Landscape seen from one of the participating schools: Polokwane, South Africa

The theories most widely used in planning health behaviour change interventions include Social Cognitive Theory and social cognition models. There is considerable overlap among these theories. The state of the art is well reflected in a recent European model (see figure below). Other theories that add to our understanding of health related behaviours and behaviour change are Problem Behaviour Theory and Stages of Change Theory.

Researchers generally agree that interventions based on the systematic application of relevant theory are more likely to be successful than interventions based on good intentions and enthusiasm only.

With regard to African target populations, it has been suggested that a combination of current social cognition models and a value utilisation/norm change model based on a systematic ethnographic approach for determining adolescents’ cultural beliefs, core values and social norms, may enhance the effectiveness of AIDS prevention programs. Central components of such a program should be improving coping behaviours and strategies, emotional reinforcing of core values, and critiquing or bolstering of social norms.

At a more practical level, it has been found that the use of the following basic educational principles increases impact of interventions:

• a case description approach to risk communication
• an emphasis on the short-term consequences of behaviour
• the teaching of social skills to improve self efficacy
• mobilising social support by involving "significant others", for example parents
• peer education and influence
• active involvement as opposed to passive reception
• "inoculation" against negative influences


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Rutter, D. & Quine, L. (2002). Changing health behaviour. Buckingham: Open University Press.