Theory: How It Fits into Public Health Interventions
Our focus for the coming weeks is upon various theories that aim to explain health behavior. For our purposes, a theory is a set of interrelated concepts that allow us to describe, understand, and predict a given phenomenon. As such, we will discuss numerous theories that have been put forth to explain the determinants and process of health behaviors. In short, these theories attempt to explain why people do what they do when it comes to their health.
Most of the theories of health behavior that we will discuss in the coming weeks trace their roots to theoretical paradigms in psychology and related disciplines. Behavioral psychology, cognitive psychology, and social psychology have each contributed to major health behavior theories.
Behavioral psychology
Behavioral psychology assumes that behaviors are learned through a process of stimulus and response. Behaviors stem from reflexes more than from thinking or emotion. Early behavioral theory focused upon classical conditioning. Pavlov is likely the best known of the classical conditioning researchers. Classical conditioning shows us that some behaviors are simply conditioned responses to a stimulus. Pavlov demonstrated this by conducting an experiment in which meat powder was placed on a dog s tongue while a bell was rung. Later, Pavlov discovered that the dog s mouth would water at the sound of the bell, independent of the meat powder. The dog would salivate (action) simply in response to a stimulus (the bell).
Later, Skinner proposed a form of conditioning more relevant for our purposes - operant conditioning. Skinner noted that certain behaviors could be conditioned through the administration of positive and negative stimuli. That is, a rat could be taught to push a red button but not a blue one if a treat was given whenever the red button was pushed but a shock administered when the blue one was. Certain behaviors can be conditioned or deconditioned through the use of reward and punishment. Deconditioning is used today as the basis for many behavior modification programs such as those used for smoking cessation, addiction treatment and other programs. These basic assumptions about learning behavior through positive and negative reinforcements appear in a number of health behavior theories.
Cognitive psychology
Cognitive psychology focuses on thinking as the fundamental determinant of behavior. Cognitive theorists are primarily interested in the ways that individuals take in new information so as to understand and solve problems. They want to understand how people think, perceive, recognize, and learn. Cognitive psychologists look to understand the links between stimulus and response; how is it that the rat learns not to push the blue button? How does it take information from the stimulus and process it, allowing it to learn not to be shocked? Cognitive psychology primarily underlies the individual-level health behavior models we will discuss in the coming weeks.
Social psychology / sociology
Social psychology is different from the previously discussed branches of psychology in that it focuses not on the individual in isolation, but on the ways in which individuals interact with others and their social situation. In many ways, social psychology is more akin to sociology than to other branches of psychology. Acknowledging the significance of social context in shaping the decisions that individuals make is of crucial importance for understanding health behaviors. Individuals do not act in a vacuum. As you are well aware from our earlier discussion of the social aspects of health, social context is crucially important for understanding the decisions people make and the lives people lead. Social psychology reminds us that the decisions that people make are often influenced by the attitudes and beliefs of others.