PSY 325 8th Edition Lecture 4 Outline of Current Lecture I. Adhering to Healthy BehaviorII. Factors Predicting AdherenceIII. Theories of Adherence: Continuum Theoriesa. Health Belief Modelb. Self-Efficacy Theoryc. The Theory of Planned Behaviord. Behavioral TheoryIV. Theories of Adherence: Stage Theoriesa. Transtheoretical Modelb. Precaution Adoption Process Modelc. Health Action Process ApproachV. Other Considerations: Improving Adherence VI. Four Categories of Behavioral Strategies for Improving AdherenceVII. What Is Stress?VIII. Nervous SystemIX. Neuroendocrine SystemX. Physiological Components of Stressa. AllostasisXI. General Adaptation SyndromeXII. Transactional theory of StressXIII. Theories of StressXIV.Sources of Stressa. Coping With StressXV. Psychoneuroimmunology (PNI)XVI. Stress and DiseaseCurrent LectureAdhering to Healthy Behavior:Factors Predicting Adherence- Severity of the diseaseo People’s perception of the severity of their disease is more predictive of adherence than objective severity of disease. Ex: people attributing acute vs chronic illness.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- Treatment Characteristicso Side effects of the medication Side note: when do they have to report side effects? When one person experiences it. o Complexity of the treatment Increasing dosage, taking more frequently… chances of you following drops to 40 percent. - Personal Characteristics (in isolation they play only a small role)o Age- the young and old are more likely to be non-adherento Gender- generally, women and men have same adherence rateso Personality patterns- there is no global set pattern of personality trait that leads to adherence (optimism, hope)o Emotional factors- high stress and depression is related to non-adherence. Anxiety has a smaller effect. Three times more likely to not adhere if you’re depressed. - Environmental Factorso Economic factors- the number one predictor of adherence. People with greater income and greater education are more adherent to medical advice.o Social support- tangible and intangible help a person receive from friends and or familyo Cultural norms-individuals less acculturated to Western medicine have poorer adherence. Theories of AdherenceContinuum theories—health belief modelBecker and Rosenstock, 1984 Health belief modelSuggests four beliefs that should predict health-related behaviors (including adherence):1. Perceived susceptibility to disease2. Perceived Severity of the disease3. Perceived Benefits of health-enhancing behaviors4. Perceived Barriers to health-enhancing behaviors—Best predictorCommon sense is not always the best predictor of behaviors in psychology.  Self-Efficacy Theory (Bandura, 1986)People will adhere to behaviors if they:o 1. Believe they can initiate and carry out this behavior (self-efficacy)o 2. Believe that the behavior will produce valuable outcomes (outcome expectations)o This is very much a situational model, very context dependent. o Theory of self-efficacy is embedded in his model of Reciprocal Determinism Criticism-ignores motivation, social pressure. People are more likely to change behavior if they are self motivated and interested rather than pressured. The Theory of Planned BehaviorThree Factors shape intention:1. Attitude toward behavior2. Perceived behavioral control3. Subjective norms—what does society say you should do? How does peer pressure influenceThis model does identify beliefs. Has been useful in guiding Internet based interventions,presents literature on the positives and negatives of treatment. It is the most successful at predicting physical activity and dieting activities. However, it is not very good at predicting risky behavior. Example: intend to wear a condom every time you have sex, but don’t. One’s intentions do not always predict behavior.  Behavioral TheoryReinforcement strengthens behaviorExamples: incentives or cuesPunishment decreases behaviorThis is not very often used in health psychology Strength: very practical model to use in childrenWeakness: punishment is not a good predictor of behavior changeOverall strengthsHas produced substantial amounts of research to help understand theoriesIdentify beliefs that should motivate anyone to change his or her behaviorAll models are better than chance at predicting behavior. Overall WeaknessesSome theories are better at predicting intentions than behaviorsRely heavily on self-reportLeave out important factors such as self-identity and emotionsTheories of Adherence: Stage Theories: Transtheoretical model Transtheoretical Modelo Pre-contemplation—no intention of stopping or changing this behavior, its not even a thought in your head. o Contemplation--When a person starts thinking of negative consequences, they think about/want change.o Preparation—thinking of ways to do ito Action—actually changing behavioro Maintenance—staying in new behaviors, not going backwardsResearch says you can potentially jump from stage to stage. This is a theory of motivation to change one’s behaviors. Proposes ten processes to move from stage to stage, useful in interventions. Strengths: helps capture the progress someone makes to change his or her behaviors. You are able to meet the person where they are. Contemplation vs. pre-contemplation: throw out ideas about change. Works well with quitting smoking behaviors. Weaknesses: Moving from stage to stage may be more difficult for certain individuals than others. Also it has been proposed that having fewer stages is a good idea.  Precaution Adoption Process Model (Weinstein, 1998)(7 stages) This is somewhat similar to the transtheoretical model.Stages 4 and 5 are very critical...decide whether they will change or not change. *Optimistic bias—an important concept that came out of this concept. Thinking you cannot take medication for example, thinking you don’t need it or will be fine without it and then it bites you in the butt later.Personal and environmental factorsSimilar to trans theoretical, unclear if you need to go from one to the next. Research is lacking I this area for this model Health Action Process Approacho Two general stages: Motivational Phaseo Volitional phase—includes planning and actiono Major strength of this model: takes into account the PLANNING stage. This is significant because its specific