Abstract :
There is evidence that good theories are needed for explaining and predicting
health behavior. Also, it is common sense that theories are needed
for designing and evaluating interventions aiming at behavior change.
Although the history of testing, applying, and refining theories is long, controversial
debates about constructs and assumptions exist (Weinstein, 2007;
Schwarzer, 2008) and unresolved issues can be detected (Dombrowski,
Sniehotta, Avenell, & Coyne, 2007). In this sense, it is required that processes
in theories should be refined; theories should be empirically supported
(Weinstein, 2007), validated as productive, and made easier to use (Michie,
Rothman, & Sheeran, 2007). Generally, theories are needed to understand
what actually drives behavior change and to gather knowledge so that the
wheel is not reinvented.
This Special Issue stands as a collection of conceptual and empirical
articles using different theoretical approaches to explain and improve health
behavior change. What these approaches provide to the advancement of
theory and evidence-based practice will be discussed to direct new paths
toward improved theory-based interventions. The following articles make
conceptual and empirical contributions to the current debate on health
behavior theories.
The first contribution by Nigg, Borrelli, Maddock, and Dishman presents
a new model—the
Physical Activity Maintenance theory
. This theory incorporates
individual psychosocial variables (goal-setting, motivation, and selfefficacy),
as well as contextual variables of the environment and life stress,
which are discussed as triggers of relapse. Various methods of investigating
the theory’s assumptions are reported and these may also be used to test
other theories.
The second article provides a framework for comparing theories or to
evaluate progress within a theory. This is illustrated with the
TranstheoreticalModel
(TTM)—that has a history of about 25 years. The authors summarise
general criteria to investigate and evaluate theories, and review the
TTM in the light of these criteria, i.e. by applying a hierarchy of criteria to
the TTM.
In the third contribution, Velicer, Cumming, Fava, Rossi, Prochaska, and
Johnson discuss the shortcomings of traditional null hypothesis testing and
outline an alternative approach. This involves generating explicit
effect size
predictions
from theory that are then compared to the effect size estimates
and related confidence intervals. This quantitative method can also be used
for the evaluation of other theories.
Fourth, the fundamental problem that predictors of
behavior
are not
necessarily predictors of behavior
change
is illustrated in the contribution
by Skår, Sniehotta, Araújo-Soares, and Molloy, and potential solutions to
solve this problem are presented. Skar et al. used the
Theory of Planned
Behavior
as background in their study.
Article number five, by Plotnikoff, Lippke, Courneya, Birkett, and Sigal,
provides evidence for the utility of the
Social Cognitive Theory
in individuals
with either Type 1 or Type 2 diabetes. With a nested model approach,
differences and similarities of the two diabetes groups were investigated.
The sixth article, by Luszczynska and Tryburcy, evaluates the effects of a
self-efficacy intervention on exercise and deals with important disease
specific moderators (i.e. diabetes and cardiovascular diseases). The authors
used the Social Cognitive Theory as the basis for their intervention, and
investigated factors that
mediate and moderate intervention effects
.
The seventh contribution, by Michie, Johnston, Francis, Hardeman, and
Eccles, describes in detail how we can translate theories more effectively
into interventions by mapping theoretically derived behavioral determinants
to behavior change techniques. By reviewing numerous theories and techniques
of behavior change, the authors offer an
overview and systematisation
to link theory and behavior change techniques.
In contribution number eight, Mikolajczak, Kok, and Hospers apply
the
Intervention Mapping
approach to the development of a theory- and
evidence-based internet HIV prevention intervention. The authors outline in
detail practical strategies for designing interventions.
The last contribution, by Lippke and Ziegelmann, reviews the eight
articles in this Special Issue. Certain themes and findings of the articles are
discussed and their interrelations are reviewed to gain further insights into
the science of explaining and changing health behaviors
