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Application and Analysis #3 1. Explain how the PAPM model was used to address planning and intervention characteristics in the Costanza et al. (2009) article. In this study, the authors clearly listed out the different steps of the Precaution Adoption Process Model (PAPM) under the Theoretical Basis of the Intervention section. They also mentioned how the PAPM is different from the Transtheoretical Model (TTM) by combining steps 1-4 of the PAPM into one for the TTM. The authors determined that the fourth and fifth stages were the most critical for their program so they decided to split those stages up into subgroups 4, 4a, 4b, 5, 5a, 5b, and 5c and focus on how they could control those subgroups and what they could learn from them (Costanza, et al, 2009). Stage 4 individuals were those who decided they would not get a mammogram or those who would only get one if their perceived risk increased. Stage 5 individuals were those who were open to the idea of a mammogram in the near future or in general. This is the extent to where the PAPM was discussed in the article. 2. Determine and explain if the use of the model made sense based on the description of the model in the appropriate textbook chapter and supplemental materials. It seems that although the authors had good intentions in using the PAPM for their program, they did not follow through with the model nor did they effectively use the sections they desired to use. It is logical to use only the parts of the model that are applicable to the experiment but it is also logical to go beyond just one step and to have more results than were found to justify further use of the program to reach that one step. Moving from stage 3 (deciding about acting) to stage 4 (deciding not to act) or stage 5 (deciding to act) seems like a task that could be better handled with a theory that works around changing someone’s behavior, like the value-expectancy theories. It was an experiment focusing on the “how” of the problem instead of the “why,” which is in line with a stage model, but it did not allow room for moving up and down the stages because there was only one place to move. The simplicity of the experiment and the lack of movement seems more fitting of other types of models instead of the Precaution Adoption Process Model. Along with that note, the authors explained how the PAPM would be used but they did not continue to reference those parts throughout the article so it all got lost quickly after the explanation. If someone without knowledge of the model came along and read the article, they would be confused by how it all ties into the experiment. To say you are using a model, it is important to continue referencing it to ensure it is clearly understood by the readers. 3. In review of your chosen secondary articles, how did the application of the model differ between the interventions? In your opinion, is one application a better use of the model than the other? Explain. In 2005, there was a study published by The British Psychological Society that questioned Germans and their reactions to meat consumption after the Bovine Spongiform Encephalopathy outbreak, more commonly known as “mad cow disease (BSE, 2013),” in the early 2000’s (Sniehotta, et al, 2005). Their study was to compare the changes, or lack thereof, of people’s beef consumption and compare that to their perceived susceptibility. By using the PAPM as a categorical model, they were able to take the 808 participants and split them up into their respective stages depending on how they answered a questionnaire. After that, they were questioned on their perception of their risk of getting BSE which resulted in classifications of each stage. For example, they were able to determine that those who were in Stage 2 (unengaged) perceived themselves as having low vulnerability. Also an example of the Precaution Adoption Process Model, in 2007 there was a study performed that questioned people who suffer of epilepsy and their perceived risk of osteoporosis since epileptic drugs are often related to high bone loss and osteoporosis (Elliott, et al, 2007). After finding participants for the study through a local doctor’s office, the researchers either asked epileptic patients who were visiting the doctor a set of questions or they mailed out questionnaires for patients to complete and send in. The questions asked them about their current forms of bone loss prevention, a high calcium diet, calcium supplements, exercise, and DEXA (a bone density screening), and how they perceived their susceptibility to osteoporosis is. With this information, the researchers were able to find out what types of people were proactive about prevention and what the most popular options were. I was not aware of how much the PAPM could be used as a survey tool more than anything else. It seems like a good model for addiction recovery and dieting as it allows room for relapse, but it makes sense to use it for survey information as well. I believe that the study about mad cow disease was the most PAPM effective as it continually referenced the model and how it was working with the constructs to find the most valuable information. The other two articles definitely had a way of incorporating the model into the studies but they did not continually explain how it all worked together so the model got lost at times. It is difficult to understand the structure of a study if the model is only mentioned at the beginning and not throughout the article as a reference. References BSE (Bovine Spongiform Encephalopathy, or Mad Cow Disease). (2013, Feb. 21). Centers for Disease Control and Prevention. Retrieved on November 19, 2014, from http://www.cdc.gov/ncidod/dvrd/bse/ Costanza, M.E., Luckmann, R., White, M.J., Rosal, M.C., LaPelle, N., Cranos, C. (2009, June 11). Moving mammogram-reluctant women to screening: A pilot study. The Society of Behavioral Medicine. Retrieved on November 18, 2014, from https://engage.cune.edu/learn/pluginfile.php/29391/mod_page/content/6/Week%204_MP H515_PAPM.pdf DiClemente, R.J., Salazar, L.F., Crosby, R.A. (2013). Health behavior theory for public health: principles, foundations, and applications. Jones & Bartlett Learning, LLC. Burlington: MA. Elliott, J.O., Seals, B.F., Jacobson, M.P. (2007, Dec. 7). Use of the Precaution Adoption Process Model to examine predictors of osteoprotective behavior in epilepsy. European Journal of Epilepsy. 16(5). Retrieved on November 19, 2014, from http://www.seizurejournal.com/article/S1059-1311(07)00056-8/fulltext Sniehotta, F.F., Luszczynska, A., Scholz, U., Lippke, S. (2005). Discontinuity patterns in stages of the precaution adoption process model: Meat consumption during a livestock epidemic. British Journal of Health Psychology. Retrieved on November 19, 2014, from http://onlinelibrary.wiley.com/doi/10.1348/135910705X26137/full