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According
to Ganz, Rimer, & Viswanath (2008) there have been over three hundred
theories and models in psychology to date where the top five most influential
are the Health Belief Model, Social Cognitive Theory, Theory of Reasoned
Action, Theory of Planned Behavior, and the Transtheoretical Model / Stages of
Change. The intention of these models it to understand behavior change and promote healthy behaviors. The health belief model (HBM) is one of the
first theories in health psychology developed in the 1950s. The theorists were S.
Stephen Kegeles, Godfrey M. Hochbaum, Irwin M. Rosenstock, and Howard Leventhal
who worked for the U.S. Public Health Service as social psychologists.
HBM is one of the most widely used models of
behavioral change and is used in research, to understand the change process,
health interventions and programs. Developed by these social scientists, it was
directed toward determining the reasoning behind why individuals would fail to
participate in health programs to prevent and detect disease. It is a model
that still is in use today.
The key constructs of the model include: perceived
susceptibility, severity, benefits, and barriers along with cues to action, and
self-efficacy. Champion & Skinner (2008) discuss its application
to two scenarios: breast cancer screening and risky sexual behaviors. One of their findings was that perceived barriers was the most powerful
indicator for mammography and perceived
susceptibility is necessary before behavioral change will occur in regards
to risky sexual behaviors. Self-efficacy, added later, was the most significant
indicator for specific behavioral changes.
The HBM constructs have been combined with The Transtheoretical Model
(TTM) (Prochaska, Redding & Evers, 2008) and its staging methodology for behavior
outcome.
Theorist
James O. Prochaska from the University of Rhode Island along with his
associates are the originators of the transtheoretical model, which was
introduced in the mid 1970’s. Its basis is on theories of psychotherapy and introduces
the construct of intention combined with actual behavior. There exists fifteen
core constructs across ten stages of change. Though the constructs between the HBM and TTM models
vary, it is believed that the conceptualization across the theories within them
is similar.
The
constructs of TTM include: conscious raising, environmental reevaluation,
dramatic relief, social liberation, self reevaluation, self-liberation, helping
relationships, counter conditioning, reinforcement, management, stimulus
control, changing increasing, cons of changing decreasing and self-efficacy
increasing. TTM uses stages of change as the method to integrate processes and
principles across several theories while HBM is a continuous model. It was introduced in the attempt to integrate the
over 300 theories of psychotherapy. As such, the model is more complex than HBM
with more methodological refinement. This provide a better application to
cognitive computational algorithms. While HBM provides the meta-structure.
The
TTM and HBM both have some degree of notoriety within the health psychology industry
and have had much application. Their importance lies within the foundational
work that has been built upon them.
Combined they represent a stepwise progress of deeper understanding into
the potential mechanisms involved in health behavior change, intervention, and
education programs. The application of
these models to cognitive computation provides a new perspective and approach
for artificial intelligent systems and learning systems.
In
attempting to understand a high level aspect of health behavior change, the HBM
would be more appropriate. Its
simplicity and design provide more of a meta-model framework or environment to
work within. In computation of big data,
this model would provide the paradigm or viewpoint to support the organization
of underlying algorithms. Its simplicity can also be seen as a weakness though.
As a researcher, it is best used in conjunction with other models and so
combining it with TTM provides a logical approach to the application of
research the author is pursuing in cognitive computation and learning systems
in artificial intelligence.
Understanding
the perceived barriers to change not only can be applied to development of educational
material or intervention approaches in health psychology, but also to the
understanding and implementation of machine learning algorithms used in our
virtual reality environment for providing rapid data to decisions and learning
systems within high-dimensional data space. Intention, motivation, bias are
also influential.
The ten processes of change within TTM can be
applied to the application of our cognitive-based learning algorithm (patent
pending). It would provide the ability to step participants through the phases
of data assimilation that lead to a change in perception, and understanding, of
underlying meaning hidden within complex, big data analyses.
In summary, both models have been is use for fifty
years or more. Much research and foundational work has been done based upon
their constructs. They have evolved, developed and refined over time and
continue to show value to researcher. Not only do these models hold importance
directly in health psychology, they have application to computational methods
and other adjacent fields. They provide
a meaning metaphor for complexity reduction in computational methods.
References
Champion,
V.L. & Sugg Skinner, C. (2008) The Health Behavior Model. In Health
behavior and health education: Theory, research, and practice (4th Ed ed.,
pp. 169 - 188). John Wiley & Sons.
McAlister,
A., Perry, C. & Parcel, G. (2008). How Individuals, Environments, and
Health Behaviors Interact – Social Cognitive Theory. In Health behavior and
health education: Theory, research, and practice (4th Ed ed., pp. 169 -
188). John Wiley & Sons.
Montaño, D.
E. & Kasprzyk. (2008) Theory of Reasoned Action, Theory of Planned
Behavior, and the Integrated Behavioral Model. In Health behavior and health
education: Theory, research, and practice (4th Ed ed., pp. 67 - 96). John
Wiley & Sons.
Prochaska,
J.O., Redding, Colleen A., & Evers, K.E. The Transtheoretical Model and
Stages of Change. (2008) In Health behavior and health education: Theory,
research, and practice (4th Ed ed., pp. 67 - 96). John Wiley & Sons.
Schwarzer,
R., Lippke, S., & Luszczynska, A. (2011). Mechanisms of health behavior
change in persons with chronic illness or disability: the Health Action Process
Approach (HAPA). Rehabilitation Psychology, 56(3), 161.
Spahn, J.
M., Reeves, R. S., Keim, K. S., Laquatra, I., Kellogg, M., Jortberg, B., &
Clark, N. A. (2010). State of the evidence regarding behavior change theories
and strategies in nutrition counseling to facilitate health and food behavior
change. Journal of the American Dietetic Association, 110(6),
879-891.
Sun, R.
(2008). Introduction to computational cognitive modeling. Cambridge handbook
of computational psychology, 3-19.
Weinstein, N. D., Sandman, P. M. & Blalock, S. J. (2008)
The Precaution Adoption Model. In Health behavior and health education:
Theory, research, and practice (4th Ed, pp. 67 - 96). John Wiley
& Sons.
Additional
Reference
Glanz, K.,
Rimer, B. K., & Viswanath, K. (Eds.). (2008). Health behavior and health
education: theory, research, and practice. (3rd Ed) John Wiley
& Sons.
