The coronary risk factor problem: A behavioral perspective

Abstract

This paper examines the conditions under which one would expect to observe the development and perpetuation of preventive health behavior patterns in populations. It is hypothesized that preventive health behavior is a function of both macro-level societal constraints and micro-level organizational, group, and individual factors. The concept of the “at risk” or “high-risk” role is developed and contrasted with the traditional sick and illness roles. Based on the behavioral science literature, the following macro-level factors are presented as predictors of preventive health behavior: (a) legislation and economic incentives; (b) social norms and cultural patterns; (c) training and consequent practices of physicians and other health professionals; and (d) organization of health services. On the micro-level, the following predictors of preventive health behavior can be supported: (a) social supports from primary and reference groups; (b) socialization of children; (c) formal organizational sanctions; and (d) individual motivation and responsibility. In support of the theoretical framework, the paper draws upon the literature reviewed in the recent American Heart Association Monograph Applying Behavioral Science to Cardiovascular Risk. The authors describe some current risk factor intervention studies and conclude with a proposal for community intervention projects with simple, quasi-experimental designs in which outside facilitators would initiate programs and continuing education for local health professionals who would eventually assume responsibility for their perpetuation.