Theory/Model

Summary

Key Concept

Intrapersonal/Individual

Health Belief Model (HBM)

For people to adopt recommended physical activity behaviors, their perceived threat of disease (and its severity) and benefits of action must outweigh their perceived barriers to action.

·      Perceived susceptibility

·      Perceived severity

·      Perceived benefits of action

·      Perceived barriers to action

·      Cues to action

·      Self-efficacy

Stages of change

(Transtheoretical

Model)

In adopting healthy behaviors (e.g., regular physical activity) or eliminating unhealthy ones (e.g., watching television), people progress through five levels related to their readiness to change—pre contemplation, contemplation,  preparation, action, and maintenance. At each stage, different intervention strategies will help people progress to the next stage.

·      Pre-contemplation

·      Contemplation

·      Preparation

·      Action

·      Maintenance

Relapse prevention model (RP)/ Marlatt’ s Cognitive-Behavioral Model

Marlatt and Gordon’s (1985) RP model is based on social-cognitive psychology and incorporates both a conceptual model of relapse and a set of cognitive and behavioral strategies to prevent or limit relapse episodes.

Persons who are beginning regular physical activity programs might be aided by interventions that help them anticipate barriers or factors that can contribute to relapse.

·      Skills training

·      Cognitive reframing

·      Lifestyle rebalancing

Information-Processing

Model/ Lefrancois Theory

The impact of persuasive communication,

which can be part of a social marketing

campaign to increase physical activity, is

mediated by three phases of message

processing—attention to the message,

comprehension of the content, and

acceptance of the content.

Exposure; Attention

Liking/interest;

Comprehension; Skill

acquisition; Yielding

Memory storage

Information search and

Retrieval; Decision;

Behavior; Reinforcement;

Post-behavior

consolidation.

The Precaution Adoption Process Model (PAPM)

The PAPM attempts to explain how a person comes to decisions to take action and how he or she translates that decision into action. Adoption of a new precaution or cessation of a risky behavior requires deliberate steps unlikely to occur outside of conscious awareness. The PAPM applies to these types of actions, not to the gradual development of habitual patterns of behavior, such as exercise and diet, in which health considerations may play little role (though it would apply to the initiation of a new exercise program or a new diet). Nor does the PAPM explain the commencement of risky behaviors—such as a teenager accepting her first cigarette–which seem to be better explained in terms of a “willingness” to act rather than in terms of any plan to act (Gibbons, Gerard, Blanton, & Russell, 1998).

·         Unaware of issue

·         Unengaged of issue

·         Undecided about acting

·         Decided not to act

·         Decided to act

·         Acting

·         Maintenance

Interpersonal Level

Social learning/ social

cognitive theory

Health behavioral change is the result of

reciprocal relationships among the

environment, personal factors, and

attributes of the behavior itself. Self-efficacy

is one of the most important characteristics

that determine behavioral change.

·         Self-efficacy

·         Reciprocal determinism

·         Behavioral capability

·         Outcome expectations

·         Observational learning

Theory of

Reasoned Action (TRA)

For behaviors that are within a person’s

control, behavioral intentions predict actual behavior. Intentions are determined by two factors—attitude toward the behavior and beliefs regarding others people’s support of the behavior.

Attitude toward the

behavior

• Outcome expectations

• Value of outcome

expectations

Subjective norms

• Beliefs of others

• Desire to comply with

others

Theory of Planned

Behavior (TPB)

People’s perceived control over the

opportunities, resources, and skills needed

to perform a behavior affect behavioral

intentions, as do the two factors in the

theory of reasoned action.

Attitude toward the

behavior

• Outcome expectations

• Value of outcome

expectations

Subjective norms

• Beliefs of others

• Desire to comply with

others

Perceived behavioral

control

Social Support

Often incorporated into health promotion

interventions, social support can be

instrumental, informational, emotional, or

appraising (providing feedback and

reinforcement of new behavior)

·   Instrumental support

·   Informational support

·   Emotional support

·   Appraisal support

Community Level

Community

organization model

Public health workers help communities

identify health and social problems, and

they plan and implement strategies to

address these problems. Active community

participation is essential.

·   Social planning

·   Locality development

·   Social action

Ecological approaches

Effective interventions must influence

multiple levels because health is shaped by

many environmental subsystems, including

family, community, workplace, beliefs and

traditions, economics, and the physical and

social environments.

Multiple levels of

influence

• Intrapersonal

• Interpersonal

• Institutional

• Community

• Public policy

Organizational change

theory

Certain processes and strategies might

increase the chances that healthy policies

and programs will be adopted and

maintained in formal organizations.

Definition of problem

(awareness stage)

Initiation of action

(adoption stage)

Implementation of change

Institutionalization of

change

Diffusion of innovations

theory

People, organizations, or societies adopt

new ideas, products, or behaviors at

different rates, and the rate of adoption is

affected by some predictable factors.

·         Relative advantage

·         Compatibility

·         Complexity

·         Trialability

·         Observability