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Application of the

Social Cognitive Theory

Group:

John Botts, Courtney Haun, Dan McKenzie, Casey Morrell, & Kristy Turner

Journal Quality

- All manuscripts are double-blind reviewed

- Where appropriate, health service research statisticians review papers with statistical content

- The editor makes changes to the paper after review before the document is accepted for publication

Overall Significance of the Study

- This study shows how the use of non-pharmaceutical interventions (i.e. self-efficacy education programs) can help patients abstain from drug use and effectively lower the chance of a relapse.

- Although the study population was small, a similar population of opium addicts could have a better chance of relapse prevention if their treatment consists of a similar educational program based on SCT.

Information

Awareness and Education on addiction process, complications and treatment

Inspiring Vulnerability

- Participants divided into groups and group discussion was initiated in an effort to change attitudes

- Focused on education and development of self-regulatory skills

Enhancement of Social Self-efficacy

Four sessions

  • Problem-solving skills
  • Decision-making skills
  • Self-projection skills
  • Review previous skills and communication skills

All of these skills help increase self-efficacy

Social Support

Final Session

2 sessions

  • Kinds of family support debated - close family members were invited
  • Self-governing group was invited

Previous eight sessions summed up and clients guided to future referrals

SCT-based Intervention

How Model Was Applied

- The basis of the intervention strategy

- Model is based on concepts of personal efficacy, self-regulatory process, and self-efficacy

- Self-efficacy is a person’s belief in his/her ability to achieve something/succeed

-Self -regulation is the capacity to control one's impulses

Problem Background

Article: The Effect of Bandura's Social Cognitive Theory Implementation on Addiction Quitting of Clients Referred to Addiction Quitting Clinics

Problem: The health issue of addiction quitting in Iran. According to the National Institute of Drug Abuse, relapse occurs in about 40-60% of addicts. The article implements the SCT in regard to therapeutic methods.

The Scope of

the Problem

- Substance abuse on the rise

- "200 million drug users across the world" - WHO

(Annual Report of 2005, according to article)

- WHO World Drug Report 2012 says 230 million people (5% of the world population) have used illicit drugs before; 27 million users in the world

(data from WHO website -- contradicts stats in article)

- “Illicit drugs undermine economic and social development and contribute to crime, instability, insecurity and the spread of HIV.”- WHO

- Iran borders Afghanistan, the world's biggest producer of opium

Impact Factor

- The journal Impact Factor- Average number of citations received per paper published over the two previous years

- 2015 Impact Factor=

# of times all published items in '13 and 14' are cited/

total # of citable items in '13 and '14

- It appears the journal is not cited often

Authors Expertise/ Field of Study

- Abbas Heydari – Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

- Ali Dashtgard – Department of Community Health Care Nursing, Birjand University of Medical Sciences, Ghayen School of Nursing and Midwifery, Ghayen, Iran

- Zahra Emami Moghadam – Department of Health and Psychatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Extrapolation

  • SCT models work to increase knowledge and skills such as communication, decision-making, problem-solving and self-projection, which can lead to positive behavioral change.
  • Believing you can (self-efficacy) quit helps you to succeed!
  • SCT could be used for other types of addictive behavior, such as cigarette smoking

Methods

- Experimental study design -

Pre-test-posttest with control group

-Demographics collected and addiction quitting self-efficacy questionnaires

-Intervention group participated in SCT-based intervention; Control group participated in conventional treatment

-Post-intervention follow-up

- Addiction-quitting self-efficacy questionnaires administered post-intervention

- Analyzed with SPSS

Interpretation

- Clients in the SCT-based intervention showed increased self-efficacy which translates to increased success at addiction quitting and decreased recurrence

-Short-term, but not long-term benefits of SCT-based intervention assessed

-Small sample size

-External validity/ generalizability

MAARIE FRAMEWORK

Assignment

How were participants assigned to groups?

60 eligible clients randomly assigned to either test or control group

Small sample size: 60 people

Eligibility Criteria:

  • Addiction confirmation by physician
  • History of addiction < 10 years
  • Lack of recurrence > 2 times
  • No drug dependency other than opium
  • No chronic and psychiatric disease

Results

- Randomization effectively distributed confounding variables between groups

- Test group more successful than control in addiction quitting (90% vs. 73.3%)

- Recurrence was lower in the test group (14.8% vs 40.9%) Fisher's exact test (P ≤ 0.05)

- Significant difference in self-efficacy scores before and after intervention in test group, but not in control

t-test (P ≤ 0.05)

Groups Analyzed for

Potential Confounders

No significant difference with respect to age, self-efficacy level before intervention, sex, marital status, educational level, type of quitting, way of using drug, addiction of family members, number of children, history of cigarette smoking, history of alcohol abuse, and profession

Assessment

Garth W. Martin

Addiction Research Foundation, Toronto, Canada and University of Toronto

Drug Avoidance Self-Efficacy Scale (DASES) - appears to be a reliable and valid scale in measuring self-efficacy in drug users

Validity and reliability of questionnaires confirmed by

Martin and Bramson

Validity reconfirmed through face and content validity

No copy of the questionnaire provided

Bramson

The impact of peer mentoring on drug avoidance self-efficacy and substance use (dissertation)

University of Northern Colorado

Now a psychologist?

Introduction

- Social Cognitive Theory (SCT): theory that learning occurs in a social context with a dynamic and reciprocal interaction of the person, environment, and behavior.

- Started in the 1960's by Albert Bandura as the Social Learning Theory

- Unique feature focusing on social influences on external and internal reinforcements (including past, present, and future experiences)

Key Concepts

of SCT:

  • Self-efficacy
  • Vicarious learning
  • Reciprocal determinism
  • Self-regulation

Some individuals hold different attitudes about alcohol versus other drugs. One difference is that we are more likely to view alcoholism as a disease rather than a drug addiction.

What social influences might impact this?

Discussion Questions

Do you believe self-efficacy is a lead driving force in more health issues other than addiction?

TN is the first state to begin prosecuting pregnant women who test positive for illegal drugs.

What are some pros and cons to this new law?

References

- Bandura, Albert. (n.d.). Retrieved February 17, 2015, from http://learningandtheadolescentmind.org/people_06.html

- Edberg, M. (2007). Essentials of health behavior: Social and behavioral theory in public health. Sudbury, Mass.: Jones and Bartlett.

- Heydari, A., Dashtgard, A., & Moghadam, Z. (n.d.). The effect of Bandura's social cognitive theory implementation on addiction quitting of clients referred to addiction quitting clinics. Retrieved February 17, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917180/

- Statistics. (n.d.). Retrieved February 20, 2015, from http://ijnmr.mui.ac.ir/index.php/ijnmr/about/statistics?statisticsYear=2014

- UNODC, World Drug Report 2012 (United Nations publication, Sales No. E.12.XI.1) http://www.unodc.org/documents/data-and-analysis/WDR2012/WDR_2012_web_small.pdf

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