Behavior change, in context of public health, refers to efforts put in place to change people's personal habits and attitudes, to prevent disease.[1] Behavior change in public health can take place at several levels and is known as social and behavior change (SBC).[2] More and more, efforts focus on prevention of disease to save healthcare care costs.[3] This is particularly important in low and middle income countries, where supply side health interventions have come under increased scrutiny because of the cost.[4]


The 3-4-50 concept[5] outlines that there are 3 behaviors (poor diet, little to no physical activity, and smoking), that lead to four diseases (heart disease/stroke, diabetes, cancer, pulmonary disease), that account for 50% of deaths worldwide. This is why so much emphasis in public health interventions have been on changing behaviors or intervening early on to decrease the negative impacts that come with these behaviors. With successful intervention, there is the possibility of decreasing healthcare costs by a drastic amount, as well as general costs to society (morbidity and mortality). A good public health intervention is not only defined by the results they create, but also the number of levels it hits on the socioecological model[6] (individual, interpersonal, community and/or environment). The challenge that public health interventions face is generalizability: what may work in one community may not work in others. However, there is the development of Healthy People 2020 that has national objectives aimed to accomplish in 10 years to improve the health of all Americans.[citation needed]

Health conditions and infections are associated with risky behaviors. Tobacco use, alcoholism, multiple sex partners, substance use, reckless driving, obesity, or unprotected sexual intercourse are some examples. Human beings have, in principle, control over their conduct. Behavior modification can contribute to the success of self-control, and health-enhancing behaviors. Risky behaviors can be eliminated including physical exercise, weight control, preventive nutrition, dental hygiene, condom use, or accident prevention. Health behavior change refers to the motivational, volitional, and action based processes of abandoning such health-compromising behaviors in favor of adopting and maintaining health-enhancing behaviors.[7][8][9] Addiction that is associated with risky behavior may have a genetic component.[10]


Behavior change programs tend to focus on a few behavioral change theories which gained ground in the 1980s. These theories share a major commonality in defining individual actions as the locus of change. Behavior change programs that are usually focused on activities that help a person or a community to reflect upon their risk behaviors and change them to reduce their risk and vulnerability are known as interventions. Examples include: "Transtheoretical (Stages of Change) Model of Behavior Change", "theory of reasoned action", "health belief model", "theory of planned behavior",[11] diffusion of innovation",[12] and the health action process approach.[13] Developments in health behavior change theories since the late 1990s have focused on incorporating disparate theories of health behavior change into a single unified theory.[14][15]

Individual and interpersonal



Behavior change communication (BCC)

Main article: Social and behavior change communication

Behavior change communication, or BCC, is an approach to behavior change focused on communication. It is also known as social and behavior change communication, or SBCC. The assumptions is that through communication of some kind, individuals and communities can somehow be persuaded to behave in ways that will make their lives safer and healthier. BCC was first employed in HIV and TB prevention projects.[18][19] More recently, its ambit has grown to encompass any communication activity whose goal is to help individuals and communities select and practice behavior that will positively impact their health, such as immunization, cervical cancer check up, employing single-use syringes, etc.[citation needed]

List of behavior change strategies

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See also


  1. ^ WHO 2002: "World Health Report 2002 – Reducing Risks, Promoting Healthy Life". Retrieved February 2015.
  2. ^ "Why Social and Behavior Change Communication? – Health Communication Capacity Collaborative – Social and Behavior Change Communication". Health Communication Capacity Collaborative – Social and Behavior Change Communication. Retrieved 2016-06-17.
  3. ^ US Center for Disease Control and Prevention. "National Prevention Strategy". Retrieved February 2015.
  4. ^ Jamison DT, Breman JG, Measham AR, et al., (eds) (2006) Disease Control Priorities in Developing Countries. 2nd edition Chapter 2: Intervention Cost-Effectiveness Retrieved February 2015.
  5. ^ "SD County". Archived from the original on 2019-04-30. Retrieved 2017-08-06.
  6. ^ "American College Health Association". Archived from the original on 2017-08-07. Retrieved 2017-08-06.
  7. ^ "SAID project". Private Sector Partnerships. SAID project focused on increasing the private sector's role in providing high-quality health products and services in developing countries.
  8. ^ "Barrier Analysis website". Barrier Analysis website.
  9. ^ "Designing for Behavior Change Curriculum". Designing for Behavior Change Curriculum. Archived from the original on 2016-11-20. Retrieved 2012-11-29.
  10. ^ Biliński P, Wojtyła A, Kapka-Skrzypczak L, Chwedorowicz R, Cyranka M, Studziński T (2012). "Epigenetic regulation in drug addiction". Ann. Agric. Environ. Med. 19 (3): 491–496. PMID 23020045.
  11. ^ "Theory of Planned Behavior – The Health COMpass". Archived from the original on 2016-08-13. Retrieved 2016-06-17.
  12. ^ "Diffusion of Innovations – The Health COMpass". Archived from the original on 2016-11-09. Retrieved 2016-06-17.
  13. ^ Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology: An International Review, 57(1), 1–29.
  14. ^ Ryan, Polly (2009). "Integrated Theory of Health Behavior Change: Background and Intervention Development". Clinical Nurse Specialist. 23 (3): 161–172. doi:10.1097/NUR.0b013e3181a42373. PMC 2778019. PMID 19395894.
  15. ^ Prochaska, James; Velicer, Wayne (1997). "The Transtheoretical Model of Health Behavior Change". American Journal of Health Promotion. 12 (1): 38–48. doi:10.4278/0890-1171-12.1.38. PMID 10170434. S2CID 46879746.
  16. ^ Janz, Nancy K.; Becker, Marshall H. (2016-09-04). "The Health Belief Model: A Decade Later" (PDF). Health Education Quarterly. 11 (1): 1–47. doi:10.1177/109019818401100101. hdl:2027.42/66877. PMID 6392204. S2CID 10938798.
  17. ^ Rogers, Ronald W. (1975-09-01). "A Protection Motivation Theory of Fear Appeals and Attitude Change1". The Journal of Psychology. 91 (1): 93–114. doi:10.1080/00223980.1975.9915803. ISSN 0022-3980. PMID 28136248.
  18. ^ "Brazil: Behavior Change Communication for More Effective Tuberculosis Control". John Snow Inc. 2010–2011. Retrieved 2 August 2016.
  19. ^ "Behaviour Change Communication (BCC)for HIV/AIDS a Strategic Framework" (PDF). September 2002. Archived from the original (PDF) on 17 April 2016. Retrieved 2 August 2016.
  20. ^ Programs, Johns Hopkins Center for Communication. "CCP Home Page". Johns Hopkins Center for Communication Programs. Retrieved 2020-04-26.
  21. ^ "DMI – Where we work". Archived from the original on 2015-08-31. Retrieved 2015-09-06.
  22. ^ "Evidence Action Beta".
  23. ^ "Science Of Behavior Change". Retrieved 2020-04-26.
  24. ^ Kharas, Firdaus. "Keynote Speaker | Firdaus Kharas". Chocolate Moose Media. Retrieved 2020-04-26.
  25. ^ "LOOKAHEADE". Retrieved 2020-04-26.
  26. ^ "Shape Up Somerville". City of Somerville. Retrieved 2020-04-26.
  27. ^ "Diabetes Prevention Program (DPP)". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 2020-04-26.
  28. ^ "Truth Initiative: inspiring tobacco free-lives". Retrieved 2020-04-26.
  29. ^ "Home". Campaign for Tobacco-Free Kids. 2017-05-25. Retrieved 2020-04-26.
  30. ^ "About the Tobacco Regulatory Science Program (TRSP)". Office of Disease Prevention. Retrieved 2020-04-26.