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Health promotion interventions focus on keeping people healthy rather than treating them after they become sick. This can be achieved in several ways, including helping people become more motivated to change their behavior and modifying the environment to make it more conducive to health-promoting behaviors. The field of health promotion is based on the assumptions that people’s behaviors impact their health outcomes that people can change their health-related behaviors when they have the necessary knowledge, resources, motivation, and skills, as well as a supportive environment, and that interventions can provide or increase their knowledge, resources, motivation, and skills. The goal of health promotion interventions is to empower people to modify their behavior to optimize their health. Many of the risk and protective factors for health and disease outcomes are behaviors that can be modified, including diet, physical activity, tobacco, alcohol, and other substance use, sexual behaviors, and screening.1 Because optimal health involves the performance of multiple healthy behaviors and the avoidance of multiple unhealthy behaviors, health promotion interventions often emphasize broad lifestyle changes rather than modification of a single behavior. The design of behavioral interventions involves a series of decisions including operationalization of the goals of the intervention (e.g., prevent substance use, increase physical activity, increase condom use), the target population (e.g., adults, adolescents, a specific ethnic group), the way in which the intervention will be delivered (e.g., mass media, in person, online), and the design of the specific intervention messages and activities.

The process of modifying health behaviors proceeds via several steps. First, the interventionist must define precisely which behaviors need to be modified. For example, to prevent obesity, an interventionist might decide to encourage participants to increase their physical activity, decrease their sedentary behavior, increase their vegetable intake, decrease their sugar intake, or improve all of these behaviors. It is essential to determine which behaviors the intervention will target, so that intervention messages can be designed to encourage individuals to modify those particular behaviors. The target behavior should be operationalized as concretely as possible (e.g., “walk 10,000 steps per day” rather than “get more exercise”).

The next step is to understand the conditions that facilitate or hinder performance of the target behaviors and determine which of these are modifiable. For example, if people are not engaging in physical activity because they lack knowledge of the benefits of physical activity, an intervention could teach them about the benefits of physical activity. However, if they already know the benefits of physical activity but lack a safe place to exercise or friends to exercise with, teaching them about the benefits of physical activity is unlikely to change their behavior. A possible solution might be to increase the safety of the neighborhood, but that is probably not under the interventionist’s control. In this case, a possible intervention strategy might be to work with local institutions such as schools or churches to provide group exercise classes in ...

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