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Social and Behavioral Theories

6. Theory Use in Intervention Research

Recently, several reviews have examined which theories were used in health behavior intervention research and whether theory-based strategies are positively associated with desirable outcomes. Table 2 summarizes 11 systematic reviews published since 2000 – most within the past three years – that reported on theory use and in several cases, the effects of using theories for intervention design. They cover a range of behavioral topics: dietary fat and fruit and vegetable intake; cancer screening; injury prevention; HIV-related sexual risk behaviors; and contraception. These reviews also examined tailored print and computer-based interventions.

Table 2

Reviews of Theory Use in Health Behavior Intervention Research

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Table 1: Reviews of Theory Use in Health Behavior Intervention Research

Table 2

Reviews of Theory Use in Health Behavior Intervention Research

Article Topical Focus Theories Used Comments
Ammerman et al., 2002 Dietary fat, fruit and vegetable (F&V) consumption Theory use yes/no; SCT constructs (goal setting); social support Using a theoretical basis was associated with greater fat reduction and higher F&V intake Goal setting, family and social support strategies more effective
Legler et al., 2002 Mammography promotion in historically underserved groups Theory used in 68.4% of included studies. Most-used: HBM, TTM, SCT, PRECEDE/PROCEED Strongest interventions were access-enhancing, consistent with SCT, HBM and ecological model.
Trifiletti, Gielen, Sleet & Hopkins, 2005 Unintentional injury prevention research Most-used: TRA/TPB, HBM, PRECEDE/PROCEED Model. Theories were not well-represented in injury prevention research from 1980 to 2001
Noar, Benac & Harris, 2007 Tailored print health behavior change interventions TTM/stages of change, HBM, TRA/TPB, most used. Nearly every study tailored on at least one theoretical concept Tailoring with 4-5 concepts yielded larger effect sizes than tailoring on 0-3 concepts. Nearly all studies that tailored on theoretical constructs had larger effect sizes
Joronen, Rankin & Astedt-Kurki, 2008 School-based drama interventions SCT, TTM Use of social cognitive theory most common (role models, interaction, etc). Mostly positive effects found
Noar, 2008 Reducing HIV-related sexual risk behavior – review of 18 meta-analyses Most often mentioned: self-management, problem-solving training, skills training with SCT concepts 3 meta-analyses found theory-based strategies superior, 2 showed possible evidence, 2 were null or against theory-based components
Albada et al., 2009 Tailored information about cancer risk and screening Most-used were TTM, HBM, SCT, PAPM Review suggested that theory-based interventions are most effective
Lopez, Tolley, Grimes & Chen-Mok, 2011 Interventions for contraception (non-high-risk groups) SCT was the main theoretical basis in most trials Theory-based intervention groups had more positive results in majority of trials
Lustria, Cortese, Noar & Glueckauf, 2009 Computer-tailored interventions delivered over the web – various behaviors (diet, activity, alcohol, smoking) Most-used theories are SCT, TTM, TRA/TPB. Most studies indicated a theoretical framework. Use of multiple theories and concepts was common, because online computer-tailored strategies are more complex than print tailoring
Noar, Black, & Pierce, 2009 Computer technology-based HIV prevention interventions Theories used: SCT, TPB, Integrated Model of Behavior (IMB), TTM Interventions using TTM/stages of change and individual tailoring were most effective
Noar, Palmgreen et al., 2009 HIV/AIDS mass communication campaigns Mass communication theories used; message content based on HBM, SCT, TTM, TPB and others 44% of campaigns reported using theory, mainly for message design

** From Glanz & Bishop, Ann Rev PH 2010