goals. Individual self-efficacy in any specific behaviour may be
increased through provision of 1) exposure to mastery experiences
(successful experiences in the behaviour of interest), 2)
vicarious learning (modelling or observing others performing
similar tasks), 3) receiving physiological feedback following
achievement of the behaviour of interest (physiological signs),
and 4) verbal persuasion (receiving positive feedback) (Bandura,
1998). From this theoretical perspective, what people believe
Approaches to behaviour change informed by Self-Managed
Care help people to develop self-esteemregarding their abilities
in the behaviours of interest, gain insight into their own behavioural
triggers, and develop the knowledge and confidence to
make healthy choices (McGowan, 2005). Motivational
In summary, two theoretical approaches and the evidence
reviewed informed the development of the expanded NCM
interventions included in this study. The purpose of the interventions
was to improve client medication self-efficacy and
adherence, reduce blood pressure and achieve long-termstroke
risk reduction for a specific subset of high risk for stroke SPC
clients. Interventions included 1) facilitating medical management,
2) provision of home self-monitoring devices, 3) supportive
lifestyle and adherence counselling, and 4) adherence
monitoring. Adherence monitoring was performed in collaboration
with community providers (pharmacists, family practitioners
and family caregivers).