Read the following questions. Think of how you would answer each one. Click on the questions to see a discussion of each answer.

Question 1: What is behavioral and social science theory?

Answer: This kind of theory spells out the relationships between human behaviors and various individual, social or environmental factors. The factors are sometimes called behavioral determinants. The cause-effect linkages in the top theories have been tested in scientific research and have held up fairly well. Unlike a program logic model (such as “MY MODEL” in the Social Marketing edition of CDCynergy), a theory does not normally explain how the determinants will be affected by a specific social marketing strategy.

Question 2: How are behavioral and social sciences theories useful in social marketing?

Answer: Theories are useful in several ways:

• By laying out concepts in causal sequences, theories help social marketers map out the causes of health problems. The Social Marketing edition of CDCynergy, advises incorporating theoretical causal sequences in the “Problem Analysis Worksheet.”
• Concepts from behavioral and social science theory can serve as a checklist to make sure that important issues are not overlooked in focus groups and other market research. Marketing of any sort draws from Exchange Theory from economics; questions for audience members should reflect but not be limited to Exchange Theory’s broad central concepts -- costs and benefits.
• After audience research has confirmed the applicability of certain theoretical concepts and put them into local context, audiences can be segmented partially on the basis of the concepts.
• The choice of strategies and channels can be informed by theory. For example, Diffusion Theory holds that early adopters of an innovative behavior are influenced by information in the mass media (e.g., the internet), while late adopters are more influenced by observing and getting advice from people they know. If most of an audience segment is already performing a health behavior, it may be best to reach the remaining few through other members of their social networks.
• Program evaluators can often measure theoretical determinants of a behavior even when the behavior itself is unobservable or a behavioral objective is long range.
• When an outcome behavior can be measured directly, and an evaluation shows positive change in a target behavior but the study design is weak and subject to bias, positive change in theoretically related determinants adds credibility to the main evaluation result by offering a reasonable explanation for how it came about.
• When evaluation results are negative, a manager can sometimes distinguish between a bad plan and a badly executed plan by examining measures of determinants. If they changed and the target behavior did not, then the behavior was not well understood. If similar programs have been successful at changing determinants but the program under study was not, then the program may not have been properly carried out.

Question 3: Which theories have useful in the past or are considered really promising now?

Answer: Theories of individual behavior change that have informed several successful interventions in the past include the Theory of Reasoned Action, Applied Behavioral Analysis (sometimes called the ABC Model for “antecedents, behavior, and consequences”), and the theories described in Theory At A Glance. For a longer list that includes promising theories that have not been used as often in public health to date, go to the website of the Communication Initiative (http://www.comminit.com/changetheories.html). Theories of communication itself are also relevant to Social Marketing; four major ones are described at http://carbon.cudenver.edu/~mryder/itc/comm_theory.html.

 

For suggestions about how elements of theory might be applied in Social Marketing campaigns, see pages 9-24 of Promoting Nutrition and Physical Activity Through Social Marketing: Current Practices and Recommendations by Alcalay and Bell, 2000 (http://socialmarketing-nutrition.ucdavis.edu/publications.htm#review1).

Question 4: Do I need to stick with one theory, or can I use concepts from several?

Answer: There is some overlap in concepts across theories of behavior change, and social marketers often use a mix of concepts from several theories. Some experts advise picking one theory that seems to fit your situation best and retaining all of its major variables so that its basic causal sequence remains intact. Variables from other theories could be included in audience research to help flesh out the picture as interview time or questionnaire space permitted.

 

Other experts advise using a set of useful variables drawn from various theories. (see the NIMH_theorists_consensus.pdf), or employing a theory of behavior change along with a theory that embeds the behavior of individuals in a larger context (see Theory At A Glance for examples).

Question 5: Do you need to bring in a social scientist to use this kind of theory effectively?

Answer: It depends. Getting the most from theory involves a lot of technical knowledge and skill. You probably won’t need technical assistance from a social scientist if you are adapting an effective, theory-based model program and you don’t change the core elements of the intervention. If you’re starting from scratch, though, it is very helpful to have a social scientist on the design team. Faculty and advanced graduate students at local universities often play this role.

Question 6: How can I tell which theory is the best fit with my health problem?

Answer: There is no way to know in advance which theory will be the best fit with a particular health problem, and eminent social scientists can disagree. In general, you will be well-served by any one of the well-respected theories referenced above if you make your choice on the basis of the following criteria:

• the theory appears to be a good fit, incorporating the main explanatory factors that seem logical to include
• basic research studies in peer-reviewed scientific journals found that the concepts in the theory predicted the health behavior or similar behaviors (search this literature for free at http://www.pubmed.gov)
• evaluation studies in peer-reviewed scientific journals found that programs informed by the theory were successful in changing the health behavior or another behavior in your target audience
• the social or behavioral scientist on your team has experience with the theory and/or is comfortable applying it.