Development of theory-based health messages: three-phase programme of formative research

TLDR

Online health‑behaviour interventions hold promise, yet their effectiveness is often limited by insufficient formative and theoretical groundwork. This study outlines a formative research process to create culturally relevant, theory‑based health messages for an online intervention aimed at promoting healthy lifestyles among first‑year university students. Guided by the Theory of Planned Behaviour, researchers conducted a three‑phase programme with prospective and current undergraduates to identify salient beliefs about fruit and vegetable intake, physical activity, binge drinking and smoking, determine which beliefs predicted intentions or behaviour, and uncover underlying reasons to target in messages. The programme yielded 56 beliefs from 96 pre‑university students, identified 32 predictive beliefs from 3,026 incoming students, and gathered 102 underlying reasons from 627 current students, demonstrating a robust, theory‑driven method for crafting health messages.

Abstract

Online health behaviour interventions have great potential but their effectiveness may be hindered by a lack of formative and theoretical work. This paper describes the process of formative research to develop theoretically and empirically based health messages that are culturally relevant and can be used in an online intervention to promote healthy lifestyle behaviours among new university students. Drawing on the Theory of Planned Behaviour, a three-phase programme of formative research was conducted with prospective and current undergraduate students to identify (i) modal salient beliefs (the most commonly held beliefs) about fruit and vegetable intake, physical activity, binge drinking and smoking, (ii) which beliefs predicted intentions/behaviour and (iii) reasons underlying each of the beliefs that could be targeted in health messages. Phase 1, conducted with 96 pre-university college students, elicited 56 beliefs about the behaviours. Phase 2, conducted with 3026 incoming university students, identified 32 of these beliefs that predicted intentions/behaviour. Phase 3, conducted with 627 current university students, elicited 102 reasons underlying the 32 beliefs to be used to construct health messages to bolster or challenge these beliefs. The three-phase programme of formative research provides researchers with an example of how to develop health messages with a strong theoretical- and empirical base for use in health behaviour change interventions.