In a social action view, compliance is best understood as a process of acquiring and enhancing self-protective capabilities. The social action framework integrates disparate social, psychological, and behavioral perspectives in a tripartite model that clarifies self-change processes while suggesting new intervention approaches, hypotheses, and experiments. An action state perspective generates behavioral objectives for interventions to encourage sustained self-protective action. A model of self-change processes offers a blueprint for intervention planning by organizing the problem solving, motivational, cognitive skill, and social interactive components of self-change. Finally, a contextual model aids the planner in identifying social and biological structural factors that could impede critical self-change processes, thus making it easier to target vulnerable population subgroups.
The present approach represents a move away from narrowly individualistic conceptions of self-regulation that have characterized psychology, toward a more social-contextual perspective. Thus the notion of action linkage in social interdependence, and the emphasis on social interaction processes, focus attention on the interconnectedness of people's action goals and scripts, as well as the interactive "competence" of their relationship systems. Not only do these influences shape people's health outcome beliefs; they also affect their sense of personal agency, their goals, and their readiness to engage in practical problem-solving activities that translate motivation into sustained patterns of health protective behavior. The task of explaining how social-contextual processes operate to affect compliance at different points in the life span provides a stimulating and potentially fruitful agenda for compliance research.
Preparation of this chapter was supported in part by grant RO1-HL36298 from the National Heart, Lung, and Blood Institute.
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