willingness to change

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Lecture 5 Willingness to change

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

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Page 1: Willingness to change

Lecture 5

Willingness to change

Page 2: Willingness to change

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)

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SDT and (sustainable) health behavior

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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

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AutonomyIntrinsicMotivation

IntrinsicMotivation

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)

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Induced (forced) compliance Let’s asume you have to do boring task for 1 hour

(e.g. take part in health screening test) You are offered either 1 euro or 20 euro to 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 of 1 euro or 20 euro)?

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Forced compliance experiment: Results

-1

-0.5

0

0.5

1

1.5

2

enjoyable task? participatesimilar task?

1$ 20$

Festinger & Carlsmith (1959)Festinger & Carlsmith (1959)

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So, undermining effect of extrinsic

rewards?

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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

greater initial weight loss, but also better

maintenance over a two-year period

(Vansteenkiste, et al., 2007)

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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

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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

people’s openness to

information and likelihood of

complying with

recommendations is thus high

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Competence and Relatedness?

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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…

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Results stepping experiment (Catzisarantis,

2007) Immediately after manipulation attitudes and intentions were measured

-2

-1

0

1

2

3

4

5

6

Neutral Controlling incomplete complete

attitude

intention

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Thou shalt not …

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Psychological Reactance

If freedom to engage or not engage in a behavior is threatened or denied, motivational

arousal is prompted to restore lost freedom(Brehm & Brehm, 1981)

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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 one’s 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’…

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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… They’re 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???

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Results (Silvia, 2006)

3

4

5

No threat Threat atstart

Threat atend

Agreement

Credibility

Counterarguing

Source derogationSource derogation

Restoring threatened freedom

Restoring threatened freedom

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Source derogation

Has 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)

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Implicit and explicit (anti & pro) smoking

messages

2

3

implicit explicit

message evaluation

source evaluation

Higher score = More negative

Higher score = More negative

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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 to reject smoking

Think about differences in ‘tone of voice’ (implicitness and explicitness) of health ads and commercial ads

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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 of controlling language, higher levels of concreteness should pose no threat to self-determination or autonomy

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Effects of controlling and concreteness