Change theory and models for change intervention | dnp | Chamberlain College of Nursing


Change Theory and Models for Change Intervention

I selected a behavioral change theory as a framework to guide my practice problem intervention.  The Theory of Reasoned Action (TRA) originated in the 1960s, has been used in past to guide clinical practice intervention in behavioral related changes (Chamberlain College of Nursing, 2020). For example, it has been used in smoking cessation, dieting, the use of seat belts, voting, breastfeeding, as well as HIV/AIDS intervention both in and outside the United States (Fishbein et al,1994 as cited in White et al., 2016).

The theory of reasoned action has four key components. They are behavior, intention, attitude, and norms (White et al., 2016). The theory is based on the belief that people are rational creatures and that their willingness to change behaviors have a lot to do with their conscious commitment. The following variables according to Fishbein et al, (1994 as cited in White et al., 2016) are interrelated; They are

1. Behavior – what is needed to happen so that the person understands what has to be done to achieve change.

2. Intention – The person’s readiness to change the behavior. That behavior change depends on the last two components attitude and norms.

3. Attitude – what are the approval and disapproval feeling the person may have about the behavior.

4. Norms (subjective)– How does that person who is about to undertaking that particular behavioral change believes others will feel about the behavior.

In this particular theory, there is no clear component for networking with the stakeholders during the phases of the practice changes. I was unable to find ways to evaluate the evidence. I was not able to identify any component for identifying nor addressing barriers to implementation. However, TRA has been implemented successfully in multiple clinical interventions to adopt healthy behavior. In a recent research study using TRA to understanding teen pregnancy in the American Indians communities, they found that the subject’s attitude about using birth control and the favorable or unfavorable opinions of others indicate whether or not these teenagers used contraceptives (Dippel et al., 2017).

For the practice intervention to be successful, the individuals have to be prepared to change their beliefs and attitudes towards obesity. The perspective participants, who are one of the key stakeholders in this project have to be vested in the plan. There need to be a desire to lost weight and work towards maintaining it. They also have to know that their support system, that is family and friends will be supportive throughout. For any change to occur, the door to communicating with all key stakeholders need to remain open throughout the implementing and evaluation phase of the practice change intervention and beyond.


Chamberlain College of Nursing. (2020). NR-701 Week 4: Change theory and models for change intervention [Online lesson]. Adtalem.

Dippel, E.A., Hanson, J.D., Mchahon, T.R., Griese, E.R. & Kenyon, D.B. (2017). Applying the theory of reasoned action to understanding teen pregnancy with American Indians communities. Maternal Child Health Journal, 21 1449-1456. doi:10.1007/s10995-017-2262-7

Family Health International. (1996). Behavior change: A summary of four major theories.

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (2016). Translation of evidence into nursing and health care (2nd ed.). New York, NY: Springer Publishing Company.


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