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3.3. Nivel de investigación
An effective strategy might involve augmentation of existing methods (e.g., the information provision approach of public health campaigns) with novel methods that may incentivise consumption of this food group. Evidence-based models of behaviour change are important to consider in this context as a means of identifying strategies that are likely to be effective at motivating population-level changes in dietary behaviour. It is critical to use these theories to formulate intervention strategies which capitalise on peoples’ existing cognitions as these are likely to be the most effective and economical methods of behaviour change.
In line with systematic reviews and meta-analyses of effective behaviour- change techniques (Michie et al., 2009; Pomerleau et al., 2005), Carver and Scheier’s (1990) Self-Regulation Model of Health Behavior regards behavioural change to be critically dependent on goal-directed action plans. For behaviour modification to be successful, individuals must establish a goal, which involves identification of a perceived discrepancy between the current self and a desired state. The individual must then use existing or newly acquired knowledge to determine how best to reduce this discrepancy. This suggests that fruit and vegetable consumption may improve if participants are encouraged to create strong motivational goals or reinforce extant ones. The Health Action Process Approach (Schwarzer, 2008) is a similar model which suggests that an initial motivational phase (in which goals are set) should be followed by phases which actively structure the initiation and maintenance of behavioural change.
The Information-Motivation and Behavioral Skills Model (Fisher & Fisher, 1992; Fisher, Fisher, Williams, & Malloy, 1994) was initially developed to predict sexual behaviours associated with HIV transmission, but has potential utility for a wide range of health behaviours. This model proposes that behaviour change is contingent on a participants’ informedness (i.e. knowledge of the risks associated with particular behaviours) and motivation to perform that behaviour, and that these are two independent constructs; i.e. an individual can be informed, but not motivated (as appears to be the case with diet in industrialised nations) and vice-versa. The evidence behind this model further suggests that information-provision alone is an ineffective means of motivating improvements in dietary behaviour and that it is important to develop materials that are effective in encouraging fruit and vegetable consumption whilst providing information on their benefits.
TheTranstheoretical Model of Behaviour Change(Prochaska & DiClemente, 1984) regards behavioural interventions to be most effective when materials are tailored to the individual’s readiness to alter a given behaviour. According to this popular theory, individuals progress from a precontemplation stage (in which there is no desire to change behaviour) to one of contemplation (in which behaviour begins to be evaluated), followed by the preparation and completion of specific actions. Successful long-term behaviour modification is subsequently achieved via active maintenance of changes and elimination of previous habits. This theoretical framework highlights the importance of using intervention methods that are able to target behaviour change across these critical stages. Although it is important to intervene in the early, precontemplational and contemplational stages, in the interests
of economy, it is also important to demonstrate that a given intervention strategy remains effective once participants advance through theoretical stages.
The concept of self-efficacy (Bandura, 1977) considers individuals’ cognitions surrounding their competence in achieving behaviour-change goals. Highlighting the importance of this construct it has been incorporated into a large number of theories of behaviour change, including those outlined above, in addition to Social Cognitive Theory(N. E. Miller & Dollard, 1941), Social Learning Theory
(Bandura, 1989) andSelf-Concept Theory (Mcadam, 1986). These theories posit that individuals with low self-efficacy are likely to avoid specific tasks they perceive as difficult (even if specific plans are laid out, Richert et al., 2010), hence it is important to investigate and develop effective methods of improving confidence in achieving motivating behavioural outcomes.
The concept of social norms has also valuably contributed to understanding of human behaviour. Humans have a strong tendency to act in accordance with the perception of others’ behaviour (D. Yun & Silk, 2011), hence it may be valuable to highlight to individuals that large numbers of people can and do perform target dietary behaviours, thereby making behaviour changes appear less challenging. Social norms are key to both the Theory of Reasoned Action (Fishbein & Ajzen, 1975) and the subsequentTheory of Planned Behavior(Ajzen, 1985) which posit that successful behaviour change is contingent on one’s attitudes towards that behaviour and on one’s beliefs about how their peers will interpret behaviour of that action. The
Theory of Planned Behaviour (Ajzen, 1985) additionally incorporates individuals’ perception of control, a concept similar to that of self-efficacy.
The above theories and theoretical constructs highlight a number of intervention components which may be useful in establishing behavioural change. Typically, these components are delivered in a particularly effortful manner (Michie et al., 2009; Pomerleau et al., 2005), but it is now important from a public health viewpoint to investigate more parsimonious and effective means of delivery. Providing information on the health benefits of certain behaviours is likely to be ineffective when in isolation, but this approach is likely to be more successful when paired with intervention techniques which encourage the development of clear and achievable goals.