Inside the Black Box of Interactions Between Programs and Participants: Re-conceptualizing Subgroups for Fatherhood Program Evaluation. V. FINDINGS: PSYCHOSOCIAL DETERMINANTS OF BEHAVIOR CHANGE

10/12/2012

Behavior change theories seek to explain how the cognitive psychology of individuals influences behavior, alone or in concert with the social environment (Nigg et al. 2002). Individual-level theories focus on "cognitions" (that is, what an individual believes and how he thinks about things) such as knowledge, attitudes, motivations, perceptions, expectations, and behavioral intentions. Contextual theories go beyond such individual factors and also include social influences, such as social norms and relationships with important others. Interest in these "psychosocial factors" stems from their presumed utility as necessary (though not sufficient) "determinants" of health behavior. Recently, economists have integrated aspects of cognitive psychology into traditional economic frameworks to better understand individuals' decision-making processes. Research on fatherhood does not focus narrowly on behavior change or decision making, but rather, draws from psychological and sociological theories to examine how individual, interpersonal, and contextual factors influence a broad range of fatherhood-related behaviors. (See Appendix B for a summary of these theories.)

Our review of the theoretical determinants of behavior change, psychological and developmental theories of fathering behavior, and concepts from audience segmentation research revealed that although each theory has its distinct elements, there is considerable overlap in terms of factors hypothesized to be key determinants of behavior change (Table V.1). For example, self-efficacy is a central tenet in virtually all health behavior change theories and is considered a "psychological barrier" to change in behavioral economics theory. In some cases, different terms are used for the same or similar concepts. For example, identity theory suggests that the more central the role of "father" is to a man's identity, the more he will engage in a fatherhood-related behaviors and the more open he may be to improving his fathering. Similarly, behavioral economics suggests that behaviors that are congruent with how an individual views himself are more likely to occur than behaviors that are incongruent with these views. Though health behavior change theories do not typically address identity per se, many of these theories emphasize the important role of outcome salience in shaping an individual's behavior, and the desirability of an outcome could, at least in part, stem from the degree to which it resonates with the individual's views of himself.

We therefore found it useful first to integrate the relevant concepts from these key theories into a common framework; these concepts then guided our review of the literature on predictors of fathering among low-income men and served as the organizing framework for presenting our findings in Section VI. Below we present this framework, organizing these concepts into major categories, defining each concept, and offering hypotheses pertaining specifically to fathers and fatherhood.

1. Personal History

·      Family of origin ("Where I came from"): The nature of the parenting/caregiving received by the father as a child, as well as his past and current relationship with his parents. Fathers who received adequate care as a child are better equipped to care for their own children.



 

Table V.1. Psychosocial Determinants of Behavior and Behavior Change Addressed in Key Theories

 

Predictor Categories

Theories

Personal History

Identity

Values and Lifestyle

Stress and Coping

Knowledge

Cognitions

Social norms

Relationship with child's mother

Social Support

Health Behavior Change Theories

 

 

 

 

 

 

 

 

 

Theory of Reasoned Action/ Theory of Planned Behavior

 

 

 

 

 

X

X

 

X

Health Beliefs Model

 

 

X

 

 

X

 

 

 

Transtheoretical Model/Stages of Change

 

 

 

 

X

X

 

 

 

Social Learning/Social Cognition Theory

 

 

 

 

 

X

X

X

X

Social Networks and Social Supports

 

 

 

 

 

 

X

X

X

Transactional Model of Stress and Coping

 

 

 

X

X

X

 

X

X

Ecological Models

X

X

X

X

X

X

X

X

X

Social Marketing

 

 

X

 

X

X

X

 

 

Behavioral Economics Theory

 

X

X

 

 

X

X

 

 

Psychological and Developmental Theories

 

 

 

 

 

 

 

 

 

Personality Theories

 

X

 

X

 

 

 

 

 

Attachment Theory

X

 

 

 

 

X

 

X

X

Life Course/Life Stage Theory

X

X

X

X

 

 

 

 

 

Developmental/Generativity Theory

X

X

 

 

 

 

 

 

 

Identity Theory

 

X

 

 

 

 

X

X

 

Motivation Theory

 

 

 

X

 

X

 

X

 

Parental Investment Theory

 

X

 

 

 

X

 

 

 

Social Scripting Theory

 

 

 

 

 

 

X

X

 

Audience Segmentation

 

X

X

 

X

X

X

X

 

 

2. Identity

·      General ("Who I am"): Personality characteristics (openness, conscientiousness, extraversion, agreeableness, neuroticism), and dispositions/emotional states (for example, anger/resentment, hopeful/optimistic). Fathers with personality traits conducive to more positive parenting (such as emotional stability) and/or to positive behavior change (such as openness to change) may be more responsible and effective fathers and, when faced with the opportunity to improve (their parenting, their economic circumstances), they are more likely to take advantage of the opportunity.

·      Identity-related ("Who I am as a…"): The father's concept of self as a father/parent and co-parent, provider, worker, and spouse/partner. Fathers will engage in behaviors in direct proportion to the salience of that role to their overall identity.

3. Values and Lifestyles

·      Values ("What's important to me"): Life goals and values pertaining to the father as a father/parent and co-parent, provider, worker, and spouse/partner. Fathers will engage in behaviors (and in programs seeking to change these behaviors) in direct proportion to the degree that they value the behavior and/or its likely outcome.

·      Lifestyle ("How I live"): Behaviors and life choices reflected in how the father spends his time and his preferred activities, including his work schedule, family routines, family activities, and religious/civic activities. Fathers will engage in behaviors (and in programs seeking to change these behaviors) in direct proportion to the degree that align with (or at least do not contradict) how they live their lives. Programs that address what's important to the father-in both program content and service delivery-may be more effective. Programs that seek explicitly to change fathers' lifestyles (for example, reduce antisocial and criminal activity) may face strong resistance unless or until the fathers are ready to embrace the change and have formal and informal networks to support the change.

4. Stress and Coping

·      Stressors ("Things that cause me stress"): Things that cause an individual stress and include major life events as well as daily hassles, sometimes deriving from roles as a father/parent and co-parent, provider, worker, and spouse/partner. Fathers with many and/or acute stressors may find it more difficult to change unless or until the stressors and the fathers' response to them is addressed.

·      Stress ("How I am affected by stressors"): The subjective state (psychological distress, depression) resulting from exposure to and ineffective management of stressors, and occurring in various domains, such as parenting stress, financial stress, and work stress. Fathers with greater psychological distress may find it more difficult to change unless or until the stress is reduced.

·      Coping ("How I manage stress"): Strategies used to reduce and manage the emotional reactions to stress, including seeking social and instrumental supports and adopting positive dispositions (such as optimism, hope, and religiosity). Fathers with fewer coping skills may especially need the assistance of a program to address life challenges and engage in behavior change.

5. Knowledge

·      Factual knowledge ("What I know"): Knowledge about child development, effective discipline strategies, rights and responsibilities of noncustodial parents, and how to establish paternity and have child support and visitation orders adjusted. Fathers with limited knowledge or misinformation in these areas are less likely to make well-informed decisions and make positive changes in their behavior.

6. Cognitions

·      Perceived risk for negative outcomes ("Am I at risk?"): Beliefs about vulnerability to various negative outcomes, such as, for noncustodial fathers, the perceived likelihood of losing visitation rights if they engage in risky and/or illegal activity. Fathers who do not perceive the consequences of their behavior to be negative do not perceive a need to change; they are less likely to engage in behavior change.

·      Salience of outcome ("How important is this outcome to me?"): The value fathers place on a specific outcome. Fathers who desire the outcome may be more willing to engage in behaviors likely to achieve the outcome.

·      Outcomes expectancies ("What will happen if I change?"): What fathers expect will happen, both directly and indirectly, as a result of behavior change. Fathers will engage in behavior in direct proportion to their expectations that it will yield a desired outcome.

·      Willingness to change ("Am I open to change, and am I willing to do what's necessary to change?"): Fathers' openness to change in general, as well as their desire to change in specific ways. Fathers will engage in new behavior only if they possess a willingness to do so.

·      Responsibility for change ("Is it up to me to do something about this?"): The degree to which fathers accept responsibility for their behavior and for the consequences of their behavior. Fathers who tend to blame others for their shortcomings are less likely to feel the need to change their behavior.

·      Deservingness ("Do I deserve better?"): The extent to which fathers feel they deserve to achieve their goals. Fathers with low self-worth in general or who feel they do not deserve to achieve fatherhood-related goals are not likely to take steps toward goals. On the other hand, fathers who have a sense of entitlement may not feel they should have to change their behavior to get what they perceive to be rightfully theirs (for example, visiting their child).

·      Self-efficacy/locus of control ("Can I change?"): Fathers' confidence in their ability to change. Fathers who do not believe they can do what it would take to change, or who believe that the factors requiring change are not within their control, are less likely to try to change.

·      Motivation to change ("Why do I want to change?"): The perceived rewards of change (for example, "being there" for their child) and the perceived punishments from failing to change (for example, sanctions from the child support agency). Fathers who perceive few rewards and/or few punishments from failing to change may not be adequately motivated.

·      Readiness to change ("Am I ready to change?): A psychological disposition and functional readiness to take steps toward behavior change. Fathers who are ready to be involved and engaged with their children, take on additional household and child care responsibilities, engage in employment activities, and work on the relationship with a spouse/partner/co-parent are more likely to take steps toward change in these areas.

·      Intentions to change: General goals ("I intend to change") and specific plans ("I have plans to change"). Fathers who have committed to change and have devised action steps necessary to achieve that change are more likely to actually follow-through and take steps toward change.

7. Social Norms

·      Social/peer norms ("What we believe and do"): The messages and expectations regarding "responsible" behavior that fathers are exposed to. Fathers exposed to positive messages about fatherhood may be more likely to embrace fatherhood and engage in positive fatherhood behaviors.

8. Relationship with Child's Mother

·      Relationship with child's mother ("How I feel about and interact with my child's mother"): The structural/residential status of the relationship; the quality of the relationship and interactions; and the expectations of, support/encouragement for, and appraisals of the father as a parent, partner, provider, and worker by the child's mother. Fathers living apart from their child's mother, or who have a poor relationship with their child's mother, or perceive the child's mother as unsupportive or even openly hostile to them and their efforts to be good fathers may have greater difficulty making desired changes.

9. Social Support

·      Kin and social networks/support ("Who helps me when I need it"): The extent to which fathers have access to friends, family, and service agencies that provide emotional and instrumental support. Fathers who receive support from informal and formal networks, such as encouragement, parenting advice, and assistance with child-support orders, are better able to effect the sought-after change.

There are three common themes reflected in this framework. First, determinants of behavior can originate within individuals, through interpersonal relationships, and from external forces. Second, individuals are more likely to engage in behaviors if the perceived benefits outweigh potential costs and consequences; thus, perceptions and expectations play an important role in determining behavior. Finally, individuals' desire and readiness to change behavior, as well as their beliefs and confidence in their ability to change, are theorized to be necessary prerequisites of behavior change.

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