Evaluation of Communication Models in Healthcare Practices Report

This report provides a comprehensive analysis of communication models within the healthcare sector, focusing on the Theory of Planned Behavior (TBP) and the Transtheoretical Model (TTM). It critically examines these models, exploring their theoretical underpinnings, practical applications, and effectiveness in health communication and practices. The report also delves into the roles of advocacy and mediation in health promotion, linking the self-efficacy process to the Health Belief Model. Furthermore, it assesses the strengths and weaknesses of each model, offering practical examples and suggestions for their effective utilization by health practitioners. The report aims to enhance understanding of communication strategies and their impact on patient outcomes, offering a valuable resource for students and professionals in the healthcare field.

Running head: MODELS OF COMMUNICATION
Models of Communication
Name of the University
Name of the Student
Author note

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MODELS OF COMMUNICATION
Executive Summary
The chief purpose of the report is to analyze critically the two models of communication and
their relevancy in health communication and practices. The report also focuses on the critical
evaluation of the application and effectiveness of the two selected models of communication in
the health sector. The two theories chosen for the purpose include, The Theory of Planned
Behavior and the Transtheoretical Model. Further, the report focuses on the process of advocacy
and mediation in relation to health promotion. The self-efficacy process has also been identified
as having a link to the Health Belief Model of communication. The report concludes with a
summary of the theories and models discussed and suggestions regarding the proper utilization
of these theories in practice.

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Table of Contents
Executive Summary.........................................................................................................................1
Introduction......................................................................................................................................3
Analyzing the selected models and linking those to theoretical perspectives.................................3
Effectiveness of TBP and TTM in practice.....................................................................................5
Advocacy and mediation in relation to relevant communication approaches.................................7
Self-efficacy process........................................................................................................................8
Conclusion.......................................................................................................................................9
Bibliography:.................................................................................................................................11

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Introduction
Health practitioners and counselors have one of the most difficult tasks in the world as
many depend on them for resolving their personal, emotional and physical issues. To approach a
client in an effective manner, health practitioners need to develop a strong understanding of the
various methods of communication (Golden and Earp 2012). They also have to utilize these in
accordance with the situation of the client. Numerous theorists have developed different models
of communication that are applied to various fields. The Theory of Planned Behavior (TBP), the
Health Belief Model under Cognitive theories, the Transtheoretical model of communication
(TTM), the Process of Behavior Change and so on under Stage theories are some of the
communication theories and models that are applied to practice (Corcoran 2013).
The given report focuses mainly on two theories of communication- one from Cognitive
and one from Stage theories and tries to analyze these two theories in regards to practical
examples.
The two models or theories of communication selected for the report are the Theory of
Human Behavior and the Transtheoretical model of communication.
Analyzing the selected models and linking those to theoretical perspectives
Ajzen and Fishbein proposed the Theory of Planned Behavior during the 1980s initially called
the Theory of Reasoned Action that comes under the Cognitive theories of human behavior.
Later, the theorists modified it in the early 90s where they added one more dimension to the
previous theory- the perceived behavior control (Forestry.gov.uk 2017). The theory stresses on
the fact that human behavior is influenced by three major activities. The first is one’s own

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attitude, second is external pressure or motivation from society and the third is the apparent
behavioral control. These factors decide the consequent intention of the individual whether to
accept and act upon that behavior or not. Ultimately, the behavioral intention leads to what the
individual ends up doing that is the achieved behavior (Montano and Kasprzyk 2015). A close
study at the TBP reveals its evident link with the Freudian concept of psychodynamic. According
to Freud, human personality comprises three elements- the Id, Ego and the Superego. The Id is
accountable for instincts and pleasure seeking. It urges the mind to want something obsessively;
the Superego gives more importance to the obligations and rules imposed by parents and society;
and the Ego tries to strike a balance between the Id and the Superego. It tries to mediate between
the two and explore new ways to get what the Id wants without disturbing the societal rules and
norms (Marmor 2012).
Now, one can clearly notice that Freud’s Id is closely linked to the first stage of TBP that
is the attitude towards behavior. The second stage of TBP coincides with the Ego that pays more
attention to what the society that is family and friends have to say. The third TBP stage- the
apparent behavior control- can be associated with Freud’s third element, which is the Superego.
The next model of communication selected for the purpose of health communication is
the Transtheoretical Model. Prochaska and Diclemente introduced the Transtheoretical Model
(TTM) in 1983 that comes under the Stage-step theories (Prochaska 2013). This theory rejected
the Cognitive views of human behavior and focused more on the stages of behavior not the ages.
The TTM suggests that humans go through a cyclical process of behavior change. The process
begins with pre-contemplation where humans do not intend to change their behavior as they
think it does not cause any harm or danger. They tend to remain in this inactive phase of
behavior. This stage is followed by the contemplation stage where humans start giving thoughts

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to change in behavior. They start thinking of the harms of being inactive and contemplate on
changing it. The next is the preparation stage where they initiate the first steps towards change. It
is then followed by the action stage where the individual has started acting on his contemplation
and has been doing or planning to do it for a longer period. The action stage gives way to the
stage of maintenance that involves continuation of the action. After a period of action and its
continuation, the individual might decide to drop the idea and go back to the previous stages.
This is the relapse stage in the behavior cycle (Sharma 2016).
Erikson’s psychosocial model comprises eight stages of human behavioral development-
trust as opposed to mistrust, autonomy against doubt, initiative versus guilt, industry versus
inferiority, identity opposed to role confusion and so on (Cragg 2013). The TTM mainly
concerns the stage of indentify versus role confusion that involves individuals between the ages
of 13 to 21 years. The reason for choosing this stage is its close link to the stages of the cyclical
human behavior. According to Erikson, at this stage, the youngsters start to feel that they need to
develop their own identity (Jones et al. 2014). Prior to this stage, they were not concerned about
how they looked and what others might think of them. To say this in terms of TTM, they were in
the pre-contemplation stage. When they passed that stage, they contemplated on developing their
own identity. When the contemplation stage is over, the youngsters then give a thought whether
they are prepared for the change or not.
Effectiveness of TBP and TTM in practice
In the field of health communication, these two theories have been largely utilized.
Health practitioners are applying the Theory of Planned Behavior to promote healthy habits
amongst adults like walking daily, dangers associated with smoking, motivating exercise and so

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on. However, it is imperative to realize the manners in which this theory can be applied while
communicating with a service user.
As per the TBP, an individual’s intention is the main driving force behind the
achievement of any behavior. In health sector, practitioners apply this theory to influence clients
to take up healthy habits or behaviors. To cite an example, a person’s addiction to smoking can
be reduced through the three phases prior to the attitude stage. At first, the person would question
his own behavioral beliefs whether the outcomes of the decision would be positive or negative.
The second phase is the normative beliefs that results in apparent pressure from the society that
compels the person to consider the attitude of his family and friends towards his decision. The
final phase involves the control beliefs of the person where he questions his own ability and
knowledge. The TBP can be used in this case to design an intervention for the person addicted to
smoking (Gault et al. 2016).
Many have nonetheless argued against the application and effectiveness of the TBP in the
modern technologically advanced era. The theory gives excessive attention to hypothetical
behavioral tendencies or attitudes, point out critics that might or might not influence behavior.
Moreover, the theory does not include health determinants that might lead to an incomplete or
sometimes incorrect behavior determination (Sniehotta, Presseau and Araújo-Soares 2014).
Health communicators have widely used the Transtheoretical model of communication to
interact effectively with their clients (Dray and Wade 2012). The TTM has received great
popularity owing to its simple process. Known also as the Stages of Change Model, TTM has
been successfully applied to achieve several health related targets. Specifically targeted towards
intervention programs, the TTM has provided positive results in the sector. The model was

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initially designed for the purpose of intervening smoking habits; it began to be used in areas such
as encouraging vegetable and fruit consumption, encouraging physical activity and injury
avoidance.
The Transtheroretical Model has largely been criticized for its exclusion of priority-based
intervention. To give an example, quitting smoking might not be seen as a priority by many and
hence, the TTM stages may not be applicable to that person. Furthermore, to decide as to which
stage the user belongs might cause conflict between the health practitioner and the client. Many
critics have also pointed out to the weaknesses of the stages in TTM like the pre-contemplation
and contemplation stage. They argue that there is hardly any behavioral change visible from the
pre-contemplation to the contemplation stage. Some have limited the success of this model to
short-term goals only.
Advocacy and mediation in relation to relevant communication approaches
An advocate or mediator has a very important role to play in an individual’s life. Advocacy
generally refers to the process of helping someone and supporting someone. It allows people to
express their views and get justice for them. People play the role of an advocate either knowingly
or without knowing. Social workers, mental health experts, clergy, government officials and
even a friend or a relative could be an advocate as per situations. Service users in particular could
be empowered and protected through the utilization of advocacy effectively (Ncbi.nlm.nih.gov,
2017).
Mediation, on the other hand is a slightly different process than advocacy, as it does not
involve supporting one side against the other. Mediation is a process where a person acts as the
mediator for solving issues between conflicting groups by making them come together and have

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a conversation. This process works best when the two conflicting parties come into an agreement
to resolve disputes through mutual understanding. In addition, the parties involved in mediation
possess the capability to live up to their promises and discontinue the conflict in future.
Health practitioners especially counselors who look to resolve disputes between husband
and wife, their families and so on widely use both advocacy and mediation. Communication
strategies used by health professionals to advocate or mediate a service user must be as per the
demand of the situation.
Self-efficacy process
In the health sector, communication plays a vital role for both patients and practitioners.
However, despite improved knowledge and training on patient communication, severity of
communication still persist. Communication is a process of exchanging information and ideas
and views and one cannot proceed further if the other feels inferior or low. Self-efficacy thus
becomes an important parameter to establish a congenial relationship between the user and the
practitioner. Self-efficacy refers to the capability of an individual to develop potential without
anyone’s help (Schwarzer 2014). Self-efficacy is an individual’s belief that he or she can
produce desired results or that he or she can control or influence any situation. In the field of
health practices, this belief is very important especially for the service user. Possessing self-
efficacy allows the service user to open up about their problems and freely discuss with the
practitioner (Lee et al. 2012).
Studies have found that the Health Belief Model (HBM) is an ideal communication
model that can be linked to the process of self-efficacy in service users. Health Belief Model
(HBM) proposes certain principles that are supposed to influence behavior. According to HBM,

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behavior of people could change through an incentive; there must be vulnerability in them to act
in a certain way and they must be assured that the change would bring advantages and that these
advantages must overshadow the barriers. Lastly, people must possess that confidence or self-
efficacy that they can overcome barriers to achieve a behavioral change (Montanaro and Bryan
2014).
The practical application of HBM supporting self-efficacy is evident in the health sector
where service users are allowed to strengthen their own will to achieve behavioral change. To
cite an example, a person meets with an accident and is bedridden for months. He is unable to
walk and his counselor or health advisor pushes him to the extreme to make him believe that he
can walk if he tries (Wang et al. 2014). The person then establishes that self-belief and
confidence that he can achieve that change.
The contemporary health sector applies the HBM largely to help patients with Tay-Sachs
disease, exercise and nutrition programs and so on. However, it needs to be mentioned that the
applicability and effectiveness of the HBM is limited to certain areas of health sector (Eldredge
et al. 2016). The model lacks the analytical worth for some of its vital views. To illustrate, a
person would not just agree for a behavior change by looking at the severity of the illness. The
illness might not be as serious to the person as it may seem to the health practitioner (Sundqvist
et al. 2016)
Conclusion
One cannot deny the effectiveness of the various models of communication in the field of
health services. In the past years, health communication through campaigns and advertisements
used to be done on extemporary basis but the scenario has changed now. Health practitioners

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now prefer the practical implementation of the various theories and models in order to achieve
maximum result. The report has critically explained the connection of the various models of
communication to the theories of Freud and Erikson. Sigmund Freud and Erik Erikson were the
two exponents of the psychodynamic theory and the psychosocial theory, both of which are
applicable to behavioral change in humans. The report has highlighted the different models of
communication along with their application and effectiveness in practice. The Theory if Planned
Behavior (TBP), the Transtheoretical Model (TTM) and the Health Belief Model (HBM) have
been discussed elaborately in the report. The report has also mentioned the critical aspects of the
theories and has put forth their drawbacks as well. It however needs to be pointed out that these
models of communications are apt in their own places but their effectiveness depends on the way
these are utilized. It therefore can be suggested that the communicators or practitioners of health
utilize the different models of communication through a deep understanding of the user’s needs
and requirements.

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Eldredge, L.K.B., Markham, C.M., Ruiter, R.A., Kok, G. and Parcel, G.S., 2016. Planning health
promotion programs: an intervention mapping approach. John Wiley & Sons.
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