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1. stages of changes - pre contemplation, contemplation, preparation, action, and maintenance. example: widely used in Quit Smoking program where a person trying to stop smoking will go through different stages.

2. Social cognitive theory is a general theory that stresses learning from the social environment.

example: learning or following a good or bad deed that our parents do to others.

3. Reason for Change Theory - a given behavior can be predicted by intentions (example: motivations) to engage in that behavior

example: if we believe smoking can harm other people, we won't intend to smoke.

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1.     Stages of changes theory application: Medication adherence

Precontemplation: Patient doesn't recognize non-adherence as a problem

Contemplation: Patient acknowledges missing doses but is ambivalent about change

Preparation: Patient starts planning strategies like pill organizers or reminders

Action: Patient actively implements adherence strategies

Maintenance: Patient consistently takes medications as prescribed

2.     Social cognitive theory application: Counseling for device technique e.g., insulin pen

Observational Learning

-        Direct Demonstration: Pharmacist demonstrates each step, uses actual device

-        Visual Aids: Video demonstrations, step-by-step infographics

3.     Reason of change theory application: Medication adherence

·        Internal reason: The patient wants to get better so that he can perform Haji

·        External reason: Cost consideration i.e. not compliance --> disease not well-controlled --> more frequent appointments given by clinic --> increase transportation cost

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1. The Stages of Change theory is a psychological model that outlines the stages individuals go through when modifying behavior. It includes five stages:

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1. The Stages of Change theory is a psychological model that outlines the stages individuals go through when modifying behavior. It includes five stages:

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Consider someone trying to lose weight:

Precontemplation: They might not see their eating habits as a problem and feel satisfied with their lifestyle.

Contemplation: They begin to realize that their weight could affect their health and start thinking about losing weight.

Preparation: They research diets and workout plans, maybe even setting a start date.

Action: They start a new diet and exercise routine, actively working towards their weight loss goal.

Maintenance: After reaching their weight loss target, they focus on maintaining their new habits and avoiding old behaviors.

2. Social Cognitive Theory (SCT) is a psychological model that emphasizes the role of observational learning, imitation, and modeling in behavior change. It posits that individuals learn not only through direct experience but also by observing others. As an example, imagine a teenager learning to play basketball:

Observational Learning: They watch their favorite basketball player perform drills and techniques in games or videos.

Self-Efficacy: After practicing and seeing improvement, the teen develops confidence in their ability to shoot hoops.

Reciprocal Determinism: The teen practices more (behavior), which leads to better skills (personal factor), and this improvement encourages them to join a local team (environment).

Through these processes, the teenager not only learns how to play basketball but also develops a greater sense of competence and motivation to continue improving.

3. The Theory of Planned Behavior (often referred to as the Reasoned Action Theory) is a psychological model that explains how individual intentions influence behavior. It posits that behavior is driven by intentions, which are shaped by three key factors : attitude, subjective norms and perceived behavioral control.

Example:

Consider someone intending to start a regular exercise routine:

Attitude: They believe that exercising will improve their health and mood, leading to a positive evaluation of the behavior.

Subjective Norms: Friends and family encourage exercise, creating social pressure that supports the decision to get fit.

Perceived Behavioral Control: They feel they can realistically find time to exercise amidst their busy schedule, believing they have the necessary resources (like a gym membership or access to outdoor spaces).

If these three factors align positively, the individual is more likely to form the intention to exercise and ultimately follow through with the behavior.

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1. Stages of Change Model

The Stages of Change Model outlines the process individuals go through when changing behaviour. It involves five stages :

1. Pre-contemplation

Example : A patient ignores medical advice about managing diabetes.

2. Contemplation

Example : A patient realizes they need to manage their diabetes better but feels overwhelmed.

3. Preparation

Example : A patient consults with a nutritionist to develop a diabetes management plan.

4. Action

Example : A patient adheres to their diabetes management plan, regularly checking blood sugar levels.

5. Maintenance

Example : A patient regularly monitors blood sugar levels and adjusts diet accordingly long-term.

2. Social Cognitive Theory

Social Cognitive Theory emphasizes the role of observational learning, reinforcement, self-control and self-efficacy in behaviour change.

Example : An individual observes a family member successfully managing their diabetes through diet and exercise. This observation motivates them to adopt similar healthy habits, believing that they can achieve similar results.

3. Reasons for Change Theory

The Theory of Change is a framework that outlines how specific interventions lead to desired outcomes by mapping the causal pathways and assumptions involved.

Example : People reduce sugar intake after experiencing negative health effects such as weight gain or increased blood sugar levels (reaction to personal health issues).

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Stages of Change Theory: Five stages individuals go through when changing behavior. For example, someone aiming to lose weight

1. Precontemplation: At this stage, the person may not see their weight as an issue or have no intention of losing weight, believe their current habits are fine and aren’t considering change.

Example: "I’m not interested in dieting or exercising. I’m happy with my body and don’t need to change anything."

2. Contemplation: The person recognizes their weight may be an issue and considers making a change, but hasn’t committed to taking action. They weigh the pros and cons of losing weight.

Example: "I know I could be healthier if I lost some weight, but it seems really hard, and I’m not sure if I can stick to it."

3. Preparation: The person has decided to lose weight and begins to plan how they will make changes, involves setting small goals and identifying resources, like a gym membership or healthy recipes.

Example: "I’ve decided I want to lose weight. I’m going to start by cutting out soda and maybe join a local fitness class."

4. Action: The individual actively makes changes in their behavior, environment, or experiences to lose weight. This could include consistent exercise, a new diet, or avoiding certain foods. They might seek support or track their progress.

Example: "I’m exercising three times a week and eating more vegetables. I also started a journal to keep track of my meals and progress."

5. Maintenance: The person works to sustain their weight loss and prevent relapse. This stage focuses on building long-term habits that can maintain the progress made.

Example: "I’ve kept up with my new habits for six months, and it’s part of my routine now. I’m also planning ahead for holidays and stressful times so I don’t slip back into old habits."

6. Relapse: Sometimes, people may experience setbacks, where they return to previous habits. Recognizing this as part of the journey is important, and they may cycle through the stages again.

Example: "I fell off track during the holidays, but now I’m ready to get back to my healthier habits."

Social Cognitive Theory: This theory emphasizes how personal beliefs, behaviors, and environment interact to influence change. Example, a stroke survivor aiming to regain mobility and independence.

1. Personal Factors (Self-Efficacy and Goals)

Example: A stroke survivor feels uncertain about their ability to walk independently again, but they set a small goal to walk a few steps with assistance. As they progress and see improvements, their confidence (self-efficacy) grows. They then set a new goal of walking independently with a cane.

2. Behavioral Factors (Self-Regulation and Observational Learning)

Example: The survivor attends physical therapy sessions where they practice exercises designed to strengthen their muscles. They observe other stroke survivors performing similar exercises, which motivates them by showing that progress is possible. They also monitor their improvements (e.g., increased steps, less pain) to stay motivated and self-regulate their efforts.

3. Environmental Factors (Social Support and Reinforcement)

Example: Family members, friends, and healthcare providers offer encouragement, providing positive reinforcement each time the survivor completes a goal or shows improvement. They may also share stories of others who have recovered mobility after a stroke, reinforcing the belief that the survivor can achieve their goals with persistence.

The Reason of Change Theory suggests that a person’s intentions to change behavior are shaped by their attitudes, perceived social norms, and perceived control over the behavior. Example, a methadone patient aiming to stop using opioids:

1. Attitude Toward the Behavior

Example: The methadone patient believes that stopping opioid use will lead to better health, improved relationships, and greater life stability. They feel that, although challenging, the long-term benefits of avoiding opioids outweigh the immediate relief or pleasure they may have experienced. This positive attitude toward the change increases their intention to stay committed to methadone treatment.

2. Subjective Norms (Social Influence)

Example: The patient is surrounded by family members, friends, and a support group who encourage and believe in their ability to stay clean. Knowing that others are rooting for them and seeing that people in their life want them to succeed in recovery reinforces the patient’s motivation to continue with methadone treatment. This social support influences their intention to stay engaged in their recovery.

3. Perceived Behavioral Control

Example: The patient feels that, with methadone and access to therapy, they have the tools to manage their cravings and maintain a stable routine. They believe that they can access help when they need it, making the goal of abstaining from opioids more achievable. This sense of control strengthens their intention to avoid relapse and to adhere to their recovery plan.

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1. Stages of changes.

There are 5 stages of changes which are:

i.  Precontemplation -This is a stage where patient usually unaware & focus on the cons of changing behavior.

-Eg. Having unhealthy amounts of sweet food eg: boba tea, dessert frequently & experiencing weight gain.

ii. Contemplation – The stage of recognizing the problem & more thoughtful consideration of pros & cons.

-Eg: I should take care of my weight & health, stop or reduce my sugary intakes so I would not develop diabetes.

iii. Preparation- This stage involves the readiness & small steps taken for behaviour change.

-Eg: Planned to reduce intake of sugar to 1 sweet drink with  1-2 teaspoon per day & stop taking sweet drinks or desserts.

iv. Action -At this stage people may acquire new healthy behaviours & intend to maintain it.

-Eg: Reduced sugar intake by only have 1 cup of coffee/tea with 1-2 teaspoon per day & drink water the whole day.

v. Maintenance – already stick to new healthy regime (at least 6 months) prevent going back to bad routine previously.

-Eg: Enjoying a less sweet drinks, avoid desserts & manage to finish at least 1.2L water per day.

2. Social cognitive theory

Founded prominently by Albert Bandura -stated that human product behavior is the result of interaction between personal factors, environmental influences & behavioral patterns. He suggest that people can be influenced by & actively influence the environment where the major component of this theory is observational learning.

Eg: A child learn by observing their parents. If a parent love to read & frequently read with their child, soon the children will love to read & acquired books.

3. Reason of change theory is developed by Fishbein & Azjen where it focuses on intention that is influenced by personal attitude & it extended model can be referred to as theory of planned behavior. Intention will drive the behavior change which can be influenced by 3 factors: attitude, subjective norms & perceived behavior control.

Eg: Sleeping late can give brain fog & increase lethargy, thus a person will change it sleeps schedule, reduce caffeine intake & reduce screen time to get better sleep. His or her intention to increase productivity with sharp mind during the day will encourage a better sleep hygiene & routine.

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1) Stage of changes

People are at different stages of readiness to make changes

Example - adopt a healthy sleeping pattern for better management of hypertension

Precontemplation - patient is unaware that poor sleep pattern leads to high BP.

Contemplation - patient starts to think about getting good quality of sleep but is not ready to change

Preparation - identify factors that cause sleep deprivation and seek help from professionals

Action - start sleeping at a reasonable hour and apply good sleep hygiene

Maintenance - stay consistent with the new sleeping habit and monitor BP readings to prevent relapse

2) Social cognitive theory

People not only learn from personal experiences but also from watching the behaviors of others

Example: Observational learning

A new PRP performed an outstanding counseling session regarding insulin technique after observing his preceptor's method.

3) Reason of change theory

Behavior is determined by individual's intention

Example: People will make the commitment to break their unhealthy habits if they believe that leading a healthy lifestyle can prevent chronic diseases.

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1)Stages of changes theory: 5 stages individual undergo when changing behavior, For example, a person plan to quit smoking.

Precontemplation: The person or individual may not yet considering of the action need to be taken in order from him to quit smoking.

Contemplation: At this stage, the individual started to have awareness on the need of behavioural changes and started to look for ways to change.

Preparation: Necessary action were taken at this stage for behavioural changes to quit smoking. Example the person set individual target on the day he/she will totally stop smoking.

Action: This is the step where the person will totally stop smoking based on the target set in preparation step.

Maintenance: Effort to being consistent on the action taken previously were taken at this steps. Example: distance himself from smoking community or friends to prevent behaviour changes back to starting point.

2)Social Cognitive Theory (SCT) is a theory on how a person behaviours, attitudes, and values were learned by seeing others within the community. For example, a person observed their family members that is currently on diet and successfully manage to reduce body weight. By observing the meal taken, time of meal taken and portion of meal. The person can make changes in relation to the family members behaviour and attitude towards achieving goal to reduce weight.

3)Social theories changes over time for several reasons, usually due to improvement of society knowledge, easy to get information access and increase awareness to have knowledge. For example, person looking for a supplement from trusted place. Currently expanding on online market, we can see a lot of products being sold online. Individual or person now usually will try to check with Community Pharmacist on the product registration, legibility and safety of the product before started to buy and consume.

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The stages of change theory explains an individual's readiness to change their behaviour. It describes the process of behaviour change as occurring in stages. These stages include:

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The stages of change theory explains an individual's readiness to change their behaviour. It describes the process of behaviour change as occurring in stages. These stages include:

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• Pre-contemplation stage is where individuals are not yet considering change, often because they are not aware of the need for it. In other words, there is no intention of taking action. For example pharmacists noticed patients are not yet ready to quit smoking or unsure about starting a new medication.

• Contemplation stage is when individual starts to recognize the need for change and begins to consider it. For example pharmacists discuss the pros and cons of quitting, addressing concerns like side effects or withdrawal with the smoker patients.

• Preparation stage take place when an individual has intention to take make a change and action have been taken. In this stage, patient and pharmacists set a date to quit smoking or start a medication routine.

• Action stage is where patients actively work on changing the behaviour by implementing specific tools or strategies. For example pharmacist can actively monitors and supports the patient, offering tools like nicotine patches or medication blister packs.

• Maintenance stage is when patients works to sustain the change over the long term and develop strategies to prevent relapse. In this stage, smoker patient maintain to quit smoking over a period of time and pharmacists can help in developing strategies to prevent relapse, such as routine check-ins or encouragement for sticking with the plan.

Social Cognitive Theory is rooted in the idea that learning occurs within a social context and is influenced by observing others, self-efficacy and environmental influences. For example in promoting healthy lifestyle changes.

o From the Observational learning, pharmacists can serve as role models by encouraging a healthy lifestyle, sharing success stories, or connecting patients with support groups.

o In term of self -efficacy, pharmacists can help patients feel confident in managing conditions by offering skills and knowledge, for example knowledge on healthy diet control.

o For environmental Support, pharmacies can create a supportive environment with accessible resources, like educational materials, posters, or group counseling sessions for topics such as weight loss or smoking cessation.

The reason of change theory says that people are more likely to change if they have a positive view, social support, and feel they can do it. For example, people feel donating blood is a good deed and valuable. With the support from friends, family or social making blood donation is more acceptable in social. In order to make donating blood accessible to people, a clear information and accessible location should be considered. With these positive factors people are encouraged to donate blood.

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1. Stages of changes

Example: In a cancer patient’s adaptation pre- and post- diagnosis of cancer:

Pre-contemplation stage: Before diagnosis, a person might not be aware of any symptoms or may in denial that such symptoms may lead to a serious illness such as cancer. Patient might ignore mild symptoms and may not seek for any treatment or medical check-up.

Contemplation stage: Once patient experience more significant symptoms such as weight loss or uncontrollable pain, patient may start to think of more serious possibility of diagnosis. Then, he/she may start seeking for medical attention.

Preparation stage: At this stage, diagnosis has been made (cancer). Patient in a shocking phase to accept the reality and how to face it. Patient may start gathering information on treatment and seek for moral support. He/she needs to prepare mentally and physically for any lifestyle changes required during treatment phase.

Action stage: Now, patient will undergo treatment. This is an intense phase where many changes happened and patient need to deal with it – physically, mentally and emotionally.

Maintenance phase: Usually, at this phase patient is on post-treatment. He/she may need to adhere with healthy lifestyle and following up on medical appointments. Here is where resilience is important. Patient need to sustain the changes that been made in action stage and adapt well with those changes as a cancer patient.

2. Social cognitive theory

Example: Methadone Maintenance Therapy Program (Sharing session)

Group session allow patients to share their thoughts and experiences. During this session, methadone patients who has fully recovered from addiction are invited. They will share their tips in combating their addiction (eg: being physically active, managing stress, quit smoking). This will enhance confidence level of other methadone patients and give ideas on how to manage their addiction and be compliance with methadone therapy. Being in this circle also build positive relationship, thus preventing methadone patients to re-involve with negative groups. This is important to provide strong moral and mental support to patients in combating their addiction.

3. Reasons of change theory
Example: Alcoholic patients who tries to make a change (Alcohol Recovery Program)

Attitude: In the program, counsellor / healthcare practitioners may give talks about the harms of alcohol and benefits of sobriety. This will increase knowledge and awareness of patients, thus shift their perception and attitude towards making a change.

Subjective norms: Societal views on the harmful of alcohol (eg: highlight news related to car accidents due to drunk driver) may also be one of the pushing factors for them to make a change.

Perceived behavioral control: Inclusive treatment programs which can provide moral support, manage stressor and help in developing their coping skills may help to boost patients’ perceived control.

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Following are example each of the social theories

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Following are example each of the social theories

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1. Stages of change theory

Example: a person wants to quit smoking. Initially, they might be in the pre-contemplation stage, where they don't see a need to stop. Later, they move to contemplation, considering the benefits of quitting. They can progress to preparation, perhaps researching methods and setting a quit date. In the action stage, they actively quit smoking, and in maintenance, they work to prevent relapse.

2. Social cognitive theory

Example: a teenager is motivated to exercise more after seeing their friends enjoy fitness activities and social media influencers promote fitness. According to SCT, this happens because of observational learning (seeing others succeed), self-efficacy (believing they can also succeed), and environmental reinforcements (positive comments from friends). The teen's behavior is shaped by these social influences.

3. Reasons of change theory

Exampe: an individual considers adopting a vegetarian diet. They form a behavioral intention based on their attitude (they believe it is healthier and better for the environment), subjective norms (their friends and family support vegetarianism), and perceived behavioral control (they believe they have access to vegetarian options and can manage the diet change). This intention leads to an actual change in behavior.

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Stages of changes theory : There are 5 stages individuals go through when changing behaviour.

Example : To start a new healthy lifestyle with exercise

1. Precontemplation : Believes his/her current lifestyle is fine and hasn’t considered the benefits of physical activity

2. Contemplation : Starts to notice that feels tired and lacks energy. Begins to think about how exercise might improve his/her health but hasn’t made any plans yet

3. Preparation : Wants to start exercising within the next month. Figure out different workout options, buys a pair of running shoes, and schedules time in his/her calendar for workouts

4. Action : Begins exercising three times a week

5. Maintenance : After several months of regular exercise, He/She has integrated it into her routine. He/She feels healthier and has developed strategies to stay motivated

Social Cognitive Theory

Example : To add aerochamber to asthmatic patient because of poor coordination and technique.

Patient learns about asthma management by watching others who are using aerochamber (observational).

Patient develops confidence in their ability to manage asthma through skills training with the help of aerochamber (self-efficacy).

Patient starts to use aerochamber with the support of the family member and friends. Hence, more likely to adhere treatment plan and improve treatment outcomes.(reciprocal determinism).

Reason of Change Theory

Example: A student wants to start study for an exam.

A student decides to study for an exam (intention) because they believe it will lead to good grades (attitude), feel their friends expect them to do well (subjective norm), and they feel capable of studying effectively (perceived behavioural control).

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1. Stages of Changes Theory

Explain how people or societies change across time. Usually addressing both internal processes (such as motivation, awareness, or readiness) and external forces (such as societal pressures, policy changes, or technology developments) guiding people and communities through various phases of change. Designed by James Prochaska and Carlo DiClemente, this model finds usage in social settings as well as in psychology and public health to characterise personal transformation. The five stages consist:

i. Precontemplation: No intention to change; lack of awareness or denial of a need for change.

Eg: "Exercise takes too much time; I am healthy enough just as it is." Here, they ignore the long-term advantages of consistent exercise or any health hazards connected with inactivity. Their lack of knowledge prevents them from even giving reforms any thought.

ii. Contemplation: Growing awareness and consideration of change but no commitment to act.

Eg: "I should most likely eat better, but I'm not sure how to start and I still enjoy my regular meals." Though they are assessing the benefits and drawbacks, they have not yet changed anything specifically.

iii. Preparation: Planning to take action and gathering resources or support.

Eg: Someone who wants to start working out looks at nearby gyms, buys workout gear, and designs a basic workout schedule to get going. They are organising to fit workouts into their calendar and have agreed to start the next week.

iv. Action: Active steps taken to enact change.

Eg: Someone who has resolved to get healthier by consistent exercise begins three times a week gym visits. They are truly committed to better living since they registered for a membership, developed a fitness schedule and are following it.

v. Maintenance: Sustaining change and preventing relapse.

Eg: Many months after reaching their initial fitness objectives, someone who has dedicated to consistent exercise and a good diet keeps up their regimen. They have included these activities into their weekly calendar, changed their food to be balanced, and might even work with a trainer or support group to keep inspired and stop past behaviours from returning.

2. Social Cognitive Theory

Developed by Albert Bandura that clarifies how people learn by seeing others in a social setting and how they influence, and are influenced by, their surroundings and personal elements. Combining behavioural and cognitive theories, it emphasises how experiences, social contacts, and observation shape learning. From education, health, and organisational behaviour to understanding motivation, behaviour modification, personality development, and social learning in many environments, SCT finds wide uses.

i. Observational Learning (Modeling)

Individuals acquire behaviours by observing others, who are referred to as "models," particularly when they identify with or admire the model.

Eg: Seeing their elder sister share with pals helps a young toddler learn sharing of toys. The observer is more prone to copy the model if it is rewarded for the behaviour.

ii. Reciprocal Determinism

Reciprocal determinism is the concept that personal factors (such as opinions and beliefs), behavioural factors, and environmental factors can all interact and influence one another.

Eg: The personal element of a student's self-confidence determines their inclination to engage in class (behaviour), thereby influencing their response from peers and professors (environmental factor). This contact forms beliefs and future behaviour.

iii. Self-Efficacy

Self-efficacy is the belief of an individual in their capacity to take the necessary actions to manage specific situations or achieve goals.

Eg: High self-efficacy public speakers are more likely to volunteer for a presentation, practise assiduously, and conquer apprehension.

iv. Outcome Expectations

An individual's propensity to engage in certain behaviours can be influenced by their beliefs regarding the probable outcomes or repercussions of those behaviours.

Eg: A student feels that studying hard will result in great grades (positive outcome anticipation) and is so motivated to put up more effort.

v. Goal Setting and Self-Regulation

Goal-setting and self-regulatory processes are employed by individuals to motivate themselves and to monitor, evaluate, and modify their behaviour in order to achieve their objectives.

Eg: Someone who is trying to stop smoking sets a weekly target of lowering their use of cigarettes and tracks their development, praising themselves at every turning point.

3. Reason for Change Theory

A methodology that emphasises comprehending and recognising the fundamental elements that motivate individuals, communities, or societies to instigate and maintain change. It entails analysing motivations, perceived advantages, and contextual elements that affect individuals' decisions to modify their behaviours, beliefs, or societal standards. This methodology is frequently employed in disciplines such as psychology, sociology, business, and health to develop effective treatments and foster positive transformations.

Eg: Social Influence and Norms.

A business wellness program encourages employees to take part in group exercise challenges. Employees are motivated to join because their coworkers are doing so, and they want to fit in with a culture that promotes health and fitness. Positive peer pressure contributes to increased engagement in physical activities.

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1. Stages of Changes

It is a transtheoretical model that describe the process of the changing behavioral. There are five stages in changes as listed below:

a) Precontemplation: individual with no motivation to change because he/she does not believe that one exists (sometimes in denial) and usually have limited awareness. Eg: Parents who has autistic child and does not want to get any diagnosis and treatment for the child because they see there is nothing wrong about the child.

b) Contemplation: individual already have awareness and acknowledge the problem but no correction being done. Eg:  Parents acknowledge the child has problem and need to do something about it.

c) Preparation: Individual wants can make a commitment to correct their behavior. Eg: parents gather info, find appropriate person to ask around to get the child treated.

d) Action: Individual has willingness to receive assistance and support. Eg: Parents bring the child to see psychiatrist to get diagnose and treatment accordingly ie bring to see therapist.

e) Maintenance: Individuals continue the new behaviour to maintain positive changes.

2.        Social Cognitive

Is a general theory that focus on observational learning through modeling including motivation and self-regulation in behavioural changes. Eg: Pharmacist should be a role model to a good behaviour in working environment to the PRP and people surrounding.

3.        Reason of Change theory

This theory explains how interventions taken is expected to lead to significant behavioural changes. Eg: TB patients start to take the anti-TB medications regularly because they know the medications can lead to curable TB and prevent their family to get affected by TB. Thus, patients feel capable to taking the medications even though the drugs got a lot of unpleasant side effects.

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Stages of Change Theory

1.      Pre-contemplation

"why should i do mammogram and health check ups since im a healthy person"

2.     Contemplation

I aware I have strong family history of cancer and I should do something about it.

3.     Preparation

Gathering all the information of early detection of breast cancer and preventive measurements.

4.     Action

Im implementing healthy lifestyle and booked/planned for mammogram and health screening

5.     Maintenance

Maintain healthy lifestyle and annual health check up

Social Cognitive Theory

i.e Breast feeding education programme

1. Personal – showing models performing breastfeeding correctly to improve self-efficacy

2. Behavioral –weekly check-ins for three months reinforced participants' skills

3. Environmental – mothers were given an observational checklist to make sure they successfully completed the behavior.

Mothers exposed to the program showed significant improvement in their breastfeeding skills, were more likely to exclusively breastfeed, and had fewer problems then the mothers who were not exposed to the educational program

Reasons for Change Theory

Concept of digitalization in pharmacy setting in current era.

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1. Stages of Change is describing the phases that people go through when they are changing their behavior. There is 6 phases which is precontemplation, contemplation, preparation, action, maintenance and relapse that a person will go through when making behavior changes

Eg:

Preparation

A phase where the patient start to set a plan when or how he going to change his behavior. For example, the patient start to enroll into smoking cessation clinic and build his own support group to help him quit smoking

2. Social cognitive theory is describing how people pick up behaviors by watching other people and their surroundings. It highlights the significance of three primary elements in behavior modification which is environmental, behavioral , and personal components.

For example a successful patient who quit smoking through a smoking cessation clinic, give talk or share his experience when he enrolls in a smoking cessation clinic to motivate a group of people who are trying to stop smoking.

3. Reason of change theory is a behavioral theory that describes how and why individuals choose to alter their behavior.

For example, if they quit smoking, they can cut monthly cost of buying cigarette and use the money to buy new cars

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1. Stages of changes describes the process people go through to change behavior, which is precontemplation, followed by contemplation, preparation, action and maintenance. One of the example we can see is with patients considering for smoking cessation program. In the program, patient will be assisted on the preparation, action stage and maintenance, while pre-contemplation, contemplation are from patient's own conscience.

2. Social Cognitive Theory (SCT) explains how people acquire and maintain behaviors, considering the dynamic interaction between individuals, their social environment, and their cognitive processes. One of the example is the introduction of a new service into the pharmacy department. Each staff of the department will need to identify each one role in the new system, and how the interact with the environment in terms of placement of items, workflow and interaction with customers / patients.

3. Reasons of change refers to the underlying factors, motivations, or causes that drive shifts in behavior, culture, institutions, policies, and social structures within a society. One of the example would be any changes done with regards to Medication Error. After an error occurs, and improvement steps taken to avoid the error to happen in future, each individuals related will have a unified reason of change, mostly for patient safety.

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Stages of Change stated that behavioral change as a process through sequential changes. Example: A young 30 year old woman with no history of previous medication has recently started with Simvastatin after the staff's annual health screening.

1) Precontemplation: She doesn't think she needs the statin and believes lifestyle alone can reduce her cholesterol.

2) Contemplation: She considers the risks of high cholesterol but still hesitates to take the medication.

3) Preparation: She starts making small lifestyle changes and reads about the benefits of the statin.

4) Action: She decides to take the statin as prescribed, along with maintaining her lifestyle changes

5) Maintenance: She keeps up with her medication and healthy habits and check her cholesterol level regularly

6) Relapse: During a busy period, she stops taking the statin but later resumes it after cholesterol rises

Social Cognitive Theory stated that behavior is influenced by interaction between personal, environmental and behavioral factors. Example: In the same case of example above, in social cognitive theory, environmental influence, in this case is the discussion on cholesterol and statin between the doctor and patient makes the woman consider or question her initial believe on refusing to take statin. She might also observing other's success with statins that affect her decision.

Reason of Change Theory stated that behavior is determined by intentions, attitudes and perceived control. Example: Doctor and her family are supporting the use of statin. This influence her decision to not be skeptical about statins. She gains confidence in managing her health through statin adherence.

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Example of sociology theories:

1. Stages of Change (Transtheoretical Model)

Elaboration: The Stages of Change model, developed by Prochaska and DiClemente, outlines how individuals progress through different stages when modifying behavior. The stages are: Precontemplation, Contemplation, Preparation, Action, and Maintenance.

Example: A person who smokes may start in the Precontemplation stage, unaware of the negative health effects. Upon learning more, they enter the Contemplation stage, recognizing the need to quit. In the Preparation stage, they might set a quit date. During the Action stage, they actively quit smoking and utilize resources like support groups. Finally, in the Maintenance stage, they work to avoid relapse and continue healthy habits.

2. Social Cognitive Theory

Elaboration: Developed by Albert Bandura, Social Cognitive Theory emphasizes the importance of observational learning, imitation, and modeling. It posits that individuals learn not only through direct experience but also by watching others, and it incorporates concepts like self-efficacy and reciprocal determinism.

Example: A child learns to solve a math problem by observing a parent work through it. If the child sees the parent’s success and encouragement, they may feel more confident (self-efficacy) in attempting similar problems. The child’s behavior (solving math), environment (supportive parent), and personal factors (belief in their ability) all interact to influence learning and behavior.

3. Reasoned Action Theory (Theory of Planned Behavior)

Elaboration: The Theory of Reasoned Action, later expanded into the Theory of Planned Behavior, posits that an individual’s intention to engage in a behavior is influenced by their attitudes toward the behavior, subjective norms, and perceived behavioral control. This model highlights the role of rational decision-making in behavior change.

Example: A student considering whether to vote may evaluate their attitude toward voting (e.g., believing it’s important), the influence of peers (e.g., friends encouraging participation), and their perceived ability to vote (e.g., being registered and knowing the process). If they have a positive attitude, supportive social norms, and feel capable, they are more likely to intend to vote, leading to the actual behavior of voting.

These theories provide valuable frameworks for understanding how individuals change behaviors and the social factors that influence these processes.

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1.STAGES OF CHANGES

Individuals aiming to stop unhealthy behaviours and adopt healthier ones typically progress through five stages:

These stages represent a progression in motivation and readiness to change

Precontemplation: Not yet considering change; unaware of the need for it.

Eg: I’m not convinced I have a problem?why do they keep saying I do? What’s wrong with the way I’m doing things?

Contemplation: Aware of the issue and thinking about making a change but not ready to act.

Eg:Maybe I do have a problem,but, what do I need to do to get it fixed?

Preparation: Planning for change and making small steps toward it.

Eg: I am ready to change. I want to make this change. I’m going to take the steps necessary for change.

Action: Actively implementing new behaviours and making significant changes.

eg:I’ve made that commitment to change and I’m finally doing something about it.

Maintenance: Sustaining the new behaviours and preventing relapse.

Eg: I will focus on sustaining my goals and recovery by utilize strategies such as attending support groups, or engaging in counseling. Committing myself to activities that support my well-being and prevent relapse.

2.SOCIAL COGNITIVE THEORY

Social cognitive theory emerged from behaviour, which emphasizes that behaviour is driven by stimulus-response processes, where past rewards and punishments influence future actions.

Eg:In clinical learning, medical students will learn through observing physicians, modeling their behaviours, forming their own understanding of how the behaviour is performed, and reflecting on the outcomes of their own performance.

3.REASON OF CHANGE THEORY

It outlines how specific interventions are expected to drive development change, based on causal analysis and evidence.

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1. Stage of changes: It have five stages which are precotemplation, cotemplation, preparation, action and maintainence.

Example cases:

(PRECOTEMPLATION) MR X is unaware of his hypertension risks and does not take his medication consistently. The pharmacist educates him about the importance of managing his condition. (COTEMPLATION) Then, he starts to recognize the need for change but is unsure about the necessity of his medication. The pharmacist helps him weigh the benefits and risks of adherence.

(PREPARATION), Mr X decides to start taking his medication regularly and sets reminders. The pharmacist assists him in creating a medication schedule and addressing potential side effects.

(ACTION), Mr X actively takes his medication and tracks his blood pressure. The pharmacist provides ongoing support and encourages his progress. (MAINTANENCE) After several months, Mr X has successfully maintained his medication routine and healthy blood pressure. The pharmacist continues to monitor his progress and celebrates his achievements.

2. SOCIAL COGNITIVE THEORY

EXAMPLE :

Patient: Emily, a patient diagnosed with depression who struggles with medication adherence and self-care.

1. Observational Learning: The pharmacist organizes a support group where individuals share their coping strategies and successes in managing depression, allowing Emily to learn from their experiences and see that recovery is possible.

2. Self-Efficacy: The pharmacist helps Emily set small, achievable goals, such as journaling her feelings or taking a short walk each day, which boosts her confidence in her ability to make positive changes.

3. Reciprocal Determinism: The pharmacist connects Emily with mental health resources, including counseling services and community support groups, creating a supportive environment that encourages her to engage in treatment.

4. Outcome Expectations: They discuss the potential benefits of consistent medication adherence and self-care practices, such as improved mood and energy levels, helping Emily visualize the positive changes that can come from her efforts.

5. Behavioral Capability: The pharmacist provides educational materials on recognizing symptoms of depression and developing coping strategies, ensuring Emily has the tools she needs to manage her condition effectively.

By applying the principles of Social Cognitive Theory, the pharmacist can support Emily in her journey toward better mental health, enhancing her ability to manage her depression.

3. REASON TO CHANGE THEORY

Might be due to the motivation, pt hv understood the motivation. For example, obese pt, on what is the benefit in health when they loosing weight.