Willingness to change

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Health communication lecture about people\'s willingness to change behavior

Text of Willingness to change

  • 1.Lecture 5 Willingness to change

2. Today

  • Self-determination theory
  • Reactance
  • Forced compliance
  • Empowerment
  • What do these concepts have in common?
    • Control issue (internal or external)
    • Motivation issue (intrinsic or extrinsic)

3. SDT and (sustainable) health behavior 4. Sustainable health behavior

  • According to SDT, maintenance of behaviours over time requires that patients internalize values and skills for change, and experience self-determination.
  • Ryan et al., 2008

5. Autonomy Intrinsic Motivation

  • Dental hygiene (motivation continuum)
    • Not brush your teeth
    • Brush your teeth because your parents force you to
    • Brush your teeth because you feel you have to (guilt)
    • Brush your teeth because you do not want to have cavities
    • Brush your teeth because you like to do it (self-determined)

6. Induced (forced) compliance

  • Lets asume you have to do boring task for 1 hour (e.g. take part in health screening test)
  • You are offered either1 euroor20 euroto tell others that this is enjoyable and intriguing (so, you have to lie)
  • Afterwards, you are asked how enjoyable this task was, and if you would do a similar task again ( on a scale from -5 to 5 ).
  • What do you think increases the enjoyment of the task and your intention to do this again (offer of1 euroor20 euro )?

7. Forced compliance experiment: Results Festinger & Carlsmith (1959) 8. So, undermining effect of extrinsic rewards? 9. SDT and Obese

  • Intervention for obese children showed that a focus on intrinsic goals of health rather than extrinsic goal of attractiveness as reasons for change resulted not only in greaterinitialweight loss, but also bettermaintenanceover a two-year period (Vansteenkiste, et al., 2007)

10. Competence (ability)

  • For internalization to occur a person has to experience the confidence and competence to change
    • Sense of competence is facilitated by autonomy
    • Competence alone is not sufficient to ensure adherence: it must be accompanied by volition or control

11. Relatedness

  • A sense of being respected, understood, and cared for is essential to forming the experiences of connection and trust for internalization to occur
  • The impact of relatedness on peoples openness to information and likelihood of complying with recommendations is thus high

12. Competence and Relatedness? 13. Bench stepping experiment (Chatzisarantis, 2007)

  • Four conditions
    • Neutral: participants were (simply) asked to practice bench-stepping, 3 days per week, for at least 20 minutes each time, over the next 2 months, during their leisure time
    • Incomplete autonomy support: participants read txt about decision to practice bench-stepping (the choice is up to you) and signed consent form (I truly choose to )
    • Complete autonomy support: same as above with addition of rationale (doing this activity has been shown to be useful ) and acknowledgement of feelings (I know doing this activity is not much fun )
    • Controlling: Participants read txt Now you do not have much choice and you should practice

14. Results stepping experiment (Catzisarantis, 2007)

  • Immediately after manipulation attitudes and intentions were measured

15. Thou shalt not 16. Psychological ReactanceIf freedom to engage or not engage in a behavior is threatened or denied, motivational arousal is prompted to restore lost freedom (Brehm & Brehm, 1981) 17. Threat to freedom

  • Motivation to maintain personal freedom creates resistance to persuasion.
  • People feel free to hold particular attitudes, to change their attitudes, or to avoid committing to any position
  • If a communicator threatens ones freedom to disagree(What I am going to tell you now, is very important and you must agree! Smoking is bad for your health!) , then the freedom to disagree can be reasserted by disagreeing(I will listen but I will decide for myself whether I disagree or not! Smoking is not that bad!)
  • Known as boomerang effect

18. Threatened freedom experiment (Silvia, 2006)

  • Message: Physical exercise is good for you! followed by several arguments
    • Condition 1 Threat at start: Here are my reasons Theyre good reasons, so I know you completely agree with all of them. Because when you think about it you are really forced to agree with me because this is a health issue
    • Condition 2 Threat at end: So those are my reasons etc..
    • Condition 3 No threat
    • Effect???

19. Results (Silvia, 2006) Source derogation Restoring threatened freedom 20. Source derogationHas long term implications for ongoing influence attempts, because the sources of a reactance producing messages may lose referent power and credibility and thus suffer diminished future influence over their reactant audiences (Miller et al., 2007) 21. Implicit and explicit (anti & pro) smoking messagesHigher score = More negative 22. Implicit and explicit smoking messages

  • So when middle and high school-aged students are confronted with explicit (overtly persuasive) antismoking messages they are less likely to comply and more likely to engage in smoking
  • Moreover (!) when students are confronted with an explicit prosmoking message they are more likely torejectsmoking
  • Think about differences in tone of voice (implicitness and explicitness) ofhealthads andcommercialads

23. Lexical concreteness

  • Messages stated in concrete terms tend to provide specific details (e.g. sugar causes obesity and tooth decay) as opposed to abstract vague generalities (Sugar is bad for you)
    • See similarity with single action or goal
  • In contrast to the heated emotive responses as a consequence ofcontrollinglanguage, higher levels ofconcretenessshould pose no threat to self-determination or autonomy

24. Effects of controlling and concreteness

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