Epidemiol Rev 2003;25:65-76
Copyright © 2003 by the Johns Hopkins Bloomberg School of Public Health
PREVENTION |
Application of Behavior-Change Theories and Methods to Injury Prevention
1 Center for Injury Research and Policy, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
2 Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.
Received for publication August 29, 2002; accepted for publication February 24, 2003.
Abbreviation: HIV, human immunodeficiency virus.
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INTRODUCTION |
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Reducing the burden of injury is an international health goal, one that requires an interdisciplinary perspective. Injuries, whether self-inflicted, inflicted by others, or unintentional, have one thing in common: They are largely preventable. Behaviors that give rise to violence and injury are amenable to preventive intervention, just as are many of the behaviors that give rise to diseases. Thus, behavioral science is an integral part of a comprehensive injury prevention strategy.
Applications of behavioral science to injury prevention lagged behind other approaches during the last half of the 20th century. Despite recognition by injury control professionals of the importance of behavioral research in injury prevention, behavioral solutions to preventing injury were deemphasized until recently (1, 2). Historically, little scholarly attention has been paid to understanding determinants of injury-related behaviors or how to initiate and sustain behavioral changes. Interventions often seemed to have been based on simplistic assumptions
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ROLE OF BEHAVIOR CHANGE IN INJURY PREVENTION |
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Need for integrating passive and active strategies
Need for new models
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ROLE OF THEORY IN BEHAVIOR CHANGE |
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New emphasis on ecologic models in public health
Levels of influence and intervention
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APPLICATION OF THEORY TO INJURY PREVENTION |
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Individual-level theories and methods
Health belief model. Theory of reasoned action. Stages of change. Applied behavioral analysis. Integrating models at the individual level. Community-level theories and methods
Community organization. Community moblization. Empowerment. Community-based participatory research.
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THE HEALTH PROMOTION FRAMEWORK |
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CONCLUSIONS |
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FUTURE NEEDS |
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ACKNOWLEDGMENTS |
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Reprint requests to Dr. Andrea Carlson Gielen, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 (e-mail: agielen@jhsph.edu).
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