GEDRAGSVERANDERING
,Inhoud
1. inleiding................................................................................................4
Wat is gezondheid?................................................................................4
Wat is gedrag?.......................................................................................4
Waarom is gedrag belangrijk voor gezondheid?....................................4
2. Even terug in de tijd..............................................................................5
Prehistorie..............................................................................................5
Oude Grieken.........................................................................................5
Middeleeuwen : terugval in geneeskunde.............................................5
Renaissance : opkomst biomedisch perspectief....................................5
Biomedisch perspectief (Dualistische visie)...........................................5
Bio-Psycho-sociaal perspectief..............................................................6
Gezondheidspromotie:..............................................................................7
Er zijn 5 redenen voor de opkomst van het biopsychosociaal perspectief8
Preventie Vormen:.....................................................................................9
3. werken aan gezondheid in het bio-psycho-sociaal model........................9
4. Gedragsverandering..............................................................................11
Kwaliteitsstandaarden:..........................................................................11
5. Intervention mapping.............................................................................11
1. Terminologie...........................................................................................13
1. intervation mapping..............................................................................14
1. Beschrijven van de doelgroep.............................................................14
2. Beschrijving van het probleem...........................................................14
Omvang of morbiditeit............................................................................15
Multimorbiditeit.......................................................................................16
Ernst of kwaliteit van elven.....................................................................16
Mortaliteit of sterfte................................................................................16
Levensverwachting.................................................................................16
QALY’s en DALY’s.....................................................................................16
ADL’s (Activities of Daily Living).............................................................17
3. Gedrags- en omgevingsanalyse.............................................................18
1. Biologische of persoonsgebonden risico’s..........................................18
1
, 2. Leefstijl en gedrag..............................................................................18
3. Omgeving stap 2.................................................................................19
1. Health Belief Model (Rosenstock, 1974).................................................20
2. ASE-Model (Attitude - Sociale Invloed - Eigen Effectiviteit) (De Vries et
al., 1988)....................................................................................................21
3. Transtheoretisch Model (Stages of Change) (Prochaska & DiClemente,
1993)..........................................................................................................21
4. I-Change Model (De Vries).....................................................................22
5. Behaviour Change Wheel (Michie et al., 2011)......................................22
6. Gedragswiel Gezond Leven (Vlaamse toepassing).................................23
1. Competenties (kunnen)..........................................................................25
2. Drijfveren (willen)...................................................................................26
3. Context (omgeving)...............................................................................31
4. Distale Determinanten...........................................................................37
STAP 2: Veranderingsmatrix opstellen......................................................38
1️. Formuleer van programmadoel...........................................................38
2️. Formuleer doelen voor gedrag en omgeving......................................39
3️. Kies belangrijke én veranderbare determinanten...............................41
4️. Maak de veranderingsmatrix..............................................................42
................................................................................................................44
6.1 Terminologie.........................................................................................45
6.2 Stappenplan.........................................................................................47
12 Algemene technieken voor gedragsverandering...............................51
6.3 : methodieken kiezen op basis van determinant.................................59
6.4 algemene technieken voor gedragsverandering..................................85
7.1 Interventie opbouwen..........................................................................91
7.2 implementatie van de interventie........................................................97
7.3 Evaluatie van de interventie................................................................98
1. probleemanalyse..............................................................................102
2. veranderingsmatrix opstellen...........................................................103
3. methoden en strategieën bepalen.......................................................104
4. ontwerp van de interventie...............................................................104
5. implementatie van de interventie.....................................................105
2
, 6. evaluatie...........................................................................................105
9.1 Bereiken van doelgroep.....................................................................107
Population based approach...................................................................107
High-risk approach................................................................................107
Probleem high risk en population approach.......................................107
Mattheüseffect......................................................................................108
Health Literacy......................................................................................109
Equity en Equality.................................................................................109
Proportioneel universalisme..................................................................110
Common risk factor approach...............................................................110
Upstream vs downstream.....................................................................112
Wie doet wat?.......................................................................................114
Zijn wij dan zo slecht bezig?.................................................................114
9.2 Ongelijkheid in de mondgezondheid verminderen.............................115
Internationaal: interventies...................................................................115
Betalingssystemen in de zorg...............................................................115
9.2 Ongelijkheid in de mondgezondheid verminderen.............................116
3
,Inhoud
1. inleiding................................................................................................4
Wat is gezondheid?................................................................................4
Wat is gedrag?.......................................................................................4
Waarom is gedrag belangrijk voor gezondheid?....................................4
2. Even terug in de tijd..............................................................................5
Prehistorie..............................................................................................5
Oude Grieken.........................................................................................5
Middeleeuwen : terugval in geneeskunde.............................................5
Renaissance : opkomst biomedisch perspectief....................................5
Biomedisch perspectief (Dualistische visie)...........................................5
Bio-Psycho-sociaal perspectief..............................................................6
Gezondheidspromotie:..............................................................................7
Er zijn 5 redenen voor de opkomst van het biopsychosociaal perspectief8
Preventie Vormen:.....................................................................................9
3. werken aan gezondheid in het bio-psycho-sociaal model........................9
4. Gedragsverandering..............................................................................11
Kwaliteitsstandaarden:..........................................................................11
5. Intervention mapping.............................................................................11
1. Terminologie...........................................................................................13
1. intervation mapping..............................................................................14
1. Beschrijven van de doelgroep.............................................................14
2. Beschrijving van het probleem...........................................................14
Omvang of morbiditeit............................................................................15
Multimorbiditeit.......................................................................................16
Ernst of kwaliteit van elven.....................................................................16
Mortaliteit of sterfte................................................................................16
Levensverwachting.................................................................................16
QALY’s en DALY’s.....................................................................................16
ADL’s (Activities of Daily Living).............................................................17
3. Gedrags- en omgevingsanalyse.............................................................18
1. Biologische of persoonsgebonden risico’s..........................................18
1
, 2. Leefstijl en gedrag..............................................................................18
3. Omgeving stap 2.................................................................................19
1. Health Belief Model (Rosenstock, 1974).................................................20
2. ASE-Model (Attitude - Sociale Invloed - Eigen Effectiviteit) (De Vries et
al., 1988)....................................................................................................21
3. Transtheoretisch Model (Stages of Change) (Prochaska & DiClemente,
1993)..........................................................................................................21
4. I-Change Model (De Vries).....................................................................22
5. Behaviour Change Wheel (Michie et al., 2011)......................................22
6. Gedragswiel Gezond Leven (Vlaamse toepassing).................................23
1. Competenties (kunnen)..........................................................................25
2. Drijfveren (willen)...................................................................................26
3. Context (omgeving)...............................................................................31
4. Distale Determinanten...........................................................................37
STAP 2: Veranderingsmatrix opstellen......................................................38
1️. Formuleer van programmadoel...........................................................38
2️. Formuleer doelen voor gedrag en omgeving......................................39
3️. Kies belangrijke én veranderbare determinanten...............................41
4️. Maak de veranderingsmatrix..............................................................42
................................................................................................................44
6.1 Terminologie.........................................................................................45
6.2 Stappenplan.........................................................................................47
12 Algemene technieken voor gedragsverandering...............................51
6.3 : methodieken kiezen op basis van determinant.................................59
6.4 algemene technieken voor gedragsverandering..................................85
7.1 Interventie opbouwen..........................................................................91
7.2 implementatie van de interventie........................................................97
7.3 Evaluatie van de interventie................................................................98
1. probleemanalyse..............................................................................102
2. veranderingsmatrix opstellen...........................................................103
3. methoden en strategieën bepalen.......................................................104
4. ontwerp van de interventie...............................................................104
5. implementatie van de interventie.....................................................105
2
, 6. evaluatie...........................................................................................105
9.1 Bereiken van doelgroep.....................................................................107
Population based approach...................................................................107
High-risk approach................................................................................107
Probleem high risk en population approach.......................................107
Mattheüseffect......................................................................................108
Health Literacy......................................................................................109
Equity en Equality.................................................................................109
Proportioneel universalisme..................................................................110
Common risk factor approach...............................................................110
Upstream vs downstream.....................................................................112
Wie doet wat?.......................................................................................114
Zijn wij dan zo slecht bezig?.................................................................114
9.2 Ongelijkheid in de mondgezondheid verminderen.............................115
Internationaal: interventies...................................................................115
Betalingssystemen in de zorg...............................................................115
9.2 Ongelijkheid in de mondgezondheid verminderen.............................116
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