Using Theory to Design Effective Health Behavior Interventions

From the Abstract of this journal article, appearing in Communication Theory, Volume 13 Issue 2, Pages 164 - 183: "This article demonstrates the usefulness of two theories for the development of effective health communication campaigns. The integrative model of behavioral prediction focuses on changing beliefs about consequences, normative issues, and efficacy with respect to a particular behavior. Media priming theory focuses on strengthening the association between a belief and its outcomes, such as attitude and intention toward performing the behavior. Both the integrative model of behavioral prediction and media priming theory provide guidance with respect to the selection of beliefs to target in an intervention. The article describes the theories, shows how they can be applied to the selection of target beliefs, and, for each theory, defines the criteria for belief selection. The two theories as well as their appropriate analytic strategies are complementary rather than conflicting."

The purpose of this document is to demonstrate the tools available through these two theories for identifying the specific beliefs one needs to address in order to change or maintain a given health behaviour. According to this document, the integrative model represents the view that changing beliefs can result in changing intentions. The media priming theory predicts that a strengthened association between beliefs and intention results in changed intention. The document intends to show the complementary contribution these theories can make to health communication campaign development.

In applying the integrative model, the first step is to identify the behaviour to be changed or reinforced, including the action (getting/using/buying), the target or object (mammograms/condoms), and the context (at the women's clinic/for professional sex workers). The element of time (in the next 3 months/before going to work) must be considered. It is then necessary to measure the intended population group's beliefs, attitudes, norms, self-efficacy, intention, and behaviour, by investigating the population; determining what influences their intention; and identifying differences in belief between those who do and do not perform the behaviour in question. The aim is to isolate and change specific beliefs about a health-related behaviour. The document establishes three criteria for selecting the belief to use as the focus of the health communication campaign: 1) the belief should be strongly related to the behaviour or intention one wishes to change; 2) there should be a sufficient portion of the population in focus that do not already hold that belief; and 3) one should assess whether the belief can be changed, through evidence and plausibility.

The theory of media priming suggests that exposure to a message increases access to information; and, the more accessible it is, the more it influences attitudes, norms, and self-efficacy. It doesn't require meeting the selection criteria of the integrative model; it assumes that exposure to a belief activates the belief. However, according to the document, a useful strategy may be to choose health messages from "primed" beliefs - those already held by the majority of the population (possibly through prior health messaging campaigns) - that also suit the criteria of the integrative model and the population chosen.

In conclusion, the theoretical models are described as complementary, offering tools for choosing beliefs for the focus of messages in health communication campaigns.