Normally, behavior change intervention involves complex measures aimed at changing the behavior of an individual or a group of individuals. Regarding this particular research, it is aimed at studying health behaviors of a particular social group and introducing a behavior change concept that will improve a healthcare situation within a selected group and motivate people to maintain a healthy lifestyle.
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For these purposes to be achieved, a number of scholarly resources will be used as the major means of systematization of the existing behavior change practices. It is known that in behavioral medicine clinicians resort to the concrete models to explain people’s health-related behavior: the health belief model (HBM), the transtheoretical model (TTM), reasoned and planned behavior theory, learning theories, and social cognitive theory (Jones, Smith, & Llewellyn, 2014). The ability to choose among the models allows one to operate with a greater number of behavior change techniques and develop a concept that can totally fulfill the initially set goals.
Population and Behavior Change Selection
The population under research will include young men and women from 14 to 21 years of age who may be classified as a high-risk group of people due to their health behavior. In accordance with the Youth Risk Behavior Survey (YRBS), the overall health of middle and high school students is of the utmost concern in Jacksonville (Jones et al., 2014). Florida Department of Health in Duval County (DOH-Duval) monitors the most spread health-risk behavior among youth and uncovers a number of factors leading to the problem aggravation.
Alcohol, tobacco, sexually transmitted diseases, and unhealthy dietary are usually in the list of the most threatening phenomena causing harm to a person’s state of health through toxic substances, excessive calories, and harmful bacteria.
Naturally, to have this situation improved a substantial behavior change intervention is required. That is why it is critical to develop a behavior change model that would prevent young men and women from such diseases as hepatic cirrhosis, pulmonary cancer, etc., which result from unhealthy behavior. As Hieftje, Edelman, Camenga, and Fiellin (2013) point out in their research, “using electronic media can improve health and safety behaviors in young persons” (p. 574). Considering this fact, it is reasonable to start implementing an electronic media model to stabilize the situation in Jacksonville.
Factors of Influence and the HBM/TTM
Alcohol and Tobacco
Naturally, these two factors appear to be the threat not only to youth but to people of middle and senior age as well. However, in the case of youth, they cause higher risk since adolescent organism is subject to a more destructive influence of the harmful substances these products contain. Normally, when communicating with their counterparts, young men and women share the habits of the latter and follow the established social trends in order to remain members of the same subculture.
Such a tendency quite often leads to keeping an unhealthy and even dangerous lifestyle. For a lot of people of younger age, alcohol and tobacco act as some sort of ‘maturity’ indicators that every teenager needs to try. Vagi, Olsen, Basile, and Vivolo-Kantor (2015) stress out that alcohol drinking is often associated with health-risk behaviors provoking violence among younger age representatives. The fact young men and women are usually not aware of the consequences such activity may lead to, brings another evidence to the statement that a serious intervention is required to change health behaviors of adolescents in Jacksonville and other cities across the USA.
Sexually Transmitted Diseases
One more factor to mention is a high-risk sexual behavior. Led by their primary instincts, adolescents usually find it difficult to resist sexual desires and engage in behaviors that have a disruptive impact on both their mental and physical health. Unintended pregnancy and sexually transmitted diseases turn out to be the burdens of the century that also act as the premises for further drama occurrences, such as abortion and sexual health deterioration.
Vagi et al. (2015) highlight that inability to find a sexual partner is, in the majority of cases, treated as an invalidity indicator, serving as a signal for society to ignore a person. Viewing it as a problem, many adolescents desperately try to find a sexual involvement and thus, often get into a variety of troubles.
Another widely spread behavior leading to the occurrence of cardiovascular and weight disorders among youth is unhealthy dietary. The arrival of fast-food canteens and restaurants has seriously contributed to the problem aggravation. It is known that both teenagers and seniors suffer from the disorders due to a sedentary lifestyle and consuming unhealthy food on a daily basis. Thus, after a couple of decades, the excessive weight has turned out to be a problem to discuss nationwide.
As an attempt to combat the issue, healthcare organizations have introduced a behavior change model that is assigned to fight the problem not only in Florida but on a country-wide scale. The model presupposes mobile health interventions that “appear to be a viable health behavior change intervention modality for youth” (Fedele, Cushing, Fritz, Amaro, & Ortega, 2017, p. 461). With its help healthcare units expect to reduce the issue reoccurrence and raise youth’s interest for physical activities at one and the same time.
The HBM and the TTM Models and Their Implementation
As one of the earliest frameworks for explaining human behavior, the health belief model (HBM) states that health related actions are always taken on the basis of the six concepts of perception of a disease: perceived susceptibility, perceived severity, perceived benefits, perceived costs, and cues to action. The model is mainly applicable for predicting limited or one-time behaviors. However, it is inappropriate when dealing with habitual behaviors (Davis, Campbell, Hildon, Hobbs, & Michie, 2015).
On the other hand, transtheoretical model (TTM) is more aimed at a gradual change of behavior and can be applied for transforming the established behavioral trends (Kowalski, Jeznach, & Tuokko, 2014). Considering the fact the model includes six stages of behavior intervention (pre-contemplation, contemplation, preparation, action, maintenance, and termination), it has also acquired the name ‘stages of change.’ Regarding the purposes of this particular study, it is recommended to use the transtheoretical framework for the behavioral changes to be successful within a given population. The above-mentioned factors can only be removed when using a long-term behavior intervention strategy.
Behavior Change Techniques
Behavior change technique (BCT) is defined as a systematic procedure that is used as an active component of behavior change intervention. Among the three most frequently used techniques one may figure out persuasive communication, modeling, and fear appeals (Davis et al., 2015). As derived from the name, persuasive communication or persuasion presupposes influencing a person’s intentions or changing attitudes of a whole group (Davis et al., 2015).
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The technique can bring results when operating with transtheoretical concepts used to improve the situation within a chosen population. Another effective technique is modeling, involving imitation and copying of other representatives of a social group.
It is inherent in the youth to copy each other and follow the most prominent fashion/communication trends, meaning that the method is also recommended to resort to when changing a behavior of an entire community. Finally, fear appeals that are widely used in commercials on TV can have a positive outcome as well. Adding pictures of various diseases to tobacco products and alcohol drinks, for example, can evoke fears of getting those diseases. The method is reasonable when attempting to break the bad habits posed as a defining feature of a younger generation.
Challenges of Model Implementation
The major challenge of the program implementation is delivering the key message to the audience in a proper way. Using media can, of course, greatly assist this matter, but alas commonly used sources of media, i.e., television and radio, do not enjoy wide popularity among youth and demonstrate low efficiency in the matters of information delivery. As Hieftje et al. (2013) highlight, “other types of media, such as computer or video games, may be more effective in producing behavior change because they encourage active engagement” (p. 574).
However, using computer games as the source of propaganda requires extra time, funds, and human resources that appear to be additional challenges to deal with. Moreover, one cannot neglect such a transtheoretical concept as imitation of the negative attitude. Thus, if some individuals express the opinion that the product is worthless, the rest may share their thoughts too.
Summarizing the results, the factors influencing health behaviors among adolescents in Jacksonville, Florida require introducing an efficient transtheoretical model of behavior change intervention. The model is supposed to be based on the three behavior change techniques, such as persuasive communication, modeling, and fear appeals, and involve the usage of electronic media. Each technique carries its own value in the matters of goals achievement. However, when used in complex, they create a favorable environment for healthier lifestyle promotion and overcoming the major challenges the program is expected to face.
Davis, R., Campbell, R., Hildon, Z., Hobbs, L., & Michie, S. (2015). Theories of behaviour and behaviour change across the social and behavioural sciences: A scoping review. Health Psychology Review, 9(3), 323-344.
Fedele, D. A., Cushing, C. C., Fritz, A., Amaro, C. M., & Ortega, A. (2017). Mobile health interventions for improving health outcomes in youth: A meta-analysis. Jama Pediatrics, 171(5), 461-469.
Hieftje, K., Edelman, E. J., Camenga, D. R., & Fiellin, L. E. (2013). Electronic media–based health interventions promoting behavior change in youth: A systematic review. JAMA Pediatrics, 167(6), 574-580.
Jones, C. J., Smith, H., & Llewellyn, C. (2014). Evaluating the effectiveness of health belief model interventions in improving adherence: A systematic review. Health Psychology Review, 8(3), 253-269.
Kowalski, K., Jeznach, A., & Tuokko, H. A. (2014). Stages of driving behavior change within the transtheoretical model (TM). Journal of Safety Research, 50, 17-25.
Vagi, K. J., Olsen, E. O. M., Basile, K. C., & Vivolo-Kantor, A. M. (2015). Teen dating violence (physical and sexual) among US high school students: Findings from the 2013 National Youth Risk Behavior Survey. JAMA Pediatrics, 169(5), 474-482.