Beyond Individual Cognitions: Time for Intervention Science to Focus on Health Context and Audience

Intervention science faces a hazardous paradox: on the one hand, vulnerable populations (eg, patients, people from low socioeconomic background, older adults) are those for whom adoption of healthy behaviors is most urgent; on the other hand, behavior change models are less predictive, and interventions less successful, in these populations. This commentary presents 4 reasons that may explain this issue: (1) research mostly focuses on what causes behavior and how to change it, at the expense of investigating among whom and under what conditions models are valid; (2) models put an undue emphasis on individual cognitions; (3) most studies are not conducted on vulnerable populations; and (4) most researchers are from high-income countries. Several avenues are proposed to address this issue: (1) providing a central place to the context and audience in health behavior change modelization, through collaborations with researchers from other disciplines and countries, and with members of the targeted audience; (2) better reporting samples' sociodemographic characteristics and increasing samples' diversity; and (3) using more rigorous and innovative designs (eg, powered randomized controlled trials, N-of-1 trials, intensive longitudinal studies). In conclusion, it becomes urgent to change the way we do research: the social utility and credibility of intervention science depend on it.

Automated summary

Intervention science faces a paradox where the most vulnerable populations require behavior change, but current models and interventions are less successful in these populations. This issue can be explained by a focus on causation and individual cognitions, lack of research on vulnerable populations, and a dominance of high-income country researchers. To address this issue, collaboration, improved reporting, and more rigorous designs are suggested. It is urgent to change research approaches to enhance the social utility and credibility of intervention science.