Beyond Individual Cognitions: Time for Intervention Science to Focus on Health Context and Audience.

Abstract

Intervention science faces a hazardous paradox: on the one hand, vulnerable populations (eg,patients, people from low socioeconomic background, older adults) are those for whom adoption of healthy behaviors is most urgent; on the other hand, behavior change models are less predictive, and interventions less successful, in these populations. This commentary presents 4 reasons that may explain this issue: (1)research mostly focuses on what causes behavior and how to change it, at the expense of investigating among whom and under what conditions models are valid; (2)models put an undue emphasis on individual cognitions; (3)most studies are not conducted on vulnerable populations; and (4)most researchers are from high-income countries. Several avenues are proposed to address this issue: (1)providing a central place to the context and audience in health behavior change modelization, through collaborations with researchers from other disciplines and countries, and with members of the targeted audience; (2)better reporting samples' sociodemographic characteristics and increasing samples' diversity; and (3)using more rigorous and innovative designs (eg,powered randomized controlled trials, N-of-1 trials, intensive longitudinal studies). In conclusion, it becomes urgent to change the way we do research: the social utility and credibility of intervention science depend on it.