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Behavioural change theories are attempts to explain why behaviours change. These theories cite environmental, personal, and behavioural characteristics as the major factors in behavioural determination. In recent years, there has been increased interest in the application of these theories in the areas of health, education, criminology, energy and international development with the hope that understanding behavioural change will improve the services offered in these areas. Some scholars have recently introduced a distinction between models of behavior and theories of change. Whereas models of behavior are more diagnostic and geared towards understanding the psychological factors that explain or predict a specific behavior, theories of change are more process-oriented and generally aimed at changing a given behavior. Thus, from this perspective, understanding and changing behavior are two separate but complementary lines of scientific investigation.

General theories and models

Each behavioural change theory or model focuses on different factors in attempting to explain behaviour change. Of the many that exist, the most prevalent are learning theories, social cognitive theory, theories of reasoned action and planned behaviour, transtheoretical model of behavior change, the health action process approach and the BJ Fogg model of behavior change. Research has also been conducted regarding specific elements of these theories, especially elements like self-efficacy that are common to several of the theories.

Self-efficacy

Self-efficacy is an individual’s impression of their own ability to perform a demanding or challenging task such as facing an exam or undergoing surgery. This impression is based upon factors like the individual’s prior success in the task or in related tasks, the individual’s physiological state, and outside sources of persuasion. Self-efficacy is thought to be predictive of the amount of effort an individual will expend in initiating and maintaining a behavioural change, so although self-efficacy is not a behavioural change theory per se, it is an important element of many of the theories, including the health belief model, the theory of planned behaviour and the health action process approach.

Learning theories and behaviours analytic theories of change

Social learning and social cognitive theory

According to the social learning theory (more recently expanded as social cognitive theory), behavioural change is determined by environmental, personal, and behavioural elements. Each factor affects each of the others. For example, in congruence with the principles of self-efficacy, an individual’s thoughts affect their behaviour and an individual’s characteristics elicit certain responses from the social environment. Likewise, an individual’s environment affects the development of personal characteristics as well as the person’s behavior, and an individual’s behaviour may change their environment as well as the way the individual thinks or feels. Social learning theory focuses on the reciprocal interactions between these factors, which are hypothesised to determine behavioral change.

Theory of reasoned action

The theory of reasoned action assumes that individuals consider a behaviour’s consequences before performing the particular behaviour. As a result, intention is an important factor in determining behaviour and behavioural change. According to Icek Ajzen, intentions develop from an individual’s perception of a behaviour as positive or negative together with the individual’s impression of the way their society perceives the same behaviour. Thus, personal attitude and social pressure shape intention, which is essential to performance of a behaviour and consequently behavioural change.

Theory of planned behaviour

In 1985, Ajzen expanded upon the theory of reasoned action, formulating the theory of planned behaviour, which also emphasises the role of intention in behaviour performance but is intended to cover cases in which a person is not in control of all factors affecting the actual performance of a behaviour. As a result, the new theory states that the incidence of actual behaviour performance is proportional to the amount of control an individual possesses over the behaviour and the strength of the individual’s intention in performing the behaviour. In his article, Further hypothesises that self-efficacy is important in determining the strength of the individual’s intention to perform a behaviour. In 2010, Fishbein and Ajzen introduced the reasoned action approach, the successor of the theory of planned behaviour.

Transtheoretical or stages of change model

According to the transtheoretical model of behavior change, also known as the stages of change model, states that there are five stages towards behavior change. The five stages, between which individuals may transition before achieving complete change, are precontemplation, contemplation, preparation for action, action, and maintenance. At the precontemplation stage, an individual may or may not be aware of a problem but has no thought of changing their behavior. From precontemplation to contemplation, the individual begins thinking about changing a certain behavior. During preparation, the individual begins his plans for change, and during the action stage the individual begins to exhibit new behavior consistently. An individual finally enters the maintenance stage once they exhibit the new behavior consistently for over six months. A problem faced with the stages of change model is that it is very easy for a person to enter the maintenance stage and then fall back into earlier stages. Factors that contribute to this decline include external factors such as weather or seasonal changes, and/or personal issues a person is dealing with.

Health action process approach

The health action process approach (HAPA) is designed as a sequence of two continuous self-regulatory processes, a goal-setting phase (motivation) and a goal-pursuit phase (volition). The second phase is subdivided into a pre-action phase and an action phase. Motivational self-efficacy, outcome-expectancies and risk perceptions are assumed to be predictors of intentions. This is the motivational phase of the model. The predictive effect of motivational self-efficacy on behaviour is assumed to be mediated by recovery self-efficacy, and the effects of intentions are assumed to be mediated by planning. The latter processes refer to the volitional phase of the model.

Fogg Behavior Model

The BJ Fogg Behavior Model. The different levels of ability and motivation define whether triggers for behavior change will succeed or fail. As an example trying to trigger behavior change through something difficult to do (low ability) will only succeed with very high motivation. In contrast, trying to trigger behavior change through something easy to do (high ability) may succeed even with average motivation.

The BJ Fogg Behavior Model. The different levels of ability and motivation define whether triggers for behavior change will succeed or fail. As an example trying to trigger behavior change through something difficult to do (low ability) will only succeed with very high motivation. In contrast, trying to trigger behavior change through something easy to do (high ability) may succeed even with average motivation.

The Fogg Behavior Model (FBM) is a design behavior change model introduced by BJ Fogg. This model posits that behavior is composed of three different factors: motivation, ability and triggers. Under the FBM, for any person (user) to succeed at behavior change needs to be motivated, have the ability to perform the behavior and needs a trigger to perform this behavior. The next are the definitions of each of the elements of the BFM:

1. Motivation

BJ Fogg does not provide a definition of motivation but instead defines different motivators:

• Pleasure/Pain: These motivators produce a response immediately and although powerful these are not ideal. Boosting motivation could be achieved by embodying pain or pleasure.
• Hope/fear: Both these motivators have a delayed response and are the anticipation of a future positive outcome (hope) or negative outcome (fear). As an example people joining a dating website hope to meet other people.
• Social acceptance/rejection: People are motivated by behaviors that increase or preserve their social acceptance.

2. Ability

This factor refers to the self efficacy perception at performing a target behavior. Although low ability is undesirable it may be unavoidable: “We are fundamentally lazy” according to BJ Fogg. In such case behavior change is approached not through learning but instead by promoting target behaviors for which the user has a high ability. Additionally BJ Fogg list several elements or dimensions that characterize high ability or simplicity of performing a behavior:

• Time: The user has the time to perform the target behavior or the time taken is very low.
• Money: The user has enough financial resources for pursuing the behavior. In some cases money can buy time.
• Physical effort: Target behaviors that require of physical effort may not be simple enough to be performed.
• Brain cycles: Target behaviors that require of high cognitive resources may not be simple hence undesirable for behavior change.
• Social deviance: These comprehend behaviors that make the user socially deviant. These kind of behaviors are not simple
• Non-routine: Any behavior that incurs disrupting a routine is considered not simple. Simple behaviors are usually part of routines and hence easy to follow.

3. Triggers

Triggers are reminders that may be explicit or implicit about the performance of a behavior. Examples of triggers can be alarms, text messages or advertisement, triggers are usually perceptual in nature but may also be intrinsic. One of the most important aspects of a trigger is timing as only certain times are best for triggering certain behaviors. As an example if a person is trying to go to the gym everyday, but only remembers about packing clothing once out of the house it is less likely that this person will head back home and pack. In contrast if an alarm sounds right before leaving the house reminding about packing clothing, this will take considerably less effort. Although the original article does not have any references for the reasoning or theories behind the model, some of its elements can be traced to social psychology theories, e.g., the motivation and ability factors and its success or failure are related to Self-efficacy.

4. Education

Behavioural change theories can be used as guides in developing effective teaching methods. Since the goal of much education is behavioural change, the understanding of behaviour afforded by behavioural change theories provides insight into the formulation of effective teaching methods that tap into the mechanisms of behavioural change. In an era when education programs strive to reach large audiences with varying socioeconomic statuses, the designers of such programs increasingly strive to understand the reasons behind behavioural change in order to understand universal characteristics that may be crucial to program design.

In fact, some of the theories, like the social learning theory and theory of planned behaviour, were developed as attempts to improve health education. Because these theories address the interaction between individuals and their environments, they can provide insight into the effectiveness of education programs given a specific set of predetermined conditions, like the social context in which a program will be initiated. Although health education is still the area in which behavioural change theories are most often applied, theories like the stages of change model have begun to be applied in other areas like employee training and developing systems of higher education.

5. Criminology

Empirical studies in criminology support behavioural change theories[citation needed]. At the same time, the general theories of behavioural change suggest possible explanations to criminal behaviour and methods of correcting deviant behaviour. Since deviant behaviour correction entails behavioural change, understanding of behavioural change can facilitate the adoption of effective correctional methods in policy-making. For example, the understanding that deviant behaviour like stealing may be learned behaviour resulting from reinforcers like hunger satisfaction that are unrelated to criminal behaviour can aid the development of social controls that address this underlying issue rather than merely the resultant behaviour.

Specific theories that have been applied to criminology include the social learning and differential association theories. Social learning theory’s element of interaction between an individual and their environment explains the development of deviant behaviour as a function of an individual’s exposure to a certain behaviour and their acquaintances, who can reinforce either socially acceptable or socially unacceptable behaviour. Differential association theory, originally formulated by Edwin Sutherland, is a popular, related theoretical explanation of criminal behaviour that applies learning theory concepts and asserts that deviant behaviour is learned behaviour.

6. Energy

Recent years have seen an increased interest in energy consumption reduction based on behavioural change, be it for reasons of climate change mitigation or energy security. The application of behavioural change theories in the field of energy consumption behaviour yields interesting insights. For example, it supports criticism of a too narrow focus on individual behaviour and a broadening to include social interaction, lifestyles, norms and values as well as technologies and policies—all enabling or constraining behavioural change.

The Social Norms Theory was first used by Perkins and Berkowitz in 1986 to address student alcohol use patterns. As a result, the theory, and subsequently the social norms approach, is best known for its effectiveness in reducing alcohol consumption and alcohol-related injury in college students. The approach has also been used to address a wide range of public health topics including tobacco use, driving under the influence prevention, seat belt use, and more recently sexual assault prevention. The target population for social norms approaches tends to be college students, but has recently been used with younger student populations (i.e., high school).

This theory aims to understand the environment and interpersonal influences (such as peers) in order to change behavior, which can be more effective than a focus on the individual to change behavior. Peer influence, and the role it plays in individual decision-making around behaviors, is the primary focus of Social Norms Theory. Peer influences and normative beliefs are especially important when addressing behaviors in youth. Peer influences are affected more by perceived norms (what we view as typical or standard in a group) rather than on the actual norm (the real beliefs and actions of the group). The gap between perceived and actual is a misperception, and this forms the foundation for the social norms approach. 

The Social Norms Theory posits that our behavior is influenced by misperceptions of how our peers think and act. Overestimations of problem behavior in our peers will cause us to increase our own problem behaviors; underestimations of problem behavior in our peers will discourage us from engaging in the problematic behavior. Accordingly, the theory states that correcting misperceptions of perceived norms will most likely result in a decrease in the problem behavior or an increase in the desired behavior. 

Social norms interventions aim to present correct information about peer group norms in an effort to correct misperceptions of norms. In particular, many social norms interventions are social norms media campaigns where misperceptions are addressed through community-wide electronic and print media that promote accurate and healthy norms about the health behavior. The phases of a social norms media campaign include:

• Assessment or collection of data to inform the message
• Selection of the normative message that will be distributed
• Testing the message with the target group to ensure it is well-received
• Selection of the mode in which the message will be delivered
• Amount, or dosage, of the message that will be delivered
• Evaluation of the effectiveness of the message

Social norms media campaigns are currently being funded by many federal agencies, state agencies, foundation grants, and non-profit organizations.   Sometimes social norms media campaigns are funded by industry. There has been a good deal of evaluations conducted on social norms campaigns.

There are several limitations of Social Norms Theory that need to be considered prior to using the theory. Limitations of the theory include the following:

• Participants of an intervention focused on social norms are likely to question the initial message being presented to them due to misperceptions they hold. Information must be presented in a reliable way to correct those misperceptions.
• Poor data collection in the initial stages can lead to unreliable data and poor choice of normative message. This can undermine the campaign and reinforce misperceptions.
• Unreliable sources, or sources that are not credible to the target population, can result in an unappealing message that undermines the campaign, even if the message is correctly chosen.
• The dose, or amount, of the message received by the target population must be enough to make an impact, but not too much that it becomes commonplace.

Although these limitations exist, when used correctly Social Norms Theory can be very effective in changing individual behavior by focusing on changing misperceptions at the group level. Social norms interventions can be used alone or in conjunction with other types of intervention strategies. The most effective social norms interventions are those that have messages targeted to the at-risk population that are correct and influential. To target messages, a substantial amount of research and data collection has to be invested to understand the norms that exist in the group of interest. Social norms interventions are also most effective when presented in interactive formats that actively engage the target audience.

The Health Belief Model (HBM) was developed in the early 1950s by social scientists at the U.S. Public Health Service in order to understand the failure of people to adopt disease prevention strategies or screening tests for the early detection of disease. Later uses of HBM were for patients’ responses to symptoms and compliance with medical treatments. The HBM suggests that a person’s belief in a personal threat of an illness or disease together with a person’s belief in the effectiveness of the recommended health behavior or action will predict the likelihood the person will adopt the behavior.

The HBM derives from psychological and behavioral theory with the foundation that the two components of health-related behavior are

• The desire to avoid illness, or conversely get well if already ill.
• The belief that a specific health action will prevent, or cure, illness.

Ultimately, an individual’s course of action often depends on the person’s perceptions of the benefits and barriers related to health behavior. There are six constructs of the HBM. The first four constructs were developed as the original tenets of the HBM. The last two were added as research about the HBM evolved.

Perceived susceptibility

This refers to a person’s subjective perception of the risk of acquiring an illness or disease. There is wide variation in a person’s feelings of personal vulnerability to an illness or disease.

Perceived severity

This refers to a person’s feelings on the seriousness of contracting an illness or disease (or leaving the illness or disease untreated). There is wide variation in a person’s feelings of severity, and often a person considers the medical consequences (e.g., death, disability) and social consequences (e.g., family life, social relationships) when evaluating the severity.

Perceived benefits

This refers to a person’s perception of the effectiveness of various actions available to reduce the threat of illness or disease (or to cure illness or disease). The course of action a person takes in preventing (or curing) illness or disease relies on consideration and evaluation of both perceived susceptibility and perceived benefit, such that the person would accept the recommended health action if it was perceived as beneficial.

Perceived barriers

This refers to a person’s feelings on the obstacles to performing a recommended health action. There is wide variation in a person’s feelings of barriers, or impediments, which lead to a cost/benefit analysis. The person weighs the effectiveness of the actions against the perceptions that it may be expensive, dangerous (e.g., side effects), unpleasant (e.g., painful), time-consuming, or inconvenient.

Cue to action

This is the stimulus needed to trigger the decision-making process to accept a recommended health action. These cues can be internal (e.g., chest pains, wheezing, etc.) or external (e.g., advice from others, illness of family member, newspaper article, etc.).

Self-efficacy

This refers to the level of a person’s confidence in his or her ability to successfully perform a behavior. This construct was added to the model most recently in mid-1980. Self-efficacy is a construct in many behavioral theories as it directly relates to whether a person performs the desired behavior.

Limitations of Health Belief Model

There are several limitations of the HBM which limit its utility in public health. Limitations of the model include the following:

• It does not account for a person’s attitudes, beliefs, or other individual determinants that dictate a person’s acceptance of a health behavior.
• It does not take into account behaviors that are habitual and thus may inform the decision-making process to accept a recommended action (e.g., smoking).
• It does not take into account behaviors that are performed for non-health related reasons such as social acceptability.
• It does not account for environmental or economic factors that may prohibit or promote the recommended action.
• It assumes that everyone has access to equal amounts of information on the illness or disease.
• It assumes that cues to action are widely prevalent in encouraging people to act and that “health” actions are the main goal in the decision-making process.

The HBM is more descriptive than explanatory, and does not suggest a strategy for changing health-related actions. In preventive health behaviors, early studies showed that perceived susceptibility, benefits, and barriers were consistently associated with the desired health behavior; perceived severity was less often associated with the desired health behavior. The individual constructs are useful, depending on the health outcome of interest, but for the most effective use of the model it should be integrated with other models that account for the environmental context and suggest strategies for change.

An ecosystem model is an abstract, usually mathematical, representation of an ecological system (ranging in scale from an individual population, to an ecological community, or even an entire biome), which is studied to better understand the real system.

Using data gathered from the field, ecological relationships such as the relation of sunlight and water availability to photosynthetic rate, or that between predator and prey populations are derived, and these are combined to form ecosystem models. These model systems are then studied in order to make predictions about the dynamics of the real system. Often, the study of inaccuracies in the model (when compared to empirical observations) will lead to the generation of hypotheses about possible ecological relations that are not yet known or well understood. Models enable researchers to simulate large-scale experiments that would be too costly or unethical to perform on a real ecosystem. They also enable the simulation of ecological processes over very long periods of time (i.e. simulating a process that takes centuries in reality, can be done in a matter of minutes in a computer model).

Ecosystem models have applications in a wide variety of disciplines, such as natural resource management, ecotoxicology and environmental health, agriculture, and wildlife conservation. Ecological modelling has even been applied to archaeology with varying degrees of success, for example, combining with archaeological models to explain the diversity and mobility of stone tools.

Types of The Ecological Model

There are two major types of ecological models, which are generally applied to different types of problems:

• Analytic models
• Simulation / computational models

Analytic models are typically relatively simple (often linear) systems, that can be accurately described by a set of mathematical equations whose behavior is well-known. Simulation models on the other hand, use numerical techniques to solve problems for which analytic solutions are impractical or impossible. Simulation models tend to be more widely used, and are generally considered more ecologically realistic, while analytic models are valued for their mathematical elegance and explanatory power. Ecopath is a powerful software system which uses simulation and computational methods to model marine ecosystems. It is widely used by marine and fisheries scientists as a tool for modelling and visualising the complex relationships that exist in real world marine ecosystems.

The Ecological Model design

The process of model design begins with a specification of the problem to be solved, and the objectives for the model.

Ecological systems are composed of an enormous number of biotic and abiotic factors that interact with each other in ways that are often unpredictable, or so complex as to be impossible to incorporate into a computable model. Because of this complexity, ecosystem models typically simplify the systems they are studying to a limited number of components that are well understood, and deemed relevant to the problem that the model is intended to solve.

The process of simplification typically reduces an ecosystem to a small number of state variables and mathematical functions that describe the nature of the relationships between them. The number of ecosystem components that are incorporated into the model is limited by aggregating similar processes and entities into functional groups that are treated as a unit.

After establishing the components to be modeled and the relationships between them, another important factor in ecosystem model structure is the representation of space used. Historically, models have often ignored the confounding issue of space. However, for many ecological problems spatial dynamics are an important part of the problem, with different spatial environments leading to very different outcomes. Spatially explicit models (also called “spatially distributed” or “landscape” models) attempt to incorporate a heterogeneous spatial environment into the model. A spatial model is one that has one or more state variables that are a function of space, or can be related to other spatial variables.

Validation

After construction, models are validated to ensure that the results are acceptably accurate or realistic. One method is to test the model with multiple sets of data that are independent of the actual system being studied. This is important since certain inputs can cause a faulty model to output correct results. Another method of validation is to compare the model’s output with data collected from field observations. Researchers frequently specify beforehand how much of a disparity they are willing to accept between parameters output by a model and those computed from field data.

The theory of reasoned action (ToRA or TRA) aims to explain the relationship between attitudes and behaviours within human action. It is mainly used to predict how individuals will behave based on their pre-existing attitudes and behavioral intentions. An individual’s decision to engage in a particular behavior is based on the outcomes the individual expects will come as a result of performing the behavior. Developed by Martin Fishbein and Icek Ajzen in 1967, the theory derived from previous research in social psychology, persuasion models, and attitude theories. Fishbein’s theories suggested a relationship between attitude and behaviors (the A-B relationship). However, critics estimated that attitude theories were not proving to be good indicators of human behavior. The TRA was later revised and expanded by the two theorists in the following decades to overcome any discrepancies in the A-B relationship with the theory of planned behavior (TPB) and reasoned action approach (RAA). The theory is also used in communication discourse as a theory of understanding.

The primary purpose of the TRA is to understand an individual’s voluntary behavior by examining the underlying basic motivation to perform an action. TRA states that a person’s intention to perform a behavior is the main predictor of whether or not they actually perform that behavior. Additionally, the normative component (i.e. social norms surrounding the act) also contributes to whether or not the person will actually perform the behavior. According to the theory, intention to perform a certain behavior precedes the actual behavior. This intention is known as behavioral intention and comes as a result of a belief that performing the behavior will lead to a specific outcome. Behavioral intention is important to the theory because these intentions “are determined by attitudes to behaviors and subjective norms”. The theory of reasoned action suggests that stronger intentions lead to increased effort to perform the behavior, which also increases the likelihood for the behavior to be performed.

Key concepts and conditions

Behavior

A positivistic approach to behavior research, TRA attempts to predict and explain one’s intention of performing a certain behavior. The theory requires that behavior be clearly defined in terms of the four following concepts: Action (e.g. to go get), Target (e.g. a mammogram), Context (e.g. at the breast screening center), and Time (e.g. in the 12 months). According to TRA, behavioral intention is the main motivator of behavior, while the two key determinants on behavioral intention are people’s attitudes and norms. By examining attitudes and subjective norms, researchers can gain an understanding as to whether or not one will perform the intended action.

Attitudes

According to TRA, attitudes are one of the key determinants of behavioral intention and refer to the way people feel towards a particular behavior. These attitudes are influenced by two factors: the strength of behavioral beliefs regarding the outcomes of the performed behavior (i.e. whether or not the outcome is probable) and the evaluation of the potential outcomes (i.e. whether or not the outcome is positive). Attitudes regarding a certain behavior can either be positive, negative or neutral. The theory stipulates that there exists a direct correlation between attitudes and outcomes, such that if one believes that a certain behavior will lead to a desirable or favorable outcome, then one is more likely to have a positive attitude towards the behavior. Alternatively, if one believes that a certain behavior will lead to an undesirable or unfavorable outcome, then one is more likely to have a negative attitude towards the behavior.

Behavioral belief

Behavioral belief allows us to understand people’s motivations for their behavior in terms of the behavior’s consequences. This concept stipulates that people tend to associate the performance of a certain behavior with a certain set of outcomes or features. For example, a person believes that if he or she studies for a month for his or her driver’s license test, that one will pass the test after failing it the first time without studying at all. Here, the behavioral belief is that studying for a month is equated with success, whereas not studying at all is associated with failure.

Evaluation

The evaluation of the outcome refers to the way people perceive and evaluate the potential outcomes of a performed behavior. Such evaluations are conceived in a binary “good-bad” fashion-like manner. For example, a person may evaluate the outcome of quitting smoking cigarettes as positive if the behavioral belief is improved breathing and clean lungs. Conversely, a person may evaluate the outcome of quitting smoking cigarettes as negative if the behavioral belief is weight gain after smoking cessation.

Subjective norms

Subjective norms are also one of the key determinants of behavioral intention and refer to the way perceptions of relevant groups or individuals such as family members, friends, and peers may affect one’s performance of the behavior. Ajzen defines subjective norms as the “perceived social pressure to perform or not perform the behavior”. According to TRA, people develop certain beliefs or normative beliefs as to whether or not certain behaviors are acceptable. These beliefs shape one’s perception of the behavior and determine one’s intention to perform or not perform the behavior. For example, if one believes that recreational drug use (the behavior) is acceptable within one’s social group, one will more likely be willing to engage in the activity. Alternatively, if one’s friends groups perceive that the behavior is bad, one will be less likely to engage in recreational drug use. However, subjective norms also take into account people’s motivation to comply with their social circle’s views and perceptions, which vary depending on the situation and the individual’s motivations.

Normative beliefs

Normative beliefs touch on whether or not referent relevant groups approve of the action. There exists a direct correlation between normative beliefs and performance of the behavior. Usually, the more likely the referent groups will approve of the action, the more likely the individual perform the act. Conversely, the less likely the referent groups will approve of the action, the less likely the individual will perform the act.

Motivation to comply

Motivation to comply addresses the fact that individuals may or may not comply with social norms of the referent groups surrounding the act. Depending on the individual’s motivations in terms of adhering to social pressures, the individual will either succumb to the social pressures of performing the act if it is deemed acceptable, or alternatively will resist to the social pressures of performing the act if it is deemed unacceptable.

Behavioral intention

Behavioral intention is a function of both attitudes and subjective norms toward that behavior (also known as the normative component). Attitudes being how strongly one holds the attitude toward the act and subjective norms being the social norms associated with the act. The stronger the attitude and the more positive the subjective norm, the higher the A-B relationship should be. However, the attitudes and subjective norms are unlikely to be weighted equally in predicting behavior. Depending on the individual and situation, these factors might have different impacts on behavioral intention, thus a weight is associated with each of these factors. A few studies have shown that direct prior experience with a certain activity results in an increased weight on the attitude component of the behavior intention function.

In psychology, the theory of planned behaviour (abbreviated TPB) is a theory that links one’s beliefs and behaviour.

The theory states that intention toward attitude, subject norms, and perceived behavioural control, together shape an individual’s behavioural intentions and behaviours.

The concept was proposed by Icek Ajzen to improve on the predictive power of the theory of reasoned action by including perceived behavioural control. It has been applied to studies of the relations among beliefs, attitudes, behavioural intentions and behaviours in various fields such as advertising, public relations, advertising campaigns, healthcare, sport management and sustainability.

Concepts of key variables

Normative beliefs and subjective norms

• Normative belief: an individual’s perception of social normative pressures, or relevant others’ beliefs that they should or should not perform such behaviour.
• Subjective norm: an individual’s perception about the particular behaviour, which is influenced by the judgment of significant others (e.g., parents, spouse, friends, teachers).

Control beliefs and perceived behavioural control

• Control beliefs: an individual’s beliefs about the presence of factors that may facilitate or hinder performance of the behaviour. The concept of perceived behavioural control is conceptually related to self-efficacy.
• Perceived behavioural control: an individual’s perceived ease or difficulty of performing the particular behaviour. It is assumed that perceived behavioural control is determined by the total set of accessible control beliefs.

Behavioural intention and behaviour

• Behavioural intention: an indication of an individual’s readiness to perform a given behaviour. It is assumed to be an immediate antecedent of behaviour. It is based on attitude toward the behaviour, subjective norm, and perceived behavioural control, with each predictor weighted for its importance in relation to the behaviour and population of interest.
• Behaviour: an individual’s observable response in a given situation with respect to a given target. Ajzen said a behaviour is a function of compatible intentions and perceptions of behavioural control in that perceived behavioural control is expected to moderate the effect of intention on behaviour, such that a favorable intention produces the behaviour only when perceived behavioural control is strong.

Conceptual / operational comparison

Perceived behavioural control vs. self-efficacy

As Ajzen (1991) stated in the theory of planned behaviour, knowledge of the role of perceived behavioural control came from Bandura’s concept of self-efficacy. More recently, Fishbein and Cappella stated[16] that self-efficacy is the same as perceived behavioural control in his integrative model, which is also measured by items of self-efficacy in a previous study.

In previous studies, the construction and the number of item inventory of perceived behavioural control have depended on each particular health topic. For example, for smoking topics, it is usually measured by items such as “I don’t think I am addicted because I can really just not smoke and not crave for it,” and “It would be really easy for me to quit.”

The concept of self-efficacy is rooted in Bandura’s social cognitive theory. It refers to the conviction that one can successfully execute the behaviour required to produce the outcome. The concept of self-efficacy is used as perceived behavioural control, which means the perception of the ease or difficulty of the particular behaviour. It is linked to control beliefs, which refers to beliefs about the presence of factors that may facilitate or impede performance of the behaviour.

It is usually measured with items which begins with the stem, “I am sure I can … (e.g., exercise, quit smoking, etc.)” through a self-report instrument in their questionnaires. Namely, it tries to measure the confidence toward the probability, feasibility, or likelihood of executing given behaviour.

Attitude toward behaviour vs. outcome expectancy

The theory of planned behaviour specifies the nature of relationships between beliefs and attitudes. According to these models, people’s evaluations of, or attitudes toward behaviour are determined by their accessible beliefs about the behaviour, where a belief is defined as the subjective probability that the behaviour will produce a certain outcome. Specifically, the evaluation of each outcome contributes to the attitude in direct proportion to the person’s subjective possibility that the behaviour produces the outcome in question.

Outcome expectancy was originated from the expectancy-value model. It is a variable-linking belief, attitude, opinion and expectation. The theory of planned behaviour’s positive evaluation of self-performance of the particular behaviour is similar to the concept to perceived benefits, which refers to beliefs regarding the effectiveness of the proposed preventive behaviour in reducing the vulnerability to the negative outcomes, whereas their negative evaluation of self-performance is similar to perceived barriers, which refers to evaluation of potential negative consequences that might result from the enactment of the espoused health behaviour.

Social influence

The concept of social influence has been assessed by the social norm and normative belief in both the theory of reasoned action and theory of planned behaviour. Individuals’ elaborative thoughts on subjective norms are perceptions on whether they are expected by their friends, family and the society to perform the recommended behaviour. Social influence is measured by evaluation of various social groups. For example, in the case of smoking:

• Subjective norms from the peer group include thoughts such as, “Most of my friends smoke,” or “I feel ashamed of smoking in front of a group of friends who don’t smoke”;
• Subjective norms from the family include thoughts such as, “All of my family smokes, and it seems natural to start smoking,” or “My parents were really mad at me when I started smoking”; and
• Subjective norms from society or culture include thoughts such as, “Everyone is against smoking,” and “We just assume everyone is a nonsmoker.”

While most models are conceptualized within individual cognitive space, the theory of planned behaviour considers social influence such as social norm and normative belief, based on collectivistic culture-related variables. Given that an individual’s behaviour (e.g., health-related decision-making such as diet, condom use, quitting smoking and drinking, etc.) might very well be located in and dependent on the social networks and organization (e.g., peer group, family, school and workplace), social influence has been a welcomed addition.

Social Cognitive Theory (SCT) started as the Social Learning Theory (SLT) in the 1960s by Albert Bandura. It developed into the SCT in 1986 and posits that learning occurs in a social context with a dynamic and reciprocal interaction of the person, environment, and behavior. The unique feature of SCT is the emphasis on social influence and its emphasis on external and internal social reinforcement. SCT considers the unique way in which individuals acquire and maintain behavior, while also considering the social environment in which individuals perform the behavior. The theory takes into account a person’s past experiences, which factor into whether behavioral action will occur. These past experiences influences reinforcements, expectations, and expectancies, all of which shape whether a person will engage in a specific behavior and the reasons why a person engages in that behavior.

Many theories of behavior used in health promotion do not consider maintenance of behavior, but rather focus on initiating behavior. This is unfortunate as maintenance of behavior, and not just initiation of behavior, is the true goal in public health. The goal of SCT is to explain how people regulate their behavior through control and reinforcement to achieve goal-directed behavior that can be maintained over time. The first five constructs were developed as part of the SLT; the construct of self-efficacy was added when the theory evolved into SCT.

1. Reciprocal Determinism

This is the central concept of SCT. This refers to the dynamic and reciprocal interaction of person (individual with a set of learned experiences), environment (external social context), and behavior (responses to stimuli to achieve goals).

2. Behavioral Capability

This refers to a person’s actual ability to perform a behavior through essential knowledge and skills. In order to successfully perform a behavior, a person must know what to do and how to do it. People learn from the consequences of their behavior, which also affects the environment in which they live.

3. Observational Learning

This asserts that people can witness and observe a behavior conducted by others, and then reproduce those actions. This is often exhibited through “modeling” of behaviors. If individuals see successful demonstration of a behavior, they can also complete the behavior successfully.

4. Reinforcements

This refers to the internal or external responses to a person’s behavior that affect the likelihood of continuing or discontinuing the behavior. Reinforcements can be self-initiated or in the environment, and reinforcements can be positive or negative. This is the construct of SCT that most closely ties to the reciprocal relationship between behavior and environment.

5. Expectations

This refers to the anticipated consequences of a person’s behavior. Outcome expectations can be health-related or not health-related. People anticipate the consequences of their actions before engaging in the behavior, and these anticipated consequences can influence successful completion of the behavior. Expectations derive largely from previous experience. While expectancies also derive from previous experience, expectancies focus on the value that is placed on the outcome and are subjective to the individual.

6. Self-efficacy

This refers to the level of a person’s confidence in his or her ability to successfully perform a behavior. Self-efficacy is unique to SCT although other theories have added this construct at later dates, such as the Theory of Planned Behavior. Self-efficacy is influenced by a person’s specific capabilities and other individual factors, as well as by environmental factors (barriers and facilitators).

Limitation of Social Cognitive Theory

There are several limitations of SCT, which should be considered when using this theory in public health. Limitations of the model include the following:

• The theory assumes that changes in the environment will automatically lead to changes in the person, when this may not always be true.
• The theory is loosely organized, based solely on the dynamic interplay between person, behavior, and environment. It is unclear the extent to which each of these factors into actual behavior and if one is more influential than another.
• The theory heavily focuses on processes of learning and in doing so disregards biological and hormonal predispositions that may influence behaviors, regardless of past experience and expectations.
• The theory does not focus on emotion or motivation, other than through reference to past experience. There is minimal attention on these factors.
• The theory can be broad-reaching, so can be difficult to operationalize in entirety.

Social Cognitive Theory considers many levels of the social ecological model in addressing behavior change of individuals. SCT has been widely used in health promotion given the emphasis on the individual and the environment, the latter of which has become a major point of focus in recent years for health promotion activities. As with other theories, applicability of all the constructs of SCT to one public health problem may be difficult especially in developing focused public health programs.

Behavioral economics studies the effects of psychological, cognitive, emotional, cultural and social factors on the decisions of individuals and institutions and how those decisions vary from those implied by classical economic theory.

Behavioral economics is primarily concerned with the bounds of rationality of economic agents. Behavioral models typically integrate insights from psychology, neuroscience and microeconomic theory. The study of behavioral economics includes how market decisions are made and the mechanisms that drive public choice. The three prevalent themes in behavioral economics are:

• Heuristics: Humans make 95% of their decisions using mental shortcuts or rules of thumb.
• Framing: The collection of anecdotes and stereotypes that make up the mental filters individuals rely on to understand and respond to events.
• Market inefficiencies: These include mis-pricing and non-rational decision making.

In 2002, psychologist Daniel Kahneman was awarded the Nobel Memorial Prize in Economic Sciences “for having integrated insights from psychological research into economic science, especially concerning human judgment and decision-making under uncertainty.” In 2013, economist Robert J. Shiller received the Nobel Memorial Prize in Economic Sciences “for his empirical analysis of asset prices” (within the field of behavioral finance). In 2017, economist Richard Thaler was awarded the Nobel Memorial Prize in Economic Sciences for “his contributions to behavioral economics and his pioneering work in establishing that people are predictably irrational in ways that defy economic theory.”

The field of behavioral economics blends ideas from psychology and economics, and it can provide valuable insight that individuals are not behaving in their own best interests.

Behavioral economics provides a framework to understand when and how people make errors. Systematic errors or biases recur predictably in particular circumstances. Lessons from behavioral economics can be used to create environments that nudge people toward wiser decisions and healthier lives.

Behavioral economics emerged against the backdrop of the traditional economic approach known as rational choice model. The rational person is assumed to correctly weigh costs and benefits and calculate the best choices for himself. The rational person is expected to know his preferences (both present and future), and never flip-flop between two contradictory desires. He has perfect self-control and can restrain impulses that may prevent him from achieving his long-term goals.

Traditional economics uses these assumptions to predict real human behavior. The standard policy advice that stems from this way of thinking is to give people as many choices as possible, and let them choose the one they like best (with minimum government intervention). Because they know their preferences better than government officials do. Individuals are in the best position to know what is best for them.

In contrast, behavioral economics shows that actual human beings do not act that way. People have limited cognitive abilities and a great deal of trouble exercising self-control. People often make choices that bear a mixed relationship to their own preference (happiness). They tend to choose the option that has the greatest immediate appeal at the cost of long-term happiness, such as taking drugs or overeating.

They are profoundly influenced by context, and often have little idea of what they will prefer next year or even tomorrow. As Daniel Kahneman (2011, p5) put this, “It seems that traditional economics and behavioral economics are describing two different species.” The latter shows that we are exceptionally inconsistent and fallible human beings. We choose a goal and then frequently act against it because self-control prevents us from implementing our goals.

Behavioral economics traces these decision errors to the design of the human mind. Neuroscientists argue that the mind consists of many different parts (mental processes), each operating by its own logic (Kurzban, 2011). Brocas and Carrillo (2013) note that the brain is best represented by an organization of systems that interact with each other. A key insight is that the brain is a democracy (Tononi, 2012). That is, there is no dominant decision-maker. Although the behavioral goal of an individual can be stated as maximizing happiness, reaching that goal requires contributions from several brain regions.

Behavioral economics attempts to integrate psychologists’ understanding of human behavior into economic analysis. In this respect, behavioral economics parallels cognitive psychology, which attempts to guide individuals toward more healthy behaviors by correcting cognitive and emotional barriers to the pursuit of genuine self-interest (Lowenstein, and Haisley, 2008).

Finally, behavioral economics suggests ways how policymakers might restructure environments to facilitate better choices (Sunstein, 2014). The focus on errors suggests ways that policymakers might restructure environments to facilitate better choices. For example, simply rearranging items that are currently offered within the school encourages children to buy more nutritious items (e.g., placing the fruit at eye level, making choices less convenient by moving soda machines into distant areas, or requiring students to pay cash for desserts and soft drinks).

In sum, the basic message of behavioral economics is that humans are hard-wired to make judgment errors and they need a nudge to make decisions that are in their own best interest. The understanding of where people go wrong can help people go right. This approach complements and enhances the rational choice model.

Nudge is a concept in behavioral economics, political theory, and behavioral sciences which proposes positive reinforcement and indirect suggestions as ways to influence the behavior and decision making of groups or individuals. Nudging contrasts with other ways to achieve compliance, such as education, legislation or enforcement.

The nudge concept was popularized in the 2008 book Nudge: Improving Decisions About Health, Wealth, and Happiness, by two American scholars at the University of Chicago: behavioral economist Richard Thaler and legal scholar Cass Sunstein. It has influenced British and American politicians. Several nudge units exist around the world at the national level (UK, Germany, Japan and others) as well as at the international level (e.g. World Bank, UN, and the European Commission). It is disputed whether “nudge theory” is a recent novel development in behavioral economics or merely a new term for one of many methods for influencing behavior, investigated in the sciences of behavior analysis.

The first formulation of the term and associated principles was developed in cybernetics by James Wilk before 1995 and described by Brunel University academic D. J. Stewart as “the art of the nudge” (sometimes referred to as micronudges). It also drew on methodological influences from clinical psychotherapy tracing back to Gregory Bateson, including contributions from Milton Erickson, Watzlawick, Weakland and Fisch, and Bill O’Hanlon. In this variant, the nudge is a microtargetted design geared towards a specific group of people, irrespective of the scale of intended intervention.

In 2008, Richard Thaler and Cass Sunstein’s book Nudge: Improving Decisions About Health, Wealth, and Happiness brought nudge theory to prominence. It also gained a following among US and UK politicians, in the private sector and in public health. The authors refer to influencing behaviour without coercion as libertarian paternalism and the influencers as choice architects. Thaler and Sunstein defined their concept as:

A nudge, as we will use the term, is any aspect of the choice architecture that alters people’s behavior in a predictable way without forbidding any options or significantly changing their economic incentives. To count as a mere nudge, the intervention must be easy and cheap to avoid. Nudges are not mandates. Putting fruit at eye level counts as a nudge. Banning junk food does not.

In this form, drawing on behavioral economics, the nudge is more generally applied to influence behaviour.

One of the most frequently cited examples of a nudge is the etching of the image of a housefly into the men’s room urinals at Amsterdam’s Schiphol Airport, which is intended to “improve the aim”.

Types of Nudges

Nudges are small changes in environment that are easy and inexpensive to implement. Several different techniques exist for nudging, including defaults, social proof heuristics, and increasing the salience of the desired option.

A default option is the option an individual automatically receives if he or she does nothing. People are more likely to choose a particular option if it is the default option. For example, Pichert & Katsikopoulos found that a greater number of consumers chose the renewable energy option for electricity when it was offered as the default option.

A social proof heuristic refers to the tendency for individuals to look at the behavior of other people to help guide their own behavior. Studies have found some success in using social proof heuristics to nudge individuals to make healthier food choices.

When an individual’s attention is drawn towards a particular option, that option will become more salient to the individual, and he or she will be more likely to choose to that option. As an example, in snack shops at train stations in the Netherlands, consumers purchased more fruit and healthy snack options when they were relocated next to the cash register. Since then, other similar studies have been made regarding the placement of healthier food options close to the checkout counter and the effect on the consuming behavior of the customers and this is now considered an effective and well-accepted nudge.

Application of Theory

Behavioral insights and nudges are currently used in many countries around the world.

1. Government

In 2008, the United States appointed Sunstein, who helped develop the theory, as administrator of the Office of Information and Regulatory Affairs

Notable applications of nudge theory include the formation of the British Behavioural Insights Team in 2010. It is often called the “Nudge Unit”, at the British Cabinet Office, headed by David Halpern.

Both Prime Minister David Cameron and President Barack Obama sought to employ nudge theory to advance domestic policy goals during their terms.

In Australia, the government of New South Wales established a Behavioural Insights community of practice.

In 2020, the UK government of Boris Johnson decided to rely on nudge theory to fight the coronavirus pandemic. Patrick Vallance, the UK’s chief scientific adviser, seeks to encourage “herd immunity” with this strategy.

2. Business

Nudge theory has also been applied to business management and corporate culture, such as in relation to health, safety and environment (HSE) and human resources. Regarding its application to HSE, one of the primary goals of nudge is to achieve a “zero accident culture”.

Leading Silicon Valley companies are forerunners in applying nudge theory in corporate setting. These companies are using nudges in various forms to increase productivity and happiness of employees. Recently, further companies are gaining interest in using what is called “nudge management” to improve the productivity of their white-collar workers.

3. Healthcare

Lately, the nudge theory has also been used in different ways to make health care professionals make more deliberate decisions in numerous areas. For example, nudging has been used as a way to improve hand hygiene among health care workers to decrease the number of healthcare associated infections. It has also been used as a way to make fluid administration a more thought-out decision in intensive care units, with the intention of reducing well known complications of fluid overload.

Each day, humans and animals rely on habits to complete routine tasks such as eating and sleeping. As new habits are formed, this enables us to do things automatically without thinking. As the brain starts to develop a new habit, in as little as a half a second, one region of the brain, the dorsolateral striatum, experiences a short burst in activity. This activity burst increases as the habit becomes stronger. A Dartmouth study demonstrates how habits can be controlled depending on how active the dorsolateral striatum is. The results are published in the Journal of Neuroscience.

In prior research at MIT, the senior author found that this burst in brain activity in the dorsolateral striatum correlated with how habitual a running maze task was for rats. The activity was found to be accentuated at the beginning and end of the maze run.

For this study, the researchers sought to manipulate this burst in brain activity in rats using a method called optogenetics. With this method, the neurons (brain cells) in the dorsolateral striatum, which have been found to be associated with forming habits, can be excited or inhibited using light. Optogenetics enables the brain cells to express a receptor that is sensitive to light, and is painless. A flashing blue light excites the brain cells while a flashing yellow light inhibits the cells and shuts them down.

Using maze running tasks, rats were trained to run in a cross-shaped maze. (There was only one rat in a maze at a time). The rats began in one of two starting arms and ran from one end of the cross and ran to the center decision point. They were trained to turn either left of right and run to the end, where a sugar pellet reward was waiting; only one arm of the cross was baited with the reward. As soon as the animals started the maze run and turned in the correct direction of where the reward was located, they received a sugar pellet reward.

After the rats had learned the maze training runs, the optogenetics component of using the flashing color lights to manipulate the dorsolateral striatum activity, was incorporated. When the cells in the dorsolateral striatum were excited for just a half a second as the rats initiated their runs, the rats would run more vigorously and habitually on the entire maze. The habit had been formed, once the rats ran to the center of the cross-shaped maze and turned immediately towards the direction of where the reward was located. The animals would no longer stop at the center to look around, once they knew where to go.

In contrast, when the cells where inhibited, the rats were slow and appeared to lose their habit altogether. Once they reached the center of the cross-shaped maze, they paused and would turn around a lot as though deliberating, before ultimately making their choice. Even more striking, the researchers also tested how habitual the animals were by changing the tasty reward to something not tasty. In this case, the excitation made the rats continue running by habit for the now unpleasant outcome, while the inhibition made the rats essentially refuse to run when there was no reward to gain from it.

When the researchers applied the light manipulations during the middle of the runs on another day, there was little effect. Once the rats had already set in motion the full sequence of behavior — run, turn and stop sequence -this habit appeared to dictate their actions, as if they were on auto-pilot.

“Our findings illustrate how habits can be controlled in a tiny time window when they are first set in motion. The strength of the brain activity in this window determines whether the full behavior becomes a habit or not,” explained senior author, Kyle S. Smith, an associate professor and director of graduate studies in the department of psychological and brain sciences at Dartmouth, whose lab focuses on the neuroscience of reward and action. “The results demonstrate how activity in the dorsolateral striatum when habits are formed really does control how habitual animals are, providing evidence of a causal relationship,” he added.

Gaining a better understanding of the specific role that the dorsolateral striatum plays in habit memory and other behaviors is critical. Damage to this brain area has been found to be associated with Parkinson’s disease, a neurodegenerative disorder that often affects body movement. In the study, the researchers explain how targeting the time window as to when habits are formed could be leveraged in “designing intervention strategies for humans with otherwise treatment-resistant compulsive behaviors.”