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


CONCLUSIONS
Further research and analysis is needed urgently to determine which models might best improve adherence to long-term treatment regimens.
Munro
Salla
S
South African Cochrane Centre, Medical Research Council of South Africa, Tygerberg, Cape Town, South Africa. salla.munro@mrc.ac.za
Lewin
Simon
S
Swart
Tanya
T
Volmink
Jimmy
J
D001521:Behavior Therapy; D003071:Cognition; D016206:Databases, Bibliographic; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D011582:Psychological Theory; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy* / Q000523:psychology