# Presentation: 025250

## Is There Nothing So Practical as a Good Theory?: Why Interventions are Needed to Promote Innovations in Social Psychological Theory

- Alex Rothman
- University of Minnesota

- “...Many psychologists working today in an applied area are keenly aware of the need for close cooperation between theoretical and applied psychology.  This can be accomplished in psychology, as it has been accomplished in physics, if the theorist does not look toward applied problems with highbrow aversion or with a fear of social problems, and if the applied psychologist realizes that there is nothing so practical as a good theory.”
- 	--Kurt Lewin (1943-44), “Problems of research in 						social psychology”

- _Overview_
- There are numerous social psychological theories of health behavior (e.g., Health belief model; Theory of reasoned action/planned behavior; Transtheoretical model; Social cognitive theory) and they have stimulated an tremendous amount of research.

## [Adapted from Noar and Zimmerman (in press)]

- _Overview_
- There are numerous social psychological theories of health behavior and they have stimulated a tremendous amount of research
- Yet, over time there have been strikingly few modifications to our theories (e.g., specification of parameters; delineation of mediators and moderators)
- The process by which we refine, revise, or refute our theories is not working as well as it could (Noar & Zimmerman, in press; Rothman, 2004; Weinstein & Rothman, in press).

- _Overview_
- We need to do a better job of challenging our theories.  Practical problems afford a valuable opportunity to clarify the strengths and weakness of our theories, but only if we take advantage of it (Rothman, 2004).
*Example:  Why do people who successfully*
* **	**	**change their behavior have difficulty*
* **	**	**maintaining it over time?*

## Model of Behavioral Initiation and Maintenance(Rothman, 2000; Rothman, Baldwin, & Hertel, 2004)

-      _Behavioral Initiation_
- Guided by expectations about change
***Optimistic expectations predict interest and initial success***
- Motivated by desire to *approach* favorable goal (i.e., to be thin)
- Progress is marked by a change in discrepancy between current state and a goal state

- _Behavioral Maintenance_
- Guided by satisfaction with outcomes
***Satisfaction predicts long-term success***
- Satisfaction based on comparison of outcomes to expectations
- Motivated by a desire to *avoid* unfavorable goal (i.e., not be a smoker)
- Progress is marked by a sustained discrepancy between current state and a prior state

## Specifying the Determinants of the Initiation and Maintenance of Behavior Change

- Series of interventions to promote smoking cessation (Hertel et al., in preparation) and to promote weight loss (Finch et al., in press)

## Specifying the Determinants of the Initiation and Maintenance of Behavior Change

- Series of interventions to promote smoking cessation (Hertel et al., in preparation) and to promote weight loss (Finch et al., in press)
- Examine the challenge posed by trying to specify the factors that uniquely contribute to decisions to initiate and decisions to maintain a pattern of behavior.

## Disentangling Predictors of Sustained Behavior Change

- Smoke Free at Session 10

- Self-efficacy  at Session 10

- Smoke Free at 12 months

- (p < .01)

-  =1.32

- Satisfaction with quit at Session 10

- Note: Session 10 is 3 months after quit date; 4 months into program

**(Baldwin et al., under review)**

## Disentangling Predictors of Sustained Behavior Change

- Smoke Free at Session 10

- Self-efficacy  at Session 10

- Smoke Free at 12 months

- (p < .01)

-  =1.32

- Satisfaction with quit at Session 10

- Note: Session 10 is 3 months after quit date; 4 months into program

- =.36
- (p<.01)

- =.21
- (p<.03)

**(Baldwin et al., under review)**

## Disentangling Predictors of Sustained Behavior Change

- Self-efficacy  at Session 10

- Smoke Free at 12 months

- =.76
- (_p_ < .01)

- Satisfaction with quit at Session 10

- =.07
- (ns)

**Disentangling Predictors of Sustained Behavior Change**

**(Baldwin et al., under review)**

## Disentangling Predictors of Sustained Behavior Change

- Self-efficacy  at Session 10

- Smoke Free at 12 months

- =.16
- (ns)

- Satisfaction with quit at Session 10

- =.35
- (p<.01)

**Disentangling Predictors of Sustained Behavior Change**

**(Baldwin et al., under review)**

- _Observations_
- Practical problems can shed light on important theoretical issues.
- Efforts to test predictions regarding determinants of behavior need to be guided by theory (e.g., where people are in the behavior change process) and not necessarily by the intervention (e.g., time in the intervention schedule)

- _Does the Analysis Test the Theory?_

- _Does the Analysis Test the Theory?_
- Behavioral maintenance can be thought of as attempt to minimize deviations from a current state and prevent the return to a prior undesired state.
- Higgins (1998) has proposed that prevention-oriented people might be particularly good at persisting at a task.  Some supporting evidence from laboratory tasks, but all have involved a limited time frame.

- _Does the Analysis Test the Theory?_

- _Does the Analysis Test the Theory?_
- Initial analysis did NOT test our hypothesis
- We wanted to test whether smokers who are high in prevention-focus would have a greater chance of  maintaining a successful quit.

- _Does the Analysis Test the Theory?_

- _Does the Analysis Test the Theory?_

- _Final Thoughts_
- We need to reinvigorate the reciprocal relation between theory and practice
- Applying our theories to practical problems will stimulate innovations in our models by helping to clarify what we can and cannot explain
- As we refine our theories, their impact on practice will increase.  This will, in turn, generate a richer base of evidence which can guide further refinements and revisions.

- _Research Team_
-  **Psychology**: Andy Hertel, Kristi Kelly, Emily Finch, Steven Martino, Loran Nordgren, Helen Sullivan, Keilah Worth, Marc Kiviniemi, Austin Baldwin, Paul Fuglestad
**Epidemiology**: Bob Jeffery, Harry Lando, Jennifer Linde, Christie King, Debbie Ng, Kerrin Brelje
- Research supported by NINDS Grant NS38441

## Mean Ratings of Self-Efficacy and Satisfaction at Session 10 by Smoking Status at 12 months

- 		     Smoking at Session 10	     Quit at Session 10
- 	            Smoking at      Quit at		     Smoking at	   Quit at
- 	            12 months        12 months	     12 months	   12 months
- Self-Efficacy	   3.04		   4.40		         6.04	       6.76
- (at session 10)
- Satisfaction	  -1.25		   0.50		         1.49	       2.91
- (at session 10)
- Self-efficacy assessed on scale from 0 to 8; higher numbers indicate greater confidence
- Satisfaction assessed on scale from –4 to +4; higher numbers indicate greater satisfaction