Essay Transtheoretical Model and Stages of Change

– Choose a health topic and create an
intervention to address that issue. In your outline essay you should identify
the health issue, the target audience, describe the intervention, and any
expected outcomes. The foundation of the intervention must be based on one of
the following theories Health Belief Model, Ecological Model, or Transtheoretical
Model and Stages of Change.- Also I will provide an example of that and the example is about HIV (don’t copy or take the same example)


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Health Science:
Human and Social
Dr. M. L. Holt
Lecture Three
Morgan State University
Let’s Review
Ecological Model
The microsystem’s setting is the direct
environment we have in our lives.
The mesosytem involves the relationships between the
microsystems in one’s life
The exosystem is the setting in which there is a link between
the context where in the person does not have any active role,
and the context where in is actively participating.
The macrosystem setting is the actual culture of an
Bronfenbrenner’s ecological framework
Ecological Model
Social Exclusion
Social Exclusion
A dynamic, multidimensional process driven by unequal power
Exclusion process operates along four main dimensions
2. Political
3. Social
4. Cultural
? At different levels including individual, household, group, community,
country and global regional levels.
Psychological Health
The study of the thinking or mental (cognitive) process that
influence human behavior
Involves the ability to deal effectively with psychological
challenges in life
The qualities of ones psychological health often affects the
other components of health such as social, spiritual, and
physical health
The study of body functions and psychology
Self Esteem
A key component of personality that influences an individuals
thoughts, actions, and feelings
High Self Esteem
A high degree of independence
Are satisfied with themselves
Accept challenges and work well with others
Low Self Esteem
Have difficulty making decisions
Resist changing their behavior
Resent any form of criticism, even if it is constructive
Rosenberg Self Esteem Scale
On the whole, I am satisfied with myself
2. * At times, I think I am not good at all
3. I feel like I have a number of good qualities
4. I am able to do thinks as well as most other
5. * I feel I do not have much to be proud of
6. * I certainly feel useless at times
7. I feel that I’m a person of worth, at least on
a equal plane with others
8. * I wish I could have more respect for myself
9. * All in all, I am inclined to feel that I am a
10. I take a positive attitude toward myself
Rosenberg Self Esteem Scale
Scoring [Questions with * (2,5,6,8,9)]
SA = 0
SD = 3
SA = 3
SD = 0
Score – 15-25 is the normal range. Lower than 14 in the low self esteem range
Physiological Illness
a severe type of mental illness characterized by disorganized thoughts
and unreal perceptions that result in strange behavior, isolation,
delusions, and hallucinations
inaccurate or unreasonable beliefs that often result in decision making
false sensory perceptions that have not apparent external cause, but they
are real to the psychotic individual
Anxiety Disorders
Generalized Anxiety Disorder
Condition characterized by uncontrollable chronic worrying
and nervousness
A intense or irrational fear of an object or a situation
Panic Disorder
Features panic attacks, unpredictable episodes of extreme
anxiety, and loss of emotional control
Anxiety Disorders cont.
Post Traumatic Stress Disorder (PTSD)
occur after you have gone through an extreme emotional
trauma that involved the threat of injury or death
Obsessive Compulsive Disorder (OCD)
an anxiety disorder in which people have unwanted and
repeated thoughts, feelings, ideas, sensations (obsessions), or
behaviors that make them feel driven to do something
Impulse Control Disorders
Attention-Deficit Hyperactivity Disorder
Characterized by short attention span and/or
hyperactivity-impulsivity that results in serious social
Problem Gambling
Mood Disorders
Major Depressive Disorder
Persistent and profound sadness, hopelessness, helplessness,
and feelings of worthlessness; lack of energy; loss of interest in
Bipolar Disorder (Manic Depression)
Unusual shifts in mood, energy, and physical activity levels,
and ability to carry out daily task
Seasonal Affective Disorder
Persons become depressed around mid-fall and late fall and
their depression ends in late winter and early spring
Eating Disorders
Anorexia Nervosa
Severe psychological disturbance in which an individual
refuses to eat enough food to maintain a healthy weight
Bulimia Nervosa
Characterized by a craving for food that is difficult to satisfy
Binge Eating Disorder
a pattern of eating excessive amounts of food in response to
distress such as anxiety or depression
Other Disorders
People who experience extreme disorganized thought
processes, including hallucinations and delusions
The deliberate ending of one’s own life
The Health Belief Model
Historical Perspectives
• Early 1952: U.S. Public Health Service hired G.
Hochbaum to study the reasons for low
participation in TB screening programs
• Geoffrey Hochbaum, along with Stephen Kegels
and Irwin Rosenstock, proposed the basic
health belief model (HBM) in the late 1950s
• Expanded in the 1980s by Becker
• Based on general principles of value
expectancy—desire to avoid sickness (value),
belief in availability of preventive tools
Constructs of the HBM
Constructs of the HBM
• Perceived susceptibility: Belief of a person
regarding the possibility of acquiring a
disease or harmful state as a result of a
particular behavior
• Define population at risk (apply descriptive
• Personalize risk (discussion, role play,
simulation, case study)
• Consistent with actual risk (apply analytical
Constructs of the HBM (cont’d)
• Perceived severity: Belief of a person regarding
the extent of harm that can result from the
acquired disease or harmful state as a result of a
particular behavior
– Specify consequences of the risk and the
condition (lecture, discussion, self-reflection,
case study, case narration, video presentation)
Constructs of the HBM (cont’d)
• Perceived benefits: Belief of a person
regarding the usefulness of the methods
suggested for reducing risk or seriousness of
the disease or harmful state resulting from a
particular behavior
– Define action to take (clear steps, specific
demonstration, re-demonstration)
– Clarify the positive effects to be expected
(discussion, lecture, self-reading, video
presentation, computer-aided presentation)
Constructs of the HBM (cont’d)
• Perceived barriers: Belief of a person
regarding actual and imagined costs of
performing the new behavior
• Reassurance (one-on-one counseling, case
study, discussion, active listening)
• Correction of misinformation (lecture, video
presentation, role play)
• Incentives (tangible and intangible aids,
verbal encouragement, case accounts)
• Assistance (providing services,
Constructs of the HBM (cont’d)
• Cues to action: Precipitating force that
makes the person feel the need to take
– Provide how-to information (lecture,
demonstration, re-demonstration, role play)
– Employ reminder system (buddy system, log,
diary, Post-it notes)
Constructs of the HBM (cont’d)
• Self-efficacy: Belief or confidence to
perform a behavior
– Provide training in small steps
(demonstration, re-demonstration)
– Progressive goal setting (self-reflection, diary)
– Verbal reinforcement (one-on-one
– Reduce anxiety (stress management
Health Science:
Human and Social
Dr. M. L. Holt
Lecture Five
Morgan State University
Health Belief Model
S Contains several primary constructs that predict why
people will take action to prevent for, screen for, or to
control illness conditions; these include
S Susceptibility
S Seriousness
S Benefits and barriers to behaviors
S Cues to action
S Self efficacy
Health Belief Model cont.
Theories of Stress and Coping
• Stress is the response of
– Body
– Mind
– Behaviors
• As a result of
– Encountering environmental events (stressors)
– Interpreting these events
– Making judgments about controlling or
influencing these events
Let’s Review
Transactional Model
• Primary appraisal
• Am I OK or am I in trouble?
• Judgment based on past; knowledge about
oneself, about event; influence on others
• Secondary appraisal
• How much control do I have over the
Transactional Model (cont’d)
• Coping
• Application of means identified
• Reappraisal
• Determining whether the original stressor
has been negated
Types of Coping
• Problem-focused coping
– Based on one’s capability to think and alter
the environmental event or situation
• Emotion-focused coping
– Based on focusing inward on altering the way
one thinks or feels about a situation or an
Problem-Focused Coping
• Examples of this strategy at the thought
process level include:
– Utilization of problem-solving skills
– Interpersonal conflict resolution
– Advice seeking
– Time management
– Goal setting
– Gathering information about what is causing
one stress
Problem-Focused Coping (cont’d)
• Examples of this strategy at the behavioral
or action level include activities such as:
– Joining a smoking cessation program
– Compliance with a prescribed medical
– Adherence to a diabetic diet plan
– Scheduling and prioritizing tasks for
managing time
Emotion-Focused Coping
• Examples of this strategy at the thought
process level include:
– Denying the existence of the stressful
– Freely expressing emotions
– Avoiding the stressful situation
– Making social comparisons
– Minimization or looking at the bright side of
Emotion-Focused Coping (cont’d)
• Examples of this strategy at the behavioral
or action level include:
– Seeking social support
– Use of exercise
– Relaxation
– Meditation
– Support groups

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