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BMC Public Health
Published in: BMC Public Health 1/2007

Open Access 01-12-2007 | Research article

A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS?

Authors: Salla Munro, Simon Lewin, Tanya Swart, Jimmy Volmink

Published in: BMC Public Health | Issue 1/2007

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Abstract

Background

Suboptimal treatment adherence remains a barrier to the control of many infectious diseases, including tuberculosis and HIV/AIDS, which contribute significantly to the global disease burden. However, few of the many interventions developed to address this issue explicitly draw on theories of health behaviour. Such theories could contribute to the design of more effective interventions to promote treatment adherence and to improving assessments of the transferability of these interventions across different health issues and settings.

Methods

This paper reviews behaviour change theories applicable to long-term treatment adherence; assesses the evidence for their effectiveness in predicting behaviour change; and examines the implications of these findings for developing strategies to improve TB and HIV/AIDS medication adherence. We searched a number of electronic databases for theories of behaviour change. Eleven theories were examined.

Results

Little empirical evidence was located on the effectiveness of these theories in promoting adherence. However, several models have the potential to both improve understanding of adherence behaviours and contribute to the design of more effective interventions to promote adherence to TB and HIV/AIDS medication.

Conclusion

Further research and analysis is needed urgently to determine which models might best improve adherence to long-term treatment regimens.
Appendix
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Literature
1.
2.
Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: The use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005, 58: 107-112. 10.1016/j.jclinepi.2004.09.002.CrossRefPubMed
3.
Michie S, Abraham C: Interventions to change health behaviours: Evidence-based or evidence-inspired?. Psychol Health. 2004, 19: 29-49. 10.1080/0887044031000141199.CrossRef
4.
Haynes RB, McDonald H, Garg AX, Montague P: Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev. 2002, CD000011-2
5.
Raviglione M, Snider D, Kochi A: Global epidemiology of tuberculosis: Morbidity and mortality of a worldwide epidemic. J Am Med Assoc. 1995, 273: 220-226. 10.1001/jama.273.3.220.CrossRef
6.
Sackett DL, Snow JC: The magnitude of adherence and non-adherence. Compliance in Health Care. Edited by: Haynes RB, Taylor DW, Sackett DL. 1979, Baltimore: Johns Hopkins University Press, 11-22.
7.
World Health Organisation: Adherence to long-term therapies: Evidence for action. Geneva. 2003
8.
Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A: Making psychological theory useful for implementing evidence based practice: A consensus approach. Qual Saf Health Care. 2005, 14: 26-33. 10.1136/qshc.2004.011155.CrossRefPubMedPubMedCentral
9.
Leventhal H, Cameron L: Behavioural theories and the problem of compliance. Patient Educ Couns. 1987, 10: 117-138. 10.1016/0738-3991(87)90093-0.CrossRef
10.
Brawley LR, Culos-Reed SN: Studying adherence to therapeutic regimens: Overview, theories, recommendations. Control Clin Trials. 2000, 21: 156S-163S. 10.1016/S0197-2456(00)00073-8.CrossRefPubMed
11.
Ross E, Deverell A: Psychosocial approaches to health, illness and disability: A reader for health care professionals. 2004, Pretoria: Van Schaik
12.
13.
Sumartojo E: When tuberculosis treatment fails: A social behavioural account of patient adherence. Am Rev Respir Dis. 1993, 147: 1311-1320.CrossRefPubMed
14.
Singh V, Jaiswal A, Porter JDH, Ogden JA, Sarin R, Sharma PP, Arora VK, Kain RC: TB control, poverty and vulnerability in Delhi, India. Trop Med Int Health. 2002, 7: 693-700. 10.1046/j.1365-3156.2002.00909.x.CrossRefPubMed
15.
Dunbar JM, Marshall GD, Hovell MF: Behavioural strategies for improving compliance. Compliance in health care. Edited by: Haynes RB, Taylor DW, Sackett DL. 1979, Baltimore: Johns Hopkins University Press, 174-190.
16.
Simoni JM, Pearson CR, Pantalone DW, Marks G, Crepaz N: Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load: a meta-analytic review of randomized controlled trials. J Acquir Immune Defic Syndr. 43 (Suppl 1): S23-S35. 2006 Dec 1
17.
Mannheimer SB, Morse E, Matts JP, Andrews L, Child C, Schmetter B, Friedland GH: Sustained benefit from a long-term antiretroviral adherence intervention : results of a large randomized clinical trial. J Acquir Immune Defic Syndr. 43 (Suppl 1): S41-S47. 2006 Dec 1
18.
Lewin SA, Skea ZC, Entwistle V, Zwarenstein M, Dick J: Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database Syst Rev. 2001, 4: CD003267-PubMed
19.
Murray E, Burns J, See Tai S, Lai R, Nazareth I: Interactive Health Communication Applications for people with chronic disease. Cochrane Database Syst Rev. 2005, 4: CD004274-PubMed
20.
McKinstry B, Ashcroft RE, Car J, Freeman GK, Sheikh A: Interventions for improving patients' trust in doctors and groups of doctors. Cochrane Database Syst Rev. 2006, 3: CD004134-PubMed
21.
Griffin SJ, Kinmonth A, Veltman MWM, Gillard S, Grant J, Stewart M: Effect on Health-Related Outcomes of Interventions to Alter the Interaction Between Patients and Practitioners: A Systematic Review of Trials. Ann Fam Med. 2004, 2: 595-608. 10.1370/afm.142.CrossRefPubMedPubMedCentral
22.
Stroebe W: Social psychology and health. 2000, Buckingham: Open University Press, 2
23.
Gebhardt WA, Maes S: Integrating social-psychological frameworks for health behaviour research. Am J Health Beh. 2001, 25: 528-536.CrossRef
24.
Weinstein ND: The precaution adoption process. Health Psychol. 1988, 7: 355-386. 10.1037/0278-6133.7.4.355.CrossRefPubMed
25.
Ingham R, Woodcock A, Stenner K: The limitations of rational decision-making models as applied to young people's sexual behaviour. AIDS: Rights, risk and reason. Edited by: Aggleton PP, Davies P, Hart G. 1992, London: Falmer Press, 163-173.
26.
Bloor M: A user's guide to contrasting theories of HIV related risk behaviour. In Medicine, health and risk: Sociological approaches (Sociology of Health and Illness Monograph Series). Edited by: Gabe J. 1995, London: Blackwell Publishers, 19-30.
27.
Becker MH, Maiman LA, Kirscht JP, Haefner DP, Drachman RH, Taylor DW: Patient perceptions and compliance: Recent studies of the Health Belief Model. Compliance in Health Care. Edited by: Haynes RB, Taylor DW, Sackett DL. 1979, Baltimore: Johns Hopkins University Press, 78-109.
28.
Armitage CJ, Conner M: Social cognition models and health behaviour: A structured review. Psychol Health. 2000, 15: 173-189.CrossRef
29.
Bandura A: Self-efficacy: The exercise of control. 1997, New York: W. H. Freeman and Company
30.
Rosenstock IM, Strecher VJ, Becker MH: Social learning theory and the health belief model. Health Educ Q. 1988, 15: 175-183.CrossRefPubMed
31.
Strecher V, Rosenstock I: The health belief model. Cambridge Handbook of psychology, health and medicine. Edited by: Baum A, Newman S, Weinman J, West R, McManus C. 1997, Cambridge: Cambridge University Press, 113-116.
32.
Stroebe W, de Wit J: Health impairing behaviours. Applied Social Psychology. Edited by: Semin GR, Fiedler K. 1996, London: Sage, 113-143.CrossRef
33.
Rosenstock IM: The health belief model: Explaining health behavior through expectancies. Health behaviour and health education. Edited by: Glanz K, Lewis FM, Rimer BK. 1990, San Francisco: Josey-Bass, 39-62.
34.
35.
Harrison JA, Mullen PD, Green LW: A meta-analysis of studies of the health belief model with adults. Health Educ Res. 1992, 7: 107-116. 10.1093/her/7.1.107.CrossRefPubMed
36.
De Villiers S: Tuberculosis in anthropological perspective. South African Journal of Ethnology. 1991, 14: 69-72.
37.
Rogers RW: A protection motivation theory of fear appeals and attitude change. J Psychol. 1975, 91: 93-114.CrossRef
38.
Maddux JE, Rogers RW: Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change. J Exp Soc Psychol. 1983, 19: 469-479. 10.1016/0022-1031(83)90023-9.CrossRef
39.
Floyd DL, Prentice-Dunn S, Rogers RW: A meta-analysis of research on protection motivation theory. J Appl Soc Psychol. 2000, 30: 407-429. 10.1111/j.1559-1816.2000.tb02323.x.CrossRef
40.
Bandura A: Health promotion from the perspective of social cognitive theory. Understanding and changing health behaviour: From health beliefs to self-regulation. Edited by: Norman P, Abraham C, Conner M. 2000, Amsterdam: Harwood Academic Publishers, 299-339.
41.
Bandura A: Health promotion by social cognitive means. Health Educ Behav. 2004, 31: 143-164. 10.1177/1090198104263660.CrossRefPubMed
42.
43.
44.
Fishbein M, Ajzen I: Belief, attitude intention and behaviour: An introduction to theory and research. 1975, Menlo Park: Addison-Wesley
45.
Sutton S: Theory of planned behaviour. Cambridge handbook of psychology, health and medicine. Edited by: Baum A, Newman S, Weinman J, West R, McManus C. 1997, Cambridge: Cambridge University Press, 177-179.
46.
St Claire L: Rival Truths: Common sense and social psychological explanations in health and illness. 2003, Hove: Psychology PressCrossRef
47.
Hardeman W, Johnston M, Johnston DW, Bonetti D, Wareman NJ, Kinmonth AL: Application of the theory of planned behaviours in behaviour change interventions: A systematic review. Psychol Health. 2002, 17: 123-158. 10.1080/08870440290013644.CrossRef
48.
Godin G, Kok G: The theory of planned behavior: A review of its applications to health-related behaviours. Am J Health Promot. 1996, 11: 87-98.CrossRefPubMed
49.
Armitage CJ, Conner M: Efficacy of the theory of planned behaviour: A meta-analytic review. Br J Soc Psychol. 2001, 40: 471-499. 10.1348/014466601164939.CrossRefPubMed
50.
Mullen PD, Hersey JC, Iverson DC: Health behavior models compared. Soc Sci Med. 1987, 24: 973-981. 10.1016/0277-9536(87)90291-7.CrossRefPubMed
51.
Fisher JD, Fisher WA: Changing AIDS-risk behaviour. Psychol Bull. 1992, 11: 455-474. 10.1037/0033-2909.111.3.455.CrossRef
52.
Fisher JD, Fisher WA, Amico KR, Harman JJ: An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006, 25: 462-73. 10.1037/0278-6133.25.4.462.CrossRefPubMed
53.
Amico KR, Toro-Alfonso J, Fisher JD: An empirical test of the information, motivation and behavioral skills model of antiretroviral therapy adherence. AIDS Care. 2005, 17: 661-73. 10.1080/09540120500038058.CrossRefPubMed
54.
Leventhal H, Leventhal EA, Schaefer PM: Vigilant coping and health behaviour. Aging health and behaviour. Edited by: Ory MG, Abeles RD, Lipman PD. 1992, Newbury Park: Sage, 109-140.
55.
Edgar KA, Skinner TC: Illness representations and coping as predictors of emotional wellbeing in adolescents with Type I diabetes. J Pediatr Psychol. 2003, 28: 485-493. 10.1093/jpepsy/jsg039.CrossRefPubMed
56.
Benyamini Y, Gozlan M, Kokia E: On self-regulation of a health threat: Cognitions, coping and emotions among women undergoing treatment for fertility. Cognit Ther Res. 2004, 28: 577-592. 10.1023/B:COTR.0000045566.97966.22.CrossRef
57.
Leventhal H, Meyer D, Nerenz D: The common sense representation of illness danger. Contributions to medical psychology. Edited by: Rachman S. 1980, Oxford: Pergamon Press, 2: 7-30.
58.
Sutton S: A critical review of the transtheoretical model applied to smoking cessation. Understanding and changing health behaviour: From health beliefs to self-regulation. Edited by: Norman P, Abraham C, Conner M. 2000, Amsterdam: Harwood Academic Publishers, 207-225.
59.
Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consult Clin Psychol. 1983, 51: 390-395. 10.1037/0022-006X.51.3.390.CrossRef
60.
Prochaska JO, DiClemente CC, Norcross JC: In search of how people change: Applications to addictive behaviours. Am Psychol. 1992, 47: 1102-1114. 10.1037/0003-066X.47.9.1102.CrossRefPubMed
61.
Prochaska JO: Strong and weak principles for progressing from precontemplation to action on the basis of twelve problem behaviours. Health Psychol. 1994, 13: 47-51. 10.1037/0278-6133.13.1.47.CrossRefPubMed
62.
Prochaska JO, Velicer WF, DiClemente CC, Fava J: Measuring processes of change: Applications to the cessation of smoking. Journal of Consult Clin Psychol. 1988, 56: 520-528. 10.1037/0022-006X.56.4.520.CrossRef
63.
Sutton S: Transtheoretical model of behaviour change. Cambridge handbook of psychology, health and medicine. Edited by: Baum A, Newman S, Weinman J, West R, McManus C. 1997, Cambridge: Cambridge University Press, 180-182.
64.
Riemsma RP, Pattenden J, Bridle C, Sowden AJ, Mather L, Watt IS, Walker A: Systematic review of the effectiveness of stage based interventions to promote smoking cessation. Br Med J. 2003, 326: 1175-1177. 10.1136/bmj.326.7400.1175.CrossRef
65.
Marshall SJ, Biddle SJH: The transtheoretical model of behaviour change: A meta-analysis of applications to physical activity and exercise. Ann Behav Med. 2001, 23: 229-246. 10.1207/S15324796ABM2304_2.CrossRefPubMed
66.
Weinstein ND: Testing four competing theories of health-protective behaviour. Health Psychol. 1993, 12: 324-333. 10.1037/0278-6133.12.4.324.CrossRefPubMed
67.
Ashing-Giwa K: Health behaviour change models and their socio-cultural relevance for breast cancer screening in African American women. Women Health. 1999, 28: 53-71. 10.1300/J013v28n04_04.CrossRefPubMed
68.
Singh JA, Upshur R, Padayatchi N: XDR-TB in South Africa : No time for denial or complacency. PLOS Medicine. 2007, 4: 19-25. 10.1371/journal.pmed.0040050.CrossRef
69.
Kok G, Schaalma H, Ruiter RAC, Van Empelen P: Intervention mapping: A protocol for applying health psychology theory to prevention programmes. J Health Psychol. 2004, 9: 85-98. 10.1177/1359105304038379.CrossRefPubMed
70.
Oxman AD, Fretheim A, Flottorp S: The OFF theory of research utilization. J Clin Epidemiol. 2005, 58: 113-116. 10.1016/j.jclinepi.2004.10.002.CrossRefPubMed
71.
The Improved Clinical Effectiveness through Behavioural Research Group (ICEBeRG): Designing theoretically-informed implementation interventions. Implementation Science. 2006, 1: 4-10.1186/1748-5908-1-4.CrossRef
72.
Amico KR, Harman JJ, Johnson BT: Efficacy of antiretroviral therapy adherence interventions: A research synthesis of trials, 1996 to 2004. J Acquir Immune Defic Syndr. 2006, 41: 285-297. 10.1097/01.qai.0000197870.99196.ea.CrossRefPubMed
73.
Abraham C, Norman P, Conner M: Towards a psychology of health-related behaviour change. Understanding and changing health behaviour: From health beliefs to self-regulation. Edited by: Norman P, Abraham C, Conner M. 2000, Amsterdam: Harwood Academic Publishers, 343-369.
74.
Weinstein ND, Rothman AJ: Commentary: Revitalizing research on health behaviour theories. Health Educ Res. 2005, 20: 294-297. 10.1093/her/cyg125.CrossRefPubMed
75.
Munro S, Lewin S, Smith H, Engel M, Fretheim A, Volmink J: Patient adherence to tuberculosis treatment : a systematic review of qualitative research. PLoS Medicine (submitted, provisionally accepted, pending final decision).
76.
Simoni JM, Frick PA, Pantalone DW, Turner BJ: Antiretroviral adherence interventions : A review of current literature and ongoing studies. Top HIV Med. 2003, 11: 185-198.PubMed
77.
Volmink J, Garner P: Directly observed therapy for treating tuberculosis. The Cochrane Database of Systematic Reviews. 2006, 2
78.
Davies P, Walker A, Grimshaw J: Theories of behaviour change in studies of guideline implementation. Proceedings of the British Psychological Society. 2003, 11: 120-
79.
Schedlbauer A, Schroeder K, Peters TJ, Fahey T: Interventions to improve adherence to lipid lowering medication. The Cochrane Database of Systematic Reviews. 2004, 4
80.
Vermeire E, Wens J, Van Royen P, Biot Y, Hearnshaw H, Lindenmeyer A: Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. The Cochrane Database of Systematic Reviews. 2005, 2
81.
Mills EJ, Nachega JB, Bangsberg DR, Singh S, Rachlis B, Wu P, Wilson K, Buchan I, Gill CI, Cooper C: Adherence to HAART : a systematic review of developed and developing nation patient-reported barriers and facilitators. PLoS Med. 2006, 3 (11): e438-10.1371/journal.pmed.0030438.CrossRefPubMedPubMedCentral
82.
Farmer P: Social scientists and the new tuberculosis. Soc Sci Med. 1997, 44: 347-358. 10.1016/S0277-9536(96)00143-8.CrossRefPubMed
83.
Lewin S, Dick J, Zwarenstein M, Lombard CJ: Staff training and ambulatory tuberculosis treatment outcomes: A cluster randomized controlled trial in South Africa. Bull World Health Organ. 2005, 83: 250-259.PubMedPubMedCentral
84.
Mukherjee JS, Ivers L, Leandre F, Farmer P, Behforouz H: Antiretroviral therapy in resource-poor settings : decreasing barriers to access and promoting adherence. J Acquir Immune Defic Syndr. 43 (Suppl 1): S123-S126. 2006 Dec 1
85.
Lim WS, Low HN, Chan SP, Chen HN, Ding YY, Tan TL: Impact of a pharmacist consult clinic on a hospital based geriatric outpatient clinic in Singapore. Ann Acad Med. 2004, 33: 220-227.
86.
Schaffer SD, Tian L: Promoting adherence: Effects of theory-based asthma education. Clin Nurs Res. 2004, 13: 69-89. 10.1177/1054773803259300.CrossRefPubMed
87.
Tuldra A, Fumaz CR, Ferrer MJ, Bayes R, Arno A, Balague M, Bonjoch A, Jou A, Negredo E, Paredes Ruiz L, Romeu J, Sirera G, Tural C, Burger D, Clotet B: Prospective randomised two-arm controlled study to determine the efficacy of a specific intervention to improve long-term adherence to highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2000, 25: 221-228. 10.1097/00042560-200011010-00003.CrossRefPubMed
88.
Armitage CJ, Conner M: Reducing fat intake: Interventions based on the theory of planned behaviour. Changing health behaviour. Edited by: Rutter D, Quine L. 2002, Buckingham: Open University Press, 87-104.
89.
Theunissen NCM, de Ridder DTD, Bensing JM, Rutten GEHM: Manipulation of patient-provider interaction: discussing illness representations or action plans concerning adherence. Patient Educ Couns. 2003, 51: 247-258. 10.1016/S0738-3991(02)00224-0.CrossRefPubMed
90.
Aveyard P, Cheng KK, Almond J, Sherratt E, Lancashire R, Lawrence T, Griffin C, Evans O: Cluster randomised controlled trial of expert system based on the transtheoretical ("stages of change") model for smoking prevention and cessation in schools. BMJ. 1999, 319 (7215): 948-53.CrossRefPubMedPubMedCentral
Metadata
Title
A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS?
Authors
Salla Munro
Simon Lewin
Tanya Swart
Jimmy Volmink
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2007
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-7-104

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