Effective community health education requires theories which combine the perspectives of behavior change at the levels of the individual with those at the levels of the community. Within the framework of reciprocal determinism, a variety of theories and concepts are integrated to understand behavior change at levels of the individual and levels of the community. These concepts are applied at each step in the behavior change process, and categories of intervention are explained within the proposed framework. A variety of specific intervention procedures are generated from the framework for promoting behavior change at each level and stage of change. Such a comprehensive integrated framework holds promise of designing more effective health education programs.
Get full access to this article
View all access options for this article.
References
1.
BettinghausE. P., Health Promotion and the Knowledge-Attitude-Behavior Continuum, Preventive Medicine, 15, pp. 475–491, 1986.
2.
WatkinsJ. D.WilliamsT. F.MartinD. A.HoganM. D., and AndersonE., A Study of Diabetic Patients at Home, American Journal of Public Health, 57, pp. 452–459, 1967.
3.
HaynesR. B.TaylorD. W., and SackettD. L. (eds.), Compliance in Health Care, The Johns Hopkins University Press, Baltimore, 1979.
4.
GochmanD. S. (ed.), Health Behavior, Emerging Research Perspectives, Plenum, New York, 1988.
5.
MatarazzoJ. D.WeissS. M.HerdJ. A.MillerN. E., and WeissS. M. (eds.), Behavioral Health, A Handbook of Health Enhancement and Disease Prevention, Wiley, New York, 1984.
6.
BanduraA., The Self-System in Reciprocal Determinism, American Psychologist, 33, pp. 344–360, 1978.
7.
WooleyS. C.BlackwellB., and WingetC., A Learning Theory Model of Chronic Illness Behavior: Theory, Treatment and Research, Psychosomatic Medicine, 40, pp. 379–401, 1978.
8.
HallC. S. and LindzeyG., Theories of Personality, (2nd edition), Wiley, New York, 1970.
9.
U.S. Department of Health and Human Services, The Health Consequence of Smoking: Cardiovascular Disease, A Report of the Surgeon General, DHHS Publication No. (PHS) 84-50204, U.S. Government Printing Office, Washington, D.C., 1983.
10.
HaskellW. L., Physical Activity and Health: Need to Define the Required Stimulus, American Journal of Cardiology, 44, pp. 4D–9D, 1985.
11.
BenowitzN. L.JacobP.IIIKozlowskiL.YuL., Influence of Smoking Fewer Cigarettes on Exposure to Tar, Nicotine, and Carbon Monoxide, New England Journal of Medicine, 315, 1310–1313, 1986.
12.
CialdiniR. B., Influence: Science & Practice, (2nd edition), Scott Foresman, New York, 1987.
13.
CohenS. and SymeL. (eds.), Social Support and Health, Academic Press, New York, 1985.
14.
CaplanR. D.RobinsonE. A. R.FrenchJ. R. P.Jr.CaldwellJ. R., and ShinnM., Adhering to Medical Regimes: Pilot Experiments in Patient Education and Social Support, Institute of Social Research, Ann Arbor, Michigan, 1976.
15.
BaranowskiT.BeeD.RassinD.RichardsonJ. D.BrownJ.GuentherN., and NaderP. R., Social Support, Social Influence, Ethnicity and the Breast-feeding Decision, Social Science and Medicine, 17: 21, pp. 1599–1611, 1983.
16.
PearceJ. W.LeBowM. D., and OrchardJ., Role of Spouse Involvement in the Behavioral Treatment of Overweight Women, Journal of Consulting and Clinical Psychology, 49, pp. 236–244, 1981.
17.
PettyR. E.OstromT. M. and BrockT. C. (eds.), Cognitive Responses in Persuasion, Lawrence Erlbaum, Hillsdale, New Jersey, 1981.
18.
AkamatsuR. J. and ThelenM. H., A Review of the Literature on Observer Characteristics and Imitation, Developmental Psychology, 10, pp. 38–47, 1974.
19.
FlayB. R.HansenW. B.JohnsonC. A.CollinsL. M.DentC. W.DwyerK. M.HocksteinG.GrossmanL.RauchJ.SobolD. F.SobelJ. L.SussmanS., and UleneA., Implementation Effectiveness Trial of a Social Influences Smoking Prevention Program Using Schools and Television, Health Education Research, 2, pp. 385–400, 1987.
20.
LeventhalH. and CameronL., Behavioral Theories and the Problem of Compliance, Patient Education and Counseling, 1988.
21.
LauR. R. and HartmanK. A., Common Sense Representations of Common Illnesses, Health Psychology, 2, pp. 167–185, 1983.
22.
DittoP. H.JemmottJ. B.III, and DarleyJ. M., Appraising the Threat of Illness: A Mental Representational Approach, Health Psychology, 7, pp. 183–201, 1988.
23.
SnowL. F., Folk Medical Beliefs and Their Implications for Care of Patients: A Review Based on Studies among Black-Americans, Annals of Internal Medicine, 81, pp. 82–96, 1974.
24.
WylieR. C., The Self Concept, University of Nebraska Press, Lincoln, 1974.
25.
WeinerB., Theories of Motivation, From Mechanism to Cognition, Markham, Chicago, 1972.
26.
BanduraA., Social Learning Theory, Prentice Hall, Englewood Cliffs, New Jersey, 1977.
27.
BaranowskiT.BeeD.RassinD.RichardsonJ., and PalmerJ., Expectancies Toward Infant-feeding Methods among Mothers in Three Ethnic Groups, Psychology and Health (in press).
28.
MischelW.ShodaY., and PeakeP. K., The Nature of Adolescent Competencies Predicted by Preschool Delay of Gratification, Journal of Personality and Social Psychology, 54, pp. 687–696, 1988.
29.
KuhlJ. and BeckmannJ. (eds.), Action Control, From Cognition to Behavior, Springer-Verlag, Berlin, 1985.
30.
LookerA. and ShannonB., Threat vs Benefits Appeals: Effectiveness in Adult Nutrition Education, Journal of Nutrition Education, 16, pp. 173–176.
31.
FishbeinM. and AjzenI., Belief, Attitude, Intention and Behavior: An Introduction to Theory and Research, Addison-Weseley, Reading, Massachusetts, 1975.
32.
BanduraA., Principles of Behavior Modification, Holt, Rinehart and Winston, New York, 1969.
33.
BanduraA., Self-efficacy: Toward a Unifying Theory of Behavioral Change, Psychological Review, 84, pp. 191–204, 1977.
34.
WeinerB., The Role of Emotions in a Theory of Motivation, in Motivation, Intention and Volition, HalischF. and KuhlJ. (eds.), Springer-Verlag, Berlin, pp. 21–30, 1987.
35.
AverillJ. R., The Role of Emotion and Psychological Defense in Self-protection Behavior, in Taking Care: Understanding and Encouraging Self-protective Behavior, WeinsteinN. D. (ed.), Cambridge University Press, Cambridge, pp. 54–78, 1987.
36.
LeventhalH., Findings and Theory in the Study of Fear Communications, in Advances in Experimental Social Psychology, Vol. 5, BerkowitzL. (ed.), Academic Press, New York, 1970.
37.
RogersR. W.DeckerC. W., and NewbornC. R., An Expectancy-value Theory Approach to the Long-term Modification of Smoking Behavior, Journal of Clinical Psychology, 34, pp. 563–566, 1978.
38.
KanferF. H., Self-management Methods, in Helping People Change, KanferF. H. and GoldsteinA. P. (eds.), Pergamon, New York, 1983.
39.
AbramsD. B.ElderJ. P.CarletonR. A.LasaterT. M., and ArtzL. M., Social Learning Principles for Organizational Health Promotion: An Integrated Approach, in Health and Industry, A Behavioral Medicine Perspective, CataldoM. F. and CoatesT. J. (eds.), Wiley, New York, pp. 28–51, 1986.
40.
PrestonM. A.BaranowskiT., and HigginbothamJ. C., Orchestrating the Points of Community Intervention: Enhancing the Diffusion Process, International Quarterly of Community Health Education, 9, pp. 11–34, 1988–89.
41.
JenkinsC. D., Health for All by the Year 2000: A Challenge to the Behavioral and Social Sciences, International Journal of Health Education, 1990 (in press).
42.
McLeroyK. R.BibeauD.StecklerA., and GlanzK., An Ecological Perspective on Health Promotion Programs, Health Education Quarterly, 15, pp. 351–377, 1988.
43.
GlanzK. and MullisR. M., Environmental Interventions to Promote Healthy Eating: A Review of Models, Programs and Evidence, Health Education Quarterly, 15, pp. 395–415, 1988.
44.
RogersE., Diffusion of Innovation, Free Press, New York, 1962.
45.
RogersE. and StoreyJ., Communication Campaigns, in Handbook of Communication Science, ChaffeeS. and BergerC. (eds.), Sage, Beverly Hills, California, 1987.
46.
RogersE. and KincaidD., Communication Networks: Toward a New Paradigm for Research, Free Press, New York, 1981.
47.
FloraJ. A.MaibachE. W., and MacCobyN., The Role of Media Across Four Levels of Health Promotion Intervention, Annual Review of Public Health, 10, pp. 181–201, 1989.
48.
BaranowskiT., Agency Coalitions for Targeted Service Delivery: Foiled Designs, Failed Environment, but Final Delight, International Quarterly of Community Health Education, 3, pp. 67–77, 1982–83.
49.
HornD., A Model for the Study of Personal Choice Health Behavior, International Journal of Health Education, 19, pp. 88–97, 1976.
50.
ParcelG. S. and BaranowskiT., Social Learning Theory and Health Education, Health Education, pp. 14–18, 1981.
51.
ProchaskaJ. O. and DiClementeC. C., Common Processes of Self-change in Smoking, Weight Control, and Psychological Distress, in Coping and Substance Abuse, SchiffmanS. and WillsT. (eds.), Academic Press, New York, pp. 345–363, 1985.
52.
ProchaskaJ. O.DiClementeC. C.VelicerW. F.GinpilS., and NorcrossJ. C., Predicting Change in Smoking Status for Self-Changers, Addictive Behaviors, 10, pp. 395–406, 1985.
53.
ProchaskaJ. O. and DiClementeC. C., Toward a Comprehensive Model of Change, in Treating Addictive Behaviors, MillerW. R. and HeatherN. (eds.), Plenum, New York, pp. 3–27, 1986.
54.
ProchaskaJ. O.VelicerW. F.DiClementeC. C., and FavaJ., Measuring Processes of Change: Applications to the Cessation of Smoking, Journal of Consulting and Clinical Psychology, 56, pp. 520–528, 1988.
55.
ProchaskaJ. O.VelicerW. F.DiClementeC. C.GuadagnoliE., and RossiJ. S., Patterns of Change: Dynamic Typology Applied to Smoking Cessation, Multivariate Behavioral Research, in press.
56.
RossiJ. S.ProchaskaJ. O., and DiClementeC. C., Processes of Change in Heavy and Light Smokers, Journal of Substance Abuse, 1, pp. 1–9, 1988.
57.
WilcoxN. C.ProchaskaJ. O.VelicerW. F., and DiClementeC. C., Subject Characteristics as Predictors of Self Change in Smoking, Addictive Behaviors, 10, pp. 407–412, 1985.
58.
BeckerM. H. (ed.), The Health Belief Model and Personal Health Behavior, Health Education Monographs, 2, pp. 324–508, 1974.
59.
WeinsteinN. D., The Precaution Adoption Process, Health Psychology, 7, pp. 355–386, 1988.
60.
BlockJ. H. (ed.), Mastery Learning, Theory and Practice, Holt, Rinehart, and Winston, New York, 1971.
61.
DeRisiW. J. and ButzG., Writing Behavioral Contracts, A Case Simulation Practice Manual, Research Press, Champaign, Illinois, 1975.
