Application of Behavior Change Theory to the Development
Application of Behavior Change Theory to the Development Application of Behavior Change Theory to the Development
36 BEHAVIOR CHANGE THEORY Only 29 percent expressed empathy, 25 percent attempted to use environmental reevaluation, an astonishingly low 17 percent stressed personal responsibility or encouraged self-reevaluation, and a mere 13 percent offered help. Compared with the balance of the studies, the treatment letters used by Marsh (1985- 1995), on average, employed fewer general, early, and late stage elements (personal responsibility, choice of strategy, empress empathy, strengthen self efficacy, dramatic relief, environmental reevaluation, helping relationships, and contingency management). Jones (1997) RATINGS: Design Quality: 20/24 Standard Letter: 7/33 Soft-Sell Letter: 23/33 The Jones article reported on an evaluation of the Oregon Driver Improvement Program that monitors driver records and implements corrective treatments at various levels of negligent driving behavior. The author’s focus was upon the effectiveness of a soft-sell warning letter as a countermeasure to negligent driving. Jones was motivated to initiate the study by his knowledge that much of the research into the effectiveness of low-threat warning letters was, by then, more than a quarter century old. A total of 8,462 eligible drivers were selected for this study and 4,278 received the softsell, experimental letter, while the balance was mailed the Department’s standard warning letter. Those in both treatment conditions and the no-contact control group, which consisted of 456 eligible drivers, were monitored for 26-38 subsequent months to determine the traffic safety implications of the letters. For older drivers, both letters were effective treatments relative to accident and major conviction reductions, with the soft-sell letter being the more effective, although neither was found to be more effective than the control condition. The risk of moving violations does not appear to be affected by either letter, regardless of age or gender. However, for younger drivers, accident free survival was significantly poorer for both letter groups. Generally, the warning letters, especially the soft-sell letter, were effective with drivers at least 35 years old, but for drivers 25 and under, doing nothing resulted in a significantly better result than sending either letter. Oregon’s standard (Appendix B-30) and soft-sell letters (Appendix B-31) are very different in their use of some TTM components but identical in others. The standard letter (Table 12) utilized systematic feedback from the general change elements, consciousness-raising from the early stage techniques, and helping relationships and contingency management from the late stage methods. Only 25 percent of the available methods were used in the standard letter.
BEHAVIOR CHANGE THEORY Table 12 Jones, 1997: Standard Letter Design Characteristics Score General stage Score Early stage Score Late stage Score Participation rate 70% 4 Systematic feedback 3 Consciousness raising 2 Stimulus control 0 No-treatment control 4 Personal responsibility Random assignment 4 Direct advice 0 Environmental reevaluation Similar subject characteristics Blinded to random schedule Temporality 4 Strengthen selfefficacy 0 Dramatic relief 0 Helping relationships 1 37 0 Counter conditioning 0 0 Choice of strategy 0 Social liberation 0 Contingency management 4 Express empathy 0 Self reevaluation 0 Self liberation 0 0 Total 20 3 2 2 Alternatively, the author availed himself of fifty-six percent of the sixteen TTM elements in the construction of the soft-sell treatment. However, six of the nine methods used were taken from one area, the general elements common to any effort to change behaviors. They create an environment conducive to change. Conversely, only two of the early stage and one of the late stage techniques were exploited. Oregon’s soft-sell letter (Table 13) performed commendably in setting the tone for change but did little to address the drivers’ current stage of change. Early stage methods are essential for those drivers who may not be thinking about change or are ambivalent toward abandoning the status quo. Late stage techniques reinforce the driver who is committed to change but needs support to avoid relapse into earlier behaviors. Table 13 Jones, 1997: Soft Sell Letter Design Characteristics Score General stage Score Early stage Score Late stage Score Participation rate 70% 4 Systematic feedback 3 Consciousness raising 2 Stimulus control 0 No-treatment control 4 Personal responsibility 3 Dramatic relief 2 Helping relationships 1 Random assignment 4 Direct advice 3 Environmental reevaluation 0 Counter conditioning 0 Similar subject 0 Choice of strategy 3 Social liberation 0 Contingency 0 characteristics management Blinded to random schedule 4 Express empathy 3 Self reevaluation 0 Self liberation 0 Temporality 4 Strengthen selfefficacy 3 Total 20 18 4 1 1
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36<br />
BEHAVIOR CHANGE THEORY<br />
Only 29 percent expressed empathy, 25 percent attempted <strong>to</strong> use environmental<br />
reevaluation, an as<strong>to</strong>nishingly low 17 percent stressed personal responsibility or<br />
encouraged self-reevaluation, and a mere 13 percent <strong>of</strong>fered help.<br />
Compared with <strong>the</strong> balance <strong>of</strong> <strong>the</strong> studies, <strong>the</strong> treatment letters used by Marsh (1985-<br />
1995), on average, employed fewer general, early, and late stage elements (personal<br />
responsibility, choice <strong>of</strong> strategy, empress empathy, streng<strong>the</strong>n self efficacy, dramatic<br />
relief, environmental reevaluation, helping relationships, and contingency<br />
management).<br />
Jones (1997)<br />
RATINGS:<br />
Design Quality: 20/24<br />
Standard Letter: 7/33<br />
S<strong>of</strong>t-Sell Letter: 23/33<br />
The Jones article reported on an evaluation <strong>of</strong> <strong>the</strong> Oregon Driver Improvement Program<br />
that moni<strong>to</strong>rs driver records and implements corrective treatments at various levels <strong>of</strong><br />
negligent driving behavior. The author’s focus was upon <strong>the</strong> effectiveness <strong>of</strong> a s<strong>of</strong>t-sell<br />
warning letter as a countermeasure <strong>to</strong> negligent driving. Jones was motivated <strong>to</strong><br />
initiate <strong>the</strong> study by his knowledge that much <strong>of</strong> <strong>the</strong> research in<strong>to</strong> <strong>the</strong> effectiveness <strong>of</strong><br />
low-threat warning letters was, by <strong>the</strong>n, more than a quarter century old.<br />
A <strong>to</strong>tal <strong>of</strong> 8,462 eligible drivers were selected for this study and 4,278 received <strong>the</strong> s<strong>of</strong>tsell,<br />
experimental letter, while <strong>the</strong> balance was mailed <strong>the</strong> Department’s standard<br />
warning letter. Those in both treatment conditions and <strong>the</strong> no-contact control group,<br />
which consisted <strong>of</strong> 456 eligible drivers, were moni<strong>to</strong>red for 26-38 subsequent months <strong>to</strong><br />
determine <strong>the</strong> traffic safety implications <strong>of</strong> <strong>the</strong> letters.<br />
For older drivers, both letters were effective treatments relative <strong>to</strong> accident and major<br />
conviction reductions, with <strong>the</strong> s<strong>of</strong>t-sell letter being <strong>the</strong> more effective, although nei<strong>the</strong>r<br />
was found <strong>to</strong> be more effective than <strong>the</strong> control condition. The risk <strong>of</strong> moving<br />
violations does not appear <strong>to</strong> be affected by ei<strong>the</strong>r letter, regardless <strong>of</strong> age or gender.<br />
However, for younger drivers, accident free survival was significantly poorer for both<br />
letter groups. Generally, <strong>the</strong> warning letters, especially <strong>the</strong> s<strong>of</strong>t-sell letter, were<br />
effective with drivers at least 35 years old, but for drivers 25 and under, doing nothing<br />
resulted in a significantly better result than sending ei<strong>the</strong>r letter.<br />
Oregon’s standard (Appendix B-30) and s<strong>of</strong>t-sell letters (Appendix B-31) are very<br />
different in <strong>the</strong>ir use <strong>of</strong> some TTM components but identical in o<strong>the</strong>rs. The standard<br />
letter (Table 12) utilized systematic feedback from <strong>the</strong> general change elements,<br />
consciousness-raising from <strong>the</strong> early stage techniques, and helping relationships and<br />
contingency management from <strong>the</strong> late stage methods. Only 25 percent <strong>of</strong> <strong>the</strong> available<br />
methods were used in <strong>the</strong> standard letter.