health behavior and health education theory research and
For the Fourth Edition of the book, we put together a comprehensive set of companion materials.
theory, research, and practice
Chapter 6 Theory of Reasoned Action, Theory of Planned Behavior, and the Integrated Behavioral Model 95
Daniel E. Monta˜no and Danuta Kasprzyk
Kasisomayajula “Vish” Viswanath, PhD, is the Lee Kum Kee Professor of Health Communication in the Department of Social and Behavioral Science at the Harvard T. H. Chan School of Public Health (HSPH), a faculty member in the Center for Population Sciences at the Dana-Farber Cancer Institute (DFCI). He is also the Co-Director of Lee Kum Sheung Center for Health and Happiness at HPSH, Director of India Research Center at Harvard Chan and the Director of Translation Health Communication Science at Harvard Chan and Dana-Farber.
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Further, Glanz and Maddock ( Glanz and Maddock, 2000) argue that out of what is sometimes a confusing literature, the best and brightest will emerge. That is, every health researcher could propose a theory, but only those best supported empirically and those that resonate with researchers would proliferate further inquiry. This is likely the current state of the literature, as numerous theories exist, but some theories are used much more than others. Researchers may use theory for other reasons than suggested by Glanz and Maddock ( Glanz and Maddock, 2000), however. For instance, using a particular theory because it is easy to understand or it is the one learned during one’s academic training. In addition, the fragmentation of the HBT literature because of multiple theories and its potential slowing of our understanding of health behavior have already been discussed as problems with this approach.
There have been various attempts to create integrated theories of health behavior, and a recent example is Fishbein’s ( Fishbein, 2000) integrated theory [see also ( Institute of Medicine, 2002)]. The core constructs of the theory are essentially the TRA constructs with the addition of self-efficacy. The theory also includes constructs such as demographics and personality variables as well as skills and environmental constraints. Fishbein’s ( Fishbein, 2000) integrated model grew out of a theorists’ workshop that took place in 1991, in which many prominent theorists came together to identify core determinants of health behavior. The theorists produced a chapter that listed and described eight variables believed to be most important to health behavior and specifically to safer sexual behavior [see ( Fishbein et al., 2001)]. They discussed similarities between constructs and theories, though a common set of terminology was not proposed. The way in which these constructs combine to effect behavior was not agreed upon and was discussed as an ‘unresolved issue’. Although Fishbein ( Fishbein, 2000) suggests one conceptualization, additional conceptualizations of the same variables could also be tested. However, it is likely that many researchers would disagree with these core determinants, which is a major difficulty with the integrated approach.
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The fourth edition of the landmark book, Health Behavior and Health Education, offers an accessible, comprehensive, in-depth analysis of the health behavior theories and practices that are most relevant to health education. This thoroughly revised edition includes the most current information on theory, research, and practice at individual, interpersonal, and community and group levels. The volume includes substantial new content on current and emerging theories of health communication, e-health, culturally diverse communities, health promotion, the impact of stress, the importance of networks and community, social marketing, and evaluation.