Theoretical models of behaviour change

Many of the programmes surveyed in the meta-analysis by Dolores Albarracin were devised with a particular theory in mind about how people change their behaviour, and programmes that are theory-based have been shown in general to work better. Programmes devised without a consistent theory of behaviour change may offer subtly contradictory or antagonistic messages.

In a paper1 which used the same data as the Albarracin meta-analysis, it was found that experts trained in the theory and technique of at least one method of behaviour change produced better results when they led interventions than did briefly trained peer educators. There was one exception - peer educators worked at least as well with people under 21 as long as the educator was of the same gender and/or ethnicity as the group trained.

The theoretical models discussed here have been developed and tested by health psychologists and sociologists to explain how people change their behaviour and to aid the design of health-promotion activities. This section discusses the main theoretical models and their relevance to HIV prevention, and relates research literature on HIV prevention to these models.

HIV prevention is always based on a set of assumptions about the ways in which people make decisions about risks, and how they respond to attempts to persuade them to change their behaviour. Sometimes these assumptions are broadly correct, but sometimes researchers have discovered significant problems with such assumptions when they are tested.

The core difference between these theories is that they postulate different routes people travel in the process of changing their behaviour. Or, to put it another way, they give different weight to different drivers of behaviour, usually seeing one particular one as primary. These may be divided roughly into:

  • theories that see information about the health threat to be avoided as the main driver
  • ones that see the learning of behavioural and interpersonal skills as the main driver
  • ones that see social pressure and personal self-efficacy as the most powerful influences.

This is summarised in a diagram from the Durantini paper:

References

  1. Durantini MR Conceptualizing the Influence of Social Agents of Behavior Change: a Meta-Analysis of the Effectiveness of HIV-Prevention Interventionists for Different Groups. Psychological Bulletin 132, No. 2, 212-248, 2006
This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.