A conceptual framework for developing and evaluating behavior change interventions for injury control

This paper addresses issues and research needs in the domain of behavior modification for injury control. Although much of the discussion focuses on traffic safety, the concepts and principles are applicable to all areas of injury control (e.g. on the job and in the home). Field research that has increased safety belt use is reviewed briefly to illustrate a tripartite classification of injury control factors (i.e. environmental, individual, or behavioral variables), and to introduce a heuristic framework for categorizing and evaluating behavior change strategies. A multiple intervention level hierarchy depicts a progressive segmentation of the target population as more effective (and costly) interventions are implemented; and a taxonomy of 24 behavior change techniques includes a scoring system for predicting short and long term effects of intervention programs. It is presumed that more risk-prone individuals require higher-level interventions, which are those that provide specific response information and extrinsic controls, while also eliciting active participant involvement, social support, and perceptions of autonomy. Although extrinsic controls increase the immediate impact of an intervention program, these techniques may jeopardize response maintenance when the program is withdrawn.