Adherence to Lipid-Lowering Dietary Advice
Lynn B. Myers, Kenny Midence in Adherence to Treatment in Medical Conditions, 2020
In clinical terms, it is of great importance to improve adherence to dietary advice. However, it is not clear that effective methods of accomplishing this have been established. Increasingly it is being suggested that simple recommendations about the dietary changes are not adequate methods for achieving change, and the poor outcome of the community studies certainly suggests that simple advice is inadequate. The challenge is therefore to understand and promote ways of improving the uptake of healthy eating. One important approach is a shift in focus away from the content of the dietary advice, onto the recipients of the interventions (Health Education Authority, 1995). Accompanying this refocusing is the suggestion that interventions should concentrate on those most likely to benefit from a given course of treatment at a given moment in time. Traditionally HPs approach their patients as though they were all equally ready to implement the treatments prescribed for them. The implication of the proposed change of focus is that the characteristics of individual clients should guide the treatment packages offered to them. It is in this area that perhaps the greatest contribution of the transtheoretical model (Prochaska and DiClemente, 1982) can be made.
Practical Implementation of Exercise Prescriptions
Maria A. Fiatarone Singh, John Sutton Chair in Exercise, Nutrition, and the Older Woman, 2000
Simply identifying the appropriate exercise goals is not sufficient to ensure a change in behavior. It is equally important to identify in what stage of behavioral change the person is currently, if the counseling is to have any effect. In the transtheoretical model of behavior, individuals advance through stages of pre-contemplation, contemplation, action, regular activity, and maintenance in regard to any behavioral choice. Offering a pre-contemplator a free membership to a gym will be unlikely to induce exercise adoption for example, while the same incentive given to someone who has advanced to the contemplation or action stage may be just the motivation needed to start a regular new habit of physical activity. Once someone is in a regular pattern of behavior, techniques such as positive reinforcement, record keeping, external reminders of the desired behavior, goal-setting, and relapse prevention all work to keep the behavior ongoing. Maintenance is a phase indicating at least 6 months of continuous adherence to the new behavior, whether it is exercise, dietary change, smoking cessation, or other lifestyle habits, and evidence indicates that recidivism is quite low if you can get patients to this point. Most failures in any new behavior occur long before the 6-month interval has passed, so it makes sense to put in place rigorous behavioral programs in this critical initial period. These may take the form of supervised classes, logs to send in, rewards, telephone calls, financial incentives, group support mechanisms, etc.
Developing an Interdisciplinary Multidisciplinary Chronic Pain Management Program: Nuts and Bolts
Michael E. Schatman, Alexandra Campbell, John D. Loeser in Chronic Pain Management, 2007
The treating pain clinician must develop trust and rapport with the patient in order to understand barriers to recovery (i.e., contentious relationships involving family, employer, case manager, and the legal system) that may potentially lead to delay of clinical improvement and case resolution. Many times, the success of developing that relationship begins at the initial evaluation. Understandably, patients in MPC treatment are asked to make significant changes in the ways they cope with pain and function. Readiness to make such important changes has been found to be associated with treatment success (7,8) and readiness to self-manage pain increases from pre- to post-MPC treatment (9). Based on the transtheoretical model of behavior change, individuals are seen as progressing through a number of stages involving decisions about change and include precontemplation, contemplation, action, maintenance phases (10). These basic concepts are important for the physician to explore during the evaluation and often becomes a focus of discussion between the evaluating team (i.e., pain psychologist, physician, and vocational counselor) when deciding whether the patient is an appropriate candidate for interdisciplinary treatment. Unfortunately, like many psychosocial and operant issues, the patient’s own “story” and representation of these issues may vary between the evaluating individuals.
Understanding sustainability: Perspectives of Canadian occupational therapists
Published in World Federation of Occupational Therapists Bulletin, 2020
Crystal C.Y. Chan, Lois Lee, Jane A. Davis
An assessment of the attitudes, skills, and knowledge of Canadian occupational therapists toward incorporating sustainability into practice can provide insight into their readiness for change and guide the development of practice approaches. The Transtheoretical Model of Change, which has been widely applied to health behaviour change (Prochaska et al., 2015), is an analytical framework that delineates the process toward change in theoretical stages to recognise, assess, and track changes at the behavioural level (Prochaska & Velicer, 1997). This analytical framework can be applied with Canadian occupational therapists to understand their readiness to change and their progress toward incorporating sustainability into practice. By mapping the current stage of change using this analytical framework, potential next steps for action can be identified and evaluated for practice approaches.
Identifying patient-level factors associated with interest in psychosocial services during cancer: A brief report
Published in Journal of Psychosocial Oncology, 2021
Timothy S. Sannes, William F. Pirl, Joseph S. Rossi, Lawrence Grebstein, Colleen A. Redding, Ginette G. Ferszt, James O. Prochaska, Ilana M. Braun, Miryam Yusufov
Applying evidence-based theories of what factors are associated with readiness to use psychosocial services is critical to distribute services efficiently and identify which patients may actually engage and which patients may benefit from alternative strategies to reach. One of the most widely applied, evidence-based theories of behavior change is the transtheoretical model (TTM) of behavior change.7 Within this model, decisional balance (e.g., pros/cons of a behavior) and self-efficacy (confidence in one’s ability to engage in a particular behavior) are established as important constructs in predicting readiness for behavioral change.8 In prior work in cancer, women report lower self-efficacy to manage the sequalae of their treatment.9 The goal of the current study was to expand on a recently developed and validated measure10 of decisional balance (pros/cons) and physical/emotional self-efficacy of engaging in psychosocial care in a national sample of adult cancer patients in the United States. We were specifically interested in whether demographic and treatment-related factors were related to: (1) decisional balance (pros/cons) and (2) physical/emotional self-efficacy. Consistent with prior research,6,9 we hypothesized that younger female patients would express more pros, fewer cons, and lower self-efficacy than male participants.
‘SI VIS VITAM, PARA MORTEM’ terror management theory and psychosocial healthcare practice
Published in Social Work in Health Care, 2019
The formation and enactment of health-related cognitions and behaviors can be explained by a variety of theories. Most of them can be classified as social cognition models. These include specific health related models, such as the ‘health belief model’ (Hochbaum, Rosenstock, & Kegels, 1952) and the ‘protection motivation theory’ (Rogers, 1975), as well as more general models, such as the ‘self-efficacy theory’ (Bandura, 1986), the ‘theory of reasoned action’ (Ajzen & Fishbein, 1980), and the ‘theory of planned behavior’ (Ajzen, Netemeyer, & Ryn, 1991). An additional well known health model is the ‘transtheoretical model’ (Prochaska, Diclemente, & Norcross, 1992) which focuses on the stages through which health-related motivation for change is formed. The terror management health model (TMHM) (Goldenberg & Arndt, 2008; Arndt & Goldenberg, 2017) does not negate or compete with those models but rather suggests an additional layer by which health and illness cognitions and behaviors can be understood and related to. This model offers a perspective for gaining insights about “…the underlying factors that influence harmful and beneficial health decisions as well as the fundamental processes of how people manage existential insecurity…” (Spina, Arndt, Boyd, & Goldenberg, 2016, p. 47).
Related Knowledge Centers
- Behaviour Therapy
- Cognitive Therapy
- Theory of Planned Behavior
- Behavioural Change Theories
- Self-Efficacy
- Decisional Balance Sheet
- Diffusion of Innovations
- Counterconditioning
- Theory of Planned Behavior
- Motivational Interviewing
- Exposure Therapy