Models of Prevention

Abstract

In this chapter, four specific, powerful models of prevention currently in use are presented, together with the effective intervention strategies that have developed out of these models. First, underlying theoretical concepts are described. Prochaska and DiClemente (1984) have delineated a five-stage model as a transtheoretical approach to understanding how human beings change behavior. The five stages (precontemplation, contemplation, preparation, action, and maintenance) are described here, along with the implications of this model for changing high-risk sexual behavior. Other cognitive behavioral constructs are then described which have been shown to be effective in designing effective intervention strategies, including the Theory of Reasoned Action (Azjen & Fishbein, 1980) and the Information-Motivation-Behavioral Skills (IMB) Model developed by Fisher and Fisher (1992) specifically for HIV prevention work. Various applications of the IMB Model are described, including the use of Natural Opinion Leaders (NOLs; Kelly et al., 1991) who generate support for the intervention among their peers. Next, “Reducing the Risk,” a school-based intervention to decrease high-risk sexual behavior (Kirby, Barth, Leland, & Fetro, 1991), is described. Models for preventing teen pregnancy are then discussed, which include attention to the effects of personality factors, cognitive components, and social and environmental elements.