As we have suggested, there is not a singular theory or conceptual framework that dominates behavioral intervention research or which is appropriate for use by all behavioral intervention studies. However, most effective public health and health promotion interventions tend to embrace or begin with an ecological perspective at the broadest level as shown with the earlier GBGB example (Glanz & Bishop, 2010;

Noar, 2005). Explanatory theories as to why behaviors occur and change theories to suggest best ways to influence behavior change are also very useful within the ecological perspective. Some of the most common theories framing behavioral intervention research include Social Learning Theory; Theory of Reasoned Action; Health Belief Model; Social Cognitive Theory, self-efficacy; Theory of Planned Behavior; and TTM of Stages of Behavior Change (Glanz & Bishop, 2010), and these are described in more detail in Table 4.1. Also, as shown by Table 4.1, theories are not static; they evolve and are refined over time as new data emerge that necessitate incremental changes to the tenets of the theory/model. For example, the Health Belief Model was originally proposed in 1974 (Rosenstock, 1974), but in 1988, it was expanded to include the construct of self-efficacy (Rosenstock, Strecher, & Becker, 1988). Further, Heckhausen and colleagues originally proposed the Life-Span Theory of Control in 1995, but in 2010, they presented an expanded version of the theory, the Motivational Theory of Life-Span Development on the basis of theoretical advancements and empirical research on goal engagement/disengagement (Heckhausen & Schulz, 1995; Heckhausen, Wrosch, & Schulz, 2010). The Life-Span Theory of Control sought to explain the processes by which individuals choose goals to optimize control. Their more recent theoretical work integrates this and other related models to provide a more comprehensive framework for understanding personal agency throughout the life span.

Similarly, the Theory of Planned Behavior extended the Theory of Reasoned Action by adding the construct of “perceived behavioral control,” conceptualized as the degree to which an individual perceives a specific behavior as either easy or difficult to enact (Ajzen & Fishbein, 1980; Ajzen & Madden, 1986). Thus, theories are not static. Rather, they change and advance over time as hypotheses are tested and new data emerge that support or refute the propositions, relationships, constructs, and concepts suggested by a theory.

Table 4.1 is not an inclusive list nor should it be construed that these are the only theories to consider or use in behavioral intervention research. Rather, the table represents a starting point for considering ways to inform intervention development and evaluation.

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