Leah Gramlow Part I

1. A Chaotic View of Behavior Change: A Quantum Leap for Health PromotionBy Ken Resnicow & Roger Vaughan Leah Gramlow Part I

2. Previous Theories • Common Denominators • Cognitive-rational paradigm • Pros and cons are weighed • Conceptualized as linear process • Imperfect statistical models

3. Alternative View • Behavior change initiated by quantum events • Huge surges in motivation or inspiration may not arrive from a cognitive-rational decision making process Mini epiphanies may explain many behavior changes!

5. History of Chaos Theory • Chaos theory started developing in the 1880’s • In the 1960’s Edward Lorenz discovered chaos in weather patterns. • Discovered chaotic systems are sensitive to initial conditions. Commonly known as the butterfly effect.

6. Principles • Chaotic systems can be mathematically modeled in a non linear form, but impossible to predict • Chaotic systems are sensitive to initial conditions • Complex systems involve multiple components that interact in a non linear fashion • The results of complex systems are greater than the sum of their parts

7. Fractal Patterns • Another component within Chaos • Recurring patterns within larger systems • Examples: snowflakes, microvascular system, fern leaf • Do they exist in human behavior?

8. Fractal Patterns in Humans

10. Principles Applied to Health Behavior • Chaotic systems can be mathematically modeled in a non linear form, but impossible to predict • Chaotic systems are sensitive to initial conditions • Experience with the negative outcome

11. Principles Applied to Health Behavior • Complex systems involve multiple components that interact in a non linear fashion • Interaction of constructs: knowledge , attitude, belief, efficacy • The results of complex systems are greater than the sum of their parts

12. Mathematical Representation • Chaos theory represented by quadratic or non- linear models • Linear models can model many interactions but they are limited statistically and conceptually • Detect magnitude of interaction • Untangle three way or higher order interactions • Impossible!

13. Mathematical Representation Cholesterol intervention Two-way interaction Relationship depends on another variable: gender Cholesterol Reduction

14. Chaos vs. Random Events • Chaos does not equal randomness • Randomness can occur within chaotic systems • External or intrapsychic

15. Applied Example: Smoking Cessation Unplanned vs. Planned • Unplanned is less likely to relapse • Unplanned is most common quit method Could this be true for other health behaviors?

16. A Chaotic View of Behavior Change: A Quantum Leap for HealthPromotion:II PartBy Ken Resnicow & Roger Vaughan ThushiPerera

17. Confused Yet?

18. Up to Par What is Chaos Theory Concepts Components

19. Moving Forward Chaotic patterns can stimulate behavior change in two distinct ways. 1. Single external random events. Tipping point for motivational change. 2. Absence of an external event. Current knowledge or attitude may randomly blend to form a perfect motivational storm.

20. Quantum change In Different Words More a dramatic and mystical experience More a sudden insight or sense of finding one's truth

21. More on Two Processes The two processes of linear and quantum pathways to change, may impact behavioral outcomes differently.

22. "Tipping Points" Tipping points are dramatic changes in social behavior that arise quickly and usually unexpectedly. Are virtually impossible to predict, yet retrospectively coherent explanations for the phenomena are routinely offered. Ex: Stock market

23. "Tipping Points“ Contd; Threshold effects or tipping points are commonly used in epidemiology. In behavioral terms, the tipping point refers to the threshold at which individuals or groups of individuals adopt a particular idea or practice. Ex: Fad Diets

24. "Tipping Points“ Contd; The chaotic perspective of behavior change focuses mostly on the individual intra-psychic dimension. Environmental factors such cost, availability, legal restrictions etc also interact with intra-psychic determinants. Ex: Cigarette taxes

25. Resistance to Chaos Accepting randomness as a primal determinant of human behavior may be contrary to the deterministic view characteristic of western thought.

26. Resistance to Chaos Contd; Randomness may conflict with causality and predictability. Ex: Winning a lottery/ earned or karma

27. Resistance to Chaos Contd; Accepting randomness requires that we relinquish the faith that reward and punishment; fortune and misfortune. For public health professionals it requires a new conceptualization of health behavior as well as how and why we influence change.

28. Resistance to Chaos Contd; In the complex system approach, the role of health communications may be analogous to the spinning of ping pong balls in a lottery machine. Each ping pong ball represents a chunk of knowledge, attitude, efficacy, or intention. On each ball lies a few strips of Velcro; the soft side. Inside the human psyche lies strips of the opposite, hard side of Velcro, which serve as potential motivational "receptors".

29. Resistance to Chaos Contd; Some of the motivational ‘ping pong balls’ may have resided in the system for years while others may recently implanted. Rather than attempting to predict which piece or pieces of motivation may "tip" the individual, the role of the health professional is to ensure the balls are kept spinning at various intervals and velocities to maximize the chances of adherence to their receptors.

30. Resistance to Chaos Contd; When sufficient balls have adhered a tipping point may occur. Which balls or combination of balls may trip the motivational switch or when and why they may stick, are chaotic events that defy accurate prediction.

31. Resistance to Chaos Contd; • The linear and chaotic paradigms are not necessarily mutually exclusive. • Behavior change includes both chaotic and rational processes. • Some individuals may by their nature be prone to employ rationale decision making / left hemispheric function. • On the other hand some may be more predisposed to quantum processes where change is more dramatic and less planned.

32. Continuum of Motivational Processes

33. Resistance to Chaos Contd; • Linear vs. quantum process, depending on mood or other initial conditions. • The interaction of linear and quantum processes depends on cognitive-rational factors. • Thus, health promotion may be viewed as priming individuals so that when chaotic environmental or intra-psychic events occur, they have a greater likelihood of taking root. • Whether individuals possess a predisposition to either style is an important issue with considerable implications for health communications. • Tailored intervention and delivery to matched individual cognitive/motivational styles. • Quantum processes may be more operative at initiation of change, it is possible that cognitive-rational processes may be more relevant to maintenance of behavior change.

34. Summary and Implications • Provide clients with considerable opportunity to explore life with and without their risk behavior; let the balls spinning/ Motivational Storm. • Individually tailored interventions to maximize the likelihood of a perfect motivational storm.

35. Summary and Implications • Rather than assuming unaccounted for variance or "error", non-linear models could be used to explore alternative mathematical relationships.

36. Summary and Implications • Individual patterns of changes are likely to be unique. • But, chaotic, patterns across individuals, may in aggregate, and tend to "pool" in a defined geographic area. • Identify common pathways to change based on individual parameters/ sophisticated audience segmentation analyses and more effective interventions that account for the chaotic element of change. • A "mixture model" of both chaotic and linear progression can helps us best understand change.

37. Future Research • Magnetic Resonance Imaging (fMRI) and Momentary psychologic assessment, to map neurologically different types of motivations. • Predict when and why quantum transformations occur. • Theoretical and statistical research to identify behavior change from a quantum perspective. • Degree to which transformational motivation observed in the addiction field operates in the nutrition and physical activity domains, and • Whether inspiration based changes are more enduring than changes arrived at from the more cognitive.

38. Thank You