chapter  18
20 Pages

Using Behavioral Theory to Transform Consumers and Their Environments to Prevent the Spread of Sexually Transmitted Infections

ByMartin Fishbein, Susan E. Middlestadt

Health and well-being result from individuals acting in their environments. Our central proposition is that, through a behavioral analysis, we can transform consumers and the environments that in$ uence their behaviors and, through this transformation, we can improve health and well-being. We begin by making the case that reducing sexually transmitted infections (STIs) can improve well-being for a substantial proportion of the world, and describing the role behavior plays in sexual transmission. We present the Integrative Model (IM), the most recent formulation of a Reasoned Action Approach, and show how research guided by this model can help develop interventions to transform consumers. We describe two interventions that have successfully transformed behavior, both of which take the typical, straightforward approach of identifying and modifying beliefs associated with condom use and thereby increasing condom use, an end health behavior. # en, we argue for an expanded use of a theory-based behavioral analysis, one that takes a public health perspective. Stated another way, we argue that a behavioral analysis can be used to develop the more complex, multilevel, or multicomponent interventions recognized as essential in public health. More speci! cally, we explain how a behavioral analysis can be used to understand the upstream behaviors that lead to the end health behavior, identify aspects of the environment that might be addressed by structural interventions, and determine how to change the behavior of agents who control the environments that in$ uence our behavior. We conclude with recommendations for research based on this expanded use of a behavioral analysis.