PUH 5304, Health Behavior 1 Course Learning Outcom

PUH 5304, Health Behavior 1
Course Learning Outcomes for Unit VI
Upon completion of this unit, students should be able to:
5. Examine health behavior intervention strategies.
5.1 Assess the many aspects that accompany intervention
planning such as goals and objectives,
setting, community resources, and timelines.
5.2 Identify an intervention strategy that relates to intervention
implementation within a community.
Course/Unit
Learning Outcomes
Learning Activity
5.1
Unit Lesson
Chapter 12
Unit VI Assignment
5.2
Unit Lesson
Chapter 12

Unit VI Assignment
Reading Assignment
Chapter 12: Translating Research to Practice: Putting “What
Works” to Work
Unit Lesson
In Unit V, we addressed how theories and models such as the
social cognitive theory, the health behavior
model, and the theory of planned behavior play a role in
intervention planning. This unit, we will build on the
foundation of theories and models and look at how to be
strategic in determining interventions. The reading
highlights the concerns that health educators should have as it
relates to the design and evaluation process to
determine the successfulness of interventions for a given health
behavior.
Intervention Strategizing
When a health educator is developing an intervention strategy to
help with a particular health behavior, there
are a few key factors to consider: identifying the target
population, selecting a setting, setting goals and
objectives, and identifying resources and a timeline. Each of
these factors are a concern for health educators
when developing interventions (Powell et al., 2017).
Target population: Who are you planning the intervention for?
Are there any special needs? For instance,
adolescents have special needs because they are in school

during the day, so an intervention for them would
need to be after school, on the weekend, or through the school.
An intervention for seniors should be held
during the day because seniors normally shy away from being
out at dusk or dark. If the intervention were for
the working population, there would be better attendance in the
evenings or weekends. The goal with
determining the population for the intervention is to think of
alleviating any barriers that may affect most of the
population (Powell et al., 2017).
Setting: Where will the intervention be held? Is there handicap
access for seniors or elevator accessibility? Is
the location easily accessible? Is there public parking? What is
the room reservation process? Is the setting
outdoors, and if so, are there backup plans in case of bad
weather? As the health educator, you should take
into account the best setting to meet the needs of the population
that has been identified (Nilsen, 2015).
UNIT VI STUDY GUIDE
Interventions for Health Behavior
UNIT x STUDY GUIDE
Title

Goals/Objectives: The health educator should be clear on the
goals and objectives of the intervention
(Eldredge, Markham, Ruiter, Fernandez, Kok, & Parcel, 2016).
The intervention goal is the intended behavior
outcome. This includes examples such as quitting smoking,
lowering blood pressure, lowering A1C levels,
increasing food access or decreasing teen pregnancy. The
objectives are the steps that will be taken to meet
the goals. Offering coaching is an objective for the goal to quit
smoking. Eating a healthy diet is an objective
to reach the goal to lower blood pressure, increasing physical
activity is an objective for lowering A1C levels,
adding bus routes to local grocers is an objective to increasing
food access, and implementing a sex
education course for adolescents is an objective to decreasing
teen pregnancy. A health educator should be
concerned with making clear and SMART goals (specific,
measurable, attainable, realistic, and timebound).
Resources: The health educator should be concerned with
resources when it comes to interventions.
The health educator has to determine staff availability to assist
with the intervention, community
resources that complement the intervention, as well as funding
that will support the planned intervention.
Many resources could be available for interventions such as
parent volunteers, grant funds, corporate
donations, and free spaces. A successful intervention is
implemented in conjunction with resources that
support the goals and objectives of the intervention (Nilsen,
2015).
Timeline: The timeline of an intervention can also be a concern

for health educators (Eldredge et al.,
2016). As a health educator, setting time goals should always be
a component that is considered. The
health educator has to set a time frame on how long it will take
to meet goals and objectives, and often
timing is related to resource availability. For instance, if a
health educator is offering a health behavior
intervention in the school setting, there is about a nine-month
window to deliver the intervention because
schools recess for summer for approximately three months each
year. Thus, the time it will take to market
the intervention, implement the intervention, and collect data
for the intervention has to be done within the
nine months. Health educators are also concerned with the
timing relating to funding for health
interventions. If a health educator receives a grant to implement
a health intervention, the grant may have
its own timeframe to consider as well.
Health Professional Interview
In this unit, we interviewed Dr. Caira Boggs, PhD, MCHES to
get additional insight of factors to consider when
implementing behavior change programs. Dr. Boggs is currently
lead faculty for Master of Public Health
Programs at Columbia Southern University and contributes at a
nonprofit hospital in the community health
and outreach department. Caira is a Master Certified Health
Education Specialist (MCHES) and certified
Intrinsic Health Coach. She holds a Doctor in Health Education
from A.T. Still University, a Master of Exercise
Science in Health Science from Oakland University and a
Bachelor of Science in Human Movement Science
from Bowling Green State University. Caira has worked in the
health and wellness industry for the past 16

years. She is an advocate for healthy living at any age.
(Vaeenma, n.d.)
UNIT x STUDY GUIDE
Title
Click here to listen to the interview.
Click here to view the transcript.
Bringing it All Together

A health educator’s strategic process for picking interventions
plays a key role in the successfulness of
behavior change. As noted in many of the models and
framework applications for intervention planning,
strategizing is cyclical in nature. The evaluation process is a
part of the cyclical process to highlight the
strengths of the intervention as well as the weakness, which will
be covered in the next unit. It assists in
seeing what should remain and what should be tweaked before
beginning the cycle all over again.
References
Eldredge, L. K. B., Markham, C. M., Ruiter, Fernandez, M. E.,
R. A. C., Kok, G., & Parcel, G. S. (2016).
Planning health promotion programs: An intervention mapping
approach (4th ed). Hoboken, NJ:
Wiley.
Nilsen, P. (2015). Making sense of implementation theori es,
models and frameworks. Implementation
Science, 10(1), 53. doi:10.1186/s13012-015-0242-0
Powell, B. J., Beidas, R. S., Lewis, C. C., Aarons, G. A.,
McMillen, J. C., Proctor, E. K., & Mandell, D. S.
(2017). Methods to improve the selection and tailoring of
implementation strategies. The Journal of
Behavioral Health Services & Research, 44(2), 177–194.
doi:10.1007/s11414-015-9475-6

Vaeenma. (n.d.). SMART goals (ID 85663874) [Image].
Retrieved from https://www.dreamstime.com/stock-
photo-smart-goals-presenting-diagram-image85663874
Learning Activities (Nongraded)
Nongraded Learning Activities are provided to aid students in
their course of study. You do not have to submit
them. If you have questions, contact your instructor for further
guidance and information.
In this unit, we heard from Dr. Caira Boggs, a professional in
the field of health education. As a student,
consider the importance of hearing from someone already in the
field of health. What did you learn? What
could you take away from the interview and apply to your own
life?
https://online.columbiasouthern.edu/bbcswebdav/xid-
111890338_1
https://online.columbiasouthern.edu/bbcswebdav/xid-
111890318_1

Course Learning Outcomes for Unit V
Upon completion of this unit, students should be able to:
1. Appraise the theoretical models used to define health
behavior principles.
1.1 Apply the best theory/model to a chosen health issue.
1.2 Analyze the role of a health professional when identifying
theories and models to be applied to
health issues.
Course/Unit
Learning Outcomes
Learning Activity
1.1
Unit Lesson
Chapter 7
Unit V Assignment
1.2
Unit Lesson
Chapter 7
Unit V Assignment
Reading Assignment
Chapter 7: Social Cognitive Theory Applied to Health Behavior

Unit Lesson
In the previous unit, we took an in-depth look at the
transtheoretical model of change (TMC) and the role that
it plays in health behavior. The TMC is only one of many
models and frameworks that are related to health
behavior. The reading in this unit goes in-depth on the social
cognitive theory (SCT) which relates individuals
and their environment to their health behavior. In additional to
the SCT, there is another model and another
theory that should be highlighted for their importance in health
behavior: the health belief model and the
theory of planned behavior.
Health Belief Model
The health belief model (HBM) focuses on a person’s belief of
if he or she is at risk of getting ill or having a
health issue. It is also based on how much he or she believes a
recommended health behavior will be
effective at preventing the illness or health issue. It is those
benefits that will predict the likelihood of a person
adopting a specific behavior (Glanz, Rimer & Viswanath, 2015).
The HBM was developed by social
psychologists at the U.S. Public Health Service in the early
1950s (DiClemente, Salazar, & Crosby, 2019).
The psychologists were trying to understand why people did not
participate in disease prevention strategies or
early detection screenings. In a clinical setting, the HBM has
been used to understand how patients
responded to the health symptoms they were having and why
they are or are not compliant with a physician’s
treatment orders (DiClemente et al., 2019). The psychological
and behavioral theories are at the foundation of
the HBM (Carpenter, 2010). There are two main aspects to the

model:
1. the desire to not want to get sick or the will to want to get
well if already sick, and
2. how much a person believes that taking a specific health-
related action will prevent him or her from
getting sick or turning a health issue around that he or she may
already have (Carpenter, 2010).
In a nutshell, the HBM focuses on the idea that the health
behavior a person chooses to engage in depends
upon a person’s perception of the benefits and barriers he or she
will encounter if a specific health behavior is
chosen. The HBM is comprised of six constructs; the first four
were a part of the original model when it was
UNIT V STUDY GUIDE
Health Behavior Models and Theories
UNIT x STUDY GUIDE
Title
developed in the 1950s. These constructs include perceived
susceptibility, perceived severity, perceived

benefits, and perceived barriers (Carpenter, 2010). After
additional research and application of the model, the
final two constructs were added: cue to action and self-efficacy
(Carpenter, 2010). Below you will find more
information about each construct.
Perceived Susceptibility: This phase looks at a person’s view of
the likelihood that an illness or health disease
is currently, or will in the future, directly affect him or her
(Carpenter, 2010).
Perceived Severity/Seriousness: This phase is involved with a
person’s view of how severely he or she will be
affected by an illness or health disease if he or she does not
participate in the health-promoting behavior
(Carpenter, 2010). For instance, will the health disease or
illness kill them, will it cause uncomfortable living
for the rest of their life, will it cause them pain for a long time,
will it cause them pain for a short period or will it
only be an ache?
Perceived Benefits: This phase of the model looks at a person’s
belief about how effective the actual health
promoting behavior will be toward preventing or alleviating the
health issue (Carpenter, 2010). This is the idea
that one takes into consideration about how effective the health-
promoting behavior will be in mitigating
health-related problems, as well as if the health issue will be
severe enough to warrant action.
Perceived Barriers: This phase is involved with a person’s
assumption of the barriers he or she will be faced
with if they participate in the health-promoting behavior
(Carpenter, 2010). A barrier could be physical, social,

or psychological.
Cues to Action: These are nudges or prompts that a person may
need to begin working toward the specific
action of participating in the health-promoting behavior
(Carpenter, 2010). A nudge could be learning that a
close friend or relative was negatively affected by a health
condition or it could be seeing a friend or loved one
successful at sticking with a health-promoting behavior.
(Laurenhan, 2013)
UNIT x STUDY GUIDE
Title
Self-Efficacy: This is one’s own belief of his or her ability to
follow through with the health-promoting behavior
(Carpenter, 2010). If people think that they cannot stick with
the health-promoting behavior, that it will be
difficult, or they think they will fail, it is less likely that they
will begin engaging in the health-promoting
behavior.
Health Belief Model Limitations
Just like with anything, there are limitations to models and

theories. When determining which model or theory
to apply to health behaviors, it is important to know the
limitations. There are a few limitations of the health
belief model, which may include that it:
determinants of health such as economic,
educational, or environmental factors
(later in the course we will discuss in more detail about the
effects of social determinants);
relates to their decision-making
process to adopt a health behavior;
affect him or her adopting a specific
health behavior;
acceptability and the relationship of what is
acceptable with a person adopting a health behavior;
the health issues;
change; and
benefits of health are the main goal of a
person adopting the health behavior
(DiClemente et al., 2019)
Theory of Planned Behavior

The theory of planned behavior (TPB) first started as the theory
of reasoned action in the early 1980s
(DiClemente et al., 2019). The theory of reasoned action
predicted a person’s intentions of engaging in a
specified behavior at an exact time and place. The original goal
of the theory was to explain any behaviors
that a person could apply self-control. TPB’s key aspect of this
theory is intent; a person’s intended behaviors
are influenced by his or her attitude toward the likelihood that
the engaged behavior will have the outcome he
or she expects. This also includes how the person views the
risks and benefits of the outcome. TPB rests on
the premise that a person adopting a health behavior is
dependent on his or her motivation (intentions) and
ability (behavior control) (McEachan, Conner, Taylor, &
Lawton, 2011). This theory takes into account three
beliefs: behavioral, normative, and control. The TPB has five
parts: attitude, subjective norms, perceived
behavioral control, intention, and behavior. (McEachan et al.,
2011):
(Orzanna, 2015)
UNIT x STUDY GUIDE
Title

Attitude: This portion of the theory is related to the outlook one
has about how enticing or unenticing the end
behavior is (McEachan et al., 2011).
Subjective norms: This portion of the theory is related to the
outlook of approval or disapproval one may have
about the given behavior, as well as how they will be viewed by
peers if they do or do not engage in the
behavior (McEachan et al., 2011).
Perceived behavioral control: This portion of the theory refers
to one’s view of how easy or difficult it will be to
engage in the specific behavior (McEachan et al., 2011). This
control can change depending on different
situations that a person is in or the specific actions they have
taken, leading to them having a magnitude of
assumptions about the behavior. This aspect of the theory was
not always included, but was later added to
the theory.
Intention: This portion of theory is related to the intention one
have of carrying out a behavior; the stronger
ones’ intention, the more likely it is that he or she will follow
through to behavior (McEachan et al., 2011).
Behavior: This portion of the theory is the end goal/outcome
(McEachan et al., 2011).
Theory of Planned Behavior Limitations
A few limitations that have been noted with TPB. There are
limitations in the way the theory.
successful in adopting the health

behavior whether planning to adopt the health behavior or not.
s economic,
educational, or environmental factors
that could influence a person’s attitude toward the health
behavior; however, it does consider
normative influences.
behavior results from a linear decision-
making process that does not change over time.
in a specific health behavior and actively
participating in the health behavior.
ons play in adopting a
health such as a person’s experiences,
fears, motivation, or their current mood.
Putting it All Together
The theories and models presented in this unit have their pros
and cons as well as their own special place
depending on the person that needs to adopt a health behavior.
As with the information presented on the SCT
in the textbook, it is important to note the limitations to theories
and models in order to understand the
constraints of each as you apply them. It is also essential to
point out that the models and theories discussed
in this unit evolved from their initial intent by the developer(s).
It is important to understand that health
behavior theories and models are foundational. As a public
health professional, you can use the bases of the
models and theories and add additional components that fit your

own goal. By doing so, you could come up
with the next evolution of a model or theory of your own.
References
Carpenter, C. J. (2010). A meta-analysis of the effectiveness of
health belief model variables in predicting
behavior. Health Communication, 25(8), 661–669.
doi:10.1080/10410236.2010.521906
DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2019).
Health behavior theory for public health: Principles,
foundations, and applications (2nd ed.). Burlington, MA: Jones
& Bartlett Learning.
Glanz, K., Rimer, B. K., Viswanath, K. (Eds.) (2015). Health
behavior: Theory, research, and practice (5th
ed.). Hoboken, NJ: Wiley.
UNIT x STUDY GUIDE
Title

Laurenhan. (2013). The health belief model [Image]. Retrieved
from
https://commons.wikimedia.org/wiki/File:The_Health_Belief_M
odel.pdf
McEachan, R. R. C., Conner, M., Taylor, N. J., & Lawton, R. J.
(2011). Prospective prediction of health-
related behaviours with the theory of planned behaviour: a
meta-analysis. Health Psychology Review,
5(2), 97–144. https://doi.org/10.1080/17437199.2010.521684
Orzanna, R. (2015). Theory of planned behavior [Image].
Retrieved from
https://commons.wikimedia.org/wiki/File:Theory_of_planned_b
ehavior.png

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