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Behavioral Science

Behavior Change Theories that can be Applied to
Injury Prevention and Control

(See: Gielen, AC, Sleet, DA, DiClementi, RJ (Eds). Injury and Violence Prevention: Behavioral Science Theories, Methods, and Applications. San Francisco: Jossey-Bass, 2006)

While we realize that many of the resources listed do not consist of injury or violence topics, they are included to demonstrate the use of different theories and to show conceptual frameworks.

Effective injury and violence prevention programs are grounded in or based on tested theories and models used in behavioral and social sciences. The theories and models most often used in these programs are highlighted below, along with articles and resources describing the specific benefits. While we realize that many of the resources listed do not consist of injury or violence topics, they are included to demonstrate the use of different theories and to show conceptual frameworks. For additional literature on theories used in unintentional injury prevention, see the CDC Behavioral Science / Injury Bibliography (Sleet DA & Hopkins, K, 2004).

Community Organization Theory

This theory focuses on the community's strengths. Key concepts are: empowerment, critical consciousness, community capacity, issue selection, and participation and relevance. 

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Diffusion of Innovations Theory

This theory concentrates on the process in which a new idea is disseminated throughout a society.  Key components are: innovations, communication channels, time to reach members, and social networks.

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Ecological / Social Ecological Model

These models focus on multi-level approaches as to how an individual's behavior may be affected by the surrounding environmental and sociological influences. 

  • Ecological Models for the Prevention of Unintentional Injury
    Allegrante, JP, Marks, R, Hanson, DW. In Gielen, A, Sleet, DA, Diclemente, R (Eds). Injury and Violence Prevention: Behavioral Science Theories, Methods, and Applications. San Francisco: Jossey Bass, 2006 (in press)

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Extended Parallel Processing Model

This fear appeal theory addresses how people process and respond to messages, making them more aware that they could be at risk.  Planners must also provide a method of overcoming the risk.

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Health Belief Model

This model looks at perceived threat of disease and net benefit of changing behavior to determine if and why a person will adopt a behavior change.

  • The Health Belief Model: A Decade Later
    Janz, N K, Becker, M.A
    Health Education Quarterly, 1984: 11, 1-47.

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Health Promotion Models

A combination of health education and specific interventions to promote change to healthy lifestyles.  Incorporates ways to enhance public awareness of health issues.

  • Drinking, Driving and Health Promotion
    Sleet, DA, Wagenaar, A, Waller, P (Eds).
    Health Education Quarterly (Theme Issue), Fall 1989: Vol. 16, No. 3.
  • Health Promotion Research Approaches to the Prevention of Injuries and Violence [Editorial]
    Liller, KD, Sleet, DA
    American Journal of Health Behavior, 2004: Vol. 28 (Suppl 1), S3-S5.
  • Increasing the Use of Bicycle Helmets: Lessons from Behavioral Science
    Thompson, N, Sleet, DA, Sacks, J
    Patient Education and Counseling, 2002: Vol. 46, No. 3, 191-197.
  • Preventing Alcohol-Related Traffic Injury: A Health Promotion Approach
    Howat, P, Sleet, DA, Elder, R, Maycock, B.
    Traffic Injury Prevention, 2004: Vol. 5, No. 3, 208-219.
  • Using Behavioral Science to Improve Fire Escape Behaviors in Response to a Smoke Alarm
    Thompson, NJ, Waterman, MB, Sleet, DA.
    Journal of Burn Care and Rehabilitation, 2004: Vol. 25, No. 2, 179-188.

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Integrated Models

This section highlights models that were combined specifically to address injury prevention.  Ex. Haddon Matrix with PRECEDE framework; and the Public Health model with the Social-Ecological model.

  • Health Education and Injury Control: Integrating Approaches
    Gielen, AC
    Health Education Quarterly, Summer 1992: Vol. 19, No. 2, 203- 218.
  • Introduction: Back to the Future—Revisiting Haddon's Conceptualization of Injury of Epidemiology and Prevention
    Runyan, CW
    Epidemiologic Reviews, 2003: Vol. 25, 60-64.
  • Integrating Behavioral and Social Sciences With Public Health
    N. Schneiderman, M.A. Speers, J.M. Silva, H. Tomes, & J.H. Gentry (Eds).  2001, Washington, DC: American Psychological Association.
    • Chapter 5- Lorion, R.P.  Exposure to Urban Violence: Shifting from an Individual to an Ecological Perspective, pp. 97- 113.
    • Chapter 6- Cook, S.L. & Koss, M.P.  Action Research: Informing Interventions in Male Violence Against Women, pp. 115- 139.
    • Chapter 10- Gielen, A.C. & Girasek, D.C. (2001). Integrating perspectives on the prevention of unintentional injuries. (pp. 203-227).

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This planning and evaluation model addresses social, epidemiological, behavioral & environmental, educational & ecological, and administrative & policy assessments, as well as implementation and process, impact and outcome evaluation.

  • To view this planning model, visit the website of one of the framework's creators—Dr. Larry Green.

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Public Health Model

This planning model consists of four steps: define the problem, identify the risk, develop and test prevention strategies, and disseminate the effective interventions.

  • An Overview of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention
    Sleet, DA, Bonzo, S, Branche C.
    Injury Prevention, December 1998: Vol. 4, No. 4, 308-312.

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Review of Multiple Behavior Change Theories

This section provides a general overview of several behavior change theories that are often used by health educators.

  • Injury and Violence Prevention: Behavioral Science Theories, Methods, and Applications
    Gielen, AC, Sleet, DA, DiClementi, RJ (Eds). San Francisco: Jossey-Bass, 2006.
  • Application of Behavior—Change Theories and Methods to Injury Prevention
    Gielen, AC, Sleet, DA
    Epidemiologic Reviews, 2003: Vol. 25, 65-76.
  • Behavioral and Social Sciences Theories and Models: Are they used in Unintentional Injury Prevention Research?
    Triffiletti, LB, Gielen, AC, Sleet, DA, Hopkins, K.
    Health Education Research, June 2005: Vol. 20, No. 3, 298-307.
  • Developing Injury Interventions: the role of behavioral science
    Sleet, DA, Gielen, AC
    In McClure, R, Stevenson, M, McEvoy, S (Eds). The Scientific Basis of Injury Prevention and Control. Victoria, Australia: IP Communications, pp. 214-232, 2004.
  • Emerging Theories in Health Promotion Practice and Research: Strategies for Improving Public Health
    Ralph J. DiClemente, Richard A. Crosby, Michelle C. Kegler (Eds.) (2002).  San Francisco: Jossey-Bass.
  • Health Behavior and Health Education: Theory, Research and Practice (3rd edition)
    Karen Glanz, Barbara K. Rimer, Frances Marcus Lewis (Eds.) (2002). San Francisco: Jossey-Bass.

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Social Cognitive Theory

This theory centers on the idea that personal factors, environment and behavior all influence one another.  Self efficacy, observational learning, reinforcements and expectations are some of the key concepts.

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Theory of Reasoned Action / Theory of Planned Behavior

These theories focus on intentions to perform a behavior based on attitudes toward the behavior and social acceptance of a behavior (TRA) and perceived behavioral control (TPB).

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Transtheoretical Model (Stages of Change)

This model helps program planners to tailor interventions based on a person's stage of readiness to change: Precontemplation, contemplation, preparation, action, or maintenance.

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