Health Education Research, Vol. 17, No. 5, 493-494,
October 2002
© 2002 Oxford University Press
EDITORIAL |
Improving the health of the public: a behavior-change perspective
Department of Health Behavior and Health Education School of Public Health University of North Carolina Chapel Hill, NC USA
This issue of Health Education Research provides 15 articles prepared by more than 40 researchers, primarily in the US, as part of an initiative to improve the science and the art of health promotion, largely from an individual behavior-change perspective. With funding from the National Institutes of Health (NIH), the Robert Wood Johnson Foundation and the American Heart Association, these projects, known collectively as the Behavior Change Consortium (BCC), represent an effort to expand health behavior-change research on such contemporary threats to health as tobacco dependence, lack of physical activity and poor diets. In addition to targeting multiple behavior change, the approaches described in this collection employ diverse theoretical perspectives, some of which are new to the field.
The rationale behind the BCC undertaking, as well as its long-term goals, are competently described in the introductory articles by Solomon and Kingston (Solomon and Kingston, 2002) and by Ory et al. (Ory et al., 2002
). Moreover, the summary article by Nigg et al. (Nigg et al., 2002) reviews some trans-study issues that the BCC initiative is attempting to address, issues that virtually all researchers in this arena confront. Hopefully, the lessons learned from the BCC undertaking will lead not only to more effective health-promotion programs, but also to more effective methods for mounting research in the area of behavior change.
The Editors of Health Education Research were interested in publishing the articles in this collection because they provided, among other things, an opportunity to have some of the leading individual behavior-change researchers in the US describe in detail how they used theory to inform their programs. Accumulating analytical work, in particular formal statistical meta-analyses, suggests that at least in some health behavior domains, theoretically informed programs are more effective than those that are not theory informed (Ratner et al., 2001). Given this, while there are important efforts to describe theories and their use in behavior-change programs (Glanz et al., 1997), the processes by which theories are selected, the methods by which abstract theoretical constructs are operationalized into program components and descriptions of how programs have their effects, from program component to behavioral outcome (Baranowski et al., 1997), are not well developed in the literature.
With the objective of adding to the literature on how theories can be used to inform interventions, as well as contributing to research that more specifically permits description of how such programs have their effects, the authors of the articles in this issue were asked to address the following topics:
- What theories or constructs were considered in developing the interventions, and why were some theories or constructs selected and others not.
- How were abstract theoretical constructs translated into concrete intervention program components and what problems were experienced in this process.
- How were program components expected to have an effect on the behaviors of interest, i.e. what were the mediating factors.
- In what ways do the approaches the researchers adopted make a contribution to better understanding the use of theory to inform behavior-change interventions.
To a large extent, these objectives have been achieved in these articles. We believe that in so doing, the articles in this theme issue will be of use to a variety of audiences, including students, researchers developing new programs and practitioners who want to better appreciate how theory can be used in developing more effective behavior-change programs.
Health Education Research has a tradition of publishing theory-informed interventions. Hopefully, in the process, we are contributing to the science and the art of using theory to develop more effective health-promotion and disease-prevention programs, whether the unit of intervention is the individual, the family, social groups, institutions or societies. The BCC collection of articles in this theme issue adds to this tradition by expanding our thinking about the use of theory to develop, implement and evaluate behavior-change approaches to improve the health of the public.
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 Top References |
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Solomon, S. and Kington, R. (2002) National efforts to promote behavior-change research: views from the Office of Behavioral and Social Research. Health Education Research, 17, 495–499.
Ory, M. G., Jordan, P. J. and Bazzarre, T. (2002) The Behavior Change Consortium: setting the stage for a new century of health behavior-change research. Health Education Research, 17, 500–511.
Nigg, C. R., Allegrante, J. P. and Ory, M. (2002) Theory-comparison and multiple-behavior research: common themes advancing health behavior research. Health Education Research, 17, 670–679.
Ratner, P. A., Bottoroff, J. L., Cook, R. and Lovato, C. Y. (2001) A meta-analysis of mammography screening promotion. Cancer Detection and Prevention, 23, 147–160.
Glanz, K., Lewis, F. M. and Rimer, B. (eds) (1997) Health Behavior and Health Education, 2nd edn. Jossey-Bass, San Francisco, CA.
Baranowski, T., Lin, L. S., Wetter, D. W., Resnicow, K. and Hearn, M. D. (1997) Theory as mediating variables: why aren’t community interventions working as desired? Annals of Epidemiology, 7 (S7), S89–S95.
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