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

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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

DOI 10.1177/1090198116647712PMC PMC5503486

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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.
ORCID: Bluethmann, Shirley M.
Bartholomew, L. Kay
Murphy, Caitlin C.
Vernon, Sally W.
Venue: Health Education & Behavior
Publisher: SAGE Publications
Published: 2016-07-10
Volume: 44
Issue: 2
Pages: 245-253
ISSN: 1090-1981 (ISSN-L)
1552-6127
DOI: 10.1177/1090198116647712
PMC: PMC5503486
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: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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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Use of Theory in Behavior Change Interventions: An Analysis of Programs to Increase Physical Activity in Posttreatment Breast Cancer Survivors

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