Chapter 5 Socio Environmental Theories – Flashcards
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Socio Environmental Theories
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address external factors and their interactions: people + environment-> HB->Health Outcome
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What are the 4 socioenvironmental theories
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Social Cognitive Theory, Social Network Theory, and Diffusion of Innovations, Social Marketing
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Social Cognitive Theory
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An interpersonal level theory , developed by Albert Bandura, the dynamic interaction btw people (personal factors), their behavior, and their environments. evolved from social learning theory
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what were the 2 constructs added to social learning theory that changed it to social cognitive theory?
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self-efficacy and modeling
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What are the individual characteristics/factors of (SCT)?
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knowledge, self-efficacy;behavioral capabilities/facilitation:, outcome expectations,expectancies; self regulation/personal goals;emotional coping response, agency
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What are the socio environmental factors of SCT?
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vicarious learning, situations, reinforcement, and reciprocal determinism
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reciprocal determinism
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personal factors, behavior, and the environmental factors in which the behavior is performed, continuously interact through influencing and being influenced by each other.
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behavior
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a person acts/behaves based on the interaction of individual factors and socio environmental cues, receives a response from the socioenvironment, adjusts the behavior acts again and so on.
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vicarious/observational learning/modeling
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a person learns by observing the behavior of others and the consequences of that behavior. (cooking food channel, child learning to walk)
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situations
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The social/physical environment in which the behavior takes place and a person's perception of those factors. (being in a bar and smoking)
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reinforcement
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response to a person's behavior that increases or decrease the likelihood of reoccurrence. A person is conditioned for positive or negative response to a person's behavior
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positive reiniforcement
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rewards
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negative reinforcement
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punishment
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locus of control
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The sense of being in control of what is happening in your life.
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external locus of control
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believe their decisions and life are controlled by environmental factors which they cannot influence, or by chance or fate
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internal locus of control
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the person believes they can control their life
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Knowledge
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a precondition to behavioral change, involves both content knowledge and procedural knowledge
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content knowledge
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understanding the advantages and drawbacks of a given health behavior = awareness
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procedural knowledge
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understanding how to engage in a health behavior=learning how to prepare healthy meals
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how does knowledge work in a SCT program?
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first creating awareness of the health behavior and proceed to levels of procedural knowledge. Learning how to do something and doing it on a regular basis=2 different things
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perceived self-efficacy
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confidence in one's ability to perform a given behavior. questions must be task specific
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what are the 4 methods of learning to increase perception of self-efficacy?
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1. physiological state 2. verbal persuasion 3.vicarious experience/modeling 4. enactive attainment
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physiological state
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learning to diminish fear and other negative outcomes that may be associated with performing the behavior (going to the dentist)
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verbal persuasion
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convince people that they can indeed perform a given health-protective behavior (may be counterproductive)
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modeling
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increases self efficacy by people learning by watching others perform a given behavior.
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collective self-efficacy
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confidence or belief in a group's ability to perform actions to bring about desired change and willingness of community member's to intervene in order to help others.
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how do you use collective self-efficacy
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bring people together & mobilize them to action. develop group activities , that help individuals get to know each other better.
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resilient self-efficacy
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the belief that an individual can perform a health-protective behavior even under adverse circumstances. example (1) medication compliance among those who have stable lives vs. the homeless population. example (2) Pap test in women with insurance vs. women without health insurance
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behavioral capability/faciliatation
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a person's level of knowledge and skill in relation to a behavior.
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Facilitation
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providing tools, resources, or environmental changes that make new behaviors easier to perform
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How to use it: behavior capability
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provide both knowledge-based training and skill-based training to intervention participants
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Outcome Expectations
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Beliefs about the likelihood & value of the consequences of behavioral choices, i.e., the anticipated positive outcomes that stem from engaging in the health behavior (if I do X then Y will happen); e.g. "I believe that if I use a condom, then I will avoid getting HIV"
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hedonic prinicple
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i.e., "if all things are equal, a person will choose a behavior that maximizes a positive outcome or minimizes a negative outcome". • using this principle as a motivator, you should emphasizing immediate positive rewards (expectancies) to influence behavior change
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External/Extrinsic incentives
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financial reward, approval by others
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Internal/Intrinsic incentives
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internal satisfaction, do something for free
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which incentive is more powerful in changing behavior?
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intrinsic incentives
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self-regulation
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Controlling oneself through self-monitoring, goal-setting, feedback, self-reward, self-instruction, & enlistment of social support
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emotional coping ability
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The ability to deal with the emotions involved in the behavior change
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Techniques to Deal with Excessive Emotional Coping Arousal?
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Help them recognize their own psychological defenses, such as denial, repression ...etc Introduce useful cognitive techniques such as problem restructuring to help them reorient their learning process Introduce stress management techniques (e.g. progressive relaxation & exercise)
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Limitations of SCT
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Its comprehensiveness & complexity make it difficult to operationalize It is unclear the extent to which person, behavior, and environment factor into actual behavior and if one is more influential than another. Heavily focuses on processes of learning and in doing so disregards biological and hormonal predispositions that may influence behaviors, regardless of past experience and expectations. Does not focus on emotion or motivation, other than through reference to past experience.
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Applications of the SCT
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Internet-based Obesity Prevention using SCT, Adolescent Mothers HIV Risk Reduction Program
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(SNT) Social Network Theory
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A dyadic relationship, "A person-centered web of social relationships"
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dyadic
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as an adjective, describes the interaction between a pair of individuals. A dyad can be linked via general communication, romantic interest, family relation, interests, work, partners in crime, and so on.
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(SNT) Social Network Theory
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"A person-centered web of social relationships" Emphasizes the importance of relationships between & among individuals, and how those relationships influence beliefs & behavior
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What are the types of social networks?
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ego-centered network and full relational network
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ego-centered network
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a "map" of the social relations surrounding an individual, the EGO, with the others in the network, the ALTERS
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full relational network
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includes reciprocal information from all other members of the network
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Quality of a Social Network
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Centrality vs. Marginality of individuals in the network, Reciprocity of relationships, complexity, intensity, geographic dispersion, Homogeneity or diversity of people in the network, Communication Patterns, Subgroups, Cliques and Linkages
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Centrality vs. Marginality of individuals in the network:
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extent to which a given individual has interactions with people in the network
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complexity
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extent to which social relationships serve many factors
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intensity
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extent to which social relationships offer emotional closeness
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Subgroups, Cliques and Linkages:
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are there concentrations of interaction among some members of the network? What is the nature of these? are any members linked to other social networks
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Critiquing the SNT
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(1) labor intensive and can be difficult (2) limited theory and approach primarily useful for small or defined groups
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Application of the SNT
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(1)Identify the important characteristics of the network (egocentered vs. full relational network) (2) Develop an intervention that specifically works with the network as a facilitator, i.e., using the network to distribute information
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examples of SNT
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(1)The Multicultural AIDS Prevention Project (MAPP) uncovering the highest risk relationship patterns in these networks, the team was able to direct a targeted educational & other interventions to those" relational subsets" (2) Natural Helper Interventions: Black churches project identified such helpers in church congregations, who were trained as health promoters
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intervention
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an idea, practice, or object that is perceived as new
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diffusion of innovations
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the process by which an innovation is communicated, via certain channels over time, among the members of a social system, with the aim being to maximize the exposure & reach of innovations, strategies, or programs. (chronicallogicaly)
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What are the 5 stages of DOI?
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1.Innovation Development 2. Dissemination 3.Adoption 4. Implementation 5. Maintenance
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Innovation Development:
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from planning --> formative research -->testing
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Stages of Adoption
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1.Awareness knowledge: the innovation exists 2. Procedural knowledge: how to use it 3. Principles knowledge: understanding how the innovation works
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Types of adopters
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Early adopters • Early majority adopters • Late majority adopters • Laggards
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Diffusion can occur as a multilevel change process
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Individual, family, or small group, organizational level, communitywide or societal level.
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DOI individual
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implementation of a HB change innovations typically involves changes in lifestyle practices
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DOI organizational level
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workplace, school, health care setting....etc. •successful uptake of an innovation may require the introduction of particular programs or services, and/or changes in policies or regulations, and /or changes in the roles and functions of particula
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DOI community wide
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e.g. tobacco control; the diffusion process can involve the use of media, support from government policies & legislation, and/or coordination of a variety of other initiatives for individuals and groups in the community
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DOI attributes
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relative advantage, communicability, commitment
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social marketing
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incorporates the principles of marketing to achieve health aims. the main aim is to influence the voluntary behavioral change of a target market based on mutual fulfilment and self interest. common in HIV studies
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What are the four p's of social marketing?
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Product, price, place, and promotion
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price
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The cost involved in adopting a behavior by the target audience (market)
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product
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The behavior/technology you are offering, identify the attributes and benefits of the product. Tangible: e.g. condoms; fruit Services: e.g. medical exams, immunizations
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Place
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Where the target market spend their time An element of place is deciding how to ensure accessibility of the offering & quality of the service delivery. condoms & bath house
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promotion
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Making the target population aware of the previous three elements. The focus relies on creating & sustaining a demand for the product ,i.e., in HB, a demand for the behavior change
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Limitations of the DOI & SM?
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Do not provide a direct and/or immediate reinforcement. Assessing the impact of a social marketing campaign may be very difficult.
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CATCH
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Child Adolescent trial for Cardiovascular health. Used SCT to target 3rd to 5th grade students.School environmental modifications related to food consumption, physical activity, and tobacco use
