The Handbook of Health Behavior Change 4th Edition PDF

The Handbook of Health Behavior Change

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The adoption and maintenance of healthy lifestyle behaviors and adhering to prescribed therapies are key to optimal health. Four lifestyle behaviors in particular—getting regular physical activity, eating a healthy diet, not smoking, and limiting alcohol consumption— contribute to a longer and healthier life. Indeed, people who engage in all four of these behaviors are significantly less likely to die early from cancer, cardiovascular disease, and other causes compared to people who do not (Ford, Zhao, Tsai, & Li, 2011). Unfortunately, in 2010, 51% of noninstitutionalized American adults had at least one chronic illness; 26% had two or more (Ward & Schiller, 2013). Moreover, chronic illnesses comprised 7 of the top 10 causes of death in 2008 including heart disease, cancer, chronic lower respiratory diseases, stroke, Alzheimer’s disease, diabetes, and kidney disease. Together, these 7 chronic illnesses accounted for approximately 67% of all deaths in the United States (Heron, 2012). It is clear that increased attention to the adoption and maintenance of behaviors for optimal health can have significant public health impact.
The overarching goal of the fourth edition The Handbook of Health Behavior Change is to inform health care providers, policy makers, health services, and behavioral, and social science researchers of the most current theories, challenges, and interventions for supporting health behavior change, including lifestyle behaviors and chronic disease management. The Handbook of Health Behavior Change was first published in 1988 and with each edition there has been growing appreciation for the critical role health behavior plays in maintaining health and well-being. Research has evolved from a primary focus on understanding predictors of engaging in positive health behaviors and the impact of health behaviors on the onset, progression, and exacerbation of diseases to the evaluation of interventions in controlled clinical trials. Now 25 years later, the themes of the previous editions continue to be relevant. In addition, the fourth edition includes new chapters that reflect current practices in the field of health behavior change, including an emphasis on the need to implement and disseminate interventions in real-world settings and a call for a focus on eliminating ever growing health disparities.
Understanding theoretical frameworks that guide the development of strategies and interventions to achieve change in behaviors and inform health behavior research is the first step in supporting meaningful and lasting health behavior change. Therefore Section I: Chapters 1 to 3 focus on the most frequently used theoretical models in health behavior change research. While each theory is unique, there are many commonalities among them as well. As such, for the fourth edition this section has been reorganized based on the level at which the theories are operating: individual theories, community and population-based models, and health system models. This new organization allows the reader to better understand the strengths and weaknesses of each model relative to other theories operating on the same level.
Section II: Chapters 4 to 6 provide updated reviews of the factors that predict or serve as obstacles to lifestyle change and adherence. The authors in this section consider individual characteristics, psychosocial factors, and the family, community, and broader social and cultural context. Specific challenges faced by vulnerable populations such as children, adolescents, and the elderly and considerations for interventions at different developmental stages are presented. In addition, the interrelationships among culture, health disparities, and health behavior change and the need to take these into account when designing health behavior change programs and policies are addressed in the context of the growing cultural diversity in the United States.
Lifestyle changes, including the big four noted above (physical activity, nutrition, and tobacco and alcohol use), are the topics of Chapters 7 to 12 in Section III. This section provides updated reviews of the challenges in maintaining and changing these behaviors as well as the efficacy of various intervention strategies. Beyond these four lifestyle behaviors, there is a chapter on stress management, given the increasingly recognized role of stress in contributing to the development of chronic illnesses, such as cardiovascular disease and cancer, as well as overall mortality. This chapter provides a review of a variety of approaches for addressing stress that are often integrated into other behavior change interventions. Recognizing that risky lifestyle behaviors most often co-occur and are best considered within the context of their interdependence, the final chapter in this section tackles the complexities of multiple-risk behavior change.
Section IV: Chapters 13 to 18 address the challenges of adhering to lifelong medical regimens. The chapters focus on many of the most prevalent chronic illnesses that contribute to avoidable mortality including cardiovascular disease, diabetes, respiratory diseases (specifically asthma and chronic obstructive pulmonary disease [COPD]), infectious diseases (including HIV, other sexually transmitted diseases, and tuberculosis), cancer, and obesity. These chapters highlight the prevalence of nonadherence to regimen components as well as review the efficacy of interventions to support and improve treatment adherence.
New to the handbook, Section V: Chapters 19 to 22 focus on the development and evaluation of behavior change interventions implemented within a variety of contexts including community settings such as schools and work places, health care systems, and the built environment. This focus on the environments in which behavior change interventions may take place highlights the opportunities and challenges of working within these systems. It also reflects the growing recognition of the importance of implementation science—that interventions must be developed and evaluated in the contexts in which they will ultimately be disseminated.
Section VI: Chapters 23 and 24 flow nicely from the preceding sections and highlights methodological innovations in health behavior change research. The first chapter focuses on the technological innovations in behavior measurement that have occurred since the third edition. Many new opportunities now exist to objectively measure behavior with less burden and more precision. These innovations are allowing health care providers to begin using these tools in clinical care to shape and modify behavior. Perhaps more than any other innovation, the ongoing development and influence of dissemination and implementation of science theories and methodologies have greatly influenced health behavior research. The final chapter of the handbook highlights the importance of conducting translational research and sets out a framework and set of recommendations for moving the field of behavior change research forward to enhance population health.

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