Theory-based health behavior change: Developing, testing, and applying theories for evidence-based interventions

Theories are needed to explain and predict health behavior, as well as for the design and evaluation of interventions. Although there has been a history of developing, testing, applying, and refining health behavior theories, debates and limitations in evidence exist: The component of theories which, for example, predicts change should be better elaborated so that we can more easily understand what actually drives behavior change. Theories need to be empirically testable in two ways. Theories need to specify a set of changeable predictors to describe, explain, and predict behavior change, and they should enable us to design an effective intervention that produces exactly those changes in behavior that are predicted by the relevant theory. To make this possible, theories need to be specified in such a way that they can be rigorously tested and falsified. Moreover, for the design of theory-based interventions it must be possible to derive change techniques from the theory and to use them to generate changes in behavior. Based on eight state-of-the-science articles that make conceptual and empirical contributions to the current debate on health behavior theories, various approaches are discussed to gain further insights into explaining and changing health behaviors and the iterative process of theory development.