Reciprocal determinism at the stages of behavior change: an integration of community, personal and behavioral perspectives.

Effective community health education requires theories which combine the perspectives of behavior change at the levels of the individual with those at the levels of the community. Within the framework of reciprocal determinism, a variety of theories and concepts are integrated to understand behavior change at levels of the individual and levels of the community. These concepts are applied at each step in the behavior change process, and categories of intervention are explained within the proposed framework. A variety of specific intervention procedures are generated from the framework for promoting behavior change at each level and stage of change. Such a comprehensive integrated framework holds promise of designing more effective health education programs.