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Structuring HIV prevention service delivery systems on the basis of social science theory

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Abstract

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.

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Authors and Affiliations

  1. National Center for Prevention Services, Centers for Disease Control, 1600 Clifton Road, Mailstop E07, 30333, Atlanta, Georgia

    Ronald O. Valdiserri MD, MPH (Deputy Director (HIV)

Authors
  1. Ronald O. Valdiserri MD, MPH
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  2. Gary R. West MPA
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  3. Melinda Moore MD, MPH
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  4. William W. Darrow PhD
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  5. Alan R. Hinman MD, MPH
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Additional information

Ronald O. Valdiserri is Deputy Director (HIV) of the National Center for Prevention Services; Gary R. West is Assistant Deputy Director (HIV) of the National Center for Prevention Services; Melinda Moore is Deputy Director of the International Health Program Office; William W. Darrow is Chief of the Behavioral and Prevention Research Branch, Division of Sexually Transmitted Diseases/HIV Prevention, National Center for Prevention Services; and Alan R. Hinman is Director of the National Center for Prevention Services, all at the U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Atlanta, Georgia.

The authors would like to thank Lynn Erickson for her secretarial assistance and Mary Willingham for her bibliographic assistance.

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Valdiserri, R.O., West, G.R., Moore, M. et al. Structuring HIV prevention service delivery systems on the basis of social science theory. J Community Health 17, 259–269 (1992). https://doi.org/10.1007/BF01324356

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