THEORY: A DRIVER OF BEHAVIORAL INTERVENTION RESEARCH
. . . there is nothing so practical as a good theory.
—Lewin (1951, p. 169)
Theory is one of the key drivers of behavioral intervention research. Nevertheless, its role in the development, evaluation, and implementation phases of a behavioral intervention is not clearly understood or fully recognized. Unfortunately, theory continues to be undervalued and underutilized and to receive little attention in the planning and publication of behavioral intervention research (Glanz & Bishop, 2010; The Improved Clinical Effectiveness through Behavioural Research Group [ICEBeRG], 2006).
The importance of theory in guiding intervention development, evaluation, and implementation should not be underestimated. The explicit use of theory can help to identify the treatment components and delivery characteristics of an intervention; to apprise the selection of outcome measures and an understanding of how and why desired outcomes are achieved; to inform as to the replication potential of a proven intervention; and to shed light as to why implementation is successful or not. Theories can also help to explain why some people actively engage in an intervention and others do not, thus informing intervention design and the selection of strategies for enhancing the delivery of an intervention to boost its effects for targeted individuals.
Interventions that are atheoretical or derived without a conceptual foundation do not advance an understanding of behavior change, how and why particular outcomes from an intervention are achieved, or how and why the implementation of the intervention is effective. Interventions that are grounded in a theory or conceptual framework tend to be more effective than those lacking one (Glanz & Bishop, 2010). Using theory also greatly enhances the potential for replication by helping to identify the essential components of an intervention that must be maintained and the most effective mechanisms for its implementation (Glanz & Bishop, 2010; ICEBeRG, 2006).
Our goal in this chapter is to examine the role of theory in behavioral intervention research. We first define theory and examine its specific and differential roles in each phase of the pipeline (Chapter 2). Through exemplars, we articulate the linkage of theoretical frameworks to treatment components and intervention delivery characteristics. Then we examine principles for selecting a theory/conceptual framework and the key challenges in using theories.