Social and Behavioral Theories

8. Choosing the Right Theory

Public health experts at once benefit from and are challenged by the multitude of theoretical frameworks and models from the social sciences available for their use, because the best choices and direct translations may not be immediately evident.

Effective interventions and sound research both depend on marshalling the most appropriate theory and practice strategies for a given situation. Different theories are best suited to different units of practice, such as individuals, groups, and organizations. For example, when one is attempting to overcome women's personal barriers to obtaining mammograms, the Health Belief Model may be useful. The Transtheoretical Model may be especially useful in developing smoking cessation interventions. When trying to change physicians' mammography practices by instituting reminder systems, organizational change theories are more suitable. At the same time, physicians might use The Transtheoretical Model to inform their discussions with individual patients about getting a first mammogram or annual screening.

The choice of a suitable theory or theories should begin with identifying the problem, goal, and units of practice, not with selecting a theoretical framework because it is intriguing, familiar, or in vogue. One should start with a logic model of the problem and work backwards to identify potential solutions.