Integrating Theories of Message Effects and Health Behavior Change to Improve Cancer Control

In recognition of cancer communication as an "Extraordinary Opportunity," the National Cancer Institute's Behavioral Research Program (part of DCCPS) supports the Theories Project to examine the role of theory in health behavior and to promote the use of theory in health behavior research. To this end, a meeting titled "Toward Better Theories of Health Behavior" was held in Santa Fe, New Mexico, in May 2002 to discuss how different communication theories could be integrated to create more effective intervention programs.

Theories

The meeting focused on three classes of theory and how they could be integrated and applied to the prevention of risky behavior and adoption of healthy behaviors. The three classes included:

1. Theories pertinent to behavior change; specifically, "dual process" approaches to message effects and information processing
2. Theories describing rational, emotional, social, and personal predictors of healthy and risky behavior
3. Theories predicting the format and content of messages that produce effects on cognitive, attitudinal, and emotional outcomes

Goals

The meeting drew some of the most distinguished scholars in the health behavior field. Their task was to represent their own theoretical position and to tie their perspective to existing theoretical work in the other two traditions, with the goals of:

• Producing significant developments in the integration of three theoretical traditions
• Increasing the likelihood of collaborative work across domains and disciplines
• Improving the predictive and explanatory power of interventions in service of better health outcomes and reduced risky behaviors
• Producing documents for the scientific community that will become the basis for theory-based interventions and new lines of research in health communication

Key Questions

In opening a dialogue among researchers in each of these areas, NCI hoped to improve applications in health communication by assessing what researchers know, what they don't know, what they surmise, and how the theories can be integrated, thereby clarifying the agenda for future research into crafting and delivering effective messages.

Among the key questions the meeting addressed were:

• What are the most promising health communication theories?
• Do behavior change and health communication scholars see theories in fundamentally different ways?
• Are message-effects theories really just behavior change theories with different wrapping, or are there unique aspects of each?
• To the extent that message-effects theories allow us to better understand how people process messages but don't necessarily provide a direct means to behavior change, should we think of these theories and behavior change theories as operating in tandem?
• Is there a need for new theory, theory development, and theory comparison?
• Should we be seeing different theories as playing different roles for different problems (e.g. prevention vs. early detection, initiation vs. maintenance of behaviors) both good and bad)?
• What impediments are there to the broader collaboration of scientists in message effects and behavior change?
• What are the implications of multimedia technologies? How do they change the nature, design, and effects of the health message? Are new theories of behavior change and message effects needed in these contexts?
• Do the theories apply equally to diverse populations?
• In each of the areas above, what is the evidence base? What do we know? What do we not know? About what do we speculate?
• Finally, what kinds of research do we need to answer the most immediately important questions?