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📖 Theory Guide →
HBM · SDT · TTM · Self-Efficacy · Operant Conditioning · Adherence
Chapter 3 Theory Quiz
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Chapter 3 Case Studies
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Case Study MCQ
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Five Stages of Change (TTM)
| Stage | Definition | Trainer Strategy |
|---|---|---|
| Precontemplation | Not active, not planning to start in next 6 months | Raise consciousness; discuss risks; don't push — build rapport |
| Contemplation | Inactive but thinking about change in next 6 months | Explore pros/cons; serve as cue to action; keep plan simple |
| Preparation | Taking small steps; may exercise but inconsistently | Collaboratively design a starter program; set SMART goals |
| Action | Consistently active for fewer than 6 months | Reinforce habits; address lapses proactively; build social support |
| Maintenance | Active 6+ months; habit established | Prevent relapse; diversify program; strengthen community ties |
Ten Processes of Change
| Process | Type | Description |
|---|---|---|
| Consciousness Raising | Cognitive | Finding and learning new facts about healthy behavior change |
| Dramatic Relief | Cognitive | Experiencing negative emotions about unhealthy behavior, then relief from deciding to change |
| Self-Reevaluation | Cognitive | Recognizing behavior change as part of one's identity |
| Environmental Reevaluation | Cognitive | Realizing how behavior affects the social environment |
| Self-Liberation | Cognitive | Deciding to change and believing in the ability to do so |
| Helping Relationships | Behavioral | Seeking and using social support for behavior change |
| Counter-Conditioning | Behavioral | Substituting healthy behaviors for unhealthy ones |
| Reinforcement Management | Behavioral | Increasing rewards for healthy behavior; reducing rewards for unhealthy |
| Stimulus Control | Behavioral | Removing cues for unhealthy behavior; adding cues for healthy behavior |
| Social Liberation | Behavioral | Taking advantage of social environments that reinforce new behavior norms |
Operant Conditioning Outcomes
| Type | What Happens | Effect |
|---|---|---|
| Positive Reinforcement | Positive stimulus added | ↑ Behavior |
| Negative Reinforcement | Negative stimulus removed | ↑ Behavior |
| Extinction | Positive stimulus removed | ↓ Behavior |
| Punishment | Aversive stimulus added | ↓ Behavior |
Health Belief Model Variables
Perceived SusceptibilityHow likely does the person think they are to develop a health problem?
Perceived SeriousnessHow severe do they believe the consequences of illness would be?
Perceived BenefitsDoes the person believe action will reduce the threat? Benefits must outweigh barriers.
Perceived BarriersObstacles (time, cost, embarrassment) the person believes stand in the way.
Cues to ActionAny trigger that prompts the decision to change — labs, advice, family illness.
6 Sources of Self-Efficacy
1. Past Performance ExperienceMost powerful source. Previous success directly raises self-efficacy.
2. Vicarious ExperienceObserving someone similar succeed ("If they can, so can I").
3. Verbal PersuasionEncouragement and positive feedback from a credible source.
4. Physiological State AppraisalsHow clients interpret bodily sensations — teach normal vs. warning signs.
5. Emotional State AppraisalsPositive emotions raise SE; negative emotions lower it.
6. Imaginal ExperiencesMental image of what exercise will feel like — cultivate positively.
6 Cognitive Distortions
All-or-Nothing Thinking"I missed one session — my whole week is ruined." No middle ground.
Overgeneralizing"I always quit everything." One setback = permanent pattern of failure.
Catastrophizing / MagnificationBlowing things out of proportion. "Even if I lose weight, I'll gain it all back."
Jumping to ConclusionsMind reading or fortune telling without evidence.
Labeling"I'm just not a fitness person." Rigid negative labels on self.
Personalization & BlameTaking full blame for things outside control, or blaming others for own choices.
SDT — Three Core Needs
CompetenceBelief in ability to perform tasks. Built by achievable challenges and positive feedback.
AutonomyFeeling behavior is self-chosen. Involve clients in goal-setting and program decisions.
RelatednessBelonging and connectedness. Introduce clients; encourage accountability partnerships.
Task vs Ego ClimateTask climate (effort-focused) → commitment. Ego climate (rivalry-focused) → dropout.
Adherence Determinants
Personal — Strongest PredictorPA history. Internal locus of control. Low negative affect. Enjoyment of activity.
Environmental — SocialSpousal support = most reliable social predictor of exercise adherence.
Environmental — AccessProximity to facility is a consistent predictor. Time = most cited barrier.
PA Factors — DesignEnjoyment is paramount. Avoid excessive early intensity (injury = dropout). Customize everything.