Health Education Research, Vol. 19, No. 3, 349-351,
June 1, 2004
© 2004 Oxford University Press
Book Reviews
Review of Emerging Theories in Health Promotion Practice and Research: Strategies for Improving Public HealthRalph J. DiClemente, Richard A. Crosby and Michelle C. Kegler (eds)
Jossey-Bass, San Francisco, CA, 2002
432 pp. ISBN 0-7879-5566-3 (hb)
According to renowned social psychologist Kurt Lewin, ‘Nothing is as practical as a good theory’, and there are many from which to choose. This new book highlights a number of emerging theories of health promotion. The book attempts to provide understanding of new developments in the fields of social and behavioral health sciences. The book achieves this through well-detailed descriptions of theory and practical applications. A major strength of the book is inclusion of a range of theories and concepts relevant to health education and health promotion practice. The theories come from a broad range of disciplines and are described through a variety of case studies incorporating a breadth of health issues (Radon Testing, HIV, Teen Driving, Nutrition, Child Immunization, General Health, Safe Sex behaviors, Tobacco). Individual chapters offer a good discussion of stage issues (Weinstein and Sandman), in-depth discussion of how communication-based theory applies to behavior change (Petty, Barden and Wheeler), and application of motivational theory to HIV prevention (e.g. Fisher and Fisher). The challenge to the reader, of course, is to figure out which theory is most useful for a given problem and how then to apply it.
As with any edited volume, the chapters are variable in length and format, but most are well written and informative. In some cases critical issues are not adequately addressed, making it difficult for the reader to make informed decisions about the utility and applicability of the theory. Generally, very little information is provided on approaches to the measurement of constructs. Subjective versus objective measures and qualitative versus quantitative techniques require different capacities, resources and affect research design. Only some chapters provide a discussion of the strengths and weaknesses of the theory, and few discuss ethical implications, which should be an implicit concern when considering theory application.
The aforementioned limitations notwithstanding, this book also offers theoretical underpinnings of how existing vehicles for delivering public health interventions work (coalitions, Butterfoos and Kegler; and community capacity, Norton, McLeroy, Burdine, Felix and Dorsey). Several theoretical applications of social approaches are described, including theories using existing structures (parenting, Simons-Morton and Hartos; and natural community helpers, Eng and Parker) and the creating of new structures (coalitions, Butterfoos and Kegler; and community capacity, Norton et al.) to impact health. Several of these theories are interrelated (e.g. community capacity, social capital, community coalitions, etc.). Only time (and empirical investigations) will tell if they are indeed separate or components of a larger integrated model. Prevention marketing (although limited in its title; Kennedy and Crosby) is one example of a logical integration of complementary approaches.
Relatedly, several chapters argue for a broader, multilevel approach to health promotion (Norton et al.; Kreuter and Lezin; Hovell, Wahlgren and Gehrman) due to the finite impact of individual-based behavior change theories. In fact, in the conclusion the editors note that this compilation of emerging theories ‘reflects a common movement toward less reliance on individual-based approaches and greater use of theories that account for social and contextual influences’ (p. 387). This reflects current trends in the health behavior change arena [e.g. (Sallis and Owen, 1997)]; however, the individual cannot be ignored as they are the target impacted by the social and contextual environmental constructs/changes and are the ultimate performers of the health behavior.
This book increases the breadth and completes the required reading for graduate-level classes dealing with aspects of health behavior change and health promotion, and spans various content areas (e.g. Social and Behavioral Health Sciences, Kinesiology, Nutrition, Health Psychology, Health Education, Community Health, Public Health, etc.). Practitioners will be interested in this book to attempt new approaches or to integrate their current programs with ideas presented in this book. Finally, this book provides research opportunities in terms of theory integration and theory comparison with existing theories (Nigg et al., 2002).
Department of Public Health Services and Epidemiology, John A. Burns School of Medicine, University of Hawaii at Manoa
References
1. 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.
2. Sallis, J.F. and Owen, N. (1997) Ecological models. In Glanz, K., Lewis, F.M. and Rimer, B.K. (eds), Health Behavior and Health Education: Theory, Research, and Practice, 2nd edn. Jossey-Bass, San Francisco, CA, pp. 403–424.
Tailoring Health Messages: Customizing Communication With Computer Technology
M. Kreuter, D. Farrell, L. Olevitch L and L. Brennan
Lawrence Erlbaum Associates, Mahwah, NJ, 2000
280 pp. ISBN 0805833870 (pb)
This book addresses a timely and highly relevant topic. Recent advances have created the technology to disseminate tailored communication on a mass scale. This book provides the ‘know-how’ to harness this technology to create, disseminate and evaluate tailored health communication. Although the technology is available to develop tailored health communications for a variety of channels (i.e. computer kiosks, the Internet, CD-ROM, etc.), the book focuses specifically on tailored print communication.
This book contains 270 pages, divided into 14 chapters. It begins with an overview of tailored health communication (Chapters 1, 2 and 3), and then focuses on specific topics related to the design (Chapters 4–6), development (Chapters 7–11), implementation (Chapter 12) and evaluation (Chapter 13) of tailored health communication. The final chapter (Chapter 14) discusses the future of tailored health communication.
Key topics emphasized in the book include discussions regarding the design and development of the tailoring questionnaire; the computer algorithm that determines the conditions under which specific messages are selected by the algorithm; the corresponding computer program that operationalizes the algorithm; staffing issues; and program implementation. The authors also provide a thorough discussion related to message design, including message content and presentation format. Critical issues related to program evaluation are also discussed in detail.
This book is timely, providing a step-by- step template for designing tailored print communications using current computer technology. Numerous tables, figures, graphics and examples located throughout the book enhance its message and add to its appeal. The book is informative, well researched and highly credible.
Strengths: the authors of this book are highly experienced and credible, with proven track records in tailored communication. It is comprehensive and addresses the critical concerns for successfully tailoring health messages. The book is well written and researched, including an extensive list of scholarly references. The index is well designed, making it fairly easy to locate topics of interest. Charts, tables, figures, graphs and other visual aids are numerous, and appear throughout the book.
Weaknesses: the layout and cosmetics detract somewhat from the overall appeal. Notably, the type is dense and the font small, making it difficult to skim the text. Some chapters contain few graphics. The book’s scholarly tone may be less appealing to readers not in research or academia.
This book is text-heavy. In an attempt to thoroughly review the topic, an extensive amount of detail is offered. Although someone familiar with the topic will find it valuable to have a comprehensive resource on tailoring health communication, it may be difficult for the novice to sort through the volume of information presented.
Suggestions for future editions of the book include using more sub-headings to break up large blocks of text; beginning each chapter with a clear description of its purpose; concluding each chapter with a summary of its main points, presented in bulleted format and expanding the content to include other forms of tailored health communication.
This is an excellent ‘how-to’ guide for anyone interested in designing effective tailored health communication messages. It serves as a comprehensive, well-designed guide for developing, implementing and evaluating tailored print communications. In this reviewer’s opinion, this book is a ‘must-have’ resource for both experienced and novice practitioners interested in tailored health communication.
Children's Nutrition Research Center, Baylor College of Medicine
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