“There is nothing as useful as a good theory!” Kurt Lewin
Behavior change is…• central objective of public health interventions andprimal goal of all prevention programs;• the motivational and actional reduction of risky (orhealth-compromising) behaviors in favor of theaugmentation and sustentation of health-enhancingbehaviors;• achieved through behavior change communication(BCC).
Then behavior change communication is…• a scientifically-informed effort, integrated into eachand every public health program;• an interactive process within the community;• aimed at developing positive behaviors that promoteand sustain behavior change;• carried out through specific messages andapproaches using a variety of communicationchannels.
The information deficit modelBasic Assumption:The adolescents would refrain from risky behaviorif they were provided with adequate informationdemonstrating that this behavior may causeserious harm to the body.Great! But…
The information deficit modelPrograms based solely on this objective didincrease knowledge as intended, but they wereevaluated as ineffective in terms of behaviorchange.
The affective education modelBasic Assumption:If a person develops stronger interpersonalresources (building self-esteem) and generalsocial competence (decision-making,communication, and assertiveness) he or shewould be able to avoid risky behavior, since he orshe would realize it as such.Great! But…
The affective education modelEvaluation of these programs demonstrated thatthey were almost as ineffective in reducing riskybehavior, as programmes based on theinformation deficit model. ?
Health belief modelBasic Assumption:If a person has a desire to avoid illness or toget well (value) and the belief that a specifichealth action would prevent illness(expectancy), then a positive behavioral actionwould be taken with regards to that behavior.
Health belief modelKey theoretical concepts in theadoption of healthy behavior:• Perceived susceptibility: Individuals considerthemselves at risk.• Perceived severity: Individuals consider the risk tohave serious consequences.• Perceived benefits: Individuals consider that takingactions will be beneficial.• Perceived barriers: Individuals consider that costsare less than benefits.
Health belief modelIn the context of peer education:The most relevant concept in the health beliefmodel is that of perceived barriers. A peereducator could reduce perceived barriers throughreassurance, correction of misinformation,incentives and assistance.
Theory of reasoned actionBasic Assumption:The individual performance of a given behavior ispreliminary determined by a person’s intention toperform that behavior. The intention isdetermined by two major factors:
Theory of reasoned actionA person’s subjective beliefs and his or herbeliefs about the consequences of that behavior.A person’s normative beliefs, that is, how aperson’s view is shaped by the norms andstandards of his or her society and by whetherpeople important to him or her approve ordisapprove of the behavior.
Theory of reasoned actionIn the context of peer education:This concept is relevant because young people’sattitudes are highly influenced by their perceptionof what their peers do and think.Also, young people may be motivated by theexpectations of respected peer educators.
Diffusion of innovations theoryBasic Assumption:Social influence plays an important role in behaviorchange. The role of opinion leaders in a community,acting as agents for behavior change, is a keyelement of this theory. Their influence on groupnorms or customs is predominantly seen as a resultof person-to-person exchanges and discussions.
Diffusion of innovations theoryIn the context of peer education:The selected peer educators should betrustworthy and credible opinion leaders withinthe target group. The opinion leader’s role aseducator is especially important in informal peereducation, where the target audience is notreached through formally planned activities, butthrough everyday social contacts.
IMBR modelBasic Assumption:A sustainable health behavior can be achieved ifa person receives or develops:• the Information or the “What?”;• the Motivation or the “Why?”;• the Behavioral skills or the “How?”;• the Resources the “Where?”;needed for that behavior.
IMBR modelIn the context of peer education:This means that a programme that does not havea comprehensive approach including all fourIMBR concepts probably lacks essentialcomponents for reducing risky behavior andpromoting healthier lifestyles.
Social ecological model for health promotionBasic Assumption:According to this model, behavior is viewed asbeing determined by the following:•Intrapersonal factors•Interpersonal processes and primary groups•Institutional factors•Community factors•Public policy
Social ecological model for health promotionIn the context of peer education:This means that it is important to recognize thatpeer education is just one piece of the puzzle.While peer education can be an importantintervention to affect intrapersonal andinterpersonal change, in order to be successful,peer education activities must be coordinatedwith other efforts designed to influenceinstitutions, communities, and public policy.
Social learning theoryBasic Assumption:People learn through:• Through direct experience.• Indirectly, by observing and modeling thebehavior of others with whom the personidentifies.• Through training that leads to confidence inbeing able to carry out behavior (self-efficacy).
Social learning theoryIn the context of peer education:1. Тhis means that the inclusion of interactiveexperiential learning activities is extremelyimportant, and2. Peer educators can be influential teachers androle models.
Theory of participatory educationBasic assumption:The empowerment and full participation of thepeople affected by a given problem is a key tobehavior change.
Theory of participatory educationIn the context of peer education:Many advocates of peer education believe thatthe process of peers talking among themselvesand determining a course of action is a key to thesuccess of a peer education project.
Instead of conclusion… а question:Single theory or a theoretical framework?