Information-motivation-behavioral+skills+model

Primary Author: Kulin Mehta

__Information-motivation-behavioral skills model (IMB)__

The constructs of the Information-motivation-behavioral skills model (IMB) provide a platform to design interventions that help to induce change in the pattern of health behavior and plan preventive public health programs. IMB model was first used in a HIV risk behavior study (J.Fisher and Fisher, 1992;2000; W.Fisher and Fisher, 1993;1999) which established that “the IMB model conceptualizes psychological determinants of the performance of behaviors that have the capacity to impair or to improve health status”. The IMB model incorporates and addresses three components namely information, motivation and behavior each of which are defined here along with examples of public health interventions where the IMB model is implemented. The ‘information’ component targets understanding of the concepts that lead to behavior change and the ways and means of achieving the behavior change. The ‘motivation’ aspect deals with individual affect and favorable attitude towards positive health behaviors and utilizing existing social support systems to reinforce motivation. Motivation is also enhanced by recognizing the possible barriers and finding ways to overcome those limitations. The behavioral aspect of the IMB model reflects the psychomotor or ‘action’ component that allows learning of skills required to bring about change in behavior (W.Fisher, J.Fisher and Harman, 2003). Interrelationships among the three constructs (J.Fisher and Fisher, 1992) of the IMB model as well a set of operations(W.Fisher and Fisher, 1993) are used to translate the IMB model into health promotion interventions.

According to the IMB model, information is the critical determinant of health behavior performance and it comprises of the relevant data that influences performance of health behavior by an individual in his or her social existence (J.Fisher and Fisher, 1992; 2000; W.Fisher and Fisher, 1993; 1999). Information includes, but not limited to, relevant research data, health promotion information, preventive or risk details about the disease or behavior in consideration and information on positive outcomes from behavioral change. Example of information may include ‘condom use prevents the spread of HIV infection’(Bracher, Santow and Watkins, 2004). An IMB model on HIV risk behavior among women of low income housing was implemented by Anderson et al., (2006) in which surveys gathered information on condom use; condom use motivation was assessed by each participants estimate of risk on a scale (of 1 to 5) and analyzed in context to social norms, attitudes and intentions; behavioral skills were assessed by yes/no questions on condom use in the last 2 months. Upon testing this IMB model, authors concluded that the preventive information of condom use, motivation and behavioral skills induces condom use behavior based on available information and motivation from resources and thus, the IMB model and its variables prove to be an effective intervention (Anderson et al., 2006).

The IMB model specifies that motivation acts as a catalyst to health related behaviors and determines whether even well-informed individuals will be inclined to undertake health promotion actions (W.Fisher, J.Fisher and Harman, 2003). In context to HIV prevention, personal attitudes towards condom use in terms of preventing spread of disease and perception of social support towards it determine the effective condom use behavior. In context to breast cancer screening and prevention, the conscious realization of importance of breast self examination and having an attitude to follow it, along with social support regarding breast self examination, predicts its performance (Misovich, Martinez, Fisher, Bryan and Catapano, 2003).

Behavioral skills for performance of health promotion actions are an additional critical determinant of whether, people who adopted information and are motivated towards healthy behavior change, would be capable of effectively bringing about that change. Behavior skills is dependent on individual self efficacy in carrying out a health related behavior (W.Fisher, J.Fisher and Harman, 2003). Information and motivation act as tools to develop these behavioral skills. 'Breast self-examination prevents breast cancer recurrence in most survivors of breast cancer' is an example of behavioral skills for breast cancer prevention intervention(Trask, Pahl and Begeman, 2008). A study used the IMB model to predict risky sexual behavior amongst underserved minority youth and concluded that “intervention programs designed targeting preadolescents should focus on building long-lasting behavioral skills that emphasize the reduction of peer pressure and normative influences on risky sexual behaviors and components of the IMB model clearly have a role in the design of efficacious interventions” (Bazargan, Stein, Bazargan-Hejazi and Hindman, 2010). IMB model has also been used for the adherence to antiretroviral therapy and gained optimal adherence (Starace, Massa, Amico and Fisher, 2006).

IMB model thus postulates the constructs of information, motivation and behavioral skills towards intervention development. It must be noted that information and motivation are potentially independent constructs which means that well informed individuals are not necessarily motivated to engage in health promotion behaviors or well motivated individuals are not necessarily well informed about health promotion practices (J.Fisher and Fisher, 1992; J.Fisher, W.Fisher, Williams, Malloy, 1994). IMB model brings about a step wise transition in society for effective execution of public health intervention. Firstly, resources are pooled together to establish a proven standard and authenticity of information, research data, surveys and questionnaires that help to determine the information, motivation and behavioral skill factors of the health intervention. Once that is available, behavior specific interventions are designed and implemented with respect to target health behavior. Lastly, an evaluation-outcome research is conducted to assess the impact of the IMB model to produce the desired effect.. A comparison is made with the deficits of the earlier faulty health behavior that persisted before application of the IMB model (W.Fisher, J.Fisher and Harman, 2003).

References

Anderson E.S., Wagstaff D.A., Heckman T.G., Winett R.A., Roffman R.A., Solomon L.J., Cargill V, Kelly J.A, Sikkema K.J (2006). Information-Motivation-Behavioral Skills (IMB) Model: testing direct and mediated treatment effects on condom use among women in low-income housing. Annals of Behavioral Medicine. 2006 Feb;31(1):70-9.

Bazargan M., Stein J.A., Bazargan-Hejazi S, Hindman D.W. (2010). Using the information-motivation behavioral model to predict sexual behavior among underserved minority youth. Journal of School Health. 2010 Jun;80(6):287-95.

Bracher M., Santow G., and Watkins S.. (2004).Assessing the Potential of Condom Use to Prevent the Spread of HIV: A Microsimulation Study. //Studies in Family Planning//, Vol. 35, No. 1 (Mar., 2004), pp. 48-64.

Fisher, J.D., and Fisher,W.A (1992). Changing AIDS risk behavior. Centre for Heath, Information and Prevention Documents. Paper 2. Retrieved from http://digitalcommons.uconn.edu/chip_docs/2.

Fisher, W.A, and Fisher,J.D (1993). A general social psychological model for changing AIDS risk behavior. The Social Psychology of HIV Infection. p.27-53.

Fisher, J.D., Fisher., W.A., Williams, S.S., and Malloy, T.E (1994). Empirical tests of an information-motivation-behavioral skills model of AIDS preventive behavior with gay men and heterosexual university students. Health Psychology. Vol 13(3). P.230-50.

Fisher,W.A, and Fisher,J.D (1999). Understanding and promoting sexual and reproductive health behavior: Theory and method. Annual Review of Sex Research. Vol 9. p39-76.

Fisher J.D., and Fisher,W.A (2000). Theoretical approaches to individual level change in HIV risk behavior. Centre for Heath, Information and Prevention Documents. Paper 4. Retrieved from http://digitalcommons.uconn.edu/chip_docs/4.

Fisher, W.A., Fisher, J.D., Harman, J. (2003). The Information-Motivation-Behavioral Skills Model: A general social psychological approach to understanding and promoting health behavior. Social Psychological Foundations of Health and Illness. p. 82-106.

Misovich, S.J., Martinez T., Fisher J.D., Bryan A.D., and Catapano N (2003). Breast self examination: A test for the Information Motivation Behavioral Skills model. Journal of Applied Social Psychology.Vol 33. Issue 4; p.775-790.

Starace, F., Massa, A., Amico, K., and Fisher, J. (2006). Adherence to antiretroviral therapy: An empirical test of the information- motivation-behavioral skills model. Health Psychology, 25(2), 153-162. doi:10.1037/0278-6133.25.2.153.

Trask, P., Pahl, L., & Begeman, M.. (2008). Breast self-examination in long-term breast cancer survivors. //Journal of Cancer Survivorship//, 2(4), 243-52.