confidence to carry out a behaviour necessary to reach a desired goal. • Self-efficacy is enhanced when patients succeed in solving patient- identified problems. • Evidence from controlled clinical trials suggests that – (1) programs teaching self-management skills are more effective than information-only patient education in improving clinical outcomes; – (2) in some circumstances, self-management education improves outcomes and can reduce costs for arthritis and probably for adult asthma patients; and – (3) in initial studies, a self-management education program bringing together patients with a variety of chronic conditions may improve outcomes and reduce costs. Bodenheimer T, Lorig K, Holman H, & Grumbach K. 2002. Patient Self-management of Chronic Disease in Primary Care. JAMA, 288:2469-2475
can master a situation, and produce a positive outcome • Bandura’s Social Cognitive Model says that there are 3 factors that influence self- efficacy: Behaviors, Environment, and personal/cognitive factors. • They all affect each other, but the cognitive factors are important. Bandura believed that there is more to learning than just ‘behaviorism’, what you believe about a situation is important too. Behaviours Personal/cognitive factors Environment
a four-step pattern that combined a cognitive and operant view of learning. Attention notices something in the environment Retention remembers what was noticed Reproduction produces an action that is a copy of what was noticed Motivation consequence changes the probability the behavior will be emitted again
is expressed in the concept of self-efficacy. – “Self-efficacy is the belief in one’s capabilities to organize and execute the sources of action required to manage prospective situations.” (Bandura, 1986)
behaviour takes place – pain after exercise vs. training effect – withdrawal after smoking vs. disappearance of withdrawal • Concept of Mastery Experiences: if you master one task, there is a better chance of being successful at other similar tasks. (It is important to note here that the mastery experience must be attributed to themselves… not luck, or chance, or others help.)
I believe I can do this ... myself! • Box B: high self-efficacy/external LOC – I believe I can do this ... the doctor said I can! • Box C: low self-efficacy/internal LOC – I don’t think I can do this, but I’m in control here! • Box D: low self-efficacy/external LOC – I don’t think I can do this...no matter what the doctor says!
how to tie your shoes? – Know how to speak French? – Know how to mix chemicals? • Now how many of you: – Would be interested in taking a 2 hour seminar in how to tie your shoes in 12 different ways? – Would be interested in 2 semesters of French? – Would be interested in taking 8 years of university to become an expert chemist, or to learn how to create liquid crystal inventions? • Level of Self-Efficacy + interest = odds of participation?
– Conflict – Complexity – Novelty – Uncertainty • Self-efficacy is directly related to all four of these, so self-efficacy indirectly influences interest through 4 variables… quadratically. • Uncertainty plays the biggest role in interest. • Self-efficacy affects uncertainty: “How will the activity end up?”
to hit target with dart at various distances – distance was adjusted at varying length for different groups, as well as varying the lengths for another group – interest decreased when it got too easy – those put in the moderate difficulty condition were most interested in repeating the task – those who were placed farthest from the target agreed that it would be more interesting if the line was moved closer to the target
Self-Efficacy Emotional and Physiological arousal Relaxation techniques, calming fears Verbal Persuasion encouragement, convince them success is result of self. Vicarious Experiences observation of modeled behaviors Imagined Experience imagining yourself in the experience Performance Experience actual practice of the activity, “Practice makes perfect!” Maddux (1995)
theory of behavior change. Psychological Reviews, 84: 191-215 • Bendura A. (1997). Self-efficacy: The exercise of control. New York: Freeman. • Maddux JE. (Ed). (1995). Self-Efficacy, Adaptation, and Adjustment: Theory, Research, and Application. New York: Plenum. • Marks R, Allegrante JP & Lorig K. 2005. A review and synthesis of research evidence for self-efficacy: Enhancing interventions for reducing chronic disability. Implications for Health Education Practice Part I. Health Promotion Practice. 6: 37-43 • Marks R & Allegrante JP. 2005. A review and synthesis of research evidence for self-efficacy: Enhancing interventions for reducing chronic disability. Implications for Health Education Practice Part II. Health Promotion Practice. 6: 148-156