Preventing Unintentional Injury: A Review of Behavior Change Theories for Primary Care

Many injuries are preventable, and most have a behavioral component on their causal pathway. However, far more effective use of theory-based approaches to behavioral risk management is needed, which remains a challenge for practitioners. This review discusses theories and applications of behavioral change principles for use in primary care and community health settings. Injury-related behaviors cannot be separated from the environments in which they take place. Preventing unintentional injuries requires an understanding of patient knowledge, attitudes, and behaviors, as well as community norms, that lead to injuries. In addition to the role clinicians have in counseling for lifestyle change to prevent injuries, reducing exposure of patients to hazardous products and environments, and fostering social and organizational change to improve public policy, legislation, and enforcement to prevent injuries are equally important. Challenges lie ahead in testing the applicability of these theories in primary care settings and in predicting and understanding injury-related behaviors of patients. Training more medical practitioners in the epidemiology of injury and the science of injury control is an urgent priority. Success will partly depend on how behavioral theories can be integrated into practice and adapted through clinical experience to benefit patients.