What are you afraid of? Probably a lot of things. If there is something you are afraid of, you will avoid it. That’s what fear appeals do, they make you fear something to avoid it. Fear appeals can be used in good ways (think CDC’s anti-smoking campaign). Some in not so good ways (think of Dr. Wakefield’s Lancet study forever incorrectly linking the MMR vaccine to autism). The Protection Motivation Theory first developed in 1975 was designed to explain fear appeals.
Social Ecological Models are not one model per se, they are models that are multi-level. They idea is that a person is influenced by their environment from their family to the community, to the society as a whole. McLeroy, Bibeau, Stecklter & Glanz (1988) developed the model for use in health education programs. The model starts with the individual and the knowledge they have within. The next is interpersonal which includes family and friends and now in this day and age friends in person and on the Internet. Organizational which are the organizations that the individual works with and the community which is the network of organizations. Finally, public policy which are the laws that everyone abides by.
The Theory of Reasoned Action was developed in 1967 that looks at the expectations of the person who performs the behavior (Fishbein & Azjen, 1975). The job of the person using this model is basing their outcomes on what the person or group expects will happen, not what they think should happen. This points back to perceptions. Even if I believe the outcome to a behavioral intervention will be positive, the person may have beliefs which has them thinking otherwise. In public health we can assume anything about any group we are working with.
The next article in a series of health education model critiques is the Health Belief Model. This model attempts to explain what beliefs and perceptions will prompt someone to promote or not perform a health behavior. The model was developed in the 1950’s by Godfrey Hochbaum, Irwin Rosenstock, Stephen Kegeles, and Howard Leventhal (Janz & Becker, 1984). Understanding the perceptions of the health behavior is key to understanding why someone will or will not do it.
There are many different models that someone can use to develop and implement a public health education campaign. The University of Texas El Paso listed 26 different models that could be used. I’m not going to go through each model here, but over the next several weeks, I will write a post about some of these models and why I feel they need to go further to include diverse populations.
I’ll start with the Social Learning Theory. This theory states that a person learns through modeling the behavior change in others (Bandura, 1971). How to we best model behavior? A person would need to see someone like themselves modeling the correct behavior. Think about a major movie star or sports star doing something on television or the Internet, if this highly successful person is doing it, maybe I should do it too. That can lead to both good and bad behaviors depending on what is seen. One major problem is, the star may not care about the outcome.