on apersons behaviour. This phenomenon has been most consistently demonstrated in theearly research on self-fulfilling prophecies, which showed that teachers expectationsof their students were consistently related to the students subsequent performance,even when these expectations were based on falsified information. Thus, support andencouragement, or conversely, low expectations from significant or respected others,can affect and bring about, (or not), changes in individual behaviour.Health Belief ModelThe Health Belief Model attempts to explain health-behaviour in terms of individualdecision-making, and proposes that the likelihood of a person adopting a given healthrelatedbehaviour is a function of that individuals perception of a threat to theirpersonal health, and their belief that the recommended behaviour will reduce thisthreat.Thus, a person would be more likely to adopt a given behaviour (e.g. walk or cycleregularly) if non-adoption of that behaviour (e.g. unclean air or confused trafficsituations) is perceived as a health threat and adoption is seen as reducing that threat.To date, the Health Belief Model has not received consistent or strong support inexplaining behaviour change. When the concept of self-efficacy is added to themodel, however, prediction of behaviour increases.Social Marketinganother(prenominal) approach that has been used to bring about behaviour change is that of socialmarketing. The concept of social marketing is based on marketing principles andfocuses on four key elements, including development of a harvest -time the promotion of the product the place the price.As such, this approach is not so much a theory of behaviour change but a proposedframework, which situates people as consumer who will potentially buy into acertain idea or argument, given the appropriate selling techniques are applied. It isthen assumed that the get in to that idea by individuals will result in behaviourchange.Theory of Interpersonal Behaviour clothes strength is another concept that has been found to be important in predicting orchanging behaviour. Habit is an important element of the theory of interpersonalbehaviour, which proposes that the likelihood of engaging in a given behaviour is afunction of the habit of performing the behaviour the intention to perform the behaviour conditions which act to facilitate or inhibit performance of the behaviour.In turn, intentions are said to be shaped by a cognitive component, an affectivecomponent, a social component, and a personal normative belief. The theory ofi