Research article

A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS?

Salla Munro¹ , Simon Lewin² , Tanya Swart³ and Jimmy Volmink⁴

¹  South African Cochrane Centre, Medical Research Council of South Africa, P.O. Box 19070, Tygerberg 7505, Cape Town, South Africa

²  Health Systems Research Unit, Medical Research Council of South Africa and Department of Public Health and Policy London School of Hygiene and Tropical Medicine, Keppel Street London WC1E7 HT, UK

³  Department of Psychology School of Human & Community Development, University of the Witwatersrand Private Bag X3, Wits, 2050, South Africa

⁴  South African Cochrane Centre, Medical Research Council of South Africa and Deputy Dean: Research Faculty of Health Sciences, Stellenbosch University PO Box 19063, Tygerberg 7505, Cape Town, South Africa

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BMC Public Health 2007, 7:104doi:10.1186/1471-2458-7-104

Published:	11 June 2007

Abstract

Background

Suboptimal treatment adherence remains a barrier to the control of many infectious diseases, including tuberculosis and HIV/AIDS, which contribute significantly to the global disease burden. However, few of the many interventions developed to address this issue explicitly draw on theories of health behaviour. Such theories could contribute to the design of more effective interventions to promote treatment adherence and to improving assessments of the transferability of these interventions across different health issues and settings.

Methods

This paper reviews behaviour change theories applicable to long-term treatment adherence; assesses the evidence for their effectiveness in predicting behaviour change; and examines the implications of these findings for developing strategies to improve TB and HIV/AIDS medication adherence. We searched a number of electronic databases for theories of behaviour change. Eleven theories were examined.

Results

Little empirical evidence was located on the effectiveness of these theories in promoting adherence. However, several models have the potential to both improve understanding of adherence behaviours and contribute to the design of more effective interventions to promote adherence to TB and HIV/AIDS medication.

Conclusion

Further research and analysis is needed urgently to determine which models might best improve adherence to long-term treatment regimens.