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Kenneth Resnicow, PhD and Scott E. Page, PhD

Ken Resnicow is with the School of Public Health, University of Michigan, Ann Arbor. Scott E. Page is with the Center for the Study of Complex Systems, University of Michigan, Ann Arbor.

Correspondence: Requests for reprints should be sent to Ken Resnicow, Professor, University of Michigan, School of Public Health Department of Health Behavior & Health Education, 109 Observatory Street, Room 3867 SPH I, Ann Arbor, MI 48109-2029 (e-mail: kresnic{at}umich.edu).

Public health research and practice have been guided by a cognitive, rational paradigm where inputs produce linear, predictable changes in outputs. However, the conceptual and statistical assumptions underlying this paradigm may be flawed. In particular, this perspective does not adequately account for nonlinear and quantum influences on human behavior. We propose that health behavior change is better understood through the lens of chaos theory and complex adaptive systems. Key relevant principles include that behavior change (1) is often a quantum event; (2) can resemble a chaotic process that is sensitive to initial conditions, highly variable, and difficult to predict; and (3) occurs within a complex adaptive system with multiple components, where results are often greater than the sum of their parts.

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