TABLE 4-1 Major Reasons for Doing Risky Things and Corresponding Reasons for Behavioral Change and Behavioral Change Strategies

Streams of Influence

Reasons for Doing Risky Things

Reasons for Behavioral Change

Behavioral Change Strategy

Sociocultural, attitudinal

It makes me feel good; it’s good for me

It will be good for me; to gain benefits or avoid negative consequences; to improve myself (health) in ways I value

Information: make benefits salient and visible

Values clarification: make goals/ improvements clear


Others want me to; it’s what others expect of me; everyone else is doing it; to gain social acceptance

Others want me to; it’s what others expect of me; everyone else is doing it; to please others

Modeling/ demonstrating behavior

Social reinforcement/ support


I don’t know how not to or how to change; things remind me of it (cues); I can’t help myself

I am confident that I can do it; I think I have the skill to do it; I have the will to do it

Teach/learn/practice skills

Build in prompts, cues, reminders


SOURCE: Flay (2005).

Examples include limits on the sales and advertising of alcohol and tobacco products to minors and other measures such as the placement of social marketing, prevention, and health promotion strategies in the environments of youth.2


One recent report that has advocated a comprehensive strategy to address underage drinking is the study Reducing Underage Drinking: A Collective Responsibility (National Research Council and Institute of Medicine, 2004). Another example of environmental forces that influence adolescent health decision making is addressed in the study Food Marketing to Children and Youth: Threat or Opportunity? (Institute of Medicine, 2006).

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