Valdiserri R O, West G R, Moore M, Darrow W W, Hinman A R
National Center for Prevention Services, U.S. Department of Health and Human Services, Centers for Disease Control, Atlanta, Georgia 30333.
J Community Health. 1992 Oct;17(5):259-69. doi: 10.1007/BF01324356.
In order to identify the optimal configuration of HIV prevention programs, it is necessary to examine different theoretical models of behavior change. Cognitive/decision-making theories of human behavior change are compared to social learning theories vis-a-vis their influence on the structure of service delivery systems. Cognitive/decision-making theories ascribe behavior change to the provision of new information and favor the development of homogeneous interventions providing clients with information about risk behaviors. These interventions are easily standardized across delivery sites and various target populations. Social learning theories view behavior change as a series of stages and recognize the influence of sociocultural variables. They favor multiple heterogeneous interventions in a variety of settings, with the provision of skills training as well as information. Ongoing HIV prevention research indicates that social learning theories provide a more accurate paradigm of human behavior change for the complex behaviors related to HIV risk. Public health agencies must therefore continue to strengthen organizational and referral relationships with community-based organizations that can provide the specialized prevention interventions called for by social learning theory. This will require ongoing collaboration and technical assistance.
为了确定艾滋病病毒预防项目的最佳配置，有必要审视行为改变的不同理论模型。将人类行为改变的认知/决策理论与社会学习理论在其对服务提供系统结构的影响方面进行比较。认知/决策理论将行为改变归因于新信息的提供，并倾向于开发为客户提供风险行为信息的同质化干预措施。这些干预措施易于在不同的服务地点和各类目标人群中实现标准化。社会学习理论将行为改变视为一系列阶段，并认识到社会文化变量的影响。它们倾向于在各种环境中采取多种异质化干预措施，同时提供技能培训和信息。正在进行的艾滋病病毒预防研究表明，对于与艾滋病病毒风险相关的复杂行为，社会学习理论为人类行为改变提供了更准确的范式。因此，公共卫生机构必须继续加强与社区组织的组织和转诊关系，这些社区组织能够提供社会学习理论所要求的专门预防干预措施。这将需要持续的合作和技术援助。
