Introduction
Just like with everything else in life, there are certain theories that people draw up about certain topics. Social cognitive theory, self-regulation, the health belief models, theory of planned behavior, and transtheoretical model are a few of these theories that have been hypothesized. Theoretical models of health behavioral change are focused on cognitive variables, such as beliefs/values, attitudes, and expectations, and the factors that influence these variables (Kristin, et. al., 2014). Influences can come from social status to economic status that can actually affect peoples thought processes. If a person’s main goal is to figure out what they are going to eat that evening, then they wouldn’t be able to focus on the betterment of their life.
Theories can be useful in designing health intervention programs for a variety of reasons, mainly for implementation. In order to establish the groundwork for a health intervention program, you need structure and key concepts to follow. When there isn’t any organization, it will be hard to follow accordingly, thus resulting in people losing the initiative to proceed. When people see good structure in a program, they are more susceptible to follow it from beginning to end. This will guide the intervention program into great successes in any field of health promotion category.
Choose a Theory of Health Behavior
The theory that will be implemented in this health promotion program will be the social cognitive theory, which uses the reciprocal nature of influences that produce behavior. Moreover, reciprocal influences help change behavior through personal factors, existing behaviors, and physical or social environment (Kristin, et. al., 2014). The main constructs of the social cognitive theory are mainly based around a persons social and physical environment. The paradigm that says a person with beliefs, attitude, information, and needs will engage in behavior that has some consequent outcome (Kristin, et. al., 2014).
Behavior change and maintenance of behavior are split into two separate functions. One, expectations of the outcomes will result from engaging in some kind of behavior. And secondly, their expectation and their ability to execute or engage in the certain behavior and the outcome (Kristin, et. al., 2014). Furthermore, outcome expectations consist of believing in any given behaviors leading to given outcomes. Whilst self-efficacy consists of one believing in their ability to perform these behaviors that lead to certain outcomes. If a person in the target population has a low level of self-efficacy, then they tend to ruminate on their own deficiencies. This leads to a lower level of confidence and more anxiety/depressive feelings.
This theory is appropriate for this given health promotion program for more ways than one. When the adolescent group within our community have someone to admire/look up to, they begin to mold themselves to that behavior. Helping their self-efficacy levels rise, will begin to put them into a higher level of confidence, which is key in most behaviors, especially when trying to reach a certain outcome. Seeing their friends making the effort to change their life for the better, can also influence them to change their behavior. I am a strong proponent of the nurture aspect, especially in our adolescent years. We have built the level of understanding up to this point, so how could they be wrong. The advent of the internet — social media mostly—children have taken the aspect of comparing themselves to others to a whole new extreme. If their social, and physical environment is positive, no matter which way they look, they will move towards that more often. These are just a few explanations of why a certain social construct can have more influence than one may think.
Theory-based Program Activities
One activity that explicitly addresses the constructs of the social cognitive theory is through self-analyzing every behavior they are involved in. Taking a moment after every interaction can help understand if there was anything you personally did that resulted in the outcome of the interaction, whether good or bad. The construct factor of their belief in their ability to perform an action can be more self-analytic. When a person takes a moment to think before and after an interaction, then they are in control of their behavior, which may lead to a favorable outcome. Personally, no one can control another person, however, we all can control how we react to a certain topic. Even going into an interaction, and taking a moment to analyze your behavior, you can usually come out with a favorable outcome.
Another activity that can be conducted is meditating first thing in the morning, or even throughout the day. To address the other factor of this theory, ones expectations of outcome when conducting a certain behavior, taking time to analyze will be better. And that is the benefit of meditation. Even doing a small session of meditation can help soothe the mind for whatever is thrown at you during the day. A calm mind leads to a calm heart, and a calm heart leads to a calm self-environment. People will surround themselves with whatever they are feeling at the time. Which of course can be a bad thing, especially in the adolescent target population. Surrounding themselves with like minded people will just influence them to continue to their goals. You surround yourself with five turkeys, you will walk everywhere you want to go. Surround yourself with five eagles, and you can learn to soar.
Tailor the Program
Tailoring to program activities has to do with the program that is being implemented. Adjusting all the proper topics and events for the program can help with the organization of the program. A weakness that does arise in most adaptation methods is that individual steps lack certain detail pertaining to the program (Mudd-Martin et.al., 2013). Without proper adapting protocol, tailoring the program can begin to fall apart. Recruitment, setting, timing and personnel are all a dire asset to the program, and are usually solicited from the target population (Chen, et. al., 2013). With this program target population being adolescents, we would need to solicit some candidates as pawns on the board. Having their same aged individuals pushing for this certain program, they can all begin to relate to it, and start making their way into the same slots as their social counterparts.
Program Logic Model
| Inputs | Outputs | Short Term Outcomes | Midrange Outcomes | Long term Outcomes |
| Recruitment | Educators, find target population team members | Begins bringing people on board | Build a solid foundation of people outside of founders | Have established members for the program |
| Investing in Non-profit | Brings in the finances needed for implementation | Start small and get larger | Establish the foundation of our facilities and incentive program | Cooperation between founders and investors |
| Volunteer hours | More people helping the cause | Bring more people to our program | Begin to put more people in place | Have solid managerial members within the program |
| Building of facilities | Bringing the health club to fruition | Pinpoint locations of health club | Finalize utilities and proper expenses for the club | A fully self-sufficient club 24/7 |
| Implementation | People seeing healthier lifestyles | Get our target population leaning towards the program | Begin lowering overweight adolescents | Lowering the obesity rate, and raising the physical activity rate |
| Furthering our reach | Reach more towns within the state | Go from Natrona County, to Campbell County | Start the recruitment of staff for that area | Find ourselves to be in as many towns as possible |
| Maintenance | Keep the ball rolling with our momentum | Healthy lifestyles become more prominent | Having adolescents become more engrained in our society | 10 years—target population is older, with more of an influence in the community |
All great successes must start from scratch at some point, with like minded people. Bringing those people together and recruiting the proper staff for a program like this would be main priority. Without enough staff, the program would just fizzle out. Getting the source of revenue to start implementing the program may be difficult. However, a 501(c) (3) Non-Profit organization becomes more noticed by local investors. Larger corporations can use it as a tax right off, for “charitable” causes. Getting the volunteers to help build the relationship in the community, especially in the target population. At this point, we are at the peak of the program, where the large-scale building of the facilities needs to be regulated. Expenses are going to go through the roof at this stage, but it will have a ROI within due time. Implementation can go right along with furthering our reach. Where our reach stays strong in our local community and prolonging it even further to other communities. And the final stage of change, maintenance. Keeping all this logic model running, we would need to bring new topics of discussion to the table to help brainstorm future endeavors.
Program Implementation Plan
Program implementation is going to be the key aspect to this entire program. Having our established founders of three people, we can begin bringing people into the program that are fellow acquaintances. If each one of the founders brings on 5 people for a volunteer aspect at first, then we will be sitting around 18 people to begin writing the by laws for the program. Building a string solid foundation is going to be a key aspect of the entire program. If our adaptation isn’t sufficient, then it will fall apart at the very first barrier. Adoption of the program will need to rely on these 18-starting people. With those 18 people, they all know some number of adolescents that they can begin using as pawns in the real-world chess game. Sending them out there to their fellow adolescents will get our reach stronger.
The first barrier we would encounter would be finances. A suitable strategy for his problem would be building the 501(c) (3) nonprofit and be recognized by the IRS on a federal level. This can help bring funding in from more than our local community. There are organizations that will donate to programs like this one. Jumping that barrier will get the ball rolling for the building of facilities. With the funding program we mentioned earlier, we would have at least one million dollars upon acceptance. Meeting all the requirements for this funding offer will get this more mainstream.
Another barrier that we cold encounter would be if the target population doesn’t want to follow the program. Of course, forcing people to do something that they don’t want to do in this Country is frowned upon. Jumping this implementation barrier will be through the incentive programs that will be involved. People love free stuff, and if all they must do is go to a gym a certain number of times a week, then that is an easy task. Once they begin building the habit, then their desire to complete the task will be second nature. I was told something once, that in life, we do what we must do, well because we have to. Soon enough, we do what we have to because it becomes second nature. And sooner than later, we do what we have to do, because we want to do it. All good things take time, and this isn’t going to happen overnight. However, our adolescents will begin to age into early adults, with a good solid foundation of a healthier lifestyle. Where they will then pass down to their kids, and their kids will pass it down to their kids, for generations to come. It all starts here.
-Cyral I Callender III
Reference:
Chen, E. K., Reid, M. C., Parker, S. J., & Pillemer, K. (2013). Tailoring evidence-based interventions for new populations: a method for program adaptation through community engagement. Evaluation & the health professions, 36(1), 73–92. https://doi.org/10.1177/0163278712442536
Kristin A. Riekert, P., Judith K. Ockene, P. Me. M., & Lori Pbert, P. . (2014). The Handbook of Health Behavior Change, 4th Edition: Vol. 4th edition. Springer Publishing Company.
Mudd-Martin, G., Martinez, M. C., Rayens, M. K., Gokun, Y., & Meininger, J. C. (2013). Sociocultural tailoring of a healthy lifestyle intervention to reduce cardiovascular disease and type 2 diabetes risk among Latinos. Prev Chronic Dis, 10, 130137. Available online: https://www.cdc.gov/pcd/issues/2013/13_0137.htm
Health and Wellness Repertoire 
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