*As always, cite sources as appropriate.
Multiple choice, true/false, fill-in the blank[1 point each; please highlight AND bold the correct answer]
- A randomized intervention in Zimbabwe to promote regular condom use found both the intervention and the control groups reported similar decreases in unprotected sex. An evaluation based on the Integrated Behavior Model concluded:
- The intervention group shared information with the control group, accounting for the similar outcomes
- Behavioral, normative, and efficacy beliefs were not correlated with behavioral intention
- The intervention was effective in changing the beliefs and intentions in the intervention group to a greater degree than in the control group
- Observed changes were likely due to factors outside of the intervention, such as condom availability
- The effectiveness of the intervention could not have been improved
- One challenge to using the TTM for an intervention is:
- It is only effective for drug and alcohol cessation and physical activity interventions
- There are no applied studies, only theoretical studies, demonstrating effectiveness
- It may be difficult to recruit individuals who are in the precontemplation stage
- It is inappropriate with low-literacy populations
- It requires that people in different stages of change receive the same intervention, which may be inappropriate for participants
- Retention is notoriously difficult in behavior change programs. Which strategy helps increase retention?
- Incentives to join the program
- Carefully match tailored intervention to stage of change
- Only enroll participants in the action stage
- Require participants sign a contract to complete the entire program as part of their informed consent
- Integrate additional Stages of Change models such as the Precaution Adoption Process Model
- Reliance on commitments, conditioning, environmental controls, and support is most likely to happen among people in which stages of the TTM?
- Precontemplation and contemplation
- Action and maintenance
- Consciousness raising and self-reevaluation
- Decisional balance and self-efficacy
- Temptation and termination
- The Precaution Adoption Process Model (PAPM) was originally developed to explain the process by which people adopted precautions to detect carbon monoxide in their homes.
- An individual who smoked for twenty years completed a smoking cessation program and reports not smoking for twelve months. She is in the maintenance stage.
- Normative beliefs refer to whether important referent individuals approve or disapprove of performing the behavior.
- The Theory of Reasoned Action and the Theory of Planned behavior both posit that demographic and environmental characteristics independently contribute to behaviors.
- One benefit of the Transtheoretical Model is that effective intervention strategies are the same for individuals at different stages of the model.
- The influence of a smoker’s partner in a smoking cessation intervention would likely be considered which construct of the Theory of Reasoned Action?
Short answer: [10 points, 5 points each]
Select One (either Question 11 or Question 12)
- What is the one construct that HBM, EPPM, PMT and IBM have in common? Why do you think that all of these models contain this one construct? Do you think that adding this construct to these models improves the models’ effectiveness to explain/predict behavior? Why?
- The PAMP was initially used to screen for environmental health issues. What other types of health behaviors have been attempted to be changed using the PAPM as a framework? Is this model effective?
- [Must complete] From a public health perspective, we know that we can reach the most people with policy-level changes. Some may even dismiss the use of individual-level models/theories in health promotion activities. Describe at least two merits of individual-level models/theories and explain why these models/theories still have a place in the field of public health promotion today. Provide evidence to support your claims.
Applied Exercise:[25 points]
- You work at a local non-profit organization aimed at reducing cardiovascular disease among women living in the three poorest zip codes of your city. Your current funding is running out and if you don’t successfully design a fundable program, you will likely lose your job! The funding agency has put out a request for proposals (RFP) for up to $150,000 per year for three years. If you get this grant, you will get to keep your job for three years. You meet with your supervisor and she asks you to draft up a proposal using the Transtheoretical Model as the theoretical foundation of the programming that will be proposed.
- Please design the questionnaire that will be used to “sort” people into the various stages of the model.
- Briefly describe the components of each stage of your intervention, as it relates to cardiovascular disease among women of low socioeconomic status.
- What format will you use to deliver your intervention? Face-to-face? Social media? Computer-based online learning module? Text-messaging? Or other? Why did you select this method for program delivery?
- What is your strategy for reaching members of the target population and getting them to participate in your program?
- How would you measure the success of your program?