9781284292497_SLID_CH04.pptx

CHAPTER 4 Social and Behavioral Sciences and Public Health Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com. Learning Objectives (1 of 2)  Explain relationships between the social and behavioral sciences and public health....

CHAPTER 4 Social and Behavioral Sciences and Public Health Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com. Learning Objectives (1 of 2)  Explain relationships between the social and behavioral sciences and public health. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Illustrate how socioeconomic status affects health.  Illustrate how culture and religion affect health.  Describe the relationship between income and socioeconomic status and health. Learning Objectives (2 of 2)  Describe the roles of theory in understanding health behavior. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Describe four widely used health behavior theories or models.  Describe applications of behavioral economics to public health.  Explain the principles of social marketing.  Identify the steps of the PRECEDE-PROCEED planning framework. Vignette 1  You travel to a country in Asia and find that this nation’s culture affects most parts of life. From the food the people eat and their Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com method of cooking to their attitudes toward medical care to their beliefs about the cause of disease and the ability to alter it through public health and medical interventions, this country is profoundly different from the United States.  You ask yourself: How does culture affect health? Vignette 2  You are working in a community in the United States with strict Islamic practices and find that religion, like culture, can have major Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com impacts on health. Religious practices differ widely—from beliefs about food and alcohol to sexual practices, such as male circumcision and female sexual behavior, to acceptance or rejection of interventions aimed at women’s health.  You ask yourself: How does religion affect health? Vignette 3  You are trying to help your spouse quit smoking cigarettes and prevent your kids from starting. You know that gentle Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com encouragement and support on a one-on-one basis are essential, but are often not enough because cigarette smoking is an addiction that produces withdrawal and long-term cravings.  You wonder what other factors in the social system influence behavior, and how they can be addressed. Vignette 4  Your efforts to convince your friends to avoid smoking (or stop smoking) focus on giving them the facts about how cigarettes Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com cause lung cancer, throat cancer, and serious heart disease. You are frustrated by how little impact you have on your friends.  You wonder what tools are available to more effectively change health behavior. Vignette 5  Your classmate, who is the first in her family to attend college, received word that her father lost his job at the local factory. He Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com also lost his health insurance and worries about how he will get his medicine. Your classmate needs to take a leave from school because her family can no longer afford tuition.  You wonder how this will affect her and her family. Vignette 6  Your town board just approved extending public transportation services to a wider geographic area. Although there are several Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com opponents to the plan, you learn that a group of public health professionals supports this extension of services.  You wonder what this transportation plan has to do with health. Vignette 7  You are in the checkout line at the grocery store, and a pregnant mother is ahead of you. You glance at the sugary cereals, snacks, Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com and sodas she is purchasing and happen to notice that she is using an EBT card from the Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp program.  You wonder what could be done to encourage the consumption of healthy food options. Vignette 8  Every day on your way to work, you pass the same young homeless man on the same corner. You notice that over the past Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com few weeks he has been coughing, and you figure he must have a cold now that COVID-19 has been controlled. Today when you walk by his usual place on the corner, he is not there, but someone has left a sign that reads “Rest in peace, Ramón.” You are surprised, especially because he was so young.  You wonder whether there was anything that could have been done to prevent his death from tuberculosis. Questions (1 of 3)  How is public health related to the social and behavioral sciences? Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  How are social systems related to health?  How do socioeconomic status, culture, and religion affect health?  Can individual health behavior be changed?  Why are some individual health behaviors easier to change than others?  How can individual behavior be changed? Questions (2 of 3)  How can group and population interventions complement individual interventions? Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  What are some widely used theories of behavioral change?  What are some effective principles for influencing individual behaviors?  How can marketing principles be used to change behavior?  What role can education play in vaccine acceptance? Questions (3 of 3)  What can be done to achieve vaccine acceptance when education alone is not effective? Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  How can efforts to change individual behavior be evaluated? How Is Public Health Related to the Social and Behavioral Sciences?  These subject areas share a fundamental belief that understanding the organization and motivation behind social forces, along with a Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com better understanding of the behavior of individuals, can be used to improve the lives of individuals, as well as society as a whole.  Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Table 4.1 Examples of Contributions of Social and Behavioral Sciences to Public Health How Are Social Systems Related to Health?  Social systems influence health and health behavior by: Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Shaping norms  Enforcing patterns of social control  Providing or not providing opportunities to engage in certain behaviors  Encouraging selection of healthy behaviors as a coping strategy How Do Socioeconomic Status, Culture, and Religion Affect Health?  These three key components of the social system have a strong relationship with health. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Broad social influences can affect an individual’s response to disease.  Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Table 4.2 Examples of Ways That Socioeconomic Status May Affect Health  Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Table 4.3 Examples of Ways That Culture Can Affect Health  Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Table 4.4 Examples of Ways That Religion May Affect Health Can Individual Health Behavior Be Changed?  Some health behaviors are intentional, whereas others are not motivated by health concerns. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Behavioral change is possible.  For both the better and for the worse.  Examples of behavioral changes:  Reduction in cigarette smoking  Seat belt use  Mask use  Some behaviors are easier to change than others. Why Are Some Individual Health Behaviors Easier to Change? (1 of 2)  Behavior change is easier when one behavior can be substituted for a similar one that is considered acceptable and convenient. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Substitution of acetaminophen (Tylenol) for aspirin to prevent Reye’s syndrome.  Incentives can encourage rapid acceptance and motivate behavioral change.  Reduced cost.  Increased availability  Improvements in ease of use. Why Are Some Individual Health Behaviors Easier to Change? (2 of 2)  The most difficult behaviors to change are those that have a physiologic component or addictive element. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Obesity  Cigarette smoking or opioid addiction  Physical, social, and economic barriers can stand in the way of behavior change.  Even if the individuals are motivated. How Can Individual Behavior Be Changed?  Wide variety of theories and models to help understand individual health behaviors and how to effectively intervene. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  A widely used example: Stages of Change Model  Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Table 4.5 Stages of Change Model and Cigarette Smoking  Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Table 4.5 Stages of Change Model and Cigarette Smoking How Can Group and Population Interventions Complement Individual Interventions?  Individual behavior develops and changes in response to group and population influences. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Group and population interventions often reinforce individual interventions. Table 4.6 Stages of Change—Individual, Group and Population/Social Interventions to Change Cigarette Smoking Behavior Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com What Are Other Widely Used Theories of Behavioral Change?  Interpersonal, intrapersonal, and population level theories and models Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Health Belief Model  Diffusion of Innovation What Are Some Effective Principles for Influencing Individual Behaviors?  Behavioral economics Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Losses loom larger than gains.  Just-in-time reminders.  Default choices are usually retained.  Creating new habits is key to behavioral change. How Can Marketing Principles Be Used to Change Behavior?  Social marketing is a use and extension of traditional product marketing to change health behavior. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  The truth® campaign  National Youth Anti-Drug campaign  The VERB™ campaign  Structured by the “4 P’s”:  Product  Price  Place  Promotion  Relies on branding What Role Can Education Play in Vaccine Acceptance?  Effectively communicate accurate information. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Do not wait.  Be credible.  Be clear.  Express empathy and show respect.  Acknowledge uncertainty and manage expectations. What Can Be Done to Achieve Vaccine Acceptance When Education Alone Is Not Effective?  Motivation Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Incentives  Obligation  Mandates  Innovation  New, more acceptable, modes of vaccine administration  Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Table 4.7 Approaches to Vaccine Acceptance How Can Efforts to Change Individual Behavior Be Evaluated?  PRECEDE-PROCEED planning framework Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Provides a structure to design and evaluate health education and health promotion programs using a diagnostic planning process followed by an implementation and evaluation process.  Nine steps, divided into two phases:  PRECEDE  PROCEED Diagnostic Phase: PRECEDE 1. Social assessment Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com 2. Epidemiological assessment 3. Behavioral and environmental assessment 4. Educational and organizational assessment 5. Administrative and policy assessment 1. Social Assessment  Assess people’s perceptions of their own needs and quality of life through data collection activities such as surveys, interviews, focus Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com groups, and observation.  Example: Gun violence  Gun violence emerged as a major concern among community members through focus groups that were conducted to explore health and safety concerns in the community. 2. Epidemiological Assessment  Determine which health problems are most important for which groups in the community, often by analyzing data from vital Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com statistics, state and/or national surveys, etc.  Assists in identifying subpopulations at high risk.  Provide data to set measurable objectives.  Example: Gun violence  Data from death certificates and crime reports in a community reveal that the majority of deaths among males younger than 24 years are due to gunshot wounds. 3. Behavioral and Environmental Assessment  Identify risk factors, internal and external to the individual, that contribute to the heath issue of interest. Literature searches and Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com theory application provide guidance.  Example: Gun violence  A literature search provides insight into factors contributing to gun violence among males younger than 24 years. Gang-related behavior is found to be frequent in populations with similar socioeconomic status as that of the target population. 4. Educational and Organizational Assessment  Preceding and reinforcing factors that initiate and sustain behavior change are identified, such as an individual’s knowledge, skills and Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com attitudes, social support, peer influence, and availability of services.  Example: Gun violence  Interventions aimed at males aged 16 years and younger are found to be the most successful. Young males with older positive male role models are more likely to view gangs as negative and more likely to participate in sports and community service. 5. Administrative and Policy Assessment  Identify policies, resources, and circumstances that may help or hinder the implementation of the intervention. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Example: Gun violence  A communication system was recently established between school systems and law enforcement to report truancy and criminal behavior among the student population. May assist in identifying subgroups to target intervention. Implementation and Evaluation Phase: PROCEED 6. Implementation Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com 7. Process evaluation 8. Impact evaluation 9. Outcome evaluation 6. Implementation  The intervention is implemented. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Example: Gun violence  An after-school program is implemented that incorporates educational, service-oriented, and physical activity components and is led by males from the community. The program is tailored for males 12 to 16 years of age. 7. Process Evaluation  Process evaluation assesses the extent to which the intervention was implemented as planned. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Example: Gun violence  Evaluate how program activities were delivered and attended. 8. Impact Evaluation  Impact evaluation assesses the change in the factors identified by the behavioral and environmental assessment and the educational Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com and organizational assessment.  Example: Gun violence  Evaluate subsequent gang membership or relationships among participants in the after-school programming. 9. Outcome Evaluation  Outcome evaluation assesses the effect of the intervention on the health issue of interest. Copyright © 2025 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com  Example: Gun violence  Evaluate deaths due to gun violence in the community before and after the intervention.