Application of Behavior Change Theory to the Development

• Relapse: Assist reentry into the change process as soon as possible.
iv
BEHAVIOR CHANGE THEORY
Miller and Brown (1991) reported that brief interventions are potent agents for change
because their major impact is motivational. Specifically, the authors believe these brief
interventions elicit commitments from subjects to try changing their behaviors and to
persevere in their efforts. Previous research has identified three types of elements
useful to the change process: General elements necessary to any change strategy; Early
Stage elements to promote movement through pre-contemplation, contemplation, and
determination; and Late Stage elements to elicit movement through the action,
maintenance, and relapse phases.
Previous research also has identified 16 elements that promote change through the
Stages noted above. Six of these are General elements necessary to any behavioral
change strategy, five promote Early Stage change and five are needed in the Late Stages.
However, no previous research has evaluated the treatment letters used in traffic safety
in terms of the 16 Transtheoretical Model (TTM) components. The results of that type
of research might provide the means to develop treatment letters capable of more
powerful effects in the future.
Research Methods
A total of 198 references were accumulated from journal articles and previously
published literature reviews. Approximately 58 of the original articles were eliminated
from further consideration due to titles that intimated unsuitable content. The
remaining 140 references formed the pool of studies to be reviewed for information
pertaining both to letter-style, treatment methods and to components within the letter
treatments shown to be effective change agents. Of the 140 titles reviewed in the initial
stage, 46 were found to contain treatments other than advisory letters. The remaining
94 studies were included in the second phase of the literature review. A total of 44 of
these were traffic safety studies and the other 50 involved research articles in the fields
of transformational psychology and goal attainment scaling. Approximately 70 studies
were ultimately utilized, including 13 negligent operator treatment studies that
evaluated 42 treatment letters.
The criteria used to evaluate the quality of the research and validity of the treatment
methods evolved with a growing awareness that many of the administered treatments
lacked a theoretical basis and several of the studies neither provided examples of the
advisory letters sent to negligent operators nor supplied adequate descriptions of their
contents. In the final analysis, the quality of the research was estimated from the
descriptions of the research design contained in the reviewed studies. One point was
awarded for the existence of each of the following six elements: participation rate of at
least 70%; no-treatment control group; random assignment; similar subject
characteristics; researcher blinded to randomization schedule; and, temporality, the
evidence that treatment preceded outcome. The minimum and maximum possible
points ranged from 0 to 6. These points were then multiplied by a factor of four to
arrive at the final Design Quality score that ranged from 0 to 24. The factor of four was
established to emphasize that the design is the most important consideration in
research.