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Social Cognitive Theory. Applied to Health Behavior Chase Cameron. Background. Social Cognitive Theory Albert Bandura and Social Learning Theory. Tenants of Social Cognitive Theory (SCT). Lends itself nicely to public health!

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social cognitive theory

Social Cognitive Theory

Applied to Health Behavior

Chase Cameron

background
Background
  • Social Cognitive Theory
    • Albert Bandura and Social Learning Theory
tenants of social cognitive theory sct
Tenants of Social Cognitive Theory (SCT)
  • Lends itself nicely to public health!
  • “Interaction among person, environment and behavior” - Bandura
    • Five Key Constructs
    • Reciprocal Triadic Causation
    • Threefold Stepwise Implementation Model
five key constructs
Five Key Constructs
  • Knowledge
  • Perceived Self-Efficacy
  • Outcome Expectations
  • Goal Formation
  • Sociostructural Factors
first two key constructs
First Two Key Constructs:

Knowledge

Perceived Self-Efficacy

“A precondition for behavior change” - Bandura

Confidence and ability to adopt behavior

knowledge
Knowledge
  • Necessity vs. Sufficiency
  • Content knowledge vs. procedural knowledge
knowledge1
Knowledge:
  • Necessity vs. Sufficiency
    • Is knowledge necessary for behavior change?
    • Is knowledge sufficient for behavior change?
  • Notable public efforts devoted to this idea!
    • Your examples of effective efforts?
    • Your examples of ineffective efforts?
knowledge2
Knowledge:
  • Content knowledge
    • Understandings of benefits and drawbacks of health behavior.
  • Procedural knowledge
    • Understandings of how to engage in health behavior.
  • Examples?
five key constructs1
Five Key Constructs
  • Knowledge
  • Perceived Self-Efficacy
  • Outcome Expectations
  • Goal Formation
  • Sociostructural Factors
perceived self efficacy1
Perceived Self-Efficacy
  • Critical to Adoption and Maintenance of health behaviors
    • Programs must accommodate differences in self-efficacy.
  • Requires Resiliency
    • Many health promoting behaviors:
      • occur under difficult circumstances.
      • include multiple steps of varying complexity
building self efficacy
Building Self-Efficacy
  • Methods Given:
    • Physiological State (overcoming fear/negativity)
    • Verbal Persuasion (convincing)
    • Vicarious Experiences (demonstrating)
    • Enactive Attainment (guiding and coaching)
in class activity
In- Class Activity:

(Front of Room)

1. Break into groups as shown

2. For the selected health behavior, develop an example program using each step: (pg 170)

Physiological State (overcoming negativity/fear)

Verbal Persuasion (convincing)

Vicarious Experiences (demonstrating)

Enactive Attainment (guiding and coaching)

final point about self efficacy
Final Point about Self Efficacy:
  • Behavioral Capacity:
    • “Actual” ability to perform health behavior
    • May be misaligned!
five key constructs2
Five Key Constructs
  • Knowledge
  • Perceived Self-Efficacy
  • Outcome Expectations
  • Goal Formation
  • Sociostructural Factors
outcome expectation
Outcome Expectation
  • Knowledge is a necessary gateway to action
    • How to engage in behavior
  • Perceived self-efficacy will determine whether or not action takes place
    • Ability to engage in behavior
  • Outcome expectation is equally responsible in motivating behavior.
    • Must be a belief the behavior will pay off!
    • Also based on perceptions.
outcome expectations
Outcome Expectations
  • Related Concepts
    • Net gain - weighing pros and cons
    • “Ulysses contracts”
outcome expectations1
Outcome Expectations

Gauging the Difficulty of behavior change

Easier . . .

More intensive...

outcome expectations2
Outcome Expectations
  • Expectancies vs. Expectations
    • Expectancies: “the expectation that Y will occur following X and a positive or negative value attached to Y.”
outcome expectations3
Outcome Expectations
  • Reinforcement:
    • Positive or Negative it leads to an increase!
      • Take something bad away = Negative
      • Add something good = Positive
    • Extrinsic or intrinsic
      • Socially structured reinforcement = extrinsic
      • Not socially structured = intrinsic
five key constructs3
Five Key Constructs
  • Knowledge : Necessary Condition
  • Perceived Self-Efficacy
  • Outcome Expectations
  • Goal Formation
  • Sociostructural Factors

Level of Motivation

goal formation
Goal Formation
  • -According to by Social Cognitive Theory goals are best achieved by being broke down into a progressive series of sub-goals
    • Easier to obtain long term, more complex goals
      • Long term goals may be hard for individual to envision, making behavior change difficult
      • Setting smaller goals that are easier to obtain and will build up to accomplishing bigger goal
    • Setting smaller easily obtained goals increases self-efficacy
      • Little success increase belief that individual can obtain the larger goal
    • Increases expectancies
        • Outcome of continued pursuit will be positive
        • Increased desire to obtain behavior change
sociostructural factors
Sociostructural Factors
  • -The environment that an individual lives in affects ability to engage in behavior
    • Built environment, policy, culture
    • Supporting factors for change
      • Increase self efficacy
      • Examples: gyms that are close, stores that supply healthier foods, free vaccination clinics, local norms support healthy behavior
    • Impeding factors for change
      • People may have content knowledge on health behavior but…
      • Examples: no source for healthy foods, lack of health care facilities, reference groups are performing bad behavior
      • Self-efficacy is lowered
  • -To counteract impeding factors
    • Alter perception to individuals can defy norms
      • provide procedural knowledge
reciprocal triadic causation
Reciprocal Triadic Causation
  • -This model is an important connection between the SCT and health promotion
  • -Reciprocality= mutual influence

ENVIRONMENT

BEHAVIOR

PERSON

reciprocal triadic causation1
Reciprocal Triadic Causation

ENVIRONMENT

BEHAVIOR

PERSON

reciprocal triadic causation2
Reciprocal Triadic Causation

ENVIRONMENT

BEHAVIOR

PERSON

reciprocal triadic causation3
Reciprocal Triadic Causation

ENVIRONMENT

BEHAVIOR

PERSON

reciprocal triadic causation4
Reciprocal Triadic Causation

ENVIRONMENT

BEHAVIOR

PERSON

three fold stepwise implementation model
Three Fold Stepwise Implementation Model
  • -Level One: High levels of self-efficacy and strong outcome expectations
    • very little, if any, intervention needed before they adopt behavior
    • They have a high level of readiness
      • Self-efficacy and outcome expectations are only related to specific behavior
    • Will move from level one to action easily
      • Does not mean they will stick with behavior long term
  • -Level Two: Doubts about self-efficacy and weak outcome expectations
    • More intense interventions needed than level one
    • Multiple intervention points needed (these correspond with Reciprocal Triadic Causation
  • -Level Three: Belief that personal control over behavior is lacking
    • Intense intervention needed to establish personal agency
      • May have universal lack of belief
    • Without personal agency, individuals may not even try
slide33

PERSON

Goal Formation

ENVIRONMENT

(sociocultural factors)

the theory of triadic influence
THE THEORY OF TRIADIC INFLUENCE

GENETICS

ENVIRONMENT

IntraPersonal

Environment

Social Situation

Attitudes Toward

Behavior

Self-Efficacy

Social Normative

Beliefs

Intentions/Decision

BEHAVIOR

34

bandura 2004 primacy of se you can see why bandura and fishbein could never quite agree
Bandura, 2004: Primacy of SEYou can see why Bandura and Fishbein could never quite agree!

Attitudes

Intentions

Social Influences  SNB ??

slide36

SCT aligned with the TTI

Levels of

Causation

Ultimate

CULTURAL

SOCIAL

BIOLOGY/

Causes

ENVIRONMENT

SITUATION

PERSONALITY

1

2

3

4

5

6

a

f

Social/

Personal

Nexus

c

d

e

b

Sense of

Information/

Interpersonal

Others’

Social

Interactions w/

Self/Control

Opportunities

Bonding

Beh & Atts

Competence

Social Instit’s

Distal

Influences

7

8

9

10

11

12

l

Expectancies

& Evaluations

Self

Skills:

Motivation

Perceived

Values/

Knowledge/

Determination

Social+General

to Comply

Norms

Evaluations

Expectancies

13

14

15

16

17

18

s

x

ATTITUDES

SOCIAL

SELF-EFFICACY

u

w

v

t

Affect and

Cognitions

TOWARD THE

NORMATIVE

BEHAVIORAL

BEHAVIOR

BELIEFS

CONTROL

Proximal

19

20

21

Predictors

Decisions

A

G

B

H

C

I

D

E

F

22

K

Experiences

23

Related Behaviors

J

Intrapersonal Stream

Social/Normative Stream

Cultural/Attitudinal Stream

Biological/Nature

Nurture/Cultural

Role Models

g

r

p

i

q

h

k

n

m

j

o

Why not Norms??

Expectancies

GOALS/MOTIVATION

Socio-structural factors = behavioral control,

and are influenced by self-efficacy - really?

Trial Behavior

EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological

36