On March 30, 2017 at the Society for Healthcare Epidemiology of America (SHEA) Spring 2017 Conference, plenary speaker Matthew W. Kreuter, PhD, MPH, from The Brown School at Washington University in St. Louis, afforded conference attendees fresh insight on delivering health behavior change strategies in order to better prevent hospital infections.
According to Dr. Kreuter, the founding father of health behavior theory is Albert Bandura, who stressed that there are three essential factors that matter when it comes to behavior change: the person, the environment, and the behavior.
When it comes to the person who will be taking on the behavioral change, “what that person thinks, what they know, what they believe, [and] what they feel, [are] all personal-level variables [that] influence behavior,” Dr. Kreuter said. Environmental factors consist of social factors such as the individuals in your surroundings, laws or policies, or any other environmental conditions that “present or restrict opportunities for people to engage in particular behaviors.” Lastly, there is behavior itself, and the key takeaway that Dr. Kreuter stressed is that “behavior is not behavior is not behavior; it’s not one thing. The characteristics and the demands of different behaviors are different, and you have to understand those [differences] if you are going to be able to select appropriate strategies to change those behaviors.”
Dr. Kreuter emphasized that these variables aren’t siloed off; they affect one other. For example, just as environment can affect behavior, behavior can affect environment, and he referred to that interplay as “reciprocal determinism.”
Dr. Kreuter then proceeded to outline a three-step approach for assessing and addressing a problem from a behavioral science perspective. The first step is to “try to understand behavior, people, and environment for a particular behavior or set of behaviors.” Then, try to identify the determinants of that behavior. Finally, you can begin developing and testing strategies for that behavior.