Health Behavior, Prevention, and Health Promotion
Core concepts
Know the major health behavior theories and when each applies: Health Belief Model (perceived susceptibility, severity, benefits, barriers, cues to action, self-efficacy), Transtheoretical/Stages of Change (precontemplation through maintenance; processes of change and decisional balance), Theory of Planned Behavior (attitudes, subjective norms, perceived behavioral control predicting intention), Social Cognitive Theory (reciprocal determinism, self-efficacy, observational learning), and the Ecological Model (intrapersonal through policy levels). Distinguish primary, secondary, and tertiary prevention, and understand motivational interviewing as a collaborative, autonomy-supportive approach rather than persuasion.
Traps
Stems frequently describe a patient "not ready to change"-the trap is selecting an action-oriented intervention when a stage-matched, motivational response is correct. Another trap: conflating the Health Belief Model's perceived barriers with self-efficacy, or attributing intention-behavior gaps to attitudes alone. Prevention-level questions hinge on timing relative to disease onset (screening is secondary, not primary). Also watch for over-claiming that education alone changes behavior; the evidence favors multicomponent, environment-supported interventions.
Worked example
A smoker in precontemplation is told by a physician to quit "because it's bad for you." Best response: brief, nonjudgmental feedback and exploration of ambivalence (MI-consistent), not a detailed quit plan. Rule of thumb: match the intervention to the stage; confrontation predicts dropout.
Study tip
For any behavior-change vignette, first name the stage and the target construct, then choose the intervention that maps to both.