The use of behavioral theory has been generally weak or nonexistent in these interventions.
Two interventions—the “I Can Do”16 and the preventive intervention for enhancing
resilience21—have used only one component of social cognitive theory (SCT):3,4 selfefficacy
in dealing with selected stressors. Perhaps as a result of a somewhat atheoretical
approach, all of these interventions have been of long duration—ranging from a minimumof
12 sessions16-21 to an entire academic year.12-15 The length of these interventions is a
major barrier to implementation for elementary teachers (who have limited time for
health education) and public health educators (who have limited time for direct educational
activities in schools). Using theory to guide program development can help focus a
program on the most critical concepts and skills and create a more efficient learning
process.