Theories and intervention approaches to health-behavior change in primary care.

CONTENT Providers typically rely on health information and their professional status to convince patients to change. Health-behavior theories and models suggest more effective methods for accomplishing patient compliance and other behavior change related to treatment regimens. Behavior modification stresses the remediation of skill deficits or using positive and negative reinforcement to modify performance. Like behavior modification, the Health Belief Model stresses a reduction of environmental barriers to behavior. Social Learning Theory suggests that perceptions of skills and reinforcement may more directly determine behavior. Self-management models put the above theories into self-change actions. Social support theories prioritize reinforcement delivered through social networks, whereas the Theory of Reasoned Action emphasizes perceptions of social processes. Finally, the Transtheoretical Model speaks of the necessity to match interventions to cognitive-behavioral stages. Strategies derived from each of these theories are suggested herein.