Page 181 - Nutrition Counseling and Education Skills: A Guide for Professionals

about their abilities.
Does will power have anything to do with behavior change? Albert Bandura does not believe that

appropriate behavior, such as healthful eating and regular exercise, is achieved by a feat of will power. He
recognized that learning and behavior change are influenced not only by external cues and rewards that are
discussed in Chapter 7, but also by the interaction of demands on one’s coping capabilities.

In Bandura’s view, successful therapies work by increasing an individual’s skills and confidence in the ability
to engage in or practice a specific behavior.11 This allows individuals to exercise greater self-control over their
behavior, motivation, and environment. Participants in an online intervention of nutrition and physical
activity found success depended on users developing SE for behavior change, the extent for setting personal
goals, and tracking and receiving positive feedback on targeted behaviors.17

SELF-ASSESSMENT 2

On a scale of 1 to 5, with 5 the highest, rate your level of confidence (self-efficacy) in your
ability to do the following:

1. Exercise three times a week.
2. Give a 45-minute speech.
3. Make healthful food choices.
4. Ski downhill.
5. Control your weight.
6. Give a dinner party for 20 people.

What effect does a high or low rating have on your choice of activities?

Bandura distinguishes between “efficacy” expectations (“Can I do it?”) and “outcome” expectations (“What
I expect will happen if I perform the behavior”).18–20 An “outcome” expectancy is a person’s estimate or belief
that a given change or behavior will or will not lead to an outcome the person values.21 For example, the
behavior of reducing dietary sodium will result in an outcome of lower blood pressure and better health;
following a dietary regimen will lead to an outcome of weight loss and better physical appearance and health;
or successfully completing a project for one’s superior will result in a salary increase or promotion. Besides cost
and benefit outcomes, people weight the outcomes of social approval or disapproval, pleasurable or aversive
expectations, and personal standards against which one evaluates oneself.20

SE and outcomes are differentiated because people may believe that certain actions can produce an
outcome, but they may have serious doubts about whether or not they can cope with the necessary changes
and overcome barriers to reach the outcome. These perceptions and evaluations, not necessarily the person’s
true capabilities, may apply to performing a desired behavior, such as eating less, as well as abstaining from a
problem one, such as overeating.

Choice of Behaviors and Activities

Efficacy expectations are a major determinant of people’s choice of activities.11 Clients involved in a change of

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