ABSTRACT
The knowledge and experience gained by effective health behavior research programs
can be applied to adolescent hearing-loss prevention programs to address the public
lack of awareness and concern about the risks of hearing loss. Informative conceptual
theories can be found in the health behavior literature. These theoretical models
have been tested in a variety of settings over many decades. Continuing health communication
interventions that examine changes in awareness levels, attitudes, and risky behaviors
have supported the key constructs described in these behavior theories. Intrapersonal-level
theories predict how knowledge, attitudes, beliefs, and other traits within the individual
will affect health behaviors. Interpersonal-level theories predict how our relationships
with significant others affect our social identity and normative expectations and
how these in turn will affect our health behaviors. The Transtheoretical Model (also
called Stages of Change) focuses on an individual's readiness to make a change in
behavior. The underlying principle of this model is that behavior change is achieved
through various stages. Research driven by the Theory of Reasoned Action and the Theory
of Planned Behavior demonstrates that there is substantial evidence that behavioral
intentions are highly predictive of future behavior. These theories explain the importance
of subjective norms and perceived behavioral control. The Health Belief Model identifies
five important factors that may influence an individual's decision to practice a health
behavior, including perceptions of susceptibility and severity, perceived benefits
and barriers to making a change, and environmental cues to action. Finally, the Social
Cognitive Theory attempts to predict behavior by understanding the interactions that
take place within an individual's social environment. In addition, new models of behavior
change have been introduced that are dynamic and far-reaching. It is time for hearing-conservation
interventions to reap the benefits of research driven by behavioral theory.
KEYWORDS
Health behavior theories - hearing protection - peer pressure
REFERENCES
- 1 World Health Organization .Prevention of Noise-Induced Hearing Loss. Report of an
Informal Consultation, 1997. Geneva, Switzerland; WHO Available at: http://www.who.int/pbd/deafness/en/noise.pdf Accessed November 18, 2006
- 2
Brookhouser P E, Worthington D W, Kelly W J, Pillsbury H C.
Noise-induced hearing-loss in children.
Laryngoscope.
1992;
102
645-655
- 3
Bess F H, Dodd-Murphy J, Parker R A.
Children with minimal sensorineural hearing loss: prevalence, educational performance,
and functional status.
Ear Hear.
1998;
19
339-354
- 4
Folmer R L, Griest S E, Martin W H.
Hearing conservation education programs for children: a review.
J Sch Health.
2002;
72
51-57
- 5 National Cancer Institute .U.S. Dept. of Health and Human Services. Theory at a
Glance: A Guide for Health Promotion Practice. Bethesda, MD; National Institutes of
Health 2005: 1-49 NIH Publication No. 05-3896
- 6
Prochaska J O, Redding C A, Harlow L L, Rossi J S, Velicer W F.
The transtheoretical model of change and HIV prevention: a review.
Health Educ Q.
1994;
21
471-486
- 7
Prochaska J O.
A stage paradigm for integrating clinical and public health approaches to smoking
cessation.
Addict Behav.
1996;
21
721-732
- 8
Hacker K E, Brown E, Cabral H, Dodds D.
Applying a transtheoretical behavioral model (TTM) of behavioral change to adolescent
reproductive health counseling.
J Adolesc Health.
2005;
37
S80-S93
- 9
Hollis J F, Polen M R, Whitlock E P et al..
Teen reach: outcomes from a randomized controlled trial of a tobacco reduction program
for teens seen in primary medical care.
Pediatrics.
2005;
115
981-989
- 10
Aveyard P, Markham W A, Almond J, Lancashire E, Cheng K K.
The risk of smoking in relation to engagement with a school-based smoking intervention.
Soc Sci Med.
2003;
56
869-882
- 11
Kristjansson S, Helgason A R, Mansson-Brahme E, Widlund-Ivarson B, Ullen H.
You and your skin: a short duration presentation of skin cancer prevention for teenagers.
Health Educ Res.
2003;
18
88-97
- 12
Kidd P, Reed D, Weaver L, Westneat S, Rayens M K.
The transtheoretical model of change in adolescents: implications for injury prevention.
J Safety Res.
2003;
34
281-288
- 13 Fishbein M, Ajzen I. Belief, Attitude, Intention and Behavior: An Introduction
to Theory and Research. Reading, MA; Addison-Wesley 1975
- 14
Albarracin D, Fishbein M, Johnson B T, Muellerleile P A.
Theories of reasoned action and planned behaviors as models of condom use: a meta-analysis.
Psychol Bull.
2001;
127
142-161
- 15
Donovan T D, Singh S N.
Sun-safety behavior among elementary school children: the role of knowledge, social
norms, and parental involvement.
Psychol Rep.
1999;
24
831-836
- 16
Chemak G D, Curtis L, Seikel J A.
The effectiveness of an interactive hearing conservation program for elementary school
children.
Lang Speech Hear Serv Sch.
1996;
27
29-39
- 17
Bandura A.
Self-efficacy: toward a unifying theory of behavior change.
Psychol Rev.
1977;
84
191-215
- 18 Bandura A. Self-Efficacy: The Exercise of Control. Englewood Cliffs, NJ; Prentice
Hall 1986
- 19 Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood
Cliffs, NJ; Prentice Hall 1986
- 20
Meyer G, Roberto A J, Boster F J, Roberto H L.
Assessing the Get Real About Violence (R) curriculum: process and outcome evaluation
results and implications.
Health Commun.
2004;
16
451-474
- 21
Tsorbatzoudis H.
Evaluation of a planned behavior theory-based intervention programme to promote healthy
eating.
Percept Mot Skills.
2005;
101
587-604
- 22
Backman D R, Haddad E H, Lee J W, Johnston P K, Hodgkin G E.
Psychosocial predictors of healthful dietary behavior in adolescents.
J Nutr Educ Behav.
2002;
34
184-193
- 23
Lien N, Lytle L A, Komro K A.
Applying theory of planned behavior to fruit and vegetable consumption of young adolescents.
Am J Health Promot.
2002;
16
189-197
- 24
Baranowski T, Cullen K W, Nicklas T, Thompson D, Baranowski J.
Are current health behavioral change models helpful in guiding prevention of weight
gain efforts?.
Obes Res.
2003;
11
23S-43S
- 25
Knobloch M J, Broste S K.
A hearing conservation program for Wisconsin youth working in agriculture.
J Sch Health.
1998;
68
313-318
- 26
Devries H, Dijkstra W, Kok G.
The utilization of qualitative data for health-education program-planning, implementation,
and evaluation-a spiral approach.
Health Educ Q.
1992;
19
101-115
- 27
Main D S, Iverson D C, McGloin J et al..
Preventing HIV-infection among adolescents: evaluation of a school-based education
program.
Am J Prev Med.
1994;
23
409-417
- 28
Noland M P, Kryscio R J, Riggs R S, Linville L H, Ford V Y, Tucker T C.
The effectiveness of a tobacco prevention program with adolescents living in a tobacco-producing
region.
Am J Public Health.
1998;
88
1862-1865
- 29
Price J H, Beach P, Everett S, Telljohann S K, Lewis L.
Evaluation of a three-year urban elementary school tobacco prevention program.
J Sch Health.
1998;
68
26-31
- 30
Janz N K, Becker M H.
The health belief model: a decade later.
Health Educ Q.
1984;
11
1-47
- 31
Basen-Engquist K.
Psychosocial predictors of ‘safer sex’ behaviors in young adults.
AIDS Educ Prev.
1992;
4
120-134
- 32
Catania J, Kegeles S M, Coate T J.
Towards an understanding of risk behavior: an AIDS risk reduction model (ARRM).
Health Educ Q.
1990;
17
53-77
- 33
Black D R, Gobler N S, Sciacca J P.
Peer helping/involvement: an efficacious way to meet the challenge of reducing alcohol,
tobacco, and other drug use among youth.
J Sch Health.
1998;
68
87-93
- 34
Reding D J, Fisher V, Gunderson P, Lappe K, Anderson H, Calvert G.
Teens teach skin cancer prevention.
J Rural Health.
1996;
12
265-272
- 35
Garcia A W, Broda M AN, Frenn M, Coviak C, Pender N J, Ronis D L.
Gender and developmental differences in exercise beliefs among youth and prediction
of their exercise behavior.
J Sch Health.
1995;
65
213-219
- 36
Ievers-Landis C E, Burant C, Drotar D, Morgan L, Trapl E S, Kwoh C K.
Social support, knowledge, and self-efficacy as correlates of osteoporosis preventive
behaviors among preadolescent females.
J Pediatr Psychol.
2003;
28
335-345
- 37
Fulkerson J A, French S A, Story M, Hannan P J, Sztainer-Neumark D, Himes J H.
Weight-bearing physical activity among girls and mothers: relationships to girls'
weight status.
Obes Res.
2004;
12
258-266
- 38
Dishman R K, Motl R W, Saunders R, Felton G, Ward D S, Pate R R.
Self-efficacy partially mediates the effect of a school-based physical activity intervention
among girls.
Prev Med.
2004;
38
628-638
- 39
Dishman R K, Sallis J F, Dunn A L et al..
Self-management strategies mediate self-efficacy and physical activity.
Am J Prev Med.
2005;
29
10-11
- 40
Hortz B, Petosa R.
Impact of the ‘planning to be active’ leisure time physical program on rural high
school students.
J Adolesc Health.
2006;
39
530-535
- 41
Trevino R P, Pugh J A, Hernandez A E, Menchaca V D, Ramirez R R, Mendoza M.
Bienestar: a diabetes risk-factor prevention program.
J Sch Health.
1998;
68
62-67
- 42
Baranowski T, Davis M, Resnicow K et al..
Gimme 5 fruit, juice, and vegetable for fun and health: outcome evaluation.
Health Educ Behav.
2000;
27
96-111
- 43
Burgess-Champoux T, Marquart L, Vickers Z, Reicks M.
Perceptions of children, parents, and teachers regarding whole-grain foods, and implications
for a school-based intervention.
J Nutr Educ Behav.
2006;
38
230-237
- 44
Rinderknecht K, Smith C.
Social cognitive theory in an after-school nutrition intervention for urban Native
American youth.
J Nutr Educ Behav.
2004;
36
298-304
- 45
Shin Y, Yun S, Pender N, Jang H.
Test of the health promotion model as a causal model of commitment to a plan for exercise
among Korean adults with chronic disease.
Res Nurs Health.
2005;
28
117-125
- 46
Booth S L, Sallis J F, Ritenbaugh C et al..
Environmental and societal factors affect food choice and physical activity: rationale,
influences, and leverage points.
Nutr Rev.
2001;
59
S21-S39
- 47 Green L W, Kreuter M W. Health Promotion Planning: An Educational and Ecological
Approach. Mountain View, CA; Mayfield 1999
- 48
Klesges L M, Estabrooks P A, Dzewaltowski D A, Bull S S, Glasgow R E.
Beginning with the application in mind: designing and planning health behavior change
interventions to enhance dissemination.
Ann Behav Med.
2005;
29
66-75
Judith SobelPh.D. M.P.H.
School of Community Health, Portland State University
P.O. Box 751, Portland, OR 97207
eMail: sobelj@pdx.edu
