Podcast
Questions and Answers
What does the ecological perspective emphasize?
What does the ecological perspective emphasize?
Individual behavior can be influenced by multiple levels of influence according to the ecological perspective.
Individual behavior can be influenced by multiple levels of influence according to the ecological perspective.
True
Name two key concepts identified by McLeroy and colleagues for promoting health using the ecological perspective.
Name two key concepts identified by McLeroy and colleagues for promoting health using the ecological perspective.
interaction + interdependence
The Health Belief Model (HBM) addresses the individual's perceptions of the threat posed by a health problem, the benefits of avoiding the threat, and factors influencing the decision to act (barriers, cues to action, and __________).
The Health Belief Model (HBM) addresses the individual's perceptions of the threat posed by a health problem, the benefits of avoiding the threat, and factors influencing the decision to act (barriers, cues to action, and __________).
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Match the model with its description:
Match the model with its description:
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What does empowerment describe in the context of community organizing?
What does empowerment describe in the context of community organizing?
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What does community capacity refer to in the context of community organizing?
What does community capacity refer to in the context of community organizing?
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Social action model is primarily conflict-oriented.
Social action model is primarily conflict-oriented.
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Critical consciousness helps community members identify the __________ of social problems.
Critical consciousness helps community members identify the __________ of social problems.
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Match the following terms with their definitions:
Match the following terms with their definitions:
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What is the additional construct included in the Theory of Planned Behavior (TPB) that differs from the Theory of Reasoned Action (TRA)?
What is the additional construct included in the Theory of Planned Behavior (TPB) that differs from the Theory of Reasoned Action (TRA)?
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According to the TPB, which factors influence behavioral intention?
According to the TPB, which factors influence behavioral intention?
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In the Precaution Adoption Process Model (PAPM), individuals can move backwards from later stages to earlier ones.
In the Precaution Adoption Process Model (PAPM), individuals can move backwards from later stages to earlier ones.
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What theory emphasizes the reciprocal interactions of people and their environments, and the psychosocial determinants of health behavior?
What theory emphasizes the reciprocal interactions of people and their environments, and the psychosocial determinants of health behavior?
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Match the following factors with their description based on Social Cognitive Theory (SCT):
Match the following factors with their description based on Social Cognitive Theory (SCT):
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What is the term used to describe the process in which someone tells the audience what aspect of the story is important?
What is the term used to describe the process in which someone tells the audience what aspect of the story is important?
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E-health is the use of emerging information and communication technology to improve or enable health and health care.
E-health is the use of emerging information and communication technology to improve or enable health and health care.
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What bridges clinical and non-clinical sectors and includes both individual and population health-oriented tools?
What bridges clinical and non-clinical sectors and includes both individual and population health-oriented tools?
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Interactive games offer another vehicle for intervention, such as designed Nintendo video games by Lieberman et al. to improve children's and adolescents' ________ and self-care behaviors.
Interactive games offer another vehicle for intervention, such as designed Nintendo video games by Lieberman et al. to improve children's and adolescents' ________ and self-care behaviors.
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Study Notes
The Ecological Perspective: A Multilevel, Interactive Approach
- Health promotion involves more than just educating individuals about healthy practices, it also involves changing organizational behavior, physical and social environment, and developing policies that support health.
- The ecological perspective emphasizes the interaction between and interdependence of factors within and across all levels of a health problem.
- Two key concepts of the ecological perspective:
- Behavior is affected by and affects multiple levels of influence.
- Individual behavior shapes and is shaped by the social environment (reciprocal causation).
Multiple Levels of Influence
- Five levels of influence identified by McLeroy and colleagues (1988):
- Intrapersonal or individual factors
- Interpersonal factors
- Institutional or organizational factors
- Community factors
- Public policy factors
- Each level of influence can affect health behavior, and addressing the community level requires considering institutional and public policy factors, as well as social networks and norms.
Theories and Applications
- The ecological perspective shows the advantages of multilevel interventions that combine behavioral and environmental components.
- Effective tobacco control programs often use multiple strategies to discourage smoking, including employee smoking cessation clinics, workplace no-smoking policies, and city clean indoor air ordinances.
Theoretical Explanations of Three Levels of Influence
- Three key concepts that cut across individual-level theories:
- Behavior is mediated by cognitions.
- Knowledge is necessary for, but not sufficient to produce, most behavior changes.
- Perceptions, motivations, skills, and the social environment are key influences on behavior.
- Community-level models offer frameworks for implementing multi-dimensional approaches to promote healthy behaviors.
Individual or Intrapersonal Level
- The individual level is the most basic level in health promotion practice.
- Individual-level theories focus on intrapersonal factors, such as knowledge, attitudes, beliefs, motivation, self-concept, developmental history, past experience, and skills.
- Theories at the individual level include:
- The Health Belief Model (HBM)
- The Stages of Change (Transtheoretical) Model
- The Theory of Planned Behavior (TPB)
- The Precaution Adoption Process Model (PAPM)
The Health Belief Model (HBM)
- Developed in the 1950s to explain why people were not participating in disease prevention and detection programs.
- Six main constructs influence people's decisions about whether to take action to prevent, screen for, and control illness:
- Perceived susceptibility
- Perceived severity
- Perceived benefits
- Perceived barriers
- Cue to action
- Self-efficacy
The Stages of Change (Transtheoretical) Model
- Developed by Prochaska and DiClemente to explain the process of behavior change.
- Five stages of change:
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
- People at different stages have different informational needs, and benefit from interventions designed for their stage.
The Theory of Planned Behavior (TPB)
- Explores the relationship between behavior and beliefs, attitudes, and intentions.
- Assumes behavioral intention is the most important determinant of behavior.
- Influenced by a person's attitude toward performing a behavior, and by beliefs about whether individuals who are important to the person approve or disapprove of the behavior (subjective norm).### Community Organizing Approaches
- Empowerment is a social action process that enables individuals, organizations, or communities to gain confidence and skills to improve their quality of life.
- Community capacity refers to characteristics of a community that allow it to identify social problems and address them.
- Participation in the organizing process helps community members to gain leadership and problem-solving skills.
- Relevance involves activating participants to address issues that are important to them.
- Issue selection entails pulling apart a web of interrelated problems into distinct, immediate, solvable pieces.
- Critical consciousness emphasizes helping community members to identify the root causes of social problems.
Social Action Model
- The social action model differs from other forms of community intervention in that it is grassroots-based, conflict-oriented, and geared to mobilizing disadvantaged people to act on their own behalf.
- Goals vary, but typically include policy and other significant changes that participants have identified as important.
- This approach employs direct-action strategies as the primary means of fostering change.
- It focuses on building power and encouraging community members to develop their capacities as active citizens.
Media Advocacy
- Media Advocacy is an essential tactic in community organizing, involving the strategic use of the mass media to advance public policies.
- The media set the agenda for the public and policymakers by bringing attention to specific issues.
- Media advocacy assumes that the root of most health problems is not a lack of information, but a lack of power to change social and economic conditions.
- It seeks to balance news coverage by framing issues to emphasize social, economic, and political influences on health.
Participatory Action Research
- Participatory action research involves people being studied taking an active role in some or all phases of the research.
- It builds an alliance between professional researchers and lay participants, enabling a dialogue between them.
- Participants engage in a learning process, checking and complementing expert knowledge.
Diffusion of Innovations
- The 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.
- The theory explains how innovations are communicated through certain channels over time among the members of a social system.
- Factors that determine how quickly and to what extent an innovation will be adopted and diffused include:
- Relative advantage
- Compatibility
- Complexity
- Trialability
- Observability
Media Effects
- Media effects research investigates how the media influence the knowledge, opinions, attitudes, and behaviors of audience members.
- Two central questions are:
- What factors affect the likelihood that a person will be exposed to a given message?
- How do media effects vary with the amount of exposure to that message?
Agenda Setting
- The mass media can illuminate and focus attention on issues, helping to generate public awareness and momentum for change.### Theories of Health Behavior
- The Theory of Planned Behavior (TPB) includes three constructs: attitude toward behavior, subjective norm, and perceived behavioral control
- Perceived behavioral control is the individual's belief that they can control their behavior
- TPB explains how behavioral intention determines behavior, and how attitudes, subjective norms, and perceived behavioral control influence behavioral intention
Precaution Adoption Process Model (PAPM)
- PAPM specifies seven distinct stages in the journey from lack of awareness to adoption and/or maintenance of a behavior
- The stages are: unawareness, awareness, unengaged, deciding about acting, deciding not to act, acting, and maintaining
- People pass through each stage of precaution adoption without skipping any of them
- PAPM recognizes that people who are unaware of an issue, or are unengaged by it, face different barriers from those who have decided not to act
Interpersonal Level
- Social Cognitive Theory (SCT) explores the reciprocal interactions between people and their environments
- SCT states that personal factors, environmental factors, and human behavior exert influence upon each other
- Three main factors affect the likelihood that a person will change a health behavior: self-efficacy, goals, and outcome expectancies
Social Cognitive Theory (SCT)
- SCT describes a dynamic, ongoing process in which personal factors, environmental factors, and human behavior exert influence upon each other
- Self-efficacy is the most important personal factor in behavior change
- Strategies for increasing self-efficacy include setting incremental goals, behavioral contracting, and monitoring and reinforcement
- Observational learning, or modeling, refers to the process whereby people learn through the experiences of credible others
- Reinforcements can be internal or external, and can be used to increase the likelihood of repeating a behavior
Community Level
- Community-level models explore how social systems function and change, and how to mobilize community members and organizations
- Community-level models address individual, group, institutional, and community issues
- Community organizing is a process through which community groups are helped to identify common problems, mobilize resources, and develop and implement strategies to reach collective goals
- Community organizing projects that start with the community's priorities are more likely to succeed
Community Organization and Other Participatory Models
- Community organization is a process-oriented approach that focuses on building consensus and capacity
- Social planning is a task-oriented approach that stresses problem-solving and usually relies heavily on expert practitioners
- Social action is a process- and task-oriented approach that aims to increase the community's capacity to solve problems and achieve concrete changes that redress social injustices
New Communication Technologies
- New communication technologies have opened up avenues for influencing health behavior
- E-health strategies include health information on the Internet, online support groups, and online collaborative communities
- E-health interventions can address issues at the individual, group, or community/societal level, and different theories may be appropriate, depending on the project's goals
- Innovative e-health projects are expanding the range of tools that planners can use to develop cancer control and other interventions
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Description
Learn about the ecological perspective in health promotion, a multilevel approach that involves changing organizational behavior, physical and social environment, and advocacy for health policies.
