Social and Behavioral theories & public health

why is theory important to health promotion and health behavior practice?

they help maintain and improve health, reduce disease risks, and manage chronic diseases
can also lead to successes in behavior change

what is theory?

a set of concepts, constructs, definitions, and propositions that help explain and predict events or situations by illustrating relationships between variables

How can theory help plan effective programs?

theories help planners look at the bigger picture and develop unique, tailored solutions to problems like interventions and evaluating their successes
answers "why, what, and how" of health problems
helps identify most suitable target audiences, methods f

Explanatory theory

describes why a problem exists
HBM, TPB, PAPM

Change theory

guides the development of interventions
diffusion of innovations

why are culture and ethnicity critical to consider when applying theory to a health problem?

1. morbidity and morality rates vary by race and ethnicity
2. differences in prevalence of risk behavior
3. determinants of health behaviors vary

ecological perspective

highlights people's interactions with their physical and social-cultural environments
1. behavior affects and is affected by multiple levels of influences
2. individual behavior shapes and is shaped by the social environment

ecological perspective: influences

intrapersonal factors
interpersonal factors
organizational factors
community factors
public policy factors

Intrapersonal factors

Individual characteristics that influence behavior, such as knowledge, attitudes, beliefs, and personality traits

Interpersonal factors

Interpersonal processes and primary groups, including family, friends, and peers that provide social identity, support, and role definition

Organizational factors

Rules, regulations, policies, and informal structures, which may constrain or promote recommended behaviors

Community factors

Social networks and norms, or standards, which exist as formal or informal among individuals, groups, and organizations

Public policies

Local, state, and federal policies and laws that regulate or support healthy actions and practices for disease prevention, early detection, control, and management

Individual and Interpersonal theory key concepts

behavior is mediated by cognition
knowledge is necessary for most behavior change
perceptions, motivations, skills, and social environment influences on behavior

Health Belief Model

addresses people's beliefs about whether or not they susceptible to disease, and their perceptions of the benefits of trying to avoid it, influenced their readiness to act

Health Belief Model 6 constructs

Perceived susceptibility: belief that they are susceptible to a condition
perceived severity: belief that the condition has serious consequences
perceived benefits: belief that taking action would reduce their susceptibility or severity
perceived barriers

Transtheoretical Model/Stages of Change

describes individuals' motivation and readiness to change a behavior
behavior change is a process, not an event
easy to relapse at any stage

Transtheoretical Model 5 stages

Precontemplation: no intention of taking action
Contemplation: intends to take action
Preparation: intends to take action and develops concrete action plans
Action: has changed behavior; social support and reinforcement
maintenance: has maintained this ch

Theory of Planned Behavior/Theory of Reasoned Action

explore the relationship between behavior and beliefs, attitudes, and intentions.
behavioral intention is the most important determinant of behavior.

TPB/TRA key concepts

Behavioral intention: Perceived likelihood of performing behavior
Attitude: Personal evaluation of the behavior
Subjective norm: Beliefs about whether key people approve or disapprove of the behavior; motivation to behave in a way that gains their approva

What is the difference between TPB and TRA?

TPB includes an additional construct, perceived behavioral control; this construct has to do with people's beliefs that they can controla particular behavior

Precaution Adoption Process Model

names seven stages in an individual's journey from awareness to action. It begins with lack of awareness and advances through subsequent stages of becoming aware, deciding whether or not to act, acting, and maintaining the behavior.

PAPM 7 stages

1. Unaware of issue
2. unengaged by issue
3. deciding about acting
4. decided not to act
5. decided to act
6. acting
7. maintenance

Interpersonal level theory concepts

assume individuals exist within, and are influenced by, a social environment. The opinions, thoughts, behavior, advice, and support of the people surrounding an individual influence his or her feelings and behavior, and the individual has a reciprocal eff

Social Cognitive Theory

describes a dynamic, ongoing process in which personal factors, environmental factors, and human behavior exert influence upon each other

SCT 3 main factors that can affect the likelihood that a person will change a behavior

self-efficacy**
goals
outcome expectancies

SCT 6 concepts

1. reciprocal determinism: interaction of the person, behavior, and the environment in which the behavior is performed
2. behavioral capability: Knowledge and skill to perform a given behavior
3. expectations: Anticipated outcomes of a behavior
4. self-ef

Community level models

explore how social systems function and change and how to mobilize community members and organizations. They offer strategies that work in a variety of settings, such as health care institutions, schools, worksites, community groups, and government agenci

Diffusion of Innovations Theory

addresses how ideas, products, and social practices that are perceived as "new" spread throughout a society or from one society to another.

DOI 4 concepts

1. innovation: An idea, object, or practice that is thought to be new by an individual, organization, or community
2. communication channels: The means of transmitting the new idea from one person to another
3. Social system: A group of individuals who to

Communication theory

explores "who says what, in which channels, to whom, and with what effects." It investigates how messages are created, transmitted, received, and assimilated.

Planning Models

help practitioners develop programs step by step, integrating multiple theories to explain and address health problems

Social Marketing

uses marketing techniques to influence the voluntary behavior of target audience members for health benefit

the 4 P's of social marketing

Product (the right kind of behavioral change) includes not only the behavior that is being promoted, but also the benefits that go along with it.

Price (an exchange of benefits and costs) refers to barriers or costs involved in adopting the behavior (e.

PRECEDE-PROCEED model

It does not predict or explain factors linked to the outcomes of interest, but offers a framework for identifying intervention strategies to address these factors.
an "educational diagnosis"
(PRECEDE) and an "ecological diagnosis" (PROCEED

PRECEDE

acronym stands for Predisposing, Reinforcing, Enabling Constructs in Educational/ Environmental Diagnosis and Evaluation
an educational diagnosis is needed to design a health promotion intervention, just as a medical diagnosis is needed to design a treatm

PROCEED

stands for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development.
to take into account the impact of environmental factors on health

PRECEDE steps

(1) social assessment: data collection like surveys
(2) epidemiological assessment: secondary data analysis or original data collection
(3) behavioral and environmental assessment:internal and external factor identification
(4) educational and ecological

PROCEED steps

(6) implementation: prepare plans for evaluating the process
(7) process evaluation: gauges the extent to which a program is being carried out according to plan
(8) impact evaluation: looks at changes in factors (i.e., predisposing, enabling, and reinforc