A Review of Current Health Education Theories. Part 3
All of these theories seek to interpret or analyze health behaviors at the individual level, where intention is independent of the overt actions of others. Among this group of theories, Festinger’s (1957) Cognitive Dissonance theory is noticeably different. Festinger’s work does not focus on outcome expectation or threat, but instead focuses on the consonance between thought and action. Festinger posited that when this equilibrium is disrupted, one acts to restore the balance. Either the behavior or the attitude must change so that they are in concert with one another. The remaining theories make outcome expectations explicit as constructs, by assessing health threats, susceptibility, and the potential for efficacy of action.
Among the interpersonal health behavior models are Alfred Bandura’s Social Cognitive Theory (Bandura & Walters, 1963; Bandura, 1969, 1977a, 1977b), H. C. Triandis’ Theory of Interpersonal Behavior (1977, 1980, 1994, 1995), the combined works of Gordan Caplan (1974), S. Cobb (1976), J. S. House (1981), R. L. Kahn and T. C. Antonucci (1980) in social support, and coping, the works of Barbara S. Wallston, Kenneth A. Wallston, Gordan D. Kaplan, and S. A. Maides (1976; Wallston Maides, & Wallston (1976).) concerning Locus of Control, and Richard Petty & John Cacioppo’s Elaboration Likelihood Model (Cacioppo, 1979, 1981, 1986, 1986a; Cacioppo & Petty, 1979). These theories move one step beyond the individual health behavior theories to consider the influence of other persons on health behavior. These theories share several concepts not only with the group theories, but also with the individual health theories.
Social systems, the third category of theory to be reviewed, included two articles concerned with social systems theory. One article specifically addressed General Systems Theory, which was first conceived by L. Von Bertalanffy (1950), (International Society for the Systems Sciences, n.d.). Dr. Bertalanffy was a biologist and a renowned theorist in the early 20th century. The General Systems Theory addresses the complexities and solutions of virtually every scientific field (International Society for the Systems Sciences, n.d.), but for our purposes in health education, it is applied to the socio-cultural and psychological domains (Von Bertalanffy, 1976), and more specifically, to the field of social marketing (Sirgy, 1984).
The fourth grouping of health behavior theories contains what are referred to as stage theories. Piaget’s Child Development Theory (Jean Piaget Society, n.d.) describes children’s developmental stages from birth through age fifteen. Green’s Precede-Proceed Model (Green & Kreuter, 1991) is a comprehensive staged program planning model, extending from needs assessment through outcome evaluation. Only the final three models, Prochaska and DiClemente’s Transtheoretical Model (Glanz, Lewis, & Rimer, 1997; Kreuter & Lezin, 2002; Zimmerman, Olsen, Bosworth, 2000), Rogers’ Diffusion of Health Promotion Innovation (1983), and Weinstein’s Precaution Adoption Model (1988), are concerned directly with following or predicting the progress of adoption of behavior changes.