Use of Health Behavior Theory in Funded Grant Proposals: Cancer Screening Interventions as a Case Study

Interventions using theory should change behavior and identify both mechanisms of effect and necessary conditions. To date, inconsistent description of “use of theory” has limited understanding of how theory improves intervention impact. The purpose of this study was to describe the use of theory in health behavior intervention development by coding grant proposals. We developed an abstraction tool to characterize investigators, interventions, and theory use and identified seven core elements describing both how and how much theory was used. We used the tool to review and code NCI’s funded cancer screening intervention R01 proposals, 1998–2009. Of 116 proposals, 38 met criteria; all but one described a conceptual model unique to the proposed research. Few proposals included plans to identify mechanisms of effect or conditions necessary for intervention effectiveness. Cancer screening intervention grant proposals rarely use theory in ways that advance behavioral or theoretical sciences. Proposed core elements may classify and synthesize the use of theory in behavioral intervention research.