Meets Tuesday from 4-5 pm (Tolman 3201, Warner Brown room). 1. Introductions. 2. Elicit thoughts on the five broad questions below. Two optional readings: Call by NIH Behavior Change Initiative Tue Feb 14 Cognitive Behavioral Therapy (link to page in Knowledge Base) Q: How can cognitive behavioral techniques be applied to specific instances of behavior change? Q: What contexts (e.g. participants, kinds of behavior) are they likely to be most and least effective for? Q: How can they be improved? Tue Feb 21 Use of text-messaging in behavior change interventions Tue Feb 28 Transtheoretical Model of behavior change It is very widely applied, and the basic idea is to categorize people as being in particular states of readiness to change. Interventions can then be focused on moving people from one stage of readiness to another, or tailored to be most effective for the particular stage someone is in. This website provides an overview of the Transtheoretical model of behavior change: http://www.uri.edu/research/cprc/TTM/detailedoverview.htm (This pubmed link is for a more comprehensive review: http://www.ncbi.nlm.nih.gov/pubmed/10170434) Some discussion questions: 1. Which interventions will be most effective at different stages? (e.g. CBT techniques covered, text messaging interventions). 2. What are the pros and cons of using this particular model? 3. How could this model improve behavior change interventions in a specific practical context? (Think of a behavior change you're interested in and consider how you could use this model to improve it.) Tue Mar 13 Generating behavior change by targeting people's implicit theories of whether personality traits are fixed or malleable. One of the most effective ways to change behavior may not be targeting the behavior directly, but instead changing people's implicit underlying assumptions about whether behaviors or personalities in general are fixed or malleable. It may seem obvious – or at least most would agree once it's pointed out to them – that people will be more likely to change a behavior if they believe it can be changed. But many interventions to change behavior don't make this a central feature. It could be argued that it is more important to retain the typical focus on making people more motivated or providing instruction on how to change a specific habit and behavior. Beliefs about whether a behavior change can be achieved can then follow suit. The key value of the work on implicit theories is explicating what form this knowledge takes, how it can be changed, and what the impact is. For example, for a brief overview see: Some studies have revealed extremely impressive findings: teaching middle school students and undergraduates that intelligence is malleable (rather than fixed) can improve their actual grades. Very few interventions impact such an important and broad measure, despite using far more time and resources. They are also often restricted to just one content area or set of skills. Little work has examined how changing mindsets can result in greater behavior change, but there is a great deal of potential. March People's implicit theories of how they can change their behavior: How do these influence their success in behavior change? Carol Dweck: Reading tba April Commitment contracts: Making an arrangement to have a monetary gain or penalty on changing a behavior or reaching a target goal. (Discussion led by Justin White, in Health Economics) Guiding questions for organizing and relating papers Although there will be a wide range of readings, one way we can focus our reading and discussion might be towards answering the questions below (other suggestions welcome!). These questions are too broad to generate definitive answers, but we will discuss our own answers to them as a way to start thinking about these issues. 1. What are we referring to when we say "behavior change"? 2. What do you think are the most effective ways to change such behavior? 3. What are important open research questions for investigation? Which of these intersect with your basic research program so far? 4. Thousands of variables and factors can influence behavior change. How can these be organized into underlying principles? What are the key constructs – factors, processes and mechanisms – that provide a framework for understanding and predicting behavior change across multiple contexts? 5. What are the relevant sources of literature for understanding behavior change? Future potential reading topics (and potential papers) Theories of Reasoned Action & Planned Behavior: Provides an introduction to the construct of "utility" or the value people assign to an action/outcome, and how one can understand different factors (e.g. personal attitudes, social norms) as influencing people's evaluation of how good/bad an action/outcome is. (Montaño, D.E. & Kasprzyk, D.(2008). The Theory of Reasoned Action, Theory of Planned Behavior and the Integrated Behavioral Model. Chapter 4 K. Glanz, B.K. Rimer, & K. Viswanath (Eds.) Health Behavior and Health Education (4th ed) (pp. 68-‐96). San Francisco, CA: Jossey-‐Bass.) Motivational interviewing: (Harris, R. S., Aldea, M. A., & Kirkley, D. E. (2006). A motivational interviewing and common factors approach to change in working with alcohol use and abuse in college students. Professional Psychology: Research and Practice, 37(6), 614.) Implicit theories of behavior change: (Carol Dweck paper). Mindfulness and Acceptance-Commitment therapy These approaches are becoming a greater part of cognitive behavioral therapy approaches. A key idea is that people often automatically and unquestioningly respond to negative events (e.g. anxiety or stress leading to smoking, eating or substance abuse). Practicing mindfulness and awareness of personal thoughts and sensations, and accepting the presence of negative feelings, can reduce impulsive behavior and improve mood. (Kabat-‐Zinn J. (2003). Mindfulness-‐based interventions in context: past, present and future.)
Social context of behavior change: (McAlister, A.L., Perry, C.L., Parcel, G.S. (2008). How individuals, environments and health behavior interact: Social Cognitive Theory. Chapter 8 in K. Glanz, B.K. Rimer, & K. Viswanath (Eds.) Health Behavior and Health Education (4th ed) (pp. 169-‐188). San Francisco, CA: Jossey-‐ Bass. Heaney, C.A. & Isreal, B.A. (2008). Social networks and social support. Chapter 9 in K. Glanz, B.K. Rimer, & K. Viswanath (Eds.) Health Behavior and Health Education (4th ed) (pp. 189-‐210). San Francisco, CA: Jossey-‐Bass.)
Cognitive Behavioral Approaches to behavior change -frustration tolerance -changing misleading thoughts -altering positive & negative associations Altering choice sets and choice architecture to guide people's decisions (Thaler & Sunstein. Nudge, Academic articles). Positive psychology Transtheoretical model of behavior change Automatic habits Use of games and social technology (Case study: Kees) USE OF TECHNOLOGY Delivering health interventions online, E-health Delivering of interventions and logging of mood through traditional mobiles and smartphones Text messaging reminders. |
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