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HEED 103 CH5 ASSIGNMENT
1. What is the interaction between social and cognitive in Social Cognitive
Theory?
2. What does Bandura mean by reciprocal determinism?
3. What is the basic difference between the explanation for behavior in Social
Network Theory and the explanation in theories such as the Health Belief
Model?
4. What do social marketing and diffusion of innovation approaches have in
common with marketing in a business context? What is different?
5. What are some of the key factors that determine speed of adoption in
diffusion of innovations theory?
Social, Cultural, And
Environmental Theories
(Part I)
Chapter 5
INTERPERSONAL THEORIES
• Examines behavior within the context of other
factors/spheres of influence
• “Assumes that other people influence our
behavior by sharing their thoughts, advice,
and feelings and by the emotional support
and assistance they provide”
– Family, friends, peers, health care providers, or coworkers
•
Reference: NCI, 2005
Intrapersonal vs. Interpersonal
Intrapersonal
• Individual theories
• Focus on individual as
primary source of behavior
• Internal factors
• Individual
Interpersonal
• Social/environmental
theories
• Focus on the interaction
between
social/environmental
context and the individual
• External factors
• Social
– Family, peer, teachers, health
care providers, co-workers
SOCIAL COGNITIVE THEORY
SOCIAL COGNITIVE THEORY (SCT)
• Evolved from the Social Learning Theory (SLT)
– Key principle – learning by observation of others
(vicarious learning)
• Over time, SLT grew to include other constructs
related to an individual’s interaction with an
environment
– One of the most important of these is self-efficacy
– Reciprocal determinism was later added
SOCIAL COGNITIVE THEORY (SCT)
• Later renamed the Social Cognitive
Theory
– To separate it from its behaviorist roots
– Position it as a theory that addresses
individuals consciously operating within an
environment
SOCIAL COGNITIVE THEORY (SCT)
• Assumption:
– People can learn through observation
– Reciprocal Determinism (key construct)
Self-efficacy
• Key element in how people change behavior
moves beyond the conditioning process of
behaviorism
– Individuals have a role in their own processes
of change (referred to as agency)
– Confidence in your own ability to perform a
behavior and overcome obstacles (barriers) to
doing it
Reciprocal Determinism
• Continuous interactive cycle/process
• A person’s behavior is based on individual
factors and social/environmental cues
• Three key domains (one influencing the
other)
• Person
• Behavior
• Environment
Social Cognitive Theory
Reference: http://www.uky.edu/~eushe2/Pajares/eff.html
Reciprocal Determinism
➢A person interacts with an environment
➢Receives a response from the
environment
➢Adjusts behavior
➢Interacts again, etc.
Changing Behavior: A Function of…
• Individual (internal) characteristics
– A person’s sense of self-efficacy about a new
behavior
• Environmental (external) factors
– The social/physical environment surrounding
individuals (including the modeling behavior of
others)
• Reciprocal determinism
SCT CONSTRUCTS
• Individual Characteristics
–
–
–
–
–
–
Self-efficacy
Outcome Expectations
Outcome Expectancies
Behavioral Capability
Self-Control of Performance
Emotional Coping
• Environmental Factors
–
–
–
–
Reciprocal Determinism
Reinforcement
Observational (Vicarious) Learning
Environment (Situation)
SCT Constructs
• Self-efficacy
– confidence in ability to perform a behavior
• Expectations
– What a person thinks will happen if he or she
makes a behavior change
• Expectancies
– Whether a person thinks the expected outcome is
good or likely to be rewarded
SCT Constructs
• Self-Control
– How much control a person has over making a
change
• Behavioral Capability
– A person’s level of knowledge and skill in relation
to a behavior
• Emotional coping responses
– a person’s ability to deal with emotions involved in
a behavior change
SCT Constructs
• Observation Learning
– A person learns by observing the behavior of others
and the consequences of that behavior
• Environment (Situation)
– The social/physical environment in which the behavior
takes place, and a person’s perception of those factors
• Reinforcement
– Positive or negative responses to a person’s behavior
• Reciprocal Determinism
SOCIAL NETWORK THEORY
SOCIAL NETWORK THEORY (SNT)
• Key to explaining behavior
– Specific or unique characteristics (attitudes,
beliefs, gender) are not important
• Focus
– On relationships between and among
individuals
– How the nature of those relationships
influences beliefs and behaviors
SOCIAL NETWORK THEORY (SNT)
• Social network
– Network of relationships surrounding a
person, or larger networks involving the
person
– A set of relationships that an individual
participates in
• Family/kin networks
• Work networks
• Social groups
SOCIAL NETWORK THEORY (SNT)
• Has gained increasing prominence
recently, especially in the area of
HIV/AIDS and in the development of
network-based interventions.
DIFFUSION OF INNOVATIONS
DIFFUSION OF INNOVATIONS
• Addresses the gap between introduction of
a new technology or behavior and the
actual adoption of the behavior by a large
community or group.
• Examples
– Use of Oral Rehydration Therapy (child
health – prevents dehydration from
diarrheal disease)
– Condom use for HIV/AIDS prevention
DIFFUSION OF INNOVATIONS
• The emphasis is on dissemination of a
new behavior or technology:
– Innovation=technology or behavior
– Diffusion=process by which innovation is
communicated
DOI – Key Stages
1. Innovation Development – refers to the development
of the innovation itself. (Planning)
2. Dissemination – process by which the innovation is
communicated. Actively transferring knowledge from
the resource system to the user system
3. Adoption – refers to the “uptake” of the innovation by
the target population.
DOI – Key Stages
4. Implementation – initial and regular use of the
innovation, focus on improving self-efficacy and skills
of adopters.
5. Maintenance – focus on sustainability, keeping
adoption of the behavior. Ongoing use of the
innovations in practice and continued adoption of the
behavior.
DOI – OTHER KEY CONCEPTS
• Idea of diffusion context – characteristics of
the social setting where the innovation is to
be implemented that may help or hinder
diffusion, including
– cultural beliefs,
– political/social structures,
– regulations, etc.
SOCIAL MARKETING
• Applies principles of marketing to social and
health communications.
• Goal is to influence “consumers” to “buy” a
behavior change or health-related
product/technology.
SOCIAL MARKETING
• Social marketing campaigns are built around
the “FOUR Ps”:
–
–
–
–
Product: The behavior, program, technology
Price: Cost of adoption (not necessarily financial)
Place: Where product available
Promotion: How to promote the first three “Ps”
OTHER SOCIAL MARKETING
CONSTRUCTS
• Market segmentation – a term common in
marketing parlance. Refers to the segmentation
of a target population into meaningful subgroups
so that messages and campaigns can be
appropriately channeled.
• Targeting – The process of developing
campaigns closely tailored to the needs,
attitudes, beliefs and behaviors of specific
market segments.
OTHER SOCIAL MARKETING
CONSTRUCTS
• Both social marketing and general health
communication efforts incorporate
behavioral theories and constructs we
have already discussed
– e.g., self-efficacy, vicarious learning,
perceived costs/benefits, etc.
References
•
•
•
•
Edberg, M. C. (2015). Essentials of Health Behavior: Social and Behavioral Theory in Public
Health. (2nd ed.). R. Riegelman (Ed.). Burlington, MA: Jones and Bartlett Learning.
Glanz, K., Rimer, B. & Viswanath, K. (eds.) (2008). Health Behavior and Health Education:
Theory, Research, and Practice (4th ed.). San Francisco, CA: John Wiley and Sons
National Cancer Institute. (2005). Theory at a Glance: A Guide for Health Promotion Practice
(2nd ed.). Washington, DC: U.S. Department of Health and Human Services. Retrieved
January 25, 2013 from http://www.cancer.gov/cancertopics/cancerlibrary/theory.pdf.
Pajares, F. (2002). Overview of social cognitive theory and of self-efficacy. Retrieved Sept. 20,
2015, from http://www.uky.edu/~eushe2/Pajares/eff.html.
HEED 103 CH6 ASSIGNMENT
1. What do “encoding” and “decoding” information refer to in communcations
theory? Why are these important for communicating about health behavior?
2. In terms of an ecological model, what kinds of things does a community
mobilization effort address?
3. What is meant by “organizational culture”? How does it relate, for example,
to work-related health behavior?
4. Using HIV/AIDS as an example, what issues would a political-economic
approach address in terms of potential action?
5. What is cultural about an ethnomedical system?
SOCIAL, CULTURAL, AND
ENVIRONMENTAL THEORIES
(PART II)
Chapter 6
COMMUNICATION
• “Who says what in which channel to whom
and with what effect?” – Harold Lasswell
• Process of transmitting, receiving, and
processing information important for behavior
What is a Communication Channel?
• The MEDIUM through which you transmit the
information:
– newspapers, TV, video, internet, interpersonal
communication, rallies, etc.
– Channels can also be more specific, like Hispanic
newspapers, or college radio, or through
churches, etc.
What is a Communication Channel?
• The use of media and communications in public
health aims to
– Provide information
– Influence behavior change
– Impact the AGENDA of what people are
concerned about, in order to set the stage for
action
THINGS TO THINK ABOUT
• It is sometimes complicated and difficult to
assess the impact of a communications effort.
• Because there are many levels of possible
impact:
– Simple exposure – how many of the intended
audience were exposed to the message?
– How many of those exposed will make the
behavior change?
THINGS TO THINK ABOUT/ CRITIQUES
• Technology, technology, technology!
• The nature of communication and the media
of communication are changing rapidly due to
mobile devices.
COMMUNITY AND ORGANIZATIONAL
CHANGE
• Usually Change in the health behavior of individuals
first requires change in the community itself, in
norms, laws, physical conditions, systems, or
organizations relevant to the situation.
• Communities, organizations and systems can either
support or inhibit health behavior change.
COMMUNITY AND ORGANIZATIONAL
CHANGE
• Important because many of the conditions that are
conducive to or a barrier to health are ecological
– Lack of available health facilities for underserved
populations
– Regulations that allow the sale of cigarettes in locations
easily accessible to young people
– A toxic waste site or other source of population
– Lack of sidewalks and green space in urban areas
COMMUNITY MOBILIZATION
• Collective action by groups and community
members to
– Increase awareness about the problem
– Advocate for policy change
– Engage in other activities to address the
ecology of a health problem
– Involving and empowering of the community
COMMUNITY MOBILIZATION
• Empowerment
– community takes charge of the issue, defines what
the goals are, and takes the necessary action
• Community gains experience and sense of
efficacy about resolving local problems
COMMUNITY MOBILIZATION
• KEY issues in mobilizing communities:
– Defining the community
– Assessing and working with the community’s
capacity for mobilizing
– Understanding the community agenda and
selecting the right issue
ORGANIZATIONAL AND SYSTEMS
CHANGE
• Health promotion, disease prevention, and
health care are all accomplished through
organizations and systems
• Organizations
– Agencies, hospital, programs
• Systems
– Healthcare systems, linked service systems, policy
coordination systems
ORGANIZATIONAL AND SYSTEMS
CHANGE
• Organizations or systems may be a facilitator
or barrier to resolving a particular health issue
• Organizational change improves the capability
of organizations and systems to respond to
health issues through a change process that
focuses on several steps (see next slide)
POLITICAL ECONOMY AND HEALTH
• Under this approach, solutions must address
the social relationships (e.g., economic
patterns, relationships of ethnicity, etc.) that
contribute to the problem.
• Example: Why has HIV/AIDS in the U.S. had a
such a disproportionate effect on poor,
minority, urban communities? How does that
setting impact the problem?
POLITICAL ECONOMY AND HEALTH
• Think about HIV/AIDS as more than a health
problem
• Rather a product of a larger set of
relationships of socioeconomic structure,
class, ethnicity, and gender
• Similar to other health problems
disproportionately found in poor urban
populations
– Tuberculosis, infant mortality, hypertension,
diabetes, substance abuse
POLITICAL ECONOMY AND HEALTH
• What conditions promote their existence?
– Prevalence of poverty and unemployment
– Lack of access to healthcare options
– Commonality of deteriorated and substandard
schools
– Lack of economic resources and job availability
– Drug trafficking, illegal activities, prostitution
– Lack of stable family structures
– Overall relationships (in society) between minority
and majority ethnic groups
ANTHROPOLOGY AND CULTURAL
THEORY
• Biological anthropology
– Health behavior as a species adaptation to (or
interaction with) an environment
• Cultural anthropology
– Health behavior as part of a pattern of living that
integrates action with meaning, symbols, and
values, as these are connected to a larger social
structure.
– The role that culture in human behavior
ANTHROPOLOGY AND CULTURAL
THEORY
• Example: Use of health care services (a
behavior) in an urban immigrant community
may be an outcome of integrated factors:
– language barriers,
– economic resources (to pay for care),
– beliefs about the nature, cause, and
treatment of illness (culture),
– social hierarchies in the community, etc.
ANTHROPOLOGICAL APPROACHES,
EXAMPLES
• Identifying the elements of cultural
knowledge and practice systems
(ethnomedical systems) related to health that
might be shaping health behavior.
• Collaborating with key individuals or groups
representing these cultural practices in order
to identify and implement health promotion
approaches that fit the population.
ANTHROPOLOGICAL APPROACHES,
EXAMPLES
• Identifying channels of communication and
dissemination that are relevant to a particular
population or group, and working through
those channels to provide information.
• Identifying barriers to health care/prevention
access that are important for a particular
population or group, and working
collaboratively to resolve those barriers.
References
•
Edberg, M. C. (2015). Essentials of Health Behavior: Social and Behavioral Theory in
Public Health. (2nd ed.). R. Riegelman (Ed.). Burlington, MA: Jones and
Bartlett Learning.
…
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