5.1 Social Ecological, Communication, Planning and Evaluation Theories

Question 1

Ecological Theories and Model

Answer 1

• Focus on interaction between individual and ecosystem (environment)

Question 2

Communication Theories

Answer 2

• Focus on manners and patterns of the spread of information and ideas

Question 3

Planning and Evaluation Models

Answer 3

• Distinguished by emphasis on community contexts

Question 4

Ecological Theories and Models

Answer 4

• Interactions between person and ecosystem

- Family, community, culture, physical environment

Question 5

Social Ecological Model (SEM)

Answer 5

• Interrelationship between organism and environment
• Health is affected by complex physical and social environmental factors and core individual behaviors
• Health promotion targets environmental change to facilitate behavior change

Question 6

Salutogenic Theory (ST)

Answer 6

• Focuses on health and how to enhance well being rather than risk factors for disease
• Combines cognitive, behavioral, and motivational constructs

Question 7

Communication Theories (Diffusion of Innovation)

Answer 7

• Explains the spread of new ideas in a population
• Diffusion of a new idea depends on the innovation itself, the social system, the available channels of communication, and the opinion leaders to spread the information.
• In order for health promotion (new idea) to be adopted, it needs to offer an advantage, be consistent with values and needs, capacity for experimentation, and observable (capacity to produce results).
• Advantage
• Compatible
• Triable
• Observable
• Opinion leaders are very useful in getting something implemented

Question 8

Planning and Evaluation Models-

Answer 8

• Used for community and not individual
• Helps guide community needs, planning, implementation, and evaluation
• Helps researchers in measuring effectiveness of health promotion programs.

Question 9

PRECEDE-PROCEED MODEL (PPM)

Answer 9

• Guides development of health education programs
• Assesses health needs of the community and guides to develop and evaluate the intervention
  PROPOSITIONS
• Health and health risks have multiple determinants
• Efforts to change behavioral, environmental, and social factors must be multidimensional

Question 10

PRECEDE

Answer 10

P - Predisposing
R - Reinforcing
E - Enabling
C - Constructs
E - Educational
D - Diagnosis
E - Evaluation

Question 11

PRECEDE 5 Steps

Answer 11

ASSESSMENT

1. Social Assessment
2. Epidemiologic Assessment (Identify Health Determinants)
3. Behavioral/Environmental Assessment
4. Educational/Ecological Assessment
5. Administrative/Policy Assessment

Question 12

PROCEED

Answer 12

P - Policy
R - Regulatory
O - Organizational 
C - Constructs
E - Educational
E - Environmental
D - Development

Question 13

PROCEED 5 Steps

Answer 13

IMPLEMENTATION AND EVALUATION
6 - Implementation
7 - Process Evaluation 
8 - Impact Evaluation
9 - Outcome Evaluation

Question 14

PPM Weaknesses

Answer 14

• Costly and time intensive

- Does not focus on intervention development

Question 15

Health Promotion Model (Nola Pender)

Answer 15

• Based on behavioral science perspective but fear or threat is not a motivator for change
• Individuals regulate their own behavior
• Behavior is rational and economical
• Individuals engage in behavior that will result in positive outcome
  BASED ON 3 AREAS DESCRIBED NEXT

Question 16

Individual Characteristics and Experiences

Answer 16

• Prior related behavior is predictive of future behavior
• Personal Factors such as biological, psychological, socio-cultural are of varying importance in predicting certain behavior.
• These shape behavior cognition and affect

Question 17

Behavior-Specific Cognitions and Affects

Answer 17

PRIOR RELATED BEHAVIORS
- Perceived benefits of action - Anticipated positive outcomes that will come from health behavior
- Perceived barriers to action - Barriers to change
- Perceived Self Efficacy - Do I have the capability to implement a health promoting behavior. Higher efficacy results in lower perception of barriers.
- Activity Related Affect - Positive/Negative feelings that occur before/during/after behavior. The more positive the feeling the more efficacy
PERSONAL FACTORS
- Interpersonal Influences - Expectation of others, social support and modeling, families, peers, healthcare providers
- Situational Influences - Perceptions of a situation and influence behavior. Perceptions of options available, features of the environment of the health program.

Question 18

Behavioral Outcomes

Answer 18

• Commitment to plan of action - Leads to implementation of healthy behavior
• Competing demands - Alternative behaviors that individuals have low control over (work or family responsibilities)
• Competing Preferences - Behaviors people have high control over such as peach or candy for a snack
  Health Promoting Behavior
• Action directed towards achieving positive outcome.

Question 19

Penders Model Nursing Interventions

Answer 19

• Raising consciousness
• Re-evaluating Self (would I like myself better if I)
• Setting goals for change
• Promoting Self-Efficacy
• Enhancing the benefits of change (gather baseline data)
• Using cues to promote change (can be negative or positive)
• Managing barriers to change