Use of Social Cognitive Theory to Guide a Medical Treatment Adherence Intervention

By Marie Chisholm-Burns and Christina Spivey.

Published by The Social Sciences Collection

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Article: Print $US10.00
Article: Electronic $US5.00

In this paper, we discuss the application of social cognitive theory as the basis for an intervention to promote medical treatment adherence among renal transplant recipients (RTRs). Social cognitive theory proposes that behavior is affected by multiple influences including environmental and personal (biological, affective, cognitive) factors, and aspects of the behavior itself. Similarly, research including our own indicates that there are multiple barriers and/or causes of non-adherence to medical treatment, including physiological, psychological, environmental, locus of control, economic, medical, and educational factors. Further, social cognitive theory suggests that a person must believe in his/her ability to perform a behavior (i.e., self-efficacy) and must perceive a benefit to the behavior; moreover, a person must place value on the consequences or outcomes associated with the behavior. Therefore, interventions to improve adherence should address each factor relevant to the individual recipient and incorporate elements of benefits and outcomes/consequences. Behavioral contracting, a behavior modification technique guided by social cognitive theory, is a promising approach to adherence intervention as it incorporates behavioral, cognitive, social, and environmental components to address a target behavior. Contracts are patient-specific written agreements between the patient and practitioner that generally identify and modify: (1) antecedents of the target behavior(s); (2) the target behavior(s); and (3) the consequences that shape the target behavior(s). We hypothesize that a behavioral contract intervention grounded in social cognitive theory will improve the medical treatment adherence behaviors of renal transplant recipients.

Keywords: Social Cognitive Theory, Behavioral Contracting, Medical Treatment Adherence

International Journal of Interdisciplinary Social Sciences, Volume 5, Issue 7, pp.97-108. Article: Print (Spiral Bound). Article: Electronic (PDF File; 671.765KB).

Dr. Marie Chisholm-Burns

Professor and Department Head, Pharmacy Practice and Science, Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, Arizona, USA

Marie A. Chisholm-Burns, RPh, PharmD, MPH, FCCP, FASHP, is Professor and Head of the Department of Pharmacy Practice and Science at The University of Arizona College of Pharmacy. She received her BS in Psychology and Biology from Georgia College, BS in Pharmacy and Doctor of Pharmacy degrees from The University of Georgia, and Masters in Public Health from Emory University. Dr. Chisholm-Burns is Founder and Executive Director of the Medication Access Program which increases medication access to transplant patients. With more than 200 publications and approximately $8 million in external funding as principal investigator from organizations such as the National Institutes of Health, she is a prolific scholar. In 2008, a textbook co-edited by Dr. Chisholm-Burns, Pharmacotherapy Principles and Practice, received the Medical Book Award from the American Medical Writers Association. She has received numerous awards and honors including the Robert K. Chalmers Distinguished Pharmacy Educator Award from the American Association of Colleges of Pharmacy, the Clinical Pharmacy Education Award from the American College of Clinical Pharmacy, the Daniel B. Smith Practice Excellence Award from the American Pharmacists Association, and the Rufus A. Lyman Award for most outstanding publication in the American Journal of Pharmaceutical Education (in 1996 and 2007).

Dr. Christina Spivey

Coordinator of Research and Administration, Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, Arizona, USA

Christina A. Spivey, PhD, MA, LMSW, is a Coordinator of Research and Administration in the Department of Pharmacy Practice and Science at The University of Arizona College of Pharmacy. She received her BA in Justice from American University, MA in Social Service Administration from The University of Chicago, and PhD in Social Work from The University of Georgia. Dr. Spivey’s previous work experiences include the Child and Family Services Agency in Washington, D.C., and the Midwest Center for Justice in Chicago, IL where she acted as an advocate for death row inmates. She has approximately 20 publications in journals spanning such fields as social work, geriatrics, public health, pharmacy, and transplantation.


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