OF HEALTH AND
A G u i d e F o r H e a l t h P ro m o t i o n P ra c t i ce
A Guide For Health Promotion Practice
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
decade ago, the first edition of Theory at a Glancewas published. The guide was
a welcome resource for public health practitioners seeking a single, concise
summary of health behavior theories that was neither overwhelming nor superficial.
As a government publication in the public domain, it also provided cash-strapped
health departments with access to a seminal integration of scholarly work that was useful to
program staff, interns, anddirectors alike. Although they were not the primary target audience,
members of the public health research community also utilized Theory at a Glance, both as
a quick desk reference and as a primer for their students.
The National Cancer Institute is pleased to sponsor the publication of this guide, but its
relevance is by no means limited to cancer prevention and control. The principles describedherein can serve as frameworks for many domains of public health intervention,
complementing focused evidence reviews such as Centers for Disease Control and
Prevention’s Guide to Community Preventive Services. This report also complements a
number of other efforts by NCI and our federal partners to facilitate more rigorous testing
and application of health behavior theories through trainingworkshops and the development
of new Web-based resources.
One reason theory is so useful is that it helps us articulate assumptions and hypotheses
concerning our strategies and targets of intervention. Debates among policymakers
concerning public health programs are often complicated by unspoken assumptions or
confusion about which data are relevant. Theory can inform these debates byclarifying key
constructs and their presumed relationships. Especially when the evidence base is small,
advocates of one approach or another can be challenged to address the mechanisms by
which a program is expected to have an impact. By specifying these alternative pathways to
change, program evaluations can be designed to ensure that regardless of the outcome,
improvements in knowledge, programdesign, and implementation will occur.
I am pleased to introduce this second edition of Theory at a Glance. I am especially
impressed that the lead authors, Dr. Barbara K. Rimer and Dr. Karen Glanz, have enhanced
and updated it throughout without diminishing the clarity and efficiency of the original. We
hope that this new edition will empower another generation of public health practitionersto
apply the same conceptual rigor to program planning and design that these authors exemplify
in their own research and practice.
Robert T. Croyle, Ph.D.
Division of Cancer Control and Population Sciences
National Cancer Institute
The National Cancer Institute would like to thank Barbara Rimer Dr.P.H. and
Karen Glanz Ph.D., M.P.H.,authors of the original monograph, whose knowledge of
healthcommunications theory and practice have molded a generation of health promotion
practitioners. Both have provided hours of review and consultation, and we are grateful to
them for their contributions.
Thanks to the staffs of the Office of Communications, particularly Margaret Farrell,
and the Division of Cancer Control and PopulationSciences and Kelly Blake, who guided
this monograph to completion. We appreciate in particular the work of Karen Harris,
whose attention to detail and commitment to excellence enhanced the monograph’s
content and quality.
Table of Contents
Audience and Purpose
Part 1: Foundations of Theory in Health Promotion and Health Behavior
Why Is Theory...