National Cancer Institute   National Cancer Institute

Behavioral Research

1 Description and Theoretical Background
2 Use in Health Behavior Theories
3 Measures and Measurement
4 Most Common Barriers
5 Measurement and Methodological Issues


7 References
8 Appendix 1
9 Appendix 2
10 Appendix 3
11 Appendix 4
12 Published Examples

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Other Constructs



Dispositional Optimism




Illness Representations

  Implementation Intentions
  Intention, Expectation, and Willingness
  Normative Beliefs
  Optimistic Bias
  Perceived Benefits
  Perceived Control
  Perceived Severity
  Perceived Vulnerability
  Self-Reported Behavior
  Social Influence
  Social Support

Perceived Barriers to Self-Management and Preventive Behaviors
Russell E. Glasgow, Ph.D.

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The concept of perceived barriers is both important and central to a variety of prominent health behavior theories. There are a number of validated barrier measures available for use that target screening for cancer and other diseases, and especially for preventive health behaviors. Additional research is needed to address issues such as: 1) the impact of culture, race, ethnicity, health literacy, and other factors on perceptions of barriers; 2) if a standard, feasible core set of barrier questions and responses can be identified by content area for the different purposes of prediction and individual tailoring of intervention; and 3) interpretive problems and lack of conceptual clarity that are discussed above (Glasgow et al., 2001; McCauley et al., 1998). Future research should also pay increased attention to emotional and "distress"-related issues that are proving to be of critical importance in chronic illness (Anderson et al., 2007; Fisher et al., 2007). A final topic for further research is the issue of barriers among patients who have several comorbid conditions and receive multiple health behavior recommendations. Such "high-risk" patients may face barriers that are qualitatively and quantitatively different than those experienced by those with fewer conditions (Bayliss et al., 2003).

As in many areas of research, several investigative teams have made progress, but often appear to be unaware of or not influenced by alternative approaches or developments in different areas. With barriers, the key issue is not the exact measure or analysis used, but how the results are interpreted. As with many attempts to apply theory to real-world health behaviors, there are challenges to appropriate operationalization and interpretation of results (Weinstein, 2007). Future research will likely see continued and expanded use of barrier concepts and measures, especially in areas such as barriers to genetic screening.

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Health Behavior Constructs: Theory, Measurement, & Research