Health Promotion and the Knowledge-Attitude-Behavior Continuum

October 14, 2020 - Erv Bettinghaus

Originally published in 1986.

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     Two beliefs have characterized many of the health promotion campaigns con- ducted in the United States. The first belief is that if people are just given “the facts,” they will behave in ways that accord with those facts. Thus, health educa- tion campaigns have been conducted under the premise that if people know, for example, that smoking causes lung cancer and that obesity is linked with heart disease, people will stop smoking and lose weight. The second belief held about health promotion is that if people can be induced to hold favorable or unfavorable “attitudes” about a particular practice, they will change their behaviors to fit the attitudes. This belief says that if persuasive materials intended to create a nega- tive attitude about smoking are presented to an individual, the adoption of the negative attitude will lead the individual to stop smoking.

     Although both of these beliefs do seem to underlie many health promotion campaigns, we shall see that the research evidence does not fully justify blind belief in the efficacy of presenting just the facts or in the importance of attitudes to health promotion. After a brief examination of the history of the knowledge- attitude-behavior continuum, we look at a set of variables and persuasive com- munication techniques that may give promise of improving the linkage between overt behavior and variables such as information level and attitude.