Health Behaviour Theories

"Theories and models help explain behaviour, as well as suggest how to develop a more effective way to influence and change behaviour"(Glanz, n.d.) When faced with developing or initiating a public health or health promotion program, theories can guide you to: understand why people do or do not practice proactive health-promoting behaviours and help identify what information is needed for an effective initiative.

Below I will provide a brief overview of four common theoretical models of health behaviour.

Health Belief Model

Introduced in the 1950s, the health belief model (HBM) was developed to explain why people will not participate in programs to prevent and detect disease. The model has since evolved to address concerns in prevention and detection, lifestyle behaviours and injury prevention. "The HBM theorizes that people's beliefs about whether or not they are at risk for a disease or health problem, and their perception of benefits taking action to avoid it, influence their readiness to take action" (Glanz, n.d.). The theory consists of six main constructs that influence people's decisions about whether they are ready to take action to prevent, screen, and manage an illness. It is believed that people are prepared to act if:

• Believe the condition has serious consequences (perceived severity)

• Believe taking action would reduce their susceptibility to the condition or its severity (perceived benefits)

• Believe the benefits outweigh the costs of taking action (perceived barriers)

• Are exposed to factors that prompt action (e.g., a television ad or a reminder from one's physician to get a mammogram) (cue to action)

• Are confident in their ability to act successfully (self-efficacy)

Health motivation is the main focus of the HBM; therefore, this model is most effective when looking to address problem behaviours (high-risk sexual behaviours) or prevention-related topics (mammography, influenza vaccines) (Theory at a Glance, n.d.)

Transtheoretical Model (Stages of Change)

The transtheoretical model (TTM) basic premise is that behaviour change is a process, not an event (Theory at a Glance, n.d.). The model looks to understand how individuals progress towards adoption and maintaining health behaviours change for better overall health. Behaviour changes unfold through a series of stages, from not ready to change/no recognition that change is needed to maintaining a behaviour change. The five stages of change are:

Stages of Change

When using this model, it is essential to remember that people do not always linearly progress through the stages. Often, relapses occur, and individuals regress to an earlier stage or begin the process again.

Social Cognitive Theory

The Social Cognitive Theory (SCT) is a reciprocal model that describes the interactions of person, environment, and behaviour. People learn not only through their own experiences but also by observing others' actions and the results of those actions (Glanz, n.d.). The SCT comprises four processes of goal realization: self-observation, self-evaluation, self-reaction and self-efficacy.

The Social-Ecological Model

The Social-Ecological Model (SEM) is a framework for identifying, understanding and addressing the social determinants of health on many levels. The SEM shifts the focus from an individual behaviour approach towards interventions directed at changing individual, interpersonal, organizational, community, and public policy, to influence health outcomes (Max et al., 2015). The model believes that interventions are more likely to be effective when they address all determinants of health.

Choosing a Theory

Different theories are best suited to different public health or health promotion initiatives. It is suggested that when choosing a suitable theory, you should begin with identifying the problem and goal. Based on my readings and learning from this week, I will apply one of the above approaches to next week's blog on increasing influenza vaccination rates.

References

Glanz, K. (n.d.). Social and behavioral theories. Office of Behavioral & Social Science Research. Retrieved October 26, 2020, from http://www.esourceresearch.org/Default.aspx?TabId=728

Max, J. L., Sedivy, V., & Garrido, M. (2015). Increasing our impact by using a social-ecological approach. Washington, DC: Administration on Children, Youth and Families, Family and Youth Services Bureau. Retrieved October 25, 2020 from https://teenpregnancy.acf.hhs.gov/sites/default/files/resource-files/Increasing_Our_Impact%20508.pdf

National Cancer Institute. (n.d.). Theory at a glance a guide for health promotion practice. U.S. Department of Health and Human Services Retrieved October 26, 2020 from http://www.sbccimplementationkits.org/demandrmnch/wp-content/uploads/2014/02/Theory-at-a-Glance-A-Guide-For-Health-Promotion-Practice.pdf