“The value of a psychological theory is judged not only by its explanatory and predictive power, but by its operative power to guide psychosocial changes.”
How about this one: if we’re going to have discussions that talk about triggering behaviors in an audience at the public health level (and by that I mean everyone) and you’re proposing ideas for how best to achieve particular goals – speak in terms that the audience can understand.
“Theories are predictive and operative tools. In the final analysis, the evaluation of a
science of self-regulation for health promotion will rest heavily on its social utility.”
Dude, what are you talking about? You’re point rests heavily on social utility, too, and any unique it was completely lost on me because it was communicated in an overly obtuse way.
What isn’t entirely lost on me, though, is the irony of my negative reaction to an author involved in experiments seeking insights into agression. Maybe he’s been the target of aggression for his tone…
Ok, seriously there are a couple nuggets of interest:
3 generic functions to self-regulation of health:
1. self-monitoring of behavior / social and cognitive conditions
2. adoption of goals
3. self-motivating incentives with social supports to sustain healthful practices.
and…
4 possible mechanisms through which health communications could
alter health habits:
1. By transmitting information on how habits affect health;
2. arousing fear of disease;
3. increasing perceptions of one’s personal vulnerability or risk;
4. or by raising people’s beliefs in their efficacy to alter their habits.
I prefer these types of insights communicated through a Fogg type of model, which makes them infinitely easier to digest.
Doug:
October 10th, 2011 at 10:11 am
Albert Bandura presents his views on health self-management in his article “The Primacy of Self-Regulation in Health Promotion.” This dense article is written for Applied Psychology: An International Review and is clearly not intended for non-professionals.
Bandura begins by stating, “Health habits are not changed by an act of will. Self-management requires the exercise of motivational and self-regulatory skills.” He sees three main elements as essential:
1. Self-monitoring of health-related behavior including the related social & cognitive conditions
2. Goal-setting and a plan for achieving them
3. Self-monitoring incentives & social supports
Later he divides patients into three categories with each requiring a different level of support to reach goals.
1. “The first level includes people with a high sense of efficacy and positive outcome expectations for behavior change.” These patients will succeed on their own.
2. Second level patients “have self-doubts about their efficacy and the likely benefits of their efforts.” They need additional support and individualized interaction to achieve their goals.
3. Third level patients “believe that their health habits are beyond their personal control, they are convinced of the futility of effort, and are highly skeptical of the value of behavioral changes. They need a great deal of personal guidance in a structured mastery program.”
Bandura then references the work of Kate Lorig at Stanford University, the designer of the Chronic Disease Self-Management Program (http://patienteducation.stanford.edu/programs/cdsmp.html). This treatment is focused beyond just learning skills directly related to a patient’s condition. It aims to develop an effective methodology of “problem-solving, self-diagnostic skills.”
In the end, Bandura proposes very little of substance himself other than a summary of other’s work. Since I am already familiar with Lorig’s work, this article was not informative.
Ji Hyun Moon:
October 11th, 2011 at 3:19 pm
The Primacy of Self-Regulation in Health Promotion
This reading inform that how the self-regulation management affect on and act for our healthy life. I realize that there are some trends and patterns of people’s behaviors in the field of health life. Divergent life style in the modern ear gives people much opportunities to manage and control their individual life on their owns. However, theoretical incompatibilities, lack of systematic facilities, creative translational( turn the theory into the effective health practices) and social diffusion models( promoting widespread adoption of successful practices by functional adaptation to different life circumstances) instill setting up the appropriate goal of managing health life.
The reading introduces some burning education issue of a knowledge of health management, ‘Self-management of health habits will keep people healthy life.’ This promotion mandates some exercises for adopting self-management health life, which are one is a motivation and the other is self-regulatory skills. Additionally, all requires also a self-monitoring of health-related behavior and social and cognitive conditions. DeBusk introduces the self-management model, combined with development of motivational and self-regulatory skills with computer-assisted implementation. His model requires people’s self monitoring of health habits, setting attainable short-term goals, and reporting the changes they are making. The model of self management will give some feedback to people and also provide a guides do tasks efficiently, and realistically. I realize that for designing a system to change behaviors and inform people the proper health life habits among their routine lives, we need to follow some steady, confirmative strategies. Thus, according to the reading, we need to set up a guide for people to be positive, active that leads an accomplishment of the changes they seek in health. Moreover, the self-management system should not require time and place limits. This is because everyone has different circumstance that affects on people’s prompt or permanent behaviors. Of course, supporting cost effectiveness couldn’t be denied to concern.
I agree that the writer mentions the global applications of social cognitive theory shapes with three models; theoretical model, translational and implementational mode, and social diffusion model. Also as the reading focuses on the self-management system in the world-wide health issue, from the society, we can expect more sophisticated, and diverse improvements in health in ethnic applications. Not just do the self regulation health system exists in theory, but we need to activate the ideal model of self-management health care system in the social utility.
Ryan:
October 15th, 2011 at 11:35 am
I thought the article was a little dry and generic but very informative. The beginning of the article mentioned our class objective: our model of health care is backwards—we need to begin with promoting health management rather then disease management. Bandura explains, “The quality of health is heavily influenced by lifestyle habits.” I think this is a good place to go from.
Bandura talks about one study in particular how “health habits are not changed by an act of will”—which we have discussed briefly in class. People need motivation and self –regulatory skills. I think this is why the health system is the way it is. If we go back to Fogg’s simple graph showing “ability” vs. “motivation” it reveals the difficulty of promoting even the simplest behavior change. When you ask some one to manage even one health parameter that is huge responsibility. I still find myself having difficulty managing simple things like drinking enough water, or remembering to eat when I have a block of classes. The health world is full of all these little behaviors how do we manage each of them and what tools can we build to help us.
I would like to discuss this in terms of our class and what I think we are here to discover. We have the challenge of creating a system to give the population a tool change their behavior in a healthy way. The issue that Bandura highlights is that people often fall short on the requisite skills to track them selves—this statement is key. How do we make whatever we build in this class accessible for the public and engaging? I am still in the dark about what I am going to do for my project but this article helped me define my scope. I think I want to focus on motivation of self-tracking and maybe the importance of self-tracking, much like the QS site promotes. I will probably change my focus next week but overall the article’s message was useful to reiterate our design goal in the class.
Craig:
October 15th, 2011 at 8:18 pm
Like Fred mentioned in his post, this article was a bit cumbersome to digest. It was written for an academic/research community, and, as a result, I found myself reading, re-reading, and re-re-reading sentences to try and wrap my head around what he was trying to say.
That being said, I think I extracted som some key points that reenforce a lot of what we’ve been learning in class thus far. Bandura sets the playing field by implying that our medical system is much more a Sick-Care System than a Health Care System and that aging populations, more than anything, will force this to shift in the other direction.
Bandura goes on to explore how people can have more control over their own well-being in a way that is actually viable. The model he prescribes is a self-management model, which, combines motivational and self-regulatory skills with computer assisted implementation. According to his analysis, the self-management system has huge upsides because its scalable, personalized, has lower barriers to entry, and is well suited for chronic illness. Elaborating on the “personalized” component, the model is amendable based on a patient’s level of motivation and feelings of efficacy. A sense of self-efficacy is a key-component that Bandura claims can be increased by providing meaningful feeedback through the computer reports.
Overall, Bandura seems to be aligned with the Fogg model in that he addresses motivation, ability (self-regulatory skills), and triggers (computer assisted implementation). He also tacks on at the end that the achievement of widespread health benefits require a clear set of fundamental principles, a way to actualize those principles into health practices, and a way to adapt those practices to any life circumstance. I’d like to think our work in this class is aligned with both the self-management model and the principles necessary for advancing the overall health of the population.
Frankie:
October 16th, 2011 at 12:31 am
After reading Pryor and Fogg, this reading was a lot more difficult to get through. The second half of the paper was especially dense – he goes into discussing several different models in a dry way.
Overall, the main point seems to be that shifting from a “disease model” – where supplying medical interventions to manage diseases – to a “health model” where people self manage their own health by adopting healthly lifestyle habits – is a good thing because it will help avoid the increasingly staggering costs of health care. I agree with this – it seems like the smart thing to do.
And the key to moving toward this health model is helping individuals control their motivation and health behaviors by having them practice self-management skills – which include self-monitoring, setting goals, and setting up their own support and reward framework. Yes, this would be helpful – but it seems like it’ll be a lot of work for the individual. If we take it in small steps and perhaps have a trainer help shape some of these behaviors in the beginning, it might be successful.
Jamie:
October 16th, 2011 at 4:46 am
Like others, I found this reading a bit difficult to get through. For the most part it felt like it was just re-affirming what we already know with more solid evidencing behind it.
Example:
self-management = better solution than medical care
- esp with the shift from acute to chronic maladies (medicine is more a one time treatment)
3 self-motivation levels in individuals/patients
technology can be a key asset in self-management
But I was impressed that this piece came from 2005, which isn’t too long ago, but I feel certainly before self-quantification became as popular as it is now. It also got me thinking on how much we take our bodies for granted. People constantly neglect their health and get upset when modern medicine can’t fix a problem they’ve left developing for 20 years over night. This is where I find my parents’ focus is generally on prevention should be the motto I follow, even though it occasionally leads into odd superstitions. (Eg. sneezing means your body is already sick, jumping/basketball makes you grow, using an umbrella indoors will stunt your growth)
Paul:
October 16th, 2011 at 5:27 pm
This is a reasonably dense treatment of some topic’s we’ve come to be familiar with in class; mainly that many systems that have been designed to persuade and change behaviour don’t actually achieve those goals – they are informative without being truly persuasive. They try to forecast or predict the consequences of bad habits, but don’t help us adopt good ones – let alone maintain these habits for a span of time.
The author argues that through the creative use of technology a system can be designed that helps a user self-monitor, offers tailored feedback and does both of these things through convenient and accessible channels – the computer or cell phone. The final major point of the paper seems to be to push home the idea that the people who currently control healthcare systems are poorly equipped, and may actively work against, the adoption of self-regulation systems.
I think this is a useful article because it highlights that the efficacy of the types of systems we’re trying to design has been proven through clinical studies. The language of the piece is dry and a bit impenetrable – but that doesn’t make the information less valuable (Fred).
Valentina:
October 16th, 2011 at 7:36 pm
I found this reading very dense and difficult to follow the author’s point. Although there are some useful ideas that can be discuss.
Besides that the health structure is shifting from a disease to a health model, I found there are some imprecision about the way they describe the self-monitoring system.
I found very aggressive to said that the self-monitoring system is a better solution than the regular medical care. This should be a collaborative model, not choosing one instead of another. By implementing the change of mind about health, people will be more conscious, and will apply some self- monitoring techniques, but to get there, people will need to be trained and should always have medical care as a useful support.
I found interesting when Bandura talked about Individualization of the self-monitoring system. I would love to see how efficient and how accurate could a system like this be. There are some examples in the digital world, but are they really personalized?? This article make me think about ways in which we can achieve this goal.
Carl:
October 16th, 2011 at 11:16 pm
As I mentioned in my “Don’t Shoot the Dog” post I was at a family wedding last weekend. Two of my uncles are Doctors and we inevitably end up talking about interesting things. I was telling my uncle Mike that I was in a class called DIY Health. We talked for a while, and one ended up talking about this article exactly. He was convinced that I was under estimating the ignorance of most patients. The quote from the Bandura, “Individuals continuously preside over their own behavior” contradicted Mikes point. Mike and I both agreed that Americans (in this case) don’t take ownership of their health to the same degree.
Not everyone is willing to do the same things, and in some cases people are almost incapable of taking things into their own hands. It seems like Bandura was talking about designing a “helping hand”. But ultimately I think that there will always be a range of patients some who respond to self-monitoring systems and some who do not.
Suvarchala:
October 16th, 2011 at 11:45 pm
Bandura’s article is obtusely written, and is far less an enjoyable read than Fogg, but he does have some pertinent points to make. The idea that health habits are not changed by an act of will only seem obvious after being in this class. Before it seemed that the ability to be healthy/quit smoking etc was a reflection of one’s character or will power. This class has proven quite effectively that a dependence on will power often leads to failure. This article too reiterates the concept that motivation is a key aspect as well as emphasizing the role of goals, incentives and social support.
The most important part for me was the reference to the self-management model developed by DeBusk. I love that this model adjusted for human faillibility. There was a back-up system for providing guides on managing trouble areas as well as the genius of self-efficacy ratings, which allows the identification of subjective weaknesses that can then be taught to overcome. It’s a good example of a personalized system that takes into account an individual’s unique strengths and flaws and works with them.
I’m also interested by the importance given to self-efficacy. He brings this up with the Lorig studies as well and I find this fascinating because the level of self-efficacy is such a strong determinant of the success or failure of behaviour change. Raising self-efficacy therefore is an outcome I would love to measure in my later projects.
In the end, the idea that self-management produces better results than medical management is not much of a surprise, but one that still seems to be a long way from universal adoption. That is what, in many regards, makes this an exciting area right now.
Fred:
October 6th, 2011 at 4:59 pm
This one is a snoozer.
“The value of a psychological theory is judged not only by its explanatory and predictive power, but by its operative power to guide psychosocial changes.”
How about this one: if we’re going to have discussions that talk about triggering behaviors in an audience at the public health level (and by that I mean everyone) and you’re proposing ideas for how best to achieve particular goals – speak in terms that the audience can understand.
“Theories are predictive and operative tools. In the final analysis, the evaluation of a
science of self-regulation for health promotion will rest heavily on its social utility.”
Dude, what are you talking about? You’re point rests heavily on social utility, too, and any unique it was completely lost on me because it was communicated in an overly obtuse way.
What isn’t entirely lost on me, though, is the irony of my negative reaction to an author involved in experiments seeking insights into agression. Maybe he’s been the target of aggression for his tone…
Ok, seriously there are a couple nuggets of interest:
3 generic functions to self-regulation of health:
1. self-monitoring of behavior / social and cognitive conditions
2. adoption of goals
3. self-motivating incentives with social supports to sustain healthful practices.
and…
4 possible mechanisms through which health communications could
alter health habits:
1. By transmitting information on how habits affect health;
2. arousing fear of disease;
3. increasing perceptions of one’s personal vulnerability or risk;
4. or by raising people’s beliefs in their efficacy to alter their habits.
I prefer these types of insights communicated through a Fogg type of model, which makes them infinitely easier to digest.
Doug:
October 10th, 2011 at 10:11 am
Albert Bandura presents his views on health self-management in his article “The Primacy of Self-Regulation in Health Promotion.” This dense article is written for Applied Psychology: An International Review and is clearly not intended for non-professionals.
Bandura begins by stating, “Health habits are not changed by an act of will. Self-management requires the exercise of motivational and self-regulatory skills.” He sees three main elements as essential:
1. Self-monitoring of health-related behavior including the related social & cognitive conditions
2. Goal-setting and a plan for achieving them
3. Self-monitoring incentives & social supports
Later he divides patients into three categories with each requiring a different level of support to reach goals.
1. “The first level includes people with a high sense of efficacy and positive outcome expectations for behavior change.” These patients will succeed on their own.
2. Second level patients “have self-doubts about their efficacy and the likely benefits of their efforts.” They need additional support and individualized interaction to achieve their goals.
3. Third level patients “believe that their health habits are beyond their personal control, they are convinced of the futility of effort, and are highly skeptical of the value of behavioral changes. They need a great deal of personal guidance in a structured mastery program.”
Bandura then references the work of Kate Lorig at Stanford University, the designer of the Chronic Disease Self-Management Program (http://patienteducation.stanford.edu/programs/cdsmp.html). This treatment is focused beyond just learning skills directly related to a patient’s condition. It aims to develop an effective methodology of “problem-solving, self-diagnostic skills.”
In the end, Bandura proposes very little of substance himself other than a summary of other’s work. Since I am already familiar with Lorig’s work, this article was not informative.
Ji Hyun Moon:
October 11th, 2011 at 3:19 pm
The Primacy of Self-Regulation in Health Promotion
This reading inform that how the self-regulation management affect on and act for our healthy life. I realize that there are some trends and patterns of people’s behaviors in the field of health life. Divergent life style in the modern ear gives people much opportunities to manage and control their individual life on their owns. However, theoretical incompatibilities, lack of systematic facilities, creative translational( turn the theory into the effective health practices) and social diffusion models( promoting widespread adoption of successful practices by functional adaptation to different life circumstances) instill setting up the appropriate goal of managing health life.
The reading introduces some burning education issue of a knowledge of health management, ‘Self-management of health habits will keep people healthy life.’ This promotion mandates some exercises for adopting self-management health life, which are one is a motivation and the other is self-regulatory skills. Additionally, all requires also a self-monitoring of health-related behavior and social and cognitive conditions. DeBusk introduces the self-management model, combined with development of motivational and self-regulatory skills with computer-assisted implementation. His model requires people’s self monitoring of health habits, setting attainable short-term goals, and reporting the changes they are making. The model of self management will give some feedback to people and also provide a guides do tasks efficiently, and realistically. I realize that for designing a system to change behaviors and inform people the proper health life habits among their routine lives, we need to follow some steady, confirmative strategies. Thus, according to the reading, we need to set up a guide for people to be positive, active that leads an accomplishment of the changes they seek in health. Moreover, the self-management system should not require time and place limits. This is because everyone has different circumstance that affects on people’s prompt or permanent behaviors. Of course, supporting cost effectiveness couldn’t be denied to concern.
I agree that the writer mentions the global applications of social cognitive theory shapes with three models; theoretical model, translational and implementational mode, and social diffusion model. Also as the reading focuses on the self-management system in the world-wide health issue, from the society, we can expect more sophisticated, and diverse improvements in health in ethnic applications. Not just do the self regulation health system exists in theory, but we need to activate the ideal model of self-management health care system in the social utility.
Ryan:
October 15th, 2011 at 11:35 am
I thought the article was a little dry and generic but very informative. The beginning of the article mentioned our class objective: our model of health care is backwards—we need to begin with promoting health management rather then disease management. Bandura explains, “The quality of health is heavily influenced by lifestyle habits.” I think this is a good place to go from.
Bandura talks about one study in particular how “health habits are not changed by an act of will”—which we have discussed briefly in class. People need motivation and self –regulatory skills. I think this is why the health system is the way it is. If we go back to Fogg’s simple graph showing “ability” vs. “motivation” it reveals the difficulty of promoting even the simplest behavior change. When you ask some one to manage even one health parameter that is huge responsibility. I still find myself having difficulty managing simple things like drinking enough water, or remembering to eat when I have a block of classes. The health world is full of all these little behaviors how do we manage each of them and what tools can we build to help us.
I would like to discuss this in terms of our class and what I think we are here to discover. We have the challenge of creating a system to give the population a tool change their behavior in a healthy way. The issue that Bandura highlights is that people often fall short on the requisite skills to track them selves—this statement is key. How do we make whatever we build in this class accessible for the public and engaging? I am still in the dark about what I am going to do for my project but this article helped me define my scope. I think I want to focus on motivation of self-tracking and maybe the importance of self-tracking, much like the QS site promotes. I will probably change my focus next week but overall the article’s message was useful to reiterate our design goal in the class.
Craig:
October 15th, 2011 at 8:18 pm
Like Fred mentioned in his post, this article was a bit cumbersome to digest. It was written for an academic/research community, and, as a result, I found myself reading, re-reading, and re-re-reading sentences to try and wrap my head around what he was trying to say.
That being said, I think I extracted som some key points that reenforce a lot of what we’ve been learning in class thus far. Bandura sets the playing field by implying that our medical system is much more a Sick-Care System than a Health Care System and that aging populations, more than anything, will force this to shift in the other direction.
Bandura goes on to explore how people can have more control over their own well-being in a way that is actually viable. The model he prescribes is a self-management model, which, combines motivational and self-regulatory skills with computer assisted implementation. According to his analysis, the self-management system has huge upsides because its scalable, personalized, has lower barriers to entry, and is well suited for chronic illness. Elaborating on the “personalized” component, the model is amendable based on a patient’s level of motivation and feelings of efficacy. A sense of self-efficacy is a key-component that Bandura claims can be increased by providing meaningful feeedback through the computer reports.
Overall, Bandura seems to be aligned with the Fogg model in that he addresses motivation, ability (self-regulatory skills), and triggers (computer assisted implementation). He also tacks on at the end that the achievement of widespread health benefits require a clear set of fundamental principles, a way to actualize those principles into health practices, and a way to adapt those practices to any life circumstance. I’d like to think our work in this class is aligned with both the self-management model and the principles necessary for advancing the overall health of the population.
Frankie:
October 16th, 2011 at 12:31 am
After reading Pryor and Fogg, this reading was a lot more difficult to get through. The second half of the paper was especially dense – he goes into discussing several different models in a dry way.
Overall, the main point seems to be that shifting from a “disease model” – where supplying medical interventions to manage diseases – to a “health model” where people self manage their own health by adopting healthly lifestyle habits – is a good thing because it will help avoid the increasingly staggering costs of health care. I agree with this – it seems like the smart thing to do.
And the key to moving toward this health model is helping individuals control their motivation and health behaviors by having them practice self-management skills – which include self-monitoring, setting goals, and setting up their own support and reward framework. Yes, this would be helpful – but it seems like it’ll be a lot of work for the individual. If we take it in small steps and perhaps have a trainer help shape some of these behaviors in the beginning, it might be successful.
Jamie:
October 16th, 2011 at 4:46 am
Like others, I found this reading a bit difficult to get through. For the most part it felt like it was just re-affirming what we already know with more solid evidencing behind it.
Example:
self-management = better solution than medical care
- esp with the shift from acute to chronic maladies (medicine is more a one time treatment)
3 self-motivation levels in individuals/patients
technology can be a key asset in self-management
But I was impressed that this piece came from 2005, which isn’t too long ago, but I feel certainly before self-quantification became as popular as it is now. It also got me thinking on how much we take our bodies for granted. People constantly neglect their health and get upset when modern medicine can’t fix a problem they’ve left developing for 20 years over night. This is where I find my parents’ focus is generally on prevention should be the motto I follow, even though it occasionally leads into odd superstitions. (Eg. sneezing means your body is already sick, jumping/basketball makes you grow, using an umbrella indoors will stunt your growth)
Paul:
October 16th, 2011 at 5:27 pm
This is a reasonably dense treatment of some topic’s we’ve come to be familiar with in class; mainly that many systems that have been designed to persuade and change behaviour don’t actually achieve those goals – they are informative without being truly persuasive. They try to forecast or predict the consequences of bad habits, but don’t help us adopt good ones – let alone maintain these habits for a span of time.
The author argues that through the creative use of technology a system can be designed that helps a user self-monitor, offers tailored feedback and does both of these things through convenient and accessible channels – the computer or cell phone. The final major point of the paper seems to be to push home the idea that the people who currently control healthcare systems are poorly equipped, and may actively work against, the adoption of self-regulation systems.
I think this is a useful article because it highlights that the efficacy of the types of systems we’re trying to design has been proven through clinical studies. The language of the piece is dry and a bit impenetrable – but that doesn’t make the information less valuable (Fred).
Valentina:
October 16th, 2011 at 7:36 pm
I found this reading very dense and difficult to follow the author’s point. Although there are some useful ideas that can be discuss.
Besides that the health structure is shifting from a disease to a health model, I found there are some imprecision about the way they describe the self-monitoring system.
I found very aggressive to said that the self-monitoring system is a better solution than the regular medical care. This should be a collaborative model, not choosing one instead of another. By implementing the change of mind about health, people will be more conscious, and will apply some self- monitoring techniques, but to get there, people will need to be trained and should always have medical care as a useful support.
I found interesting when Bandura talked about Individualization of the self-monitoring system. I would love to see how efficient and how accurate could a system like this be. There are some examples in the digital world, but are they really personalized?? This article make me think about ways in which we can achieve this goal.
Carl:
October 16th, 2011 at 11:16 pm
As I mentioned in my “Don’t Shoot the Dog” post I was at a family wedding last weekend. Two of my uncles are Doctors and we inevitably end up talking about interesting things. I was telling my uncle Mike that I was in a class called DIY Health. We talked for a while, and one ended up talking about this article exactly. He was convinced that I was under estimating the ignorance of most patients. The quote from the Bandura, “Individuals continuously preside over their own behavior” contradicted Mikes point. Mike and I both agreed that Americans (in this case) don’t take ownership of their health to the same degree.
Not everyone is willing to do the same things, and in some cases people are almost incapable of taking things into their own hands. It seems like Bandura was talking about designing a “helping hand”. But ultimately I think that there will always be a range of patients some who respond to self-monitoring systems and some who do not.
Suvarchala:
October 16th, 2011 at 11:45 pm
Bandura’s article is obtusely written, and is far less an enjoyable read than Fogg, but he does have some pertinent points to make. The idea that health habits are not changed by an act of will only seem obvious after being in this class. Before it seemed that the ability to be healthy/quit smoking etc was a reflection of one’s character or will power. This class has proven quite effectively that a dependence on will power often leads to failure. This article too reiterates the concept that motivation is a key aspect as well as emphasizing the role of goals, incentives and social support.
The most important part for me was the reference to the self-management model developed by DeBusk. I love that this model adjusted for human faillibility. There was a back-up system for providing guides on managing trouble areas as well as the genius of self-efficacy ratings, which allows the identification of subjective weaknesses that can then be taught to overcome. It’s a good example of a personalized system that takes into account an individual’s unique strengths and flaws and works with them.
I’m also interested by the importance given to self-efficacy. He brings this up with the Lorig studies as well and I find this fascinating because the level of self-efficacy is such a strong determinant of the success or failure of behaviour change. Raising self-efficacy therefore is an outcome I would love to measure in my later projects.
In the end, the idea that self-management produces better results than medical management is not much of a surprise, but one that still seems to be a long way from universal adoption. That is what, in many regards, makes this an exciting area right now.