Behavioral Theories

 

In order to develop a sound HIV prevention program, it is important that the intervention be based on sound behavioral theories. A theory is simply a series of facts with a relationship to one another. For example, the field of public health was founded when John Moss devised a theory that water had some connection to illness. He had noticed that people drinking out of one well got sick while those drinking from another well stayed well.

 

Theories can be used as tools to help program planners and educators better understand the influences upon human behavior and to understand the prerequisites, or necessary components for change. There are several theories that have been proposed to better understand the motivations behind health behavior.

 

Health Belief Model ? The premise for the Health Belief Model is that health related behaviors depend on four key beliefs about perceptions:

 

Perceived susceptibility: one is personally vulnerable to the condition.

?I could get HIV.?

Perceived severity: harm can be done by the condition.

?It would be really bad if I got HIV.?

Perceived benefits: a condition can be prevented.

?If I use condoms, I can protect myself from HIV.?

Perceived barriers: conditions will keep me from performing the behavior.

                        ?Using condoms would be a real mood breaker.?

 

Theory of Reasoned Action ? The basic tenant in the Theory of Reasoned Action is that in order for behavior change to occur, one must have an intention to change; intentions are influenced by two major factors - attitudes and subjective norms.

 

Attitudes toward the behavior: belief about performing the behavior, based on positive or negative consequences and evaluation of the consequences.

 

?If I asked my boyfriend to use a condom, I think he would get really mad.?

 

?Using condoms isn?t worth it if it makes my boyfriend made.?

           

Subjective norms about the behavior: what others think about performing the behavior and changing behavior based on what others think.

 

?My best friend thinks everyone should use a condom.?

 

?Since my best friend thinks using a condom is important, I will ask my boyfriend to use one.?

 

Social Learning Theory ? The Social Learning Theory proposes that behaviors are dynamic and influenced by both personal and environmental factors; behavior is learned through direct experience or by modeling others? behaviors through observation. Acquiring a new skill is often required. The chances of a behavior being repeated depend on the persons? assessment of its costs and benefits. The key components are:

 

Self-Efficacy: A person?s belief about his/her ability and confidence in performing a particular behavior, and belief that it can be done even under difficulty circumstances.

 

Outcome Expectations: The extent to which a person values the expected outcome of a specific behavior. A person?s belief about the positive or negative consequences of performing a particular behavior. It will be performed to the extent that it will lead to a positive outcome.

 

Skill Acquisition: Obtaining and/or in reasoning skills, either through direct experience or by modeling others.

 

Stages of Change (Transtheoretical) Model ? Proponents of the Stages of Change Model believe behavior change occurs in a series of stages. Movement through the stages varies from person to person and group to group. The process is not linear and often involves relapse. The key components are:

 

Pre-contemplation: No intention to change behavior; not aware of risks, or believe behaviors don?t place them at risk.

 

Contemplation: Recognizes behavior puts them at risk and is thinking of changing, but not committed to making that change

 

Preparation: Person intends to change risky behavior sometime soon and is actively preparing for it.

 

Action: Person has changed risky behavior recently, with change having occurred in the recent past.

 

Maintenance: Person has maintained behavior change for a long period of time and has adapted to the change.

 

Diffusion of Innovation: Process through which any new idea is communicated to members of a group or population, and at what stages of intervals over time people respond to and accept those messages. The key components are:

 

Communication channels: Methods of sharing information such as word of mouth, newsletters, flyers, advertisements, etc.