Reason and reaction: the utility of a dual-focus, dual-processing perspective on promotion and prevention of adolescent health risk behaviour

Abstract

Purpose: A brief overview of theories of health behaviour that are based on the expectancy-value perspective is presented. This approach maintains that health behaviours are the result of a deliberative decision-making process that involves consideration of behavioural options along with anticipated outcomes associated with those options. It is argued that this perspective is effective at explaining and predicting many types of health behaviour, including health-promoting actions (e.g. UV protection, condom use, smoking cessation), but less effective at predicting risky health behaviours, such as unprotected, casual sex, drunk driving or binge drinking. These are behaviours that are less reasoned or premeditated - especially among adolescents. An argument is made for incorporating elements of dual-processing theories in an effort to improve the 'utility' of these models. Specifically, it is suggested that adolescent health behaviour involves both analytic and heuristic processing. Both types of processing are incorporated in the prototype-willingness (prototype) model, which is described in some detail.

Methods: Studies of health behaviour based on the expectancy-value perspective (e.g. theory of reasoned action) are reviewed, along with studies based on the prototype model.

Results: These two sets of studies together suggest that the dual-processing perspective, in general, and the prototype model, in particular, add to the predictive validity of expectancy-value models for predicting adolescent health behaviour.

Conclusion: Research and interventions that incorporate elements of dual-processing and elements of expectancy-value are more effective at explaining and changing adolescent health behaviour than are those based on expectancy-value theories alone.