What does Public Health and Social & Behavioral Science both believe in?
That understanding the organization and motivation behind social forces (along w/ an understanding of the behavior of individuals) can improve the lives of individuals and society
When &Where was Social & Behavioral Science and Public Health developed? 2. What led to the idea of social justice?
*In the 19th century, it grew out of the Industrial Revolution in Europe and later in the US
*It wanted to address social and economic inequalities, which lead to the idea of social justice
Social Justice: Define
Implies a society that provides fair treatment and a fair share of the rewards to individuals and groups of individuals
Psychology: Contributions to Public Health?
*Theories on the origin of behavior
*Methods for altering individual and social behaviors
Sociology: Contributions to Public Health?
*Theories of social development, organized behavior, and thinking
*Social impacts on individual and group behaviors
Anthropology: Contributions to Public Health?
*Social and culture influences on individual and population decision making for health
Political Science/ Public Policy: Contributions to Public Health?
*Approaches to gov and policy making related to public health
Economics:Contributions to Public Health?
*Understanding the impact of micro- and macro-economics on public health
Communications: Contributions to Public Health?
Practice of mass and personalized communication to communicate health info
Demography: Contributions to Public Health?
*Understanding different changes in population due to aging, differences in birthrate, etc. and the impacts of this on health
Geography: Contributions to Public Health?
*Understand impacts of geography (location) of disease and determinants of disease
Social Systems & Health: 1. How are individuals and social systems reciprocal? 2. What does medical care do?
*Social Systems influence us and we influence social systems (people, institutions, communities, etc.)
*Medical care focuses on treating the disease w/o addressing conditions in the social system that contributed to the illness in the first place
How are socio-ecological models used? Examples?
*Used to understand various social influences on health and assist in identifying points at which to intervene
*Ex: Individual Life Style Factors, Social & Community Networks, and General Socioeconomic, Cultural, and Environmental Conditions
Individual Life Style Factors: What are they?
*Characteristics of the individual, including: knowledge, attitude, beliefs, personality, age, sex, etc.
Social & Community Networks: When does this occur? What are the 3 categories this is divided into. Describe each category
* When interaction w/ other individuals occurs
*Interactions divided into 3 categories:
*1. Interpersonal: Family, friends, and peers whoshape identity and give support
*2. Institutional/Organizational: Rules and regulations of institutions (job, school)
General Socioeconomic, Cultural, and Environmental Conditions: 1. What are they? 2. How are these conditions shaped?
*External surroundings of individual (education, house, work environment, healthcare, etc.)
*These conditions are shaped by public policy and law
Social System: Define
Patterned series of relationships b/w individuals, groups, and institutions, forming a coherent whole
How do social systems influence behavior?
*1. Shaping Norms: Certain behaviors are generally accepted in social groups. AN attitude of "everyone else is doing it" can influence an individual's decision to participate in an activity
*2. Enforcing Patterns of Social Control: Having rules and regula
How do social systems influence behavior cont'd?
*3. Providing/ Not Providinf opportunities to engagein certain behaviors: The opportunities or lack of them can influence our health (Ex: Having a pool encourages swimming and physical exerciseand reduces drowning)
*4. Reducing or peoducing stress for cer
Socioeconomic Status: What are the 3 things in includes. How is health status and socioeconomic status related? How is health status and ECONOMIC status related?
*Includes: Educational, Income, and Occupation Status
*Health Status is strongly associated w/ socioeconomic status. Greater longevity (life) is associated w. a higher social status
*Greater wealth/Higher economic status = greater living conditions = impr
How is education associated w/ health status? How is higher education & wealth associated w/health status?
More education = change change health outcomes and increase longevity
*More education & wealth = better medical care and protection against health hazards
Lower Economic Status: Individuals of a lower economic status are more subjected to what?
*Individuals of lower economic health status are more likely to be exposed to health hazards at work. In physical environment they'll be exposed to toxins in air, water, and food
Culture: What does culture say? What habits does it affect?
*Culture says what is good or bad, healthy or unhealthy, etc. It also affects daily habits, such as food preparation
What are 4 ways that culture can affect health?
*1. Can affect behavior: Can put individuals at reduced or increased risks, such as: food preferences, cooking methods, exercise, female genital mutilation, or binding of feet in China
*2. Can affect response to symptoms: Cultural differences in seeking c
4 Ways Cont'd:
*3. Affects the type of interventions accepted: Different degrees of acceptance of western medicine. Some rely on self-help or traditional healers, for spiritual things
*4. Culture affects response to disease and intervention: Cultural different in treatm
Religion: What are 4 ways religion affects health?
*1. Affects social practices that can increase or decrease individual's risk: sexual (circumcision, contraceptives), food (avoiding food, such as pork), alcohol (part of religion v. prohibited), or tobacco use
*2. Can affect response to symptoms: Christia
Religion: Ways Cont'd:
*3. Affects types of interventions acceptable: Prohibition towards blood transfusion, attitudes towards stem cell research, abortion, and end of life treatments
*4. Affects response to disease and interventions: Role of prayer as an intervention to alter
What are social determinants of health? What have these conditions shaped?
Conditions in which people are born, grow up, work, play, worship, age, and systems put in place to deal with illnesses
*These conditions have shaped economics, social policies, and politics
What are the 10 key categories of social determinants of health?
1. Social Status
2. Social Support or Alienation
3. Food
4. Housing
5. Education
6. Work
7. Stress
8. Transportation
9. Places
10. Access to Health Services
Social Status: What is it?
*Societies value on certain characterisitics
*In US: Value placed on income, education, and occupation (socioeconomic status)
Social Support or Alienation: What is it?
*Being apart of social networks benefits health
*Ex: Going running w/ someone or riding to the doctor's with them
*Social exclusions from multiple things (such as racism, discrimination) can limit education or activities. This can result in fear, anger, d
Food: What is it?
*Inadequate food source is a an issue for disadvanteged populations
*Also, excess calorie intake and lack of nutrition is a problem as well
*Education is good for being aware of health food, but also having access to affordable, health food
*Food Dessert-
Housing: What is it?
*Having an afforable, stable house influences health
*Being homeless can lead lack of nutrition, medical care,drug use,and violence
*Those witha home have better overall health
Education: What is it?
*Those w/ more education have better health than those w/o education
*In US, we are trying to increase high school graduation rate
Work: What is it?
*Employed tend to have better health than unemployed
*More income = assists a person to get resources that can help their health, such as housing, food, education, medical care, etc.
*Being employed = health insurance, if employer provides it
*Type of job
Stress: What is it?
*Stress is a social and psychological response with biological consequences
*Sustained periods of stress can negatively affect physical health due to the fight or flight response, which increases heart rate and cortisol levels
*Overtime, stress can lead t
Transportation: What is it?
*If we drive less and walk/cycle more = more physical activity
*So we should walk, cycle, or mass transit more to benefit our bodies and the environment, by reducing car use
Place: What is it?
*Where you live affects health
*Ex: In rural areas, have less healthcare services nearby, but those in urban areas are exposed to more air pollution
Access to Health Services: What is it?
*Having access to preventative health care and medical care affects overall health
Health Disparity: Define. What are health disparities connected with? Are they negative for some groups? Why?Health disparities affect what different health conditions?
*Def: Is a type of difference in health that is closely linked with a social or economic disadvantage
*Health disparities are connected with social determinants of health
*Are negative for groups that experience greater social or economic obstacles to hea
Mental Health: Define. What is it linked with? Does it cause disability?
A state of successful performance of mental functioning, resulting in productive activities, fulfilling relationships with people, and the ability to adapt to change and to cope with challenges
*Linked with mental disorders characterized by alterations in
Most preventable disease and disability today is due to...
The behavior of individuals
*Ex: Smoking, Obesity, Intentional/Unintentional Injuries, Sexual Activity, etc.
Can health behavior be changed? Are all behaviors intentional health behaviors?
Yes it can! Ex: Reduced smoking rate, infants placed on back for sleeping, seat belt use, increased calorie intake and decreased exercise (bad)
*No, not all behaviors are intentional health ones, but some are. Getting a mammogram is, but perhaps driving t
Why are some health behaviors easier to change than others? When is it EASY to change a behavior
*Some behaviors are easy to change and others are difficult
*It is EASY when on behavior is substituted for a similiar one and results in a potentially large payoff
---Knowledge is important here. Ex: The back-to-sleep campaign to reduce SIDS was easy to
When is it DIFFICULT to change a behavior?
*The most difficult behaviors to change are ones with a biological component (Ex: Obesity, Addictive Element,
*Smoking cessation only works 30% of the time
*Also, physical, social, and economic barriers can stand in the way of behavior change
What are the "forces" that work to change individual behavior (3 of them)
1. Downstream Factors- Directly involve an individual and can be potentially altered by individual interventions, such as an addiction to nicotine
2. Mainstream Factors- Result from the relationship of an individual with a larger group or population, such
How health behaviors are explained and predicted: Define theory and model. Why are theories and models used by health people?
*Theory- a set of interrelated concepts that presents a systematic view of relationships among variables in order to explain and predict events and situations
*Model- a combination of ideas and concepts taken from multiple theories and applied to specific
Theory: What are the 3 parts in a theory when researching a health problem?
A theory explores the why, what, and how of health issues during research
Theories and models are categorized by what 3 levels of influence? (Describe each)
1. Intrapersonal- Focuses on individual, including knowledge, attitude, beliefs, motivation, past experiences, and skills
*2. Interpersonal- Focuses on relationships b/w people, it acknowledges that other people influence your behavior, thoughts, advice,
What are the 3 models at the intrapersonal level?
1. Health Belief Model
2. Transtheortical Model/ Stages of Change Model
3. Theory of Planned Behavior
Intrapersonal Level: Uses different models. Describe the Health Belief Model: What does it focus on? What influences health behavior?
*Health Belief Model: focuses on individuals, including their perceptions and thought processes before taking health-related action
--Belief influences health behavior. People will be more likely to take action if they believe they are susceptible toa dis
Intrapersonal Level: Transtherotical Model/ Stages of Change Model: What is it? Mention the 5 stages
*Says that people go through a set of incremental stages when changing behavior rather than making significant changes all at once
*Stage 1: Precontemplation: Individual has not yet considered changing their behavior. Efforts to change behavior won't be s
Cont'd (Stages of Change):
*Stage 3: Preparation: Individual is developing a plan of action. Individual is susceptible to setting goals and strategies
*Stage 4: Action Phase: When the change in behavior takes place. Bring together support and rewards from new behavior
*Stage 5: Mai
Intrapersonal Level: Theory of Planned Behavior
*Based on the idea that intention is the main predictor of behavior
*Behavioral attention is influenced by individual's attitude toward performing a behavior, their beliefs about whether people important to them approve or disapprove this behavior, and th
What is the one method used at the interpersonal level?
Social Cognitive Theory
Interpersonal Level: Social Cognitive Theory: What does it focus on? According to this theory, changing behavior requires an understanding of what
*Focuses on the interaction b/w individuals and their social systems
*Requires an understanding of: Individual characteristics (knowledge, skills, beliefs), influence on social and physical environments (such as peer pressure, family support, school, neig
Social Cognitive Theory: What is a key concept in this theory? Explain it
*Key Concept: Reciprocal Determinism- the dynamic interplay among personal factors, the environment, and behavior
*The theory purposes that changing ONE of these factors will change them all
What is the method used at the population and community level?
Diffusion of Innovation
Population and Community Level: Diffusion of Innovation: What does it focus on? What does the construction include?
*Focuses on how a new idea, product, or social practice (innovation) is applied and adopted in a population
*Construction Includes: Innovation itself, time takes to adopt innovation, communicate innovation, social system where diffusion of innovation take
Diffusion of Innovation Cont'd: The adoption or rejection of an innovation in this theory is affected by what perceived attributes?(ROTCC)
*(IN = Innovation)
*Relative Advantage (Is the IN better than what it will replace
*Compatibility (Does IN fit with values and needs of audience)
*Complexity (Is the IN easy to understand)
*Traiability (Can IN be tried before adopting it)
*Observability (
Diffusion of Innovation Cont'd: What is the difference b/w early and early majority adopters and late adopters?
*Early Adopters: Those who seek to experiment with innovative ideas
*Early Majority Adopters: Opinion leaders whose social status frequently influences others to adopt the behavior
*Late Adopters: Laggards- those who need support and encouragement to make
Is there a formula for which theory or model is most appropriate for each situation? If so,what is it?
No there isn't. There isn't a set and stone way to pick a theory, but there are a few guidelines you could follow
1. Identify health issue and affected population
2. Gather info about issue and population
3. Identify possible causes/reasons for issue
4. i
What are 2 appraoches that can be undertaken to apply theory to practice
1. Social Marketing
2. PRECEDE-PROCEED Framework
Social Marketing: Define it. Who is it used on? What do you advertise? Example
*A use and extension of product marketing
*Used on those that are at high risk for health impacts of their behavior, such as smoking
*You advertise and campaign the health issue (Ex: Anti-Drug Campaign or VERB Campaign- wanted to make exercise cool for ev
Social Marketing: What are the 4 P's?
1. Product- Identify the behavior or innovation being marketed
2. Price- Identify the benefits, barriers, and financial costs
3. Place- Identify target audiences and how to reach them
4. Promotion- Organize a campaign or program to reach target audience
Social Marketing: What does it often rely on? Describe this
Branding- Words and symbols that help the target audience identify with the service,though it goes deeper than just words and symbols
PRECEDE-PROCEED Framework: Define. How many steps are there? What does PRECEDE and PROCEED consist of?
*Provides a structure to design and evaluate health education and health promotion programs through planning followed by implementation and evaluation of process
*There are 9 steps, its divided into PRECEDE and PROCEED
*PRECEDE- Collecting data and unders
Diagnostic Phase: PRECEDE- Describe the first 5 steps
*1. Social Assessment- Collecting data and info to understand societal needs
*2. Epidemiological Assessment- Prioritize community needs
*3. Behavior & Environment Assessment- Identify factors contributing to health issue
PRECEDE Cont'd
*4. Educational & Ecological Assessment- Identify factors that must be in place to initiate and sustain behavioral change
*5. Administrative and Policy Development- Identify policies, resources, and other circumstances that may assist or hinder efforts
PROCEED: What are the last 4 steps?
*6. Implementation- Intervention is implemented
*7.Process Evaluation: Process Evaluation of the intervention that was implemented
*8. Impact Evaluation: Impact evaluation assesses the change factors identified in steps 3 and 4
*9. Outcome Evaluation: Out