Empiric validation of a process for behavior change

Abstract

Most behavior change trials focus on outcomes rather than deconstructing how those outcomes related to programmatic theoretical underpinnings and intervention components. In this report, the process of change is compared for three evidence-based programs' that shared theories, intervention elements and potential mediating variables. Each investigation was a randomized trial that assessed pre- and post- intervention variables using survey constructs with established reliability. Each also used mediation analyses to define relationships. The findings were combined using a pattern matching approach. Surprisingly, knowledge was a significant mediator in each program (a and b path effects [p<0.01]). Norms, perceived control abilities, and self-monitoring were confirmed in at least two studies (p<0.01 for each). Replication of findings across studies with a common design but varied populations provides a robust validation of the theory and processes of an effective intervention. Combined findings also demonstrate a means to substantiate process aspects and theoretical models to advance understanding of behavior change.

Keywords: Behavior change; Mediation; Peer-led.

Figures

Fig 1

Basic mediation model

Fig 2

Integrated action and conceptual model components. Some components modified from Fishbein M, Cappella JN. J Commun. 2006;56:S1-S17 (with permission)

Fig 3

Validated action and conceptual model. Solid lines are confirmed paths, with the width relating to the number of studies confirming the path. The associated numbers indicate the studies in which path was confirmed. Path coefficients (standard errors) and significance levels are shown in Table 1