A Review of Current Health Education Theories. Part 2
The purpose of this article is to provide an overview of the theories and models currently being used in the field of health education. To address the issue of currency, the author reviewed theory- based articles published in 2003 in the following journals: the American Journal of Health Education, American Journal of Health Behavior, Health Education and Behavior, Health Education Research, and the International Electronic Journal of Health Education. Seventeen different theories were used to explain a wide variety of human behaviors, including pedestrian safety, physical activity, obesity, drug use, sexual behaviors, violence, vaccinations, organizational challenges, osteoporosis prevention, condom use, alcohol abuse, racial, ethnic and gender disparities, leisure activities, sunscreen use, use of complimentary and alternative medicine, tobacco use, sugar restriction, nutrition education, smoking, chronic illness management, hormone replacement therapy, soft drink consumption, environmental policy, family planning, and screening for colorectal cancer. These articles have been indexed in Appendix A, according to their theoretical base.
Some of the articles reviewed have their base in more than one theory or model. In 2003, stage theories/models were used most frequently. The Transtheoretical Model/ Stages of Change Theory served as a base for 17 articles, while the Theories of Reasoned/Action and Planned Behavior were the focus of 12 articles. Social Cognitive Theory/Social Learning Theory, which is used for understanding interpersonal health behavior was a base for 11 of the articles. The rest of the theories were cited five times or less. These include the Diffusion of Innovation Theory (five), Social Support/Social Capital (four), Health Belief Model (four), Coping Theory (two), Organizational Theory (two), and the remaining theories with one article each– Cognitive Dissonance Theory, the Elaboration Likelihood Model, Locus of Control, Piaget’s Theory of Child Development, the Precaution Adoption Model, the Precede-Proceed Model, Protection Motivation Theory, Systems Theory, and the Theory of Interpersonal Behavior. Three theories/models, the Transtheoretical Model alternatively known as the Stages of Change Theory, the Theory of Reasoned Action/Planned Behavior, and the Social Cognitive or Social Learning Theory, accounted for over half of the theoretical applications in these selected health education journals. Therefore, within this article, we will focus on these three theories/models. But first, we will examine four distinct categories of health theories and models: individual health behavior, interpersonal health behavior, group intervention, and staged models and theories.
The individual health behavior theories include Godfrey Hochbaum and Irwin Rosenstock’s, Health Belief Model (Strecher & Rosenstock, 1997), Leon Festinger’s Cognitive Dissonance Theory (1957; Glanz, Lewis, & Rimer, 1997), Icek Ajzen and Martin Fishbein’s Theory of Reasoned Action (1969, 1970, 1977, 1980; Ajzen, 1988, 1991) which in 1988 was extended to the Theory of Planned Behavior (Ajzen, 1988, 1991), and R. W. Rogers’ Protection Motivation Theory (Maddux & Rogers, 1983, Rogers, 1983, as cited in Brouwers & Sorrentino, 1983).