Knowledge of factors affecting health and health behaviors
This domain tests why people behave as they do and how social, environmental, and psychological factors shape health. Expect questions applying behavior-change theories, identifying risk and protective factors, and distinguishing determinants.
Determinants and ecological model
Health is shaped by individual factors (genes, knowledge, skills), interpersonal factors (family, peers), organizational factors (school policies), community factors (food access, transportation), and public policy (taxes, smoke-free laws). Social determinants include income, education, housing, racism, and neighborhood safety. Risk factors raise the probability of harm (low self-efficacy, peer substance use, adverse childhood experiences); protective factors buffer (caring adult, school connectedness, stable housing, problem-solving skills). The ecological model says change is most effective at multiple levels, not just individual willpower.
Behavior-change theories
Transtheoretical/Stages of Change: precontemplation (no intention in 6 months), contemplation (intends within 6 months), preparation (plans within 30 days, small steps), action (changed within 6 months), maintenance (over 6 months). Relapse is normal. Health Belief Model: perceived susceptibility, severity, benefits, barriers, and cue to action predict behavior. Social Cognitive Theory: self-efficacy, observational learning, reinforcement, reciprocal determinism. Theory of Planned Behavior: attitudes, subjective norms, and perceived behavioral control shape intention, which predicts behavior.
Applying theory
Match strategy to stage: precontemplation needs awareness and personalized feedback; contemplation needs decisional balance; preparation needs action planning; action needs skills and support; maintenance needs relapse prevention. Do not lecture a precontemplator about a plan they do not want.
Worked example: A student says, 'I know vaping is bad and I'm thinking about quitting in the next month, but I haven't set a date.' This is preparation-intention within 30 days. Best response: help set a quit date, identify triggers, and connect to cessation support. A scare-tactic assembly targets precontemplation and misses the student's stage.
Traps: calling contemplation precontemplation; assuming knowledge changes behavior; confusing self-efficacy (confidence in a specific task) with self-esteem; ignoring environment and policy; treating relapse as failure; applying the wrong theory.