Self-Efficacy and Social Learning Theory
A relative newcomer to health behavior research is the concept of self-efficacy as a determinant of behavior. This concept from social learning theory has held special fascination for health educators and other in health promotion and in patient education. The attractiveness of the self-efficacy concept in health promotion is probably because it expresses to succinctly the dominant purpose ascribed to health promotion. As declared by the Ottawa Charter, health promotion is the process of enabling people to increase control over, and to improve, their health. Self-efficacy implies a mental or cognitive state of taking control.
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| Social Learning Theory |
“Inherent in the social learning conception is the idea that people self-regulate their environments and actions. Although people are acted upon by their environments, they also help create their surroundings”. This concept of reciprocal determinism is social learning theory`s major departure from operant conditioning theory, which tends to view all behavior as a one-way product of the environment. Reciprocal determinism and its associated concepts of self-management and self-control make social learning theory ideally suited to the integration of the PRECEDE and PROCEED frameworks and the development of an educational approach to health promotion.
Learning takes place through three processes : (1) direct experience, (2) indirect or vicarious experience from observing others (modeling), and (3) the storing and processing of complex information in cognitive operations that enable one to anticipate the consequences of actions, represent goals in thought, and weigh evidence from various sources to assess one`s own capabilities. Out of the third process comes a situation-specific self-appraisal that makes the individual more for less confident in taking on new behavior in situations that may contain novel, unpredictable, or stressful circumstances. Self-efficacy, then, is a perception of one`s own capacity for success in organizing and implementing a pattern of behavior that is new, based largerly on experience with similar actions or circumstances encountered or observed in the past.
In addition to its influence on behavior, self-efficacy affects thought patterns and emotional reactions that way alleviate anxiety and enhance coping ability. These interactions make enhanced self-efficacy particularly helpful to people attempting to quit smoking and to modify other addictive and compulsive behavioral patterns where they have experienced failure and relapse, including overeating.
The self-efficacy variable has proved particularly useful in planning health promotion programs using mass media, with role models for the vicarious learning and modeling process and for instruction in self-control.
Measurement instruments to assess self-efficacy have been developing gradually in recent years. Self-efficacy scales have been validated, for example, for health-related diet and exercise behaviors, and for weight loss. A review of the literature to identify the latest measurement advances is always advisable before embarking on a survey to assess any of the predisposing factors.
References :
M.H. Bowler and D.E. Morisky, “Small Group Strategy for Improving Compliance Behavior and Blood Pressure Control”, Health Education Quarterly 10, 1983.
C. Peterson and A.J. Stunkard, “Personal Control and Health Promotion”, Social Science and Medicine 28, 1989.
K. Lorig and J. Laurin, “Some Nations About Assumptions Underlying Health Education”. Health Education Quarterly 12, 1985.
First International Conference on Health Promotion, “Ottawa Charter for Health Promotion”, Health Promotion International 1 (4), 1986.
A. Bandura, “Self-efficacy Mechanisms in Human Agency”, American Psycologist 37, 1982.
D.H. Schunk and J.P. Carbonari, “Self-efficacy Models”, in Behavioral Health : A Handbook of Health Enhancement and Disease Prevention, J.D. Matarazzo, S.M. Weiss, J.A. Herd, et al., eds, New York: Wiley, 1984.
M.M. Condiotte and E. Lichtenstein, “Self-efficacy and Relapse in Smoking Cessation Programs”, Journal of Consulting and Clinical Psychology 49, 1981.
G.A. Marlatt and J.R. Gordon, eds., Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors, New York, Guilford Press, 1985.
R.G. Kingsley and J. Shapiro, “A Comparison of Three Behavioral Programs for the Control of Obesity in Children”, Behavioral Theory , 1977.
H. de Vries, M. Dijkstra, and P. Kuhlman, “Self-efficacy: The Third Factor Besides Attitude and Subjective Norm as a Predictor of Behavioral Intentions”, Health Education Research 3, 1988.
J.F. Sallis, R.B. Pinski, R.M. Grossman, et al., “The Development of Self-efficacy Scales for Health-Related Diet and Exercise Behaviors”, Health Education Research 3, 1988.
