Increase Your Odds of Success
Let me tell you a little secret. Shh! Don’t tell anyone else! OK? Here it is: Using a behavior change theory or model as the framework of your program or its evaluation greatly improves your odds of success.
Why? Because a theory/model provides you with a specific roadmap and helps you to be organized and systematic. If you select wisely, the building blocks (i.e., constructs) of your theory/model will serve as the basis for your program activities, measurement, and evaluation.
Let me tell you another secret. Using a theory/model as a framework for your program or its evaluation, increases the odds that your results will be able to be disseminated professionally. Why? Because reviewers of peer reviewed conferences and journals also know these secrets! They are greatly impressed when you use a theory/model. Furthermore, always remember this: If your results are disseminated professionally, you can appropriately tout these accomplishments and future grant reviewers will be impressed.
Definition of a Theory
What is a theory? Put simply, a theory presents a systematic way of understanding events, behaviors, or situations (Glanz, Lewis, & Viswanath, 2008). A theory specifies the relationship between and among constructs to explain and predict human behavior and situations.
I like what Nutbeam and Harris (1999) said about theories. They said that a theory should be able to explain . . .
- the major factors that influence the phenomena of interest. For example, which factors explain why some people receive an annual flu vaccine and why others do not? Which factors determine which clients will succeed in the program and which ones will not?
- the relationship between these factors. For example, a theory could explain the relationship between the source the person’s health information, knowledge, health risk appraisal, and beliefs. Or a theory could explain the relationship between outcome expectations, self-efficacy, outcome value and enrollment in college.
- the conditions under which these relationships do or do not occur – in other words, the how, when, and why of the hypothesized relationships. For example, why and how does a person’s source of information and his/her risk appraisal predict or explain whether he/she gets a vaccine? Under what conditions does a young person’s outcome expectations, self-efficacy, and outcome value determine his/her enrollment in college?
We believe that our clients should have these factors delineated for their programs or services. Do you agree?
Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education:
Theory, research, and practice. Jossey-Bass.
Nutbeam, D. & Harris, E. (1999). Theory in a nutshell. McGraw-Hill.
How to Select the Best Theory or Model for Your Framework
How do you select a theory that is a good match for your program or service and priority population? First, you really need to know the theories/models in the field of health behavior or hire someone who does.
Below, the 1795 Group has provided you with six excellent ways of selecting a theory/model that would fit your application:
- Story: What was the story behind the development of the theory or model? Why was it created? To study what? Among whom? Is its original purpose a good fit for your program and priority population? If not, then why use it? For example, what’s the story of how the Health Belief Model (HBM) was developed? Knowing the original story, do you think that the HBM be a good choice to use as the framework for a healthy eating program for dependent kids? Why? Why not?
- Assumptions: What assumptions does the theory or model make about humans? About human behavior? Health behaviors? For example, The Theory of Reasoned Action/Planned Behavior/Integrated Behavioral Model all posit that humans are rational actors and that we make use of information that is available to us. We then ponder that information before taking action. Do we always? Do adolescents really ponder the decision to smoke when their friends offer them a cigarette?
- Constructs: Do the constructs of the theory fit your topic and priority population? Do they make logical sense? For example, it would be illogical to use any of the risk appraisal theories for young people who do not have control over important factors (e.g., what gets fixed for dinner) or who believe that they are invincible. It would also be illogical to use any of the risk appraisal theories with low-income folks who are focused on surviving for today. For example, how ridiculous to think that low-income adults would be motivated by perceived risk of any future disease when they are faced with the immediate choice to either pay rent, feed their family, or buy their medicine.
- Use in the Past: Has this theory or model been used by previous published authors who dealt with the same or a similar topic and the same priority population? If so, how did they use it? Did it work well for them? Why/why not? Did the theory predict or explain behavior?
- Predictive Validity: What did past published authors find in terms of the theory or model’s predictive validity? Did it explain or predict the priority population’s health behaviors? Why/why not? If not, why would you want to use it??
- Common Sense: Do the constructs “make sense” for your health topic and priority population? Example – Would the Transtheoretical Model (Prochaska) be a good fit for a program to help those addicted to opioids quit using? What about using the TTM to identify the respective impact of one type of teaching in school versus another?
The Best Theory/Model for You
Considering the six factors that I presented above, the best theory/model for your program/intervention would be one that . . .
- Was originally developed to study similar issues as yours in a similar priority population.
- Has assumptions about behavior that make sense in your application.
- Includes constructs that make sense in your application.
- Other researchers have successfully used the theory/model in the past in similar situations.
- The theory has proven strong predictive validity for your key behavior within your population.
How Theory Drives the Program Evaluation
Are you aware that your selection of a theory or model will “drive” the evaluation of your program?
For a deeper understanding of how these two things are inter-related, send me an email or give me a call. I would be happy to explain.
When the 1795 Group partners with our clients, we help them identify what theory or model would be the best fit for their application and priority population.
We have experts on our team who know the theories/models and how to use them in program planning, grant writing, program evaluation, and publishing.