Behavioural change theories

# Behavioral change theories and models
Behavioral change theories and models are attempts to explain the reasons behind alterations in individuals' behavioral patterns.  These theories cite environmental, personal, and behavioral characteristics as the major factors in behavioral determination.  In recent years, there has been increased interest in the application of these theories in the areas of health, education, and criminology with the hope that understanding behavioral change will improve the services offered in these areas.

# History
Many of the original works outlining the major theories that are the basis for current knowledge about behavioral change theories were published in the 1970s and 1980s.  These include Icek Ajzens articles on the Theories of Reasoned Action and Planned Behavior, Albert Banduras writings on Social Cognitive Theory, and James Prochaska and Carlo DiClementes works on the Transtheoretical Model.  More recently, interest in behavioral change theories has arisen due to their apparent application in areas like health, education, and criminology, leading to further research backed by institutions like the National Institutes of Health.  With this renewed interest, however, there is also a shift towards research into understanding the maintenance of behavioral change in addition to broadening the research base for revising current theories that focus on initial change (NIH 2003).

# General theories and models
Each behavioral change theory or model focuses on different factors in attempting to explain behavioral change.  Of the many that exist, the most prevalent are the Learning Theories, Social Learning Theory, Theories of Reasoned Action and Planned Behavior, and Transtheoretical Model.  Research has also been conducted regarding specific elements of these theories, especially elements like self-efficacy that are common to several of the theories (Ajzen 1985).

## Self-Efficacy
Self-efficacy is an individuals impression of their own ability to perform a task.  This impression is based upon factors like the individuals prior success in the task or in related tasks, the individuals physiological state, and outside sources of persuasion (Bandura 1977).  Self-efficacy is thought to be predictive of the amount of effort an individual will expend in initiating and maintaining a behavioral change, so although self-efficacy is not a behavioral change theory per se, it is an important element of many of the theories, including the Health Belief Model and the Theory of Planned Behavior (Bandura 1977 and USDHHS 1996).

## Learning Theories/Behavior Analytic Theories of Change
From behaviorists like Burrhus Frederic Skinner come the Learning Theories, which state that complex behavior is learned gradually through the modification of simpler behaviors (USDHHS 1996).  Imitation and reinforcement play important roles in these theories, which state that individuals learn by duplicating behaviors they observe in others and that rewards are essential to ensuring the repetition of desirable behavior (Skinner 1953).  As each simple behavior is established through imitation and subsequent reinforcement, the complex behavior develops. When verbal behavior is established the organism can learn through rule governed behavior and thus not all action needs to be contingency shaped.
Skinner (1957) was one of the first psychologists to recognize the critical role of imitation (what he termed echoic behavior) in the learning of language.. Behavior analytic theories of change have been quite effective in improving the human condition (see behavior modification, behavior therapy and applied behavior analysis).

## Social Learning/Social Cognitive Theory
According to the Social Learning Theory, which is also known as the Social Cognitive Theory, behavioral change is determined by environmental, personal, and behavioral elements.  Each factor affects each of the others.  For example, in congruence with the principles of self-efficacy, an individuals thoughts affect their behavior and an individuals characteristics elicit certain responses from the social environment.  Likewise, an individuals environment affects the development of personal characteristics as well as the persons behavior, and an individuals behavior may change their environment as well as the way the individual thinks or feels.  Social Learning Theory focuses on the reciprocal interactions between these factors, which are hypothesized to determine behavioral change (Bandura 1989).

## Theory of Reasoned Action
The Theory of Reasoned Action assumes that individuals consider a behaviors consequences before performing the particular behavior.  As a result, intention is an important factor in determining behavior and behavioral change. According to Icek Ajzen (1985), intentions develop from an individuals perception of a behavior as positive or negative together with the individuals impression of the way their society perceives the same behavior.  Thus, personal attitude and social pressure shape intention, which is essential to performance of a behavior and consequently behavioral change (Ajzen 1985).

## Theory of Planned Behavior
In 1985, Ajzen expanded upon the Theory of Reasoned Action, formulating the Theory of Planned Behavior, which also emphasizes the role of intention in behavior performance but is intended to cover cases in which a person is not in control of all factors affecting the actual performance of a behavior.  As a result, the new theory states that the incidence of actual behavior performance is proportional to the amount of control an individual possesses over the behavior and the strength of the individuals intention in performing the behavior.  In his article, Ajzen (1985) further hypothesizes that self-efficacy is important in determining the strength of the individuals intention to perform a behavior.

## Transtheoretical/Stages of Change Model
According to the Transtheoretical Model, which is also known as the Stages of Change Model, behavioral change is a five-step process.  The five stages, between which individuals may oscillate before achieving complete change, are precontemplation, contemplation, preparation, action, and maintenance (USDHHS 1996).  At the precontemplation stage, an individual may or may not be aware of a problem but has no thought of changing their behavior.  From precontemplation to contemplation, the individual develops a desire to change a behavior.  During preparation, the individual intends to change the behavior within the next month, and during the action stage, the individual begins to exhibit new behavior consistently.  An individual finally enters the maintenance stage once they exhibit the new behavior consistently for over six months (Behavior Change 2007).

# Applications
Behavioral change theories have potential applications in many areas.  Currently, the most prominent areas of application are in healthcare, education, and criminal behavior.  These issues are important to societal functionality and policy-making, resulting in recent renewed interest in these theories.

## Health
In the interest of promoting healthy lifestyle development, behavioral change theories have gained recognition for their possible effectiveness in explaining health-related behaviors and providing insight into methods that would encourage individuals to develop and maintain healthy lifestyles.  Specific health applications of behavioral change theories include the development of programs promoting active lifestyles and programs reducing the spread of diseases like AIDS (USDHHS 1996 and Behavior Change 2007).  In addition, the National Institutes of Health has, in recent years, funded research to broaden the information base for behavioral change theories (NIH 2003).
Models specific to health applications include the Health Belief/Health Action Model and Relapse Prevention Model.  The Health Belief Model, also known as the Health Action Model, states that individuals will alter health-related behavior according to the perceived severity of the threat to their health (Chen & Land 1986).  The Relapse Prevention Model concentrates on promoting prolonged healthy behavior by making distinctions between lapses and relapses in an attempt to encourage individuals to maintain healthy lifestyles (USDHHS 1996).

## Education
Behavioral change theories can be used as guides in developing effective teaching methods.  Since the goal of much education is behavioral change, the understanding of behavior afforded by behavioral change theories provides insight into the formulation of effective teaching methods that tap into the mechanisms of behavioral change.  In an era when education programs strive to reach large audiences with varying socioeconomic statuses, the designers of such programs increasingly strive to understand the reasons behind behavioral change in order to understand universal characteristics that may be crucial to program design (Nutbeam 2000).
In fact, some of the theories, like the Social Learning Theory and Theory of Planned Behavior, were developed as attempts to improve health education.  Because these theories address the interaction between individuals and their environments, they can provide insight into the effectiveness of education programs given a specific set of predetermined conditions, like the social context in which a program will be initiated (Nutbeam 2000).  Although health education is still the area in which behavioral change theories are most often applied, theories like the Stages of Change Model have begun to be applied in other areas like employee training and developing systems of higher education (Government 2007 and Elton 2003).

## Criminology
Empirical studies in criminology support behavioral change theories.  At the same time, the general theories of behavioral change suggest possible explanations to criminal behavior and methods of correcting deviant behavior (Akers 1979).  Since deviant behavior correction entails behavioral change, understanding of behavioral change can facilitate the adoption of effective correctional methods in policy-making.  For example, the understanding that deviant behavior like stealing may be learned behavior resulting from reinforcers like hunger satisfaction that are unrelated to criminal behavior can aid the development of social controls that address this underlying issue rather than merely the resultant behavior (Jeffery 1965).
Specific theories that have been applied to criminology include the Social Learning and Differential Association Theories.  Social Learning Theorys element of interaction between an individual and their environment explains the development of deviant behavior as a function of an individuals exposure to a certain behavior and their acquaintances, who can reinforce either socially acceptable or socially unacceptable behavior (Akers 1979).  Differential Association Theory, originally formulated by Edwin Sutherland, is a popular, related theoretical explanation of criminal behavior that applies learning theory concepts and asserts that deviant behavior is learned behavior.  Jefferys (1965) reexamination of Sutherlands original theory adds that because of the necessity of temporal proximity between punishment and behavior for conditioning to occur, the legal systems application of punishment is more likely to generate law evasion rather than to correct deviant behavior.

# Objections
Behavioral change theories are not universally accepted.  Criticisms include the theories emphases on individual behavior and a general disregard for the influence of environmental factors on behavior.  In addition, as some theories were formulated as guides to understanding behavior while others were designed as frameworks for behavioral interventions, the theories purposes are not consistent (USDHHS 1996).  Such criticism illuminates the strengths and weaknesses of the theories, showing that there is room for further research into behavioral change theories (NIH 2003).