Utilizing theoretical models in health

There are different theories strategies, and model that can be used to inform health promotion and disease prevention programs. Communities can use these theories, strategies, and models to develop and implement programs that empower and motivate people to improve and better manage their health. The theories and strategies can be implemented during program planning to ensure the integration of health promotion and disease prevention approaches to improve population health.

The Social Cognitive Theory Model

Most successful programs and initiatives are based on an understanding of health behaviours and the context in which they occur. Therefore, interventions to improve health behaviours can be best designed with an understanding of relevant theories of behaviour change and the ability to use skillfully. The science and art of using health behaviours theories reflect an amalgamation of approaches,methods and strategies. The Social Cognitive Theory (SCT) describes the influence of individual experiences, the actions of others and environmental factors on individual health behaviours. SCT provides opportunities for social support through instilling expectations, self-efficacy and using observational learning and the reinforcements to achieve behaviour changes (Nabavi, 2012).

In the video below provides a good explanation of the SCT model.

Health behaviours are shaped through a complex interplay of determinants at different levels. SCT, the cognitive formulation of social learning theory that has been articulated by Bandura explains human behaviour in therms of a three-way, dynamic, reciprocal model in which personal factors, environmental influences and behaviour continually interact. SCT synthesizes concepts and processes from cognitive, behaviouristic and emotional models of behaviour change, so it can be readily applied to intervention for disease prevention and management. A basic premise is that people learn not only through their own experiences, but also by observing the actions of others and the results of those actions. Key constructs of SCT that are relevant to disease intervention include observational learning, reinforcement, self-control and self-efficacy (Nabavi, 2012).

Whenever a nurse (or anther healthcare discipline) attempts to influence their client's health-related behaviour, they need to take into account the multifaceted factors that contribute to their behaviour. Merely to expect that an individual will change their behaviour when presented with a certain scenario, such as the threat of illness or disease, is limited and naive. Clients are not consistent in the way they approach their health and, therefore, we need to be aware of the many variations that may take place within any health encounter. Moreover, health professionals also are inconsistent in the way they view a client's health status and how it should be managed and improved. The issues surrounding behavioural change are usually complex and wide-reaching. A successful outcome is highly dependent on a good working knowledge of the complexities involved and a comprehensive grasp of the process required, in order to facilitate health-related behavioural change at all. The use of SCT model has greatly influenced the direction of preventative health behaviours, as well as impacted on the way that we all deliver client care.

In the 1960s, Bandura and his associates conducted a studies on observational learning called the Bobo Doll experiment. In this experiment, pre-school age children were exposed to an aggressive or nonaggressive adult model to see if they would imitate the model's behaviour. The gender of the model was also varied, with some children observing same-sex models and some observing opposite-sex models. In the aggressive condition, the model was verbally and physical aggressive towards an inflated Bobo doll in the presence of the child. After exposure to the model, the child was taken to another room to play with a selection of highly attractive toys. To frustrate participants, the child's play was stopped after about a few minutes. At the point, the child was taken to a third room filled with different toys, including a Bobo doll where they were allowed to play for the next 20 minutes. Bandura and his associates observed that the children in the aggressive condition were much more likely to display verbal and physical aggression, including aggression towards the Bobo doll and other forms of aggression. In addition, boys were more likely to be aggressive than the girls, especially if they had been exposed to an aggressive male model. In 1977, Bandura introduced the Social Learning Theory, which was renamed to the SCT in 1986, in order to put greater emphasis on the cognitive components of observational learning and the way behaviour, cognition and the environment interact to shape people (Nolen, n.d).

Transtheoretical Model (Stages of Change Model)

Prochaska and DiClemente's Transtheoretical Model also known as Stages of Change Model, explains an individual readiness to change their behaviour. It describes the process of behaviour change as occurring in stages (The Social Work Podcast, 2009). These stages include

• Pre-contemplation: There is no intention of taking action;

• Contemplation: There are intentions to take action and a plan to do so in the near future;

• Preparation: There is intention to take action and some steps have been taken;

• Action: Behaviour has been changed for a short period of time;

• Maintenance: Behaviour has been changed and continues to be maintained for the long-term;

• Termination: There is no desire to return to prior negative behaviours (The Social Work Podcast, 2009).

The Transtheoretical model acts as central guideline to positive-behaviour changes, indicated that individuals who were attempting to change their health behaviour might experience a series of stages of readiness for change. Movement through these stages often occurs in cyclic rather than linear patterns because many individuals must make several attempts to change their behaviour before they meet their goals and move to the next stage. In moving through these stages, people can use different strategies and technique depending on their goals and motivation to participate (The Socail Work Podcast, 2009).

I have provided a video below that elaborates more on the Transtheoretial model.

This model has been applied to domestic violence, HIV prevention and child abuse (The Social Work Podcast, 2009).

Health Belief Model

The Health Belief Model (HBM) is a theoretical model that can be used to guide health promotion and disease prevention programs. It is used to explain and predict individual changes in health behaviours. The key element of the HBM focus on individual beliefs about health conditions, which predict individual health-related behaviours . The model defines the key factors that influence health behaviours as an individual's perceived threat to sickness or disease (perceived susceptibility), belief of consequence (perceived severity), potential positive benefits of action (perceived benefits), perceived barriers to action, exposure to factors that prompt action (cue to action) and confidence in ability to succeed (self-efficacy) (Jones et al, 2015).

The HBM was developed in the early 1950s by a social scientists at the U.S. public health services names Godfrey Hochbaum, Irwin Rosenstock and Stephan Kegles in order to understand the failure of people to adopt disease prevention strategies or screening test for early detection of disease. The HBM derives from psychological and behavioural theory with the foundation that the two components of health-related behaviour are 1) the desire to avoid illness, or conversely get well if already ill; and 2) the belief that a specific health action will prevent, or cure illness (Jones et al, 2015).

Below, I have provided a link to further explain the HBM.

The Ecological Model

The Ecological Model has gain increased recognition in the field of health promotion. Goodman et al applied the ecological model approach to evaluate how well a community-based intervention to prevent alcohol, tobacco, drug abuse and related risky behaviour intervened at multiple levels and how appropriate each set of strategies was for the community's stage of readiness.

The ecological model looks at the following:

• Intrapersonal/individual factors: which influence behaviour such as knowledge, attitudes, beliefs and personality;

• Interpersonal factors: such as interactions with other people, which can provide social support or create barriers to interpersonal growth that promotes healthy behaviours;

• Institutional and organizational factors: including the rules, regulations, policies, and informal structures that constrain or promote healthy behaviours;

• Community factors: such as formal or informal social norms that exist among individuals, group or organizations, can limit or enhance healthy behaviours;

• Public policy factors: including local, state and federal policies and laws that regulate or support actions and practices for disease prevention including early detection, control and management (Newes-Adeyi, Helitzer, Caulfield & Bronner, 2000).

Below, I have provided a video explaining the ecological model.

This week, I will be reviewing the literature based on the four multilevel models of health and will select the best one for my topic. For my second assignment, I will be examining prevention of cervical cancer in the Aboriginal population.

Reference

Jones, C.L., Jensen, .D., Scherr, C.L., Brown, N.R., Christy, K. & Weaver, J. (2015). The health belief model as an explanatory framework in communication research: Exploring parallel, serial, and moderated mediation. Health Community, 30(6), 566-576. Retrieved October 25, 2020 from, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530978/

Nabavi, R.T. (2012). Bandura's social learning theory and socical cognitive learning theory. Retreived October 25, 2020 from,

https://www.researchgate.net/publication/267750204_Bandura's_Social_Learning_Theory_Social_Cognitive_Learning_Theory

Newes-Adeyi, G., Helitzer, D.L., Caulfield, L.E. & Bronner, Y. (2000). Theory and practice: applying the ecological model to formative research for a WIC training program in New York State. Human Education Research, 15(3), 283-291. Retrieved October 25, 2020 from, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530978/

Nolen, J.L. (n.d.). Bobo doll experiment. Retrieved October 25, 2020 from, https://www.britannica.com/event/Bobo-doll-experiment

The Social Work Podcast. (2009). Poschaska and DiClemente's Stages of Change Model for Social Workers. Retrieved October 25, 2020 from, https://socialworkpodcast.blogspot.com/2009/10/prochaska-and-diclementes-stages-of.html