2. Theories
Several theories may be applied when
teaching Health Education; they include:
• Locus of Control
• Transtheoretical Model of Change/Stages of
Change
• Health Belief Model
• Social Learning Theory/Social Cognitive
Theory
• Theory of Reasoned Action
• Diffusion
3. Locus of Control
• An individual’s beliefs or perceptions related to
their abilities to influence their personal health
and health outcomes
– Example: Control, or lack of control over personal health
• Primarily, individuals believe personal health is
a matter of personal control (internal locus) or
factors outside of personal control (external)
– Internal: personal choices, behaviors, habits, self-care,
positive attitude, hope
– External: fate, luck, chance, “powerful others”
• In general, the more internally oriented the
individual, the more positive their health
outcomes, whereas external individuals tend to
experience poorer health outcomes
4. Transtheoretical Model of
Change/Stages of Change
• Individuals readiness to change/attempt to
change is based upon their
placement/positioning within the model; a non-
linear process in which the person may enter at
various points and recycle through the process
• 5 Stages:
– Stage 1: Pre-contemplation
– Stage 2: Contemplation
– Stage 3: Decision
– Stage 4: Action
– Stage 5: Maintenance
6. Health Belief Model
• An individual’s health-related behavior
depends on the perception of four
critical areas:
1. Perceived susceptibility to illness
2. The perceived potential severity of illness
3. The perceived benefits of taking
preventative action
4. The perceived barriers to taking that action
• Basically scaring someone into action
before it’s too late
8. Social Learning Theory
• Behavioral change is affected by:
– Environmental influences
– Personal factors
– Attributes of the behavior itself
• Most importantly, a person must believe in
his or her capability to perform the behavior
(self-efficacy)
• Must also perceive an incentive to do so
(positive expectations outweigh negative)
• The immediate or long-term benefits must
be valued
9. Social Learning Theory
• Self-efficacy can be increased by
providing the following environment:
1. Mastery experience
2. Clear instructions
3. Skill development
4. Modeling desired behavior
10. Theory of Reasoned Action
• Individual performance of a given
behavior is primarily determined by a
person’s intention to perform that
behavior.
• This intention is determined by two major
factors:
1. The person’s attitude toward the behavior
(beliefs about the outcomes of the behavior
and value of these outcomes)
2. The influence of the person’s societal
environment or subjective norm (beliefs about
what others think the person should do)
12. Diffusion
• New ideas/practices are introduced,
accepted and spread throughout a
community/society/group by the
actions/inactions of key ‘early adopters’ who
are seen as acceptable/desirable
• For diffusion to occur, there must be:
– An innovation
– A person who knows about the innovation:
• Two types: Interpersonal and Mass Media
– Another person who does not yet know about the
innovation
13. Diffusion
• Rate of Adoption: is contingent on the
following:
– Relative advantage: innovation is seen as
improvement or better
– Compatibility: fit; innovation is in keeping with
existing values, habits, experience, need
– Complexity: ease of use v. difficulty in use or
understanding
– Trialability: try it out first; samples, free
introductory offer, money back guarantees
– Observability: visibility of results; can
see/experience results; testimonials
