For Petraits came up with the Theory of

For many years, health behavior
has been one of the topics going intense study for health psychologists. Health
behavior has caught attention of many health psychologists and is receiving
close review. Scholars have tried to identify the elements that would play
crucial role in predicting health behavior, changing negative health behaviors,
maintaining desirable health behaviors. Theories and models have been
formulated in order to obligate the field of health psychology. One such theory
is the Theory of Planned behavior by Ajzen (1991).  According to this theory, behavior is
predicted by one’s intentions. These intentions are governed by components like
attitudes, subjective norms and perceived behavioral control (PBC). Earlier
known as the Theory of Reasoned Action, this theory was modified by the
addition of PBC. This was due to fact that self-efficacy was introduced by
Bandura in 1977 and this was regarded as an integral fragment in the course of
determining behavior. Another model that was the Attitude Social Influence
Self-efficacy model (ASE) (De Vries and Mudde, 1998; De Vries et al., 1988). In
1994, Flay and Petraits came up with the Theory of Triadic In?uence (TTI) (Michal
(Michelle) Mann, Clemens M. H. Hosman, Herman P. Schaalma and Nanne K. de Vries,
(2004)). These theories provide with crucial foundations which interact with
each other to result in prediction of health behaviors. One common
consideration that all these theories have in common is the concept of ‘self’.
Within each theory, behavioral determinants are assumed to be moderated by many
distal factors including self-esteem and self-efficacy. The Theory of Triadic
In?uence (TTI) reputes self-esteem in the same sense as Attitude Social
Influence Self-efficacy model (ASE), that is, as a distal factor. The Precede–Proceed
model given by Green and Kreuter (Green and Kreuter, 1991) which aims to plan
health education and health promotion has also recognized self-esteem as an
important character (Michal (Michelle) Mann, Clemens M. H. Hosman, Herman P.
Schaalma and Nanne K. de Vries, (2004)).

The ideas and estimations that people hold about themselves identify their
identity, ambitions and aptitudes are known as one’s self-concept. Self-concept
is an extremely powerful force, that inspires internal administration, navigation
and fostering individuals throughout their lives, and governing their behavioral
practices character. Under this concept of self, there is a collection of
believes that one holds about one self. Some of these believes include the idea
of self-esteem, self-efficacy, self-image, etc. People’s feelings about
themselves is known as self-esteem (Michal (Michelle) Mann, Clemens M. H.
Hosman, Herman P. Schaalma and Nanne K. de Vries, (2004)).
Self -efficacy is a personal verdict about how well one can accomplish courses
of action needed to deal with potential situations (Stajkovic, A. D. & Luthans, F. (1998)).  Self-efficacy and self-esteem are often interwind.
This is for the reason that people frequently try to develop self-efficacy in
activities that provide them with self-worth. This makes self-efficacy and
self-esteem unidentical but nevertheless related. In context to behavioral
domain, development of self esteem can contribute to development of positive
self esteem (Michal (Michelle) Mann, Clemens M. H. Hosman, Herman P. Schaalma
and Nanne K. de Vries, (2004)). In other words, progress of self-esteem is
directly proportional to the advancement of self-efficacy.  Macdonald in 1994 said that construction of
positive self-esteem is the most basic task for one’s mental, emotional and social
health, which begins in infancy and continues until one dies (Kali H.
Trzesniewski, M. Brent Donnellan,Terrie E. ,Madison Richard W. Robins, Davis
Richie Poulton (2006)). Erik Erikson (1968) projected
a psychoanalytic theory of psychosocial development encompassing eight stages
from infancy to maturity. Erikson was concerned with the way an individual
socializes and the way this socialization touches upon their sense of self. As the
person ages, s/he passes through different stages. Each stage features some
basic qualities that a person takes n hand while moving on to the other stage. All
the stages are interconnected. Failure to accomplish the motive of any of the
stages might lead to difficulties in going through the next stage. In his 6th
stage, he looks at young adults which comes after the 5th stage
where adolescents are targeted. The 5th stage is known as “ego-identity
vs role confusion” whereas the 6th stage is called “intimacy vs
isolation”. This stage comments that success in this phase will lead to the
virtue of love. If one is unsuccessful in completing this period, it may lead
to loneliness and depression in that person’s life.
There are many programs that aim to boost self-esteem. Therefore, it is
critical to know if self esteem is associated to significant life outcomes. One
such noteworthy outcome is health behavior. From many years, studies have
inspected the consequences and correlates of self-esteem. It is claimed that understanding
of the development of self-esteem, its outcomes and its active protection are
crucial for the improvement of both mental and physical health. Literature
depicts a systematic relationship between self-esteem and internalizing problem
behavior. As seen in the health behavior models, self-esteem can act as both
determinant and an outcome of healthy behavior (Michal (Michelle) Mann, Clemens
M. H. Hosman, Herman P. Schaalma and Nanne K. de Vries, (2004)). Many studies
have shown the relation between self esteem and health behavior patterns. The
literature reveals number of studies focusing in self -esteem and health
behavior. Some of these researches demonstrate that there is positive
relationship amongst self esteem and health behavior. On the contrary, few
studies totally scratch the fact and states that there are no relations,
howsoever between self-esteem and health behavior.
In 1999, Loretta A. Seigley, highlighted many studies that proves that
correlation between self esteem and health behavior exists to a certain extent.
One such example is where Duffy explored health locus of control, self-esteem,
health concerns and health status on health behavior. The results indicated
that 25% of variance in health behavior was explained by amalgamation of
variables. Out of this 25%, self-esteem holds nearly 6% of the total variance
on its own. Another study by Meuhlenkamp and Sayles concluded that health
practices are indirectly influenced by self-esteem with social support as a
mediator. Later this study was replicated, and similar results were found (Loretta
A. Seigley, 1999). However, in the same paper, Loretta
A. Seigley talks about a report by Kalbok where no relationship was found
between self-esteem and specific health behavior exercises. A recent study by Kali
H. Trzesniewski et al. (2006) found that adolescents with low self esteem grew
up to have comparatively more mental health problems during adulthood than
adolescents with high self-esteem. It is a widely held view that mental health
problems may lead to negative health behaviors. Thus, an adolescent going with
mental health issues into adulthood is prone to adapt mal health behaviors. Prior
to the work of Loretta A. Seigley, in 2004, Michal Mann et al. studied
self-esteem as an approach for mental health promotion. In this research, it is
pointed out that self-esteem acts as a protective factor which underwrites
better health along with constructive social behavior that acts as a safeguard
against negative influences. Not only this but better self esteem also
contributes to the ability to cope with diseased like cancer and heart
diseases. As far as negative self esteem is concerned, its presence can play a
dominant role in the development of a range of problems like bulimia, anorexia
nervosa, anxiety, substance abuse and high-risk behaviors. In the same study,
it was reported by stating a study by Carvajal et al. (Carvajal et al., 1998) that
positive self-esteem is a determinant of avoiding substance abuse by
adolescents, which is mediated via attitudes, perceived norms and perceived
behavioral control. Crump et al., (1997); Jones and Heaven, (1998) studies
mentioned in Mann’s papers suggested that adolescents suffering from low
self-esteem are moderately at a greater risk for drug and alcohol abuse, and
tobacco use. Empirical studies proposed that positive self-esteem can also lead
to behaviors which are protective against contracting AIDS, while low
self-esteem contributes to vulnerability to HIV/ AIDS. According to M. Mann’s
report, lower self-esteem was also linked with damaging health behavior
practices like needle sharing. Mann’s study also marked an illustration from Paul
et al., (1993) study illustrating that reducing sexual risk behavior was
difficult among people with low self-esteem. With this illustration we can see
how health behavior is influenced by self-esteem.
Study by Gabie E. Smith et al. 1997 primarily focused upon college women as its
target group. This study tested the premise that people with high self-esteem
are more likely than those with low self-esteem to infer information about
their personal vulnerability to health risks in a self-serving style. Each of
their findings proposed that individuals with high self-esteem react to
information that threatens their perception that their own preventive behaviors
are efficacious in a more egotistical fashion than do people with low
self-esteem. This study also mentions the literatures by Campbell, 1990;
Campbell & Lavallee, 1993 that have demonstrated that individuals with high
self-esteem have more clearly defined and more stable self-schemas than do
individuals with low self-esteem. Here we can see another proof that the level
of self-esteem impacts one’s to understanding to comprehend his/her proneness
to risky behaviors. Once the person understands about certain types of risks in
a particular behavior it can be said that that person would not push oneself
into that perilous and negative behavior. 

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In a study to understand the relationship between personality attributes and
health behaviors and practices during adolescence conducted by R.M. Rivas
Torres and others, it was resulted that self-esteem explains 39% of the mental
health behavior. Not only this but self esteem is also accountable for 5% of
social health. Meanwhile, the value of health, in the case of security
behaviors, clarified 13%, and in relation to personal health behaviors, 9%. Accordingly,
the given evidence suggests that self-esteem plays a very visible role in
regulating health behavior. Researches have shown that self-esteem negatively
correlates with viewing pornography (r=-0.27). Also, the relationship between
self-esteem and physical inactivity was statistically found to be 0.24 and
-0.22 when associated with illegal drug use (YoungHo Kim Seoul, 2011). In the
light of this data, one can roughly comment that risky health behaviors such as
illegitimate drug use has chances to increase with self-esteem going down. Furthermore,
this study also indicated that there is a momentous linear relationship with most
of the health risk behaviors (strongest effect on illegal drug use, ß=?0.36). the
same study reports that in particular, negative health behavior in adolescents is
caused by negative psychological associates. These are low self-esteem and self-efficacy
in addition to loss of ability to control health. The same study mentions
another study that supports the link between self-esteem and health risk
behaviors like drinking alcohol and smoking.  
Erik T. Huntsinger’s study in 2004 accentuated that high self-esteem has been
found to predict positive health practices in general. Moreover, high self-esteem
is also associate with exercise and healthy food consumption.  However, low self-esteem has shown its link
with frequency of alcohol abuse and unhealthy food consumption.
On the contrary, some reports have claimed that there is no relation between
self-esteem and health behaviors. A report by Kali H. Trzesniewski et al. argues
that self-esteem plays no crucial role in predicting future adjustments. If this
was to be true, then all the theories mentioned above, that consider
self-esteem as an important part of the final outcomes of their models must
have some delinquency with them. Kali’s repot remarks self-esteem as an “epiphenomenon”
of socially significant outcome. Similar comments were made by some other
studies as well. Mann’s study (2004) brings in notice Poikolainen et al., (2001)
that says that no support was found for the association between self-esteem and
heavy alcohol use.  The study mentioned
earlier (Kali’s study) supports the statement people with high self-esteem are
more prone to face failure when compared with people of low self-esteem as it
is believed in this study that this declaration holds sufficient evidence.

In a study by Radius et al (1980a.
1980b), it was exhibited that, despite of the concerns expressed regarding
personal health, many young people ignorantly continue to practice maladaptive
health behavior. With this report, it is highlighted that factors that motivate
youth to adopt healthy life style need to be recognized. The boundaries of
health behaviors have not been rigidly classified. Moreover, the term health
behavior does not hold a concrete definition as such. Grochman, 1981 however
established health behavior as

 “those personal attributes such as
beliefs, expectations, motives, values, perceptions, and other cognitive
elements; personality characteristics, including affective and emotional states
and traits; and overt behavior patterns, actions and habits that relate to
health maintenance, to health restoration and to health improvement.” (Gochman,
1982, p. 169), (Gochman D.S. (1988)).

“Behavior is strong or weak because of many
variables, which it is the task of a science of behavior to identify and
classify”- Skinner, 1953