I-Change Model

In psychology, the I-change model[1][2] or the Integrated Model, for explaining motivational and behavioral change, derives from the Attitude – Social Influence – Self-Efficacy Model, integrates ideas of Ajzen's Theory of Planned Behavior,[3] Bandura's Social Cognitive Theory, Prochaska's Transtheoretical Model,[4] the Health Belief Model,[5] and Goal setting[6] theories. Previous versions of this model (referred to as the Attitude, Social Norm, Self-Efficacy (ASE) model, derived from the Theory of Planned Behavior) have been used to explain a variety of types of health behavior.

Phases of behavioral change

The I-Change Model is a phase model and assumes that at least three phases in the behavioral change process can be distinguished: 1. Awareness; 2. Motivation; 3. Action. For each phase particular determinants are more relevant.

Awareness

Awareness of a particular problem in a person is the result of accurate knowledge and risk perceptions of the person about his own behavior (not all persons are aware of the level of their own behavior, for instance, many persons overestimate the amount of their physical activity. Cues in their environment (e.g. a person with cancer) may also prompt a person to become more aware of a particular risk and the need to adopt a particular health behavior.

Motivation

Motivation to change a behavior depends on a person's attitude (the results of perceived advantages and disadvantages of the behavior), social influence beliefs (norms of others, behavior of others, and support of others) and self-efficacy expectations (the perceived ability to perform a particular health behavior). The ultimate result in level of motivation to adopt a health behavior can be measured by intentions, a concept derived from Fishbein & Ajzen's Theory of Reasoned Action[7] or related concepts such as the stage of change concept of the Transtheoretical Model of Prochaska.

Action

Intentions do not necessarily lead to behavior. Factors determining action, besides a positive intention, are again self-efficacy, action planning and goal setting. With regard to action planning we distinguish preparation planning (planning actions required to change), initiation planning (planning the actions needed to perform the new behavior for the first time) and coping or maintenance planning (planning the actions to cope with barriers and relapse in order to maintain the realized changes). Additionally, the development of skills required for the new health behavior is needed as well.

Predisposing factors

The I-Change Model assumes that these motivational processes are determined by various predisposing factors such as behavioral factors (e.g. life styles), psychological factors (e.g. personality), biological factors (e.g. gender, genetic predisposition), social and cultural factors (e.g. the price of cigarettes, policies), and information factors (the quality of messages, channels and sources used).

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See also

References
  1. De Vries, H., Dijkstra, M. & Kuhlman, P. (1988). Self-efficacy: the third factor besides attitude and subjective norm as a predictor of behavioral intentions. Health Education Research, 3, 273–282
  2. De Vries, H. & Mudde, A. (1998). Predicting stage transitions for smoking cessation applying the Attitude – Social influence – Efficacy Model. Psychology & Health, 13, 369–385
  3. Ajzen, I. From intentions to actions: A theory of planned behavior. In: Action control: From cognition to behavior. J. Kuhl & S.J. Beckmann (Eds.) 1987, Springer: Berlin. p 11–37
  4. Prochaska J.O., Velicer W.F. The transtheoretical model of health behavior change. Am J Health Promot 1997 Sep–Oct; 12(1): 38–48.
  5. Janz N.K., Becker M.H. The Health Belief Model: A decade later. Health Educ Q. 1984; 11: 1–47.
  6. Gollwitzer, P.M. Implementation intentions. Strong effects of simple plans. Am Psychol, 1999. 54 (7): p. 493–503
  7. Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.

Further reading
  • De Vries, H., Dijkstra, M. & Kuhlman, P. (1988). Self-efficacy: the third factor besides attitude and subjective norm as a predictor of behavioral intentions. Health Education Research, 3, 273–282.
  • De Vries, H. & Mudde, A. (1998). Predicting stage transitions for smoking cessation applying the Attitude - Social influence - Efficacy Model. Psychology & Health, 13, 369–385.
  • De Vries, H., Mesters, I., Van der Steeg, H., & Honing, C. (2005). The general public’s information needs and perceptions regarding hereditary cancer: an application of the Integrated Change Model. Patient Education and Counselling, 56 (2), 154–165.
  • De Vries, H., Mesters, I., Van 't Riet, J., Willems, K., & Reubsaet, A. (2006). Motives of Belgian adolescents' for using sunscreen: the role of action plans. Cancer, Epidemiology, Biomarkers and Biomarkers, 15 (7) 1360–1366.
  • De Vries, H., Kremers, S., Smeets, T., Brug, J., & Eijmael, K. (2008). The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors. American Journal of Health Promotion, 22 (6): 417–425.
  • Segaar, D., Bolman, C. Willemsen M.C., & de Vries, H. (2006). Determinants of Adoption of Cognitive Behavioral Interventions in a Hospital Setting: Example of a Minimal-Contact Smoking Cessation Intervention for Cardiology Wards. Patient Education and Counselling, 61, 262–271. Impact factor 2006: 1.356
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