Advancing Health Behavior Theory: The Interplay Among Theories of Health Behavior, Empirical Modeling of Health Behavior, and Behavioral Interventions

Intervention research aimed at modifying health behavior can go beyond merely assessing behavioral outcomes to characterizing the putative mechanisms by which interventions bring about behavior change. To characterize these mechanisms, a two-stage research program is required. The first stage involves the development and evaluation of a psychosocial model of the putative determinants of a particular health behavior. This may be a hybrid model that draws constructs from existing theories and models, and it may also integrate constructs from related areas of scholarship. The second stage involves translation of the psychosocial model into a multicomponent intervention to encourage behavior adoption. Here, each model construct is transformed into a component of the intervention and becomes a candidate mechanism by which the intervention may bring about behavior change. The intervention is evaluated in an experimental trial, followed by mediation analysis to examine putative linkages from the intervention to change on model constructs to change on behavior outcomes. This twostage approach is illustrated with examples of health behaviors aimed at disease detection and prevention, at distal and proximal threats to health, and at private and public health-related behaviors. Examination of the putative mechanisms by which interventions bring about behavior change reverses the flow of information from health behavior model to intervention. Instead, the findings from health behavior interventions can lead to theoretical advances in our understanding of health protective behavior.