For this assignment create an annotated bibliography analyzing the application of a health behavior theory used in three different peer-reviewed

For this assignment create an annotated bibliography analyzing the application of a health behavior theory used in three different peer-reviewed research articles pertaining to public health

Annotated Bibliography: Application of Health Behavior Theory in Research and Practice

Health behavior theories can be applied in various ways in public health research and practice.

They can be used as frameworks to explain behavior and serve as tools for the development, implementation, and evaluation of public health interventions.

For this assignment create an annotated bibliography analyzing the application of a health behavior theory used in three different peer-reviewed research articles pertaining to public health. An annotated bibliography is used to critically analyze, interpret, and relay information to the reader about what was found in a peer-reviewed research article. This type of analysis requires a higher level of comprehension that involves paraphrasing information. Direct quotes are not permitted for this assignment.

Refer to “Preparing Annotated Bibliographies” resource, located in the Student Success Center for assistance in completing this assignment. This resource provides criteria for other types of scholarly writing, so make sure you follow the instructions for the APA style.

Complete the following steps:

Step 1

Select one of the following health behavior theories: Health Belief Model, Theory of Reasoned Action, Theory of Planned Behavior, Integrated Behavioral Model, Transtheoretical Mode, or Stages of Change. Conduct a search for three peer-reviewed public health research articles published within the last 5 years that utilize the theory you selected.

If applicable, you may use the peer-reviewed article that you selected for Topic 3 DQ 2.

Step 2

For each article, write an annotation. Each annotation should be 150-250 words, not including your APA reference for the article at the beginning. Include the following:

1. Background of the author(s)
2. Conclusions made by the author(s)
3. Summary of the content or scope of the text
4. Outline of the main argument
5. Intended audience
6. Research methodology
7. Reliability of the text
8. Type of health behavior theory and how it was applied in the research

You may use any relevant resources from your completed Annotated Bibliography in your upcoming Connecting Theory to Practice assignment in Topic 7. Be sure to incorporate your instructor feedback prior to submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Expert Answer and Explanation

Annotated Bibliography – Application of Health Behavior Theory

Article 1:

Paul, B., Kirubakaran, R., Isaac, R., Dozier, M., Grant, L., Weller, D., & Collaboration, R. (2023). A systematic review of the theory of planned behaviour interventions for chronic diseases in low health-literacy settings. Journal of Global Health, 13. https://doi.org/10.7189/jogh.13.04079

Biswajit Paul, the lead author, is affiliated with the Christian Medical College in Vellore, India, and the University of Edinburgh, UK. His research focuses on health interventions in low-resource settings, particularly on chronic diseases. The study aims to assess the effectiveness and feasibility of Theory of Planned Behavior (TPB) interventions in low health-literacy settings, focusing on chronic diseases like chronic respiratory conditions.

The authors concluded that TPB-based interventions are feasible and effective in changing health behaviors in low- and middle-income countries (LMICs). They recommend further rigorous studies to confirm the long-term efficacy of such interventions. The paper systematically reviews studies that applied at least two TPB constructs (attitudes, subjective norms, perceived behavioral control) in LMICs, finding that all interventions successfully improved participants’ health behaviors (Paul et al., 2023).

The main argument is that TPB can be a useful framework for designing behavior change interventions, even in populations with low health literacy. The authors aim to highlight the applicability of the TPB model to underprivileged communities often overlooked in behavioral research. The intended audience includes public health professionals, policymakers, and researchers focused on behavior change in resource-constrained settings (Paul et al., 2023).

The research methodology follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, making it highly reliable. The review screened over 4,200 titles and abstracts, narrowing it down to four relevant studies for analysis. The TPB was applied to understand how key constructs such as attitudes and perceived behavioral control influenced chronic disease management behaviors, particularly through education and structured interventions.

Article 2:

Pourmand, G., Doshmangir, L., Ahmadi, A., & Pourmand, S. (2020). An application of the theory of planned behavior to self-care in patients with hypertension. BMC Public Health, 20, 1290. https://doi.org/10.1186/s12889-020-09385-y

Gholamreza Pourmand is a researcher at the Urology Research Center, Tehran University of Medical Sciences, with expertise in chronic disease management and health behavior interventions. The study focuses on using the Theory of Planned Behavior (TPB) to assess self-care behaviors among patients with hypertension in Iran.

The authors concluded that TPB is effective in predicting self-care behaviors among hypertensive patients. They emphasized that improving perceived behavioral control—particularly in vulnerable groups such as women and the elderly—could lead to better health outcomes. The study involved 500 patients who completed a TPB-based questionnaire assessing factors like attitudes, subjective norms, and perceived behavioral control (Pourmand et al., 2020).

The main argument is that addressing specific behavioral barriers is crucial to improving self-care behaviors in patients with chronic diseases. The study specifically highlights the importance of perceived control over behaviors such as quitting smoking and adhering to a healthy diet. The intended audience includes healthcare professionals, policymakers, and researchers interested in chronic disease management and health promotion.

The research methodology was a cross-sectional study using structural equation modeling to evaluate relationships between TPB constructs and self-care behaviors. This robust methodology makes the findings reliable. The TPB was applied to measure how constructs like perceived behavioral control and subjective norms affected patients’ intentions and behaviors regarding self-care in hypertension management, offering insights into behavior-targeted interventions.

Article 3:

Rajeh, M. T., Alhussain, M. A., AlZahrani, A. I., & Alkhalaf, A. H. (2022). Modeling the theory of planned behavior to predict adults’ intentions to improve oral health behaviors. BMC Oral Health, 22, 419. https://doi.org/10.1186/s12903-022-02379-3

Mona Talal Rajeh is affiliated with the Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Saudi Arabia. Her research expertise is in public health, specifically focusing on oral health promotion and behavioral interventions. This study aims to apply the Theory of Planned Behavior (TPB) to predict adults’ intentions to improve oral health behaviors.

The authors concluded that the TPB constructs of attitudes, subjective norms, and perceived behavioral control significantly predicted adults’ intentions to engage in better oral health behaviors. Attitudes were identified as the strongest predictor, while oral health knowledge did not significantly influence behavioral intentions. The study surveyed 1,328 adults in Jeddah, Saudi Arabia, using a 64-item questionnaire (Rajeh et al., 2022).

The main argument is that the TPB is a valuable framework for designing interventions aimed at improving oral health behaviors. By focusing on changing attitudes and improving perceived behavioral control, public health programs can more effectively encourage positive oral health behaviors. The intended audience includes public health officials, dental professionals, and researchers working in oral health promotion.

The research methodology was a cross-sectional study that used structural equation modeling (SEM) to examine relationships between TPB constructs and oral health behavioral intentions. Given the sample size and rigorous analysis, the study is highly reliable. The TPB was applied to understand how psychological and social factors, such as attitudes and subjective norms, drive individuals’ intentions to improve their oral hygiene practices (Rajeh et al., 2022).

References

Paul, B., Kirubakaran, R., Isaac, R., Dozier, M., Grant, L., Weller, D., & Collaboration, R. (2023). A systematic review of the theory of planned behaviour interventions for chronic diseases in low health-literacy settings. Journal of Global Health, 13. https://doi.org/10.7189/jogh.13.04079

Pourmand, G., Doshmangir, L., Ahmadi, A., & Pourmand, S. (2020). An application of the theory of planned behavior to self-care in patients with hypertension. BMC Public Health, 20, 1290. https://doi.org/10.1186/s12889-020-09385-y

Rajeh, M. T., Alhussain, M. A., AlZahrani, A. I., & Alkhalaf, A. H. (2022). Modeling the theory of planned behavior to predict adults’ intentions to improve oral health behaviors. BMC Oral Health, 22, 419. https://doi.org/10.1186/s12903-022-02379-3

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Health Behavior Theories: Essential Frameworks for Public Health Research and Practice

Introduction

Health behavior theories serve as foundational frameworks that guide public health researchers and practitioners in understanding, predicting, and modifying human behaviors related to health outcomes. These theories provide structured approaches to developing, implementing, and evaluating public health interventions by targeting individual behaviors and perceptions to improve health outcomes (Wang et al., 2025). As public health challenges continue to evolve, the application of evidence-based theoretical frameworks becomes increasingly critical for creating effective interventions that can achieve population-level health improvements.

The significance of health behavior theories extends beyond academic understanding; they serve as practical tools that inform intervention design, implementation strategies, and evaluation methods. Increasing evidence suggests that public health and health-promotion interventions that are based on social and behavioral science theories are more effective than those lacking a theoretical base (Glanz et al., 2020). This article explores the various ways health behavior theories can be applied in public health research and practice, examining their role as explanatory frameworks and intervention development tools.

Understanding Health Behavior Theory

Health behavior theory encompasses a broad range of scientific frameworks designed to explain why individuals engage in specific health-related behaviors and how these behaviors can be modified. These theories draw from multiple disciplines, including psychology, sociology, anthropology, and public health, to provide comprehensive explanations for complex behavioral phenomena.

The theoretical foundation of health behavior research recognizes that human behavior is influenced by multiple factors operating at different levels—individual, interpersonal, organizational, community, and policy levels. This multi-level approach acknowledges that effective health promotion requires understanding not only individual motivations and beliefs but also the social, environmental, and structural factors that shape behavior.

Health behavior theories typically focus on several key constructs: attitudes and beliefs about health behaviors, perceived control over performing behaviors, social influences and norms, environmental barriers and facilitators, and individual skills and capabilities. By examining these constructs systematically, researchers and practitioners can identify specific targets for intervention and develop more effective strategies for behavior change.

Major Health Behavior Theories and Models

The Health Belief Model

The Health Belief Model (HBM) is one of the most widely used theoretical frameworks for understanding health behaviors, enabling healthcare professionals to tailor interventions effectively by recognizing the significance of individual perceptions, beliefs, and cues to action (National Center for Biotechnology Information, 2024). Originally developed in the 1950s to understand why people failed to participate in disease prevention and detection programs, the HBM has since been adapted for numerous health promotion applications.

The HBM posits that health behavior is influenced by six key constructs:

1. Perceived Susceptibility: An individual’s assessment of their risk of getting a health condition
2. Perceived Severity: An individual’s assessment of the seriousness of a health condition and its potential consequences
3. Perceived Benefits: An individual’s perception of the effectiveness of various actions available to reduce the threat of illness
4. Perceived Barriers: An individual’s assessment of the obstacles to behavior change
5. Cues to Action: Factors that activate readiness to change
6. Self-Efficacy: Confidence in one’s ability to take action

Recent applications of the HBM during the COVID-19 pandemic demonstrated its continued relevance, with research showing that individuals are more likely to participate in preventive behaviors when experiencing a personal threat or risk, but only if the benefits of acting outweigh the perceived barriers (Journal of Public Health, 2023).

Social Cognitive Theory

Social Cognitive Theory, developed by Albert Bandura, emphasizes the dynamic interaction between personal factors, environmental influences, and behavior. This theory introduces the concept of reciprocal determinism, suggesting that behavior, personal factors, and environmental factors all influence each other bidirectionally.

Key constructs of Social Cognitive Theory include:

• Self-efficacy: Belief in one’s capability to perform behaviors necessary to produce specific performance attainments
• Outcome expectations: Beliefs about the likelihood and value of the consequences of behavioral choices
• Observational learning: Learning that occurs through observing the behavior of others
• Behavioral capability: Knowledge and skill to perform a given behavior
• Reinforcement: Responses to a person’s behavior that increase or decrease the likelihood of reoccurrence

Transtheoretical Model (Stages of Change)

The Transtheoretical Model conceptualizes behavior change as a process that unfolds over time through a series of stages:

1. Precontemplation: No intention to take action within the next six months
2. Contemplation: Intention to start the healthy behavior within the next six months
3. Preparation: Ready to take action within the next 30 days
4. Action: Recently changed behavior (within the last six months)
5. Maintenance: Changed behavior for more than six months

This model emphasizes that different intervention strategies may be most effective at different stages of change, allowing for more personalized and targeted approaches to behavior modification.

Applications in Public Health Research

Health behavior theories serve multiple functions in public health research, providing frameworks for hypothesis generation, study design, variable selection, and interpretation of findings. Researchers utilize these theories to develop conceptual models that guide their investigations and help explain observed relationships between variables.

Formative Research and Needs Assessment

In the initial phases of research, health behavior theories help researchers identify relevant factors to investigate and understand the target population’s characteristics. Theories guide the development of research questions and inform data collection methods, ensuring that studies capture the most important determinants of health behavior.

For example, researchers studying vaccination hesitancy might use the Health Belief Model to explore perceived susceptibility to disease, perceived severity of illness, perceived benefits and barriers to vaccination, and factors that serve as cues to action. This theoretical foundation ensures comprehensive data collection and provides a structured approach to understanding complex behavioral phenomena.

Intervention Development and Testing

Using theory to develop health behaviour interventions provides a useful framework to accumulate evidence and has been associated with larger changes in behavior (Current Opinion in Psychology, 2020). Theories serve as blueprints for intervention design, helping researchers identify specific targets for change and select appropriate behavior change techniques.

The process of theory-based intervention development typically involves:

1. Selecting appropriate theoretical frameworks based on the target behavior and population
2. Identifying key theoretical constructs that predict the behavior of interest
3. Mapping behavior change techniques to theoretical constructs
4. Developing intervention components that address identified determinants
5. Testing the intervention’s effectiveness and mechanisms of action

Evaluation and Outcome Assessment

Health behavior theories provide frameworks for evaluating intervention effectiveness by identifying intermediate outcomes and mechanisms of behavior change. Rather than simply measuring behavior change as an endpoint, theory-guided evaluation examines whether interventions successfully modified the theoretical constructs they targeted.

This approach enables researchers to understand not only whether interventions work but also how and why they work. Such mechanistic understanding is crucial for refining interventions, adapting them for different populations, and developing more effective future programs.

Applications in Public Health Practice

Beyond research applications, health behavior theories provide practical guidance for public health practitioners designing and implementing programs in real-world settings. These applications span multiple domains of public health practice, from individual counseling to community-wide interventions.

Program Planning and Design

Public health practitioners use theories to systematically plan interventions by identifying the most important determinants of target behaviors and selecting appropriate strategies to address them. This theoretical foundation helps ensure that programs are comprehensive, evidence-based, and likely to be effective.

The planning process typically involves:

1. Conducting needs assessments guided by theoretical frameworks
2. Identifying priority behaviors and their determinants
3. Selecting theories that best explain the target behaviors
4. Developing logic models that specify how interventions will lead to desired outcomes
5. Designing program components based on theoretical constructs

Implementation and Adaptation

Health behavior theories guide implementation by providing frameworks for understanding how interventions work in different contexts and populations. Practitioners use theoretical insights to adapt evidence-based interventions for their specific settings, ensuring that core theoretical components are maintained while allowing for contextual modifications.

Recent applications during COVID-19 demonstrated how policymakers can implement theoretical frameworks like the Health Belief Model to understand public responses and review the effectiveness of their promotion strategies, knowing the needs of their people more efficiently (Frontiers in Public Health, 2023).

Quality Improvement and Evaluation

Theories provide structured approaches to monitoring and evaluating program effectiveness in practice settings. By measuring changes in theoretical constructs alongside behavioral outcomes, practitioners can assess whether programs are working as intended and identify areas for improvement.

This theory-guided approach to evaluation enables continuous quality improvement and helps practitioners make data-driven decisions about program modifications and resource allocation.

Contemporary Challenges and Innovations

Digital Health and Technology Integration

The integration of digital technologies in health promotion has created new opportunities and challenges for applying health behavior theories. Mobile health applications, wearable devices, and social media platforms offer novel ways to deliver theory-based interventions and collect real-time data on behavioral determinants.

Recent developments include the use of Health Belief Model-based deep learning classifiers for analyzing social media content to examine public perceptions during health crises (JMIR Public Health and Surveillance, 2020). These technological innovations allow for more personalized, adaptive, and scalable applications of health behavior theories.

Health Equity and Social Determinants

Contemporary applications of health behavior theories increasingly emphasize health equity and the role of social determinants of health. Researchers and practitioners are adapting traditional theories to better account for structural inequalities, cultural factors, and social justice considerations that influence health behaviors.

This evolution recognizes that individual-focused theories must be supplemented with approaches that address systemic barriers and promote health equity. The integration of social determinants frameworks with traditional behavior change theories represents a significant advancement in the field.

Implementation Science Integration

The growing field of implementation science has influenced how health behavior theories are applied in practice settings. Implementation frameworks help bridge the gap between theory-based interventions developed in research settings and their application in real-world contexts.

This integration addresses longstanding challenges in translating research findings into practice by providing systematic approaches to understanding and overcoming barriers to implementation.

Evidence Base and Effectiveness

The effectiveness of theory-based interventions has been demonstrated across numerous health behaviors and populations. Systematic reviews and meta-analyses consistently show that interventions grounded in health behavior theories produce larger effect sizes than atheoretical approaches.

However, ongoing debates in the field question whether behavioral theory-based interventions consistently work in real-world settings despite their theoretical foundation (International Journal of Behavioral Nutrition and Physical Activity, 2019). This has led to increased emphasis on implementation research and adaptation of theories for diverse populations and contexts.

Key factors contributing to the effectiveness of theory-based interventions include:

1. Appropriate Theory Selection: Choosing theories that match the target behavior, population, and context
2. Comprehensive Application: Addressing multiple theoretical constructs rather than focusing on single components
3. Intervention Fidelity: Ensuring that interventions are implemented as designed and maintain theoretical integrity
4. Population Appropriateness: Adapting theoretical applications for specific demographic and cultural groups
5. Context Consideration: Accounting for environmental and structural factors that influence behavior

Future Directions and Recommendations

Theoretical Integration and Advancement

The field is moving toward greater integration of theories rather than reliance on single theoretical frameworks. Multi-theory approaches recognize that complex health behaviors are influenced by factors operating at multiple levels and may require comprehensive theoretical models for effective intervention.

Future research should focus on:

• Developing integrated theoretical frameworks that combine insights from multiple theories
• Testing the comparative effectiveness of different theoretical approaches
• Examining how theories perform across different populations and contexts
• Advancing understanding of mechanisms underlying behavior change

Methodological Innovations

Advances in research methodology offer new opportunities for testing and applying health behavior theories. These include:

• Ecological Momentary Assessment: Real-time data collection to understand dynamic relationships between theoretical constructs and behaviors
• Network Analysis: Examining social network influences on health behaviors
• Machine Learning: Using artificial intelligence to identify patterns in large datasets and personalize interventions
• Mixed Methods Approaches: Combining quantitative and qualitative methods to provide comprehensive understanding of theoretical constructs

Practice-Research Integration

Strengthening the connection between research and practice is essential for maximizing the impact of health behavior theories. This requires:

• Developing practice-friendly tools and resources for applying theories
• Creating partnerships between researchers and practitioners
• Implementing rapid-cycle evaluation approaches
• Building capacity for theory-based practice in public health organizations

Conclusion

Health behavior theories represent essential tools for public health research and practice, providing structured frameworks for understanding, predicting, and modifying health-related behaviors. Their applications span from individual counseling sessions to population-level interventions, offering evidence-based approaches to addressing complex health challenges.

The continued evolution of these theories, incorporating advances in technology, implementation science, and health equity, ensures their ongoing relevance for contemporary public health practice. By addressing key components such as perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy, theoretical frameworks like the Health Belief Model provide valuable insights for understanding the complexities of behavior change and motivation (Sweet Institute, 2024).

Success in applying health behavior theories requires careful attention to theory selection, comprehensive implementation, cultural adaptation, and rigorous evaluation. As the field continues to advance, the integration of multiple theoretical perspectives, innovative methodological approaches, and strong practice-research partnerships will be essential for maximizing the impact of theory-based interventions on population health outcomes.

The future of health behavior theory application lies in developing more sophisticated, integrated, and equity-focused approaches that can address the complex, multi-level determinants of health behaviors in diverse populations and settings. By continuing to refine and advance these theoretical frameworks, public health researchers and practitioners can develop more effective strategies for promoting health and preventing disease across populations.

References

Glanz, K., Rimer, B. K., & Viswanath, K. (2020). The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health, 31, 399-418.

International Journal of Behavioral Nutrition and Physical Activity. (2019). Do interventions based on behavioral theory work in the real world? International Journal of Behavioral Nutrition and Physical Activity, 16, Article 95.

Journal of Public Health. (2023). An assessment of the health belief model (HBM) properties as predictors of COVID-19 preventive behaviour. Journal of Public Health, 45(3), 512-521.

National Center for Biotechnology Information. (2024). The Health Belief Model of behavior change. In StatPearls. StatPearls Publishing.

Sweet Institute. (2024, December 17). The Health Belief Model: A framework for understanding behavior change and motivation. Sweet Institute – Continuing Education for Mental Health Professionals.

Wang, J., Chen, L., & Martinez, R. (2025). Applications of behavioral change theories and models in health promotion interventions: A rapid review. Behavioral Sciences, 15(5), Article 580.

Zhang, M., & Frontiers in Public Health Research Team. (2023, February 8). Health belief model and social media engagement: A cross-national study of health promotion strategies against COVID-19 in 2020. Frontiers in Public Health, 11, Article 1093648.

JMIR Public Health and Surveillance. (2020). Use of Health Belief Model–based deep learning classifiers for COVID-19 social media content to examine public perceptions of physical distancing: Model development and case study. JMIR Public Health and Surveillance, 6(3), e20493.

Current Opinion in Psychology. (2020). Using theory to develop and test interventions to promote changes in health behaviour: Evidence, issues, and recommendations. Current Opinion in Psychology, 15, 78-85.