Behavioural change theories

Behavioural change theories and models are attempts to explain the reasons behind alterations in individuals' behavioural patterns. These theories cite environmental, personal, and behavioural characteristics as the major factors in behavioural 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 behavioural 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 behavioural change theories were published in the 1970s and 1980s. These include Icek Ajzen’s articles on the Theories of Reasoned Action and Planned Behavior, Albert Bandura’s writings on Social Cognitive Theory, and James Prochaska and Carlo DiClemente’s works on the Transtheoretical Model. More recently, interest in behavioural 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 and the UK Prime Minister's Strategy Unit. With this renewed interest, however, there is also a shift towards research into understanding the maintenance of behavioural change in addition to broadening the research base for revising current theories that focus on initial change (NIH 2003) (PMSU 2008).

General theories and models
Each behavioural change theory or model focuses on different factors in attempting to explain behavioural 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 individual’s impression of their own ability to perform a task. This impression is based upon factors like the individual’s prior success in the task or in related tasks, the individual’s 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 behavioural change, so although self-efficacy is not a behavioural 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/Behaviour Analytic Theories of Change
From behaviourists like Burrhus Frederic Skinner come the Learning Theories, which state that complex behaviour is learned gradually through the modification of simpler behaviours (USDHHS 1996). Imitation and reinforcement play important roles in these theories, which state that individuals learn by duplicating behaviours they observe in others and that rewards are essential to ensuring the repetition of desirable behaviour (Skinner 1953). As each simple behaviour is established through imitation and subsequent reinforcement, the complex behaviour develops. When verbal behaviour is established the organism can learn through rule governed behaviour 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. . Behaviour analytic theories of change have been quite effective in improving the human condition (see behaviour modification, behaviour therapy and applied behaviour analysis).

Social Learning/Social Cognitive Theory
According to the Social Learning Theory, which is also known as the Social Cognitive Theory, behavioural change is determined by environmental, personal, and behavioural elements. Each factor affects each of the others. For example, in congruence with the principles of self-efficacy, an individual’s thoughts affect their behaviour and an individual’s characteristics elicit certain responses from the social environment. Likewise, an individual’s environment affects the development of personal characteristics as well as the person’s behaviour, and an individual’s behaviour 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 behavioural change (Bandura 1989).

Theory of Reasoned Action
The Theory of Reasoned Action assumes that individuals consider a behaviour’s consequences before performing the particular behaviour. As a result, intention is an important factor in determining behaviour and behavioural change. According to Icek Ajzen (1985), intentions develop from an individual’s perception of a behaviour as positive or negative together with the individual’s impression of the way their society perceives the same behaviour. Thus, personal attitude and social pressure shape intention, which is essential to performance of a behaviour and consequently behavioural 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 behaviour performance but is intended to cover cases in which a person is not in control of all factors affecting the actual performance of a behaviour. As a result, the new theory states that the incidence of actual behaviour performance is proportional to the amount of control an individual possesses over the behaviour and the strength of the individual’s intention in performing the behaviour. In his article, Ajzen (1985) further hypothesizes that self-efficacy is important in determining the strength of the individual’s intention to perform a behaviour.

Transtheoretical/Stages of Change Model
According to the Transtheoretical Model, which is also known as the Stages of Change Model, behavioural 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 behaviour. From precontemplation to contemplation, the individual develops a desire to change a behaviour. During preparation, the individual intends to change the behaviour within the next month, and during the action stage, the individual begins to exhibit new behaviour consistently. An individual finally enters the maintenance stage once they exhibit the new behaviour consistently for over six months (“Behavior Change” 2007).

Applications
Behavioural change theories have potential applications in many areas. Prominent areas of application include healthcare, education, and criminal behaviour. 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, behavioural change theories have gained recognition for their possible effectiveness in explaining health-related behaviours and providing insight into methods that would encourage individuals to develop and maintain healthy lifestyles. Specific health applications of behavioural 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 behavioural change theories (NIH 2003).

Models specific to health applications include the Health Belief/Health Action Model, Relapse Prevention Model and the I-Change Model. The Health Belief Model, also known as the Health Action Model, states that individuals will alter health-related behaviour according to the perceived severity of the threat to their health (Chen & Land 1986). The Relapse Prevention Model concentrates on promoting prolonged healthy behaviour by making distinctions between lapses and relapses in an attempt to encourage individuals to maintain healthy lifestyles (USDHHS 1996). The I-Change Model, the Integrated Model for explaining motivational and behavioural change, is derived from the Attitude – Social influence – Self-Efficacy Model. This model can be considered as an integration of ideas of Ajzen’s Theory of Planned Behavior, Bandura’s Social Cognitive Theory, Prochaska’s Transtheoretical Model, the Health Belief Model, and goal setting theories. Previous versions of this model (referred to as the ASE-model) have been used to explain a variety of types of health behaviour.

Education
Behavioural change theories can be used as guides in developing effective teaching methods. Since the goal of much education is behavioural change, the understanding of behaviour afforded by behavioural change theories provides insight into the formulation of effective teaching methods that tap into the mechanisms of behavioural 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 behavioural 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 behavioural 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 behavioural change theories. At the same time, the general theories of behavioural change suggest possible explanations to criminal behaviour and methods of correcting deviant behaviour (Akers 1979). Since deviant behaviour correction entails behavioural change, understanding of behavioural change can facilitate the adoption of effective correctional methods in policy-making. For example, the understanding that deviant behaviour like stealing may be learned behaviour resulting from reinforcers like hunger satisfaction that are unrelated to criminal behaviour can aid the development of social controls that address this underlying issue rather than merely the resultant behaviour (Jeffery 1965).

Specific theories that have been applied to criminology include the Social Learning and Differential Association Theories. Social Learning Theory’s element of interaction between an individual and their environment explains the development of deviant behaviour as a function of an individual’s exposure to a certain behaviour and their acquaintances, who can reinforce either socially acceptable or socially unacceptable behaviour (Akers 1979). Differential Association Theory, originally formulated by Edwin Sutherland, is a popular, related theoretical explanation of criminal behaviour that applies learning theory concepts and asserts that deviant behaviour is learned behaviour. Jeffery’s (1965) reexamination of Sutherland’s original theory adds that because of the necessity of temporal proximity between punishment and behaviour for conditioning to occur, the legal system’s application of punishment is more likely to generate law evasion rather than to correct deviant behaviour.

= Objections = Behavioural change theories are not universally accepted. Criticisms include the theories’ emphases on individual behaviour and a general disregard for the influence of environmental factors on behaviour. In addition, as some theories were formulated as guides to understanding behaviour while others were designed as frameworks for behavioural 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 behavioural change theories (NIH 2003).