When trying to encourage patients to adopt a healthier lifestyle, it is taken as given that they will require information. For example, information on the benefits of stopping smoking – and perhaps some practical tips on how to cut down. However, in this type of situation, another important – and sometimes overlooked – consideration may be patients’ beliefs about their ability to make, and maintain, the required changes.

‘Self-efficacy’ describes somebody’s belief in their ability to change. While behaviour change interventions to increase knowledge and skills may also result in increased patient self-efficacy, this is by no means certain. Fortunately however, research in areas such as physical activity (1) and addiction (2) has shown that interventions designed specifically to boost self-efficacy can be effective – both in terms of enhancing self-efficacy, and in ultimately changing behaviour.

This article summarises three common interventions to boost self-efficacy:

1. INSPIRE FOCUS ON PAST SUCCESSES: Strong evidence demonstrates the effect that successful past behaviour can have on self-efficacy (3). Many patients will likely have attempted the same (or very similar) health-related changes at some point in the past; encouraging the recall or listing of only parts of this behaviour (as opposed to the behaviour in its entirety) can have a positive effect on self-efficacy.

2. LEARN FROM OTHERS: However, if there are no suitable past successes we must look at alternative ways to boost self-efficacy. One approach is to demonstrate the desired behaviour. This was done in Sport England’s This Girl Can campaign, which used a variety of female role models to help persuade nearly four million women to take part in sport (4). This approach is especially effective if those demonstrating the behaviour are similar to message recipients in terms of their age, gender, and capabilities.

3. VERBAL PERSUASION: Finally, verbal persuasion involves telling the person they can successfully perform the desired behaviour, arguing against their self-doubts, and asserting that they can and will succeed. It is the trickiest of the three approaches described here – particularly if especially low self-efficacy is reinforced by highly negative experiences. However, verbal self-persuasion through instructional self-talk has been found to be effective in areas including physical activity (5).

Self-efficacy interventions work in many domains for changing self-efficacy and behaviour itself. They are mostly easy to create / implement – either as a self-help technique or prompted by professionals. Lastly, their chances of success can be further boosted through combination with other approaches such as advising on, arranging, or providing social support for the behaviour.

Chris Harvey
Founder, Activate Research

References:
1. Williams, S.L., & French, D.P. (2011). What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour? Health Education Research, 26, 308-322.
2. Hyde, J., Hankins, M., Deale, A., & Marteau, T.M. (2008). Interventions to increase self-efficacy in the context of addiction behaviours: a systematic literature review. Journal of Health Psychology, 13, 607-623.
3. Sitzmann, T., & Yeo, G. (2013). Is self-efficacy a product of past performance or a driver of future performance? Personnel Psychology, 66, 531-568.
4. https://www.thisgirlcan.co.uk/
5. Tod, D., Hardy, J., & Oliver, E. (2011). Effects of self-talk: A systematic review. Journal of Sport and Exercise Psychology, 33, 666-687.