Theories and models for health promotion interventions
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Theories and Models for Health Promotion Interventions. Build a solid foundation for the house. Definitions.

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Theories and Models for Health Promotion Interventions

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Theories and Models for Health Promotion Interventions

Build a solid foundation for the house


  • Theory: A theory is a set of interrelated concepts, definitions, and propositions that presents a systematic view of events or situations by specifying relations among variables in order to explain and predict the events of the situations.

    Glanz, Lewis & Rimer, 1977, p. 21


  • Concepts: the primary elements of theory (ideas or propositions)

  • Construct: synthesized thoughts of key concepts or specific theories

  • Variables: the operational or practical form of a construct

  • Model: a subclass of theory. May utilize a number of theories to help people understand a specific problem in a particular setting


  • See page 145

Still Confused?

  • Don’t worry about it. You aren’t alone.


  • The backbone of the processes used to plan, implement, and evaluation health promotion interventions

  • A theory-based approach provides direction and justification for program activities and serves as a basis for processes that are to be incorporated into the health promotion program


Minnesota Heart Health Program

Theories Used

Social Learning Theory

Communication-persuasion model

Model of innovation diffusion

Community development

Problem-behavior theory

Theories and HP Programs


Stanford Five-City Project

Theories Used

Social Learning Theory

Theory of Reasoned Action

Communication-persuasion model

Model of innovation diffusion

Theories and HP Programs

Behavior Change Theories

Stimulus-Response (SR) Theory:

  • Classical conditioning

  • Instrumental conditioning

  • Reinforcement

  • Punishment

  • Positive reinforcement

  • Negative reinforcement

  • Positive punishment

  • Aversive stimulus

  • Negative punishment

Behavior Change Theories

Social Cognitive Theory (SCT)

  • A.k.a. Social Learning Theory (SLT)

  • Albert Bandura

  • Learning occurs primarily through modeling and reinforcement

  • Self-efficacy

  • Efficacy expectations

  • Outcome expectations

Behavior Change Theories

Theory of Reasoned Action (TRA)

  • Fishbein & Ajzen, 1975

  • Attitude, belief, behavioral intention, and behavior

  • Incorporates the notion that individuals will behave, in part, because of how they believe significant others would have them behave (subjective norm)

Behavior Change Theories

Theory of Planned Behavior (TPB)

  • Extension of TRA

  • Incorporates the dimension “perceived behavioral control” as a determinant of intention. Can I do this? Am I in control?

  • What would Bandura call this?

  • Self-efficacy

Behavior Change Theories

Theory of Freeing (TF)

  • Friere (1973, 1974)

  • Empowerment

  • The task of health education should be to free people so they may make health-related decisions based upon their needs and interests

Health Behavior Models

Health Belief Model (HBM)

  • Frequently used

  • Based on Lewin’s decision making model

  • Probability of behavior change (likelihood of action) is based on perceived threat of a particular disease which depends on a number of factors

  • See p. 154

The Elaboration Likelihood Model of Persuasion (ELM)

  • Petty, Barden & Wheeler, 2002

  • Designed to explain how persuasion messages (communications) aimed at changing attitudes were received and processed by people

  • Elaboration = the amount of effortful processing people put into receiving messages

  • See p. 160

Transtheoretical Model (TTM)

Transtheoretical Model (TTM)

  • Stages of Change

    Precontemplation, contemplation, preparation, action, maintenance

  • Decisional Balance

    Pros, cons of changing

  • Self-Efficacy

    Confidence to change; temptation to engage in unhealthy behaviors

  • Processes of Change

    Consciousness raising; Self-reevaluation; Self-liberation; Reinforcement; Stimulus control; etc.

Transtheoretical Model (TTM)

Cognitive-Behavioral Model of the Relapse Process

  • For most people, relapse is a part of change

  • Relapse is a failed attempt to change or modify a particular habit pattern or adopt a new optimal health behavior

  • Lapse is a single slip or mistake

  • Relapse prevention (RP) training helps people anticipate and cope with the problem of relapse in the habit-changing process (see pp. 161-163)

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