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Theoretical Basis

Theory-Driven Programs Based on Current Educational Standards

A foundation in educational standards is essential for high-quality programs. In planning programs, current educational standards for domain-specific content are of prime importance. HOPE is based on current standards for physical education (SHAPE America: Physical Education, 2014; SHAPE America: Fitness Education Framework, 2012; CDC Health Education, 2013; Florida: HOPE, 2013).

In meeting standards, content must be theory driven to ensure that it is presented in a manner that is most likely to result in health behavior change in learners. Concepts and principles derived from educational and psychological theory have been used in identifying key self-management skills that are important in making health behavior changes such as those included in HOPE. A large randomized trial (Dunn et al., 1998; Dunn et al., 1999) provides evidence of the value of theory-driven programs designed to change health behavior. The self-management skills included in HOPE are derived from several health behavior change theories and models (see table 1).

Table 1 Educational and Psychological Theories and Models

Theories Description
Social cognitive theory Also referred to as social learning theory, this theory emphasizes the importance of self-efficacy and positive expectations in making behavior changes. It also emphasizes the importance of trying ability-appropriate tasks to gradually enhance self-efficacy for a specific task. The theory suggests that a person must value the outcomes of a behavior if a change in behavior is the goal.
Self-determination theory Central to self-determination theory is personal autonomy. Autonomy refers to the ability of a person to make his or her own decisions. Feelings of competence at mastering skills or tasks are also critical to the theory. Personal choice is emphasized rather than choice based on external pressures to comply. Intrinsic (internal) motivation is considered more important than extrinsic (external) motivation (e.g., rewards or payments). Intrinsic motivation makes adopting a behavior fulfilling rather than forced.
Theory of reasoned action This theory suggests that a person’s behavior is most associated with the person’s stated intention to carry out the behavior. According to this theory, a person’s intentions are influenced by attitudes (beliefs) and the social environment (opinions of others).
Theory of planned behavior This theory has many of the tenets of the theory of reasoned action, but it includes the concept of perceived control over the environment. If a person is to change a behavior, he must believe that he has some control over the factors that influence the behavior. Perceived control is in many ways similar to self-efficacy in social cognitive theory.
Models Description
Health beliefs model A model is similar to a theory in that it provides a blueprint for behavior change. This model suggests that a person’s health behavior is related to five factors: the belief that a health problem will have harmful effects, the belief that a person is susceptible to the problem, the belief that the perceived benefits of changing a lifestyle will prevent the problem, the belief that overcoming barriers to the problem will solve the problem, and confidence that he or she can do what is necessary to prevent or solve a problem.
Social ecological model The model is based on the idea that health behavior change is influenced by the interaction of cultural, social (intrapersonal), and physical environmental factors. For example, when people practice a negative behavior such as smoking, they affect the environment. Others in the environment are then exposed to a health risk. Unlike the other theories and models, the social ecological model emphasizes the importance of social and environmental factors rather than personal health behavior change.
Transtheoretical model This model is also referred to as the stages of change model. The model uses elements of all of the previously described theories and models. As noted in the student text, the model suggests that health behavior change does not occur all at once. Rather, five stages exist and behavior change occurs when people move from one stage to another. The model also emphasizes the importance of the process of change, including factors such as goal setting, self-monitoring, self-assessment, and self-planning.

References
Dunn, A.L., et al. (1998). Lifestyle physical activity interventions: History, short- and long-term effects, and recommendations. American Journal of Preventive Medicine, 15(4): 398-412.

Dunn, A.L., et al. (1999). Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness. Journal of American Medical Association, 281(4): 327-334.