Self-Change Project: Literature Review
A primary goal of the theory of planned behavior (TPB) is to change intentions in contrast to other models, such as cognitive behavior therapy (CBT), that help people carry out their intentions (Fishbein & Ajzen, 2005). For that reason, TPB is used in this project as a theoretical starting place.
TPB assumes intentions to be the most significant predictor of behavior (Blanchard et al., 2003; Scholz, Keller, & Perren, 2009). TPB identifies 3 determinants of intention: (a) attitude, (b) subjective norm, and (c) perceived behavioral control (Blanchard et al., 2003).
Attitude is understood to be the affective and instrumental judgment regarding the behavior (e.g. stretching is enjoyable vs. unenjoyable in the affective domain or helpful vs. harmful in the instrumental sense). Subjective norm reflects the social implications of either performing the behavior or not performing the behavior. In this project the subjective norm could pertain to the execution of a training program or the social implications of participation in other activities facilitated by greater flexibility. Specifically, there could be mixed social implications of, for instance, joining a yoga class by those in my cycling club or positive social implications of greater flexibility enabling me to play soccer on Friday afternoons with my colleagues. Generally speaking, the more favorable the attitudes and subjective norm are regarding a behavior, the stronger the intention will be to perform it (Blanchard et al., 2003) Lastly, perceived behavioral control is the level of anticipated success and is closely aligned with self-efficacy (Bandura, 2004; Fishbein & Ajzen, 2005; Sarafino, 2007). A meaningful approach to successfully altering my existing exercise program should at very least take into account these three determinants.
Bandura (2004) argued that the psychosocial models of health behavior are generally based on common metatheory that include different types of outcome expectations, attitudes regarding the behavior, and social norms. However, he also purports that most psychosocial models of health behavior “are concerned only with predicting health habits. But they do not tell you how to change health behavior” (p. 146). This limitation is acknowledged by Ajzen and Fishbein (2005) who offered that with TPB “two interventions may be required, one to produce the desired intention and another, very different intervention to facilitate performance of the intended behavior” (p. 29). A fairly straight forward-fitness objective for someone with a high level of self-efficacy doesn’t intuitively warrant multiple interventions.
Turning back to the project again, the overall aim in this fitness program is to foster agency so I advance into the preparation and action stages of change to intentionally improve flexibility. To that end, Bandura (2006) claimed that human agency is comprised of: (a) intentionality, (b) forethought, (c) self-reactiveness, and (d) self-reflectiveness. Intentionality involves the action plans and strategies of the individual but is also influenced by the interplay of other active agents. Forethought is the anticipatory extension of agency where goals are set and expected outcomes are used to guide action and foster motivation. Bandura’s concept of self-reactiveness goes beyond planning and anticipation into the regulation of execution. Lastly self-reflectiveness is the metacognitive ability to review and critique our thoughts and actions. Bandura’s core properties of agency further expose elements of implementing change that TPB may not address.
Given the other aspects of agency, Schwarzer’s (2008) health action process approach (HAPA) accounts for a more comprehensive approach to health behavior change. The HAPA begins with a motivational phase where intentions are established inclusive of the perceptive and cognitive factors of self-efficacy, outcome expectancies, and risk awareness. The motivational phase is followed by a volitional phase that includes detailed action planning of where, when, and how the desired behavior will be enacted along with action control along the lines of Bandura’s self-reflectiveness. The HAPA concludes with the execution of the desired behavior.
Each of the preceding theoretical models has something to offer this self-change project. The HAPA, with both a motivational phase and volitional phase, provided a comprehensive framework around which this intervention has been designed (See Figure 1).
The HAPA utilizes Bandura’s (2004) first three characteristics of agency up through the execution of the exercise and can accommodate more explicit use of the fourth characteristic of self-reflectiveness through heightened self-awareness throughout the process. The following intervention employs the attitudinal and perceived behavioral control determinants of TPB in the motivational phase. Both the subjective norm of TPB and the socially embedded nature of the human experience identified in social cognitive theory (Bandura, 2006) have been included in the motivational phase and volitional phase for their anticipated beneficial role contributing to success. Lastly, while the health belief model (Becker, 1979; Eraker, Kirscht, & Becker, 1984) has not been included in this literature review, the approach used in this project has been informed by the social support purported to increase patient action and the cues to action associated with that approach.
References
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