A Review of Current Health Education Theories. Part 4
Having reviewed the different groups of theoretical research currently being used in the specified health education journals this past year, let us turn to the three theories/models most frequently used therein. These include: The Transtheoretical/Stages of Change Model, the Theories of Reasoned/Action and Planned Behavior, and the Social Cognitive Theory/Social Learning Theory.
The Transtheoretical Model was first developed in 1983 by James O. Prochaska and C. C. DiClemente (Glanz, Lewis, & Rimer, 1997; Kreuter & Lezin, 2002). The model derives from the profession of psychology and addresses five stages of behavior change. Pre-contemplation is denial or not being aware that a behavior puts one at risk. As one develops awareness of the situation, he/she begins Contemplation of taking action, considering all of the factors that go into making the decision to change a behavior. Progressing to the Preparation phase, one might line up social support, make plans of action, and purchase necessary accoutrements. The Action phase is the actual adoption of the new behavior, and the Maintenance phase is where one works to keep their acquired behavior on-track. Maintenance is a lifelong process. There is interplay between the stages, as they are not linear. As with any behavior modification regimen, occasionally one may slip back into the maladaptive behavior. Once the slip occurs, one re-enters the process. This model has the advantage of acknowledging that these slips do occur, and preparing people for these occurrences. Slips are considered mere eventualities, as they are expected, and are not seen as catastrophic events that might lead one to abandon the positive health behaviors one is attempting to acquire. Next we will examine the Theory of Reasoned Action/Planned Behavior.
Ajzen and Fishbein’s Theory of Reasoned Action (1969, 1970, 1977, 1980) predates the eventual extension to the Theory of Planned Behavior by at least twenty years. These theorists began with the interesting notion that people behave the way that they do for a reason, and thus behavior is logical. If this holds true, we should be able to explain or predict human behavior. They began by positing that the best way to predict someone’s actions, is to ask them what they intend to do within a reasonably proximal time range. Behavioral intentions are thus the best predictors of human behavior. They determined that the best predictors of one’s stated behavioral intentions lie in attitude and subjective norm. According to Ajzen and Fishbein, one’s attitude is best predicted by examining what he/she expects to be the outcome of a particular action, and his/her evaluation of the likelihood of this outcome.