Self-Efficacy

Self-efficacy is a theory of behavior change that predicts that individuals' likeliness to undertake a given behavior is a function of their efficacy and outcome expectations related to the given behavior. The theory was introduced by Albert Bandura, whose earlier work in social learning theory provided much of the inspiration for self-efficacy theory.

Efficacy expectations represent the first factor in the theory and are based upon individuals' perceptions of their ability to successfully undertake a given behavior. An individual asks him or herself, “Can I successfully undertake this action?” Consider, for example, the behavior of smoking cessation: one would evaluate his or her perceived ability to quit smoking. These expectations are a necessary condition to affect behavior change. That is, individuals must believe they can undertake a given course of action or they will likely not attempt the action or will experience difficulty in changing their behavior. In the case of the smoker, one with low efficacy expectations will be less likely to quit or will abandon their efforts to quit over time. Thus, efficacy expectations influence one's initiation of the recommended behavior (e.g., smoking cessation) and the persistence of the recommended behavior over time in the face of difficulty.

An example might serve to illustrate efficacy expectations in health. An individual contemplating a decision to begin a challenging exercise regimen will be more likely to initiate the regimen if she or he believes their time and self-motivation allow them to succeed in accomplishing the regimen over a designated time period. Prior failed or successful plans to exercise regularly help form their expectations of their ability to succeed at initiating and maintaining the regimen, as do their current professional and personal circumstances (e.g., free time, level of obesity, social support). There is a spiraling effect with regard to efficacy expectations—previous successes or failures feed into current efforts that, in turn, guide future efforts.

An important characteristic of efficacy expectations, notes Bandura, is their importance in determining the amount of effort one expends toward a given behavior, especially in the face of obstacles and negative feedback. The individual seeking to quit smoking may be surrounded by smokers at work, experience strong cravings in particular settings (e.g., with a morning cup of coffee), or even have a cigarette or two in weak moments. But, will he or she persist in their efforts to quit smoking, despite these challenges to behavior change? They will more likely persist if their convictions are strong that they can successfully kick the habit permanently. In other words, efficacy expectations predict that an individual asks, “Can I do this?”

Self-efficacy is an important theory in the arena of health, as many health decisions are based upon individuals' perceptions of the value of undertaking a given action in relation to previous beliefs and past experiences associated with that action. A goal of many health campaign efforts is to strengthen individuals' expectations related to health. Persuasive advertisements seek to assure individuals they can successfully quit smoking, lose weight, or eat more fruits and vegetables, to use three examples. A recent example in health communication is an appraisal of patients' and providers' efficacy expectations in relation to discussing colorectal cancer screening in the context of primary care. Patients appraise their expectations related to colonoscopy (e.g., fear of pain, insurance coverage), and providers appraise their expectations in discussing screening during scheduled patient visits (e.g., time constraints, futility).

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