In This Article Behavior Change Theory in Health Education and Promotion

  • Introduction
  • General Overviews
  • Journals
  • Community-Level Theories
  • Integrative Frameworks
  • Special Populations
  • Constructs and Measurement
  • Theory Testing
  • Theory-based Intervention Development
  • Evaluation of Theory-based Interventions

Public Health Behavior Change Theory in Health Education and Promotion
by
Susan J. Curry, Robin J. Mermelstein
  • LAST REVIEWED: 14 October 2016
  • LAST MODIFIED: 22 April 2013
  • DOI: 10.1093/obo/9780199756797-0035

Introduction

The 20th century witnessed an extraordinary shift from infectious to chronic diseases as the leading causes of death. With greater understanding of the etiology of chronic disease, health behaviors have emerged as major contributors to premature morbidity and mortality. Thus, modifying health behaviors has tremendous potential to reduce the human and economic burdens of disease through prevention. Numerous studies have demonstrated that health behavior change including tobacco cessation, dietary modification with modest weight loss, and increased physical activity both prevents disease onset and improves the treatment and management of common diseases such as cardiovascular disease, cancers, and diabetes. Behavior change is complex and is most successful when resources align at the individual, interpersonal, and community levels. Health behavior change theory provides a roadmap to the major factors that influence behavior, articulates the relationships among the various factors, and considers when, where, and how these factors operate. This roadmap is critical for the development and implementation of effective approaches to health behavior change. Health behavior change theory and practice have evolved over time to focus on integrative models that examine the interplay of individual, interpersonal, social, cultural, and environmental factors. The following bibliography offers a collection of resources related to understanding, developing, testing, and applying health behavior theory at these multiple levels. It includes both early classic citations and recent theory formulations and applications. Many of the sources cited can be considered “metaresources,” as their coverage and references will lead the reader to more in-depth pursuit of specific topics.

General Overviews

Schroeder 2007 provides one of the most concise and compelling rationales for the importance of addressing health behaviors. Further detail is provided in Fisher, et al. 2011. The tables in Fisher, et al. 2011 provide detailed summaries of specific behavior–health linkages and of how behavior change interventions prevent disease, improve disease management, and improve quality of life and the overall health of the population. The slim volume Nutbeam, et al. 2010 manages to cover a broad range of theories and their application in less than one hundred pages. Three books provide more comprehensive overviews that can be used as textbooks in advanced and graduate-level courses. Included in Simons-Morton, et al. 2012 is useful coverage of theory-driven multilevel program planning. DiClemente, et al. 2013 covers multidisciplinary theories including behavioral economics, health communication, social marketing, and diffusion of innovations. Glanz, et al. 2008 is a one-stop resource for summaries of major health behavior theories and their application to intervention development and evaluation. The nine cross-cutting propositions outlined in the book’s final chapter are must-read guidance for the development, testing, and use of health behavior theory. In its critical appraisal of health behavior theory, Noar and Zimmerman 2005 argues for providing more consistency in theoretical constructs and highlights the need for more rigorous comparative theory testing.

  • DiClemente, R. J., L. F. Salazar, and R. A. Crosby. 2013. Health behavior theory for public health: Principles, foundations, and applications. Burlington, MA: Jones & Bartlett Learning.

    E-mail Citation »

    Surveys major theoretical perspectives in health behavior theory. Provides an in-depth introduction regarding the importance of health behavior for achieving broad public health goals. Includes chapters that focus on measurement and evaluation of theory-based interventions.

  • Fisher, E. B., M. L. Fitzgibbon, R. E. Glasgow, et al. 2011. Behavior matters. American Journal of Preventive Medicine 40.5: e15–e30.

    E-mail Citation »

    Outstanding summary of the central role behavior plays in the etiology and management of chronic disease. Persuasive evidence-based documentation of why behavioral approaches need a central place in preventive medicine.

  • Glanz, K., B. K. Rimer, and K. Viswanath, eds. 2008. Health behavior and health education: Theory, research, and practice. 4th ed. San Francisco: Wiley.

    E-mail Citation »

    Seminal book with comprehensive coverage of health behavior theory. Includes individual, interpersonal, and community models. Also includes coverage of using theory in research and practice, including intervention design and evaluation. An adaptation from the third edition is available online as Theory at a glance: A guide for health promotion practice.

  • Noar, S. M., and R. S. Zimmerman. 2005. Health behavior theory and cumulative knowledge regarding health behaviors: Are we moving in the right direction? Health Education Research 20.3: 275–290.

    DOI: 10.1093/her/cyg113E-mail Citation »

    Critiques the current direction of health behavior theory research, highlights the need for comparative theory studies, and suggests ways to accelerate the quality and impact of health behavior theory research.

  • Nutbeam, D., E. Harris, and M. Wise. 2010. Theory in a nutshell: A practical guide to health promotion theories. 3d ed. Sydney, Australia: McGraw-Hill.

    E-mail Citation »

    This brief book explores the main theoretical concepts and models in health promotion. The book covers theories at the individual, community, and organizational level. Focus is on practical application as well as theory, and includes innovations in theory-based approaches to health promotion such as evidence-based policymaking and health impact assessments.

  • Schroeder, S. A. 2007. We can do better—Improving the health of the American people. New England Journal of Medicine 357:1221–1228.

    DOI: 10.1056/NEJMsa073350E-mail Citation »

    Taken from a Shattuck Lecture, covers the relative contributions of genetic predisposition, environmental exposures, social circumstances, health care, and behavioral patterns in premature death. Provides a cogent summary of the critical importance of addressing health behavior.

  • Simons-Morton, B., K. R. McLeroy, and M. L. Wendel. 2012. Behavior theory in health promotion practice and research. Burlington, MA: Jones & Bartlett Learning.

    E-mail Citation »

    Surveys major behavior theory with a focus on practical application for the improvement of population health. Each chapter includes clearly defined learning objectives and practical examples.

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