Application of Behavior-Change Theories and Methods to Injury Prevention

Reducing the burden of injury is an international health goal, one that requires an interdisciplinary perspective. Injuries, whether self-inflicted, inflicted by others, or unintentional, have one thing in common: They are largely preventable. Behaviors that give rise to violence and injury are amenable to preventive intervention, just as are many of the behaviors that give rise to diseases. Thus, behavioral science is an integral part of a comprehensive injury prevention strategy. Applications of behavioral science to injury prevention lagged behind other approaches during the last half of the 20th century. Despite recognition by injury control professionals of the importance of behavioral research in injury prevention, behavioral solutions to preventing injury were deemphasized until recently (1, 2). Historically, little scholarly attention has been paid to understanding determinants of injury-related behaviors or how to initiate and sustain behavioral changes. Interventions often seemed to have been based on simplistic assumptions that changing people’s awareness about the injury problem would change their behavior. Many authors have noted the need to improve behavioral interventions by using better empirical data about determinants of behavior as well as theories and frameworks pertaining to change in health behavior (3–6). A growing body of work is emerging that demonstrates the positive impact of using behavioral science approaches in order to both understand and reduce injury risk behaviors (6–10). In this paper, we describe the role of behavior change in injury prevention and illustrate how the application of selected behavior-change theories to injury problems, within the context of a health promotion framework, can contribute to the enhancement of injury prevention programs.