KT Interventions Analysis

The Commitment to Health (CTH) theory was established as a supplement to the TTM and helps to identify, “how early health-behavior activities become lifelong behavior change” (Kelly, 2008, p.148). Kelly (2008) describes CTH as a middle-range theory in her article. Middle-range theories are “theories that have more limited scope, less abstraction, address specific phenomena or concepts and reflect practice” (Potter and Perry, 2005, p. 63). Kelly (2008) believes that CTH can be used to help create evidence-based health promotion plans for patients in the action stage of behavior change.

The Health Belief Model is commonly used for health promotion and health education. Its’ underlying concept is that health behavior is explained by perception of the disease and the strategies available to lower its occurrence. There are four perceptions of the HBM, which are perceived seriousness, perceived benefit, perceived susceptibility and perceived barriers. In addition to that, more constructs are added to health belief model that includes motivating factor, cues to action and self-efficacy. Each of these constructs in combination or individually, could be used to determine health behavior. The HBM also provides guidelines for the program development allowing planners to address reasons for non-compliance with recommended health action. The health belief model is a process used to promote healthy behavior among individuals who may be at risk of developing adverse health outcomes. A person must gauge their perceptions of severity and susceptibility of developing a disease. Then it is essential to feel vulnerable by these perceptions. Environmental factors can play a role as well as cues to action such as media, and close friends. In order to determine that taking action will be meaningful, the benefits to change must be weighed, against the barriers to change behavior (Green & Murphy, 2014).

In this part of my assignment I will describe 2 different theories of behaviour change in relation to health.

The World Health Organization recommends the standardized communication process, called SBAR, an acronym which simplifies a patient’s situation and background and the patient care provider’s assessment and recommendations (Wacogne & Diwakar, 2010). The situation, background, assessment, and recommendation (SBAR) protocol is a technique that provides structure for

Interventions are activities that are used in a program to make the program more exciting and to help get the information across to the participants in an engaging way (McKenzie et al., 2013). There are many different types of strategies that planners can use as part of an intervention (McKenzie et al., 2013). Some strategies a planner can use are health communication, health education, health policy/enforcement, environmental change, health-related community services, and community mobilization strategies. The planning committee had to pick three interventions based on the multiple intelligences wheel, strategies, and intervention activities. (See appendix I for multiple intelligences wheels and intervention activities)

The intrapersonal model focuses on health promotion and health education efforts in order to increase awareness of health-related issues among individuals, such as knowledge, attitudes, personal beliefs, and the individual’s skill set (Riegelman and Kirkwood, 2015). This is important because it zeros in on the individual and what they know and can do in order to allow for change. One of the many models within the intrapersonal theory is the transtheoretical model, also known as the stages of change model. The transtheoretical model’s constructs are that the individual goes through incremental stages when changing a behavior instead of making big changes all at the same time (Riegelman and Kirkwood, 2015). The first construct is the precontemplation stage, where the individual has not yet thought about changing their behavior. Next, is the contemplation stage, where the individual is actively thinking about the pros and cons of change. Then the next stage is preparation, where the individual is thinking about a plan of action. Next, is the action stage, where the change is taking place in the individual’s behavior. Finally, the maintenance stage, where the change becomes a permanent change in the individual’s lifestyle. (Riegelman and Kirkwood, 2015). The importance in this model is the ability

Noreen and Janevic (2013) believe that the success of patients’ preventive and curative interventions depends on the individual’s willingness to take responsibility for and maintain the necessary behaviors. Sadly, studies have shown that there is poor adherence to recommended changes in lifestyle and behaviors including attending scheduled appointments for treatments (which are missed 35% of the time) and compliance prescribed medication. Due to the evidence of subpar participation in preventive care such as screening and immunization efforts, behavioral scientist have dedicated more research to studying and identifying what determines individual’s health behaviors. This is how individual theories of health behavioral change were developed.

Program planning involves the use of many well defined evidence based practice and services. In this paper we will elaborate on three services which public health professionals may use in a variety of ways to perform their job more effectively. Our focus areas include the Community Guide, American Diabetes Association, and American Heart Association. For each area we will include a brief discussion summarizing the areas, their values in the field, relevant theories the area encompasses, and how each might be applied in the profession. While the topics of each area may differ, we hope you will gain a better understand for each and see how much of their goals and approaches overlap.

Theory helps us to understand the rationale behind the strategies and interventions chosen for a particular health issue (National Cancer Institute, 2005). Although theories are presented in the abstract, and have are not based on specific content or topic area, they become useful as they contain practical goals, topics and problems, which lend us “tools to design and evaluate health behavior and health promotion” as they also give us a way to develop interventions based upon our understand of behavior (National Cancer Institute, 2005). As a foundation for development and planning programs using evidence-based interventions in public health theory can assist and help achieve the following:

The contributing factor which makes it so successful is that it provides an explanation into the ‘how’ of behaviour change as opposed to the ‘why’, effectively demonstrating problematic areas which need to be addressed (Adam & White, 2003). This alludes to the source of the problematic behaviour and stimulates thought into how this behaviour can be changed. A main component of the model which makes it so effective is its integral focus on decision-making, important in promoting real change in the individual (Adam & White, 2003). Decision-making is imperative to this model’s success as it allows for intervention strategies that are individually tailored as well as applicable to a wider, diverse population (Nigg et al, 2011). Not all individuals begin at the same stage and hence TTM provides the appropriate mechanisms to support those who aren’t ready for change, those who are committed, and those who experience relapse (Nigg et al, 2011). For example, two individuals may utilise this model to engage in more effective behaviours regarding physical activity. Although they both share a common goal, they may be in different stages of the model – one individual may be in the preparation stage contemplating an exercise regime, while the other may be in the maintenance stage considering methods to maintain change (Nigg et al,

The change models are change agents that could explain the ways of implementing a change process. These models explain the reason for the change, what to expect during the process and the way a change occurs. Thus, these models help one understand the various aspects of the change process (Agriculture & Life Sciences: Texas A & M University, n.d.). The transtheoretical model of health behavior change could explain my evidence-based practice (EBP) project implementation plan.

The transtheoretical model posits that health behavior change involves progress through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination. Ten processes of change have been identified for producing progress along with decisional balance, self-efficacy, and temptations. Basic research has generated a rule of thumb for at-risk populations: 40% in precontemplation, 40% in contemplation, and 20% in preparation. Across 12 health behaviors, consistent patterns have been found between the pros and cons of changing and the stages of change. Applied research has demonstrated dramatic improvements in recruitment, retention, and progress using stage-matched interventions and proactive recruitment

Boskey (2014) concludes that a person’s willingness to change their health behaviors includes perceived susceptibility, perceived severity, perceived barriers, and cues to action and self-efficacy. For example, Carpenter (2010) report the Health Belief Model stipulates that a change may occur if individuals see an adverse health outcome to be severe and perceive them to be vulnerable to it. Other perceptions include benefits of behaviors that reduce the likelihood of that outcome to be high, and the barriers to adopting those behaviors low (Carter, 2010). Furthermore, the HBM addresses the relationship between a person’s beliefs and behaviors. It provides a way of understanding and predicting how clients will behave about their health and how they will comply with healthcare therapies (Boskey, 2014).

Both the health belief model (HBM) and theories of reasoned action/planned behavior (TRA/TPB) are two model that has their root from psychology. Both models rely on social cognition as a mechanism to change individuals’ behaviors. Opponent criticizes the models for being unable to target social influence outside of an individual and overlook difference between target audiences.

Health belief model was one of the first and most widely recognized theories of health behavior. (Butts & Rich, 2011). This theory was formulated in an attempt to predict health behaviors by focusing on the attitude and beliefs of individuals. It is aimed to determine the likelihood of an individual to participate in health-promotion and disease prevention programs. (Kozier & Erb, 2011). This theory postulated that if a patient is well- motivated, there is a possibility that he will participate in these activities. Motivation can be derived by the individual's perceptions towards his condition. According to Becker (1974), individual perceptions include patient's perceived susceptibility, perceived seriousness of the disease and perceived threat.