CHAPTER 3

UNDERSTANDING MOTIVATION AND

BEHAVIOR CHANGE
 Learner’s characteristics:
Factors that influence learning:
 Ability
 Motivation
 Desire

1. Culture
 Is a learned set of shared norms and practices of a
particular group that direct thinking, decisions, and
actions.
 Is an integrated pattern of human knowledge, belief, and
behavior that depends upon the capacity for learning and
transmitting knowledge to succeeding generations
Norm is a widespread or usual practice, procedure,
or custom.
Culture influences gender roles, sexual behaviors,
diet, personal hygiene, body image, drug use,
exercise, communication, and educational pursuits
etc.
It also affect the way people experience and
describe illness.
Example:
Hwa byung- a Korean folk syndrome which
literally translates into English as ‘anger syndrome’
and it is attributed to the suppression of anger.
--- Koreans’ cultural inclinations to keep family
in harmony and peacefulness, and not to
jeopardize social relationships dictate that
anger must be suppressed, pent-up and
accumulated.
--- Since mental illness among Asian culture is
associated with fear of stigma and shame
treatment would be less likely to be successful.
However, education on treatment for hwa-
byung would be more acceptable.
2. Age
As more of our population lives longer, it is
increasingly the aged who are the clients in the
health care setting.
Teaching older adult presents challenges. They
may need longer time to learn.
3. Emotional status
With all learners, emotional and mental status
should be acknowledged and taken into account in
planning an educational intervention.
Depression, stress, denial, fear and anxiety can all
impact the effectiveness of teaching.
4. Socioeconomic level
Socioeconomic level takes into account a
number of factors including income,
educational level, occupation and
employment.
The impact of it on learning has more to do
with being able to use the information being
taught rather than the process of learning.
Planning for learning
Learning is a complex process.
Approaching this with a plan that incorporates factors
that increase the likelihood of learning.
Learning Principles
1. Use several senses.
 Students learn more when information is delivered in a
variety of ways rather than in only one way.
 Students retain 10% of they read, 26% of what they
hear, 30% of what they see, 50% of what they see and
hear, 70% of what they say and 90% of what they say
as they do something. (Felder and
Silverman,2002;Stice 1987)
2. Actively involve learners in the learning process.
This principle relates to using teaching methods
used, whether active or passive.
Passive includes lecture, videos, print materials.
Active includes discussions, role playing, small-
group discussion, question and answer.
3. Provide an environment conducive for learning.
Learning takes place best when people are
comfortable and extraneous interference is kept in
minimum.
4. Assess the extent to which the learner is ready
to learn.
In general, people learn only if they are
emotionally and physically ready.
Client or student readiness,
UNFORTUNATELY, is not often in your
control.
5. Determine the perceived relevance of the
information.
Adults are generally willing to learn if they
perceive the information or skill being taught as
relevant to their lives in some way.
The easiest way to determine this perception is to
ask.
6. Repeat information.
Repetition enhances learning. It is particularly
important when information is completely new or
complex.
7. Generalize information.
Information is more readily learned if it is applied
to more than one situation.
8. Make learning a pleasant experience.
Learning is enhanced if the learning experience is
pleasant.
9. Begin with what is known; move toward what
is unknown.
It should begin with basics or general
information that is known and move toward to
new information.
10. Present information at an appropriate rate.
Nothing is more frustrating for learners than
to have new information presented at such
rapid pace that they cannot keep up.
Motivation and Behavior Change Theories
 Theory is a set of interrelated concepts, definitions,
propositions that presents a systemic view of events
or situations by specifying relations among
variables in order to explain or predict events of the
situation.
 Simply, a set of ideas that help that help explain the
relationship among factors or predict the outcome of
their interrelation.
 Does not guarantee success but increase the
likelihood of success.
Health Belief Model
is a health behavior change and psychological
 model developed by Irwin M. Rosenstock in 1966
for studying and promoting the uptake of health
services.
The model was furthered by Becker and colleagues
in the 1970s and 1980s.
Later amended in 1988.
Originally, the model was designed to predict
behavioral response to the treatment received by
acutely or chronically ill patients, but in more
recent years the model has been used to predict
more general health behaviors.
Stages of Change theory/ Transtheoretical
Model
The Transtheoretical Model of Behavior
Change assesses an individual's readiness to
act on a new healthier behavior, and provides
strategies, or processes of change to guide
the individual through the stages of change
to action and maintenance.
James O. Prochaska of the 
University of Rhode Island and colleagues
developed the transtheoretical model
beginning in 1977.
Theory of Reasoned Action
The theory of reasoned action (TRA),
developed by Martin Fishbein and Icek Ajzen.
The components of TRA are three general
constructs: behavioral intention (BI), attitude
(A), and subjective norm (SN). TRA suggests
that a person's behavioral intention depends on
the person's attitude about the behavior and
subjective norms (BI = A + SN). If a person
intends to do a behavior then it is likely that
the person will do it.
Social Cognitive Theory
Social Cognitive Theory stemmed out of
work in the area of social learning theory
 proposed by N.E. Miller and J. Dollard in
1941.
The theorists most commonly associated
with social cognitive theory are Albert
Bandura and Walter Mischel.
Self- Efficacy Theory
Self-efficacy is a term used in psychology, roughly
corresponding to a person's belief in their own
competence.
Psychologist Albert Bandura has defined self-efficacy
as one's belief in one's ability to succeed in specific
situations.
One's sense of self-efficacy can play a major role in
how one approaches goals, tasks, and challenges.
The concept of self-efficacy lies at the center of
Bandura’s social cognitive theory, which emphasizes
the role of observational learning and social experience
in the development of personality. 
Attribution Theory
Attribution is a concept in social psychology
 referring to how individuals explain causes of
behaviors and events, and the theory that
describes the process is called Attribution
Theory.
Fritz Heider was the first to propose the theory of
attribution from the book entitled The Psychology
of Interpersonal Relations(1958), and 
Bernard Weiner developed a theoretical
framework that has become a major research
paradigm in social psychology .
Types of attribution:
Explanatory attribution
People make explanatory attributions to
understand the world and seek reasons for
a particular event. Explanatory attribution
plays an important role in understanding
what is happening around us.
Predictive attribution
Attributions not only serve as an
explanation of an event but it can also
predict future events. People want to
know and understand why the event
happened, but they also want to prevent it
from happening again. Once people know
why the event happened, their future is
more predictable.
Interpersonal attribution
Sometimes, when your action or motives for
the action are questioned, you need to explain
the reasons for your action. Interpersonal
attributions happen when the causes of the
events involve two or more individuals.
More specifically, you will always want to
present yourself in the most positive light in
interpersonal attributions.
WEINER’S MODEL OF ACHIEVEMENT
ATTRIBUTIONS
 an individual's causal attributions of
achievement behaviors affect subsequent
achievement behaviors and motivation;
future achievement expectancies;
persistence at similar tasks; pride or
shame felt following success or failure.
Three dimensions:
 stability (stable and unstable)

- stability attributions affect our predictions about the

future
 locus of causality  (internal and external)

-causality attributions affect our affective(emotional)

reactions to success and failure (the more the individual
feels that his/her behavior is under conscious control,
the greater the affective response)
 control (controllable or uncontrollable)

-controllability affects our persistence on task

Behavior Modification Theory
Behavior modification is the use of
empirically demonstrated 
behavior change techniques to improve
behavior, such as altering an individual's
behaviors and reactions to stimuli through
positive and negative reinforcement of 
adaptive behavior and/or the reduction of 
maladaptive behavior through its 
extinction, punishment and/or therapy.
 Firstproposed by B. F. Skinner in 1938.
 Positive reinforcements and punishments
 No reasoning, thought, or knowledge but only external
immediate rewards.