Originated by: Dominika Murphy
Submitted: 23 May 2011
Last updated on:
23 May 2011
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Health is influenced by a variety of factors including an individual’s genetics, social circumstances, social and physical environment, behavioral patterns, and access to health care. When it comes to reducing the number of premature deaths, medical care plays a rather small role (Shroeder, 2007).
Research suggests that one of the greatest opportunities to improve health and reduce premature deaths is rooted in personal behavior. In fact, behavioral causes account for nearly 40% of all deaths in the United States. (Mokdad, 2004). Lifestyle factors such as diet, exercise, substance abuse, and the choices people make regarding them have a tremendous impact on health and well being. As health professionals, behavior models and theories should play a central role in all of the public health interventions we develop—from working with a community on cancer prevention activities to helping patients adhere to a medication regimen that was just prescribed (Glanz, 2008).
Below is a brief overview of theories and models, reasons to use them, and tools and resources to learn more.
What are theories and models?
Theories and models explain behavior and suggest ways to achieve behavior change (NIH, 2005). Theories and models also:
Help present systematic understanding of events or situations (NIH, 2005)
Are a set of concepts, definitions, and propositions that explain or predict these events or situations by illustrating the relationship between variables (NIH, 2005))
Examples: What is the relationship between age and diabetes? Between attitudes and adherence to a medication regimen? )
Why should we use them?
Programs to influence health behavior are more likely to succeed if guided by a theory of health behavior (Glanz, 2008). The use of theories and models also:
Helps serve as a road map
Helps explain and predict people’s actions
Clarifies the processes for changing the behavior
Aids us in recognizing the effects of external influences on behavior
Provides tools for moving beyond intuition and generalizations
Helps us identify the most suitable targets for programs, the methods for accomplishing change, and the outcomes for evaluation
Helps health educators step back and see the bigger picture
How should theories and models be used?
Because different theories are suited for different areas of health practice such as individuals, groups, or communities, the theories must be matched appropriately.
To choose an appropriate theory, it is a good idea to start by identifying the problem you are trying to solve and then reading different theories to see which one may work best for your intervention. It may also be helpful to research which theories and models have been used in the particular area you are working in and whether or not they have been successful.
Below are a few examples of some of the most popular models that can be used when dealing with individual and interpersonal health behavior, and with communities and groups. It is also important to note that thousands of models exist and new ones are created every day. For detailed information and to learn about additional models, please see the “Resources for Healthcare Providers and Health Educators” section.
Models of individual health behavior (ie, people learn through their own experiences):
Health Belief Model
The Transtheoretical Model and Stages of Change
Theory of Reasoned Action and the Theory of Planned Behavior
Precaution Adoption Process Model
Models of interpersonal health behavior
Social cognitive theory:
People don’t learn in a vacuum
People learn by observing others’ actions and the results of those actions
Multidimensional learning: self (personal factors and one’s behavior as a result of these factors) and the environment
Self-efficacy: empowerment and building competency and confidence
Community and group models (used with comprehensive health promotion efforts to solve a health problem or reach entire populations)
Diffusion of Innovations
Theories of Organizational Change
Glanz K, Rimer BK, Viswanath K. Health Behavior and Health Education: Theory, Research, and Practice Wiley, John & Sons, Inc; 2008.
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238-1245. http://jama.ama-assn.org/content/291/10/1238.abstract
Theory at a Glance: A Guide for Health Promotion Practice 2nd ed. NIH publication 05-3896. September 2005.
Schroeder SA. Shattuck Lecture. We can do better—improving the health of the American people. N Engl J Med. 2007; 357(12):1221-1228. http://www.ncbi.nlm.nih.gov/pubmed/17881753