The Precaution Adoption Process ModelLiz McDermottH 571: Principles of Health Behavior

Overview• Characteristics of Stage Models

• Stages included in the Precaution Adoption Process Model

• The Precaution Adoption Process Model and the Theory of Triadic Influence

• Precaution Adoption Process Model and Processes of Change

• Group Discussion

Stage Models• Change occurs as a result of passing through series of

sequential stages resulting in either:• Elimination of a health-risk behavior• Long-term adoption of a health-protective behavior

• To enter a subsequent stage, one must successfully complete the tasks of the previous stage

• Useful for developing and implementing stage-matched/stage-targeted interventions

Assumptions of Stage Models• Classification system defining stages

• Ordering of stages

• Common barriers to change experienced by individuals in same stage

• Different barriers to change experienced by individuals in different stages

Precaution Adoption Process Model (PAPM) & Your Health Behavior• Keep your health behavior of

interest in mind and think about the following:• Does your health behavior of

interest fit with the PAPM model?

• If so, what aspects of the model make it a particularly good fit for your health behavior?

• If not, why? What are some of the gaps or limitations of the model?

Stages of the PAPM• Composed of 7 stages

• Each stage represents unique patterns of beliefs, behavior, and experience

• Factors producing stage transitions differ depending on transition under consideration

Stages of the PAPM cont.

• Stage 1: Unaware of Health Issue

• Stage 2: Unengaged by Health Issue• Optimistic Bias

Stages of the PAPM cont.• Stage 3: Deciding about Acting

• Stage 4: Decided Not to Act• Confirmation Preservation, Hypothesis Preservation

Stages of the PAPM cont.• Stage 5: Decided to Act

• Stage 6: Acting

• Stage 7: Maintenance

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DECISIONS/INTENTIONS

SOCIAL SITUATION

BIOLOGY/PERSONALITY

THE THEORY OF TRIADIC INFLUENCE

ATTITUDESTOWARD THE

BEHAVIOR

SOCIALNORMATIVE

BELIEFS

Trial Behavior

EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological

SELF-EFFICACYBEHAVIORAL

CONTROL

Nurture/CulturalBiological/NatureIntrapersonal Stream Social/Normative Stream Cultural/Attitudinal Stream

Values/Evaluations

Knowledge/Expectancies

PerceivedNorms

Information/Opportunities

InterpersonalBonding

SocialCompetence

Interactions w/Social Instit’s

Others’Beh & Atts

Motivationto Comply

Skills:Social+General

Sense ofSelf/Control

SelfDetermination

1 2 3

7 8 9 10 11 12

13 14 15 16 17 18

l

4 5 6

19 20 21

22

23

DistalInfluences

ProximalPredictors

Levels ofCausation

UltimateCauses

Social/Personal Nexus

Expectancies & Evaluations

Affect andCognitions

Decisions

Experiences

a

b c d e

f

g h i

jk m n

o

p q r

s

t u v w

x

Related BehaviorsJ

K

CF

IB E HA D G

CULTURALENVIRONMENT

PAPM & Processes of Change• Does not prescribe specific processes of change

• Stage progression may occur as a result of many varied intervention techniques

• Potential of alternative theories to provide insight into mechanisms of PAPM stage movement

• Weakness of the PAPM?

Remember…PAPM & Your Health Behavior• Does your health behavior of

interest fit with the PAPM model?

• What aspects of the model make it a good fit for your health behavior?

-or-

• What prevents your health behavior of interest from fitting with the model?

• What are some of the gaps or limitations of the model?

PAPM & Potential Processes of Change• Using vaccination as your health behavior, what are some

examples of factors that may contribute to an individual’s stage progression in the PAPM?

• Stage 1 (Unaware of Health Issue) to Stage 2 (Unengaged by Health Issue)

• Stage 3 (Deciding about Acting) to Stage 4 (Decided Not to Act) -or- Stage 5 (Decided to Act)

Thank You!