How Theory of Planned Behavior Relates to Health Care

Health behavior theory is a field of public health science that tries to deconstruct human behaviors to see why people do the things they do. In other words, it’s a way to evaluate behaviors to uncover what influences them.

Using health behavior theory techniques can make your attempts to help others (or even yourself) change health and wellness habits more effective.

One popular health behavior theory is the Theory of Planned Behavior. This theory suggests that, if you intend to do something, you will eventually perform the behavior. It also suggests that the following factors influence your intentions to perform a behavior:

  • Behavioral beliefs: Your attitude about the behavior

  • Normative beliefs: Peer pressure and the influence of people in your social circle, such as family and friends, on the behavior

  • Control beliefs: Your perceived ability to physically perform a behavior

These beliefs can bolster or undermine your own desires. In other words, even though you may want to change a certain behavior, behavioral, normative, and control beliefs can determine how successful — or not — your efforts will be. How so?

Consider a hypothetical example of Tom, a 30-year old man who wants to lose weight and become healthier. He is trying to give up drinking six cans of cola per day to achieve this goal.

Here’s how you would use the Theory of Planned Behavior to help Tom achieve his weight-loss and health goals:

  1. First, assess his attitude (behavioral beliefs) to find out how he feels about cola.

    Ask questions about why he drinks cola over other beverage options. Perhaps he loves the taste and the fizz. He doesn't care to for the taste of water because it’s too bland.

    Then try to uncover information about why he wants to give it up drinking cola and to determine whether he is committed to the effort. Chances are that Tom will answer in one of the two following ways:

    1. He is unhappy with his weight or has heard that drinking so many colas per day can lead to obesity, diabetes, or something worse, and he wants to avoid these outcomes.

    2. He doesn't really want to do stop drinking cola because he feels it’s not that big of an issue.

  2. If Tom’s responses indicate that he doesn’t really want to stop the problematic behavior, you then need to assess his circle of support and other sources of influence on his behavior choices (normative beliefs).

    Perhaps Tom’s wife is making him give up drinking so much cola per day because she wants him to be healthier. He may not be 100 percent behind the idea, but his partner’s influence over him may be more powerful than his own possible reluctance to give up soda.

  3. Now take a look at his control beliefs, or his perceived ability to physically quit drinking six cans of cola per day.

    In this portion of the assessment, you discover that Tom believes that alternatives to cola, like juice, are too expensive for he and his family to afford, and you know that from his attitudinal assessment (Step 1) that he won’t drink plain water because he needs something with taste.

    Your challenge in helping Tom cut back on the six cans of cola a day is to help him find an alternative that is both affordable and tasty.

All these factors influence Tom’s intention of actually quitting. Combined, some beliefs may be more powerful than others. It all comes down to individual personalities.

As you can see, a simple decision to not drink six cans of soda per day can actually be a very complicated behavior. The scenarios you’ll deal with as a nutritionist are often even more complex than this scenario. Therefore, you need to be skilled in the field of health behavior theory. By comprehensively understanding your patients’ decision-making processes, you can provide suggestions and strategies that can more effectively help them alter behaviors to improve their health.

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