Image as a Model for Brief Multiple Behavior Prevention Intervention

Transcription

1 Image as a Model for Brief Multiple Behavior Prevention Intervention Chudley Werch, PhD Society of Behavioral Medicine Annual Meeting 2011 Revised 4/12/11

2 Chudley E. Werch, Ph.D., 1 Hui Bian, Ph.D., 2 Carlo C. DiClemente, Ph.D., 3 Michele J. Moore, Ph.D., 4 I-Chan Huang, Ph.D., 5 Steve Ames, Ph.D., 6 Sue Kreichelt, M.S. 7 1 Brief Programs for Health, Jacksonville, FL 2 East Carolina University, Greenville, NC 3 University of Maryland Baltimore County, MD 4 University of North Florida, Jacksonville, FL 5 University of Florida, Gainesville, FL 6 Mayo Clinic, Jacksonville, FL 7 Baptist Medical Center, Jacksonville, FL

3 Today s s Questions 1) What are some theoretical & practical bases for using image in prevention interventions? 2) What is the emerging Behavior-Image Model (BIM)?

4 Today s s Questions 3) What are the primary effects of a brief image-based multiple behavior intervention for high risk adolescents?

5 This research has been supported by funding from: The National Institute on Drug Abuse (NIDA) The National Institute on Alcohol Abuse and Alcoholism (NIAAA)

6 What are some theoretical and practical foundations for image in prevention and health interventions?

7 Image in Theory & Practice Image has a conceptual foundation in: Social Cognitive Theory (Bandura, 1986). Prototype/Willingness Model (Gibbons, Gerrard, & Lane, 2003). Behavior-Image Model (BIM) (Werch, 2007). The use of appealing images has a practical foundation in marketing and advertising communications.

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11 What is the emerging Behavior-Image Model (BIM)?

12 Few theoretical health models directly address how to target multiple risk behaviors (Noar, Chabot, Zimmerman, 2008; Orleans, 2004).

13 The Behavior-Image Model (BIM) An emerging paradigm for planning brief, multiple behavior interventions using images. BIM posits that positive social and future images can be used to link health risk and health promoting/protective behaviors within single health communications. BIM evolved from developing and testing brief interventions for adolescents and young adults.

14 BIM Resolves Barriers to Targeting Image Proposes asset-based, holistic interventions emphasizing positive image and behavior content and feedback eliminating defensive reactions. Avoidance of risk behaviors is linked to the promotion of positive images associated with health enhancing habits, solving the problem of visualizing non-observable observable behavior. Content emphasizing loss of positive future self- image attainment is emphasized over presenting negative prototype images, reducing defensive reactions.

15 Underlying Assumption Activating existing, or creating new images of attractive others (i.e., prototype or social images) and of our possible selves (i.e., future self-images) can integrate and motivate change in divergent health risk and promoting or protective behaviors via social and self-comparison processes.

16 BIM as a Self-regulation Model Based on self-regulation theory of health, with interventions reflecting a feedback loop presenting a hierarchy of goals (Scheier & Carver, 2003). BIM interventions provide feedback on participants concrete health behaviors to promote action goals. The discrepancy between these behaviors and abstract prototypes and future self-images are highlighted as possible higher order self goals.

17 What are the primary effects of a brief image-based multiple behavior intervention for high risk adolescents with a school infraction?

18 Method 413 high school students with a school infraction. Randomized to the brief intervention or usual care with baseline and three-month follow-up. A single 30-minute session: in-person screen, tailored consultation, and goal plan based on BIM. All targeted health and academic behaviors, and current substance use as a moderator.

19 Mean Health Behavior Scores by Treatment Group Intervention Control n = 195 n = 197 pretest posttest pretest posttest M M M M Health Promoting Behaviors Exercise Nutrition Stress Management Stress

20 Mean School Behavior Scores by Treatment Group Intervention Control n = 195 n = 197 pretest posttest pretest posttest M M M M School-Related Measures Grades Skipping School Absent from School Total Referrals

21 Mean Goal Setting Behaviors by Treatment Group Goal Setting Mean Pretest Posttest Intervention Control

22 Cessation of Marijuana Use

23 Summary of Results BI adolescents increased fruits and vegetables, relaxation activities, and goal setting, and reduced skipping school, and total school referrals. All effects were small (d s=.21 s= )..25). No effects on exercise and drug use. Marijuana users receiving BI increased cessation of frequency and quantity of marijuana use. Alcohol and cigarette use did not moderate those drugs.

24 Study Limitations Self reports Baseline differences Small sample from a single school Brief follow-up period

25 Conclusions 1. Image-based prevention programs might be useful in affecting multiple health and academic behaviors among high risk adolescents with school infractions. 2. Drug use effects from similar interventions may be limited to certain types of drug users like those currently using marijuana. 3. BIM should be used to develop and evaluate prevention interventions targeting novel combinations of health and academic behaviors among diverse youth subpopulations. 4. Creative new image-based content and strategies should be tested to enhance size and sustainability of multiple behavior effects.