Cited by 149Behavioral Health and InterventionsCancer survivorship and careHealth Policy Implementation Science

Use of Theory in Behavior Change Interventions: An Analysis of Programs to Increase Physical Activity in Posttreatment Breast Cancer Survivors

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Bluethmann, Shirley M., Bartholomew, L. Kay, Murphy, Caitlin C., Vernon, Sally W.·2017·Health Education & Behavior

Abstract

Objective. Theory use may enhance effectiveness of behavioral interventions, yet critics question whether theory-based interventions have been sufficiently scrutinized. This study applied a framework to evaluate theory use in physical activity interventions for breast cancer survivors. The aims were to (1) evaluate theory application intensity and (2) assess the association between extensiveness of theory use and intervention effectiveness. Methods. Studies were previously identified through a systematic search, including only randomized controlled trials published from 2005 to 2013, that addressed physical activity behavior change and studied survivors who were <5 years posttreatment. Eight theory items from Michie and Prestwich’s coding framework were selected to calculate theory intensity scores. Studies were classified into three subgroups based on extensiveness of theory use (Level 1 = sparse; Level 2 = moderate; and Level 3 = extensive). Results. Fourteen randomized controlled trials met search criteria. Most trials used the transtheoretical model ( n = 5) or social cognitive theory ( n = 3). For extensiveness of theory use, 5 studies were classified as Level 1, 4 as Level 2, and 5 as Level 3. Studies in the extensive group (Level 3) had the largest overall effect size ( g = 0.76). Effects were more modest in Level 1 and 2 groups with overall effect sizes of g = 0.28 and g = 0.36, respectively. Conclusions. Theory use is often viewed as essential to behavior change, but theory application varies widely. In this study, there was some evidence to suggest that extensiveness of theory use enhanced intervention effectiveness. However, there is more to learn about how theory can improve interventions for breast cancer survivors.

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Authors
Bluethmann, S. M., Bartholomew, L. K., Murphy, C. C., & Vernon, S. W.
Affiliations
  • The University of Texas School of Public Health, Houston, TX, USA
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Bluethmann, Shirley M.
Venue
Health Education & Behavior
Published
2016-07-10
Volume
44
Issue
2
Pages
245-253
ISSN
  • 1090-1981 (ISSN-L)
  • 1552-6127
OpenAlex
W2402376178
Cited by
148
References
64
Citations by year
2026: 8 · 2025: 18 · 2024: 14 · 2023: 17 · 2022: 32 · 2021: 28 · 2020: 10 · 2019: 9 · 2018: 10 · 2017: 2
FWCI
10.75
Type
journal article
Language
en
Open access
Locations
  • Health Education & Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (R25CA057712)
Topics
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
theory application, behaviour change interventions, breast cancer survivors, physical activity interventions, transtheoretical model, social cognitive theory, intervention effectiveness
MeSH terms
Behavior Therapy, Breast Neoplasms, Female, Humans, Health Behavior, Exercise, Randomized Controlled Trials as Topic, Survivors, Social Theory

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