Evaluating Theories of Health Behavior Change: A Hierarchy of Criteria Applied to the Transtheoretical Model

Abstract

The most common criteria recommended by philosophers of science for evaluating theories were organised within a hierarchy ranging from the least to the most risky tests for theories of health behavior change. The hierarchy progressed across: (1) Clarity; (2) Consistency; (3) Parsimony; (4) Testable; (5) Predictive Power; (6) Explanatory Power; (7) Productivity; (8) Generalisable; (9) Integration; (10) Utility; (11) Efficacy; and (12) Impact. The hierarchy was applied to the Transtheoretical Model (TTM) as an example of a health behavior change theory. The application was from the perspective of critics and advocates of TTM. Examples of basic and applied research challenging and supporting TTM across the hierarchy of criteria are presented. The goal is to provide a model for comparing alternative theories and to evaluate progress across the hierarchy within a particular theory. As theories meet criteria at each step in the hierarchy, the research and applications they generate can have increasing impacts on the science and practice of health behavior change.Les critères les plus courants mis en avant par les philosophes des sciences pour l'évaluation des théories ont été structurés dans le cadre d'une hiérarchie allant des épreuves les moins aux plus exigeantes en ce qui concerne les théories portant sur les changements de comportement relatifs à la santé. Cette hiérarchie progresse ainsi: 1) Clarté; 2) Cohérence; 3) Economie; 4) Accès à la vérifi-cation; 5) Pouvoir prédictif ; 6) Pouvoir explicatif; 7) Valeur heuristique; 8) Possibilités de généralisation; 9) Intégration; 10) Utilité; 11) Efficacité; 12) Impact. Cette hiérarchie a été appliquée au Modèle Transthéorique (TTM) pris comme exemple de théorie du changement comportemental lié à la santé, aussi bien du point de vue des défenseurs que des critiques du TTM. On présente des exemples de recherches fondamentales et appliquées mettant à l'épreuve ou confirmant le TTM à partir de la hiérarchie des critères. L'objectif est d'avoir un modèle permettant de comparer différentes théories et d'évaluer la progression d'une théorie particulière le long de la hiérarchie. Comme les théories trouvent un critère à chaque échelon de la hiérarchie, les recherches et les applications qu'elles génèrent peuvent avoir des retombées croissantes sur la science et la pratique du changement de comportement relatif à la santé.

Treating Tobacco Dependence at the Intersection of Diversity, Poverty, and Mental Illness: A Randomized Feasibility and Replication Trial

“…18,22,27,50,51 The pattern of increase in abstinence over time in these "cessation-induction trials" 45 is in contrast to characteristic relapse curves of traditional action-oriented treatment approaches. 52 Repeated intervention contacts provide the opportunity to engage participants not initially ready to quit. Further, the current study's 12-month abstinence rate of 26% was comparable to prior investigations of similar TTM-based approaches with inpatient psychiatric smokers, depressed outpatient smokers, and studies with smokers without mental illness.…”

The Psychological Flexibility Model: A Basis for Integration and Progress in Psychological Approaches to Chronic Pain Management

“…In this review we consider whether the models and theories underlying CBT today are optimal according to three criteria that summarize the typical criteria applied to evaluate theories. 68 We ask whether they are effectively (a) integrating current knowledge, (b) precisely organizing our research and treatment development activities, and (c) creating progress.…”

Internet Interventions for Hearing Loss: Examing rehabilitation, self-report measures and internet use for hearing-aid users

“…One outcome of audiological rehabilitation is to achieve behavioral change (McKenna, 1987;Prochaska et al, 2008;Saunders et al, 2013) and focus on where and how the person with hearing loss can use his or her skills to reach a higher level of functioning instead of focusing only on technically reducing the hearing loss (McKenna, 1987). The notion that behavioral change should be implicit in the rehabilitation plan was also described in the Audiological Rehabilitation Management Model by Goldstein and Stephens (1981).…”