Promoting healthy behavior: There is nothing so practical as a good theory
Gerjo Kok, professor of applied psychology at Maastricht University School of Psychology & Neuroscience, department of work & social psychology
Programs to guide people into more healthy behavior often see limited success. These attempts should focus more on using theory and evidence that is available. We do have the necessary knowledge to do this in a systematic way: the Intervention Mapping protocol.
Often behavior change experts are only mobilized when all other approaches to change behavior have failed, and then people often want simple and fast answers. Fact is that this is not going to happen, however, behavior scientists do have some promising answers. One approach to develop theory- and evidence-based interventions is Intervention Mapping.
Basic tenets of the Intervention Mapping protocol are: (1) Using theory and evidence as foundations. (2) Recognizing the influence of environmental factors such as influences from family, worksites, communities and society. (3) Stimulating participation of all parties involved; target groups as well as stakeholders.
Intervention Mapping recognizes that planning behavior change interventions is an iterative process: often two steps forward, one step back. Through a series of six iterative steps correct application of the protocol is meant to produce behavior change interventions that fit the characteristics of the target population and local intervention context and that have the best chances of effectiveness
First the problem has to be defined in terms of quality of life, health, behavior, and environmental factors. Then, the underlying driving forces behind the behaviors and environmental factors, the so-called determinants, need to be examined. Our knowledge about these determinants has increased further than current practice acknowledges.
Then the planning group must decide which approach would change the behavior. Again, our knowledge about methods for behavioral and environmental change, has evolved more than what is currently used in practice.
Well-developed programs will not have any effect if they are not implemented in practice. Doctors, nurses, teachers, employers, opinion leaders, politicians; they all have a responsibility to make sure that the people they are responsible for receive the best possible interventions to help them change to healthier behaviors. Planners should take that into account when developing interventions, and should also provide training for these implementers.
How to make the practice of behavior change more effective? (1) When developing interventions, use theory and evidence, recognize influences from the environment, and stimulate participation of all stakeholders involved. (2) Acknowledge that planning behavior change interventions is an iterative and cumulative process. (3) Correctly applying theories will assist the planners in finding theory- and evidence-based answers for planning questions. (4) Every planning group for a behavior change intervention should have a behavioral science expert as one of its members.