Five roles for using theory and evidence in the design and testing of behavior change interventions
Article first published online: 18 MAR 2011
© 2011 American Association of Public Health Dentistry
Journal of Public Health Dentistry
Special Issue: Behavioral and Social Intervention Research Essentials
Volume 71, Issue Supplement s1, pages S20–S33, Winter 2011
How to Cite
Bartholomew, L. K. and Mullen, P. D. (2011), Five roles for using theory and evidence in the design and testing of behavior change interventions. Journal of Public Health Dentistry, 71: S20–S33. doi: 10.1111/j.1752-7325.2011.00223.x
- Issue published online: 18 MAR 2011
- Article first published online: 18 MAR 2011
- intervention studies;
- health behavior;
- research design
Objective: The prevailing wisdom in the field of health-related behavior change is that well-designed and effective interventions are guided by theory.
Methods: Using the framework of intervention mapping, we describe and provide examples of how investigators can effectively select and use theory to design, test, and report interventions.
Results: We propose five roles for theory and evidence about theories: a) identification of behavior and determinants of behavior related to a specified health problem (i.e., the logic model of the problem); b) explication of a causal model that includes theoretical constructs for producing change in the behavior of interest (i.e., the logic model of change); c) selection of intervention methods and delivery of practical applications to achieve changes in health behavior; d) evaluation of the resulting intervention including theoretical mediating variables; and e) reporting of the active ingredients of the intervention together with the evaluation results.
Conclusions: In problem-driven applied behavioral or social science, researchers use one or multiple theories, empiric evidence, and new research, both to assess a problem and to solve or prevent a problem. Furthermore, the theories for description of the problem may differ from the theories for its solution. In an applied approach, the main focus is on solving problems regarding health behavior change and improvement of health outcomes, and the criteria for success are formulated in terms of the problem rather than the theory. Resulting contributions to theory development may be quite useful, but they are peripheral to the problem-solving process.